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ABSTRACT: There are relatively few reports describing gait patterns in multiple sclerosis (MS) and most are confined to the analysis of temporal distance parameters with some assessment of joint range of motion. The aim of this study was to perform a biomechanical characterisation of gait patterns among people with MS across a wide range of severity of ambulatory impairment.
Sixteen patients with MS were recruited for this study. Initially, the spasticity of lower limb muscle groups was measured and ambulatory ability was graded. Patients were then placed in two groups based on the level of severity of ambulatory ability. Kinematic, kinetic and EMG gait data from both MS groups were then compared to a control group of 10 healthy subjects.
Patients with MS in both groups were found to walk with reduced gait speed, reduced maximum hip and knee extension, ankle plantarflexion angle and propulsive force compared to the control group. In general, the same gait impairments were found in both MS groups compared to the control group, and were greater for the more severely affected MS patient group.
This study highlights typical gait patterns of people with MS and provides an indication of common pathways in the degeneration of ambulatory ability as a consequence of disease progression. This information should enable improved clinical treatment of ambulation, as well as the prescription, or even design, of appropriate assistive devices.
Disability and Rehabilitation 02/2010; 32(15):1242-50. · 1.50 Impact Factor
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ABSTRACT: It is recognized that for children with poor postural control, a comfortable adaptive seating system which provides them with the support needed to maintain a sitting position can be essential for raising their overall level of well being. The purpose of this study was to investigate the views of teaching staff members at special needs schools and of the parents of children who attended these schools on the provision and current technology of seating systems.
Two similar questionnaires intended to elicit the views of teaching staff and the parents of children attending these schools were designed and distributed to these groups.
Dissatisfaction exists with reliability of these systems and the time it takes for replacement systems to be issued. The perceived importance of adaptive seating role in the user being accepted by peers was found to be statistically different between the two groups. Time spent per day transferring the child to and from seating systems was found to be greater than 1 h for both groups.
Scope remains for improvements to be made in adaptive seating provision and technology. Although mainly descriptive, these results could be of use when developing newer systems and improving services.
Disability and rehabilitation. Assistive technology 01/2010; 5(1):14-24.
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ABSTRACT: Multiple sclerosis (MS) is an autoimmunogenic disease involving demyelination within the central nervous system. Many of the typical impairments associated with MS can affect gait patterns. With walking ability being one of the most decisive factors when assessing quality of life and independent living, this review focuses on matters, which are considered of significance for maintaining and supporting ambulation. This article is an attempt to describe current research and available interventions that the caring healthcare professional can avail of and to review the present trends in research to further these available options. Evidence-based rehabilitation techniques are of interest in the care of patients with MS, given the various existing modalities of treatment. In this review, we summarise the primary factors affecting ambulation and highlight available treatment methods. We review studies that have attempted to characterise gait deficits within this patient population. Finally, as ambulatory rehabilitation requires multidisciplinary interventions, we examine approaches, which may serve to support and maintain ambulation within this patient group for as long as possible.
Disability and Rehabilitation 06/2009; 31(20):1625-32. · 1.50 Impact Factor
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ABSTRACT: The biomechanical interaction between the residual limb and the prosthetic socket determines the quality of fit of the socket in lower limb prosthetics. An understanding of this interaction and the development of quantitative measures to predict the quality of fit of the socket are important for optimal socket design. Finite-element modeling is used widely for biomechanical modeling of the limb/socket interaction and requires information on the internal and external geometry of the residual limb. Volumetric imaging methods such as X-ray computed tomography, magnetic resonance imaging, and ultrasound have been used to obtain residual limb shape information. Of these modalities, ultrasound has been introduced most recently and its development for visualization in prosthetics is the least mature. This paper reviews ultrasound image acquisition and processing methods as they have been applied in lower limb prosthetics.
IEEE Transactions on Neural Systems and Rehabilitation Engineering 04/2002; 10(1):11-21. · 3.44 Impact Factor
