Tung-Wu Lu

• D.Phil. (Oxon)
• Professor and Chair at National Taiwan University

Objective Although whole-body vibration (WBV) is often employed alongside traditional physical therapies to treat cerebral palsy, its effects on motor function remain unclear. Therefore, this study investigated the effects of WBV either alone or in combination with other therapies in children with cerebral palsy, compared with control groups that u...

Purpose: Stationary cycling is essential in rehabilitation programs for various patient groups, such as knee osteoarthritis and cruciate ligament injuries and reconstruction. The study aimed to measure in vivo the 3D rigid-body and articular surface kinematics of the knee and the patellar tendon orientations during stationary cycling and isolated f...

Background Mild cognitive impairment (MCI) may lead to difficulty maintaining postural stability and balance during locomotion. This heightened susceptibility to falls is particularly evident during tasks such as obstacle negotiation, which demands efficient motor planning and reallocation of attentional resources. This study proposed a multi-objec...

Despite residual functional deficits clinically observed in conservatively treated mid-shaft clavicle fractures, no study has reported a quantitative assessment of the treatment effects on the kinematics of the shoulder complex during functional movement. Using computerised motion analysis, the current study quantified the 3D residual kinematic dev...

Monitoring dynamic balance during gait is critical for fall prevention in the elderly. The current study aimed to develop recurrent neural network models for extracting balance variables from a single inertial measurement unit (IMU) placed on the sacrum during walking. Thirteen healthy young and thirteen healthy older adults wore the IMU during wal...

Duchenne muscular dystrophy (DMD) is a genetic disease characterized by progressive muscle weakness with increased neuromechanical challenge and fall risks, especially during obstructed locomotion. This study aimed to identify the kinematic strategies for obstacle-crossing in DMD via synthesizing the changes in the joint kinematics and associated e...

Background A 2D fluoroscopy/3D model-based registration with statistical shape modeling (SSM)-reconstructed subject-specific bone models will help reduce radiation exposure for 3D kinematic measurements of the knee using clinical alternating bi-plane fluoroscopy systems. The current study aimed to develop such an approach and evaluate in vivo its a...

Introduction Mild cognitive impairment (MCI) is considered a transitional stage between soundness of mind and dementia, often involving problems with memory, which may lead to abnormal postural control and altered end-point control when dealing with neuromechanical challenges during obstacle-crossing. The study aimed to identify the end-point contr...

Overweight or obesity is known to be associated with altered activations of lower extremity muscles. Such changes in muscular function may lead to the development of mobility impairments or joint diseases. However, little is known about how individual lower extremity muscles contribute to the whole-body center of mass (COM) control during walking a...

Introduction Losing balance or tripping over obstacles is considered one of the most common causes of falls in the elderly. Tai-Chi Chuan (TCC) has been shown to improve muscle strength, inter-joint coordination and balance control in the elderly. This study aimed to determine whether older long-term TCC practitioners would show multi-joint kinemat...

Lateral ankle instability (LAI) compromises the normal kinematics of the ankle, affecting activities of daily living. In vitro kinematics of ankles with LAI during single‐plane motions are available, but active control stability of these motions remains unclear. The current study measured the 3D ankle kinematics during unresisted single‐plane motio...

Knowledge of mandibular growth and development is essential for diagnosis of malformation and early interception. A previous method of quantifying mandibular growth using the distances between selected anatomical landmarks over the growth period does not provide a complete, quantitative description of the continuous growth patterns. The current stu...

Avascular necrosis of the hip (AVN) is one of the most severe complications of surgical reduction when treating developmental dysplasia of the hip (DDH). The current study identified the differences in the balance control during walking in terms of the inclination angle (IA) of the center of pressure (COP) to the center of mass (COM), and the rate...

Older people are subject to an increased risk of falling compared to the young, especially during obstacle negotiation. This study aimed to quantify the effects of long-term Tai-Chi Chuan (TCC) practice on the balance control during obstacle-crossing in older people in terms of the inclination angles (IA) of the body’s centre of mass (COM) relative...

Losing balance or tripping during obstacle-crossing is one of the most frequent causes of falls in the elderly. As a low speed, low impact exercise, Tai Chi Chuan (TCC) can be promising in helping the elderly develop strategies for improved balance, inter-joint coordination, and end-point control during obstacle-crossing. This study investigates th...

Background: Obstacle-crossing increases the risk of falls in older people. This study aimed to identify the effects of long-term Tai-Chi Chuan (TCC) practice on the control strategies for obstacle-crossing in older people. Methods: A multi-objective optimal control technique with measured gait data was used to identify the control strategies adopte...

Older adults are at higher risk of falling following total knee arthroplasty (TKA). However, it remains unclear how long a full recovery of the balance control during gait post‐TKA will take. The current study aimed to bridge this knowledge gap via long‐term follow‐up gait analyses. Twelve older adults with severe bilateral medial knee osteoarthrit...

Introduction About 1% of the newborn population has developmental dysplasia of the hip (DDH), altering joint biomechanics, gait performance and balance control. Pemberton's osteotomy is used in early treatment but it remains unclear whether it will help the patient regain normal balance control during gait. The current study aimed to identify the c...

Background and objectives: Statistical shape modeling (SSM) based on computerized tomography (CT) datasets has enabled reasonably accurate reconstructions of subject-specific 3D bone morphology from one or two synchronous radiographs for clinical applications. Increasing the number of radiographic images may increase the reconstruction accuracy, bu...

Model-based 3D/2D image registration using single-plane fluoroscopy is a common setup to determine knee joint kinematics, owing to its markerless aspect. However, the approach was subjected to lower accuracies in the determination of out-of-plane motion components. Introducing additional kinematic constraints with an appropriate anatomical represen...

Background: Genu valgum results in lower limb malalignment and altered joint mechanics. The study aimed to identify the effects of genu valgum on balance control and muscular work at the joints during gait in children. Research question: Would bilateral genu valgum affect balance control and muscular work at the joints during gait in children?...

Featured Application Older adults adopt a crossing strategy that is different from that of the young, emphasizing foot-obstacle clearance to reduce the risk of tripping over the obstacle at the expense of increased energy expenditure. It appears that this strategy relies very much on the muscular strength of the lower extremities and the precision...

Background Mid-shaft clavicle fractures account for 35 to 44% of injuries to the shoulder girdle. There is increasing evidence to support surgical repair, but poor functional outcomes have been reported, and associated factors remain unclear. Methods The three-dimensional poses of the shoulder bones during arm elevations were measured in 15 patien...

Long-term follow-up studies on children with surgically treated developmental dysplasia of the hip (DDH) have shown that not only the affected side progresses to premature osteoarthritis, but the unaffected side may also suffer from insidious hip dysplasia or osteonecrosis. The current gait analysis study identified the loading and unloading rates...

Model-based three-dimensional(3D)/two-dimensional(2D) image registration methods have been widely applied in measuring 3D kinematics of the knee during dynamic activities. However, the combined effects of bone model compositions (radiodensity vs. homogeneous-density) and the number of fluoroscopic views on the measurement accuracy remained unclear....

Featured Application Tendon release surgery (TRS) improved the control of total leg stiffness-sharing between the lower limbs and the bilateral symmetry in leg stiffness in children with diplegic CP, suggesting that an analysis of the symmetry in bilateral leg stiffness and stiffness-sharing will be useful for a more complete gait assessment in suc...

Featured Application A novel method for three-dimensional sole morphological measurements gives high intra-rater, inter-rater, and inter-session reliability regardless of the rater’s experience or time of measurement, and will be useful for foot assessment and subsequent applications, such as design and manufacture of customized orthoses or shoes....

About half of the elderly population has knee osteoarthritis (OA), showing altered gait patterns with increased fall risk. The current study aimed to identify the effects of severe bilateral medial knee osteoarthritis on gait balance control, in terms of the inclination angle (IA) of the center of pressure to center of mass vector, and the rate of...

Long-term follow-up studies on children with surgically treated developmental dysplasia of the hip (DDH) have shown that not only the affected side progresses to premature osteoarthritis, but the unaffected side may also suffer from insidious hip dysplasia or osteonecrosis. The current gait analysis study identified the loading and unloading rates...

Biomechanical deviations at individual joints are often identified by gait analysis of patients with cerebral palsy (CP). Analysis of the control of joint and leg stiffness of the locomotor system during gait in children with spastic diplegic CP has been used to reveal their control strategy, but the differences between before and after surgery rem...

Featured Application A new fully automated model-based interleaved biplane image tracking scheme in conjunction with clinical asynchronous biplane fluoroscopy was proposed and evaluated for its performance on dynamic tibiofemoral kinematics measurements. The approach may encourage the further use of clinical imaging systems for the noninvasive and...

Objectives To measure in vivo three-dimensional kinematics of the mandible and associated end-point trajectories and to quantify their relationships during temporomandibular joint activities using 3D fluoroscopy. Methods A novel fluoroscopy-based 3D measurement method was used to measure motions of the mandible and the associated end points (i.e....

Background Soft tissue artifacts (STAs) are a source of error in marker-based gait analysis in dogs. While some studies have revealed the existence of STAs in the canine hindlimb, STAs and their influence on kinematic gait analysis remain unclear. Methods Thirteen healthy Taiwan dogs affixed with twenty skin markers on the thigh and crus were recr...

Background: Skin marker-based three-dimensional kinematic gait analysis were commonly used to assess the functional performance and movement biomechanics of the pelvic limb in dogs. Unfortunately, soft tissue artefact would compromise the accuracy of the reproduced pelvic limb kinematics. Multibody kinematics optimization framework was often emplo...

Introduction Altered trunk shape and body alignment in Lenke 1 thoracic adolescent idiopathic scoliosis (AIS) may affect the body’s balance control during activities. The current study aimed to identify the effects of Lenke 1 thoracic AIS on the balance control during level walking in terms of the inclination angles (IA) of the center of mass (COM)...

Deviations are often identified at individual joints in the gait analysis of patients with cerebral palsy. Previous gait studies on hemiplegic cerebral palsy (HCP) have focused mainly on deviations of the affected side. The current study aimed to quantify and compare the joint and leg stiffness, the contributions of skeletal and muscular components...

Adolescent idiopathic scoliosis (AIS) is the most common spinal deformity during adolescence, leading to altered postural control with compromised stability. To identify the effects of AIS on whole-body balance control during obstacle-crossing, 14 adolescents with Lenke 1 thoracic AIS and 14 healthy controls were compared in terms of the inclinatio...

Background and objectives: Minimally-invasive total knee arthroplasty (MIS-TKA) has demonstrated very good short-term success, but its mid- to long-term results remain inconclusive. The success may be related to the tradeoff between a small incision and accurate positioning of the implant components. Patient-specific instrumentation (PSI) aims to...

Purpose The purpose of this study is to propose and evaluate a slice‐to‐volume registration (SVR) method integrating an advanced dual‐slice real‐time magnetic resonance image (MRI) and three‐dimensional (3D) MRI volume of the tibiofemoral joint for determining their 3D kinematics. Methods The real‐time and 3D MRI of the knee were collected from 12...

Skin marker-based motion analysis has been widely used to evaluate the functional performance of canine gait and posture. However, the interference of soft tissues between markers and the underlying bones (soft tissue artefacts, STAs) may lead to errors in kinematics measurements. Currently, no optimal marker attachment sites and cluster compositio...

Introduction: Adolescent idiopathic scoliosis (AIS) is the most common three-dimensional spinal deformity pathology during adolescence, often accompanied with sensory integration and proprioception problems, which may lead to abnormal postural control and altered end-point control during functional activities. This paper identifies the effects of...

Objectives Our aim was to investigate the role of age, sex, and location on MR T2* values of the knee cartilage in asymptomatic controls and patients with osteoarthritis (OA). Methods A total of 100 participants, including 40 with OA and 60 asymptomatic controls, were enrolled in this study. Patients with OA were compared to age- (≥ 41 years old)...

Background Three-dimensional joint kinematics during canine locomotion are commonly measured using skin marker-based stereophotogrammetry technologies. However, marker-related errors caused by the displacement of the skin surface relative to the underlying bones (i.e., soft tissue artifacts, STA) may affect the accuracy of the measurements and obsc...

Introduction: Adolescent idiopathic scoliosis (AIS) is the most common type of three-dimensional spinal deformity. Identifying the postural adjustments or changes for different phases and events is needed for developing programs to improve the AIS gait, but such information has been limited. The current study aimed to fill the gap via three-dimensi...

Purposes: To propose a new model-based tracking method for measuring 3-D dynamic joint kinematics using a clinical alternating biplane x-ray imaging system; and to quantify in vitro its errors in measuring ankle and knee motions at different motion speeds. Methods: A new model-based tracking method based on motion component partition and interpo...

Objective: To quantify the effects of initial hip angle and angular hip velocity settings of a lower-limb wearable robotic exoskeleton (WRE) on the balance control and mechanical energy requirements in patients with paraplegic spinal cord injuries (SCI) during WRE-assisted sit-to-stand (STS). Design: Observational, cross-sectional study. Settin...

Accurate measurement of the three-dimensional scapular kinematics is essential for a better understanding of the mechanical interactions between the scapula and the other segments of the shoulder complex. The purposes of the study were: (i) to development a marker-based scapular locator for measuring scapular poses, and (ii) to determine the intra-...

Neuromuscular impairments in Parkinson’s disease (PD) alter the mechanics and control of the body, leading to an increased risk of falling during more challenging functional tasks such as obstacle-crossing. However, little is known about these changes. The current study aimed to bridge the gap by quantifying the motion of the body’s center of mass...

Preferred walking speed (PWS) reflects the integrated performance of the relevant physiological sub-systems, including energy expenditure. It remains unclear whether the PWS during over-ground walking is chosen to optimize one’s balance control because studies on the effects of speed on the body’s balance control have been limited. The current stud...

Background Cephalometric radiography has been used for orthodontic and surgical treatment planning and assessment, and for quantifying mandibular growth. However, it remains unclear how head positioning errors and the level of examiner experience affect the reliability of such morphometric measurements. The current study aimed to bridge the gap by...

Anterior cruciate ligament reconstruction (ACL-R) surgery can improve knee joint stability; however, altered sensory feedback after reconstruction surgery might affect the movement control which is required by proper multijoint coordination to compensate for the impaired sensorimotor function. The purpose of this study was to determine how interjoi...

Treadmill-based training protocols have played an important role in gait and balance training in rehabilitation settings, and the position of the body’s center of mass (COM) relative to the base of support provides an important measurement of postural stability. With the advance in wearable technology, the movement of the COM has been estimated usi...

The posterior cruciate ligament (PCL) plays an important role in the structural stability and sensory feedback at the knee. Altered structural and proprioceptive function at the PCL-deficient knee may affect the joint motions and the end-point control during functional activities. The current study identified the effects of unilateral PCL deficienc...

Soft tissue artefact (STA) represents one of the main obstacles for obtaining accurate and reliable skeletal kinematics from motion capture. Many studies have addressed this issue, yet there is no consensus on the best available bone pose estimator and the expected errors associated with relevant results. Furthermore, results obtained by different...

Treadmills have been used in rehabilitation settings to provide convenient protocols and continuous monitoring of movement over multiple cycles at well-controlled speeds for gait and balance training. However, the potential differences in the movement control may affect the translation of the training outcomes to real life over-ground walking (OW)....

Treadmills are often used in clinical settings to improve walking balance control in patients with gait impairments. However, knowledge of the effects of belt speed on balance control remains incomplete. The current study determined such effects in terms of inclination angles (IA) and the rate of change (RCIA) of the center of mass (COM) motion rel...

Knee osteoarthritis (OA) often leads to altered balance control, joint motion and loading patterns during gait. Acupuncture has been proven to be effective in pain relief but its effects on inter-joint load-sharing for body balance have not been reported. The current study bridged the gap by quantifying the immediate effects of acupuncture on the i...

Background Clinical success of total ankle arthroplasty depends heavily on the available information on the morphology of the bones, often obtained from measurements on planar radiographs. The current study aimed to evaluate the intra-rater, inter-rater and inter-session reliability and the validity of radiograph-based measurements of ankle morphol...

Date Presented 4/8/2016 Older and younger adults have different reaching-to-lifting movement performances under unexpected conditions. Also, older adults could develop different strategies to adapt to unpredictable conditions. The finding could help occupational therapists to design training sessions for clients to improve upper-extremity function....

The use of multi-body optimisation (MBO) to estimate joint kinematics from stereophotogrammetric data while compensating for soft tissue artefact is still open to debate. Presently used joint models embedded in MBO, such as mechanical linkages, constitute a considerable simplification of joint function, preventing a detailed understanding of it. Th...

Background Robot-based joint-testing systems (RJTS) can be used to perform unconstrained laxity tests, measuring the stiffness of a degree of freedom (DOF) of the joint at a fixed flexion angle while allowing the other DOFs unconstrained movement. Previous studies using the force-position hybrid (FPH) control method proposed by Fujie et al. (J Biom...

High-heeled shoes increase the risk of falling during walking, especially in the presence of obstacles. The study aimed to compare the end-point (foot/shoe) trajectories and joint angles of the lower extremities in 12 healthy females crossing obstacles of different heights while barefoot and when wearing narrow-heeled shoes (heel heights: 3.9, 6.3...

Several approaches have been used to devise a model of the human tibio-femoral joint for embedment in lower limb musculoskeletal models. However, no study has considered the use of cadaveric 6x6 compliance (or stiffness) matrices to model the tibio-femoral joint under normal or pathological conditions. The aim of this paper is to present a method t...

Although Pemberton osteotomy has shown a high success rate even in older children, the occurrence of osteonecrosis (ON) remains one of the most severe complications, leading to premature osteoarthritis. Patients with type II ON are characterized by a valgus deformity of the proximal femur with altered musculoskeletal conditions, affecting the abili...

Instrumented treadmills (IT) are used to measure reaction forces (RF) and center of pressure (COP) movements for gait and balance assessment. Regular in situ calibration is essential to ensure their accuracy and to identify conditions when a factory re-calibration is needed. The current study aimed to develop and calibrate in situ an IT using a por...

People with type II diabetes mellitus (DM) are at a high risk of falling especially during more challenging locomotor tasks such as obstacle-crossing. The current study aimed to identify the risk factors for tripping in these patients during trailing-limb obstacle-crossing. Fourteen patients with type II DM with or without mild peripheral neuropath...

Individual joint deviations are often identified in the analysis of cerebral palsy (CP) gait. However, knowledge is limited as to how these deviations affect the control of the locomotor system as a whole when striving to meet the demands of walking. The current study aimed to bridge the gap by describing the control of the locomotor system in chil...

Data contains the stiffness-related variables of CP and the controls during four phases of gait cycle. (CSV)

Background: Axial rigidity and postural instability in people with Parkinson's disease (PD) may contribute to turning difficulty. This study examined the rotation of axial segments and gait instability during turning in people with PD. Methods: Thirteen PD and twelve age-matched healthy adults were recruited. Participants performed the timed Up-...

Estimation of joint kinematics using optoelectronic system and skin markers can be performed using a multi-body optimization (MBO) method [1]. With the intent to estimate the bone segments pose, MBO should compensate for the effect of soft tissue artefacts (STA), thanks to a multi-body model made of segments and articulated joints (represented by a...

This study investigates the effect of concussion on the inter-joint coordination of the lower extremities during walking. Gait analyses were performed on 15 young adults who had suffered a concussion and 15 matched controls while walking on level ground with and without a concurrent cognitive task. The continuous relative phase (CRP), derived from...

Background/purpose: The current study aimed to determine the intra- and inter-rater, and intersession reliability of the determination of the morphological parameters of the human mandible using cone-beam computed tomography (CBCT)-synthesized cephalometric radiographs. Materials and methods: CBCT data of 12 mandibles were obtained and used to gene...

Gait analysis has been widely used in the diagnosis of locomotors pathology and the assessment of treatment. But study of gait on Piriformis syndrome (PS) remain unclear. 3-D motion analysis was used to measure the kinematic and kinetic together with temporal-spatial parameters data of patients with PS and normal controls during walking. Patients w...

Downhill walking places greater demands on the lower limb joints with a greater risk of falling when compared with level walking. The current study aimed to quantify the 3D joint kinematics and kinetics of the locomotor system, and their interactions with the trunk during downhill walking. Fifteen young adults walked at a self-selected pace on a 3-...

Canine hip dysplasia is a common disease in dogs, often diagnosed by using the Norberg angle (NA), an index for the laxity of the hip joint. Measurement of the NA can be affected by the pelvic and femoral positioning during imaging, the effects and test-retest reliability of which have not been documented. To bridge the gap in knowledge, computed t...

Adapting to a predictable moving surface such as an escalator is a crucial part of daily locomotor tasks in modern cities. However, the associated biomechanics have remained unexplored. In a gait laboratory, fifteen young adults walked from the ground onto a moving or a static surface while their kinematic and kinetic data were obtained for calcula...

Transparent conductive Al2O3-doped zinc oxide (in AZO, Al2O3 content is ~ 2 wt%) thin films are deposited on flexible polyethylene terephthalate (PET) substrates, using radio frequency (rf) magnetron sputtering. The Taguchi method with an L 9 (34) orthogonal array, a signal-to-noise ratio and analysis of variance (ANOVA) was used to determine the p...

Background The current study aimed to compare the measurements of the mandible morphology using 3D cone beam computed tomography (CBCT) images with those using 2D CBCT-synthesized cephalograms; to quantify errors in measurements based on 2D synthesized cephalograms; and to clarify the effects such errors have on the description of the mandibular gr...

Objective: To investigate the immediate efficacy of laterally wedged insoles with arch support (LWAS) on gait in persons with bilateral medial knee osteoarthritis (OA). Design: A prospective case-control intervention study. Setting: A gait laboratory with a 6-camera motion analysis system and 2 forceplates. Participants: Fifteen women with b...

Purpose: This study aimed to develop and evaluate experimentally an implant-based registration method for measuring three-dimensional (3D) kinematics of the mandible and dental implants in the mandible based on dental cone beam computed tomography (CBCT), modified to include fluoroscopic function. Materials and methods: The proposed implant-base...

The purpose of this study was to measure the long-term growth of the mandible in miniature pigs using 3D Cone-Beam Computerized Tomography (CBCT). The mandibles of the pigs were scanned monthly over 12 months using CBCT and the 3D mandibular models were reconstructed from the data. Seventeen anatomical landmarks were identified and classified into...