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Biomedical subjects

R E Major

Publications and source records attributed to R E Major.

13 recordsLinked to original sources
PubMed1992

Improvement in walking performance of children with cerebral palsy: preliminary results.

The effect of four to six months use of ankle-foot orthoses (AFOs) and balance training was determined for six children with cerebral palsy. The six consecutively referred patients had spastic diplegia or hemiplegia, with hyperextension of the knee, and had accurate voluntary control of the trunk and hips. Fixed AFOs were adjusted to control the position of the ground reaction force in relation to the knees. Balance training was targeted to the knees. All children showed a decrease in the magnitude of the knee-extending moment arm toward normal when barefoot. Improvement was noted in foot-ground contact for three children and of stance-phase posture for three. These improvements were not related to range of motion or speed, and a motor learning effect is proposed. The value of monitoring the moment arm is emphasised.

Biomechanical Phenomena↗
PubMed1990

A microcomputer-based video vector system for clinical gait analysis.

A microcomputer-based video vector system has been developed to display the resultant ground reaction force vector on a television image of the subject in real-time. For each television field the force platform signals are acquired and processed and the resultant force vector superimposed on the video image of the walking subject. The force platform results are stored on disc and the composite video signals recorded on video tape for further analysis. The system is easy to set up and use and the results can be readily interpreted. The external moments produced at the joint centers by the ground reaction forces can be observed visually and, if required, quantification of the external moments can be achieved following data collection. The spatial resolution of the system is 0.342% vertically and 0.156% horizontally. The force vector visualization technique has routine applications in orthotics and prosthetics. It is also a useful technique for the teaching of biomechanics.

Calibration↗
PubMed1990

The Edinburgh-ORLAU prosthetic system to provide reciprocal locomotion in children and adults with complete transverse lower limb deficiency.

A novel prosthetic system to provide reciprocal locomotion in children and adults with complete transverse lower limb deficiency is described. This is based on the hip joints from the ORLAU ParaWalker, a system with a proven record of success in the orthotic management of paraplegic patients. The fitting of the prototype system to an eight year old girl is described. This experience shows that the orthotic principles of the ParaWalker, which provides reciprocal locomotion for the paraplegic, is equally applicable to the prosthetic situation. Developments are therefore continuing to improve the design and to enable further fittings.

Artificial Limbs↗
PubMed1989

A review of the fundamental design problems of providing ambulation for paraplegic patients.

Walking for paraplegics with complete mid-thoracic lesions is now becoming a clinically viable reality. However, much of the literature in this field overstates the achievements and masks the difficulties that patients may encounter. This paper highlights Independence, Energy Cost, Cosmesis, Reliability and Cost as the five areas of prime interest involved in the design compromise for any walking system and urges that all relevant information for any system should be readily available to prescribers. Currently available walking systems are briefly considered.

Costs and Cost Analysis↗
PubMed1987

Dynamics of reciprocal gait of adult paraplegics using the Para Walker (Hip Guidance Orthosis).

Force plate studies with nine adult traumatic complete paraplegics with lesion at thoracic level have shown that, unlike children walking in the Oswestry Hip Guidance Orthosis (Para Walker) system, they have to apply extra stabilizing forces through the crutches for safe walking. These forces are described and are attributed to an increased crutch force applied to prevent lateral deformation of the orthosis in stance phase.

Adult↗
PubMed1984

Physiological cost index of walking for normal children and its use as an indicator of physical handicap.

Seventy-two normal children aged between three and 12 years were assessed to establish their walking function. Speed of walking and heart rate were monitored continuously, both barefoot and in shoes, over eight consecutive lengths of a 25m walkway. Since heart rate is affected by speed, the physiological cost index (PCI)--which combines the two parameters--was calculated for each child, both barefoot and in shoes. Speed tends to increase and walking heart rate to decrease with age. However, resting heart rate also decreases with age, so the PCI has the same range for all ages. The mean PCI in shoes was 0.4 and barefoot was 0.38. The PCI for children with pathological gait is appreciably greater than that for normal children, so the PCI is a valuable quantitative indicator of the level of handicap.

Child↗
PubMed1984

The technique of reciprocal walking using the hip guidance orthosis (hgo) with crutches.

An orthotic method of providing reciprocal walking for high thoracic levels of paralysis is detailed. The essential features of the hip guidance orthosis are described, as well as the basic muscle requirements for this form of walking (shoulder, arm and hand function plus Latissimus Dorsi). The walking sequence is described at each stage under the three main headings: mechanics, muscle action and hip guidance orthosis reaction--to build a complete picture of the walking process. The importance of considering the input made by the patient in addition to the purely mechanical orthotic contribution is illustrated.

Adult↗
PubMed1981

The dynamics of walking using the hip guidance orthosis (hgo) with crutches.

The variation of ground reaction forces with time for a complete hgo gait cycle using crutches has been synthesized from video recordings and force platform data. This has led to an understanding of the dynamics of hgo ambulation. The results show that when a patient used the orthosis the crutches provide a subtle control mechanism taking maximum advantage of forward momentum and produce small propulsive forces when needed to make up energy losses.

Biomechanical Phenomena↗
PubMed1980

One leg swing through gait using two crutches. An analysis of the ground reaction forces and gait phases.

Using a Force Plate the gait cycle for one leg swing-through gait of ten normal subjects on Canadian crutches was monitored, and a composite diagram of forces on the lower limb and both crutches was produced. In addition the relationship of the stance and swing phase for both the lower limb and crutches was studied and the percentage of these phases and their overlap included on the composite diagram. The average maximum vertical ground reaction to the leg was 1.32 body weight, 16 per cent higher than that reported for normal walking. The horizontal force on the lower limb in the direction of walking was 0.35 body weight, compared to 0.15 for normal walking. Vertical ground reaction to crutches was on average 0.54 body weight on the side of the landing leg and 0.51 on the contralateral side. Horizontal ground reaction on the crutches at right angles to the direction of ambulation was 0.09 body weight on the right and 0.08 on the left. The results were considered to indicate caution in the prescription of one leg swing-through gait in subjects with diseased bone and joints in the lower limb.

Adult↗
PubMedDate not supplied

Instrumentation used in clinical gait studies: a review.

This paper reviews the currently available instrumentation used for gait studies and discusses the clinical suitability of the various methods of recording gait parameters. Most of the presently available motion analysis systems appear to be more suited to research than to the routine clinical situation. However the video vector visualization technique appears to be the most useful clinically since it produces a real time display, is simple to operate and interpretation of the data is easier than other systems available. Some further development of the video vector visualization system is necessary to improve its accuracy and to produce quantitative information.

Diagnosis, Computer-Assisted↗