investigation methods ii. - home | bme-mmbencsik/lectureinvivo.pdf · classification of examination...
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Investigation methods II.
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Classification of examination methods
• Examination of live-dead tissues: SUBJECT TO APPROVAL
• Examinations according to the method:
• In vitro examination (examination on dead tissues)
• In vivo examination (examination on live bodies)
• Examinations according to types:
• Static
• Dinamic
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Motion patterns
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Motion analysis
Investigation of different motion patterns
Goal:
– Survey of motoric ability
– Learning of motion, checking the motoric memory.
– Analysis of special motion patterns
– Control the results of motion therapy and rehabilitation.
– Scientific research on motion analysis
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Types
• Kinematics: determination of the position and theorientation in the space as the function of time (e.g.Cartesian coordinate system)
Moving body
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• Kinematics: description of different motion forms, respect to a given reference frame (e.g.Cartesian coordinate system) in the function of time
• Kinetics: The investigation of forces which produce themotion
Types
Reaction force and the measuring of the pressure distribution in the function of time
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Types
• Kinematics: description of different motion forms, respect to a given reference frame (e.g. Cartesian coordinate system) inthe function of time
• Kinetics: The investigation of forces which produce the motion
• Else: Analysis of the activation of the muscles (elektromyography EMG),reaction time measuremt
m. vastus lat.
-400.0
-200.0
0.0
200.0
400.0
0.0 200.0 400.0 600.0 800.0 1000.0 1200.0
time [msec]
[mV
]
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Summarizing the motion analysis
– Goal;
– Type;
– Base;
– Equipment:
– Process of the measurement
– Measured quantities
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Kinematical investigations
Static Investigations
Goal Analysis of the relative orientation of body segments respect to each otherin a fixed position.
Types, equipments
• Radiological investigations;
• Lengths measurements, axis measurements.
• Stability mesurements;
• Phots shoots.
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Radiological investigation
Goal:• Detect of individual
deviations (fractures,degree of arthrosis -Kellgren - Lawrence scale)
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Radiological investigation
Goal:• Detect of individual deviations (fractures, degree of arthrosis
- Kellgren - Lawrence scale)
• Determination of position of inbulidposthesises
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Radiological investigation
Goal:• Detect of individual deviations (fractures,
degree of arthrosis - Kellgren - Lawrencescale)
• Determination of position of inbulid posthesises
• Determination of spatial position ofassigned bones using the charactheristicpoints of the bones (endpoints)
segment
Anatomic point
bone
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Radiológiai vizsgálatok
Goal– Detect of individual deviations
(fractures, degree of arthrosis
- Kellgren - Lawrence scale)
– Determination of position of
inbulid posthesises
– Determination of spatial
position of assigned bones
using the charactheristic
points of the bones
(endpoints)
– Determination of relativeangles in the joints (angleof the axis)
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RSA – Radiostereo-metryanalysis
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RSA methods, process
Markerbased
• Placing of (tantalum balls with 1 mm diameter ) markers
• Making X-ray images using a measurement frame or plate
• Identifying of markers and determination of coordinates based on the X-ray images.
• Calculation of the spatial coordinates of the markers.
• Calculation of the migration of the implants
Modelbased (without markers)
• Comparison of the models• Determination of the integrated
implant’s contour using X-ray• Calculation of the integrated
implant’s contour using digitaltechnics
• Determination of the non-overlapping areas
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Marker basedPlacing the markers
Injection into the bone duringsurgery
• knee: femur and tibia
• Hip: pelvis and proximal
Builiding into the prosthesis duringthe manufacturing or duringsurgery
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Markerbased RSAMaking X-ray images
• Under standard circumstances
• Nearly in the same time
• Using two X-ray tube
• Using measuring plate ormeasuring frame (globalcoordinate system)
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Markerbased RSAMaking X-ray images
Measurement plate (extrapolation)
X-ray tube 1.
Observed object
Tantulum balls,Points of an outer coordinate system
X-ray filmMeasurement plate
X-ray tube 2.
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Measurement frame (interpolation)
Measuring frame
X-ray film
Tantulum balls,Points of an outer coordinate system
X-ray tube 1
Markerbased RSAMaking X-ray images
X-ray tube 2
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Markerbased RSADetermination of coordinates
• Identifying the markers
• Digitalization
• Distinguish, markers of the prosthesis and bones and the markers of the frame
• Determination of the planar coordinates of the markers.
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Markerbased RSADetermination of coordinates
• Coordinate transformation
The transformation of local coordinates (respect to the bone) into the global (measuring frame, measuring plate) coordinate system
• Determination of the spatial coordinate using mathematical methods
•Newton-Gauss
•FCP
•DLT
•DIRSA
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Marker-based RSAComputation of migration
Migration:
The displacement of the implanted implants, prosthesises respect to implated markers
Tracking in time
Short term(1-5 years)
Long term (>5 years)
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RSA methods, process
Markerbased
• Placing of (tantalum balls with 1 mm diameter ) markers
• Making X-ray images using a measurement frame or plate
• Identifying of markers and determination of coordinates based on the X-ray images.
• Calculation of the spatial coordinates of the markers.
• Calculation of the migration of the implants
Modelbased (without markers)
• Comparison of the models• Determination of the integrated
implant’s contour using X-ray• Calculation of the integrated
implant’s contour using digitaltechnics
• Determination of the non-overlapping areas
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Modell-based RSACompilation of the model
Types of modells:
• CAD based
Based on the plans of the prosthesis
Triangle shaped elemts(hip: 12000, knee 5000)
• Reverse Engineering based
3 D scanning of the manufactured prosthesis
Max.570000 triangle shaped elemets
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Modell-based RSAContour recording
• Standard circumstances
• Nearly the same time
• Using two X-Ray tube
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Markerbased RSAImaging calculating the non-overlaped area
Reproduction of the spatial image
Determination of the spatial image using Canny edge detecting algorithm
Determination of the non-overlaping area
Determination the difference between the reproduced model and the originall model (FSQP algorithm)
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Precision of RSA
Marker-based
Depend on:
• The stability of the marker placed in the bone
• Precision of the designation of the markers
• Precision and type of the scanner
Values:
• Translation: 0.1-0.5 mm
• Rotation: 0.15 ° - 1.15°
Model-based
Depend on:
• Precision and type of the model
• Number of the elements
• Type of the elements
• Precision and type of the scanner
Values:
• Translation: 0. 8-1.0 mm
• Rotation: 1.5 ° - 2.0°
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Applications of RSA
• Following the migration of implants• Spatial movements of prosthesises early and late loosening
• Polietilénbetétek kopásának ellenőrzése Check the wear of Polyethylene inserts
• Determine the loosening tendency caused by geometric differences of the prosthesis
• Cementing techniques, comparing different bone-cements
• Following the effeciency of Crucial ligament• Knee anterior-posterior stability
• Check the knee rotation
• Checking the stability of the ankée
• Check spinal movement
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Drawbacks of RSA
• Tantalum balls can be implanted just with surgery, it is not usable in case of conservative healing
• The signing of the implants with markers is endangerous on durability of the fixation (implanting during manufacturing)
• In case of model-based RSA the inaccuracy of the initial model is decreasing the precision of the model
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Length measurements, Axis measurements
Goal:
• Determination of the lengths of limbs and it’s segments (kalipers,measuring tapes);
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Axis measurements
Goal:• Determination of the lengths of limbs and it’s segments (kalipers, measuring tapes);
• Angle of segments respect to each other (relative (goniometer):
• Q-angle (thigh and leg angles)
• Thigh-foot angle (rotation of the fibula)
• Leg-heel angle
• Ranges of joint movements.
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Stability measurements
Goal:
• Mesurements the stability of the joints (generally forward and backward)direction arthrometer
• Types:
• Investigated joint (knee-, elbow-, shoulder);
• Loaded unloaded.
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Photo shoots
Goal:
• Studying postures study, definition and recording of tbe equilibrium statedocumenting,
Muybridge: Locomation of Horses (University of Stanford)
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Dynamical motion analysis(Motion capturing)
Goal: measuring the kinematical properties during the motion, identify theforces which cause the motion
Systems:
• Kinematical measurement
• Optics-based systems
• Electromagne-based system
• Ultrasound-based systems;
• Kinetical measurements:
• Force- and foot pressure distribution measuring units.
• Else:
• Activity of muscles, electromyography Izmok aktivitását rögzítő elektromiográf (EMG);
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Visual-Based Systems
Types:
• Sensory-free (marker-free system): The points on the record can bemanually designated afterd the measurement;
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Types• Sensory-free (marker-free system): The points on the record can be manually designated afterd the
measurement;;
• Sensor-based (marker-based) sensors are placed in the test points, whichallows the automatic processing;
• Reflective sensors (passive markers)
• Emitting sensors (active markers)
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Equipments - cameras
Recording the movement with at least two video recorder, which can belight-based (conventional video camera)
or IR-based cameras.
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Equipments - markers
More sensor fixed at ananatomical point for better visibility
for better visibility the sensor attached far from the body
Individual markers attached to the skin
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Base
During the image processing, thespatial coordinates of themarkers should be determinedframe by frame (by hand orprogram) prior to themeasurement theese markersshould recorded also in thecalibration phase
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Conduction of the measurement
During the measurement the anatomical points should be touchablein caseof man half naked, bras women;
• The markers should be glued or attached with a special element avoidingthe relative motion.
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Conduction of the measurement
During the measurement the anatomical points should be touchable in cas eof man half naked, bras women;
• The markers should be glued or attached with a special element avoiding the relative motion.
• In the calibration phase a frame should assambled from known measurements rods todefine the center of the coordinate system and directions;
Calibration frame
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Conduction of the measurement
During the measurement the anatomical points should be touchable in caseof man halfnaked, bras women;
• The markers should be glued or attached with a special element avoiding the relativemotion.
• In the calibration phase a frame should assambled from known measurements rodsto define the center of the coordinate system and directions;
• During free or a predetermined motion (such as walking, elevation,etc), the motion is recorded by cameras.
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Optics based systems
Sampling rate: 200-240 Hz
Commercialy avaliable systems
• APAS
• VICON
• Motus
• Primas
• Elite
Measured quantities: The spatial coordinates of the anatomical points or the attached markers
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Advantages and drawbacks
• Any motion can be recorded;
• Complete freedom of movement;
• Requires enough experience in the application;
• Requires the use of multiple cameras;
• Large room required;
• Expensive purchase;
• Movements of the skin is also recorded;
• Point detecting, processing is slow, imprecise;
• Measurement error isin the order of centimeters
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Electromagnet-based
The basic assumption:
The human body’s segments are rigid the motions are established in thejoints.
Base:
The measuring system is recording the spatial position and orientation of inthe frame of the transmitter. If the sensor is attached moving free thusmotion of the sensor is same as the motion of the body segment
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Equipments of the measurement
The different range transmitters are placed near to themeasured person. During the motion the data aqusition box iscollecting the position and the orientation of the attachedsensors.
Large range transmitter
Medium range transmittersensor
Data aqusitionunit
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Special elements
— Frame of markers: If sensors can not attached to the bodysegments (scapula, foot) after stopping the motion usingthe frame the place of the segment is fixable
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Special element
— Marking pencil: The translation and rotation of the body segments aremeasured in the global coordinate-system and these can be transformed arotation into the local coordinate system of the segments. For this in thecalibration phase the local coordinate system of the segments should bedefined with a pencil
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Conduction of the measurement
During the measurement the anatomical points should be touchable in case of man half naked,bras women;
• markers should be glued or attached with a special element avoiding the relative motion.
• In the calibration phase the local coordinate systems should be defined.
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Conduction of the measurement
During the measurement the anatomical points should be touchable in caseof man half naked, bras women;
• markers should be glued or attached with a special element avoidingthe relative motion.
• In the calibration phase the local coordinate systems should bedefined.
• During the predermined motion (walking, armlifting, e.g. ) the spatialposition and rotatio of the sensors are measured and recorded in theglobal coordinate system
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Conduction of the measurement
During the measurement the anatomical points should be touchable in cas eof man half naked,bras women;
• markers should be glued or attached with a special element avoiding the relative motion.
• In the calibration phase the local coordinate systems should be defined.
• During the predermined motion (walking, armlifting, e.g. ) the spatial position and rotatioof the sensors are measured and recorded in the global coordinate system
• In case of the shoulder joint or foot motion after the stopping the measurements recordingof the postion of three (anatomical ) point.
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Electromagnet based systems
The sampling rate of the measurement: 20-120 Hz
Commercially available systems
• ISOTRACK
• Ascension
Measured datas: Sensor’s global position and orientation in the globalcoordinate system
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Advantages, disadvantages
• It has greater accuracy than the Optical-based systems, max. 3.5 mmmeasurement error (authentication on the shoulder joints cadaver);
• The metal is changing the accuracy (reinforced concrete buildings)
• The measuring range of the system is limited (1-3 m);
• Closely spaced sensors are in interference;
• The body-mounted sensors can modify the movement (there is nodifference after the 5-6 minute exercise);
• Recording movements of the skin;
• For the determination of the spatial position of some body-segmentsthe movement must be stopped;
• Spatial position of anatomical points can not be determined;
• To connect, synchronize other additional elements is difficult.
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Ultrasound-based system
Methods:• Individual sensor based system
• Three sensor based (using triplets)
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Equipments of the measurement
• individual, active (ultra-soundemitter) transducers
• Three sensors are inculded(reveiver) in the measuring-head
• Central unit
– individual, active
(ultra-sound
receiver)
transducers
Central unit
Measuring headThree indiviudal receiver
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Determination of the spatial coordinates of the sensors
- Measuring head is seeing thetransducers;
- The distance between thereceiver and the transducercan be determined from thepropagation time of theultra-sound;
• Three distance can bemeasurable;
• From the distances (Di) andspatial coordinates from thereceivers (xi,yi,zi) the spatialcoordinates of transducer(xa,ya,za) can be calculatedwith the method oftriangularization
x
yz
D1 D2
D3
x1,y1,z1 x2,y2,z2
x3,y3,z3xa,ya,za
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Conduction of the measurement
During the measurement the anatomical points should be touchable in cas eof man half naked,bras women;
• Transducers should be glued or attached with a special element avoiding the relativemotion.
• During the predermined motion (walking, armlifting, e.g. ) the spatial position and rotatioof the sensors are measured and recorded in the global coordinate system using the controlsoftware
Individual transducers
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Indivudal sensor based ultrasound motion analysis
Frequency of the measurement: 20-100 Hz
Commercially available systems:
•ZEBRIS CMS 10
•ZEBRIS CMS 20
Measured quantities: Spatial position of the transducers
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Advantages and disadvantages
• It has more accuracy than the optical-based systems measurement error is 5.0 mm in size (authentication on case of several motion form);
• Movements of the skin is recorded;
• Just visible anatomical points can be involved into the measurement
• The measuring range of the system is limited (1-3 m);
• Closely spaced sensors are in interference;
• The body-mounted sensors can modify the movement (there is no difference after the 5-6 minute exercise).
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Ultrasound-based system
Methods:• Individual sensor based system
• Three sensor based (using triplets)
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Base
AssumptionThe body segments of the human body are rigid all of the motions are established in thejoints
Base:The motion of each rigid body can be described in the space, if the spatial coordinates ofthree different points (triplets) of the body is known in each time-moment. Any points ofthe investigated body can be calculated from the meadured coordinates of that threepoints. The relative of position of the three measured points should be determined in the
calibration phase. [Kocsis, 2003].
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Equipments of the measurement
– Measuring head is emitting threeultra-sound signal
– The receiver triplets are mountedon the body segments
– Marking pencil for the definitionof the anatomical points in thecalibration phase
Central unit
Measuring head with three transducer
Marking pencil
Triplet
sensor(receiver)
Rigid plate
Data aqusition toolbox
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Special elements
– Polystirol belt-mounted triplet: The triplet is mounted on the body segment in motion free waybecause of the polystirol the movement of the muscle can be eliminated
triplet
polystirol belt
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Special elements
– Point mounted triplet: Because of the shape of some body-segments the mounting ofmeasurement triplets can be solved only in special ways. For example, to record themovements of the scapula and to eliminate the skin movements, an ECG ball is needed for themounting . The vacuum mounted tripled can be placed on the edge of the shoulder.
Measurement tripletECG ball for the vacuum
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Layout of the measurement
The measuring head is behind theexamined person
• Before the examined person (upperlimb examinations) [Illyés]
• Behind the examined person (lowerlimbs) [Kocsis]
The triplets are placed on the body segments.
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Calibration
Determination of the localcoordinates of the body segments inthe reference frame of three basicreference point (triplets mountedon the body segments) .
ξ
η
ρo
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Measuremnt
From distance between the markersand three sensors of the measuringhead and the knowing the positionof the transducers the globalposition of the markers arecomputable with the method oftriangularization. [Kocsis]
η
x1,y1,z1x2,y2,z2
x3,y3,z3
xa,ya,za
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Measurement
During the motion the position of theexamined anatomical point iscomputable from the global position ofthe triplets and from the local positionof theese anatomical points respect totriplets. With theese method anynumber of the anatomical point ismeasurable.
xa,1,ya,1,za,1
xa,2,ya,2,za,2
xa,3,ya,3,za,3
ρo
xo , yo, zo
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Conduction of the measurement
During the measurement the anatomical points should be touchable in caseof man half naked, bras women;
• Mounting the triplets on the body segments with polystirol belt orwith ecg bell.
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Conduction of the measurement
During the measurement the anatomical pointsshould be touchable in cas eof man half naked,bras women;
• Mounting the triplets on the bodysegments with polystirol belt or with ecgbell.
• In the calibration phase the to local position ofthe investigated anatomical point should bedetermined respect to the measurement-triplet.
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Mérés menete
During the measurement the anatomical pointsshould be touchable in cas eof man half naked,bras women;
• Mounting the triplets on the bodysegments with polystirol belt or with ecgbell.
• In the calibration phase the to local position ofthe investigated anatomical point should bedetermined respect to the measurement-triplet.
• During the predermined motion (walking,armlifting, e.g. ) the spatial position and rotatioof the sensors are measured and recorded inthe global coordinate system using the controlsoftware
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Ultra-sound based measurement system
Frequency of the measurement: 20-100 Hz
Commercially available systems:
• ZEBRIS CMS-HS
Measured quantities: Spatial coordinate of the anatomical point
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Advantages disadvantages
• High accuracy of 1mm for an experienced person, for an untrained personthe measurement error is under 3 mm measurement error, measurementerror (authentication in case of several motion);
• Fast processing of the results;
• Movement of the skin should be prevented;
• Synchronization of various additional switching elements, is solved;
• The measuring range of the system is limited (1-3 m);
• The body-mounted sensors can modify the movement (there is nodifference after the 5-6 minute exercise
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Measurement of ground- reaction force and distribution
Base: The measurement of the ground-reaction force bases on the Newton’s 3rdlaw (action-reaction principle). The body is pushing the ground with the weightof the body, and the force which acting on the body with same magnitude inopposite direction is called reaction force.
Equipments: Separated or built-in to a treadmill force plates, which measuresonly the magnitude of ground-reaction force, and or foot force distribution(pedograph).
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Conduction of the measurement
• In case of the keeping of staticequilibrium the examined personshould stand on the plate for adetermined time. (usually 30-60seconds)
• In case of walking analysis, theexaminad the person is walkingthrough the built-i n platforms/pedograph with a chosen velocity(natural, slow fast)
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Conduction of the measurement
• In case of the keeping of staticequilibrium the examined personshould stand on the plate for adetermined time. (usually 30-60seconds)
• In case of walking analysis, theexaminad the person is walkingthrough the built-i n platforms/pedograph with a chosen velocity(natural, slow fast)
• Special movement on th plane(fencing)
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Mérés menete
• In case of the keeping of static equilibriumthe examined person should stand on theplate for a determined time. (usually 30-60seconds)
• In case of walking analysis, the examinad theperson is walking through the built-i nplatforms /pedograph with a chosen velocity(natural, slow fast)
• Special movement on th plane(fencing)
• In case of treadmill built-in forceplate/pedograph, the examinedperson is walking with constantvelocity for 3-5 minutes on thetreadmill
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Reaction force measurement
Frequency of the measurement: 100-240 Hz
Commercially availabe system
• ZEBRIS
• KISTLER, e.g.
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Measured quantities
• Magnitude of the reactionforce and the changing it intime
• Figure of the force distribution
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Advantages, drawbacks
• The following of the changing of the kinematical parameters are enough fastand precious
• With the knowing of the velocity the distance-time parameters can bedetermined.
• In case of some pedographs the value of the pressure can be readable justfrom a colourscale
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Measurement of muscle activity
Base:In case of the contraction of the muscle the changing ofthe electrode-potential is measurable.
Equipments: Electromyograph, which measures the electrodepotential between two sensors Types:
• Needle (individual muscles, deep muscles, painful,sterilization, hard-hitting);
• On surface
• Method of wireing: monopolar or bipolar;
• Sensor shape: round, oval, square shape.
monopolar circularcontact sensor
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Conduction of the measurement
• Finding the muscle belly generally with Ultrasound
• Fixing the reference- or groundpoint which is neutral in electric sense
• Decreasing the resistance of the skin (hair removal, removing ofepithelial tissue with a special sandpaper)
• Mounting the electrodes. The distance between the electrodes isarbitrary, usually 10 mm .
referencepointSensorpair on the muslce belly
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Conduction of the measurement
• Finding the muscle belly generally with Ultrasound
• Fixing the reference- or groundpoint which is neutralin electric sense
• Decreasing the resistance of the skin (hair removal,removing of epithelial tissue with a specialsandpaper)
• Mounting the electrodes. The distance between theelectrodes is arbitrary, usually 10 mm .
• Trackig the changing of the electrode potentialof the examined muscle
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Muscle activity measurement
Freqency of themeasuremt 500-2000 Hz
Measured quantities:Electromyogram which is the potential-change between two electric detector, in the function of time
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Advantages, drawbacks
• If you are using a needle electrode movement will be difficult to implement,but muscles can be measured individually;
• When using surface electrodes only superficial muscles, muscle groups canbe tested, the cross-check is especially important;
• The process is difficult, but complex analysis can be made.
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Force measurements
• Static investigation
Ángyán: Az emberi test mozgástana
Grasping Force Force of the latissimus dorsi
Tension force of the shunk thigh Static force measurement with hanging
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Reaction-time measurement
• Reaction-time: the time between the stimulus and the answer (ability of concentration)
• Stimulus:• Voice
• Light stimulus
• E.g
• Answer:• Pushing button
• Field:• Sports medicine (anaerob
átmenet)
• Diseases of nervous system
Ángyán: Az emberi test mozgástana