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The study of human walking has got to go back to tracking. More scientific methods involve measurement. As is the case with science, the question is what is the question? Is it about speed, length, force, consistency, similarity to a favorite animal - what? So you get all sorts of series with 20 of these and 30 of those and 100 of this and 1000 of that. With high numbers we get deviation from normal and compare the measurements of those we know are not doing so well with those of the group who are OK. In recent times, ink blackened feet walking over paper gave us distances without timing. Tricks to add time marks to the foot prints allowed primitive - better than pure speculative - real measurement of who was doing what.
In the 1870s Muybridge set up an array of cameras triggered by strings which the horse hit as it ran by. Gotcha. Feet off the ground. Big hit. Encore. A seemingly endless run of studies of motion followed, using timed camera triggers, which captured humans walking, running, climbing stairs, wrestling, playing tennis, and on and on.
Two physiologists (Braun & Fischer) in Germany (what became East Germany) did the They not only put forth all sorts of 'normal' human walking data but even made a 3D model of stick (real wooden sticks) figures from the data which could be viewed as you would any real model.
How? An American orthopaedic student studying in Germany brought it back and became a department head and wrote a book. Braun and Fischer are noted but without even a clue as to how all that data came to be. This book author rose to great heights while Braun & Fischer kind of slid into the who-izzat realm. Even so the data in this volume came to be second hand gospel. Totally true and mysterious in origin. The original Der Gang des Menchens (in German) had to be rediscovered in a huge uncataloged library in East Germany after the Berlin Wall came down. A look inside the lecture series book I:
But practicality was at work here. Steindler was not about to repeat those methods. Aside from teaching and passing it on, what good are normal measurements, anyway, if you can't measure the abnormals? The study methods of Braun & Fischer were brilliant but difficult. You might pull it off if you spend a fortune and get a rare cooperative subject who could wear the outer space gear. Mmmmm? It was a start.
This is actually pretty good. We relate very well with these images. A bra commercial is probably still remembered by many - she dreamed she went dancing in her Maidenform Bra. The >dancing< either requires a series of images ala Muybridge, or multiple exposures in a single picture ala the strobe light. By taking tracings, we can also generate real data. These are strobes done by me and you can be assured that such measurements take forever to abstract and crunch. You have to really want that measurement. Still not practical for day to day measurement - but Here we see a young lady wearing a white body suit dribbling a (red white & blue) basket ball into a layup shot. The basket is up on the pole. Yes, she has two casts on her feet. Yes, we were able to study how to offset loss of motion by casts allowing the subject to do all sorts of stuff - using simple strobe light photo studies. Strobe plus Polaroid instant film, voila.
When Sputnick freaked out the Western Military, the thrown together Vanguard Rocket program failed terribly, but did produce this rear projection film viewing device. Note the two round knobs at the bottom which - like an etchasketch - move two cross hairs which generate, frame by frame, very high precision points of interest over the projected image of the Vanguard Rocket blowing up on the launch pad. The cameras were high speed and could suck a full movie sized roll of film to nothing in a few seconds. Well if you point those cameras at a person, not exploding, but doing something like walking - A N D - if you can get a resident to go blind looking at frame after frame and turning those knobs and pencil logging the x and y data (7 decimal places), and then doing the math, then before that subject departs this earth in old age you get to know the data. Well the orthopaedists were cheating and looking as well at the film as a step through. Data came later. This was the California contingent of Inman and his followers, and Dr. Sutherland, and the Ranchos Los Amigos group who generated quite a bit of data on stroke patients as the first order of business after prosthetics.
On the right, the Harvard-MIT team of the RERC (Research Engineering Rehabilatation Center) took the California idea and altered the cameras. The cameras were computer step driven to allow variable speed and longer sessions. Vanguard knobs and cross hairs were decomissioned. Two ultrasound microphones adorn the top and left side of the viewing screen and send data to the boxes on seen to the left (with the orange lights). They send sound delay data from the (mouse) probe sitting at rest on top of the top microphone. When you click the mouse button an ultrsound squeek is detected by the two microphones. Where the click came from is sent to the computer which steps through menus of expected named points. The two white strips are divided into boxes of command locations (menus) which allow the user to alter the data flow or skip unseen points. The computer advances the frame of film at the end of each series of points. It computes missing data from the entirety of the data. But the 7 bit word of the computer at that time could not do everything required. So.. the MIT students took it apart and added an eighth bit. No kidding. There was an unused bus line. The computer reps went goony when they saw that. The 8 bit word was now in action. More rapid data aquisition allowed actual patient data to solve actual ongoing problems (they were calling us for results the night of the study). There was also "EMG" data acquired and "force plate" data time coupled to the motion data. In addition human evaluations of things (heel strike, toe off etc, and any non motion event such as a grimace) were logged into the data base. Mathematics know-how came from advertising tech (rolling logos) and from the Smithsonian Astrophysical Observatory (tracking unseen orbit centers) and from the competing dormatories of the MIT engineering and Harvard math students and me who made the rounds of these folks. Everybody did something. This was before "Intellectual Property" and the death of explosive technology. By the way, the force plate was built by an MIT professor who wanted to measure the kick of race horces leaving the gate. Science. A weird guy who would whack the force plate at odd intervals with the wide end of a crutch, brought it to high levels of intelligence. But this system was still based on film. Film needs to be developed. What'ayamean the film was ruined? Mmmm. Do we really need 1000 frames per second. Simulations of lesser samples culled from the densely sampled files showed that filtering could drop our need (for walking) as low as 20 frames per second without much loss.
Front end was video input. We (in New Jersey now) had built for us, by a firm in Texas, a box which could track a point in video and output X-Y coordinates. With a little help from our friends (Rutgers Aeronautics Dept, AT&T, Bell Labs, and some awesome brains at EAI who program in pure binary on these machines) we had us a real time analytic machine turning out conclusions. Conclusions. They were in physics form but still with real world meaning, not just lengths or intervals.
The aeronautics folks helped us construct nasty things to wear to mimic certain kinds of restraints through a series of degrees of badness. What did the subjects do to get around the constraints? We published only a tiny bit of our findings as nearly no journal could handle the data (2 foot wide paper, tight print, 300 pages of crunched data). It took many self written programs to wade through it all to get human interpretation of what we were seeing. A tight subportion of the data was published in Clinical Orthopaedics and Related Research. We conveyed the findings of the actions of the unconstrained side when one leg had a series of constraints. What the unimpeded side did, wich was not "normal" was paliative to our devices. How so was the subject of that report. Interestingly, though we learned much about constraints, the data did not in any case resemble cerebral palsy. Three hundred dense pages of outcome data without a trace of anything looking like palsy. Range of motion is not the key factor in cerebral palsy. Not even close. Yet our terminology is nearly nothing but range of motion this and range of motion that. It was time for mathematical models. Made many. But still no clue.
It took a smaller computer (a multitasking desktop) that could be reprogramed at will, often on a whim, to give the flexibility of asking what questions were not being asked, to nail down the real factors. I used an Amiga genlocked to a double video source with EMG converted from the usual strip chart (looked at separately) to bar graphs bouncing up and down in the actual video - real time video insertion thanks to a video delay loop in the acqisition mechanism and using a telemetry based on Macintosh architecture.
The other problem was that each time we tried to retard momentum in our volunteers, we nearly killed them. Our EMG was not able to be read as it topped out. Even swapping the linear input chips for logrhythmic, which ought to measure anything, was not enough. Our subjects were on the floor, pursed lip breathing, holding their chests and asking to stop. Ahhh. We had it! Just needed an indestructible subject who could do the full range of tensions which we thought were present in the range of children with CP. Oh, notice that the computer handling of video allows superposition such that we also get our strobe effect. The human eye and what is behind it likes that. We had also learned that inches or meters mean nothing. Lengths expressed in terms of body height (height = 1 stature) blessed us with very easy to grab and hugely applicable measurements. We learned that measurements must be in tune with what you are observing. It is relative to mass and proportional lever lengths. The horizontal red bar (above) marks off distance in statures. Here the stride length is 0.78 statures. The EMG and graphs look nearly normal despite mild tension. Nearly. The nearly was the first insight to strategy number one. Make the tension go away. See the study of elastics for the rest of this.
There are now desk top commercial devices which can record video from two sources and allow user inspection and measurement taking. It's those danged golfers. What is it with golf? Everybody wants to analyze golf strokes. Then, when the product does not get a big golf following, it goes belly up. Here is one that has hung in there, Video Coach, from Draco, the Casablanca video editor company, does all the needed stuff to look at motion and check out details. It wasn't built for gait, but all the analytic tools are there.
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