Abstract
The purpose of this study is to develop an abnormal gait detection algorithm and a vibratory stimulation system on a lower limb to improve gait stability and prevent falls. The system consists of a gait measurement module, an abnormal gait detection module, and a vibratory stimulation module. The gait measurement module measures the vertical acceleration of the ankle during walking using an accelerometer. The measured acceleration values are sent to a portable microcontroller, which controls vibratory stimulations to the ankles based on an algorithm that detects the peak acceleration values. If the acceleration peaks are found to occur irregularly, the abnormal gait detection algorithm activates the vibratory stimulation module. To determine the effect of vibratory stimulations under dynamic condition, this study investigated the contribution of ankle muscle proprioception on the control of dynamic stability and lower limb kinematics while walking using vibratory stimulation to alter the muscle spindle output of individuals’ left lower limb. Vibrators were attached to the left ankle joint (tibialis anterior, triceps surae). Participants were required to walk along a travel path and step over an obstacle placed in their way. There were four task conditions; an obstacle (10%, 20%, and 30% of the participants’ height) was positioned at the midpoint of the walkway, or the participants’ walking path remained clear. For each obstacle condition, participants experienced either no vibration, or vibration of the tibialis anterior muscle and the triceps surae muscle of the left lower limb. Vibration began upon detection of an abnormal gait and continued for one second. Vibrating the ankle muscles of the left lower limb while stepping over an obstacle resulted in significant changes in COM behavior on both the anterior/posterior (A/P) and medial/lateral (M/L) planes. The results provide strong evidence that the primary endings of the ankle muscle spindles play a significant role in the control of posture and balance during the swing phase of locomotion by providing information on the movement of the body’s COM with respect to the support foot.














Similar content being viewed by others
References
Inglis, J. T., Frank, J. S., and Inglis, B., The effect of muscle vibration on human position sense during movements controlled by lengthening muscle contraction. Exp. Brain Res. 84:631–634, 1991. doi:10.1007/BF00230975.
Lord, S. R., Ward, J. A., Williams, P., and Anstey, K., Physiological factors associated with falls in older community-dwelling women. J. Am. Geriatr. Soc. 42:1110–1117, 1994.
Kim, C. G., An analysis of fall incidence rate and the related factors of fall in hospitalized patient. Master’s thesis, Seoul National University, 2003.
Kim, M. J., Associated factors caused by falls of older people in community-dwelling. Master’s thesis, Ewha Womans University, 2004.
Crawford, C., and Karabatsos, K., Normative values for healthy young and elderly adult populations on the KAT balance system. Issues On Aging. 18:10–14, 1995.
Inglis, J. T., Frank, J. S., and Inglis, B., The effect of muscle vibration on human position sense during movements controlled by lengthening muscle contraction. Exp. Brain Res. 84:631–634, 1991. doi:10.1007/BF00230975.
Sorensen, K. L., Hollands, M. A., and Patla, A. E., The effect of human ankle muscle vibration on posture and balance during adaptive locomotion. Exp. Brain Res. 143:24–34, 2002. doi:10.1007/s00221-001-0962-z.
Sabelman, E., Fiene, A., Timbie, A., Accelerometric activity identification for remote assessment of quality of movement. in Proceedings of the 26th Annual EMBS International Conference of the IEEE EMBS, San Francisco, CA, USA, pp.4781–4784, 2004.
Sekine, M., Tamura, T., Fujimoto, T., Fukui, Y., Classification of walking pattern using acceleration waveform in the elderly people. in Proceedings of the 22nd Annual EMBS International Conference, Chicago IL, USA, pp.1356–1359, 2000.
Ailisto, H., Lindholm, M., Mantyjarvi, J., Vildjiounaite, E., Makela, S., Identifying people from gait pattern with accelerometers. in Proceeding of SPIE, vol.5779. Biometric Technol. Hum. Identif. II, 7–14, 2005
Gafurov, D., Helkala, K., Soendrol, T., Gait recognition using acceleration from MEMs. In Proceedings of the First International Conference on Availability, Reliability and Security, 2006.
Wierzbicka, M. M., Gilhodes, J. C., and Roll, J. P., Vibration-induced postural post effects. J. Neurophysiol. 79:143–150, 1998.
Nardone, A., and Schieppati, M., Reflex contribution of spindle group Ia and II afferent input to leg muscle spasticity as revealed by tendon vibration in hemiparesis. Clin. Neurophysiol. 116:1370–1381, 2005. doi:10.1016/j.clinph.2005.01.015.
Sorensen, K. L., Hollands, M. A., and Patla, E., The effects of human ankle muscle vibration on posture and balance during adaptive locomotion. Exp. Brain Res. 143:24–34, 2002. doi:10.1007/s00221-001-0962-z.
Gilhodes, J. C., Gurfinkel, V. S., and Roll, J. P., Role of Ia muscle spindles afferents in post-contraction and postvibration motor effects genesis. Neurosci. Lett. 135:247–251, 1992. doi:10.1016/0304-3940(92)90447-F.
Shinohara, M., Moritz, C. T., Pascoe, M. A., and Enoka, R. M., Prolonged muscle vibration increases stretch reflex amplitude, motor unit discharge rate, and force fluctuations in a hand muscle. J. Appl. Physiol. 99:1835–1842, 2005. doi:10.1152/japplphysiol.00312.2005.
Narati, G., Rossi-Durand, C., and Schmied, A., Proprioceptive control of human wrist extensor motor units during an attention-demanding task. Brain Res. 1018:208–220, 2004. doi:10.1016/j.brainres.2004.05.066.
Riot-Ciscar, E., Rossi-Durand, C., and Roll, J. P., Increased muscle spindle sensitivity to movement during reinforcement manoeuvres in relaxed human subjects. J. Physiol. 523:271–282, 2000. doi:10.1111/j.1469-7793.2000.t01-1-00271.x.
McKinnon, C. D., and Winter, D. A., Control of whole body balance in the frontal plane during human walking. J. Biomech. 26:633–644, 1993. doi:10.1016/0021-9290(93)90027-C.
Prince, F., Winter, D. A., Stergiou, P., and Walt, S. E., Anticipatory control of upper body balance during human locomotion. Gait Posture. 2:19–25, 1994. doi:10.1016/0966-6362(94)90013-2.
Jian, Y., Winter, D. A., Ishac, M. G., and Gilchrist, L., Trajectory of the body COG and COP during initiation and termination of gait. Gait Posture. 1:9–22, 1993. doi:10.1016/0966-6362(93)90038-3.
Chou, L. S., Kaufman, K. R., Brey, R. H., and Draganich, L. F., Motion of the whole body’s center of mass when stepping over obstacles of different heights. Gait Posture. 13:17–26, 2001. doi:10.1016/S0966-6362(00)00087-4.
Chou, L. S., Kaufman, K. R., Hahn, M. E., and Brey, R. H., Mediolateral motion of the center of mass during obstacle crossing distinguishes elderly individuals with imbalance. Gait Posture. 18:125–133, 2003. doi:10.1016/S0966-6362(02)00067-X.
Robinovitch, S. N., Hsiao, E. T., Sandler, R., Cortez, J., Liu, Q., and Paiement, G. D., Prevention of falls and fall-related fractures through biomechanics. Exerc. Sport Sci. Rev. 28:74–79, 2000.
Pijnappels, M., Reeves, N. D., Maganaris, C. N., and van Dieen, J. H., Tripping without falling; lower limb strength, a limitation for balance recovery and a target for training in the elderly. J. Electromyogr. Kinesiol. 18:188–196, 2008. doi:10.1016/j.jelekin.2007.06.004.
Grabiner, M. D., Donovan, S., Bareither, M., Marone, J. R., Hamstra-Wright, K., and Gatts, S., Trunk kinematics and fall risk of older adults: translating biomechanical results to the clinic. J. Electromyogr. Kinesiol. 18:197–204, 2008. doi:10.1016/j.jelekin.2007.06.009.
Hsiao-Wecksler, E. T., Biomechanical and age-related differences in balance recovery using the tether–release method. J. Electromyogr. Kinesiol. 18:179–187, 2008. doi:10.1016/j.jelekin.2007.06.007.
Mille, M. L., Johnson, M. E., Martinez, K. M., and Rogers, M. W., Age-dependent differences in lateral balance recovery through protective stepping. Clin. Biomech. (Bristol, Avon). 20:607–616, 2005. doi:10.1016/j.clinbiomech.2005.03.004.
Vandervoort, A. A., and McComas, A. J., Contractile changes in opposing muscles of the human ankle joint with aging. J. Appl. Physiol. 61:361–367, 1986.
Doherty, T. J., Invited review: aging and sarcopenia. J. Appl. Physiol. 95:1717–1727, 2003.
Frontera, W., Suh, D., Krivickas, L., Hughes, V., Goldstein, R., and Roubenoff, R., Skeletal muscle fiber quality in older men and women. Am. J. Physiol. 279:C611–C618, 2000.
Acknowledgments
This work was supported by the Korea Research Foundation Grant funded by the Korean Government (MEST) (The Regional Research Universities Program/Center for Healthcare Technology Development, No. R01-2007-000-20926-0).
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Yu, M., Piao, YJ., Eun, Hi. et al. Development of Abnormal Gait Detection and Vibratory Stimulation System on Lower Limbs to Improve Gait Stability. J Med Syst 34, 787–797 (2010). https://doi.org/10.1007/s10916-009-9293-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10916-009-9293-6