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- All Subjects: balance
- Creators: Honeycutt, Claire
- Member of: Theses and Dissertations
- Status: Published
Description
According to the CDC in 2010, there were 2.8 million emergency room visits costing $7.9 billion dollars for treatment of nonfatal falling injuries in emergency departments across the country. Falls are a recognized risk factor for unintentional injuries among older adults, accounting for a large proportion of fractures, emergency department visits, and urgent hospitalizations. The objective of this research was to identify and learn more about what factors affect balance using analysis techniques from nonlinear dynamics. Human balance and gait research traditionally uses linear or qualitative tests to assess and describe human motion; however, it is growing more apparent that human motion is neither a simple nor a linear task. In the 1990s Collins, first started applying stochastic processes to analyze human postural control system. Recently, Zakynthinaki et al. modeled human balance using the idea that humans will remain erect when perturbed until some boundary, or physical limit, is passed. This boundary is similar to the notion of basins of attraction in nonlinear dynamics and is referred to as the basin of stability. Human balance data was collected using dual force plates and Vicon marker position data for leans using only ankle movements and leans that were unrestricted. With this dataset, Zakynthinaki’s work was extended by comparing different algorithms used to create the critical curve (basin of stability boundary) that encloses the experimental data points as well as comparing the differences between the two leaning conditions.
ContributorsSmith, Victoria (Author) / Spano, Mark L (Thesis advisor) / Lockhart, Thurmon E (Thesis advisor) / Honeycutt, Claire (Committee member) / Arizona State University (Publisher)
Created2016
Description
This dissertation aimed to evaluate the effectiveness and drawbacks of promising fall prevention strategies in individuals with stroke by rigorously analyzing the biomechanics of laboratory falls and compensatory movements required to prevent a fall. Ankle-foot-orthoses (AFOs) and functional electrical stimulators (FESs) are commonly prescribed to treat foot drop. Despite well-established positive impacts of AFOs and FES devices on balance and gait, AFO and FES users fall at a high rate. In chapter 2 (as a preliminary study), solely mechanical impacts of a semi-rigid AFO on the compensatory stepping response of young healthy individuals following trip-like treadmill perturbations were evaluated. It was found that a semi-rigid AFO on the stepping leg diminished the propulsive impulse of the compensatory step which led to decreased trunk movement control, shorter step length, and reduced center of mass (COM) stability. These results highlight the critical role of plantarflexors in generating an effective compensatory stepping response. In chapter 3, the underlying biomechanical mechanisms leading to high fall risk in long-term AFO and FES users with chronic stroke were studied. It was found that AFO and FES users fall more than Non-users because they have a more impaired lower limb that is not fully addressed by AFO/FES, therefore leading to a more impaired compensatory stepping response characterized by increased inability to generate a compensatory step with paretic leg and decreased trunk movement control. An ideal future AFO that provides dorsiflexion assistance during the swing phase and plantarflexion assistance during the push-off phase of gait is suggested to enhance the compensatory stepping response and reduce more falls. In chapter 4, the effects of a single-session trip-specific training on the compensatory stepping response of individuals with stroke were evaluated. Trunk movement control was improved after a single session of training suggesting that this type of training is a viable option to enhance compensatory stepping response and reduce falls in individuals with stroke. Finally, a future powered AFO with plantarflexion assistance complemented by a trip-specific training program is suggested to enhance the compensatory stepping response and decrease falls in individuals with stroke.
ContributorsNevisipour, Masood (Author) / Honeycutt, Claire (Thesis advisor) / Sugar, Thomas (Thesis advisor) / Artemiadis, Panagiotis (Committee member) / Abbas, James (Committee member) / Lee, Hyunglae (Committee member) / Arizona State University (Publisher)
Created2019