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Advanced Computer Methods for Pathological and Non-Pathological Human Movement Analysis

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Advanced Computer Methods for Pathological and Non-Pathological Human Movement Analysis Advanced Computer Methods for Pathological and Non-Pathological Human Movement Analysis Sérgio Miguel Barroso Gonçalves Dissertação para obtenção do Grau de Mestre em Engenharia Biomédica Júri Presidente: Prof. Doutor Hélder Rodrigues Orientadores: Prof. Doutor Miguel Pedro Tavares da Silva Prof. Doutor Jorge Manuel Mateus Martins Prof. Doutor Mamede Carvalho Vogais: Prof. Doutor Jorge Alberto Cadete Ambrósio Prof. Doutor João Nuno Marques Parracho Guerra da Costa Outubro 2010 Agradecimentos Ao Professor Miguel Tavares Silva pelo seu empenho na cadeira de Biomecânica do Movimento, que me despertou a vontade de desenvolver trabalho nesta área, bem como pela ajuda e esforço dispendido como orientador científico no desenvolvimento desta tese. Ao Professor Jorge Martins, orientador científico do Instituto Superior Técnico, pela ajuda prestada no desenvolvimento deste trabalho. Ao Professor Mamede Carvalho, orientador científico da Faculdade de Medicina de Lisboa, pelo apoio prestado Ao Doutor Cassiano Neves pela importante cooperação, encaminhando os pacientes analisados, que foram uma das pedras basilares deste trabalho. A todo o grupo do Biomechatronics Research Group, por facilitar o livre acesso ao laboratório de biomecânica, e em especial ao Daniel Simões Lopes, Paulo Melo e Sofia D’Orey pela disponibilidade demonstrada e pela valiosa ajuda prestada. À Sara Marreiros pelas horas e ideias que partilhámos no desenvolvimento das nossas teses. A todos os colegas e amigos que mostraram disponibilidade para participarem nos ensaios experimentais, bem como aos pacientes analisados pela sua participação nos ensaios por vezes demorados e cansativos. A todos os amigos e colegas que directa ou indirectamente tiveram um papel no desenvolvimento deste trabalho. Destaco as ajudas do José Ferrão, Manuel Rodrigues, Andreia Duarte, Patrícia Ângelo e Joana Aguiar, André Carreiro, João Jorge, Francisco Leão e Duarte Preto. À minha família, e em particular aos meus pais, por me proporcionarem a oportunidade de começar e acabar esta etapa, aos meus irmãos e avós, em especial à minha avó Natália pela ajuda e preocupação demonstrada. I II Resumo O objectivo principal deste trabalho passou por estudar os padrões da marcha humana não- patológica e patológica. Desta forma, foi necessário desenvolver um protocolo de análise da marcha humana, projectado para analisar uma grande variedade de parâmetros biomecânicos do movimento humano. O protocolo desenvolvido consistiu numa metodologia eficaz e eficiente para preparação do paciente e do ambiente laboratorial, permitindo a análise dos parâmetros, cinemáticos, cinéticos, electromiográficos, temporais e espaciais. A metodologia desenvolvida incluiu um protocolo de colocação de marcadores, de electromiografia e de aquisição de ensaios. Foram também desenvolvidas uma série de rotinas que permitiram automatizar o processamento de dados, com a finalidade de gerar uma base de dados de marcha não- patológica. A análise cinética recorreu ao uso de um software de análise dinâmica multicorpo – Apollo. Seguidamente, a metodologia desenvolvida foi aplicada na aquisição de padrões de marcha de três grupos não-patológicos representativos da população portuguesa (crianças, adultos do sexo masculino e adultos do sexo feminino). Os resultados obtidos foram comparados com trabalhos anteriores, observando-se resultados concordantes com estes. Desta forma, a metodologia utilizada foi validada, obtendo-se uma base de dados de padrões de marcha para utilização em futuros estudos, como em reabilitação física e análise clínica. Por fim, foram estudados dois sujeitos com patologias de marcha e comparados os seus resultados com a população padrão. Esses estudos incluíram ensaios com e sem as suas ortóteses. Uma vez mais, esta análise permitiu comprovar a boa aplicabilidade da metodologia desenvolvida, uma vez que os resultados obtidos encontravam-se concordantes com a literatura. Palavras-chave: Análise da marcha humana não-patológica, análise da marcha humana marcha patológica, análise cinemática e dinâmica da marcha, análise electromiográfica da marcha, protocolos de análise de marcha, biomecânica III IV Abstract The main objective of this work was to analyze the main human patterns of non-pathological and pathological gait. In order to achieve this objective, it was necessary to develop a protocol of gait analysis designed to withstand a vast range of biomechanical aspects of the human motion. The protocol’s desiderata consists of an effective and efficient methodology for subject instrumentation and laboratory setup, enabling the study of time-distance, kinematic, kinetic and electromyographic parameters. The proposed methodology includes a marker set protocol, a superficial electromyographic protocol and a trial acquisition protocol. Moreover, in order to automate the data processing and generate a database of non-pathological patterns a set of routines was developed. The kinetic analysis recurred to the use of the multibody dynamics software – Apollo. In a second part, the developed methodology was applied in the analysis of the gait parameters of three non-pathological groups representing the Portuguese population – children, male adult and female adult. The obtained results were compared with previous works, presenting the expected pattern. Thus, the used methodology was approved, but also allowed obtaining the gait patterns for a sample of the Portuguese population, which can be used in future studies, such as clinical analysis and physical rehabilitation. Lastly, two pathological subjects were analyzed and their results compared with the normal obtained patterns. In these studies, it was studied the subjects’ gait with and without their orthoses. Once more, the developed methodology was approved, since the obtained results were in concordance with literature. Keywords: Analysis of non-pathological human gait, analysis of pathological human gait, kinematic and kinetic analysis of gait, electromyographic analysis of gait, gait acquisition protocols, biomechanics V VI Contents Agradecimentos ................................................................................................................. I Resumo ........................................................................................................................... III Abstract ............................................................................................................................. V List of Figures ................................................................................................................. XII List of Tables .............................................................................................................. XVIII List of Symbols ............................................................................................................. XIX Glossary ......................................................................................................................... XX Chapter I ........................................................................................................................... 1 1. Introduction ................................................................................................................ 1 1.1. Motivation .......................................................................................................... 1 1.2. Objectives .......................................................................................................... 2 1.3. State of the art ................................................................................................... 2 1.3.1. Kinematic Analysis ...................................................................................... 3 1.3.2. Kinetic analysis ............................................................................................ 5 1.3.3. Electromyographic analysis ......................................................................... 6 1.3.4. Theories of Human Walking ........................................................................ 7 1.4. Main Contributions ............................................................................................. 8 1.5. Structure and Organization ............................................................................... 8 Chapter II ........................................................................................................................ 11 2. Locomotor System ................................................................................................... 11 2.1. The Skeletal Anatomy ..................................................................................... 11 2.1.1. Lower Limb ................................................................................................ 11 2.1.2. Pelvic Girdle............................................................................................... 12 2.1.3. Differences of female and male skeletons ................................................ 13 2.2. The Muscular System ...................................................................................... 13 2.2.1. Anterior Leg ............................................................................................... 14 2.2.2. Posterior Leg ............................................................................................. 14 2.2.3. Anterior thigh (Anterior external muscles) ................................................. 15 2.2.4. Posterior Thigh (Hamstrings) ....................................................................
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