The ability to adapt walking to environmental circumstances is an important aspect of walking, yetdifficult to assess. The Interactive Walkway was developed to assess walking adaptability by... Show moreThe ability to adapt walking to environmental circumstances is an important aspect of walking, yetdifficult to assess. The Interactive Walkway was developed to assess walking adaptability by augmentinga multi-Kinect-v2 10-m walkway with gait-dependent visual context (stepping targets, obstacles) usingreal-time processed markerless full-body kinematics. In this study we determined InteractiveWalkway’s usability for walking-adaptability assessments in terms of between-systems agreementand sensitivity to task and subject variations. Under varying task constraints, 21 healthy subjectsperformed obstacle-avoidance, sudden-stops-and-starts and goal-directed-stepping tasks. Variouscontinuous walking-adaptability outcome measures were concurrently determined with the InteractiveWalkway and a gold-standard motion-registration system: available response time, obstacle-avoidanceand sudden-stop margins, step length, stepping accuracy and walking speed. The same holds fordichotomous classifications of success and failure for obstacle-avoidance and sudden-stops tasks andperformed short-stride versus long-stride obstacle-avoidance strategies. Continuous walking-adapt-ability outcome measures generally agreed well between systems (high intraclass correlationcoefficients for absolute agreement, low biases and narrow limits of agreement) and were highlysensitive to task and subject variations. Success and failure ratings varied with available response timesand obstacle types and agreed between systems for 85–96% of the trials while obstacle-avoidancestrategies were always classified correctly. We conclude that Interactive Walkway walking-adaptabilityoutcome measures are reliable and sensitive to task and subject variations, even in high-functioningsubjects. We therefore deem Interactive Walkway walking-adaptability assessments usable forobtaining an objective and more task-specific examination of one’s ability to walk, which may befeasible for both high-functioning and fragile populations since walking adaptability can be assessed atvarious levels of difficulty. Show less
The goal of this pilot study was to develop and test an integrated method to assess kinematics, kinetics and muscle activation of total knee prostheses during dynamic activities, by integrating... Show moreThe goal of this pilot study was to develop and test an integrated method to assess kinematics, kinetics and muscle activation of total knee prostheses during dynamic activities, by integrating fluoroscopic measurements with force plate, electromyography and external motion registration measurements. Subsequently, this multi-instrumental analysis was then used to assess the relationship between kinematics, kinetics and muscle activation and early migration of the tibial component of total knee prostheses. This pilot study showed that it is feasible to integrate fluoroscopic, kinematic and kinetic measurements and relate findings to early migration data. Results showed that there might be an association between deviant kinematics and early migration in patients with a highly congruent mobile-bearing total knee prosthesis. Patients that showed high levels of coactivation, diverging axial rotations of the insert and a deviant pivot point showed increased migration and might be at higher risk for tibial component loosening. In the future, to confirm our findings, the same integrated measurements have to be performed in larger patient groups and different prosthesis designs. Show less
Bregman, D.J.J.; Harlaar, J.; Meskers, C.G.M.; Groot, V. de 2012
