Katarzyna Jochymczyk-Woźniak

The influence of frequency of visual disorders on stabilographic parameters.

PURPOSE Defining the influence of parameters of visual disorders on ability of balancing turns out to be an important process in effective diagnostics. Current diagnostic methods relating mainly to determination of the coefficient of BRUTM (Balance Rehabilitation Unit Trade Mark) depend on lots of tests carried out in a disturbed environment created by Virtual Reality Technology. The aim of this study is to determine the effect of the frequency of visual disturbances on stabilographic values in the virtual reality environment. METHODS The study was carried out involving one research group in Virtual Cave. There were induced visual disturbances with different frequencies and with the change of frequency during measuring the position of the center of pressure (COP) in the test. Before each test the reference test was performed. All tests were performed with disorders in two different sceneries: closed and open scenery. All measurements were carried out on an immobile Zebris platform which enables determination of feet pressure distribution. From the measured values of the position of the COP Short Time Fourier Transform (STFT) was calculated. RESULTS The results of calculation are shown in graphs. Their analysis showed that changing the parameters of disorder frequency in world created using Virtual Reality Technology affects stabilographic parameters. The intensity of these changes is also affected by applied research scenery. CONCLUSIONS Conditions have been set out to carry out similar studies in order to obtain reliable results. The study is the first step in a project to develop a system for diagnosis and rehabilitation of human movement using Virtual Reality Technology.

Application of Gait Index Assessment to Monitor the Treatment Progress in Patients with Cerebral Palsy

A three-dimensional analysis of movement is more and more often applied to assess locomotive functions of patients with cerebral palsy (CP). For the past few years there has been a growing interest in gait index methods which enable the evaluation of the patient’s gait with the use of a single numerical value. This research aimed at the assessment of the gait of patients with CP at different stages of treatment on the basis of gait indices Gillette Gait Index (defined by Shutte) and Gait Deviation Index (definied by Schwartz and Rozumalski) as well as finding dependencies between the determined indices values. The studied group consisted of 56 healthy participants and 16 patients with cerebral palsy treated using botulinum toxin. On the grounds of the determined indexes, the improvement of gait was observed in the case of 75 % of patients with CP. Statistically significant differences were found between GGI and GDI values obtained in the initial investigation and after 6 months following the administration of botulinum (PRE and POST). There was a strong linear dependence observed between the GDI and GGI* (\(GGI^*=\ln (\sqrt{GGI})\)) values. No significant dependence was observed between the percentage indices of improvement determined on the basis of the GGI and GDI results obtained (in the PRE and POST examination).

Three-Dimensional Children Gait Pattern – Reference Data for Healthy Children Aged Between 7 and 17

The research aimed to determine the standards of kinematic quantities and indices of regularity, namely the Gillette Gait Index and the Gait Deviation Index related to children aged between 7 and 17 as well as the identification of differences concerning the above-named quantities according to age and height. The study group consisted of 56 healthy children aged 7 to 17. The tests were performed using the BTS Smart system. The original applications developed in the Matlab environment for all of the children subjected to the tests enabled the identification of the Gillette Gait Index (GGI) and the Gait Deviation Index (GDI). Detailed analysis involved a set of sixteen variables describing gait kinematics; the above-named variables are used when creating the GGI. The children were divided into five groups in relation to age and six groups in relation to height. Time values of the angles of the joints were registered and then the GGI and the GDI were calculated. Sixteen parameters composing the GGI were determined for all of the children constituting the test group. The confirmation or the exclusion of differences between age-related and height-related groups was based on statistical analysis. The identified courses of the kinematic time series can be used as normative in relation to patients aged 7–17.

The Long-Term Effects of Surgery in Patients with Myelomeningocele and Their Influence on the Parameteres of Gait – Preliminary Research

The aim of the work was to assess locomotion functions and posture stability of patients who had undergone prenatal or postnatal surgery for myelomeningocele. The gait tests were conducted with BTS System and the stabilographic tests with the dynamographic platform by Zebris. Eight patients operated for myelomeningocele, 4 prenatally and 4 postnatally, have undergone the analysis. A thorough analysis was made of the set of space-time, kinematic parameters, values of the Gillette Gait Index and Gait Deviation Index. The patients’ posture stability was assessed on the basis of the path length and the ellipse area. The obtained results were compared with the standard values. The conducted biomechanical examinations of indicate that regardless of the time when the closing of the myelomeningocele was done, the patients show biggest disorders in the motion of the pelvis. Posture stability of children with myelomeningocele is reduced when compared to a group of healthy children.

Assessment of locomotor functions of patients suffering from cerebral palsy qualified to treat by different methods

The aim of this study was to assess locomotor functions of patients with cerebral palsy and qualified for various treatment procedures on the basis of indicative methods and parameters constituting the Gillette Gait Index. The studied group consisted of 57 healthy children and 60 children with different types CP and different degrees of disability: REH - patients subjected to physiotherapy only, BOT - patients subjected to the injection of botulinum toxin and intensive rehabilitation and RIZ - patients qualified for the surgical procedure of the selective dorsal rhizotomy. Gait investigations were carried out using BTS Smart system and the gait assessment was made on the basis of gait indices methods (GGI, GDI). The statistical analysis demonstrated that the most diversified parameters characterising patients with CP qualified for various treatments are: knee flexion at initial contact, time of peak knee flexion, range of knee flexion, range of pelvic tilt.

Assessment of balance of older people living at a social welfare home

More frequently fall of older people can be caused by increasing of the degeneration of a human motor system and a human maintaining balance system. The aim of study was to determine the association of balance and risk of falling of older people lived at a social welfare home. The authors examined the dependence between the ability to maintain balance in the upright position and the assessment of balance and risk of falling in a functional way. The study group were consisted of 26 elderly people. Postural stability examinations was carried out based on the Romberg test, while the functionally balance was evaluated with a Up&Go test. The statical tests did not manifest significant correlation between the static and dynamic stabiliography parameters, but one proved that there existed strong differences for obtained ellipse area results, among the group of patients performing the Up&Go Test within shorter and longer time than 20 sec.

Evaluation of Locomotor Function in Patients with CP Based on Muscle Length Changes

The aim of this study was to analyze locomotor function of children with cerebral palsy based on changes in muscle length and to evaluate if the muscle length changes may be used as a diagnostic indicator. The study group consisted of 23 people with normal gait and 3 patients with cerebral palsy. Locomotor function tests were performed using the BTS Smart system, while the length of the muscles were determined using mathematical modeling methods with the help of Anybody Modeling System software. In this study the muscle group functioning in connection with the knee joint were analyzed. The results of muscle length changes for children with CP were compared to those of people with no evidence of impaired locomotor function, as well as to the values of GGI and GDI indicators and to kinematic parameters.