000152003 001__ 152003
000152003 005__ 20180501105941.0
000152003 0247_ $$2doi$$a10.5075/epfl-thesis-4878
000152003 02470 $$2urn$$aurn:nbn:ch:bel-epfl-thesis4878-5
000152003 02471 $$2nebis$$a6163714
000152003 037__ $$aTHESIS_LIB 000152003 041__$$aeng
000152003 088__ $$a4878 000152003 245__$$aAmbulatory Assessment of Foot Kinematics and Kinetics$$bOutcome Evaluation of Ankle Osteoarthritis Treatments 000152003 269__$$a2010
000152003 260__ $$aLausanne$$bEPFL$$c2010 000152003 300__$$a276
000152003 336__ $$aTheses 000152003 520__$$aTwo surgical treatments exist for ankle osteoarthritis       (AO): ankle arthrodesis (AA) and total ankle replacement       (TAR). Due to advantages and drawbacks of each treatment,       decision making about these treatments is still a clinical       question and thus, their outcome evaluation is of clinical       interest. So far, outcome evaluation has been done via       clinical scales based on questionnaires and clinical       observations. However, clinical scales are subjective and are       not accurate enough to detect subtle alterations in foot       function. Therefore, objective outcome tools such as       instrumented gait analysis are advantageous for evaluation of       ankle osteoarthritis and its surgical treatments. In       particular, possible alterations of kinematics and kinetics       of ankle and other foot joints during gait can be relevant       for outcome evaluation of these treatments. On the other       hand, gait analysis has been performed in gait laboratories       using complex and expensive equipments which are not       available in all clinics. Besides, limited measurement space       of gait laboratories can perturb the natural gait. Therefore,       there is a need for in-field gait analysis for outcome       evaluation of ankle osteoarthritis treatments. The aim of this thesis is to design and validate new       ambulatory systems for kinematics and kinetics assessment of       multi-segment foot during long-distance gait and to apply       these systems for objective outcome evaluation of ankle       osteoarthritis treatments. The present study proposed objective kinematic criteria       for foot segmentation. According to these criteria, for       clinical evaluations, foot and ankle complex could be       reliably divided into shank, hindfoot, medial forefoot,       lateral forefoot and toes. Then, in order to choose an       appropriate joint kinematics descriptor, the common       mathematical tools to describe the kinematics of foot joints       were evaluated and showed similarly high consistency in their       results and enough low sensitivity to measurements       errors. New algorithms were introduced to estimate rotation of       foot joints, 3D ground reaction force and kinetics of foot       joints (force, moment and power) using ambulatory systems.       First, kinematics of multi-segment foot was assessed, based       on body-fixed inertial sensors (3D gyroscope ad 3D       accelerometer) on shank, hindfoot, forefoot and toes. Second,       plantar pressure insole, as an available ambulatory system in       clinics, was used for assessing 3D ground reaction force. An       optimal algorithm was proposed for estimating the 3D ground       reaction force based on plantar pressure distribution. Third,       inertial sensors and pressure insole were used for ambulatory       assessment of multi-segment foot joints kinetics. These       designed systems were validated with gold standard reference       systems. As an advantage, they can be easily used in       different clinical environments for long-distance field       measurement without perturbing the natural gait. After technical validation of the designed measurement       systems, their suitability and efficiency for clinical       evaluations were investigated within a clinical protocol.       Four populations were involved in the study: patients with       AO, patients with TAR, patients with AA and healthy subjects.       Gait parameters were measured by ambulatory systems in       long-distance walking and were compared between patient       groups and healthy subjects. In general, kinetics of foot       joints and pressure parameters showed alteration of foot       function after AO and were not completely restored after both       treatments. Rotation of joints showed improvement only after       TAR. Spatio-temporal parameters of gait and their variability       showed both of the mentioned effects as well as improvements       after both TAR and AA. Therefore, the proposed parameters       could detect the differences between patients and healthy       subjects before and after both treatments. These parameters       also showed clinical relevance based on their correlation       with clinical scales. In this thesis, using an ambulatory system consisted of       inertial sensors and plantar pressure insoles, a new way of       gait analysis to evaluate the function of the foot and ankle       complex was proposed and validated. The results provided       pertinent metrics for objective outcome evaluation of ankle       osteoarthritis treatments and confirmed the suitability of       this system for clinical routine uses.
000152003 6531_ $$aBiomechanics 000152003 6531_$$aGait Analysis
000152003 6531_ $$aTotal Ankle Replacement 000152003 6531_$$aAnkle Arthrodesis
000152003 6531_ $$aMulti-segment Foot 000152003 6531_$$aInertial Sensor
000152003 6531_ $$aPressure Insole 000152003 6531_$$aOutcome Evaluation
000152003 6531_ $$aBiomécanique 000152003 6531_$$aAnalyse de la marche
000152003 6531_ $$aArthroplastie 000152003 6531_$$aArthrodèse
000152003 6531_ $$aCheville 000152003 6531_$$aPied multi-segments
000152003 6531_ $$aCapteurs inertiels 000152003 6531_$$aSemelles de pression
000152003 6531_ $$aEvaluation des résultats 000152003 700__$$0242459$$aRouhani, Hossein$$g169278
000152003 720_2 $$0240167$$aAminian, Kamiar$$edir.$$g104385
000152003 8564_ $$s5959657$$uhttps://infoscience.epfl.ch/record/152003/files/EPFL_TH4878.pdf$$yTexte intégral / Full text$$zTexte intégral / Full text
000152003 909C0 $$0252052$$pLMAM$$xU10303 000152003 909CO$$ooai:infoscience.tind.io:152003$$pDOI$$pthesis$$pthesis-bn2018$$pDOI2$$pSTI 000152003 918__$$aSTI$$cCBT$$dEDBB
000152003 919__ $$aLMAM 000152003 920__$$b2010
000152003 970__ $$a4878/THESES 000152003 973__$$aEPFL$$sPUBLISHED 000152003 980__$$aTHESIS