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Northeastern University · Department of Physical Therapy, Movement, and Rehabilitation Sciences
Active 2016–2024
Eric Folmar is an Associate Chair and Associate Clinical Professor in the Department of Physical Therapy, Movement, and Rehabilitation Sciences at Bouvé College of Health Sciences, Northeastern University. His role involves leadership within the department, contributing to the education and training of students in physical therapy and related fields. His professional focus is on clinical practice and education within the realm of physical therapy, movement, and rehabilitation sciences.
GaitNet+ARL: A Deep Learning Algorithm for Interpretable Gait Analysis of Chronic Ankle Instability
IEEE Journal of Biomedical and Health Informatics · 2024 · 4 citations
Chronic ankle instability (CAI) is a major public health concern and adversely affects people's mobility and quality of life. Traditional assessment methods are subjective and qualitative by means of clinician observation and patient self-reporting, which may lead to inaccurate assessment and reduce the effectiveness of treatment in clinical practice. Gait analysis becomes a commonly used approach for monitoring human motion behaviors, which can be applied to specific diagnosis and assessment of CAI. However, it is still challenging to recognize the pathological gait pattern for CAI subjects. In this paper, we propose an integrated deep learning framework to solve the CAI recognition problem using kinematic data. Specifically, inspired by the biomechanics of human body system, we create a simple graph neural network (GNN), termed GaitNet, that operates on a spatial domain and exploits interactions among 3-D joint coordinates. We also develop an attention reinforcement learning (ARL) model that determines attention weights of frames on a temporal domain, which is combined with GaitNet for prediction. The effectiveness of our method is validated on the kinematic NEU-CAI dataset which is collected in our institution using a stereophotogrammetric system. According to extensive experiments, we demonstrate that the selected key phases (i.e., sequences of frames with high attentions) significantly increase the predictability of the proposed biomechanics-based GNN model to differentiate between CAI cohort and control cohort. Moreover, we show a significant prediction accuracy improvement (20%-25%) by our approach compared to state-of-the-art machine learning and deep learning methods.
Frontiers in Sports and Active Living · 2022 · 5 citations
Purpose: An investigation of the ankle dynamics in a motor task may generate insights into the etiology of chronic ankle instability (CAI). This study presents a novel application of recurrence quantification analysis (RQA) to examine the ankle dynamics during walking. We hypothesized that CAI is associated with changes in the ankle dynamics as assessed by measures of determinism and laminarity using RQA. Methods: We recorded and analyzed the ankle position trajectories in the frontal and sagittal planes from 12 participants with CAI and 12 healthy controls during treadmill walking. We used time-delay embedding to reconstruct the position trajectories to a phase space that represents the states of the ankle dynamics. Based on the phase space trajectory, a recurrence plot was constructed and two RQA variables, the percent determinism (%DET) and the percent laminarity (%LAM), were derived from the recurrence plot to quantify the ankle dynamics. Results: < 0.05. effect size = 0.86). This indicated that the ankle dynamics in individuals with CAI is less likely to remain in the same state. No significant results were found in the %DET or in the sagittal plane. Conclusion: A lower frontal-plane %LAM may reflect more frequent switching between different patterns of neuromuscular control states due to the instabilities associated with CAI. With further study and development, %LAM may have the potential to become a useful biomarker for CAI.
Conservative Treatment of Peroneal Tendon Injuries: Rehabilitation
2020-01-01 · 1 citations
Elsevier eBooks · 2020-01-01
Peroneal Tendon Injury in the Elite Athlete
2020-01-01
Principles of Lower Extremity Orthoses
Elsevier eBooks · 2020 · 5 citations
Gait & Posture · 2018-08-28 · 31 citations
A Comparison of Kinesiology and Athletic Taping on Ankle Range of Motion
Foot & Ankle Orthopaedics · 2018-07-01
Category: Other Introduction/Purpose: A high prevalence of ankle sprains exists in athletic and non-athletic populations. White athletic tape (WAT), commonly used for prevention and treatment, provides ankle stability while limiting mobility. Athletic taping has demonstrated the ability to limit ROM in all directions, particularly ankle inversion, as inversion injuries represent a vast majority of ankle sprains. Use of kinesiology taping (KT) for the purpose of limiting mobility in the ankle has not been examined. While limiting inversion range of motion may be beneficial in prophylactic management of ankle injuries, limiting ROM in other directions may impact kinematics of other joints in the kinetic chain. To determine the effectiveness of an innovative KT technique for limiting ankle inversion ROM while allowing movement in the other movements of the ankle. Methods: Fifty-three healthy 18-25 year old college students were recruited for this study. Subjects received each of the taping conditions (traditional basket weave WAT, a novel KT method, and no tape) in a randomized order. Manual goniometer measurements were taken in non-weight bearing in the inversion, eversion, dorsiflexion and plantarflexion directions. A handheld inclinometer was used to measure weight bearing ankle dorsiflexion. Measures for each were compared across each taping condition. A repeated measures ANOVA was performed. Results: Significant decreases in ankle ROM (p <.01) were observed in all measures between WAT and no tape. KT demonstrated significant decreases in all ROM compared to no tape (p <.01), except for a minimal decrease in weight bearing ankle dorsiflexion (p>.05). WAT demonstrated significantly greater ROM restriction in all directions than did KT (p<.01), including weight-bearing ankle DF. Conclusion: These results suggest that KT allows for more ankle ROM than traditional WAT in non-weight bearing and weight bearing measures, while still providing significant motion limitation in all motions except weight bearing dorsiflexion (in comparison to no tape). Limiting excessive inversion while simultaneously allowing closer to normal ROM in all other planes may decrease the risk of negatively impacting kinetic chain kinematics associated limited mobility of the ankle.
THE IMPACT OF ATTENTIONAL FOCUS ON THE TREATMENT OF MUSCULOSKELETAL AND MOVEMENT DISORDERS
International Journal of Sports Physical Therapy · 2017-11-01 · 42 citations
Treatment plans employed by physical therapists involved in musculoskeletal rehabilitation may follow a conventional medical-model approach, isolating care at the tissue level but neglecting consideration for neurocognitive contributions to recovery. Understanding and integration of motor learning concepts into physical therapy practice is integral for influencing the human movement system in the most effective manner. One such motor learning concept is the use of verbal instruction to influence the attentional focus of the learner. Evidence suggests that encouraging an external focus of attention through verbal instruction promotes superior motor performance, and more lasting effects of a learning experience than an internal focus of attention. Utilizing an external focus of attention when instructing a patient on a motor task may facilitate improved motor performance and improved functional outcomes in treatment plans devised to address musculoskeletal injury and movement disorders. The purpose of this review is to summarize the basic principles of motor learning and available evidence on the influence an external focus of attention has on motor learning and performance, including the benefits of an external focus of attention over an internal focus of attention and how therapists may inadvertently encourage the latter. Furthermore, the benefits of possessing greater awareness of neurocognitive mechanisms are discussed to exhibit how implementing such concepts into musculoskeletal rehabilitation can maximize treatment outcomes. LEVEL OF EVIDENCE: 5.
Physical Therapy Dosing: Frequency and Type of Intervention in Pediatric Postacute Hospital Care
Pediatric Physical Therapy · 2016-12-15 · 7 citations
PURPOSE: To examine differences in physical therapy dosing frequency recommendations based on children's characteristics and to describe types of intervention recommended at postacute hospital admission. METHODS: Demographic and clinical information, recommended physical therapy intervention frequency, and intervention types were collected for all admissions from April 1, 2015, to March 1, 2016. Differences across 2 groups, children with recommendations for "less" (≤3x/wk) or "more" (≥4x/wk) frequent therapy, were examined. Types of interventions recommended were described and the measure of association between frequency and type was determined. RESULTS: Older children, those with higher admission functional scores, and children with less dependence on medical technology were recommended for "more." Therapeutic exercise was the most common intervention recommended. Greater physical therapy frequency was associated with Functional Training and Motor Function Training. CONCLUSION: Children's age, functional level, and technology dependence influence dosing recommendations. Interventions focused on function are associated with greater physical therapy frequency.
Sheng‐Che Yen
Helene M. Dumas
Elaine L. Rosen
Maria A. Fragala-Pinkham
Chun-An Chou
Northeastern University
Mark Sobel
Lenox Hill Hospital
Department of Physical Therapy, Movement, and Rehabilitation SciencesPI
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Kevin K. Chui
Radford University
Heather Jennings
University of Wisconsin–Madison