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Lower-limb prosthesis users have commonly-recognized deficits in gait and posture control. However, existing methods in balance and mobility analysis fail to provide sufficient sensitivity to detect changes in prosthesis users' postural control and mobility in response to clinical intervention or experimental manipulations and often fail to detect differences between prosthesis

Lower-limb prosthesis users have commonly-recognized deficits in gait and posture control. However, existing methods in balance and mobility analysis fail to provide sufficient sensitivity to detect changes in prosthesis users' postural control and mobility in response to clinical intervention or experimental manipulations and often fail to detect differences between prosthesis users and non-amputee control subjects. This lack of sensitivity limits the ability of clinicians to make informed clinical decisions and presents challenges with insurance reimbursement for comprehensive clinical care and advanced prosthetic devices. These issues have directly impacted clinical care by restricting device options, increasing financial burden on clinics, and limiting support for research and development. This work aims to establish experimental methods and outcome measures that are more sensitive than traditional methods to balance and mobility changes in prosthesis users. Methods and analysis techniques were developed to probe aspects of balance and mobility control that may be specifically impacted by use of a prosthesis and present challenges similar to those experienced in daily life that could improve the detection of balance and mobility changes. Using the framework of cognitive resource allocation and dual-tasking, this work identified unique characteristics of prosthesis users’ postural control and developed sensitive measures of gait variability. The results also provide broader insight into dual-task analysis and the motor-cognitive response to demanding conditions. Specifically, this work identified altered motor behavior in prosthesis users and high cognitive demand of using a prosthesis. The residual standard deviation method was developed and demonstrated to be more effective than traditional gait variability measures at detecting the impact of dual-tasking. Additionally, spectral analysis of the center of pressure while standing identified altered somatosensory control in prosthesis users. These findings provide a new understanding of prosthetic use and new, highly sensitive techniques to assess balance and mobility in prosthesis users.
ContributorsHoward, Charla Lindley (Author) / Abbas, James (Thesis advisor) / Buneo, Christopher (Committee member) / Lynskey, Jim (Committee member) / Santello, Marco (Committee member) / Artemiadis, Panagiotis (Committee member) / Arizona State University (Publisher)
Created2017
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Description
Muscular weakness is a common manifestation for Stroke survivors and for patients with Anterior Cruciate Ligament reconstruction leading to reduced functional independence, especially mobility. Several rigid orthotic devices are being designed to assist mobility. However, limitations in majority of these devices are: 1) that they are constrained only to level

Muscular weakness is a common manifestation for Stroke survivors and for patients with Anterior Cruciate Ligament reconstruction leading to reduced functional independence, especially mobility. Several rigid orthotic devices are being designed to assist mobility. However, limitations in majority of these devices are: 1) that they are constrained only to level walking applications, 2) are mostly bulky and rigid lacking user comfort. For these reasons, rehabilitation using soft-robotics can serve as a powerful modality in gait assistance and potentially accelerate functional recovery. The characteristics of soft robotic exosuit is that it’s more flexible, delivers high power to weight ratio, and conforms with the user’s body structure making it a suitable choice. This work explores the implementation of an existing soft robotic exosuit in assisting knee joint mechanism during stair ascent for patients with muscular weakness. The exosuit assists by compensating the lack of joint moment and minimizing the load on the affected limb. It consists of two I-cross-section soft pneumatic actuators encased within a sleeve along with insole sensor shoes and control electronics. The exosuit actuators were mechanically characterized at different angles, in accordance to knee flexion in stair gait, to enable the generation of the desired joint moments. A linear relation between the actuator stiffness and internal pressure as a function of the knee angle was obtained. Results from this characterization along with the insole sensor outputs were used to provide assistance to the knee joint. Analysis of stair gait with and without the exosuit ‘active’ was performed, using surface electromyography (sEMG) sensors, for two healthy participants at a slow walking speed. Preliminary user testing with the exosuit presented a promising 16% reduction in average muscular activity of Vastus Lateralis muscle and a 3.6% reduction on Gluteus Maximus muscle during the stance phase and unrestrained motion during the swing phase of ascent thereby demonstrating the applicability of the soft-inflatable exosuit in rehabilitation.
ContributorsMuthukrishnan, Niveditha (Author) / Polygerinos, Panagiotis (Thesis advisor) / Lockhart, Thurmon (Committee member) / Peterson, Daniel (Committee member) / Arizona State University (Publisher)
Created2018
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Description
Individuals fluent in sign language who have at least one deaf parent are considered native signers while those with non-signing, hearing parents are non-native signers. Musculoskeletal pain from repetitive motion is more common from non-natives than natives. The goal of this study was twofold: 1) to examine differences in upper

Individuals fluent in sign language who have at least one deaf parent are considered native signers while those with non-signing, hearing parents are non-native signers. Musculoskeletal pain from repetitive motion is more common from non-natives than natives. The goal of this study was twofold: 1) to examine differences in upper extremity (UE) biomechanical measures between natives and non-natives and 2) upon creating a composite measure of injury-risk unique to signers, to compare differences in scores between natives and non-natives. Non-natives were hypothesized to have less favorable biomechanical measures and composite injury-risk scores compared to natives. Dynamometry was used for measurement of strength, electromyography for ‘micro’ rest breaks and muscle tension, optical motion capture for ballistic signing, non-neutral joint angle and work envelope, a numeric pain rating scale for pain, and the modified Strain Index (SI) as a composite measure of injury-risk. There were no differences in UE strength (all p≥0.22). Natives had more rest (natives 76.38%; non-natives 26.86%; p=0.002) and less muscle tension (natives 11.53%; non-natives 48.60%; p=0.008) for non-dominant upper trapezius across the first minute of the trial. For ballistic signing, no differences were found in resultant linear segment acceleration when producing the sign for ‘again’ (natives 27.59m/s2; non-natives 21.91m/s2; p=0.20). For non-neutral joint angle, natives had more wrist flexion-extension motion when producing the sign for ‘principal’ (natives 54.93°; non-natives 46.23°; p=0.04). Work envelope demonstrated the greatest significance when determining injury-risk. Natives had a marginally greater work envelope along the z-axis (inferior-superior) across the first minute of the trial (natives 35.80cm; non-natives 30.84cm; p=0.051). Natives (30%) presented with a lower pain prevalence than non-natives (40%); however, there was no significant difference in the modified SI scores (natives 4.70 points; non-natives 3.06 points; p=0.144) and no association between presence of pain with the modified SI score (r=0.087; p=0.680). This work offers a comprehensive analysis of all the previously identified UE biomechanics unique to signers and helped to inform a composite measure of injury-risk. Use of the modified SI demonstrates promise, although its lack of association with pain does confirm that injury-risk encompasses other variables in addition to a signer’s biomechanics.
ContributorsRoman, Gretchen Anne (Author) / Swan, Pamela (Thesis advisor) / Vidt, Meghan (Committee member) / Peterson, Daniel (Committee member) / Lockhart, Thurmon (Committee member) / Ofori, Edward (Committee member) / Arizona State University (Publisher)
Created2018
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Description
Injuries and death associated with fall incidences pose a significant burden to society, both in terms of human suffering and economic losses. The main aim of this dissertation is to study approaches that can reduce the risk of falls. One major subset of falls is falls due to neurodegenerative disorders

Injuries and death associated with fall incidences pose a significant burden to society, both in terms of human suffering and economic losses. The main aim of this dissertation is to study approaches that can reduce the risk of falls. One major subset of falls is falls due to neurodegenerative disorders such as Parkinson’s disease (PD). Freezing of gait (FOG) is a major cause of falls in this population. Therefore, a new FOG detection method using wavelet transform technique employing optimal sampling window size, update time, and sensor placements for identification of FOG events is created and validated in this dissertation. Another approach to reduce the risk of falls in PD patients is to correctly diagnose PD motor subtypes. PD can be further divided into two subtypes based on clinical features: tremor dominant (TD), and postural instability and gait difficulty (PIGD). PIGD subtype can place PD patients at a higher risk for falls compared to TD patients and, they have worse postural control in comparison to TD patients. Accordingly, correctly diagnosing subtypes can help caregivers to initiate early amenable interventions to reduce the risk of falls in PIGD patients. As such, a method using the standing center-of-pressure time series data has been developed to identify PD motor subtypes in this dissertation. Finally, an intervention method to improve dynamic stability was tested and validated. Unexpected perturbation-based training (PBT) is an intervention method which has shown promising results in regard to improving balance and reducing falls. Although PBT has shown promising results, the efficacy of such interventions is not well understood and evaluated. In other words, there is paucity of data revealing the effects of PBT on improving dynamic stability of walking and flexible gait adaptability. Therefore, the effects

of three types of perturbation methods on improving dynamics stability was assessed. Treadmill delivered translational perturbations training improved dynamic stability, and adaptability of locomotor system in resisting perturbations while walking.
ContributorsRezvanian, Saba (Author) / Lockhart, Thurmon (Thesis advisor) / Buneo, Christopher (Committee member) / Lieberman, Abraham (Committee member) / Abbas, James (Committee member) / Deep, Aman (Committee member) / Arizona State University (Publisher)
Created2019
Description
For a conventional quadcopter system with 4 planar rotors, flight times vary between 10 to 20 minutes depending on the weight of the quadcopter and the size of the battery used. In order to increase the flight time, either the weight of the quadcopter should be reduced or the battery

For a conventional quadcopter system with 4 planar rotors, flight times vary between 10 to 20 minutes depending on the weight of the quadcopter and the size of the battery used. In order to increase the flight time, either the weight of the quadcopter should be reduced or the battery size should be increased. Another way is to increase the efficiency of the propellers. Previous research shows that ducting a propeller can cause an increase of up to 94 % in the thrust produced by the rotor-duct system. This research focused on developing and testing a quadcopter having a centrally ducted rotor which produces 60 % of the total system thrust and 3 other peripheral rotors. This quadcopter will provide longer flight times while having the same maneuvering flexibility in planar movements.
ContributorsLal, Harsh (Author) / Artemiadis, Panagiotis (Thesis advisor) / Lee, Hyunglae (Committee member) / Zhang, Wenlong (Committee member) / Arizona State University (Publisher)
Created2019
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Description
Lower-limb wearable assistive robots could alter the users gait kinematics by inputting external power, which can be interpreted as mechanical perturbation to subject normal gait. The change in kinematics may affect the dynamic stability. This work attempts to understand the effects of different physical assistance from these robots on the

Lower-limb wearable assistive robots could alter the users gait kinematics by inputting external power, which can be interpreted as mechanical perturbation to subject normal gait. The change in kinematics may affect the dynamic stability. This work attempts to understand the effects of different physical assistance from these robots on the gait dynamic stability.

A knee exoskeleton and ankle assistive device (Robotic Shoe) are developed and used to provide walking assistance. The knee exoskeleton provides personalized knee joint assistive torque during the stance phase. The robotic shoe is a light-weighted mechanism that can store the potential energy at heel strike and release it by using an active locking mechanism at the terminal stance phase to provide push-up ankle torque and assist the toe-off. Lower-limb Kinematic time series data are collected for subjects wearing these devices in the passive and active mode. The changes of kinematics with and without these devices on lower-limb motion are first studied. Orbital stability, as one of the commonly used measure to quantify gait stability through calculating Floquet Multipliers (FM), is employed to asses the effects of these wearable devices on gait stability. It is shown that wearing the passive knee exoskeleton causes less orbitally stable gait for users, while the knee joint active assistance improves the orbital stability compared to passive mode. The robotic shoe only affects the targeted joint (right ankle) kinematics, and wearing the passive mechanism significantly increases the ankle joint FM values, which indicates less walking orbital stability. More analysis is done on a mechanically perturbed walking public data set, to show that orbital stability can quantify the effects of external mechanical perturbation on gait dynamic stability. This method can further be used as a control design tool to ensure gait stability for users of lower-limb assistive devices.
ContributorsRezayat Sorkhabadi, Seyed Mostafa (Author) / Zhang, Wenlong (Thesis advisor) / Lee, Hyunglae (Committee member) / Artemiadis, Panagiotis (Committee member) / Arizona State University (Publisher)
Created2018
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Description
Human walking has been a highly studied topic in research communities because of its extreme importance to human functionality and mobility. A complex system of interconnected gait mechanisms in humans is responsible for generating robust and consistent walking motion over unpredictable ground and through challenging obstacles. One interesting aspect of

Human walking has been a highly studied topic in research communities because of its extreme importance to human functionality and mobility. A complex system of interconnected gait mechanisms in humans is responsible for generating robust and consistent walking motion over unpredictable ground and through challenging obstacles. One interesting aspect of human gait is the ability to adjust in order to accommodate varying surface grades. Typical approaches to investigating this gait function focus on incline and decline surface angles, but most experiments fail to address the effects of surface grades that cause ankle inversion and eversion. There have been several studies of ankle angle perturbation over wider ranges of grade orientations in static conditions; however, these studies do not account for effects during the gait cycle. Furthermore, contemporary studies on this topic neglect critical sources of unnatural stimulus in the design of investigative technology. It is hypothesized that the investigation of ankle angle perturbations in the frontal plane, particularly in the context of inter-leg coordination mechanisms, results in a more complete characterization of the effects of surface grade on human gait mechanisms. This greater understanding could potentially lead to significant applications in gait rehabilitation, especially for individuals who suffer from impairment as a result of stroke. A wearable pneumatic device was designed to impose inversion and eversion perturbations on the ankle through simulated surface grade changes. This prototype device was fabricated, characterized, and tested in order to assess its effectiveness. After testing and characterizing this device, it was used in a series of experiments on human subjects while data was gathered on muscular activation and gait kinematics. The results of the characterization show success in imposing inversion and eversion angle perturbations of approximately 9° with a response time of 0.5 s. Preliminary experiments focusing on inter-leg coordination with healthy human subjects show that one-sided inversion and eversion perturbations have virtually no effect on gait kinematics. However, changes in muscular activation from one-sided perturbations show statistical significance in key lower limb muscles. Thus, the prototype device demonstrates novelty in the context of human gait research for potential applications in rehabilitation.
ContributorsBarkan, Andrew (Author) / Artemiadis, Panagiotis (Thesis advisor) / Lee, Hyunglae (Committee member) / Marvi, Hamidreza (Committee member) / Arizona State University (Publisher)
Created2016
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Description
Low back pain (LBP) is the most common symptom leading to hospitalization and medical assistance. In the US, LBP is the fifth most prevalent case for visiting hospitals. Approximately 2.06 million LBP incidents were reported during the timeline between 2004 and 2008. Globally, LBP occurrence increased by almost 200 million

Low back pain (LBP) is the most common symptom leading to hospitalization and medical assistance. In the US, LBP is the fifth most prevalent case for visiting hospitals. Approximately 2.06 million LBP incidents were reported during the timeline between 2004 and 2008. Globally, LBP occurrence increased by almost 200 million from 1990 to 2017. This problem is further implicated by physical and financial constraints that impact the individual’s quality of life. The medical cost exceeded $87.6 billion, and the lifetime prevalence was 84%. This indicates that the majority of people in the US will experience this symptom. Also, LBP limits Activities of Daily Living (ADL) and possibly affects the gait and postural stability. Prior studies indicated that LBP patients have slower gait speed and postural instability. To alleviate this symptom, the epidural injection is prescribed to treat pain and improve mobility function. To evaluate the effectiveness of LBP epidural injection intervention, gait and posture stability was investigated before and after the injection. While these factors are the fundamental indicator of LBP improvement, ADL is an element that needs to be significantly considered. The physical activity level depicts a person’s dynamic movement during the day, it is essential to gather activity level that supports monitoring chronic conditions, such as LBP, osteoporosis, and falls. The objective of this study was to assess the effects of Epidural Steroid Injection (ESI) on LBP and related gait and postural stability in the pre and post-intervention status. As such, the second objective was to assess the influence of ESI on LBP, and how it influences the participant’s ADL physical activity level. The results indicated that post-ESI intervention has significantly improved LBP patient’s gait and posture stability, however, there was insufficient evidence to determine the significant disparity in the physical activity levels. In conclusion, ESI depicts significant positive effects on LBP patients’ gait and postural parameters, however, more verification is required to indicate a significant effect on ADL physical activity levels.
ContributorsMoon, Seong Hyun (Author) / Lockhart, Thurmon (Thesis advisor) / Honeycutt, Claire (Committee member) / Peterson, Daniel (Committee member) / Lee, Hyunglae (Committee member) / Soangra, Rahul (Committee member) / Arizona State University (Publisher)
Created2023
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Description
With more people falling every year it is more important to continue to track everyday activity as well as follow the progress that someone is making over time. As well as at risk subjects, athletes are also wanting to track their activity as well as improve in finer control of

With more people falling every year it is more important to continue to track everyday activity as well as follow the progress that someone is making over time. As well as at risk subjects, athletes are also wanting to track their activity as well as improve in finer control of their motions and abilities. To improve someone’s balance, strength, flexibility, and more someone can now start to use different biological sensors to help live a healthier and better lifestyle. To build different sensors requires materials that are comfortable to wear and accurate in collecting data. Graphene has been considered a wonder material that is used in many different applications which allow circuits and devices to use the flexible and durable material to conduct electricity. This paper shows multiple different tests and 36 trials of using graphene as a device which measures pressure that can be used to analyze gait patterns. These tests involve walking on a dual force plate treadmill for 90 continuous seconds with the graphene strip in the heel of the shoe wirelessly transmitting data to be recorded. The initial tests show that graphene will pick up noise and that graphene can start to deteriorate without proper protection. When looking at subject 1 there is less than .01 seconds of error between the graphene circuit and the ground truth. The ground truth was collected simultaneously, and the t-tests and ANOVA tests showed that there is no statistical difference between the graphene system and the ground truth. These tests also showed a 96.7% reproducibility score. There are limitations as seen in the later subjects, but these limitations can be overcome by further protecting the graphene and replacing the strip when it starts to show signs of deterioration which will allow graphene to be used in everyday bio wearable devices.
ContributorsSweeten, William (Author) / Lockhart, Thurmon (Thesis advisor) / Arquiza, Jose Apollo (Committee member) / Soangra, Rahul (Committee member) / Arizona State University (Publisher)
Created2022
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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

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