A joint normalcy index to evaluate patients with gait pathologies in the functional aspects of joint mobility
Ki-Young Shin, Yong Hoon Rim, Youn Soo Kim, Hyo Shin Kim, Jae Woong Han, Chang Hyun Choi, Kyung Suk Lee, Joung Hwan Mun
The Journal of Mechanical Science and Technology, vol. 24, no. 9, pp.1901-1909, 2010
Abstract : Gait analysis using 3D motion capture systems provides joint kinematic and kinetic analysis results such as joint relative angles and
moments that can be use used to evaluate the degrees of pathological gait patterns. However, the complex data produced using these 3D
motion capture systems can only analyzed by experts, because the gait analysis is highly coupled to the kinematics of each joint. Therefore,
severalSeveral previous studies using gait analysis have relied on the data compression technique to represent gait deviation from
the average normal profiles as a single value. Even though it is important to evaluate gait pathologies at the joint level, all these previous
studies have just used a single value to evaluate the pathological gait pattern. Using just one variable for evaluation of a gait is limited in
terms of determining which joint movement patterns are getting better during rehabilitation. Therefore, in this study, a method suitable
for evaluating gait deviation during a gait was developed to provide three indices for the hip, knee and ankle joints. In addition, to validate
the proposed method in clinical cases, experimental tests were conducted on thirty thirty-six normal walkers and six patients with
cerebral palsy. Furthermore, to validate the proposed method in regards to rehabilitation, experimental tests were conducted on three
classified walking groups with imposed ankle equinus constraints. The JNI for the hip joint, knee joint and ankle were 8.78 (¡¾3.70), 2.92
(¡¾3.25) and 8.79 (¡¾4.38), respectively, in the normal walking group. However, these values were significantly different for the pathological
walking group with cerebral palsy. The JNI of the hip joint, knee joint and ankle joint were 203.73 (¡¾171.59), 81.23 (¡¾52.13) and
248.39 (¡¾149.99), respectively, for this group. There were also differences between any two of the three classified groups with imposed
ankle equinus constraints. In particular, the JNI of the ankle joint was statistically different at the p<0.01 level, and this parameter clearly
increased as the degree of the imposed ankle equinus was increased. These results demonstrate that the proposed JNI can be used as a
scalar factor to evaluate the angular deviation of each joint in normal and patient groups. In addition, this approach can be adapted to
evaluate rehabilitation and pre/post surgery.
Keyword : Gait analysis; Joint Normalcy Index (JNI); Multivariate analysis; Cerebral palsy; Rehabilitation |