From diagnostics to therapy – conceptual basis for real-time movement feedback in rehabilitation medicine
-
Matthias Schablowski-Trautmann
Abstract
Recently, locomotion therapy on a treadmill has become part of rehabilitation programs for neurological gait disorders (spinal cord injury, hemiplegia). Instrumental gait analysis is an important tool for quantification of therapy progress in terms of functional changes in a patient's gait patterns. Whereas most of current applications focus on diagnostic assessment of gait, the current paper presents an extension of movement analysis offering enhanced therapeutic options. Specifically, the conceptual basis for application of real-time movement feedback in rehabilitation medicine is outlined and is put into context with recent developments in the field. A first technical realization of these concepts is presented and first results are reported. Furthermore, open questions towards a universal environment for movement feedback in rehabilitation medicine are discussed and future lines of research are identified.
References
1 Abel R, Schablowski M, Rupp R, Gerner HJ. Gait analysis on the treadmill – monitoring exercise in the treatment of paraplegia. Spinal Cord2002; 40: 17–22.10.1038/sj.sc.3101239Suche in Google Scholar
2 Boyd RN, Hays RM. Current evidence for the use of botulinum toxin type A in the management of children with cerebral palsy: A systematic review. Eur J Neurol2001; 8 (Suppl 5): 1–20.10.1046/j.1468-1331.2001.00034.xSuche in Google Scholar
3 Cooper RA, Quatrano LA, Stanhope SJ, et al. Gait analysis in rehabilitation medicine: A brief report. Am J Phys Med Rehab1999; 78: 278–280.10.1097/00002060-199905000-00019Suche in Google Scholar
4 Dieterle J, Loose T, Schablowski M, Mikut R, Rupp R, Abel R. A new measure for assessing gait quality in SCI patients with 3D gait analysis. Gait Posture2002; 16 (Suppl 1): S138.Suche in Google Scholar
5 Dietz V, Colombo G, Jensen L. Locomotor activity in spinal man. Lancet1994; 344: 1260–1263.10.1016/S0140-6736(94)90751-XSuche in Google Scholar
6 Dietz V, Harkema SJ. Locomotor activity in spinal cord-injured persons. J Appl Physiol2004; 96: 1954–1960.10.1152/japplphysiol.00942.2003Suche in Google Scholar
7 Dingwell JB, Cusumano JP. Nonlinear time series analysis of normal and pathological human walking. Chaos2000; 10: 848–863.10.1063/1.1324008Suche in Google Scholar
8 Dobkin BH, Apple D, Barbeau H; SCILT Group. Methods for a randomized trial of weight-supported treadmill training versus conventional training for walking during inpatient rehabilitation after incomplete traumatic spinal cord injury. Neurorehab Neural Repair2003; 17: 153–167.10.1177/0888439003255508Suche in Google Scholar
9 Edgerton VR, Roy RR. Gravitational biology of the neuromotor systems: A perspective to the next era. J Appl Physiol2000; 89: 1224–1231.10.1152/jappl.2000.89.3.1224Suche in Google Scholar
10 Gage JR. Gait analysis. An essential tool in the treatment of cerebral palsy. Clin Orthop1993; 288: 126–134.10.1097/00003086-199303000-00016Suche in Google Scholar
11 Hesse S, Konrad M, Uhlenbrock D. Treadmill walking with partial body weight support versus floor walking in hemiparetic subjects. Arch Phys Med Rehab1999; 80: 421–427.10.1016/S0003-9993(99)90279-4Suche in Google Scholar
12 Kadaba MP, Ramakrishnan HK, Wootten ME. Measurement of lower extremity kinematics during level walking. J Orthop Res1990; 8: 383–392.10.1002/jor.1100080310Suche in Google Scholar
13 Kögel M, Rupp R, Schablowski M. A novel system for providing real-time feedback in rehabilitation of gait disorders. Biomed Tech2005; 50 (Suppl 1): 1400–1401.Suche in Google Scholar
14 Loose TS. Konzept für eine modellgestützte Diagnostik mittels Data Mining am Beispiel der Bewegungsanalyse. Universität Karlsruhe 2004.10.1524/auto.53.1.46.56702Suche in Google Scholar
15 McNevin NH, Wulf G, Carlson C. Effects of attentional focus, self-control, and dyad training on motor learning: Implications for physical rehabilitation. Phys Ther2000; 80: 373–385.10.1093/ptj/80.4.373Suche in Google Scholar
16 Öberg T, Karsznia A, Öberg K. Joint angle parameters in gait: Reference data for normal subjects, 10–79 years of age. J Rehab Res Dev1994; 31: 199–213.Suche in Google Scholar
17 Perry J, Willoughby CD, editors. Gait analysis: Normal and pathological function. Slack, Inc, 1992.10.1097/01241398-199211000-00023Suche in Google Scholar
18 Riva G. Virtual reality for health care: The status of research. Cyberpsychol Behav2002; 5: 219–225.10.1089/109493102760147213Suche in Google Scholar
19 Schablowski-Trautmann M. Konzept zur Analyse der Lokomotion auf dem Laufband bei inkompletter Querschnittlähmung mit Verfahren der nichtlinearen Dynamik. Dissertation. Universität Karlsruhe 2005.Suche in Google Scholar
20 Schablowski-Trautmann M, Gerner HJ. Comparison of two measures of dynamic stability during treadmill walking. Lect Notes Control Inf Sci 2006: in press.Suche in Google Scholar
21 Schablowski-Trautmann M, Gerner HJ. State space analysis of joint angle kinematics in normal treadmill walking. Biomed Tech2006; 51: 294–298.10.1515/BMT.2006.060Suche in Google Scholar
22 Schuld C, Gerner HJ, Rupp R, Schablowski M. Integration of a system for continuous measurement of dynamic foot pressure during treadmill walking. Biomed Tech2003; 48: 412–413.10.1515/bmte.2003.48.s1.412Suche in Google Scholar
23 Schwab ME. Repairing the injured spinal cord. Science2002; 295: 1029–1031.10.1126/science.1067840Suche in Google Scholar
24 Sternad D. Debates in dynamics: A dynamical systems perspective on action and perception. Hum Mov Sci2000; 19: 407–423.10.1016/S0167-9457(00)00024-5Suche in Google Scholar
25 Wann JP, Turnbull JD. Motor skill learning in cerebral palsy: Movement, action and computer-enhanced therapy. Bailliere's Clin Neurol1993; 2: 15–28.Suche in Google Scholar
26 Waters RL, Lunsford BR. Energy cost of paraplegic locomotion. J Bone Joint Surg Am1985; 67: 1245–1250.10.2106/00004623-198567080-00016Suche in Google Scholar
27 Wolf S, Loose T, Schablowski M, et al. Automated feature assessment in instrumented gait analysis. Gait Posture2006; 23: 331–338.10.1016/j.gaitpost.2005.04.004Suche in Google Scholar PubMed
28 Wulf G, McConnel N, Gärtner M, Schwarz A. Enhancing the learning of sport skills through external-focus feedback. J Motor Behav2002; 34: 171–182.10.1080/00222890209601939Suche in Google Scholar PubMed
©2006 by Walter de Gruyter Berlin New York
Artikel in diesem Heft
- Biosignal Processing: various concepts, various applications – but a common drive
- Detection of directed information flow in biosignals
- Data mining in medical time series
- State-space analysis of joint angle kinematics in normal treadmill walking
- From diagnostics to therapy – conceptual basis for real-time movement feedback in rehabilitation medicine
- Investigations of back muscle fatigue by simultaneous 31P MRS and surface EMG measurements
- Application of EMG signals for controlling exoskeleton robots
- Processing of physiological signals in automotive research
- Tracer kinetic analysis of signal time series from dynamic contrast-enhanced MR imaging
- A fiber optic sensor system for control of rate-adaptive cardiac pacemakers and implantable defibrillators / Ein faseroptisches Sensorsystem zur Steuerung von frequenzadaptiven Herzschrittmachern und implantierbaren Defibrillatoren
- Investigation of the influence of blood flow rate on large vessel cooling in hepatic radiofrequency ablation / Untersuchung des Einflusses der Blutflussgeschwindigkeit auf die Gefäßkühlung bei der Radiofrequenzablation von Lebertumoren
- Determination of oxygen saturation and hematocrit of flowing human blood using two different spectrally resolving sensors / Bestimmung von Sauerstoffsättigung und Hämatokrit an fließendem Blut mit zwei verschiedenen spektralen Sensoren
- Karl Fischer titration and coulometry for measurement of water content in small cartilage specimens / Bestimmung des Wassergehalts in kleinen Knorpelproben durch Karl-Fischer-Titration und Coulometrie
- Synergistic effects of mixed TiAlV and polyethylene wear particles on TNFα response in THP-1 macrophages / Synergistische Effekte gemischter TiAlV- und Polyethylen-Abriebpartikel auf die TNFα-Antwort in THP-1 Makrophagen
- FE-Simulation zur Lokalisierung hoch beanspruchter Bereiche in der Hüftpfanne von Endoprothesen / FE-analysis of surface stresses for the tribological system in total hip prostheses
- Partial hemi-resurfacing of the hip joint – a new approach to treat local osteochondral defects? / Gelenkoberflächen-Teilersatz am Hüftgelenk – ein neuer Ansatz zur Behandlung osteochondraler Defekte?
- Stellungnahme zu „Der Einfluss von Laserlichtbestrahlung niedriger Leistungsdichte auf einen experimentellen Knorpelschaden im Kniegelenk des Kaninchens: eine in vivo-Untersuchung unter Berücksichtigung makroskopischer, histologischer und immunhistochemischer Veränderungen”; Biomed Tech 2006; 51: 131–138
- Contents index volume 51 (2006)
- Author index volume 51 (2006)
Artikel in diesem Heft
- Biosignal Processing: various concepts, various applications – but a common drive
- Detection of directed information flow in biosignals
- Data mining in medical time series
- State-space analysis of joint angle kinematics in normal treadmill walking
- From diagnostics to therapy – conceptual basis for real-time movement feedback in rehabilitation medicine
- Investigations of back muscle fatigue by simultaneous 31P MRS and surface EMG measurements
- Application of EMG signals for controlling exoskeleton robots
- Processing of physiological signals in automotive research
- Tracer kinetic analysis of signal time series from dynamic contrast-enhanced MR imaging
- A fiber optic sensor system for control of rate-adaptive cardiac pacemakers and implantable defibrillators / Ein faseroptisches Sensorsystem zur Steuerung von frequenzadaptiven Herzschrittmachern und implantierbaren Defibrillatoren
- Investigation of the influence of blood flow rate on large vessel cooling in hepatic radiofrequency ablation / Untersuchung des Einflusses der Blutflussgeschwindigkeit auf die Gefäßkühlung bei der Radiofrequenzablation von Lebertumoren
- Determination of oxygen saturation and hematocrit of flowing human blood using two different spectrally resolving sensors / Bestimmung von Sauerstoffsättigung und Hämatokrit an fließendem Blut mit zwei verschiedenen spektralen Sensoren
- Karl Fischer titration and coulometry for measurement of water content in small cartilage specimens / Bestimmung des Wassergehalts in kleinen Knorpelproben durch Karl-Fischer-Titration und Coulometrie
- Synergistic effects of mixed TiAlV and polyethylene wear particles on TNFα response in THP-1 macrophages / Synergistische Effekte gemischter TiAlV- und Polyethylen-Abriebpartikel auf die TNFα-Antwort in THP-1 Makrophagen
- FE-Simulation zur Lokalisierung hoch beanspruchter Bereiche in der Hüftpfanne von Endoprothesen / FE-analysis of surface stresses for the tribological system in total hip prostheses
- Partial hemi-resurfacing of the hip joint – a new approach to treat local osteochondral defects? / Gelenkoberflächen-Teilersatz am Hüftgelenk – ein neuer Ansatz zur Behandlung osteochondraler Defekte?
- Stellungnahme zu „Der Einfluss von Laserlichtbestrahlung niedriger Leistungsdichte auf einen experimentellen Knorpelschaden im Kniegelenk des Kaninchens: eine in vivo-Untersuchung unter Berücksichtigung makroskopischer, histologischer und immunhistochemischer Veränderungen”; Biomed Tech 2006; 51: 131–138
- Contents index volume 51 (2006)
- Author index volume 51 (2006)