Static and dynamic evaluation of the influence of supplementary hip-joint stiffness on crutch-supported paraplegic stance.

Autor: van der Spek JH; Faculty of Electrical Engineering, Systems and Signals-Biomedical Engineering, University of Twente, 7500 AE Enschede, The Netherlands. Jaap.vanderSpek@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. 452-62.
DOI: 10.1109/TNSRE.2003.819940
Abstrakt: Paraplegic persons can stand with hip-knee-ankle-foot orthoses (HKAFO) and crutches. However, current HKAFOs restrict body movement extensively, which may impede functional upper-body movements. A more compliant body support using a more compliant orthosis or well-controlled functional electrical stimulation system may increase freedom of movement to the user, but should not impede stability and required arm support. In the current study, we investigated the consequences of varying stiffness applied at the hip to postural stability and required crutch force during paraplegic stance. Experiments were performed on five paraplegic persons with spinal cord lesions varying from T1 to T12. Static postures and dynamic responses to perturbations were tested for varying hip stiffness and crutch placements. The minimal hip-joint stiffness for stable stance appeared to depend on lesion level. In contrast to the predictions of a previous modeling study, no statistically significant influences of hip-joint stiffness or crutch-to-foot distance on posture and applied crutch forces were found. It is hypothesized that the main reasons of this discrepancy are the active upper-body efforts the paraplegic HKAFO users are still able to exert and the remaining flexibility of the upper trunk and shoulder region, which is present despite the restrictions of the orthosis.
Databáze: MEDLINE