Search results for: Lower Limb

Authors: Tawakal Hasnain Baluch, Adnan Masood, Javaid Iqbal, Umer Izhar, Umar Shahbaz Khan

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This paper will provide the kinematic and dynamic analysis of a lower limb exoskeleton. The forward and inverse kinematics of proposed exoskeleton is performed using Denevit and Hartenberg method. The torques required for the actuators will be calculated using Lagrangian formulation technique. This research can be used to design the control of the proposed exoskeleton.

Keywords: Dynamic Analysis, Exoskeleton, Kinematic Analysis, Lower Limb, Rehabilitation Robotics

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Authors: F. M. Nor, N. Abdullah, Al-M. Mustapa, L. Q. Wen, N. A. Faisal, D. A. A. Ahmad Nazari

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Estimation of stature is an important step in developing a biological profile for human identification. It may provide a valuable indicator for unknown individual in a population. The aim of this study was to analyses the relationship between stature and lower limb dimensions in the Malaysian population. The sample comprised 100 corpses, which included 69 males and 31 females between age ranges of 20 to 90 years old. The parameters measured were stature, thigh length, lower leg length, leg length, foot length, foot height and foot breadth. Results showed that mean values in males were significantly higher than those in females (P < 0.05). There were significant correlations between lower limb dimensions and stature. Cross-validation of the equation on 100 individuals showed close approximation between known stature and estimated stature. It was concluded that lower limb dimensions were useful for estimation of stature, which should be validated in future studies. 

Keywords: Forensic anthropology population data, lower leg length, Malaysian, stature.

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Authors: Young-Lim Choi, Nak-Yun Choi, Jae-Yong Seo, Sang-Il Park, Jong-Wook Kim

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This paper proposes a prototype of a lower-limb rehabilitation system for recovering and strengthening patients- injured lower limbs. The system is composed of traction motors for each leg position, a treadmill as a walking base, tension sensors, microcontrollers controlling motor functions and a main system with graphic user interface. For derivation of reference or normal velocity profiles of the body segment point, kinematic method is applied based on the humanoid robot model using the reference joint angle data of normal walking.

Keywords: Rehabilitation, lower limb, treadmill, humanoid robot.

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Authors: Hachmia Faqihi, Maarouf Saad, Khalid Benjelloun, Mohammed Benbrahim, M. Nabil Kabbaj

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This paper investigates and presents a cable-driven robot to lower limb rehabilitation use in sagittal plane. The presented rehabilitation robot is used for a trajectory tracking in joint space. The paper covers kinematic and dynamic analysis, which reveals the tensionability of the used cables as being the actuating source to provide a rehabilitation exercises of the human leg. The desired trajectory is generated to be used in the control system design in joint space. The obtained simulation results is showed to be efficient in this kind of application.

Keywords: Cable-driven multibody system, computed-torque controller, lower limb rehabilitation, tracking trajectory.

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Authors: Alaoui Hamza, Moutacalli Mohamed Tarik, Chebak Ahmed

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The number of people suffering from hemiplegia is growing each year. This lower limb disability affects all the aspects of their lives by taking away their autonomy. This implicates their close relatives, as well as the health system to provide the necessary care they need. The integration of exoskeletons in the medical field became a promising solution to resolve this issue. This paper presents an exoskeleton designed to help hemiplegic people get back the sensation and ability of normal walking. For this purpose, three step models have been created. The first step allows a simple forward movement of the leg. The second method is designed to overcome some obstacles in the patient path, and finally the third step model gives the patient total control over the device. Each of the control methods was designed to offer a solution to the challenges that the patients may face during the walking process.

Keywords: Ability of normal walking, exoskeleton, hemiplegic patients, lower limb motion, mechatronics.

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Authors: Alireza Noorpoor, Akbar Abvabi, Mehdi Saeed Kiasat

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Development, calibration and validation of a threedimensional model of the Legform impactor for pedestrian crash with bumper are presented. Lower limb injury is becoming an increasingly important concern in vehicle safety for both occupants and pedestrians. In order to prevent lower extremity injuries to a pedestrian when struck by a car, it is important to elucidate the loadings from car front structures on the lower extremities and the injury mechanism caused by these loadings. An impact test procedure with a legform addressing lower limb injuries in car pedestrian accidents has been proposed by EEVC/WG17. In this study a modified legform impactor is introduced and validated against EEVC/WG17 criteria. The finite element model of this legform is developed using LS-DYNA software. Total mass of legform impactor is 13.4 kg.Technical specifications including the mass and location of the center of gravity and moment of inertia about a horizontal axis through the respective centre of gravity in femur and tibia are determined. The obtained results of legform impactor static and dynamic tests are as specified in the EEVC/WG17.

Keywords: Legform impactor, Pedestrian safety, Finite element model, Knee joint, EEVC/WG17.

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Authors: L. Parisi

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Kinematic data wisely correlate vector quantities in space to scalar parameters in time to assess the degree of symmetry between the intact limb and the amputated limb with respect to a normal model derived from the gait of control group participants. Furthermore, these particular data allow a doctor to preliminarily evaluate the usefulness of a certain rehabilitation therapy. Kinetic curves allow the analysis of ground reaction forces (GRFs) to assess the appropriateness of human motion. Electromyography (EMG) allows the analysis of the fundamental lower limb force contributions to quantify the level of gait asymmetry. However, the use of this technological tool is expensive and requires patient’s hospitalization. This research work suggests overcoming the above limitations by applying artificial neural networks.

Keywords: Kinetics, kinematics, cyclograms, neural networks.

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Authors: C. Copilusi, C. Ploscaru

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This paper addresses attention to a research regarding the design of a knee orthosis in a modular form used on children walking rehabilitation. This research is focused on the human lower limb kinematic analysis which will be used as input data on virtual simulations and prototype validation. From this analysis, important data will be obtained and used as input for virtual simulations of the knee modular orthosis. Thus, a knee orthosis concept was obtained and validated through virtual simulations by using MSC Adams software. Based on the obtained results, the modular orthosis prototype will be manufactured and presented in this article.

Keywords: Human lower limb, children orthoses, kinematic analysis, knee orthosis.

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Authors: Kent Salomonsson, Xuefang Zhao, Sara Kallin

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Human soft tissue is loaded and deformed by any activity, an effect known as a stress-strain relationship, and is often described by a load and tissue elongation curve. Several advances have been made in the fields of biology and mechanics of soft human tissue. However, there is limited information available on in vivo tissue mechanical characteristics and behavior. Confident mechanical properties of human soft tissue cannot be extrapolated from e.g. animal testing. Thus, there is need for non invasive methods to analyze mechanical characteristics of soft human tissue. In the present study, the internal mechanical conditions of the lower limb, which is subject to an external load, is studied by use of the finite element method. A detailed finite element model of the lower limb is made possible by use of MRI scans. Skin, fat, bones, fascia and muscles are represented separately and the material properties for them are obtained from literature. Previous studies have been shown to address macroscopic deformation features, e.g. indentation depth, to a large extent. However, the detail in which the internal anatomical features have been modeled does not reveal the critical internal strains that may induce hypoxia and/or eventual tissue damage. The results of the present study reveals that lumped material models, i.e. averaging of the material properties for the different constituents, does not capture regions of critical strains in contrast to more detailed models.

Keywords: FEM, human soft tissue, indentation, properties.

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Authors: Takeshi Sato, Mizuki Nakajima, Macky Kato, Shoji Igawa

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The purpose of study was to investigate the effect of varying pole weights on energy expenditure, upper limb and lower limb muscle activity as Electromyogram during Nordic walking (NW). Four healthy men [age = 22.5 (±1.0) years, body mass = 61.4 (±3.6) kg, height = 170.3 (±4.3) cm] and three healthy women [age = 22.7 (±2.9) years, body mass = 53.0 (±1.7) kg, height = 156.7 (±4.5) cm] participated in the experiments after informed consent. Seven healthy subjects were tested on the treadmill, walking, walking (W) with Nordic Poles (NW) and walking with 1kg weight Nordic Poles (NW+1). Walking speed was 6 km per hours in all trials. Eight EMG activities were recorded by bipolar surface methods in biceps brachii, triceps brachii, trapezius, deltoideus, tibialis anterior, medial gastrocnemius, rectus femoris and biceps femoris muscles. And heart rate (HR), oxygen uptake (VO₂), and rate of perceived exertion (RPE) were measured. The level of significance was set at a = 0.05, with p < 0.05 regarded as statistically significant. Our results confirmed that use of NW poles increased HR at a given upper arm muscle activity but decreased lower limb EMGs in comparison with W. Moreover NW was able to increase more step lengths with hip joint extension during NW rather than W. Also, EMG revealed higher activation of upper limb for almost all NW and 1kgNW tests plus added masses compared to W (p < 0.05). Therefore, it was thought either of NW and 1kgNW were to have benefit as a physical exercise for safe, feasible, and readily training for a wide range of aged people in the quality of daily life. However, there was no significant effected in leg muscles activity by using 1kgNW except for upper arm muscle activity during Nordic pole walking.

Keywords: Nordic walking, electromyogram, heart rate.

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Authors: Dabiri Y, Najarian S, Eslami M R., Zahedi S, Moser D, Shirzad E, Allami M

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The effect of muscle loss due to transfemoral amputation, on energy expenditure of hip joint and individual residual muscles was simulated. During swing phase of gait, with each muscle as an ideal force generator, the lower extremity was modeled as a two-degree of freedom linkage, for which hip and knee were joints. According to results, muscle loss will not lead to higher energy expenditure of hip joint, as long as other parameters of limb remain unaffected. This finding maybe due to the role of biarticular muscles in hip and knee joints motion. Moreover, if hip flexors are removed from the residual limb, residual flexors, and if hip extensors are removed, residual extensors will do more work. In line with the common practice in transfemoral amputation, this result demonstrates during transfemoral amputation, it is important to maintain the length of residual limb as much as possible.

Keywords: Amputation Level, Simulation, Transfemoral Amputee.

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Authors: Chongyang Ye, Rong Liu

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Compression textiles such as compression stockings (CSs) have been extensively applied for the prevention and treatment of chronic venous insufficiency of lower extremities. The involvement of multiple mechanical factors such as interface pressure, frictional force, and elastic materials make the interactions between lower limb and CSs to be complex. Determination of Poisson’s ratio and elastic moduli of CS materials are critical for constructing finite element (FE) modeling to numerically simulate a complex interactive system of CS and lower limb. In this study, a mixed approach, including an analytic model based on the orthotropic Hooke’s Law and experimental study (uniaxial tension testing and pure shear testing), has been proposed to determine Young’s modulus, Poisson’s ratio, and shear modulus of CS fabrics. The results indicated a linear relationship existing between the stress and strain properties of the studied CS samples under controlled stretch ratios (< 100%). The proposed method and the determined key mechanical properties of elastic orthotropic CS fabrics facilitate FE modeling for analyzing in-depth the effects of compression material design on their resultant biomechanical function in compression therapy.

Keywords: Elastic compression stockings, Young’s modulus, Poisson’s ratio, shear modulus, mechanical analysis.

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Authors: Nina Robson, Kenneth John Faller II, Vishalkumar Ahir, Arthur Ricardo Deps Miguel Ferreira, John Buchanan, Amarnath Banerjee

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This paper describes the development of a virtual-reality system ARWED, which will be used in physical rehabilitation of patients with reduced upper extremity mobility to increase limb Active Range of Motion (AROM). The ARWED system performs a symmetric reflection and real-time mapping of the patient’s healthy limb on to their most affected limb, tapping into the mirror neuron system and facilitating the initial learning phase. Using the ARWED, future experiments will test the extension of the action-observation priming effect linked to the mirror-neuron system on healthy subjects and then stroke patients.

Keywords: Physical rehabilitation, mirror neuron, virtual reality, stroke therapy.

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Authors: Sana Bembli, Nahla Khraief Haddad, Safya Belghith

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This paper deals with a robust model free terminal sliding mode with gravity compensation approach used to control an exoskeleton-upper limb system. The considered system is a 2-DoF robot in interaction with an upper limb used for rehabilitation. The aim of this paper is to control the flexion/extension movement of the shoulder and the elbow joints in presence of matched disturbances. In the first part, we present the exoskeleton-upper limb system modeling. Then, we controlled the considered system by the model free terminal sliding mode with gravity compensation. A stability study is realized. To prove the controller performance, a robustness analysis was needed. Simulation results are provided to confirm the robustness of the gravity compensation combined with to the Model free terminal sliding mode in presence of uncertainties.

Keywords: Exoskeleton-upper limb system, gravity compensation, model free terminal sliding mode, robustness analysis, Monte Carlo, H∞ methods.

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Authors: Xi Wang, Xiaoming Tao, Raymond C. H. So

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As one of the convenient and noninvasive sensing approaches, the automatic limb girth measurement has been applied to detect intention behind human motion from muscle deformation. The sensing validity has been elaborated by preliminary researches but still need more fundamental studies, especially on kinetic contraction modes. Based on the novel fabric strain sensors, a soft and smart limb girth measurement system was developed by the authors’ group, which can measure the limb girth in-motion. Experiments were carried out on elbow isometric flexion and elbow isokinetic flexion (biceps’ isokinetic contractions) of 90°/s, 60°/s, and 120°/s for 10 subjects (2 canoeists and 8 ordinary people). After removal of natural circumferential increments due to elbow position, the joint torque is found not uniformly sensitive to the limb circumferential strains, but declining as elbow joint angle rises, regardless of the angular speed. Moreover, the maximum joint torque was found as an exponential function of the joint’s angular speed. This research highly contributes to the application of the automatic limb girth measuring during kinetic contractions, and it is useful to predict the contraction level of voluntary skeletal muscles.

Keywords: Fabric strain sensor, muscle deformation, isokinetic contraction, joint torque, limb girth strain.

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Authors: XueSong Yu, JiaFeng Liu, XiangLong Tang, JianHua Huang

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For improving the efficiency of human 3D tracking, we present an algorithm to track 3D Arm Motion. First, the Hierarchy Limb Model (HLM) is proposed based on the human 3D skeleton model. Second, via graph decomposition, the arm motion state space, modeled by HLM, can be discomposed into two low dimension subspaces: root nodes and leaf nodes. Finally, Rao-Blackwellised Particle Filter is used to estimate the 3D arm motion. The result of experiment shows that our algorithm can advance the computation efficiency.

Keywords: Hierarchy Limb Model; Rao-Blackwellised Particle Filter; 3D tracking

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Authors: Noor Ayuni Che Zakaria, Takashi Komeda, Cheng Yee Low, Kaoru Inoue, Fazah Akhtar Hanapiah

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Previous studies have shown that there are arguments regarding the reliability and validity of the Ashworth and Modified Ashworth Scale towards evaluating patients diagnosed with upper limb disorders. These evaluations depended on the raters’ experiences. This initiated us to develop an upper limb disorder part-task trainer that is able to simulate consistent upper limb disorders, such as spasticity and rigidity signs, based on the Modified Ashworth Scale to improve the variability occurring between raters and intra-raters themselves. By providing consistent signs, novice therapists would be able to increase training frequency and exposure towards various levels of signs. A total of 22 physiotherapists and occupational therapists participated in the study. The majority of the therapists agreed that with current therapy education, they still face problems with inter-raters and intra-raters variability (strongly agree 54%; n = 12/22, agree 27%; n = 6/22) in evaluating patients’ conditions. The therapists strongly agreed (72%; n = 16/22) that therapy trainees needed to increase their frequency of training; therefore believe that our initiative to develop an upper limb disorder training tool will help in improving the clinical education field (strongly agree and agree 63%; n = 14/22).

Keywords: Upper limb disorders, Clinical education tool, Inter/intra-raters variability, Spasticity, Modified Ashworth Scale.

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Authors: Jae Kyun Bang, Sung Jae Hwang, Chang Yong Ko, Chi Hyun Kim

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Prolonged immobilization leads to significant weakness and atrophy of the skeletal muscle and can also impair the recovery of muscle strength following injury. Therefore, it is important to minimize the period under immobilization and accelerate the return to normal activity. This study examined the effects of heat treatment and rest-inserted exercise on the muscle activity of the lower limb during knee flexion/extension. Twelve healthy subjects were assigned to 4 groups that included: (1) heat treatment + rest-inserted exercise; (2) heat + continuous exercise; (3) no heat + rest-inserted exercise; and (4) no heat + continuous exercise. Heat treatment was applied for 15 mins prior to exercise. Continuous exercise groups performed knee flexion/extension at 0.5 Hz for 300 cycles without rest whereas rest-inserted exercise groups performed the same exercise but with 2 mins rest inserted every 60 cycles of continuous exercise. Changes in the rectus femoris and hamstring muscle activities were assessed at 0, 1, and 2 weeks of treatment by measuring the electromyography signals of isokinetic maximum voluntary contraction. Significant increases in both the rectus femoris and hamstring muscles were observed after 2 weeks of treatment only when both heat treatment and rest-inserted exercise were performed. These results suggest that combination of various treatment techniques, such as heat treatment and rest-inserted exercise, may expedite the recovery of muscle strength following immobilization.

Keywords: Electromyography, Heat Treatment, Muscle, Rest-Inserted Exercise.

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Authors: Mamta Agrawal, Neeru Adlakha, K.R. Pardasani

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An attempt has been made to develop a seminumerical model to study temperature variations in dermal layers of human limbs. The model has been developed for two dimensional steady state case. The human limb has been assumed to have elliptical cross section. The dermal region has been divided into three natural layers namely epidermis, dermis and subdermal tissues. The model incorporates the effect of important physiological parameters like blood mass flow rate, metabolic heat generation, and thermal conductivity of the tissues. The outer surface of the limb is exposed to the environment and it is assumed that heat loss takes place at the outer surface by conduction, convection, radiation, and evaporation. The temperature of inner core of the limb also varies at the lower atmospheric temperature. Appropriate boundary conditions have been framed based on the physical conditions of the problem. Cubic splines approach has been employed along radial direction and Fourier series along angular direction to obtain the solution. The numerical results have been computed for different values of eccentricity resembling with the elliptic cross section of the human limbs. The numerical results have been used to obtain the temperature profile and to study the relationships among the various physiological parameters.

Keywords: Blood Mass Flow Rate, Metabolic Heat Generation, Fourier Series, Cubic splines and Thermal Conductivity.

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Authors: Qinghua Zhang, Yanhe Zhu, Xiang Zhao, Yeqin Yang, Hongwei Jing, Guoan Zhang, Jie Zhao

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This paper presents a wearable reconfigurable supernumerary robotic limb with differential actuated joints, which is lightweight, compact and comfortable for the wearers. Compared to the existing supernumerary robotic limbs which mostly adopted series structure with large movement space but poor carrying capacity, a prototype with the series-parallel configuration to better adapt to different task requirements has been developed in this design. To achieve a compact structure, two kinds of cable-driven mechanical structures based on guide pulleys and differential actuated joints were designed. Moreover, two different tension devices were also designed to ensure the reliability and accuracy of the cable-driven transmission. The proposed device also employed self-designed bearings which greatly simplified the structure and reduced the cost.

Keywords: Cable-driven, differential actuated joints, reconfigurable, supernumerary robotic limb.

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Authors: Adrian Bostan, Nicolae Tapus, Adriana Tapus

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The purpose of this research paper is to study and develop a system that is able to help identify problems and improve human rehabilitation after traumatic injuries. Traumatic injuries in human’s lower limbs can occur over a life time and can have serious side effects if they are not treated correctly. In this paper, we developed an intelligent cane (IntelliCane) so as to help individuals in their rehabilitation process and provide feedback to the users. The first stage of the paper involves an analysis of the existing systems on the market and what can be improved. The second stage presents the design of the system. The third part, which is still under development is the validation of the system in real world setups with people in need. This paper presents mainly stages one and two.

Keywords: IntelliCane, 3D printing, microprocessor, weight measurement, rehabilitation tool.

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Authors: Arunesh Chandra, Pankaj Chandna, Surinder Deswal, Rajesh Kumar Mishra, Rajender Kumar

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The arm length, hand length, hand breadth and middle finger length of 1540 right-handed industrial workers of Haryana state was used to assess the relationship between the upper limb dimensions and stature. Initially, the data were analyzed using basic univariate analysis and independent t-tests; then simple and multiple linear regression models were used to estimate stature using SPSS (version 17). There was a positive correlation between upper limb measurements (hand length, hand breadth, arm length and middle finger length) and stature (p < 0.01), which was highest for hand length. The accuracy of stature prediction ranged from ± 54.897 mm to ± 58.307 mm. The use of multiple regression equations gave better results than simple regression equations. This study provides new forensic standards for stature estimation from the upper limb measurements of male industrial workers of Haryana (India). The results of this research indicate that stature can be determined using hand dimensions with accuracy, when only upper limb is available due to any reasons likewise explosions, train/plane crashes, mutilated bodies, etc. The regression formula derived in this study will be useful for anatomists, archaeologists, anthropologists, design engineers and forensic scientists for fairly prediction of stature using regression equations.

Keywords: Anthropometric dimensions, Forensic identification, Industrial workers, Stature prediction.

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Authors: Irfan Hussain, Adnan Masood, Javaid Iqbal, Umar S. Khan

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Above Elbow Prosthesis is one of the most commonly amputated or missing limbs. The research is done for modelling techniques of upper limb prosthesis and design of high torque, light weight and compact in size elbow actuator. The purposed actuator consists of a DC motor, planetary gear set and a harmonic drive. The calculations show that the actuator is good enough to be used in real life powered prosthetic upper limb or rehabilitation exoskeleton.

Keywords: Above Elbow prosthesis, Harmonic drive, Planetarygear set, Sagittal Plane

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Authors: Abeer A. Abdelhamed

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Background: Diabetic sensorimotor polyneuropathy (DSP) is one of the most common microvascular complications of type 2 diabetes. Loss of sensation is thought to contribute to a lack of static and dynamic stability and increased risk of falling. Purpose: The purpose of this study was to compare the effects of low-level laser (LLL) and monochromatic near-infrared photo energy (MIRE) on pain, cutaneous sensation, static stability, and index of lower limb blood flow in diabetic patients with peripheral neuropathy. Methods: Forty diabetic patients with peripheral neuropathy were recruited for participation in this study. They were divided into two groups: The MIRE group, which contained 20 patients, and the LLL group, which contained 20 patients. All patients who participated in the study had been subjected to various physical assessment procedures, including pain, cutaneous sensation, Doppler flow meter, and static stability assessments. The baseline measurements were followed by treatment sessions that were conducted twice a week for six successive weeks. Results: The statistical analysis of the data revealed significant improvement of pain in both groups, with significant improvement in cutaneous sensation and static balance in the MIRE group compared to the LLL group; on the other hand, the results showed no significant differences in lower limb blood flow between the groups. Conclusion: LLL and MIRE can improve painful symptoms in patients with diabetic neuropathy. On the other hand, MIRE is also useful in improving cutaneous sensation and static stability in patients with diabetic neuropathy.

Keywords: Diabetic neuropathy, Doppler flow meter, –Lowlevel laser, Monochromatic near-infrared photo energy.

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Authors: Nazim Mir-Nasiri, Hudyjaya Siswoyo Jo

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The paper describes conceptual design, control strategies, and partial simulation for a new fully autonomous lower limb wearable exoskeleton system for human motion enhancement that can support its weight and increase strength and endurance. Various problems still remain to be solved where the most important is the creation of a power and cost efficient system that will allow an exoskeleton to operate for extended period without batteries being frequently recharged. The designed exoskeleton is enabling to decouple the weight/mass carrying function of the system from the forward motion function which reduces the power and size of propulsion motors and thus the overall weight, cost of the system. The decoupling takes place by blocking the motion at knee joint by placing passive air cylinder across the joint. The cylinder is actuated when the knee angle has reached the minimum allowed value to bend. The value of the minimum bending angle depends on usual walk style of the subject. The mechanism of the exoskeleton features a seat to rest the subject’s body weight at the moment of blocking the knee joint motion. The mechanical structure of each leg has six degrees of freedom: four at the hip, one at the knee, and one at the ankle. Exoskeleton legs are attached to subject legs by using flexible cuffs. The operation of all actuators depends on the amount of pressure felt by the feet pressure sensors and knee angle sensor. The sensor readings depend on actual posture of the subject and can be classified in three distinct cases: subject stands on one leg, subject stands still on both legs and subject stands on both legs but transit its weight from one leg to other. This exoskeleton is power efficient because electrical motors are smaller in size and did not participate in supporting the weight like in all other existing exoskeleton designs.

Keywords: Energy efficient system, exoskeleton, motion enhancement, robotics.

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Authors: Ruey-Yu Chen, Yao-Tsung Chang, Ching-Ying Yeh, Yu-Ting Huang

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Musculoskeletal problems in the hotel sector have been little studied. The aim of this study was to examine relationships of musculoskeletal pain and work characteristics with presenteeism, i.e., feeling sick but going to work anyway. Data of a self-reported questionnaire were collected from 1,101 employees, who joined the study on a voluntary basis from four hotels in northern Taiwan. The results showed that respondents who were female, were younger, had a higher educational level, and worked in the real-service department had higher presenteeism. There were significant positive associations between presenteeism and heavy loads, frequent beatings or hits of hard objects, improper bench height, employees’ lower limb and lower back pain. Our study results imply that knowledge of work characteristics and employees' musculoskeletal problems could be advantageously used to reduce presenteeism in the workplace.

Keywords: Musculoskeletal pain, absenteeism, presenteeism, hotel employees.

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Authors: Seyed Mazyar Mortazavi, Masod Memari, Hasan Ali Ahmadi, Zhaleh Abed

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VACTERL association is a rare disorder with various congenital malformations. The aetiology remains unknown. Combination of at least three congenital anomalies of the following criteria is required for diagnosis: vertebral defects, anal atresia, cardiac anomalies, tracheo-esophageal fistula, renal anomalies, and limb defects. The first case was 1-day old male neonate with multiple congenital anomalies was bore from 28 years old mother. The mother had history of pregnancy with lymphocyte therapy. His anomalies included: defects in thoracic and lumbar vertebral, anal atresia, bilateral hydronephrosis, atrial septal defect, and lower limb abnormality. Other anomalies were cryptorchidism and nasal canal narrowing. The second case was born with 32 weeks gestational age from mother with history of pregnancy with lymphocyte therapy. He had thoracic vertebral defect, cardiac anomalies and renal defect. diagnosis based on clinical finding is VACTERL association. Early diagnosis is very important to investigation and treatment of other coexistence anomalies. VACTERL association in mothers with history of pregnancy with lymphocyte therapy has suggested possibly of relationship between VACTERL association and this method of pregnancy.

Keywords: Anal atresia, tracheo-esophageal fistula, atrial septal defect, lymphocyte therapy.

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Authors: Zeinab A.Hussein, Manal S. Abd El-Wahab, Shorouk A. W. El-Shennawy

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Children with hemiplgic cerebral palsy often walk with diminished reciprocal arm swing so the purpose of this study was to describe kinematic characteristics in children with hemiplegic cerebral palsy (CP) during the gait suphases, and find if there is a correlation between upper(shoulder and elbow) and lower(hip, knee, and ankle) limb joints either in involved or uninvolved.48 children with hemiplegic cerebral palsy (18boys, 30girls) with an average age of (5.1±0.87) years were selected randomly to evaluate joint angles during gait by 3D motion analysis system with 6 pro reflex cameras in a sagittal plane for both sides of the body. The results showed increased shoulder and elbow flexion, increased hip angular displacement, decreased knee and ankle arcs during gait cycle, also there is correlation between shoulder and elbow to hip, knee, and ankle joints during various subphases of gait.

Keywords: Cerebral palsy, Gait, Hemiplegia, Motion analysis.

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Authors: Oleksandr Poliakov, Olena Chepenyuk, Yevgen Pashkov, Mykhaylo Kalinin, Vadym Kramar

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In one of the prosthesis designs for lower limb transfemoral amputations artificial knee joints with polycentric mechanisms are used. Such prostheses are characterized by high stability during the stance phase of the movement. The existing variety of polycentric mechanisms indicates the possibility of finding the optimal prosthesis design satisfying several quality criteria.In this paper we present a multicriteria method for the synthesis of the artifical polycentric knee mechanism based on the uniform systematic study of the design parameters space and on the analysis of Pareto optimal solutions.

Keywords: Optimalcriteria, polycentric knee, prosthesis, synthesis, transfemoral amputee.

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Authors: M. K. M. Safee, W. A. B. Wan Abas, N. A. Abu Osman, F. Ibrahim

Abstract:

This paper investigates the activity of the gastrocnemius (Gas) muscle in healthy subjects during salat (ruku- position) and specific exercise [Unilateral Plantar Flexion Exercise (UPFE)] using electromyography (EMG). Both lateral and medial Gas muscles were assessed. A group of undergraduates aged between 19 to 25 years voluntarily participated in this study. The myoelectric activity of the muscles were recorded and analyzed. The finding indicated that there were contractions of the muscles during the salat and exercise with almost same EMG-s level. From the result, Wilcoxon-s Rank Sum test showed no significant difference between ruku- and UPFE for both medial (p=0.082) and lateral (p=0.226) of GAS muscles. Therefore, salat may be useful in strengthening exercise and also in rehabilitation programs for lower limb activities.

Keywords: Electromyography, salat, exercise, muscle.

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