In order to achieve a level of community involvement and physical independence, being able to walk is the primary aim of many stroke survivors. It is therefore one of the most important goals during rehabilitation. Falls are common in all stages after stroke. Reported fall rates in the chronic stage after stroke range from 43 to 70% during one year follow up. Moreover, stroke survivors are more likely to become repeated fallers as compared to healthy older adults. Considering the devastating effects of falls in stroke survivors, adequate fall risk assessment is of paramount importance, as it is a first step in targeted fall prevention. As the majority of all falls occur during dynamic activities such as walking, fall risk could be assessed using gait analysis. It is only recent that technology enables us to monitor gait over several consecutive days, thereby allowing us to assess quality of gait in daily life. This thesis studies a variety of gait assessments with respect to their ability to assess fall risk in ambulatory chronic stroke survivors, and explores whether stroke survivors can improve their gait stability through PBT.
Introduction: Falling causes long term disability and can even lead to death. Most falls occur during gait. Therefore improving gait stability might be beneficial for people at risk of falling. Recently arm swing has been shown to influence gait stability. However at present it remains unknown which mode of arm swing creates the most stable gait. Aim: To examine how different modes of arm swing affect gait stability. Method: Ten healthy young male subjects volunteered for this study. All subjects walked with four different arm swing instructions at seven different gait speeds. The Xsens motion capture suit was used to capture gait kinematics. Basic gait parameters, variability and stability measures were calculated. Results: We found an increased stability in the medio-lateral direction with excessive arm swing in comparison to normal arm swing at all gait speeds. Moreover, excessive arm swing increased stability in the anterior–posterior and vertical direction at low gait speeds. Ipsilateral and inphase arm swing did not differ compared to a normal arm swing. Discussion: Excessive arm swing is a promising gait manipulation to improve local dynamic stability. For excessive arm swing in the ML direction there appears to be converging evidence. The effect of excessive arm swing on more clinically relevant groups like the more fall prone elderly or stroke survivors is worth further investigating. Conclusion: Excessive arm swing significantly increases local dynamic stability of human gait.
BACKGROUND: Instability of the knee joint during gait is frequently reported by patients with knee osteoarthritis or an anterior cruciate ligament rupture. The assessment of instability in clinical practice and clinical research studies mainly relies on self-reporting. Alternatively, parameters measured with gait analysis have been explored as suitable objective indicators of dynamic knee (in)stability.RESEARCH QUESTION: This literature review aimed to establish an inventory of objective parameters of knee stability during gait.METHODS: Five electronic databases (Pubmed, Embase, Cochrane, Cinahl and SPORTDiscuss) were systematically searched, with keywords concerning knee, stability and gait. Eligible studies used an objective parameter(s) to assess knee (in)stability during gait, being stated in the introduction or methods section. Out of 10717 studies, 89 studies were considered eligible.RESULTS: Fourteen different patient populations were investigated with kinematic, kinetic and/or electromyography measurements during (challenged) gait. Thirty-three possible objective parameters were identified for knee stability, of which the majority was based on kinematic (14 parameters) or electromyography (12 parameters) measurements. Thirty-nine studies used challenged gait (i.e. external perturbations, downhill walking) to provoke knee joint instability. Limited or conflicting results were reported on the validity of the 33 parameters.SIGNIFICANCE: In conclusion, a large number of different candidates for an objective knee stability gait parameter were found in literature, all without compelling evidence. A clear conceptual definition for dynamic knee joint stability is lacking, for which we suggest : "The capacity to respond to a challenge during gait within the natural boundaries of the knee". Furthermore biomechanical gait laboratory protocols should be harmonized, to enable future developments on clinically relevant measure(s) of knee stability during gait.
LINK
The textile and clothing sector belongs to the world’s biggest economic activities. Producing textiles is highly energy-, water- and chemical-intensive and consequently the textile industry has a strong impact on environment and is regarded as the second greatest polluter of clean water. The European textile industry has taken significant steps taken in developing sustainable manufacturing processes and materials for example in water treatment and the development of biobased and recycled fibres. However, the large amount of harmful and toxic chemicals necessary, especially the synthetic colourants, i.e. the pigments and dyes used to colour the textile fibres and fabrics remains a serious concern. The limited range of alternative natural colourants that is available often fail the desired intensity and light stability and also are not provided at the affordable cost . The industrial partners and the branch organisations Modint and Contactgroep Textiel are actively searching for sustainable alternatives and have approached Avans to assist in the development of the colourants which led to the project Beauti-Fully Biobased Fibres project proposal. The objective of the Beauti-Fully Biobased Fibres project is to develop sustainable, renewable colourants with improved light fastness and colour intensity for colouration of (biobased) man-made textile fibres Avans University of Applied Science, Zuyd University of Applied Sciences, Wageningen University & Research, Maastricht University and representatives from the textile industry will actively collaborate in the project. Specific approaches have been identified which build on knowledge developed by the knowledge partners in earlier projects. These will now be used for designing sustainable, renewable colourants with the improved quality aspects of light fastness and intensity as required in the textile industry. The selected approaches include refining natural extracts, encapsulation and novel chemical modification of nano-particle surfaces with chromophores.
The textile and clothing sector belongs to the world’s biggest economic activities. Producing textiles is highly energy-, water- and chemical-intensive and consequently the textile industry has a strong impact on environment and is regarded as the second greatest polluter of clean water. The European textile industry has taken significant steps taken in developing sustainable manufacturing processes and materials for example in water treatment and the development of biobased and recycled fibres. However, the large amount of harmful and toxic chemicals necessary, especially the synthetic colourants, i.e. the pigments and dyes used to colour the textile fibres and fabrics remains a serious concern. The limited range of alternative natural colourants that is available often fail the desired intensity and light stability and also are not provided at the affordable cost . The industrial partners and the branch organisations Modint and Contactgroep Textiel are actively searching for sustainable alternatives and have approached Avans to assist in the development of the colourants which led to the project Beauti-Fully Biobased Fibres project proposal. The objective of the Beauti-Fully Biobased Fibres project is to develop sustainable, renewable colourants with improved light fastness and colour intensity for colouration of (biobased) man-made textile fibres Avans University of Applied Science, Zuyd University of Applied Sciences, Wageningen University & Research, Maastricht University and representatives from the textile industry will actively collaborate in the project. Specific approaches have been identified which build on knowledge developed by the knowledge partners in earlier projects. These will now be used for designing sustainable, renewable colourants with the improved quality aspects of light fastness and intensity as required in the textile industry. The selected approaches include refining natural extracts, encapsulation and novel chemical modification of nano-particle surfaces with chromophores.
The textile and clothing sector belongs to the world’s biggest economic activities. Producing textiles is highly energy-, water- and chemical-intensive and consequently the textile industry has a strong impact on environment and is regarded as the second greatest polluter of clean water. The European textile industry has taken significant steps taken in developing sustainable manufacturing processes and materials for example in water treatment and the development of biobased and recycled fibres. However, the large amount of harmful and toxic chemicals necessary, especially the synthetic colourants, i.e. the pigments and dyes used to colour the textile fibres and fabrics remains a serious concern. The limited range of alternative natural colourants that is available often fail the desired intensity and light stability and also are not provided at the affordable cost . The industrial partners and the branch organisations Modint and Contactgroep Textiel are actively searching for sustainable alternatives and have approached Avans to assist in the development of the colourants which led to the project Beauti-Fully Biobased Fibres project proposal. The objective of the Beauti-Fully Biobased Fibres project is to develop sustainable, renewable colourants with improved light fastness and colour intensity for colouration of (biobased) man-made textile fibres Avans University of Applied Science, Zuyd University of Applied Sciences, Wageningen University & Research, Maastricht University and representatives from the textile industry will actively collaborate in the project. Specific approaches have been identified which build on knowledge developed by the knowledge partners in earlier projects. These will now be used for designing sustainable, renewable colourants with the improved quality aspects of light fastness and intensity as required in the textile industry. The selected approaches include refining natural extracts, encapsulation and novel chemical modification of nano-particle surfaces with chromophores.
