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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
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Description
As life expectancy continually rises, many age-related conditions such as deteriorated gait and decreased stability begin to play a larger role in affecting the quality of life for all individuals. Medical expenses associated with falls in the elderly population surpassed $50 Billion in 2015 alone. Understanding fall risk and developing

As life expectancy continually rises, many age-related conditions such as deteriorated gait and decreased stability begin to play a larger role in affecting the quality of life for all individuals. Medical expenses associated with falls in the elderly population surpassed $50 Billion in 2015 alone. Understanding fall risk and developing robust metrics and methods of assessment has become more important than ever. While traditional fall risk has looked at classical gait parameters, dynamic stability has gained traction as a more accurate representation of stability during active movement and daily activities. This project seeks to determine the effects on the internal perturbation of gait velocity on dynamic stability represented by the Maximal Lyapunov Exponent (MLE) of multiple acceleration vectors, as well as the efficacy of varying methodology used to assess dynamic stability. Data from 15 healthy, college aged individuals was collected. Significant differences were shown between certain gait velocity trials for one analysis of the three methods explored, while overall trends suggested potential differences between gait velocities with other methodologies warranting further investigation.
ContributorsKreisler, Itai Goeta (Author) / Lockhart, Thurmon (Thesis director) / Rezvanian, Saba (Committee member) / W.P. Carey School of Business (Contributor) / Harrington Bioengineering Program (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
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Gait training therapies are methods for improving the walking stability of individuals who have difficulty walking, whether it is due to injury or neuromuscular conditions. Perturbation training that causes individuals to correct their balance and actively improve their stability could potentially lead to longer term benefits for those with unstable

Gait training therapies are methods for improving the walking stability of individuals who have difficulty walking, whether it is due to injury or neuromuscular conditions. Perturbation training that causes individuals to correct their balance and actively improve their stability could potentially lead to longer term benefits for those with unstable gait. Subjects had the medial lateral movement of their center of mass measured through motion-tracking software (D-Flow 3 and Vicon Nexus 2.2). Perturbation training completed with the GRAIL treadmill randomly triggered medial-lateral sway perturbations of 3 cm a total of fifteen times throughout a five minute training period. Data collected to compare baseline, post-training, and one week follow-up dynamic stabilities were recorded over three minutes without any perturbations. There were no statistically significant differences when comparing the results of all subjects at each instance of data collection with each other. Thus, the perturbation training had no significant impact on the dynamic stability of gait. Major limitations that lend to the inconclusive nature of this study include a small sample size, no repetitions, and only one round of training. Further work can be done to better assess the potential impacts of perturbation training on walking stability for therapeutic use.
ContributorsJamali, Neema (Author) / Lockhart, Thurmon (Thesis director) / Soangra, Rahul (Committee member) / School of Biological and Health Systems Engineering (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05