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The goal of the present work was to develop and test an innovative system for the training of paraplegic patients when they are standing up. The system consisted of a computer-controlled stimulator, surface electrodes for quadricep muscle stimulation, two knee angle sensors, a digital proportional-integrative-derivative (PID) controller and a mechanical device to support, partially, the body weight (weight reliever (WR)). A biomechanical model of the combined WR and patient was developed to find an optimum reference trajectory for the PID controller. The system was tested on three paraplegic patients and was shown to be reliable and safe. One patient completed a 30-session training period. Initially he was able to stand up only with 62% body weight relief, whereas, after the training period, he performed a series of 30 standing-up/sitting-down cycles with 45% body weight relief. The closed-loop controller was able to keep the patient standing upright with minimum stimulation current, to compensate automatically for muscle fatigue and to smooth the sitting-down movement. The limitations of the controller in connection with a highly non-linear system are considered.

A staircase was developed to record ground reactions during stair climbing at different slopes (inclinations). Each step is instrumented with six strain-gauge-based force transducers which allow the measurement of three-dimensional ground reaction force and moment as well as the centre of pressure (COP) location. A specific sensor arrangement permits accurate recording, especially of the COP location. The overall design of the staircase and details of a single instrumented step are presented. Static and dynamic characteristics have been evaluated by different experimental procedures. Preliminary results of ground reaction forces are shown.

The use of linear envelopes to represent the electromyographic (EMG) measurements obtained during locomotion has become common practice. Guidelines for designing envelope filters and specifying the minimum number of strides needed to produce valid EMG profiles have been developed. Electromyograms from eight major muscles of the lower leg are measured from five normal young adults during self-selected slow, free and fast walking speeds. 30 strides per task are measured. The 'ideal' EMG profile is defined from the ensemble average of the rectified EMG signal. An error measure is defined and used as a criterion to assess the appropriateness of various cut-off frequencies for envelope filters and the number of strides required for establishing a good EMG profile. It is found that between six and ten strides are needed to form a representative profile, and an envelope filter with a minimum cut-off frequency of approximately 9 Hz is necessary.

A protocol for clinical gait analysis is described, and data from 30 normal adult female subjects are presented. Extensive application to pathologic subjects has proven to be feasible and sufficiently accurate. The method is based on a particular location and attachment of retro-reflective markers on the body and on a particular arrangement of four TV cameras. A motion analyser measures the 3D coordinates of each marker. A modelling approach, based on individual anthropometric measurements, and a functional approach, based on kinematical considerations, are used to estimate the location of hip, knee, and ankle joint centers and the orientation of the flexion-extension axis of the knee. 3D relative and absolute movements of pelvis and lower limbs are obtained and shown to be consistent with functional anatomy.