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Title:	Development and validation of an alpha prototype device to measure weight distribution asymmetry in lower limbs
Authors:	Senthil Kumar N.S (P65532)
Supervisor:	Baharudin Omar, Prof. Dr.
Keywords:	Asymmetrical limb Kinetics Kinematics Osteoarthritis Lower limbs Dissertations, Academic -- Malaysia
Issue Date:	8-Feb-2016
Description:	Asymmetrical limb loading could alter the joint kinetics and kinematics. However, the pattern of limb loading in healthy and knee osteoarthritis populations remains unclear. Force Platform (FP) is the standard tool to assess limb loading. Nevertheless, FP is expensive, not portable and need more space and expertise, hence not feasible in clinical practice. Therefore, there is a need for a simple, objective, clinical measurement tool to evaluate limb load asymmetry (LLA). The current research was conducted in three phases: i) to explore the LLA in healthy subjects and people with knee osteoarthritis (KOA) ii) to develop and calibrate an alpha prototype device "Clinical Duple Weight Distribution Device" (CDWDD) to measure LLA iii) to validate and test the reliability of CDWDD against FP. The first phase of this crosssectional study recruited 68 subjects with knee osteoarthritis (Kellgren Lawrence grade 2 and 3) and 68 healthy controls through systematic random sampling. Two digital weighing scales (DWSs) were used to collect the limb loading data. Modified symmetry index was employed to further compute the data to obtain the LLA score. The second phase was an innovative research study in which the CDWDD was designed and tested with different test loads ranged from 10-100 kg to report accuracy, hysteresis, eccentricity error, repeatability, and uncertainty. The third phase was validity and reliability study designed to test the CDWDD against FP. Nine healthy subjects and nine individuals with symptomatic unilateral knee osteoarthritis (KOA) participants were recruited for this phase through convenient sampling. The phase 1 results had demonstrated that healthy individuals and participants with Grade 2 and Grade 3 KOA exhibited a notable difference in asymmetrical limb loading (p<0.001). Furthermore, severity in the grades of KOA demonstrated a proportional increase in LLA (p<0.001). Individuals with KOA established greater LLA and lesser perceptual errors when compared to healthy participants. Perceptual error revealed an association with LLA (r>0.3; p<0.05). Besides, vision did not affect the perception in KOA. The variables such as BMI (r=0.259, p<0.05), Quadriceps strength (r=-0.387, p<0.001), Q angle (r=0.56, p<0.001), Proprioceptive Error (r=0.289, p<0.05), LLD (r=0.255, p<0.39) were demonstrated to be significantly associated with LLA; however, not shown to be a predictor for LLA. Conversely, the three variables such as pain, knee flexion ROM and abductor strength were shown to be predictors of LLA (R=0.857, R2=0.735, p<0.001). The results from phase 2 proved that the CDWDD had excellent level of accuracy and repeatability (SD=0) with zero errors in terms of hysteresis, eccentricity, and uncertainties. The results from phase 3 established CDWDD as a valid (bias 0.5 to 1.9%) and reliable (ICC 0.98-0.99) tool for the measurement of LLA. In conclusion, healthy individuals and people with KOA exhibit difference in LLA score. LLA pattern might produce undue forces to other joint causing degeneration of joints. Therefore, it is important to consider the evaluation of LLA in the rehabilitation of KOA. The patented novel device CDWDD could be a substitute device for FP and tend to facilitate the evaluation of loading asymmetries in common practice. CDWDD have the potential to be a key component of a clinician's testing battery.,Doctor of Philosophy
Pages:	284
Call Number:	WA20.5.S478d 2016 9
Publisher:	UKM, Kuala Lumpur
Appears in Collections:	Faculty of Health Sciences / Fakulti Sains Kesihatan

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