The real time video vector display of ground reaction forces during ambulation.
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Biomedical subjects
Publications and source records attributed to G K Rose.
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Crutches can be used by patients with injuries to the lower extremities in order to perform 'swing-through' gait. Because axillary crutches have been associated with axillary artery thrombosis and crutch palsy, they have to a large extent been superseded by elbow crutches. Canadian crutches combine many of the features of axillary and elbow crutches, and a study of the three types suggests that they have advantages in terms of energy cost.
Energy expenditure is an important parameter in the assessment of gait and orthotic treatment of heavily handicapped patients, since any orthosis which increases the effort required is likely to be discarded with consequently disturbing implications. Heart rate has been shown to be a reliable monitor of energy expenditure and is convenient because ECG can be telemetered by a miniature radio transmitter. Using a transmitter causes minimal interference with the patient, but care must be employed to obtain ECG signals free of artefact from subjects who are exercising. Means of reducing artefact are discussed, as are ways in which heart rate monitoring by radio telemetry is being used in the routine assessment of orthotic treatment of paediatric patients and the development of new orthotic devices.
A new design of swivel walker for the severely disabled is described which has advantages over previous types. Increased rigidity improves the confidence of apprehensive patients, greater strength gives better reliability for those with good ambulation function and a novel construction gives more opportunity for independent transfer into and out of the orthosis, besides easing the burden of those caring for users of swivel walkers.
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A 20-year follow-up in no way suggests that an active programme of treatment could have improved this patient's function and clearly it could have resulted in much worse cosmesis.
A boy aged three with indifference to pain was followed up until his death from amyloid disease some twenty-one years later. A full necropsy was done and the neuropathology suggested a sensory neuropathy.
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Some problems of the establishment and management of a clinical gait assessment laboratory are explored. It is suggested that the term 'gait analysis' should be restricted to data gathering and that the term 'gait assessment' be used for the integration of this information with that from other sources for the purpose of clinical decision-making. Particular problems derive from the fact that gait analysis measures the effects of combined causes and compensatory activities of the body. The identification of causes requires, therefore, an initial theory which has to be tested by some interference with the system and this repeated as this proves necessary. This may be facilitated by a computer-aided decision program. The overall implications are that the whole body needs to be studied by a wide range of devices in a situation where the contribution of the clinician in regard to time more nearly matches that of the bioengineer than is customary.