A model-based approach to stabilizing crutch supported paraplegic standing by artificial hip joint stiffness.

Autor: van der Spek JH; Faculty of Electrical Engineering, Systems and Signals-Biomedical Engineering, University of Twente, 7500 AN Enschede, The Netherlands. JaapvanderSpek@telin.nl, Veltink PH, Hermens HJ, Koopman BF, Boom HB
Jazyk: angličtina
Zdroj: IEEE transactions on neural systems and rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society [IEEE Trans Neural Syst Rehabil Eng] 2003 Dec; Vol. 11 (4), pp. 443-51.
DOI: 10.1109/TNSRE.2003.819939
Abstrakt: The prerequisites for stable crutch supported standing were analyzed in this paper. For this purpose, a biomechanical model of crutch supported paraplegic stance was developed assuming the patient was standing with extended knees. When using crutches during stance, the crutches will put a position constraint on the shoulder, thus reducing the number of degrees of freedom. Additional hip-joint stiffness was applied to stabilize the hip joint and, therefore, to stabilize stance. The required hip-joint stiffness for changing crutch placement and hip-joint offset angle was studied under static and dynamic conditions. Modeling results indicate that, by using additional hip-joint stiffness, stable crutch supported paraplegic standing can be achieved, both under static as well as dynamic situations. The static equilibrium postures and the stability under perturbations were calculated to be dependent on crutch placement and stiffness applied. However, postures in which the hip joint was in extension (C postures) appeared to the most stable postures. Applying at least 60 N x m/rad hip-joint stiffness gave stable equilibrium postures in all cases. Choosing appropriate hip-joint offset angles, the static equilibrium postures changed to more erect postures, without causing instability or excessive arm forces to occur.
Databáze: MEDLINE