OTKA 115894

Gait analysis system for recording pelvis and hip motions

OTKA 115894
Research title: Gait analysis system for recording pelvis and hip motions
Lead researcher: Dr. Kiss Rita, DSc, dr.habil
Kutatási terv:

Consequences of the aging of the active population include increases in joint arthrosis and an increasing frequency of fractures of the femoral neck. A traditional method for the treatment of fractures of the femoral neck is screwing based on the principle of osteosynthesis [5]. It is becoming current to treat fractures of the femoral neck – particularly in case of large displacements or treatment over 24 hours – to build in metal implants / endoprostheses designed by engineers and physicians after removing the hip joint (15-40% of fractures of the femoral neck are treated this way) [6.7]. Endoprostheses restore a close to physiological motion range, ensuring joint motion and proper resistance to dynamic forces during motion. They provide appropriate joint stability by the ligaments and muscles surrounding the joint. Earlier research by our team involved the impact analysis of hip joint endoprosthesis implantation to the parameters of gait and gait variability [2, 8], but did not extend to the mechanism of action of prostheses built in during traumatic treatment (it was a reason for exclusion criteria in test participation). The treatment of pelvic girdle injuries represents a great challenge to traumatologists. With the development of motorization, high-energy accidental injuries – including pelvic injuries – are increasing in numbers, accounting for 3-6% of traumatological injuries today [9]. Earlier researches involved numerical (finite element) methods to study the effects of various treatment modes [9, 10]. It was concluded from research results that mobilization and rehabilitation can be launched sooner as stability increases; however, research did not deal with the issue of how more stable fixation modifies the kinematic and kinetic parameters of gait [10].

Treatment and ensuing rehabilitation of both traumatic injuries are extremely costly (450,000 to 750,000 HUF), so the effectiveness of rehabilitation after these types of intervention is highly important from the public health point of view. Numerical analysis of the effectiveness of rehabilitation should be more and more in the focus of research. It was proved by earlier research that the effectiveness of rehabilitation after orthopaedic surgery involving the lower limb can be properly described numerically using parameters defined by gait analysis [1-4, 8, 11]. Both procurement and maintenance costs are high in respect of the optics-based VICON and the ultrasound-based Zebris motion analysis systems used in the two gait laboratories in Hungary (Semmelweis University, Department of Orthopaedics; MÁV Hospital, Szolnok), and large space is required by the equipment. The two gait laboratories in Hungary cannot meet day-to-day demands (costs, transport difficulties, etc.). The first research topic is to develop a cheap gait analysis system (measuring method and processing software package) suitable for determining the kinematic (distance, time, and angle type) and kinetic parameters of gait.

Earlier research also proved [1-4, 8] that one of the important tasks of rehabilitation after surgical treatment is to restore gait variability and the associated balancing ability. Gait variability analysis requires recording and analysis of a number of motion cycles, which is also feasible by applying a treadmill. Treadmills commercially available are systems operated by controllable kinetic constraint, examining the subject’s forced reaction rather than real gait. The second research topic is the development of an intelligent treadmill to move the belt in accordance with the subject’s motion based on the data measured by the motion testing system.

There are various operative treatment modes of fracture of the femoral neck and pelvic fracture with the associated rehabilitation protocols. A cornerstone of the effectiveness of recovery from both traumatic injuries is the restitution of the appropriate gait pattern, variability of gait and the associated correct muscle functions, which is influenced by the selection of the surgical technique and of the rehabilitation protocol as well. Comparisons and the effectiveness of diverse surgical techniques and rehabilitation protocols have not been verified: no numerical data are available for characterizing gait and gait variability. In addition to hip prosthesis studies, gait pattern analysis can also be used for investigating the role in modifying gait of knee prostheses – used increasingly frequently – and of their geometric design. The third and fourth research topics include a comparative analysis of surgical procedures for the treatment of fractures of the femoral neck and pelvic fractures, respectively, on the basis of gait and gait variability parameters, with particular regard to the motion analysis of the pelvis, the hip joint, and the knee joint playing an important role in compensation.