Gait Analysis

The team was fortunate enough to use the new Practice Point Motion Capture and Gait Analysis room that was newly built and finished in February 2019. This room featured ten infrared cameras set up around the room as well as two force plates in the center of the room. Four video cameras allow for recording of the motion capture session as well as a graphical overlay which validates that the software is accurately tracking the markers. A lower body modeling plugin was used which allows the system to recognize a subject’s gait that outputs the kinematic and kinetic calculations that were required for static analysis. The outputs included are shown below:

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Output Kinematics: Angles Description

AbsAnkleAngle The angle between the AJC to KJC vector and the AJC to TOE vector

AnkelAngles _{Relative. The angles between the shank and the} foot

FootProgressAngles Absolute. The angles between the foot and the global coordinate system

HipAngles Relative. The angles between the pelvis and the thigh

KneeAngles Relative. The angles between the thigh and the shank

PelvisAngles Absolute. The angles between the pelvis and the laboratory coordinate system Table 5: Gait plug-in outputs of angles and descriptions

Output: Kinematics Description

Forces

AnkleForce The force between the shank and the foot

GroundReactionForce The force exchanged between the foot and te ground while walking

HipForce The force between the pelvis and the thigh

KneeForce The force between the thigh and the shank

NormalizedGRF The ground reaction force expressed as a percentage of the body weight

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Moments

AnkleMoment The moment between the shank and the foot

HipMoment The moment between the pelvis and the thigh

KneeMoment

The moment between the thigh and the shank WaistMoment The moment between the pelvis and the thorax

Table 6: Gait plug-in outputs and descriptions of force and moment

Output: Powers Description

AnklePower The power between the shank and the foot

HipPower The power between the pelvis and the thigh KneePower The power between the thigh and the shank

WaistPower The power between the pelvis and the thorax Table 7: Vicon output reference for powers and descriptions

The parameters of interest are knee moments, ground reaction forces, and knee angles. With these

calculations, the exact location of the biomarkers was important for auto labeling of the left and right side of the body. In order to locate the precise point for placing the knee markers (LKNE, RKNE), the subject was instructed to passively flex and extend the knee. Then identify where the knee joint axis passes through the lateral side of the knee by finding the lateral skin surface that comes closest to remaining fixed in the thigh. This is the point where the lower leg appears to rotate, which is 1.5 cm above the joint line, mid way between the front and back of the joint. This is where the marker should be placed. Figures 22, 23, and 24 below show the exact placement of the markers.

33 Figure 22: Front view of lower body

Figure 23: Back view of lower body

Figure 24: Side view of lower body

The THI and TIB markers anterior-posterior position is critical for identifying the orientation of the knee and ankle flexion axis. The thigh markers (LTHI, RTHI) are used to calculate the knee flexion axis orientation and the tibia markers (LTIB, RTIB) are used to determine the alignment of the ankle flexion axis. Using a subject, the markers were as instructed. This is shown in Figures 25, 26, 27, and 28. The subject was also instructed to raise their arms as if they were riding a motorcycle, which is the

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predetermined position that allowed accurate reading of the markers and full visibility. This is shown in Figure 29.

Figure 25 & 26: Preliminary Trial Marker Placement

35 Figure 29: Preliminary Trial Calibration Stance

This configuration was the correct marker placement on the subject. Once all markers were placed, and the subject got into the correct position in the middle of the force plates, the system was then calibrated for every trial. This occurred before any testing was performed.

36 Figure 31: Vicon Software Overall Toe-off Phase

Figures 30 and 31 show screen captures of the gait trials taken from the Vicon system. An overlay shown by the red, green, and blue lines correspond with the marker placement on the subject. This gives

validation that the raw data matches with the motion capture footage. Figure 30 shows when the subject is in the heel strike cycle. Figure 31 shows when the subject is in the toe off phase in the gait cycle. Using the different gait cycle phases, the moment and knee angles can be compared throughout the preliminary trials as well as when the device is active on the subject. Force plates, shown by the green and red 1 and 2 give information about any misalignment in the legs as well as where the center of pressure from the feet are during the gait cycle. Even weight distribution is a key aspect that the final design should have. The data can determine if one leg is applying more weight than the other which will have an effect on the overall design.

As a baseline, the group collected preliminary gait data from four iterations to show a normal gait cycle. Throughout all the gait cycles, the subject was instructed to walk in a straight line at their normal walking speed. Also, the subject started at a certain distance away from the force plates to ensure that they started at heel strike with their right leg on the right force plate. Raw data will allow us to compare results from gait trials when the subject has the brace on the leg. The parameters compared were the ground reaction forces in the z-direction, knee angles in x-direction, and knee moment in the x-direction. For reference, the first large peak in the data corresponds to the right foot when it is going through the gait cycle on the right force plate. Then the second large peak corresponds to the left foot at heel strike to toe off.

37 Figure 32: Knee Angle Preliminary Trial Results.

The line with the first peak is the right leg hitting the force plate and the second line with the second peak is the left leg hitting the second force plate.

Preliminary Angle Trials Max Values Right Leg (degrees) Max Values Left Leg (degrees)

Walking Trial 1 51.5410 55.2657

Walking Trial 2 53.3074 55.0731

Walking Trial 3 52.0245 56.4347

Walking Trial 4 51.7517 56.3097

Table 8: Knee Angle Preliminary Trial Overall Results

Figure 32 and table 8 show the raw data from four motion capture walking trials. The graph also shows the average data line as a dashed line. This will be the baseline to compare with the knee angles when the brace is on the patient. The table with the max values also provide a range of motion insight. The

maximum knee angle is 56.3 degrees which means the device needs to provide a minimum of this amount of degrees of flexion.

38 Figure 33: Ground Reaction Force Preliminary Trial.

The first ground reaction force pattern is of the right leg and the second ground reaction force pattern is of the left leg.

Preliminary GRF Trials Max Values Right Leg (Newtons)

Max Values Left Leg (Newtons)

Walking Trial 1 10.5543 10.5993

Walking Trial 2 10.5290 10.7453

Walking Trial 3 10.4625 10.5534

Walking Trial 4 10.2640 10.3425

Table 9: Ground Reaction Force Preliminary Max Values

Figure 33 and table 9 show the raw ground reaction force data from all trials as well as the average curve. The max values are also noted in the table above. A max ground reaction force of 10.7N provides data used in the static analysis.

39 Figure 34: Knee Moment Preliminary Trial Results

Preliminary Moment Trials Max Right Leg Values (Nm) Max Left Leg Values (Nm)

Walking Trial 1 34.8119 39.0439

Walking Trial 2 43.4541 44.6616

Walking Trial 3 32.9400 40.8517

Walking Trial 4 32.3426 33.7669

Table 10: Knee Moment Preliminary Trial Max Values

Figure 34 and Table 10 show the results from the smoothed moment data from all the trials. The average curve will be used to confirm what was found in previous studies about the torque requirements of flat walking. The max knee moment value is 44.7Nm. These values were calculated by converting millimeters to meters from the raw data as well as multiplying all values by 60kg, which is the subject’s weight.

4.1.4 Motion Capture Centroid Plot

40 Figure 35: Knee Centroid Plot

Figure 35 shows the centroid plot. This data was generated with motion capture markers while the subject was performing multiple movements, prioritizing the bending motion. Once preliminary testing was completed, designs could be tested to see which would be able to satisfy the parameters found through research and the preliminary testing.