Dear all CGA members, Here at Speising, Vienna-Austria we will get a complete new Motion Analysis system with the beginning of February. We also get two force plates. >From my experience from the AKH hospital I would choose a position of the second force plate right behind the first plate (no gap) but shifted by the half width of the force plate to the lateral side. Our force plate size will be about 50*50 cm. This would be our configuration for the children with CP. Also we plan to have an other position for adult of the second force plate: The same shift but 8 to 10 cm gap between the plate in the walking direction. My question to you is what positions you would recommend. We still have the option to change the plan because we do not have started to build the foundation. Best regards, Andreas -------------------------------- Privat: Mag. Andreas Kranzl Waehringer Guertel 135/23 A-1180 Wien, Austria Phone: +43 1 47 82 555 Mobil: 0676 5129787 WWW: http://members.xoom.com/Paddler -------------------------------- Arbeit: Orthopaedisches Spital Speising Labor fuer Gang- und Bewegungsanalyse Speisinger Straße 109 1130 Wien Tel: ++43-1-80182-276
Dear Andreas, and others interested, I looked into force plate positioning recently when we moved into our new lab. By a lucky accident, a lab opened up just before ours in a local hospital, and I sent my students to do a project there collecting normal adult data. You can see this lab and its force plates at: http://www.rs.polyu.edu.hk/gaitlab/fyp98/capture.jpg I was unfortunatley away in Thailand at the time of the data capture (it's a hard life over here in Asia!), but what I noticed immediately I saw the results <http://www.rs.polyu.edu.hk/gaitlab/fyp98/overview.jpg> was that the subjects were not walking naturally. They all had a short stride length and reduced walking velocity (note teh small A2 power bursts). At first I thought this was simply due to the lab dimensions (a very short walkway), but I realised later that a much more important factor was the positioning of the plates. Since they were placed together, the subjects (whether subconsciously or consciously - I don't know) targetted the plates so as to land cleanly on each with successive steps (you can actually see the subject looking at the plates in the picture). Of course, my students should have spotted this and told the subjects not to look at the plates, but I think in practice it would be very difficult for the subjects not to be influenced by the plate positions. Of course, the vast majority of patients we see in the lab are children with CP, so you could argue that this problem does not matter so much, but in my view it does, because even older children will be influenced by the plates. In my lab, therefore, I have very deliberately seperated the plates. Moreover, I have a portable Kistler plate of width only 30 cm (one of only two of its type in the world, which I managed to kidnap from Christian Calame!), and which was originally custom made for stair-climbing. I have mounted this in the modular (MERO) floor that I have, such that it can be placed in two positions - longitudinally for adults with a typically shortened stride and tranverse for children with very short stride lengths. You can see these two arrangements at: http://www.rs.polyu.edu.hk/gaitlab/plates.jpg http://www.rs.polyu.edu.hk/gaitlab/paed.jpg In my view, this small Kistler plate is a Godsend, and I wonder why manufacturers of force plates still make plates so big (40 or 50 x 50 cm) when most of us are doing gait analysis on children with very short strides most of the time. I'd especially like to hear from Kistler and AMTI why this is. Best wishes (and by the way, it would be nice to see some discussion on the list, which has been strangly one-way lately!) Chris -- Dr. Chris Kirtley MD PhD Dept. of Rehabilitation Sciences The Hong Kong Polytechnic University
Thank you for the picture of the lab with the force plates visible. It was interesting to see that not only was the subject focused on the force plate, so was everyone in the room! At the Kinetics lab in Grand Rapids, MI, USA, the force plates are hidden under a matching carpet. We have the subjects start at the same location for three trial runs, and mark where they land close to where the plates can move to each time. Then, the subject leaves the room for the physical therapy evaluation, and the forceplates are moved into position, and the carpet replaced. The subject, therefor, does not even know what we are looking for when we decide if it was a "good trial" or not. It does take extra time, since we have to process each trial at the time, but the blind results are worth it. From working with children with CP, I know that even a three year old will "stomp" on the forceplate each time if they think they should! Kristin Dart, MSPT
I have a couple of comments on the force plate position discussion that might be of interest: Since I installed Gait Labs for about 15 years (working until a few years ago for Oxford Metrics in the US) I've had the chance to set up a lot of different configurations (in 25+ labs) over the years. While I've not been involved in the day to day use after the lab has started up, I have been involved in making sure that the customer could use the lab, and that the environment and equipment worked. These comments are based on the assumption that you're setting up a lab with some sort of 3D photogrammetry system, at least one force plate and possibly an EMG system. Opinions expressed are my own. Force plate position is often one of the big questions when the lab is designed and built. For most people, given the responsibility of starting a lab, this is the first time that they've had to make this sort of discussion and it always seems to cause a lot of soul-searching. In my experience the best position for two plates is to place them adjacent to one another (separated by a gap of about 1mm) in the direction of progression of the subject down the lab walkway. The lab walkway should almost always be in the center of the lab and the force plates in the center of the walkway. This makes for an easy installation and provides the lab users with the best chance of getting the subject to produce a clean strike with one leg on one of the plates within the first two of three walks. If you have more than two plates then space them out a little further along the walkway and your chances of getting a clean strike improve somewhat. Offsetting a pair of plates slightly to either side of the walkway centerline seems to make it slightly harder to get a good strike as the subject seems to miss both plates a little more often - mainly because the subject does not always lead with the same leg as the prior trial. The walkway is always best placed down the center of the viewable part of the room. I have seen a couple of labs where the walkway was placed diagonally from corner to corner and, while this increases the length of the walkway very slightly, it can make camera placement very difficult as you're restricted in the positions of your 3D system cameras at either end of the walkway. It's not a good trade. One point to remember as you add more plates to a walkway is that, if you are using a 3D photogrammetry system, then you really need to be able to capture 3D data to complete the gait cycle both before the first plate, and after the last plate. This means that you will need a larger data capture volume (4-5 metres long) to produce accurate data unless you use smaller force plates. But using smaller force plates reduces that chance that you will get a good foot strike... I do agree that it is important that the plates are either color matched to the floor or disguised in some way - I have seen people put contact paper (normally used to line kitchen shelves) over the plates to hide them. I have seen several labs that have put carpet over the plates - this seems to work well but the carpet must be very carefully applied to avoid getting any glue around (and in) the edges of the force plate. At least one lab has had to pull the carpet up and lay it again after the carpet "settled" slightly in one direction and started applying a constant force to the plate in one axis! It's also very important that area immediately adjacent to the plate be solidly constructed so that it doesn't have any "give" in it, or sound differently to the rest of the lab floor. This reduces the chance of any subtle external cues to the subject that something is in the floor. Good construction also prevents the subject from catching their foot on the edge of the force plate. You have to balance the visibility of the force plate against the fact that the whole test will go very much faster if the people running the tests can tell immediately that the subject either got a clean force plate strike or missed... Some labs have solved the position question by installing movable plates - this has always seemed an expensive solution and I'm not certain that the lab users actually move the plates around that often in real, day to day use. Possibly in part because most 3D photogrammetry systems appear to assume that the plates are fixed to the lab and require considerably reconfiguration if the plates are moved after system setup. Regards, Edmund Cramp, Motion Lab Systems, Inc. 4326 Pine Park Drive, Baton Rouge, LA 70809 USA +1 225 928-4248 (voice, 2 lines) and +1 225 928-0261 (fax) Note - New Area Code effective April 1999! My email address is eac@emgsrus.com <mailto:eac@emgsrus.com> - web site is http://www.emgsrus.com
Dear cga subscribers, I have some strange ideas on how to avoid subjects awaring the force plates: 1) A pair of frequency-blocking goggles. Subject under testing wears this pair of goggles and do the walking as natural as he or she can. One cannot see the force plate whose surface is coated with a selective-light-frequency-absorbing material. A simpler way is to make the force plate colored differently from all else objects while the goggle block this colour. Safety on risk of falling should be observed. 2) Mask the force plates. In the old days, it's masked by carpet with same color as the ground. Modern technology and architecture made it possible by in-building sensors under the pile with the surface reveals no visible difference. 3) Stealth. From a book on espionage, a clothing using optical technology: 'instant optics folding procession', which harmonized with the surroundings to minimize the visible recognision. If such tech exists, we may probably use it on covering the plates. 4) Software that offsets the 'noise' from such influence. Advances in gait analysis machine may render such technical problem obsolete. 5) Back to basics. Study the optimum separation of two force plates to ensure such interference is minimal, which tallies with what Dr. Kirtley did. Yours, Thomas Chan Kam Kee PolyU Physio Year 3 Chan Kam Kee, Thomas Physiotherapy Year 3 Student
The following comments are based on day to day experience over 16 years using two forceplates with a video-based 3-D motion measurement system in a children's orthopaedic hospital. 1. For children, or other people who take short steps, I agree with the idea of placing the force platforms one after the other in the path of progression, without any large space between them. I do NOT agree with the idea of offsetting one of the forceplates to one side, because I think it is important to record data for both right-left and left-right double-support phases, whenever possible. If one of the forceplates is offset to one side, the tendency is to collect only one or the other double-support phase. 2. For people who take longer steps, the outputs of the two forceplates can readily be combined by a computer program to make the two adjacent forceplates look like one big forceplate. Active people who take long steps can be measured one foot at a time on this "big forceplate." After years of measuring people, many of whom found it difficult to walk, I came to regard simplicity of test procedures FOR THE TEST SUBJECT as a primary goal. Leaving the forceplates in the same place but using them differently for different subjects seemed to provide the simplest test procedures for the test subjects. Force data are very important for meaningful test results, but the quality of force data is difficult to assess by watching the test. Consequently, I always start any data processing by plotting out and examining the force and center-of-pressure data to insure that the feet were totally on the forceplates. If not, the trial is discarded without any further time being spent on it. Multiple trials are used to get the subject to step on the forceplates. If the subject does not step on the plates, he or she is started in a different place along the walkway until successful contact is made. I concur with other people's comments about the importance of avoiding targeting, that is, the tendency of a subject to alter accustomed gait in order to try to step on a forceplate. Measurements of some other variable, such as progressional velocity or acceleration, during the full period before, during and after contact with the forceplate can be used to detect such gait alterations. Best wishes for a fruitful laboratory! Larry Lamoreux Larry W. Lamoreux, Ph.D. GAIT DIMENSION P.O. Box 1186 Lafayette, CA 94549-1186 USA Telephone: 925-283-7718 FAX: 925-283-5919 Email: llamoreux@aol.com
I'd like to add a small contribution in the discussion as how to hit a force plate in the walkway. Some times, we use the following strategy, in order to obtain a maximally "natural"gait pattern, and minimizing the time to achieve a succesful trial. A self sticking little figure is put on the walkway, at approximately one stride before the force plate. The child is asked to hit this figure (make it a game), with his - let's say - left foot, and walk on untill the end of the walkway. This step is very likely not natural (due to the targeting), but the following with the same foot, that hits the "hidden" force plate, usually is. The position of the figure can be adjusted in between trials, depending on the subject's actual stride length. It can - and must - be questioned what the wash-out period of a targeted step is, but some children will get exhausted by many trails, so no representative step will be achieved at all. Kind regards, Jaap Harlaar ========================= Jaap Harlaar, PhD Dept. Rehabilitation Medicine University Hospital "Vrije Universiteit" pob. 7057 1007 MB Amsterdam The Netherlands Tel. +31 20 44 40 773 Fax. +31 20 44 40 787
We have taken a slightly different approach. We have to larger force platforms (120x60 cm) made by AMTI. They are placed side by side with a 1 cm separation, in the center of the gait lab walkway. We found this works for most of our adult and children cases. For adults that have a very long step or for running we sometimes have to preposition the subject at the start point to make them step on the plate.
You can see images of this setup at http://www.einstein.edu/phl/1214p.html and with a video of our forceline visualization system on http://www.einstein.edu/phl/clips.html
To determine "goodness" of data we use a gait consistency test as described by R. Selectar et all.
A. Esquenazi, MD- Director Gait & Motion Analysis Laboratory Regional Amputee Rehabilitation Center MossRehab Hospital/Albert Einstein Medical Center 1200 West Tabor Rd. Philadelphia PA 19141 USA Phone: 215 456 9470 Fax: 215 456 9631 A Member of the Jefferson Healthcare Network
We sometimes find that subjects either target the plates or put on their "clinic walk" for the test. Even well disguised plates are noticed and in some respects the subtler the outlines, the more 'interested' the subject is - everyone likes to play the 'lets not step on the pavement cracks' game! What we do see in the majority of these cases though is that the subject uses their 'natural' walk when returning up the walkway to the start point. So, in these cases we fake the test and get them on the way back! If your cameras are not set up for successful recording in both directions then try starting the test from the wrong end.
Jeremy Linskell, Clinical Engineer Manager, Gait Analysis Laboratory Co-Ordinator, Electronic Assistive Tehcnology Service Dundee Limb Fitting Centre Dundee, DD5 1AG, Scotland tel +1382-730104, fax +1382-480194 web: http://www.dundee.ac.uk/orthopaedics/dlfc/gait.htm
Dear all, For about a year I have avoided getting into discussion on this forum but force plates have drawn me out of my shell. Full marks to Andreas for asking the question. There seems to be a general feeling that two plates are better than one and although this may seem self evident, I feel that some fundamental issues are involved. This view has been partly vindicated by the comments from Chris on normal gait being modified to match platform spacing. Even if spacing is organised to prevent this, there may still be some modification in order to correctly contact the first platform. Concerning the comments from Kirstin Dart about using a carpet to cover the plates I have two reservations. In the first instance it is quite possible for shear forces to be transmitted between the platforms and the surroundings by the carpet. Are there any studies of the possible errors that might be introduced? More importantly, even with a platform visible, it can often be difficult to be confident that a foot has landed cleanly on a platform or that double contact has been avoided. It must be almost impossible to be sure the information is correct with a carpet obscuring the platforms. Returning to the fundamental reasons for using more than one platform, I will accept that increasing the number of platforms increases your chance of gathering useful information, but I have heard it argued that you need two platforms so as to gather double stance forces and thus get a proper understanding of the full gait cycle. Considering the layout being proposed by Andreas and two of the three featured in the Dundee site, you will find that you only gather one of the double stance periods, either left foot to right foot or the reverse. Walking over the system in the opposite direction still produces the same transition! Thus, if you really want to gather double stance forces completely, three platforms are required. This will compound the question of positioning and, I suggest, make clinical working a nightmare! I feel confident that both AMTI, Bertec, Kistler and any other manufacturer would answer Chris by saying that they will produce platforms the size and shape that are requested (I know of several labs with special size platforms). The real question is: does the gait analysis community have a real view on the ideal shape and size and is it well thought out? I suspect the answer is a resounding NO. Perhaps this area is ripe for some fundamental work. Has any such work been done? That's all folks! Richard Major Morpeth Northumberland UK
I seems about time that the force plate manufacturers get into the discussion. One of the most profound and practical answers so far came from Edmund Cramp. He mentioned almost everything which should be mentioned regarding force plate placement. Regarding the sizes: yes it is in fact possible to make almost any size of force plate. In fact we have made force plates for squirrels for an institute in Germany. While the size 40x60cm is mainly used for gait analysis (one adjacent to the other, the long way) and a wide variety of special applications the larger dimensions are often used in sports because they are easier to target. In the early days many Japanese institutes bought super large plates (up to 2 meters) which they mounted parallel for medio-lateral stride separation. While this seems to work well with the way the Japanese walk it has never been used a lot in the rest of the world. The disadvantage of very large plates is certainly the difficulty of handling and the lower natural frequency. Today there is a tendency for smaller plates for a variety of applications including gait (see Chris Kirtleys remarks about the "Godsend small plate"). Since force plates have become less expensive it has become more affordable to have three of them and measure a full gait cycle including both double stance phases. Some remarks: * A publication on the subject "Visual guidance to force plate does not influence ground reaction force variability" by Grabiner et.al. was published in Journal of Biomechanics Vol 28, No 9, pp. 1115-1117, 1995. I cannot comment it. * A carpet which is not too hard (not like linoleum) may be layed over the force plate without a gap. The force shunt will be minimal. The example mentioned by Edmund Cramp where a lab had to take the carpet out after it started applying shear forces could not have happened with a piezoelectric force plate. Best Regards Christian Calame ----------------------------------------------------------- Mr. Christian Calame, Product Manager Biomechanics Kistler Instrumente AG Winterthur, P.O.Box 304, CH-8408 Winterthur, Switzerland Tel: +41 52 224 11 11, Fax: +41 52 224 14 14 E-Mail: cl@kistler.ch, http://www.kistler.ch/biomech
Regarding Christian Calame's comments about force-plates becoming 'more affordable' and also there being a tendency for smaller plates, has anyone ever considered or used 'micro-plates', maybe 30cmx15cm or smaller, placed together in say a 4x4 matrix in the expectation that each foot would hit more than one plate, but that the plates would be small enough that both feet would not hit the same plate simultaneously during double support. Would a system like this be affordable? - I can imagine it would certainly make clinical life a lot easier! Ben Heller Medical Physics Royal Hallamshire Hospital Sheffield
As some of you know, my main concern these days is trunk accelerometry. I have followed the force plate discussion, however, and being amateurishly ignorant here, I hope I am apologized for a possibly naive idea. I wonder if a force plate for gait analysis might be constructed as a central support type with one corner being cut off at 45 degrees to be able to adjoin two plates both in the line of progression and meidiolaterally like this: _________ | | ____| | | \ | | \ ____| | | |________| (Sorry about the oblique line) From a safe distance, it seems to me that some of the alignments/small/large plate problems might find compromises this way possibly resulting in a larger rate of successful trials. But no doubt there are mountains of technical problems which I do not see from here. I am sure you can put me right. Best regards from wintry Norway Rolf Rolf Moe-Nilssen, MS, PT, Research fellow, Division of Physiotherapy Science, Department of Public Health and Primary Health Care, Faculty of Medicine, University of Bergen, Ulriksdal 8c, N-5009 Bergen, Norway, email: rolf.moe-nilssen@isf.uib.no voice:+47 55 58 61 70, fax:+47 55 58 61 30
For what its worth, our group at Surrey,UK has developed a 3.3metres long twin walkway which gives simultaneous 3D GRF, temporal and spatial data, each plate 400mm wide. This avoids most of the positioning problems encountered by the conventional force plate approach.It also gives multiple bilateral foot contact rather then just one on each traverse. If there are problems for a particular patient, then walking across them allows them to be used exactly as the smaller traditional plates. More information on our R&D by email or from our web page. http://www.surrey.ac.uk/MME/Research/BioMed/
A couple of questions appear to be coming up quite often - my experience here relates directly to the construction of Clinical Gait Analysis labs so I'll address them from this point of view, using Richard Majors message as a starting point: > There seems to be a general feeling that two plates are better than one and > although this may seem self evident, I feel that some fundamental issues > are involved. This view has been partly vindicated by the comments from > Chris on normal gait being modified to match platform spacing. Even if > spacing is organised to prevent this, there may still be some modification > in order to correctly contact the first platform. In a clinical gait test (often CP subjects in the USA) it's a reasonable assumption that the subject does not walk efficiently. This tends to mean that they get tired relatively quickly so the person conducting the test doesn't have the luxury for continually repeating the tests until they get the results that they want. Thus having more than one plate improves the chance of getting one good strike on one leg. If chances of getting a good strike on each side in the same run (for a CP subject) are so small that they can be ignored - at least from a test protocol view. My advice has always been, "If you get a L/R strike then great - but if you try to walk your subject until you get a L/R strike then it's doubtful that you'll have a representative walk because the subject may well be tired by the time that they generate the walk that you're trying to get them to do." Targeting of the plate is an issue regardless of the number of plates - this is best dealt with at the time the data is collected by careful observation of the subject. Likewise the "Doctor Walk" - the best defense for both issues is to watch the subject carefully and talk to them and/or their parents/guardians/siblings. Concerning the comments from Kirstin Dart about using a carpet to cover the plates I have two reservations. In the first instance it is quite possible for shear forces to be transmitted between the platforms and the surroundings by the carpet. Are there any studies of the possible errors that might be introduced? More importantly, even with a platform visible, it can often be difficult to be confident that a foot has landed cleanly on a platform or that double contact has been avoided. It must be almost impossible to be sure the information is correct with a carpet obscuring the platforms. I believe that there is a study on carpet vs. uncarpeted plate data and it found little difference. I have always thought that carpeted plates would modify the data but I've never seen any evidence of this happening and have not been able to distinguish carpeted force data from uncarpeted data. I would have thought that the Force Plate manufacturers would be able to provide some input on this... The issue of plate visibility in carpeted plates is a good one. In practice the users know where the plates are and seem to be able to work around this - and of course the issue of targeting goes away. Regards, Edmund Cramp, Motion Lab Systems, Inc. 4326 Pine Park Drive, Baton Rouge, LA 70809 USA +1 225 928-4248 (voice, 2 lines) and +1 225 928-0261 (fax) Note - New Area Code effective April 1999! My email address is eac@emgsrus.com <mailto:eac@emgsrus.com> - web site is http://www.emgsrus.com
I have two comments concerning the current discussion of Force Platform Layout: 1. Using a math. In our lab, we have been using a thin rubber carpet to avoid targeting for many years. Although we have not done any proper analysis, it seems unlikely to me that the carpet is transmitting any substantial forces, since the plate (piezoelectric) is extremely rigid. Before any forces are transmitted, the plate must move. If this occurs you are in trouble even without a carpet, since you no longer measure the forces between the foot and top plate (in this case you also measure inertial forces due to motion of the top plate). 2. Detection of unclean force plate hits when a carpet is used. For the staff to ensure a clean hit on the force plate we are using small white markers on the carpet in the position of the force plate corners. Such markers are also placed along the walkway at evenly distributed positions. The walkway looks like this from above: Force plate corners v v . . . . . . . . . . . . . . . . . . . . ^ ^ Force plate corners In this way the patient is guided as far as walking direction is concerned, but is not targeting the plate. The staff, on the other hand is well aware of which of the markers corresponds to the plate. (In Uppsala we also have a system where the force vectors are overlayed in real time onto video images of the walking person. By looking at a video recordning it it is easily verified if the hit was a good one.) Regards - Håkan -- *********************************************************************** * Håkan Lanshammar Systems and Control Group, Uppsala University * * P.O. Box 27, S-751 03 Uppsala, SWEDEN * * E-mail: hl@SysCon.uu.se, Tel: +46-18-471 30 33, Fax: +46-18-50 36 11* * WWW: http://www.syscon.uu.se/Personnel/hl/hl.html * ***********************************************************************
I'd like to back up the recommendations in Edmund Cramp's posting. We have 4 platforms, in line with a minimal gap between plates 1 and 2, 4" between 2 and 3, and 6" between 3 and 4. The plates are covered with linoleum matching the surrounding floor. Compared to my experience in my former lab which had 2 unmasked plates that we were constantly repositioning according to the subject, we have been very happy with this arrangement. In my opinion, the masking solves the issue of targeting. We still get kids who try to target (the gaps around the plates are still visible), but they have to look so closely to see if they are hitting the force plates, it makes the attempt obvious to detect, and generally it is then easy enough to distract these patients to make them stop trying to target. The masking does not prevent an experienced observer from detecting whether or not a clean strike is obtained. We use a sheet to keep track of left and right strikes and which plate(s) they occurred on. Using 4 platforms has dramatically reduced the number of trials needed for clean strikes, we don't insist on getting sequential left and right data, but more often than not it happens anyway, and this then becomes the preferred data. For subjects with extremely small stride lengths, we put a piece of tape down the center of the walkway and ask them to stay to one side of it, this allows us to collect data from one side only. Finally, we have not needed to set specific starting points for subjects, as other labs do. We have found that there is enough natural variability and a high enough probability of obtaining a clean strike not to have to give this instruction, and I think the less instructions needed, the more natural the walk. Bruce MacWilliams, Ph.D. Co-Director, Movement Analysis Laboratory Shriners Hospitals for Children Intermountain Unit Fairfax Rd. at Virginia St. Salt Lake City, UT 84103 Phone: 801-536-3800 Fax: 801-536-3782 Research Assistant Professor Dept. of Orthopedics University of Utah School of Medicine
Interested to see so many replies on the subject of forceplate positioning - seems to be a burning issue! The replies are all filed on the FAQ, by the way at: /faq/forceplate.html I personally cannot understand why some labs have suggested larger plates. Surely this will reduce the chances of getting a clean strike, especially in children? I guess the problem of what is the best size plate for the maximum chance of a clean strike, given a certain step length, should be solvable by an optimization method - any mathematicians out there want to give it a try? As far as modular plates made from small cells is concerned, I'm working with an electronic engineer in the UK on just that idea. He has some nice rigid piezoelectric sensors 1 cm square which are capable of measuirng shear as well as load - no moments, but I guess we can work those out from the centre of pressure if the cells are small enough. Chris -- Dr. Chris Kirtley MD PhD Dept. of Rehabilitation Sciences The Hong Kong Polytechnic University
The following paper may be of interest. I regret I couldn't get the table to print properly! Mike Whittle ---------------------------------------------------------------------- East Coast Clinical Gait Analysis Meeting, Rochester, Minnesota, 1993. EFFECT OF WALKWAY CARPETING ON GAIT ANALYSIS DATA Michael W. Whittle* and Karen J. Ferris# * The University of Tennessee at Chattanooga # Siskin Hospital for Physical Rehabilitation, Chattanooga, Tennessee INTRODUCTION With the recent growth in clinical gait analysis, there has been a move towards improving the appearance of gait laboratories (Gage, 1983), which in many cases includes carpeting the walkway, including the force platforms. The assumption is generally made that this does not affect the data obtained, but there do not appear to have been any publications on this topic. The present paper describes a study to test the hypothesis that the presence of carpeting on a gait analysis walkway does not make a significant difference to a range of commonly measured gait variables. METHODS The study was performed using a 12m walkway equipped with two Bertec 4060H force platforms and a five camera Vicon system. Ten adult volunteer subjects (5 men, 5 women) with no known disorders of the locomotor system participated in the study. The ages of the subjects were evenly spread across the range from 25 to 62 years. The standard protocol for the Vicon Clinical Manager software (Oxford Metrics, 1992) was performed with the subjects walking barefoot at a self-selected comfortable speed. Three walks were performed with the floor and force platforms covered by carpet tiles and three walks with them uncarpeted. Five of the subjects were tested first walking on the carpet, then walking on the bare floor. The other five subjects walked first on the bare floor, followed by the carpet. The carpet tiles consisted of 6mm of a dense looped pile and 2mm of stiff latex backing. Three categories of variable were chosen for analysis: the general gait parameters, 11 measurements of sagittal plane joint angle, and six components of the ground reaction force. The results from each leg, for all three walks under a given condition (carpeted or uncarpeted), were averaged and compared, using the paired t-test. RESULTS No statistically significant differences were seen between the carpeted and uncarpeted conditions for either the general gait parameters or the components of force. However, significant differences were seen between the two conditions for five measurements of sagittal plane joint angle (Table 1). DISCUSSION It might be expected that carpeting the force platforms would modify the ground reaction forces, so it is surprising that the only differences noted between the two conditions were in the joint angles. The observed differences were small, all being less than 1.5 degrees. It is possible that these results were due to random variation, since if enough variables are examined, it is likely that one or more will show significant differences. Further studies would be needed to confirm whether there are any real differences between the test conditions for these variables. Whether or not these differences are real, however, none of them was sufficiently large to be considered significant clinically. Since carpet is slightly resilient, it might be expected to reduce the magnitude of the heelstrike transient, by increasing the time to peak deceleration of the foot following initial ground contact. Although detailed measurement of the heelstrike was not attempted in the present study, it was noted that most of the subjects had a more marked heelstrike when walking on the bare floor than when walking on the carpet. The present study suggests that while there may be slight changes in gait analysis variables as a result of carpeting the walkway, the changes are unlikely to affect the results of clinical gait analysis. REFERENCES 1. Gage JR. (1983) Gait analysis for decision-making in cerebral palsy. Bulletin of the Hospital for Joint Diseases Orthopaedic Institute 43:147-163. 2. Oxford Metrics (1992) Vicon Clinical Manager Users Guide. Oxford: Oxford Metrics.
We are considering renewing the floor covering here to improve the appearance and also to reduce reflections of the current linoleum, which can cause us problems with our video and online movement analysis systems. I am concerned with the idea of using carpet on the force plates as I feel this may well affect the frequency response of the forces. If anyone knows/uses low reflective flooring in their lab (or very hard carpet!) which works well I would be really interested to know where they got it. Has anyone reported formally on different frequency responses, or rate of loading during heel strike transient using different materials? Jim Richards -------------------------------------------- Jim Richards Lecturer in Biomechanics Department of Rehabilitation University of Salford Salford UK http://www.salford.ac.uk/prosthetic/homepage.htm http://allerton-1616.salford.ac.uk
Grabiner MD, Feuerbach JW, Lundin TM & Davis BL (1995) Visual
guidance to force plates does not influence ground reaction force
variability. J Biomech 28 (9): 1115-1117.
Abendroth-Smith, J. (1996) Research Quarterly 67 (1) 97-101.
In 1979 we published the following paper for the exact
purpose/concern that you have raised:
Seliktar, R., Yekutiel, M. and Bar, A., "Gait Consistency Test
Based on the Impulse Momentum Theorem," Prosthetics and Orthotics
International 3(2), 91-98, 1979 (British Journal).
The general premise was that you allow your subject to target
himself to the force plates and screen the tests for consistency (cyclic
gait or non cyclic gait) rather than try to make your subject walk
and hit
the plates in an unbiased way. I find this approach much better especially
with individuals with neuromuscular problems.
The "consistency test" is a relatively simple one, based on
impulse-momentum consideration, and can be easily implemented
in a gait lab routine. As with many simple things, I don't think that
our
technique was widely adopted, but it's there to try never the less.
Good luck,
Hirokawa S.Normal gait characteristics under temporal and
distance constraints J
Biomed Eng 1989;1
Harrison A.J., Folland J.P., (1997) Investigation of gait
protocols for plantar pressure measurement of non-pathological subjects
using
a dynamic pedobarograph. Gait and Posture Vol 6, pp. 50-55.
The work focused primarily on pressure responses to variations
in gait controls rather than force, but I expect there would be a
similar response with force measurement.
Based on this work I have little problem with 'targeting' the
platform as long as the targeting protocol ensures the natural gait
pattern
is not noticeably distorted; e.g. a very short or very long last step.
It is obvious that wide variations in walking speed - stride
length, stride rate could affect pressure and I presume force measures.
The
problem is that we often wish to ensure we are measuring a 'natural'
gait
pattern and we worry that targeting may distort this. I would argue
that
provided the targeting protocol is reasonably representative of the
natural
stride rate and stride length, there is nothing to worry about. The
easiest
way we found to maintain a natural gait pattern and allow targetting
(and hence fewer lost trials) was to use a stride length control (SLC).
The exact protocols for this is described in the paper.
Dr Neil Fowler
Dept Exercise and Sport Science
Manchester Metropolitan University
Hassall Road
Alsager
Cheshire
ST7 2HL
Tel 0161 247 5466
Fax 0161 247 6375
email N.Fowler@mmu.ac.uk
I am about to install a 6-camera 3D Peak Performance system here, and
am
teaming up with a civil engineer who is interested in earthquakes.
We
are building a moving platform which will shaken by a large hydraulic
actuator. I am hoping this will provide a nice facility for studying
the
effect of perturbations on gait.
My question relates to the best placement for force platforms under
such
conditions. I know we have discussed this before. However, one
arrangement that we didn't mention, which I am thinking might be worth
considering is to have two long (e.g. 1.5 m or so) force platforms
longways side by side, with the subject walking down the center-line
between them. I am thinking that, providing the subject can walk
reasonably straight and has a step width greater than an inch or so
(I
suspect it may be considerably greater than this when I start shaking
the platform around!), this would allow every step to be recorded.
What are your thoughts on such an arrangement? Has anyone ever seen
it
tried anywhere?
Chris
--
Dr. Chris Kirtley MD PhD
Associate Professor
HomeCare Technologies for the 21st Century (Whitaker Foundation)
NIDRR Rehabilitation Engineering Research Center on TeleRehabilitation
Dept. of Biomedical Engineering, Pangborn 105B
Catholic University of America
I think your proposal is most interesting and multiple measurements
are
very useful. We use it particularly for amputee and CP gait studies.
Although we have not tried to make a moveable platform, you and other
subscribers may be interested in our (in house designed and built)
3.3
metre
twin force platforms at CBEC. More details are on our web site.
Chris Stevens
Chris Stevens
Biomedical Engineering Group,
SMME,
University of Surrey
Guildford
GU2 7XH
UK
Tel: +44 (0)1483 259683
Fax: +44 (0) 1483 879395
c.stevens@surrey.ac.uk
http://www.surrey.ac.uk/MME/Research/BioMed/
Supply, installation and calibration of 3.3 m. dual force platform walkway
45,000 pounds, excluding shipping and taxes.
David has also developed video vector software for use with the
platform,
cost depends on amount and type of hardware required.
I have also copied both your emails to David, who is probably a better
person to answer your question on Qualisys model.
Best
Chris S
The motor control lab at the University of Oregon, under the direction
of Marjorie Woollacott, has a pair of moveable platforms embedded
in
a walkway. The walking surface of the platforms was about 30cm
x 54cm,
and each plate had a maximum excursion of about 30cm. The plates
were housed in independent carriages that could be translated on tracks
allowing the plates to be staggered by any amount, or to be side by
side.
The two plates were offset to the inside of their individual carriage,
leaving
only a small distance between plates. This allowed us to do walking
studies
(plates staggered, capturing sequential foot contacts) and standing
perturbations
(plates side by side).
As part of my doctoral work, I spent a fair amount of time working with
this system and ironing out many kinks (from the sound of the hydraulic
pump
to post-collection force plate data processing necessary to separate
out the
effects of accelerating the plate and its strain gauges). If
you have any
other
questions I'd be happy to share some of our experiences out there,
or I can
put you in touch with people at Oregon who may have something to offer
you
in the planning stages.
Cheers,
Krisanne
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Krisanne E. Bothner, Ph.D.
Motion Analysis Center
Mary Free Bed Hospital & Rehabilitation Center
2020 Raybrook SE Suite 101
Grand Rapids, MI 49546
voice: 616.954.2318 fax: 616.954.2475
Regards,
Edmund Cramp,
Motion Lab Systems, Inc.
4326 Pine Park Drive, Baton Rouge, LA 70809 USA
+1 225 928-4248 (voice, 2 lines), +1 225 928-0261 (fax)
email eac@motion-labs.com <mailto:eac@motion-labs.com>
web site http://www.motion-labs.com <http://www.motion-labs.com>
Håkan Lanshammar, Professor,
Head of Department
Dept. of Information Technology, Systems and Control, Uppsala Univ.
P.O. Box 27, S-751 03 Uppsala, SWEDEN
E-mail: hl@SysCon.uu.se, Tel: +46-18-471 30 33, Fax: +46-18-50 36 11
WWW: http://www.syscon.uu.se/Personnel/hl/hl.html
Alberto Esquenazi, MD
Director Gait & Motion Analysis Laboratory and
Regional Amputee Center
MossRehab
1200 West Tabor Rd.
Philadelphia, PA 19141 USA
Voice: 215 456 9470 Fax: 215 456 9631
Email: Aesquena@aehn2.einstein.edu
http://www.einstein.edu/phl/1214p2.html
A Member of the Jefferson Health Network
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