Department of Biomedical Engineering, Chonbuk National University, Deogjin-Dong 1-Ga, Jeonju, Chonbuk 561-756, Republic of Korea.
J Med Syst. 2010 Oct;34(5):787-97. doi: 10.1007/s10916-009-9293-6. Epub 2009 May 20.
The purpose of this study is to develop an abnormal gait detection algorithm and a vibratory stimulation system on a lower limb to improve gait stability and prevent falls. The system consists of a gait measurement module, an abnormal gait detection module, and a vibratory stimulation module. The gait measurement module measures the vertical acceleration of the ankle during walking using an accelerometer. The measured acceleration values are sent to a portable microcontroller, which controls vibratory stimulations to the ankles based on an algorithm that detects the peak acceleration values. If the acceleration peaks are found to occur irregularly, the abnormal gait detection algorithm activates the vibratory stimulation module. To determine the effect of vibratory stimulations under dynamic condition, this study investigated the contribution of ankle muscle proprioception on the control of dynamic stability and lower limb kinematics while walking using vibratory stimulation to alter the muscle spindle output of individuals' left lower limb. Vibrators were attached to the left ankle joint (tibialis anterior, triceps surae). Participants were required to walk along a travel path and step over an obstacle placed in their way. There were four task conditions; an obstacle (10%, 20%, and 30% of the participants' height) was positioned at the midpoint of the walkway, or the participants' walking path remained clear. For each obstacle condition, participants experienced either no vibration, or vibration of the tibialis anterior muscle and the triceps surae muscle of the left lower limb. Vibration began upon detection of an abnormal gait and continued for one second. Vibrating the ankle muscles of the left lower limb while stepping over an obstacle resulted in significant changes in COM behavior on both the anterior/posterior (A/P) and medial/lateral (M/L) planes. The results provide strong evidence that the primary endings of the ankle muscle spindles play a significant role in the control of posture and balance during the swing phase of locomotion by providing information on the movement of the body's COM with respect to the support foot.
本研究旨在开发一种异常步态检测算法和下肢振动刺激系统,以提高步态稳定性,预防跌倒。该系统由步态测量模块、异常步态检测模块和振动刺激模块组成。步态测量模块使用加速度计测量行走时脚踝的垂直加速度。测量的加速度值被发送到便携式微控制器,微控制器根据检测到的峰值加速度值的算法控制脚踝的振动刺激。如果发现加速度峰值不规则出现,则异常步态检测算法会激活振动刺激模块。为了确定在动态条件下振动刺激的效果,本研究通过振动刺激改变个体左下肢肌肉梭内感受器的输出,研究了踝关节本体感觉对控制动态稳定性和下肢运动学的贡献。振动器附着在左踝关节(胫骨前肌、小腿三头肌)上。参与者被要求沿着行进路径行走,并跨过放置在行进路径上的障碍物。实验有四个任务条件:障碍物(参与者身高的 10%、20%和 30%)放置在行走路径的中点,或者参与者的行走路径保持畅通。对于每个障碍物条件,参与者体验到没有振动、胫骨前肌振动或左下肢小腿三头肌振动。一旦检测到异常步态,振动就开始,并持续一秒钟。在跨过障碍物时振动左下肢的脚踝肌肉会导致 COM 在前后(A/P)和内外(M/L)平面上的行为发生显著变化。结果提供了有力的证据,表明踝关节肌肉梭内感受器的主要末梢在运动过程中对姿势和平衡的控制中起着重要作用,通过提供关于身体 COM 相对于支撑脚的运动的信息。