Functional and Physiological Determinants of Perceived Disability in Individuals Diagnosed with Osteoarthritis of the Hip

Objectives: The main objective of this pilot study was to investigate which standardized functional and physiological test best predicted perceived disability in a single group of 21 individuals diagnosed with osteoarthritis of the hip. Design: Men and women between 60 and 70 years old with osteoarthritis of the hip were selected. If participants passed study criteria, the Western Ontario McMaster University questionnaire (WOMAC), 6 Minute Walk Test (6MWT) and Timed up and Go (TUG), strength testing and aerobic testing were obtained in one single assessment. Results: Regression analysis revealed that wait time, hip abduction strength of the affected side, Aerobic Capacity (VO2 Peak), hip Extension Peak Torque, hip Flexion Peak Torque, TUG and 6MWT were significantly correlated with the WOMAC. Yet, the 6MWT had the highest significant correlation (r = -0.86, p ≤ 0.0001); R2 = 0.75 or 75% with the WOMAC total scores, (r = -0.82, p ≤ 0.0001); R2 = 0.67 or 67% with the WOMAC function and (r = -0.60, p = .002); R2 = 0.36 or 36% with the WOMAC stiffness. While the VO2 Peak revealed the highest significant correlation (r = 0.76, p ≤ .0001); R2 = 0.57 or 57% with the WOMAC pain. Conclusions: The 6MWT and the VO2 Peak seem to be essential functional and physiological assessment tools to determine perceived disability in individuals with hip OA. The perceived disability may provide new or comprehensive knowledge of the disability problems experienced by individuals with osteoarthritis of the hip, and the association of patient perception with objective measures of functional and physiological capacity might strengthen the clinical value of this knowledge.

MRI Registration for Human Hip Kinematics

Measurement of joint kinematics can provide knowledge to help improve joint prosthesis design, as well as identify joint motion patterns that may lead to joint degeneration or injury. More investigation into how the hip translates in live human subjects during high amplitude motions is needed. This work presents a design of a non-invasive method using the registration between images from conventional Magnetic Resonance Imaging (MRI) and open MRI to calculate three dimensional hip joint kinematics. The method was tested on a single healthy subject in three different poses. MRI protocols for the conventional gantry, high-resolution MRI and the open gantry, lowresolution MRI were developed. The scan time for the low-resolution protocol was just under 6 minutes. High-resolution meshes and low resolution contours were derived from segmentation of the high-resolution and low-resolution images, respectively. Low-resolution contours described the poses as scanned, whereas the meshes described the bones’ geometries. The meshes and contours were registered to each other, and joint kinematics were calculated. The segmentation and registration were performed for both cortical and sub-cortical bone surfaces. A repeatability study was performed by comparing the kinematic results derived from three users’ segmentations of the sub-cortical bone surfaces from a low-resolution scan. The root mean squared error of all registrations was below 1.92mm. The maximum range between segmenters in translation magnitude was 0.95mm, and the maximum deviation from the average of all orientations was 1.27◦. This work demonstrated that this method for non-invasive measurement of hip kinematics is promising for measuring high-range-of-motion hip motions in vivo.

Vibrational Feedback Training System for Use with SEMG Controlled Powered Prostheses

Loss of limb results in loss of function and a partial loss of freedom. A powered prosthetic device can partially assist an individual with everyday tasks and therefore return some level of independence. Powered upper limb prostheses are often controlled by the user generating surface electromyographic (SEMG) signals. The goal of this thesis is to develop a virtual environment in which a user can control a virtual hand to safely grasp representations of everyday objects using EMG signals from his/her forearm muscles, and experience visual and vibrotactile feedback relevant to the grasping force in the process. This can then be used to train potential wearers of real EMG controlled prostheses, with or without vibrotactile feedback. To test this system an experiment was designed and executed involving ten subjects, twelve objects, and three feedback conditions. The tested feedback conditions were visual, vibrotactile, and both visual and vibrotactile. In each experimental exercise the subject attempted to grasp a virtual object on the screen using the virtual hand controlled by EMG electrodes placed on his/her forearm. Two metrics were used: score, and time to task completion, where score measured grasp dexterity. It was hypothesized that with the introduction of vibrotactile feedback, dexterity, and therefore score, would improve and time to task completion would decrease. Results showed that time to task completion increased, and score did not improve with vibrotactile feedback. Details on the developed system, the experiment, and the results are presented in this thesis.