In this study, before developing the aforementioned simulator-based education method for walking assistance techniques, we attempted to quantify the techniques of skilled physical therapists (PTs) using a humanoid simulator (model).
The subjects were eight physical therapists (PTs) who had experience assisting stroke individuals with hemiplegia to walk backward using a KAFO within a month in a clinical setting. The PTs and the model were each fitted with 17 sensors of Inertial Measurement Unit motion capture (IMU-MoCap). The PTs were briefed in advance that the model was a person with severe left hemiplegia due to a stroke and that they were to aid using methods they thought would be effective for this individual. The angles of the PTs' and the model's left (paretic) hip and knee joints were extracted from the data obtained from the IMU-MoCap, and angular velocity was also calculated (for two walking cycles). Furthermore, cross-correlation analysis was performed to check for waveform and phase delay similarities.
The PT's lower limbs were predominantly in a flexed position. On the other hand, the model's hip joints were straightened during the late stance phase. Regarding the angular velocity data for the PT and model is left (paralyzed side) hip joint flexion and extension, the timing of the PT's maximum angular velocity tended to be slightly earlier than the model's maximum angular velocity, and the PT's maximum angular velocity tended to be smaller than the model's. The maximum hip adduction angle of the model was 1.3 ± 7.6 degrees. The correlation coefficient for the waveform similarity of the hip flexion-extension angles of the PT and model was 0.71 ± 0.18, and the phase delay was -0.03 ± 0.06 s.
Skilled physical therapists could replicate an effective gait, aligning with previous research. The synchronization of hip flexion and extension movements between the therapists and the model was notable. However, the therapists tended to reach the maximum hip flexion angle momentum earlier than the model, indicating a unique and effective operating form. These findings provide valuable insights into the techniques of skilled physical therapists in assisting stroke individuals with hemiplegia to walk using a KAFO.
The results of this study have the potential to advance the development of simulator education in high-risk physical therapy techniques.
knee-ankle-foot orthosis
physical therapy techniques
