biomechanics of long distance running and injury mechanisms

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Advances in Biomechanics Applied to Sports Marcos Duarte Biomechanics and Motor Control Laboratory Federal University of ABC http ://demotu.org/ [email protected] NWO-FAPESP Joint Workshop: Research on Sports and Healthy Living March 22-23, 2016 http://demotu.org/pubs/FapespNWO2016. pdf

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Page 1: Biomechanics of long distance running and injury mechanisms

Advances in Biomechanics Applied to Sports

Marcos DuarteBiomechanics and Motor Control Laboratory

Federal University of ABChttpdemotuorg

marcosduarteufabcedubr

NWO-FAPESP Joint Workshop Research on Sports and Healthy Living March 22-23 2016

httpdemotuorgpubsFapespNWO2016pdf

FAPESP support in numbers to biomecacircnica or controle motor

36 Ongoing research grants

363 Completed research grants

61 Ongoing scholarships in Brazil

542 Completed scholarships in Brazil

10 Ongoing scholarships abroad

35 Completed scholarships abroad

1047 All Research Grants and Scholarships

Search on March 12 2016 httpwwwbvfapespbr2

Current projectsinterests of theBiomechanics and Motor Control Laboratory

bull Balance control in humans (older individuals)

bull Biomechanics of long distance running and injury mechanisms (non-athletes)

bull Modeling and simulation of human movement (open software)

bull Improvement of biomechanical analysis of human movement (clinical use)

bull Public data sets of biosignals related to human movement (BIG data worldwide)

bull Services of clinical gait analysis and wheelchair propulsion analysis (free BMClab)

bull Dissemination of science and mathematics to society using sports (La Fisica del Calcio)

3

Biomechanics of long distance runningBiomechanics and Motor Control Laboratory

bull Balance control in humans (older individuals)

bull Biomechanics of long distance running and injury mechanisms (non-athletes)

bull Modeling and simulation of human movement (open software)

bull Improvement of biomechanical analysis of human movement (clinical use)

bull Public data sets of biosignals related to human movement (BIG data worldwide)

bull Services of clinical gait analysis and wheelchair propulsion analysis (free BMClab)

bull Dissemination of science and mathematics to society using sports (La Fisica del Calcio)

4

Background

bull Increased running participation

bull Brazil ~45 million runners (anecdotal evidence)

bull USA ~30 million1

bull Increased older runnersrsquo participation2 (healthy aging)

1httpwwwrunningusaorg 2Jokl et al (2004) BJSM

Background

bull Running injury frequency between 15-851

bull Economic burden of a running injury2

bull Direct cost euro5797

bull Indirect costs euro11575

bull Older age has been associated with higher incidence3

1Nigg et al (2015) BJSM 2Hespanhol et al (2015) SJMSS 3Nielsen et al (2013) OJSM

Background

bull Running injury etiology is likely multifactorial1

bull Epidemiological data

bull Biomechanical studies

bull Clinical research

bull Behavioral research

bull Atypical running patterns have been associated with

injuries2

bull Age-related changes in running biomechanics have been

consistently observed34

1Hulme and Finch (2016) JSHS 2Hreljac (2004) MSSE 3Fukuchi and Duarte (2008)

JSS 4Fukuchi et al (2014) CB

bull stride length

bull stride frequency

bull Altered joint kinematics

Aging amp biomechanics of long distance running

Fukuchi amp Duarte (2008)

bull flexibility and muscle strength in older runners

bull Atypical gait in older runners

Kinematics Kinetics

Aging amp biomechanics of long distance running

Fukuchi et al (2014)

The Problem

bull Despite intense research the injury rates have not

declined1

bull Complex nature of running biomechanics data has been

examined by simplistic approaches2

bull What is the typical and atypical (injured) running pattern

1Nigg et al(2015) BJSM 2Chau (2001) GP 3Mullineaux et al (2001) JSS

Possible approach for a solution

bull A public database of running ranging from

demographics biomechanical musculoskeletal

function and epidemiological data with a large

population of runners

http3dgaitanalysiscom

Public running database

bull To provide good quality data to the scientific

community

bull Development and testing of novel and robust data

analysis approaches to address the complex

multivariate nature of running injuries etiology

httpmobilizestanfordedu

bull 85 overall classification accuracy rate

bull 100 classification accuracy rate was achieved

when only six kinematic features were combined

Aging amp biomechanics of long distance running

Fukuchi et al (2011)

Biomechanics of long distance runningBiomechanics and Motor Control Laboratory

bull But there are still too many unsolved problems with the

biomechanics of long distance running and injury mechanisms hellip

14

Sacco ICN

Long-distance runners (adt amp

elderly)

Foot muscle

trophism

Run amp walk biomechanics

Foot health amp

functionality

Foot-ankle and toes strength

Running-related injury

Coordination of inter and intra limbs

2 months supervised

sessions

10 months home-

exercises

12 months assessments

Aim - Investigate the effects of (1)a ground-up therapeutic approach and(2)aging onhellip hellip running and gait biomechanics on lower limbs coordination on strength and functionality of the muscles of the lower limbs and on the prevention of running-related injuries

(some) Collaborators in Satildeo Paulo State

16

Optimal Control of Human Movement

β

α

x

γ

bull Marko Ackermann ndash FEI University Satildeo Bernardo do Campo Brazil

bull Maarten F Bobbert ndash VU University Amsterdam The Netherlands

Sit-to-stand task (CNPq Project 4028312012-8 Marco Vaz PA)

Wheelchair propulsion

17

Biomechatronics = Biomechanics + Motor Control (Natuurlijk ndashFCT vd Helm-)

Models of the human motor control system from a control engineering perspective

BIOMECHATRONICS LABMECHATRONICS DEPARTMENT

ESCOLA POLITEacuteCNICA UNIVERSITY OF SAtildeO PAULO

bull FacultyArturo Forner-CorderoRafael T Moura

bull Post-docsFabianne Furtado

bull PhDLuis Filipe RossiCarlos NoriegaMilton Cortez JuniorGuilherme Umemura

bull Visiting Professors (NL)Jacques Duysens (CNPq)Bouwien Smits-EngelsmanNoel Keijsers

bull MSc studentsCamila SouitMayra B VillalpandoRafael S SouzaEduardo GarciaLeonardo F SommerMichele Sakatahttpsitespoliuspbrpmrbiomecatronica

BIOMECHATRONICS LAB (A FORNER-CORDERO)

Forner-Cordero A Rodrigues ST Duysens JObstacle crossing differences between blindand blindfolded subjects after hapticexploration J Motor Behavior (in press)

Forner-Cordero A Itiki C Souza RLourenco JCMC Krebs HI (2014)Experimental assessment of gait withrhythmic auditory perturbations BioRob2014

Sacco ICN

Kinematics Kinetics Plantar pressure

ggggg

Diabetic Neuropathy

TIBIAL ANTERIOR ndash Maacutex MCA

CONTROLE AUSENTE INTERMEDIAacuteRIO GRAVE

sEM

G m

ult

ich

ann

el

RCT Effect foot exercises in PP amp gait speed

ObrigadoMarcos Duarte

Biomechanics and Motor Control Laboratory

Federal University of ABC

httpdemotuorg

marcosduarteufabcedubr21

httpdemotuorgpubsFapespNWO2016pdf

Page 2: Biomechanics of long distance running and injury mechanisms

FAPESP support in numbers to biomecacircnica or controle motor

36 Ongoing research grants

363 Completed research grants

61 Ongoing scholarships in Brazil

542 Completed scholarships in Brazil

10 Ongoing scholarships abroad

35 Completed scholarships abroad

1047 All Research Grants and Scholarships

Search on March 12 2016 httpwwwbvfapespbr2

Current projectsinterests of theBiomechanics and Motor Control Laboratory

bull Balance control in humans (older individuals)

bull Biomechanics of long distance running and injury mechanisms (non-athletes)

bull Modeling and simulation of human movement (open software)

bull Improvement of biomechanical analysis of human movement (clinical use)

bull Public data sets of biosignals related to human movement (BIG data worldwide)

bull Services of clinical gait analysis and wheelchair propulsion analysis (free BMClab)

bull Dissemination of science and mathematics to society using sports (La Fisica del Calcio)

3

Biomechanics of long distance runningBiomechanics and Motor Control Laboratory

bull Balance control in humans (older individuals)

bull Biomechanics of long distance running and injury mechanisms (non-athletes)

bull Modeling and simulation of human movement (open software)

bull Improvement of biomechanical analysis of human movement (clinical use)

bull Public data sets of biosignals related to human movement (BIG data worldwide)

bull Services of clinical gait analysis and wheelchair propulsion analysis (free BMClab)

bull Dissemination of science and mathematics to society using sports (La Fisica del Calcio)

4

Background

bull Increased running participation

bull Brazil ~45 million runners (anecdotal evidence)

bull USA ~30 million1

bull Increased older runnersrsquo participation2 (healthy aging)

1httpwwwrunningusaorg 2Jokl et al (2004) BJSM

Background

bull Running injury frequency between 15-851

bull Economic burden of a running injury2

bull Direct cost euro5797

bull Indirect costs euro11575

bull Older age has been associated with higher incidence3

1Nigg et al (2015) BJSM 2Hespanhol et al (2015) SJMSS 3Nielsen et al (2013) OJSM

Background

bull Running injury etiology is likely multifactorial1

bull Epidemiological data

bull Biomechanical studies

bull Clinical research

bull Behavioral research

bull Atypical running patterns have been associated with

injuries2

bull Age-related changes in running biomechanics have been

consistently observed34

1Hulme and Finch (2016) JSHS 2Hreljac (2004) MSSE 3Fukuchi and Duarte (2008)

JSS 4Fukuchi et al (2014) CB

bull stride length

bull stride frequency

bull Altered joint kinematics

Aging amp biomechanics of long distance running

Fukuchi amp Duarte (2008)

bull flexibility and muscle strength in older runners

bull Atypical gait in older runners

Kinematics Kinetics

Aging amp biomechanics of long distance running

Fukuchi et al (2014)

The Problem

bull Despite intense research the injury rates have not

declined1

bull Complex nature of running biomechanics data has been

examined by simplistic approaches2

bull What is the typical and atypical (injured) running pattern

1Nigg et al(2015) BJSM 2Chau (2001) GP 3Mullineaux et al (2001) JSS

Possible approach for a solution

bull A public database of running ranging from

demographics biomechanical musculoskeletal

function and epidemiological data with a large

population of runners

http3dgaitanalysiscom

Public running database

bull To provide good quality data to the scientific

community

bull Development and testing of novel and robust data

analysis approaches to address the complex

multivariate nature of running injuries etiology

httpmobilizestanfordedu

bull 85 overall classification accuracy rate

bull 100 classification accuracy rate was achieved

when only six kinematic features were combined

Aging amp biomechanics of long distance running

Fukuchi et al (2011)

Biomechanics of long distance runningBiomechanics and Motor Control Laboratory

bull But there are still too many unsolved problems with the

biomechanics of long distance running and injury mechanisms hellip

14

Sacco ICN

Long-distance runners (adt amp

elderly)

Foot muscle

trophism

Run amp walk biomechanics

Foot health amp

functionality

Foot-ankle and toes strength

Running-related injury

Coordination of inter and intra limbs

2 months supervised

sessions

10 months home-

exercises

12 months assessments

Aim - Investigate the effects of (1)a ground-up therapeutic approach and(2)aging onhellip hellip running and gait biomechanics on lower limbs coordination on strength and functionality of the muscles of the lower limbs and on the prevention of running-related injuries

(some) Collaborators in Satildeo Paulo State

16

Optimal Control of Human Movement

β

α

x

γ

bull Marko Ackermann ndash FEI University Satildeo Bernardo do Campo Brazil

bull Maarten F Bobbert ndash VU University Amsterdam The Netherlands

Sit-to-stand task (CNPq Project 4028312012-8 Marco Vaz PA)

Wheelchair propulsion

17

Biomechatronics = Biomechanics + Motor Control (Natuurlijk ndashFCT vd Helm-)

Models of the human motor control system from a control engineering perspective

BIOMECHATRONICS LABMECHATRONICS DEPARTMENT

ESCOLA POLITEacuteCNICA UNIVERSITY OF SAtildeO PAULO

bull FacultyArturo Forner-CorderoRafael T Moura

bull Post-docsFabianne Furtado

bull PhDLuis Filipe RossiCarlos NoriegaMilton Cortez JuniorGuilherme Umemura

bull Visiting Professors (NL)Jacques Duysens (CNPq)Bouwien Smits-EngelsmanNoel Keijsers

bull MSc studentsCamila SouitMayra B VillalpandoRafael S SouzaEduardo GarciaLeonardo F SommerMichele Sakatahttpsitespoliuspbrpmrbiomecatronica

BIOMECHATRONICS LAB (A FORNER-CORDERO)

Forner-Cordero A Rodrigues ST Duysens JObstacle crossing differences between blindand blindfolded subjects after hapticexploration J Motor Behavior (in press)

Forner-Cordero A Itiki C Souza RLourenco JCMC Krebs HI (2014)Experimental assessment of gait withrhythmic auditory perturbations BioRob2014

Sacco ICN

Kinematics Kinetics Plantar pressure

ggggg

Diabetic Neuropathy

TIBIAL ANTERIOR ndash Maacutex MCA

CONTROLE AUSENTE INTERMEDIAacuteRIO GRAVE

sEM

G m

ult

ich

ann

el

RCT Effect foot exercises in PP amp gait speed

ObrigadoMarcos Duarte

Biomechanics and Motor Control Laboratory

Federal University of ABC

httpdemotuorg

marcosduarteufabcedubr21

httpdemotuorgpubsFapespNWO2016pdf

Page 3: Biomechanics of long distance running and injury mechanisms

Current projectsinterests of theBiomechanics and Motor Control Laboratory

bull Balance control in humans (older individuals)

bull Biomechanics of long distance running and injury mechanisms (non-athletes)

bull Modeling and simulation of human movement (open software)

bull Improvement of biomechanical analysis of human movement (clinical use)

bull Public data sets of biosignals related to human movement (BIG data worldwide)

bull Services of clinical gait analysis and wheelchair propulsion analysis (free BMClab)

bull Dissemination of science and mathematics to society using sports (La Fisica del Calcio)

3

Biomechanics of long distance runningBiomechanics and Motor Control Laboratory

bull Balance control in humans (older individuals)

bull Biomechanics of long distance running and injury mechanisms (non-athletes)

bull Modeling and simulation of human movement (open software)

bull Improvement of biomechanical analysis of human movement (clinical use)

bull Public data sets of biosignals related to human movement (BIG data worldwide)

bull Services of clinical gait analysis and wheelchair propulsion analysis (free BMClab)

bull Dissemination of science and mathematics to society using sports (La Fisica del Calcio)

4

Background

bull Increased running participation

bull Brazil ~45 million runners (anecdotal evidence)

bull USA ~30 million1

bull Increased older runnersrsquo participation2 (healthy aging)

1httpwwwrunningusaorg 2Jokl et al (2004) BJSM

Background

bull Running injury frequency between 15-851

bull Economic burden of a running injury2

bull Direct cost euro5797

bull Indirect costs euro11575

bull Older age has been associated with higher incidence3

1Nigg et al (2015) BJSM 2Hespanhol et al (2015) SJMSS 3Nielsen et al (2013) OJSM

Background

bull Running injury etiology is likely multifactorial1

bull Epidemiological data

bull Biomechanical studies

bull Clinical research

bull Behavioral research

bull Atypical running patterns have been associated with

injuries2

bull Age-related changes in running biomechanics have been

consistently observed34

1Hulme and Finch (2016) JSHS 2Hreljac (2004) MSSE 3Fukuchi and Duarte (2008)

JSS 4Fukuchi et al (2014) CB

bull stride length

bull stride frequency

bull Altered joint kinematics

Aging amp biomechanics of long distance running

Fukuchi amp Duarte (2008)

bull flexibility and muscle strength in older runners

bull Atypical gait in older runners

Kinematics Kinetics

Aging amp biomechanics of long distance running

Fukuchi et al (2014)

The Problem

bull Despite intense research the injury rates have not

declined1

bull Complex nature of running biomechanics data has been

examined by simplistic approaches2

bull What is the typical and atypical (injured) running pattern

1Nigg et al(2015) BJSM 2Chau (2001) GP 3Mullineaux et al (2001) JSS

Possible approach for a solution

bull A public database of running ranging from

demographics biomechanical musculoskeletal

function and epidemiological data with a large

population of runners

http3dgaitanalysiscom

Public running database

bull To provide good quality data to the scientific

community

bull Development and testing of novel and robust data

analysis approaches to address the complex

multivariate nature of running injuries etiology

httpmobilizestanfordedu

bull 85 overall classification accuracy rate

bull 100 classification accuracy rate was achieved

when only six kinematic features were combined

Aging amp biomechanics of long distance running

Fukuchi et al (2011)

Biomechanics of long distance runningBiomechanics and Motor Control Laboratory

bull But there are still too many unsolved problems with the

biomechanics of long distance running and injury mechanisms hellip

14

Sacco ICN

Long-distance runners (adt amp

elderly)

Foot muscle

trophism

Run amp walk biomechanics

Foot health amp

functionality

Foot-ankle and toes strength

Running-related injury

Coordination of inter and intra limbs

2 months supervised

sessions

10 months home-

exercises

12 months assessments

Aim - Investigate the effects of (1)a ground-up therapeutic approach and(2)aging onhellip hellip running and gait biomechanics on lower limbs coordination on strength and functionality of the muscles of the lower limbs and on the prevention of running-related injuries

(some) Collaborators in Satildeo Paulo State

16

Optimal Control of Human Movement

β

α

x

γ

bull Marko Ackermann ndash FEI University Satildeo Bernardo do Campo Brazil

bull Maarten F Bobbert ndash VU University Amsterdam The Netherlands

Sit-to-stand task (CNPq Project 4028312012-8 Marco Vaz PA)

Wheelchair propulsion

17

Biomechatronics = Biomechanics + Motor Control (Natuurlijk ndashFCT vd Helm-)

Models of the human motor control system from a control engineering perspective

BIOMECHATRONICS LABMECHATRONICS DEPARTMENT

ESCOLA POLITEacuteCNICA UNIVERSITY OF SAtildeO PAULO

bull FacultyArturo Forner-CorderoRafael T Moura

bull Post-docsFabianne Furtado

bull PhDLuis Filipe RossiCarlos NoriegaMilton Cortez JuniorGuilherme Umemura

bull Visiting Professors (NL)Jacques Duysens (CNPq)Bouwien Smits-EngelsmanNoel Keijsers

bull MSc studentsCamila SouitMayra B VillalpandoRafael S SouzaEduardo GarciaLeonardo F SommerMichele Sakatahttpsitespoliuspbrpmrbiomecatronica

BIOMECHATRONICS LAB (A FORNER-CORDERO)

Forner-Cordero A Rodrigues ST Duysens JObstacle crossing differences between blindand blindfolded subjects after hapticexploration J Motor Behavior (in press)

Forner-Cordero A Itiki C Souza RLourenco JCMC Krebs HI (2014)Experimental assessment of gait withrhythmic auditory perturbations BioRob2014

Sacco ICN

Kinematics Kinetics Plantar pressure

ggggg

Diabetic Neuropathy

TIBIAL ANTERIOR ndash Maacutex MCA

CONTROLE AUSENTE INTERMEDIAacuteRIO GRAVE

sEM

G m

ult

ich

ann

el

RCT Effect foot exercises in PP amp gait speed

ObrigadoMarcos Duarte

Biomechanics and Motor Control Laboratory

Federal University of ABC

httpdemotuorg

marcosduarteufabcedubr21

httpdemotuorgpubsFapespNWO2016pdf

Page 4: Biomechanics of long distance running and injury mechanisms

Biomechanics of long distance runningBiomechanics and Motor Control Laboratory

bull Balance control in humans (older individuals)

bull Biomechanics of long distance running and injury mechanisms (non-athletes)

bull Modeling and simulation of human movement (open software)

bull Improvement of biomechanical analysis of human movement (clinical use)

bull Public data sets of biosignals related to human movement (BIG data worldwide)

bull Services of clinical gait analysis and wheelchair propulsion analysis (free BMClab)

bull Dissemination of science and mathematics to society using sports (La Fisica del Calcio)

4

Background

bull Increased running participation

bull Brazil ~45 million runners (anecdotal evidence)

bull USA ~30 million1

bull Increased older runnersrsquo participation2 (healthy aging)

1httpwwwrunningusaorg 2Jokl et al (2004) BJSM

Background

bull Running injury frequency between 15-851

bull Economic burden of a running injury2

bull Direct cost euro5797

bull Indirect costs euro11575

bull Older age has been associated with higher incidence3

1Nigg et al (2015) BJSM 2Hespanhol et al (2015) SJMSS 3Nielsen et al (2013) OJSM

Background

bull Running injury etiology is likely multifactorial1

bull Epidemiological data

bull Biomechanical studies

bull Clinical research

bull Behavioral research

bull Atypical running patterns have been associated with

injuries2

bull Age-related changes in running biomechanics have been

consistently observed34

1Hulme and Finch (2016) JSHS 2Hreljac (2004) MSSE 3Fukuchi and Duarte (2008)

JSS 4Fukuchi et al (2014) CB

bull stride length

bull stride frequency

bull Altered joint kinematics

Aging amp biomechanics of long distance running

Fukuchi amp Duarte (2008)

bull flexibility and muscle strength in older runners

bull Atypical gait in older runners

Kinematics Kinetics

Aging amp biomechanics of long distance running

Fukuchi et al (2014)

The Problem

bull Despite intense research the injury rates have not

declined1

bull Complex nature of running biomechanics data has been

examined by simplistic approaches2

bull What is the typical and atypical (injured) running pattern

1Nigg et al(2015) BJSM 2Chau (2001) GP 3Mullineaux et al (2001) JSS

Possible approach for a solution

bull A public database of running ranging from

demographics biomechanical musculoskeletal

function and epidemiological data with a large

population of runners

http3dgaitanalysiscom

Public running database

bull To provide good quality data to the scientific

community

bull Development and testing of novel and robust data

analysis approaches to address the complex

multivariate nature of running injuries etiology

httpmobilizestanfordedu

bull 85 overall classification accuracy rate

bull 100 classification accuracy rate was achieved

when only six kinematic features were combined

Aging amp biomechanics of long distance running

Fukuchi et al (2011)

Biomechanics of long distance runningBiomechanics and Motor Control Laboratory

bull But there are still too many unsolved problems with the

biomechanics of long distance running and injury mechanisms hellip

14

Sacco ICN

Long-distance runners (adt amp

elderly)

Foot muscle

trophism

Run amp walk biomechanics

Foot health amp

functionality

Foot-ankle and toes strength

Running-related injury

Coordination of inter and intra limbs

2 months supervised

sessions

10 months home-

exercises

12 months assessments

Aim - Investigate the effects of (1)a ground-up therapeutic approach and(2)aging onhellip hellip running and gait biomechanics on lower limbs coordination on strength and functionality of the muscles of the lower limbs and on the prevention of running-related injuries

(some) Collaborators in Satildeo Paulo State

16

Optimal Control of Human Movement

β

α

x

γ

bull Marko Ackermann ndash FEI University Satildeo Bernardo do Campo Brazil

bull Maarten F Bobbert ndash VU University Amsterdam The Netherlands

Sit-to-stand task (CNPq Project 4028312012-8 Marco Vaz PA)

Wheelchair propulsion

17

Biomechatronics = Biomechanics + Motor Control (Natuurlijk ndashFCT vd Helm-)

Models of the human motor control system from a control engineering perspective

BIOMECHATRONICS LABMECHATRONICS DEPARTMENT

ESCOLA POLITEacuteCNICA UNIVERSITY OF SAtildeO PAULO

bull FacultyArturo Forner-CorderoRafael T Moura

bull Post-docsFabianne Furtado

bull PhDLuis Filipe RossiCarlos NoriegaMilton Cortez JuniorGuilherme Umemura

bull Visiting Professors (NL)Jacques Duysens (CNPq)Bouwien Smits-EngelsmanNoel Keijsers

bull MSc studentsCamila SouitMayra B VillalpandoRafael S SouzaEduardo GarciaLeonardo F SommerMichele Sakatahttpsitespoliuspbrpmrbiomecatronica

BIOMECHATRONICS LAB (A FORNER-CORDERO)

Forner-Cordero A Rodrigues ST Duysens JObstacle crossing differences between blindand blindfolded subjects after hapticexploration J Motor Behavior (in press)

Forner-Cordero A Itiki C Souza RLourenco JCMC Krebs HI (2014)Experimental assessment of gait withrhythmic auditory perturbations BioRob2014

Sacco ICN

Kinematics Kinetics Plantar pressure

ggggg

Diabetic Neuropathy

TIBIAL ANTERIOR ndash Maacutex MCA

CONTROLE AUSENTE INTERMEDIAacuteRIO GRAVE

sEM

G m

ult

ich

ann

el

RCT Effect foot exercises in PP amp gait speed

ObrigadoMarcos Duarte

Biomechanics and Motor Control Laboratory

Federal University of ABC

httpdemotuorg

marcosduarteufabcedubr21

httpdemotuorgpubsFapespNWO2016pdf

Page 5: Biomechanics of long distance running and injury mechanisms

Background

bull Increased running participation

bull Brazil ~45 million runners (anecdotal evidence)

bull USA ~30 million1

bull Increased older runnersrsquo participation2 (healthy aging)

1httpwwwrunningusaorg 2Jokl et al (2004) BJSM

Background

bull Running injury frequency between 15-851

bull Economic burden of a running injury2

bull Direct cost euro5797

bull Indirect costs euro11575

bull Older age has been associated with higher incidence3

1Nigg et al (2015) BJSM 2Hespanhol et al (2015) SJMSS 3Nielsen et al (2013) OJSM

Background

bull Running injury etiology is likely multifactorial1

bull Epidemiological data

bull Biomechanical studies

bull Clinical research

bull Behavioral research

bull Atypical running patterns have been associated with

injuries2

bull Age-related changes in running biomechanics have been

consistently observed34

1Hulme and Finch (2016) JSHS 2Hreljac (2004) MSSE 3Fukuchi and Duarte (2008)

JSS 4Fukuchi et al (2014) CB

bull stride length

bull stride frequency

bull Altered joint kinematics

Aging amp biomechanics of long distance running

Fukuchi amp Duarte (2008)

bull flexibility and muscle strength in older runners

bull Atypical gait in older runners

Kinematics Kinetics

Aging amp biomechanics of long distance running

Fukuchi et al (2014)

The Problem

bull Despite intense research the injury rates have not

declined1

bull Complex nature of running biomechanics data has been

examined by simplistic approaches2

bull What is the typical and atypical (injured) running pattern

1Nigg et al(2015) BJSM 2Chau (2001) GP 3Mullineaux et al (2001) JSS

Possible approach for a solution

bull A public database of running ranging from

demographics biomechanical musculoskeletal

function and epidemiological data with a large

population of runners

http3dgaitanalysiscom

Public running database

bull To provide good quality data to the scientific

community

bull Development and testing of novel and robust data

analysis approaches to address the complex

multivariate nature of running injuries etiology

httpmobilizestanfordedu

bull 85 overall classification accuracy rate

bull 100 classification accuracy rate was achieved

when only six kinematic features were combined

Aging amp biomechanics of long distance running

Fukuchi et al (2011)

Biomechanics of long distance runningBiomechanics and Motor Control Laboratory

bull But there are still too many unsolved problems with the

biomechanics of long distance running and injury mechanisms hellip

14

Sacco ICN

Long-distance runners (adt amp

elderly)

Foot muscle

trophism

Run amp walk biomechanics

Foot health amp

functionality

Foot-ankle and toes strength

Running-related injury

Coordination of inter and intra limbs

2 months supervised

sessions

10 months home-

exercises

12 months assessments

Aim - Investigate the effects of (1)a ground-up therapeutic approach and(2)aging onhellip hellip running and gait biomechanics on lower limbs coordination on strength and functionality of the muscles of the lower limbs and on the prevention of running-related injuries

(some) Collaborators in Satildeo Paulo State

16

Optimal Control of Human Movement

β

α

x

γ

bull Marko Ackermann ndash FEI University Satildeo Bernardo do Campo Brazil

bull Maarten F Bobbert ndash VU University Amsterdam The Netherlands

Sit-to-stand task (CNPq Project 4028312012-8 Marco Vaz PA)

Wheelchair propulsion

17

Biomechatronics = Biomechanics + Motor Control (Natuurlijk ndashFCT vd Helm-)

Models of the human motor control system from a control engineering perspective

BIOMECHATRONICS LABMECHATRONICS DEPARTMENT

ESCOLA POLITEacuteCNICA UNIVERSITY OF SAtildeO PAULO

bull FacultyArturo Forner-CorderoRafael T Moura

bull Post-docsFabianne Furtado

bull PhDLuis Filipe RossiCarlos NoriegaMilton Cortez JuniorGuilherme Umemura

bull Visiting Professors (NL)Jacques Duysens (CNPq)Bouwien Smits-EngelsmanNoel Keijsers

bull MSc studentsCamila SouitMayra B VillalpandoRafael S SouzaEduardo GarciaLeonardo F SommerMichele Sakatahttpsitespoliuspbrpmrbiomecatronica

BIOMECHATRONICS LAB (A FORNER-CORDERO)

Forner-Cordero A Rodrigues ST Duysens JObstacle crossing differences between blindand blindfolded subjects after hapticexploration J Motor Behavior (in press)

Forner-Cordero A Itiki C Souza RLourenco JCMC Krebs HI (2014)Experimental assessment of gait withrhythmic auditory perturbations BioRob2014

Sacco ICN

Kinematics Kinetics Plantar pressure

ggggg

Diabetic Neuropathy

TIBIAL ANTERIOR ndash Maacutex MCA

CONTROLE AUSENTE INTERMEDIAacuteRIO GRAVE

sEM

G m

ult

ich

ann

el

RCT Effect foot exercises in PP amp gait speed

ObrigadoMarcos Duarte

Biomechanics and Motor Control Laboratory

Federal University of ABC

httpdemotuorg

marcosduarteufabcedubr21

httpdemotuorgpubsFapespNWO2016pdf

Page 6: Biomechanics of long distance running and injury mechanisms

Background

bull Running injury frequency between 15-851

bull Economic burden of a running injury2

bull Direct cost euro5797

bull Indirect costs euro11575

bull Older age has been associated with higher incidence3

1Nigg et al (2015) BJSM 2Hespanhol et al (2015) SJMSS 3Nielsen et al (2013) OJSM

Background

bull Running injury etiology is likely multifactorial1

bull Epidemiological data

bull Biomechanical studies

bull Clinical research

bull Behavioral research

bull Atypical running patterns have been associated with

injuries2

bull Age-related changes in running biomechanics have been

consistently observed34

1Hulme and Finch (2016) JSHS 2Hreljac (2004) MSSE 3Fukuchi and Duarte (2008)

JSS 4Fukuchi et al (2014) CB

bull stride length

bull stride frequency

bull Altered joint kinematics

Aging amp biomechanics of long distance running

Fukuchi amp Duarte (2008)

bull flexibility and muscle strength in older runners

bull Atypical gait in older runners

Kinematics Kinetics

Aging amp biomechanics of long distance running

Fukuchi et al (2014)

The Problem

bull Despite intense research the injury rates have not

declined1

bull Complex nature of running biomechanics data has been

examined by simplistic approaches2

bull What is the typical and atypical (injured) running pattern

1Nigg et al(2015) BJSM 2Chau (2001) GP 3Mullineaux et al (2001) JSS

Possible approach for a solution

bull A public database of running ranging from

demographics biomechanical musculoskeletal

function and epidemiological data with a large

population of runners

http3dgaitanalysiscom

Public running database

bull To provide good quality data to the scientific

community

bull Development and testing of novel and robust data

analysis approaches to address the complex

multivariate nature of running injuries etiology

httpmobilizestanfordedu

bull 85 overall classification accuracy rate

bull 100 classification accuracy rate was achieved

when only six kinematic features were combined

Aging amp biomechanics of long distance running

Fukuchi et al (2011)

Biomechanics of long distance runningBiomechanics and Motor Control Laboratory

bull But there are still too many unsolved problems with the

biomechanics of long distance running and injury mechanisms hellip

14

Sacco ICN

Long-distance runners (adt amp

elderly)

Foot muscle

trophism

Run amp walk biomechanics

Foot health amp

functionality

Foot-ankle and toes strength

Running-related injury

Coordination of inter and intra limbs

2 months supervised

sessions

10 months home-

exercises

12 months assessments

Aim - Investigate the effects of (1)a ground-up therapeutic approach and(2)aging onhellip hellip running and gait biomechanics on lower limbs coordination on strength and functionality of the muscles of the lower limbs and on the prevention of running-related injuries

(some) Collaborators in Satildeo Paulo State

16

Optimal Control of Human Movement

β

α

x

γ

bull Marko Ackermann ndash FEI University Satildeo Bernardo do Campo Brazil

bull Maarten F Bobbert ndash VU University Amsterdam The Netherlands

Sit-to-stand task (CNPq Project 4028312012-8 Marco Vaz PA)

Wheelchair propulsion

17

Biomechatronics = Biomechanics + Motor Control (Natuurlijk ndashFCT vd Helm-)

Models of the human motor control system from a control engineering perspective

BIOMECHATRONICS LABMECHATRONICS DEPARTMENT

ESCOLA POLITEacuteCNICA UNIVERSITY OF SAtildeO PAULO

bull FacultyArturo Forner-CorderoRafael T Moura

bull Post-docsFabianne Furtado

bull PhDLuis Filipe RossiCarlos NoriegaMilton Cortez JuniorGuilherme Umemura

bull Visiting Professors (NL)Jacques Duysens (CNPq)Bouwien Smits-EngelsmanNoel Keijsers

bull MSc studentsCamila SouitMayra B VillalpandoRafael S SouzaEduardo GarciaLeonardo F SommerMichele Sakatahttpsitespoliuspbrpmrbiomecatronica

BIOMECHATRONICS LAB (A FORNER-CORDERO)

Forner-Cordero A Rodrigues ST Duysens JObstacle crossing differences between blindand blindfolded subjects after hapticexploration J Motor Behavior (in press)

Forner-Cordero A Itiki C Souza RLourenco JCMC Krebs HI (2014)Experimental assessment of gait withrhythmic auditory perturbations BioRob2014

Sacco ICN

Kinematics Kinetics Plantar pressure

ggggg

Diabetic Neuropathy

TIBIAL ANTERIOR ndash Maacutex MCA

CONTROLE AUSENTE INTERMEDIAacuteRIO GRAVE

sEM

G m

ult

ich

ann

el

RCT Effect foot exercises in PP amp gait speed

ObrigadoMarcos Duarte

Biomechanics and Motor Control Laboratory

Federal University of ABC

httpdemotuorg

marcosduarteufabcedubr21

httpdemotuorgpubsFapespNWO2016pdf

Page 7: Biomechanics of long distance running and injury mechanisms

Background

bull Running injury etiology is likely multifactorial1

bull Epidemiological data

bull Biomechanical studies

bull Clinical research

bull Behavioral research

bull Atypical running patterns have been associated with

injuries2

bull Age-related changes in running biomechanics have been

consistently observed34

1Hulme and Finch (2016) JSHS 2Hreljac (2004) MSSE 3Fukuchi and Duarte (2008)

JSS 4Fukuchi et al (2014) CB

bull stride length

bull stride frequency

bull Altered joint kinematics

Aging amp biomechanics of long distance running

Fukuchi amp Duarte (2008)

bull flexibility and muscle strength in older runners

bull Atypical gait in older runners

Kinematics Kinetics

Aging amp biomechanics of long distance running

Fukuchi et al (2014)

The Problem

bull Despite intense research the injury rates have not

declined1

bull Complex nature of running biomechanics data has been

examined by simplistic approaches2

bull What is the typical and atypical (injured) running pattern

1Nigg et al(2015) BJSM 2Chau (2001) GP 3Mullineaux et al (2001) JSS

Possible approach for a solution

bull A public database of running ranging from

demographics biomechanical musculoskeletal

function and epidemiological data with a large

population of runners

http3dgaitanalysiscom

Public running database

bull To provide good quality data to the scientific

community

bull Development and testing of novel and robust data

analysis approaches to address the complex

multivariate nature of running injuries etiology

httpmobilizestanfordedu

bull 85 overall classification accuracy rate

bull 100 classification accuracy rate was achieved

when only six kinematic features were combined

Aging amp biomechanics of long distance running

Fukuchi et al (2011)

Biomechanics of long distance runningBiomechanics and Motor Control Laboratory

bull But there are still too many unsolved problems with the

biomechanics of long distance running and injury mechanisms hellip

14

Sacco ICN

Long-distance runners (adt amp

elderly)

Foot muscle

trophism

Run amp walk biomechanics

Foot health amp

functionality

Foot-ankle and toes strength

Running-related injury

Coordination of inter and intra limbs

2 months supervised

sessions

10 months home-

exercises

12 months assessments

Aim - Investigate the effects of (1)a ground-up therapeutic approach and(2)aging onhellip hellip running and gait biomechanics on lower limbs coordination on strength and functionality of the muscles of the lower limbs and on the prevention of running-related injuries

(some) Collaborators in Satildeo Paulo State

16

Optimal Control of Human Movement

β

α

x

γ

bull Marko Ackermann ndash FEI University Satildeo Bernardo do Campo Brazil

bull Maarten F Bobbert ndash VU University Amsterdam The Netherlands

Sit-to-stand task (CNPq Project 4028312012-8 Marco Vaz PA)

Wheelchair propulsion

17

Biomechatronics = Biomechanics + Motor Control (Natuurlijk ndashFCT vd Helm-)

Models of the human motor control system from a control engineering perspective

BIOMECHATRONICS LABMECHATRONICS DEPARTMENT

ESCOLA POLITEacuteCNICA UNIVERSITY OF SAtildeO PAULO

bull FacultyArturo Forner-CorderoRafael T Moura

bull Post-docsFabianne Furtado

bull PhDLuis Filipe RossiCarlos NoriegaMilton Cortez JuniorGuilherme Umemura

bull Visiting Professors (NL)Jacques Duysens (CNPq)Bouwien Smits-EngelsmanNoel Keijsers

bull MSc studentsCamila SouitMayra B VillalpandoRafael S SouzaEduardo GarciaLeonardo F SommerMichele Sakatahttpsitespoliuspbrpmrbiomecatronica

BIOMECHATRONICS LAB (A FORNER-CORDERO)

Forner-Cordero A Rodrigues ST Duysens JObstacle crossing differences between blindand blindfolded subjects after hapticexploration J Motor Behavior (in press)

Forner-Cordero A Itiki C Souza RLourenco JCMC Krebs HI (2014)Experimental assessment of gait withrhythmic auditory perturbations BioRob2014

Sacco ICN

Kinematics Kinetics Plantar pressure

ggggg

Diabetic Neuropathy

TIBIAL ANTERIOR ndash Maacutex MCA

CONTROLE AUSENTE INTERMEDIAacuteRIO GRAVE

sEM

G m

ult

ich

ann

el

RCT Effect foot exercises in PP amp gait speed

ObrigadoMarcos Duarte

Biomechanics and Motor Control Laboratory

Federal University of ABC

httpdemotuorg

marcosduarteufabcedubr21

httpdemotuorgpubsFapespNWO2016pdf

Page 8: Biomechanics of long distance running and injury mechanisms

bull stride length

bull stride frequency

bull Altered joint kinematics

Aging amp biomechanics of long distance running

Fukuchi amp Duarte (2008)

bull flexibility and muscle strength in older runners

bull Atypical gait in older runners

Kinematics Kinetics

Aging amp biomechanics of long distance running

Fukuchi et al (2014)

The Problem

bull Despite intense research the injury rates have not

declined1

bull Complex nature of running biomechanics data has been

examined by simplistic approaches2

bull What is the typical and atypical (injured) running pattern

1Nigg et al(2015) BJSM 2Chau (2001) GP 3Mullineaux et al (2001) JSS

Possible approach for a solution

bull A public database of running ranging from

demographics biomechanical musculoskeletal

function and epidemiological data with a large

population of runners

http3dgaitanalysiscom

Public running database

bull To provide good quality data to the scientific

community

bull Development and testing of novel and robust data

analysis approaches to address the complex

multivariate nature of running injuries etiology

httpmobilizestanfordedu

bull 85 overall classification accuracy rate

bull 100 classification accuracy rate was achieved

when only six kinematic features were combined

Aging amp biomechanics of long distance running

Fukuchi et al (2011)

Biomechanics of long distance runningBiomechanics and Motor Control Laboratory

bull But there are still too many unsolved problems with the

biomechanics of long distance running and injury mechanisms hellip

14

Sacco ICN

Long-distance runners (adt amp

elderly)

Foot muscle

trophism

Run amp walk biomechanics

Foot health amp

functionality

Foot-ankle and toes strength

Running-related injury

Coordination of inter and intra limbs

2 months supervised

sessions

10 months home-

exercises

12 months assessments

Aim - Investigate the effects of (1)a ground-up therapeutic approach and(2)aging onhellip hellip running and gait biomechanics on lower limbs coordination on strength and functionality of the muscles of the lower limbs and on the prevention of running-related injuries

(some) Collaborators in Satildeo Paulo State

16

Optimal Control of Human Movement

β

α

x

γ

bull Marko Ackermann ndash FEI University Satildeo Bernardo do Campo Brazil

bull Maarten F Bobbert ndash VU University Amsterdam The Netherlands

Sit-to-stand task (CNPq Project 4028312012-8 Marco Vaz PA)

Wheelchair propulsion

17

Biomechatronics = Biomechanics + Motor Control (Natuurlijk ndashFCT vd Helm-)

Models of the human motor control system from a control engineering perspective

BIOMECHATRONICS LABMECHATRONICS DEPARTMENT

ESCOLA POLITEacuteCNICA UNIVERSITY OF SAtildeO PAULO

bull FacultyArturo Forner-CorderoRafael T Moura

bull Post-docsFabianne Furtado

bull PhDLuis Filipe RossiCarlos NoriegaMilton Cortez JuniorGuilherme Umemura

bull Visiting Professors (NL)Jacques Duysens (CNPq)Bouwien Smits-EngelsmanNoel Keijsers

bull MSc studentsCamila SouitMayra B VillalpandoRafael S SouzaEduardo GarciaLeonardo F SommerMichele Sakatahttpsitespoliuspbrpmrbiomecatronica

BIOMECHATRONICS LAB (A FORNER-CORDERO)

Forner-Cordero A Rodrigues ST Duysens JObstacle crossing differences between blindand blindfolded subjects after hapticexploration J Motor Behavior (in press)

Forner-Cordero A Itiki C Souza RLourenco JCMC Krebs HI (2014)Experimental assessment of gait withrhythmic auditory perturbations BioRob2014

Sacco ICN

Kinematics Kinetics Plantar pressure

ggggg

Diabetic Neuropathy

TIBIAL ANTERIOR ndash Maacutex MCA

CONTROLE AUSENTE INTERMEDIAacuteRIO GRAVE

sEM

G m

ult

ich

ann

el

RCT Effect foot exercises in PP amp gait speed

ObrigadoMarcos Duarte

Biomechanics and Motor Control Laboratory

Federal University of ABC

httpdemotuorg

marcosduarteufabcedubr21

httpdemotuorgpubsFapespNWO2016pdf

Page 9: Biomechanics of long distance running and injury mechanisms

bull flexibility and muscle strength in older runners

bull Atypical gait in older runners

Kinematics Kinetics

Aging amp biomechanics of long distance running

Fukuchi et al (2014)

The Problem

bull Despite intense research the injury rates have not

declined1

bull Complex nature of running biomechanics data has been

examined by simplistic approaches2

bull What is the typical and atypical (injured) running pattern

1Nigg et al(2015) BJSM 2Chau (2001) GP 3Mullineaux et al (2001) JSS

Possible approach for a solution

bull A public database of running ranging from

demographics biomechanical musculoskeletal

function and epidemiological data with a large

population of runners

http3dgaitanalysiscom

Public running database

bull To provide good quality data to the scientific

community

bull Development and testing of novel and robust data

analysis approaches to address the complex

multivariate nature of running injuries etiology

httpmobilizestanfordedu

bull 85 overall classification accuracy rate

bull 100 classification accuracy rate was achieved

when only six kinematic features were combined

Aging amp biomechanics of long distance running

Fukuchi et al (2011)

Biomechanics of long distance runningBiomechanics and Motor Control Laboratory

bull But there are still too many unsolved problems with the

biomechanics of long distance running and injury mechanisms hellip

14

Sacco ICN

Long-distance runners (adt amp

elderly)

Foot muscle

trophism

Run amp walk biomechanics

Foot health amp

functionality

Foot-ankle and toes strength

Running-related injury

Coordination of inter and intra limbs

2 months supervised

sessions

10 months home-

exercises

12 months assessments

Aim - Investigate the effects of (1)a ground-up therapeutic approach and(2)aging onhellip hellip running and gait biomechanics on lower limbs coordination on strength and functionality of the muscles of the lower limbs and on the prevention of running-related injuries

(some) Collaborators in Satildeo Paulo State

16

Optimal Control of Human Movement

β

α

x

γ

bull Marko Ackermann ndash FEI University Satildeo Bernardo do Campo Brazil

bull Maarten F Bobbert ndash VU University Amsterdam The Netherlands

Sit-to-stand task (CNPq Project 4028312012-8 Marco Vaz PA)

Wheelchair propulsion

17

Biomechatronics = Biomechanics + Motor Control (Natuurlijk ndashFCT vd Helm-)

Models of the human motor control system from a control engineering perspective

BIOMECHATRONICS LABMECHATRONICS DEPARTMENT

ESCOLA POLITEacuteCNICA UNIVERSITY OF SAtildeO PAULO

bull FacultyArturo Forner-CorderoRafael T Moura

bull Post-docsFabianne Furtado

bull PhDLuis Filipe RossiCarlos NoriegaMilton Cortez JuniorGuilherme Umemura

bull Visiting Professors (NL)Jacques Duysens (CNPq)Bouwien Smits-EngelsmanNoel Keijsers

bull MSc studentsCamila SouitMayra B VillalpandoRafael S SouzaEduardo GarciaLeonardo F SommerMichele Sakatahttpsitespoliuspbrpmrbiomecatronica

BIOMECHATRONICS LAB (A FORNER-CORDERO)

Forner-Cordero A Rodrigues ST Duysens JObstacle crossing differences between blindand blindfolded subjects after hapticexploration J Motor Behavior (in press)

Forner-Cordero A Itiki C Souza RLourenco JCMC Krebs HI (2014)Experimental assessment of gait withrhythmic auditory perturbations BioRob2014

Sacco ICN

Kinematics Kinetics Plantar pressure

ggggg

Diabetic Neuropathy

TIBIAL ANTERIOR ndash Maacutex MCA

CONTROLE AUSENTE INTERMEDIAacuteRIO GRAVE

sEM

G m

ult

ich

ann

el

RCT Effect foot exercises in PP amp gait speed

ObrigadoMarcos Duarte

Biomechanics and Motor Control Laboratory

Federal University of ABC

httpdemotuorg

marcosduarteufabcedubr21

httpdemotuorgpubsFapespNWO2016pdf

Page 10: Biomechanics of long distance running and injury mechanisms

The Problem

bull Despite intense research the injury rates have not

declined1

bull Complex nature of running biomechanics data has been

examined by simplistic approaches2

bull What is the typical and atypical (injured) running pattern

1Nigg et al(2015) BJSM 2Chau (2001) GP 3Mullineaux et al (2001) JSS

Possible approach for a solution

bull A public database of running ranging from

demographics biomechanical musculoskeletal

function and epidemiological data with a large

population of runners

http3dgaitanalysiscom

Public running database

bull To provide good quality data to the scientific

community

bull Development and testing of novel and robust data

analysis approaches to address the complex

multivariate nature of running injuries etiology

httpmobilizestanfordedu

bull 85 overall classification accuracy rate

bull 100 classification accuracy rate was achieved

when only six kinematic features were combined

Aging amp biomechanics of long distance running

Fukuchi et al (2011)

Biomechanics of long distance runningBiomechanics and Motor Control Laboratory

bull But there are still too many unsolved problems with the

biomechanics of long distance running and injury mechanisms hellip

14

Sacco ICN

Long-distance runners (adt amp

elderly)

Foot muscle

trophism

Run amp walk biomechanics

Foot health amp

functionality

Foot-ankle and toes strength

Running-related injury

Coordination of inter and intra limbs

2 months supervised

sessions

10 months home-

exercises

12 months assessments

Aim - Investigate the effects of (1)a ground-up therapeutic approach and(2)aging onhellip hellip running and gait biomechanics on lower limbs coordination on strength and functionality of the muscles of the lower limbs and on the prevention of running-related injuries

(some) Collaborators in Satildeo Paulo State

16

Optimal Control of Human Movement

β

α

x

γ

bull Marko Ackermann ndash FEI University Satildeo Bernardo do Campo Brazil

bull Maarten F Bobbert ndash VU University Amsterdam The Netherlands

Sit-to-stand task (CNPq Project 4028312012-8 Marco Vaz PA)

Wheelchair propulsion

17

Biomechatronics = Biomechanics + Motor Control (Natuurlijk ndashFCT vd Helm-)

Models of the human motor control system from a control engineering perspective

BIOMECHATRONICS LABMECHATRONICS DEPARTMENT

ESCOLA POLITEacuteCNICA UNIVERSITY OF SAtildeO PAULO

bull FacultyArturo Forner-CorderoRafael T Moura

bull Post-docsFabianne Furtado

bull PhDLuis Filipe RossiCarlos NoriegaMilton Cortez JuniorGuilherme Umemura

bull Visiting Professors (NL)Jacques Duysens (CNPq)Bouwien Smits-EngelsmanNoel Keijsers

bull MSc studentsCamila SouitMayra B VillalpandoRafael S SouzaEduardo GarciaLeonardo F SommerMichele Sakatahttpsitespoliuspbrpmrbiomecatronica

BIOMECHATRONICS LAB (A FORNER-CORDERO)

Forner-Cordero A Rodrigues ST Duysens JObstacle crossing differences between blindand blindfolded subjects after hapticexploration J Motor Behavior (in press)

Forner-Cordero A Itiki C Souza RLourenco JCMC Krebs HI (2014)Experimental assessment of gait withrhythmic auditory perturbations BioRob2014

Sacco ICN

Kinematics Kinetics Plantar pressure

ggggg

Diabetic Neuropathy

TIBIAL ANTERIOR ndash Maacutex MCA

CONTROLE AUSENTE INTERMEDIAacuteRIO GRAVE

sEM

G m

ult

ich

ann

el

RCT Effect foot exercises in PP amp gait speed

ObrigadoMarcos Duarte

Biomechanics and Motor Control Laboratory

Federal University of ABC

httpdemotuorg

marcosduarteufabcedubr21

httpdemotuorgpubsFapespNWO2016pdf

Page 11: Biomechanics of long distance running and injury mechanisms

Possible approach for a solution

bull A public database of running ranging from

demographics biomechanical musculoskeletal

function and epidemiological data with a large

population of runners

http3dgaitanalysiscom

Public running database

bull To provide good quality data to the scientific

community

bull Development and testing of novel and robust data

analysis approaches to address the complex

multivariate nature of running injuries etiology

httpmobilizestanfordedu

bull 85 overall classification accuracy rate

bull 100 classification accuracy rate was achieved

when only six kinematic features were combined

Aging amp biomechanics of long distance running

Fukuchi et al (2011)

Biomechanics of long distance runningBiomechanics and Motor Control Laboratory

bull But there are still too many unsolved problems with the

biomechanics of long distance running and injury mechanisms hellip

14

Sacco ICN

Long-distance runners (adt amp

elderly)

Foot muscle

trophism

Run amp walk biomechanics

Foot health amp

functionality

Foot-ankle and toes strength

Running-related injury

Coordination of inter and intra limbs

2 months supervised

sessions

10 months home-

exercises

12 months assessments

Aim - Investigate the effects of (1)a ground-up therapeutic approach and(2)aging onhellip hellip running and gait biomechanics on lower limbs coordination on strength and functionality of the muscles of the lower limbs and on the prevention of running-related injuries

(some) Collaborators in Satildeo Paulo State

16

Optimal Control of Human Movement

β

α

x

γ

bull Marko Ackermann ndash FEI University Satildeo Bernardo do Campo Brazil

bull Maarten F Bobbert ndash VU University Amsterdam The Netherlands

Sit-to-stand task (CNPq Project 4028312012-8 Marco Vaz PA)

Wheelchair propulsion

17

Biomechatronics = Biomechanics + Motor Control (Natuurlijk ndashFCT vd Helm-)

Models of the human motor control system from a control engineering perspective

BIOMECHATRONICS LABMECHATRONICS DEPARTMENT

ESCOLA POLITEacuteCNICA UNIVERSITY OF SAtildeO PAULO

bull FacultyArturo Forner-CorderoRafael T Moura

bull Post-docsFabianne Furtado

bull PhDLuis Filipe RossiCarlos NoriegaMilton Cortez JuniorGuilherme Umemura

bull Visiting Professors (NL)Jacques Duysens (CNPq)Bouwien Smits-EngelsmanNoel Keijsers

bull MSc studentsCamila SouitMayra B VillalpandoRafael S SouzaEduardo GarciaLeonardo F SommerMichele Sakatahttpsitespoliuspbrpmrbiomecatronica

BIOMECHATRONICS LAB (A FORNER-CORDERO)

Forner-Cordero A Rodrigues ST Duysens JObstacle crossing differences between blindand blindfolded subjects after hapticexploration J Motor Behavior (in press)

Forner-Cordero A Itiki C Souza RLourenco JCMC Krebs HI (2014)Experimental assessment of gait withrhythmic auditory perturbations BioRob2014

Sacco ICN

Kinematics Kinetics Plantar pressure

ggggg

Diabetic Neuropathy

TIBIAL ANTERIOR ndash Maacutex MCA

CONTROLE AUSENTE INTERMEDIAacuteRIO GRAVE

sEM

G m

ult

ich

ann

el

RCT Effect foot exercises in PP amp gait speed

ObrigadoMarcos Duarte

Biomechanics and Motor Control Laboratory

Federal University of ABC

httpdemotuorg

marcosduarteufabcedubr21

httpdemotuorgpubsFapespNWO2016pdf

Page 12: Biomechanics of long distance running and injury mechanisms

Public running database

bull To provide good quality data to the scientific

community

bull Development and testing of novel and robust data

analysis approaches to address the complex

multivariate nature of running injuries etiology

httpmobilizestanfordedu

bull 85 overall classification accuracy rate

bull 100 classification accuracy rate was achieved

when only six kinematic features were combined

Aging amp biomechanics of long distance running

Fukuchi et al (2011)

Biomechanics of long distance runningBiomechanics and Motor Control Laboratory

bull But there are still too many unsolved problems with the

biomechanics of long distance running and injury mechanisms hellip

14

Sacco ICN

Long-distance runners (adt amp

elderly)

Foot muscle

trophism

Run amp walk biomechanics

Foot health amp

functionality

Foot-ankle and toes strength

Running-related injury

Coordination of inter and intra limbs

2 months supervised

sessions

10 months home-

exercises

12 months assessments

Aim - Investigate the effects of (1)a ground-up therapeutic approach and(2)aging onhellip hellip running and gait biomechanics on lower limbs coordination on strength and functionality of the muscles of the lower limbs and on the prevention of running-related injuries

(some) Collaborators in Satildeo Paulo State

16

Optimal Control of Human Movement

β

α

x

γ

bull Marko Ackermann ndash FEI University Satildeo Bernardo do Campo Brazil

bull Maarten F Bobbert ndash VU University Amsterdam The Netherlands

Sit-to-stand task (CNPq Project 4028312012-8 Marco Vaz PA)

Wheelchair propulsion

17

Biomechatronics = Biomechanics + Motor Control (Natuurlijk ndashFCT vd Helm-)

Models of the human motor control system from a control engineering perspective

BIOMECHATRONICS LABMECHATRONICS DEPARTMENT

ESCOLA POLITEacuteCNICA UNIVERSITY OF SAtildeO PAULO

bull FacultyArturo Forner-CorderoRafael T Moura

bull Post-docsFabianne Furtado

bull PhDLuis Filipe RossiCarlos NoriegaMilton Cortez JuniorGuilherme Umemura

bull Visiting Professors (NL)Jacques Duysens (CNPq)Bouwien Smits-EngelsmanNoel Keijsers

bull MSc studentsCamila SouitMayra B VillalpandoRafael S SouzaEduardo GarciaLeonardo F SommerMichele Sakatahttpsitespoliuspbrpmrbiomecatronica

BIOMECHATRONICS LAB (A FORNER-CORDERO)

Forner-Cordero A Rodrigues ST Duysens JObstacle crossing differences between blindand blindfolded subjects after hapticexploration J Motor Behavior (in press)

Forner-Cordero A Itiki C Souza RLourenco JCMC Krebs HI (2014)Experimental assessment of gait withrhythmic auditory perturbations BioRob2014

Sacco ICN

Kinematics Kinetics Plantar pressure

ggggg

Diabetic Neuropathy

TIBIAL ANTERIOR ndash Maacutex MCA

CONTROLE AUSENTE INTERMEDIAacuteRIO GRAVE

sEM

G m

ult

ich

ann

el

RCT Effect foot exercises in PP amp gait speed

ObrigadoMarcos Duarte

Biomechanics and Motor Control Laboratory

Federal University of ABC

httpdemotuorg

marcosduarteufabcedubr21

httpdemotuorgpubsFapespNWO2016pdf

Page 13: Biomechanics of long distance running and injury mechanisms

bull 85 overall classification accuracy rate

bull 100 classification accuracy rate was achieved

when only six kinematic features were combined

Aging amp biomechanics of long distance running

Fukuchi et al (2011)

Biomechanics of long distance runningBiomechanics and Motor Control Laboratory

bull But there are still too many unsolved problems with the

biomechanics of long distance running and injury mechanisms hellip

14

Sacco ICN

Long-distance runners (adt amp

elderly)

Foot muscle

trophism

Run amp walk biomechanics

Foot health amp

functionality

Foot-ankle and toes strength

Running-related injury

Coordination of inter and intra limbs

2 months supervised

sessions

10 months home-

exercises

12 months assessments

Aim - Investigate the effects of (1)a ground-up therapeutic approach and(2)aging onhellip hellip running and gait biomechanics on lower limbs coordination on strength and functionality of the muscles of the lower limbs and on the prevention of running-related injuries

(some) Collaborators in Satildeo Paulo State

16

Optimal Control of Human Movement

β

α

x

γ

bull Marko Ackermann ndash FEI University Satildeo Bernardo do Campo Brazil

bull Maarten F Bobbert ndash VU University Amsterdam The Netherlands

Sit-to-stand task (CNPq Project 4028312012-8 Marco Vaz PA)

Wheelchair propulsion

17

Biomechatronics = Biomechanics + Motor Control (Natuurlijk ndashFCT vd Helm-)

Models of the human motor control system from a control engineering perspective

BIOMECHATRONICS LABMECHATRONICS DEPARTMENT

ESCOLA POLITEacuteCNICA UNIVERSITY OF SAtildeO PAULO

bull FacultyArturo Forner-CorderoRafael T Moura

bull Post-docsFabianne Furtado

bull PhDLuis Filipe RossiCarlos NoriegaMilton Cortez JuniorGuilherme Umemura

bull Visiting Professors (NL)Jacques Duysens (CNPq)Bouwien Smits-EngelsmanNoel Keijsers

bull MSc studentsCamila SouitMayra B VillalpandoRafael S SouzaEduardo GarciaLeonardo F SommerMichele Sakatahttpsitespoliuspbrpmrbiomecatronica

BIOMECHATRONICS LAB (A FORNER-CORDERO)

Forner-Cordero A Rodrigues ST Duysens JObstacle crossing differences between blindand blindfolded subjects after hapticexploration J Motor Behavior (in press)

Forner-Cordero A Itiki C Souza RLourenco JCMC Krebs HI (2014)Experimental assessment of gait withrhythmic auditory perturbations BioRob2014

Sacco ICN

Kinematics Kinetics Plantar pressure

ggggg

Diabetic Neuropathy

TIBIAL ANTERIOR ndash Maacutex MCA

CONTROLE AUSENTE INTERMEDIAacuteRIO GRAVE

sEM

G m

ult

ich

ann

el

RCT Effect foot exercises in PP amp gait speed

ObrigadoMarcos Duarte

Biomechanics and Motor Control Laboratory

Federal University of ABC

httpdemotuorg

marcosduarteufabcedubr21

httpdemotuorgpubsFapespNWO2016pdf

Page 14: Biomechanics of long distance running and injury mechanisms

Biomechanics of long distance runningBiomechanics and Motor Control Laboratory

bull But there are still too many unsolved problems with the

biomechanics of long distance running and injury mechanisms hellip

14

Sacco ICN

Long-distance runners (adt amp

elderly)

Foot muscle

trophism

Run amp walk biomechanics

Foot health amp

functionality

Foot-ankle and toes strength

Running-related injury

Coordination of inter and intra limbs

2 months supervised

sessions

10 months home-

exercises

12 months assessments

Aim - Investigate the effects of (1)a ground-up therapeutic approach and(2)aging onhellip hellip running and gait biomechanics on lower limbs coordination on strength and functionality of the muscles of the lower limbs and on the prevention of running-related injuries

(some) Collaborators in Satildeo Paulo State

16

Optimal Control of Human Movement

β

α

x

γ

bull Marko Ackermann ndash FEI University Satildeo Bernardo do Campo Brazil

bull Maarten F Bobbert ndash VU University Amsterdam The Netherlands

Sit-to-stand task (CNPq Project 4028312012-8 Marco Vaz PA)

Wheelchair propulsion

17

Biomechatronics = Biomechanics + Motor Control (Natuurlijk ndashFCT vd Helm-)

Models of the human motor control system from a control engineering perspective

BIOMECHATRONICS LABMECHATRONICS DEPARTMENT

ESCOLA POLITEacuteCNICA UNIVERSITY OF SAtildeO PAULO

bull FacultyArturo Forner-CorderoRafael T Moura

bull Post-docsFabianne Furtado

bull PhDLuis Filipe RossiCarlos NoriegaMilton Cortez JuniorGuilherme Umemura

bull Visiting Professors (NL)Jacques Duysens (CNPq)Bouwien Smits-EngelsmanNoel Keijsers

bull MSc studentsCamila SouitMayra B VillalpandoRafael S SouzaEduardo GarciaLeonardo F SommerMichele Sakatahttpsitespoliuspbrpmrbiomecatronica

BIOMECHATRONICS LAB (A FORNER-CORDERO)

Forner-Cordero A Rodrigues ST Duysens JObstacle crossing differences between blindand blindfolded subjects after hapticexploration J Motor Behavior (in press)

Forner-Cordero A Itiki C Souza RLourenco JCMC Krebs HI (2014)Experimental assessment of gait withrhythmic auditory perturbations BioRob2014

Sacco ICN

Kinematics Kinetics Plantar pressure

ggggg

Diabetic Neuropathy

TIBIAL ANTERIOR ndash Maacutex MCA

CONTROLE AUSENTE INTERMEDIAacuteRIO GRAVE

sEM

G m

ult

ich

ann

el

RCT Effect foot exercises in PP amp gait speed

ObrigadoMarcos Duarte

Biomechanics and Motor Control Laboratory

Federal University of ABC

httpdemotuorg

marcosduarteufabcedubr21

httpdemotuorgpubsFapespNWO2016pdf

Page 15: Biomechanics of long distance running and injury mechanisms

Sacco ICN

Long-distance runners (adt amp

elderly)

Foot muscle

trophism

Run amp walk biomechanics

Foot health amp

functionality

Foot-ankle and toes strength

Running-related injury

Coordination of inter and intra limbs

2 months supervised

sessions

10 months home-

exercises

12 months assessments

Aim - Investigate the effects of (1)a ground-up therapeutic approach and(2)aging onhellip hellip running and gait biomechanics on lower limbs coordination on strength and functionality of the muscles of the lower limbs and on the prevention of running-related injuries

(some) Collaborators in Satildeo Paulo State

16

Optimal Control of Human Movement

β

α

x

γ

bull Marko Ackermann ndash FEI University Satildeo Bernardo do Campo Brazil

bull Maarten F Bobbert ndash VU University Amsterdam The Netherlands

Sit-to-stand task (CNPq Project 4028312012-8 Marco Vaz PA)

Wheelchair propulsion

17

Biomechatronics = Biomechanics + Motor Control (Natuurlijk ndashFCT vd Helm-)

Models of the human motor control system from a control engineering perspective

BIOMECHATRONICS LABMECHATRONICS DEPARTMENT

ESCOLA POLITEacuteCNICA UNIVERSITY OF SAtildeO PAULO

bull FacultyArturo Forner-CorderoRafael T Moura

bull Post-docsFabianne Furtado

bull PhDLuis Filipe RossiCarlos NoriegaMilton Cortez JuniorGuilherme Umemura

bull Visiting Professors (NL)Jacques Duysens (CNPq)Bouwien Smits-EngelsmanNoel Keijsers

bull MSc studentsCamila SouitMayra B VillalpandoRafael S SouzaEduardo GarciaLeonardo F SommerMichele Sakatahttpsitespoliuspbrpmrbiomecatronica

BIOMECHATRONICS LAB (A FORNER-CORDERO)

Forner-Cordero A Rodrigues ST Duysens JObstacle crossing differences between blindand blindfolded subjects after hapticexploration J Motor Behavior (in press)

Forner-Cordero A Itiki C Souza RLourenco JCMC Krebs HI (2014)Experimental assessment of gait withrhythmic auditory perturbations BioRob2014

Sacco ICN

Kinematics Kinetics Plantar pressure

ggggg

Diabetic Neuropathy

TIBIAL ANTERIOR ndash Maacutex MCA

CONTROLE AUSENTE INTERMEDIAacuteRIO GRAVE

sEM

G m

ult

ich

ann

el

RCT Effect foot exercises in PP amp gait speed

ObrigadoMarcos Duarte

Biomechanics and Motor Control Laboratory

Federal University of ABC

httpdemotuorg

marcosduarteufabcedubr21

httpdemotuorgpubsFapespNWO2016pdf

Page 16: Biomechanics of long distance running and injury mechanisms

(some) Collaborators in Satildeo Paulo State

16

Optimal Control of Human Movement

β

α

x

γ

bull Marko Ackermann ndash FEI University Satildeo Bernardo do Campo Brazil

bull Maarten F Bobbert ndash VU University Amsterdam The Netherlands

Sit-to-stand task (CNPq Project 4028312012-8 Marco Vaz PA)

Wheelchair propulsion

17

Biomechatronics = Biomechanics + Motor Control (Natuurlijk ndashFCT vd Helm-)

Models of the human motor control system from a control engineering perspective

BIOMECHATRONICS LABMECHATRONICS DEPARTMENT

ESCOLA POLITEacuteCNICA UNIVERSITY OF SAtildeO PAULO

bull FacultyArturo Forner-CorderoRafael T Moura

bull Post-docsFabianne Furtado

bull PhDLuis Filipe RossiCarlos NoriegaMilton Cortez JuniorGuilherme Umemura

bull Visiting Professors (NL)Jacques Duysens (CNPq)Bouwien Smits-EngelsmanNoel Keijsers

bull MSc studentsCamila SouitMayra B VillalpandoRafael S SouzaEduardo GarciaLeonardo F SommerMichele Sakatahttpsitespoliuspbrpmrbiomecatronica

BIOMECHATRONICS LAB (A FORNER-CORDERO)

Forner-Cordero A Rodrigues ST Duysens JObstacle crossing differences between blindand blindfolded subjects after hapticexploration J Motor Behavior (in press)

Forner-Cordero A Itiki C Souza RLourenco JCMC Krebs HI (2014)Experimental assessment of gait withrhythmic auditory perturbations BioRob2014

Sacco ICN

Kinematics Kinetics Plantar pressure

ggggg

Diabetic Neuropathy

TIBIAL ANTERIOR ndash Maacutex MCA

CONTROLE AUSENTE INTERMEDIAacuteRIO GRAVE

sEM

G m

ult

ich

ann

el

RCT Effect foot exercises in PP amp gait speed

ObrigadoMarcos Duarte

Biomechanics and Motor Control Laboratory

Federal University of ABC

httpdemotuorg

marcosduarteufabcedubr21

httpdemotuorgpubsFapespNWO2016pdf

Page 17: Biomechanics of long distance running and injury mechanisms

Optimal Control of Human Movement

β

α

x

γ

bull Marko Ackermann ndash FEI University Satildeo Bernardo do Campo Brazil

bull Maarten F Bobbert ndash VU University Amsterdam The Netherlands

Sit-to-stand task (CNPq Project 4028312012-8 Marco Vaz PA)

Wheelchair propulsion

17

Biomechatronics = Biomechanics + Motor Control (Natuurlijk ndashFCT vd Helm-)

Models of the human motor control system from a control engineering perspective

BIOMECHATRONICS LABMECHATRONICS DEPARTMENT

ESCOLA POLITEacuteCNICA UNIVERSITY OF SAtildeO PAULO

bull FacultyArturo Forner-CorderoRafael T Moura

bull Post-docsFabianne Furtado

bull PhDLuis Filipe RossiCarlos NoriegaMilton Cortez JuniorGuilherme Umemura

bull Visiting Professors (NL)Jacques Duysens (CNPq)Bouwien Smits-EngelsmanNoel Keijsers

bull MSc studentsCamila SouitMayra B VillalpandoRafael S SouzaEduardo GarciaLeonardo F SommerMichele Sakatahttpsitespoliuspbrpmrbiomecatronica

BIOMECHATRONICS LAB (A FORNER-CORDERO)

Forner-Cordero A Rodrigues ST Duysens JObstacle crossing differences between blindand blindfolded subjects after hapticexploration J Motor Behavior (in press)

Forner-Cordero A Itiki C Souza RLourenco JCMC Krebs HI (2014)Experimental assessment of gait withrhythmic auditory perturbations BioRob2014

Sacco ICN

Kinematics Kinetics Plantar pressure

ggggg

Diabetic Neuropathy

TIBIAL ANTERIOR ndash Maacutex MCA

CONTROLE AUSENTE INTERMEDIAacuteRIO GRAVE

sEM

G m

ult

ich

ann

el

RCT Effect foot exercises in PP amp gait speed

ObrigadoMarcos Duarte

Biomechanics and Motor Control Laboratory

Federal University of ABC

httpdemotuorg

marcosduarteufabcedubr21

httpdemotuorgpubsFapespNWO2016pdf

Page 18: Biomechanics of long distance running and injury mechanisms

Biomechatronics = Biomechanics + Motor Control (Natuurlijk ndashFCT vd Helm-)

Models of the human motor control system from a control engineering perspective

BIOMECHATRONICS LABMECHATRONICS DEPARTMENT

ESCOLA POLITEacuteCNICA UNIVERSITY OF SAtildeO PAULO

bull FacultyArturo Forner-CorderoRafael T Moura

bull Post-docsFabianne Furtado

bull PhDLuis Filipe RossiCarlos NoriegaMilton Cortez JuniorGuilherme Umemura

bull Visiting Professors (NL)Jacques Duysens (CNPq)Bouwien Smits-EngelsmanNoel Keijsers

bull MSc studentsCamila SouitMayra B VillalpandoRafael S SouzaEduardo GarciaLeonardo F SommerMichele Sakatahttpsitespoliuspbrpmrbiomecatronica

BIOMECHATRONICS LAB (A FORNER-CORDERO)

Forner-Cordero A Rodrigues ST Duysens JObstacle crossing differences between blindand blindfolded subjects after hapticexploration J Motor Behavior (in press)

Forner-Cordero A Itiki C Souza RLourenco JCMC Krebs HI (2014)Experimental assessment of gait withrhythmic auditory perturbations BioRob2014

Sacco ICN

Kinematics Kinetics Plantar pressure

ggggg

Diabetic Neuropathy

TIBIAL ANTERIOR ndash Maacutex MCA

CONTROLE AUSENTE INTERMEDIAacuteRIO GRAVE

sEM

G m

ult

ich

ann

el

RCT Effect foot exercises in PP amp gait speed

ObrigadoMarcos Duarte

Biomechanics and Motor Control Laboratory

Federal University of ABC

httpdemotuorg

marcosduarteufabcedubr21

httpdemotuorgpubsFapespNWO2016pdf

Page 19: Biomechanics of long distance running and injury mechanisms

BIOMECHATRONICS LAB (A FORNER-CORDERO)

Forner-Cordero A Rodrigues ST Duysens JObstacle crossing differences between blindand blindfolded subjects after hapticexploration J Motor Behavior (in press)

Forner-Cordero A Itiki C Souza RLourenco JCMC Krebs HI (2014)Experimental assessment of gait withrhythmic auditory perturbations BioRob2014

Sacco ICN

Kinematics Kinetics Plantar pressure

ggggg

Diabetic Neuropathy

TIBIAL ANTERIOR ndash Maacutex MCA

CONTROLE AUSENTE INTERMEDIAacuteRIO GRAVE

sEM

G m

ult

ich

ann

el

RCT Effect foot exercises in PP amp gait speed

ObrigadoMarcos Duarte

Biomechanics and Motor Control Laboratory

Federal University of ABC

httpdemotuorg

marcosduarteufabcedubr21

httpdemotuorgpubsFapespNWO2016pdf

Page 20: Biomechanics of long distance running and injury mechanisms

Sacco ICN

Kinematics Kinetics Plantar pressure

ggggg

Diabetic Neuropathy

TIBIAL ANTERIOR ndash Maacutex MCA

CONTROLE AUSENTE INTERMEDIAacuteRIO GRAVE

sEM

G m

ult

ich

ann

el

RCT Effect foot exercises in PP amp gait speed

ObrigadoMarcos Duarte

Biomechanics and Motor Control Laboratory

Federal University of ABC

httpdemotuorg

marcosduarteufabcedubr21

httpdemotuorgpubsFapespNWO2016pdf

Page 21: Biomechanics of long distance running and injury mechanisms

ObrigadoMarcos Duarte

Biomechanics and Motor Control Laboratory

Federal University of ABC

httpdemotuorg

marcosduarteufabcedubr21

httpdemotuorgpubsFapespNWO2016pdf