Biomedical Engineering Reference
In-Depth Information
whole plate, was not saved for data analysis and was repeated. Some authors [
59
]
identified that fatigue affects the process of muscle excitation, and the efficiency of
the muscular mechanism, affecting the gait pattern.
In order to prevent possible cases of fatigue and its possible effects on biome-
chanical parameters, the plantar pressure assessment was performed first. If neces-
sary, between trials, subjects with greater postural instability were allowed to sit for
2 min. For gait stance phase, the study used the 1-step protocol [
93
]. Each subject
performed three times with right foot and three times with left foot. The subjects
stood in upright standing position behind the plate, and were instructed to perform
a step moving inside the plate just with one foot, and place the other foot out of
plate. If the first test was performed with the right foot, then the other two tests were
also conducted with the same foot. After the pressure assessment, subjects were
evaluated by a clinical test (Berg Balance Scale - BBS) based on a qualified scale
and applied by a specialist. The assessment is done by the visual direct observation
of the balance behaviour characteristics.
3.4.1
Phases of the Study
Due to the characteristics of this disease, which leads to difficulties in mobility,
and due to constraints associated in mounting of experimental environment, it was
not possible to collect the data only on a certain date and at the same place. Thus,
the study had to be done in several phases. As the participants were recruited and
selected, they were sequentially introduced in to the study. The study was conducted
in four phases:
•
Phase 1 - Testing in Clinical Center of Medical and Social Services (SAMS) in
Lisbon - six participants with MS were tested
•
Phase 2 - Tests on the National Headquarters of Portuguese Society of Multiple
Sclerosis - 11 participants with MS were tested
•
Phase 3 - Testing for control group in Clinical Center of Medical and Social
Services (SAMS) in Lisbon - 28 participants without neurological or orthopaedic
surgery were tested
•
Phase 4 - Testing in the Sea Clinic (Matosinhos) - 12 participants with MS were
tested
3.4.2
Protocol for Plantar Pressure Assessment
In plantar pressure study, data are collected to obtain a representative estimate of the
true plantar pressure of each participant. In this sense, they are used several walking
tests, ranging from the midgait protocol (3 steps protocol), to the lower protocols,
involving just one or two steps before contact with the plate [
94
]. However, the
better protocol choice, as well the number of tests, must be appropriate to the aims
of investigation. Collected data shall be valid and reliable when compared to the
