Clinical Biomechanics

Training and testing Core Control using Virtual Reality games

Primary Contact: Dr Gabor Barton

Course related video
GPO

Course related video
Motek Medical - Goblin Post office

BBC Radio Merseyside interview: Dr Gabor Barton - CAREN



Our multi-disciplinary research team has developed custom made computer games focusing on movement co-ordination of the trunk and pelvis, known as the core of the body. In a recent pilot study, a group of children with cerebral palsy were recruited through Alder Hey Children’s Hospital, and over 6 weeks they played variants of the Goblin Post Office game (see video above) on the first CAREN virtual reality system in the UK. In order to understand how their movement skills changed in response to the games training their walking style was tested using clinical gait analysis, and a detailed analysis was made of movement performance recorded while playing the games.

Dissemination of research

The findings of our research have been presented at national and international scientific conferences, and disseminated to physiotherapists in research seminars and postgraduate training programmes. We continue to analyse and publish the results of our research in peer reviewed scientific journals. The novelty and potentially high impact of our research has been recognised by the WellChild Researcher Award 2010. Our findings will be summarised as part of the invited symposia within the 16th Congress of the European College of Sport Science. In an invited keynote presentation coupled with a hands-on workshop our results will be shared with participants of the Clinical Movement Analysis Society (UK and Ireland) meeting in 2012.

What comes next?

The next stage of the research will take place in schools across Merseyside. In order to make the method available to a larger number of children, a portable prototype of the game has been developed. It will be used in schools to train and test children with cerebral palsy, focusing on the core of the body, as well as the ankle, knee, and hip joints.

References

Award Winning Published Output

  1. Barton GJ, Holmes G, Hawken M, Lees A, Vanrenterghem J (2006) A virtual reality tool for training and testing core stability: a pilot study. Abstract / Gait and Posture, 24/Suppl. 2: S101-S102. 1st Joint ESMAC – GCMAS Meeting, Amsterdam, The Netherlands, 28-30 Sept. Winner of the Best Poster Prize. Alternative format
  2. Barton GJ (2008) Improving core control of children with cerebral palsy using virtual reality games. 1st Conference of the Institute for Health Research, Liverpool John Moores University. 9 May. Winner of Best combined Oral and Poster Prize.
  3. Foster R, Bass A, Holmes G, Hawken M, Barton GJ (2009). Integration of a portable controller into virtual reality based core training for implementation in clinical practice. 2nd Conference of the Institute for Health Research, Liverpool John Moores University. 15th May. Runner up for Best Poster Prize. Alternative format
  4. Barton GJ, Hawken MB, Butler P, Holmes G, Foster RJ (2010) Movement control of the trunk and pelvis in cerebral palsy diplegia. 3rd Conference of the Institute for Health Research, Liverpool John Moores University. 21st May. Runner up for Best Poster Prize and winner of Special Prize for External Collaboration.

Esteem/awards

  • The Goblin Post Office computer game developed within the WellChild research project won the 2nd place in the Serious Games category at the Dutch Game Awards 2009.
  • Winner of WellChild Research Award, 2010.

Peer Reviewed Publications

  1. Hawkins PJR, Hawken MB, Barton GJ (2008) Effect of game speed and surface perturbations on postural control in a virtual environment. Proceedings of the 7th ICDVRAT with ArtAbilitation, Maia, Portugal.
  2. Barton GJ (2010) Virtual rehabilitation – a focus on movement function. Biomechanica Hungarica. 2/2: 7-14.

Published and Peer Reviewed Conference Abstracts

  1. Hayes SC, Barton GJ, Hawken MB, Butler PB, Jarvis SE (2007) Joint specific responses to controlled perturbations in targeted training – a pilot study. Abstract / Gait and Posture, 26/Suppl.1: S75-S76. 16th ESMAC Meeting and Conference, Athens, Greece, 27-29 Sept. Alternative format
  2. Foster RJ, Hawken MB, Barton GJ (2008) Movement co-ordination of the pelvis in a virtual game environment. Abstract / Gait and Posture, 28S: S10-S11. 17th ESMAC Meeting and Conference, Antalya, Turkey, 11-13 Sept.
  3. Barton GJ (2009) Virtual rehabilitation in cerebral palsy. Abstract / Journal of Sports Sciences, 27S1: S3. The Ergonomics Society: 6th International Conference on Sport, Leisure and Ergonomics. 16th Nov. 2007.
  4. Barton GJ, Butler PB, Hawken MB, Jarvis SE (2009) Re-direction of movement perturbation by rotating around the targeted joint. Abstract / Journal of Sports Sciences, 27S1: S3-S4. The Ergonomics Society: 6th International Conference on Sport, Leisure and Ergonomics. 14th Nov. 2007.
  5. Barton GJ, Hawken MB, Butler P, Holmes G, Foster RJ (2009) Movement control of the trunk and pelvis in cerebral palsy diplegia. Abstract / Gait and Posture, 30 (S1):147-8. 18th ESMAC Meeting and Conference, London, UK, 15-19 Sept. Alternative format
  6. Foster RF, Hawken MB, Butler P, Holmes G, Barton GJ (2010) The effects of game training on trunk to pelvis coupling: A case study of a child with Cerebral Palsy. BASES Biomechanics Interest Group Meeting, Bath, 21 April.
  7. Barton GJ, Hawken MB, Foster RJ, Holmes G, Butler PB (2011) Playing the Goblin Post Office game improves movement control of the core: A case study. International Conference on Virtual Rehabilitation, Zurich Switzerland, 27-29 June.

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Biomechanics and control of upper limb movement

Primary Contact: Dr Mark Robinson

The primary focus of upper limb research has been in the evaluation of the posterior deltoid tendon transfer in tetraplegia. Following a tendon transfer, an identical activation pattern of the same muscle will lead to a different mechanical action coupled with changed proprioceptive and visual feedback about the task. The focus of our research is to explore the re-adaptation mechanisms of the neuro-musculo-skeletal system. The Brain and Behaviour research group are also collaborating in this area.

Award Winning Published Output
  • Robinson, M., Barton, G., Lees, A. And Sett, P. (2008). Reaching Ability Of Tetraplegics In Their 3D Workspace After Tendon Transfer Surgery. Journal of Biomechanics, 41(S1), S112.
    Student award runner up at European Society of Biomechanics Conference, 2008.
Peer Reviewed Publications
  • Robinson, M., Barton, G. Lees and Sett, P. (2010). Analysis of tetraplegic reaching in their 3D workspace following posterior deltoid-triceps tendon transfer. Spinal Cord, 48, 619-627.
  • Robinson, M., Hayes, S., Bennett, S., Barton, G. and Elliott. (2010). Sensory-motor equivalence: manual aiming in C6 tetraplegics following musculotendinous transfer surgery at the elbow. Experimental Brain Research, 206, 81-91.


The role of posture and balance throughout life and in sport

Primary Contact: Dr Jos Vanrenterghem

A multifactorial approach addresses the role of posture and balance in activities ranging from daily life tasks such as normal walking, walking across an obstacle, sit-to-stand and lifting, to tasks as part of dynamic sports activities such as side cutting manoeuvres, drop landing and vertical jump. During recent years advanced methods have been explored, developed, and used in the context of assessment or interventions.

Publications
  • Vanrenterghem J, Barton JG, Lake M, Lees A (2005) Changing the axes of rotation in a six degrees of freedom moving platform used for postural research. Abstract / Gait and Posture, 21/Suppl.1: 152. ISPGR XVIIth Conference - Marseille, France, 29 May – 2 June.
  • Sturnieks, D.L., Menant, J., Vanrenterghem, J., Fitzpatrick R.C., Lord, S.R. (2011) Stepping responses to force-controlled perturbations predict falls in older adults. Australian and New Zealand Society of Biomechanics, Canberra, Australia.
  • Vanrenterghem, J. (2011) Side cutting manoeuvres in sport: where balance and injury risk confront performance. Invited lecture at European Congress of Sport Science, Liverpool, UK.
  • Vanrenterghem J., Galna B., Cable N.T., Goldspink D., Barton G. (2010) Differential benefits of past and present sport participation to functional mobility in healthy 55-65 year-old adults. European Congress of Sport Science, Antalya, Turkey.


Exercise and therapeutic interventions to improve neuromuscular function

Primary Contact: Dr Jos Vanrenterghem

The successful recent developments of highly advanced methods allow for accurate measurement of biomechanical loading and neuromuscular function during movement. This has led to the initiation of collaborations with several academic and commercial partners to investigate the effectiveness of exercise or therapeutic interventions. Current projects involve the influence of exercise interventions such as targeted muscle training or therapeutic interventions such as taping on the biomechanical loading and neuromuscular function during movement.

Publications
  • Vanrenterghem, J., Gormley, D., Robinson, M., Lees, A. (2010) Solutions for representing the whole-body centre of mass in side cutting manoeuvres based on data that is typically available for lower limb kinematics. Gait and Posture, 31, 517-521. [IF 1.7].

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Performance characteristics of the CAREN system

Primary Contact: Dr Malcolm Hawken

A new apparatus (CAREN, Motek, Amsterdam) has recently become available which consists of a 2 m diameter platform that can be moved by six computer driven hydraulic actuators in six degrees of freedom. This is used for research into rehabilitation, posture and balance. Some of its basic functional characteristics have been the subject of our earlier investigations.

Kinematic response characteristics of the CAREN moving platform

The aim of this study was to determine the technical performance of the CAREN system by defining its kinematic response characteristics to two commonly used input functions (sine and ramp) for each of its six translational and rotational axes. The results suggest that the CAREN platform is a mid-range system with regard to single degree of freedom moving platform devices reported in the literature. The low level of maximal cross-talk in displacement (1.5%) and velocity (3.3%) together with the ability to faithfully follow ramp input functions make the CAREN system an appropriate device for postural and balance research with some unique features.

Publication
  • Lees A, Vanrenterghem J, Barton JG, Lake M (2007) Kinematic response characteristics of the CAREN moving platform system for use in posture and balance research. Medical Engineering and Physics. 29/5:629-635.

Manipulation of the CAREN platform’s axes of rotation

The purpose of this study was to locate the CAREN platform’s default axes of rotation, implement an algorithm for relocating its axes of rotation, and evaluate the algorithm. The method developed allows rotating the supporting platform around specific joints which triggers proprioceptive receptors in the targeted joint only and so the method opens up the possibility of gaining a more detailed understanding of the roles of individual joints in balance corrections.

Publications
  • Barton JG, Vanrenterghem J, Lees A, Lake M (2006) A method for manipulating a movable platform’s axes of rotation: a novel use of the CAREN system. Gait and Posture. 24/4: 510-514.
  • Barton JG, Vanrenterghem J, Lees A (2005) Joint specific proprioceptive perturbation of standing balance on a movable platform. Abstract / Gait and Posture, 22/Suppl. 1: 50. 14th ESMAC Meeting and Conference, Barcelona, Spain, 22-24 Sept.
  • Vanrenterghem J, Barton JG, Lake M, Lees A (2005) Changing the axes of rotation in a six degrees of freedom moving platform used for postural research. Abstract / Gait and Posture, 21/Suppl.1: 152. ISPGR XVIIth Conference - Marseille, France, 29 May – 2 June.


Neural Networks in Clinical Gait Analysis

Primary Contact: Dr Gabor Barton

Details of abnormal gait can be captured by quantifying the three dimensional joint angles, moments and powers of the lower limbs but the complexity of the resultant high dimensional data space makes data interpretation prone to bias. Self-organising neural networks can be used successfully to map complex gait data onto a two dimensional topographic map, thereby improving the efficiency of decision making in clinical gait analysis.

We have developed the Movement Deviation Profile which shows the deviation of an individual’s movement from normality in a single curve and a single number.

Publications
  • Barton GJ, Hawken MB, Scott M, Schwartz MH (2010) Movement Deviation Profile: a measure of distance from normality using a self organising neural network. Invited paper in Special Issue on Network Approaches in Complex Environments, Human Movement Science. In Press.
  • Barton GJ, Lees A, Lisboa P, Attfield S (2007) Gait quality assessment using self-organising artificial neural networks. Gait and Posture. 25/3: 374-379.
  • Barton JG, Lees A, Lisboa P, Attfield S (2006) Visualisation of gait data with Kohonen self‑organising neural maps. Gait and Posture. 24/1: 46-53.
  • Barton JG (2006) Visualisation of gait data using a self organising artificial neural network. Invited Chapter in Computational Intelligence for Movement Sciences: Neural Networks, Support Vector Machines and other Emerging Techniques. Editors: Begg, RK and Palaniswami, M. pp. 197-216. Idea Group Inc., USA.
  • Lees A, Barton JG (2005) A characterisation of technique in the soccer kick using a Kohonen neural network analysis. In T. Reilly, J. Cabri and D. Araujo (Eds) Science and Football V . Proceedings of the Fifth World Congress of Science and Football, (pp. 83-88), London, Routledge.
  • Lees A, Barton JG (2004) A characterisation of technique in the soccer kick using a Kohonen neural network analysis. Journal of Sports Sciences, 22(6), 491-492. Conference Communication.
  • Barton JG, Lees A, Lisboa P, Attfield S (2003) Visualisation of gait quality using self organising artificial neural networks. Abstract / Gait and Posture, 18/Suppl.2: 119. 12th ESMAC Meeting and Conference, Marseille, France, 8-13 Sept.
  • Lees A, Barton JG, Kershaw L (2003) The use of Kohonen neural network analysis to establish characteristics of technique in soccer kicking. Abstract / Journal of Sports Sciences, 21, 243-244.

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Page last modified by Zoe Miveld on 28 March 2012.
 
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