The group is led by three Professors, based in the schools of Health Sciences (Granat and Kenney) and Computing, Science and Engineering (Howard) and group members have a broad range of expertise, spanning biomedical engineering, medical instrumentation, biomechanics, gait analysis, activity monitoring, rehabilitation medicine, geriatrics, physiotherapy, public health, prosthetics and orthotics, health sciences, and psychology. Our group includes around ten academic members of staff, six research assistants/fellows and ten PhD students. Our current research is supported by external grants worth well over £2million from NIHR, EPSRC andcharities. Members of the group have well over 200 journal publications and we have been instrumental in setting up the new International Society for the Measurement of Physical Behaviour (www.ismpb.org) and the associated journal . Our group recently hosted the XV International Symposium on 3D Analysis of Human Movement(2018) and will host the Trent International Prosthetics Symposium (2019) – with Newcastle and Greenwich Universities.
The main highlights of our research are:
Our research broadly falls into the following three areas:
We study the applications of objective measurement and quantification of free-living physical behaviour(s) and its related constructs using body-worn devices. We are developing event-based analysis techniques and outcome measures for the quantification of free-living physical behaviours. Collaborationswith clinicians and health practitioners allow this research to be applied across varied populations where the benefits of physical activity to health are of key importance. Outcomes measures, based on physical activity patterns, are being developed to quantify the effectiveness of interventions in awide range of clinical groups and these techniques are also being used to enhance our understanding of how physical behaviours are affected by environmental and social factors.
Our approach to the design and development of new technologies is to first gain an in-depth understanding of the limitations of current devices. We build on this understanding to produce novel designs, often in collaboration with leading companies, including Chas A Blatchford (prosthetics and orthotics)and Odstock Medical (FES). We have been involved in work leading to the regulatory approvals of a number of medical devices, including ShefStim and StimUStep. We have also published the first research showing the potential of miniature hydraulics for advanced energy storage and return in lower-limb prosthetics.
In order to properly understand the limitations with current technologies, we are developing new evaluation techniques, often based on wearable sensors and, where relevant, in collaboration with psychologists. We use advanced mechanics-based modelling to inform some of this work. For example, our groupwas one of the first to publish on an approach to gait prediction based on inverse-dynamics combined with optimisation. Our most recent work has introduced a novel mechanics-based approach to evaluating the stability of walking aid users.
The work of this group is undertaken under four closely connected, but broad, research themes.
Falls monitoring and falls prediction
Both the incidence of falls and the severity of the consequences increase with age. Current body-worn falls-alarms, which alert carers, suffer from poor detection rates. We have shown that a novel approach which is based on posture measurement leads to improved detection. Our aim is to investigate this approach in the elderly and also capture information on the type of fall and any potential recovery. Future work will focus on developing a deployable system and to use information on activity recorded prior to the fall to inform new falls prediction algorithms. This work has involved collaboration Four Seasons Healthcare and with the University of Ulm in Stuttgart.
Development of physical activity outcomes for clinical populations
Outcomes measures, based on physical activity patterns, are being developed to quantify the patterns of behaviour and the effectiveness of interventions in a wide range of clinical groups (including osteoarthritis, stroke and heart failure). These techniques are also being used to enhance our understanding of how physical behaviours in these populations can be affected by environmental and social factors. In this theme, we collaborate extensively with a range of clinical partners.
Physical behaviour and public health
Physical inactivity is a major risk factor for all-cause mortality, coronary heart disease, type 2 diabetes, and breast and colon cancers and physical inactivity is estimated to be responsible for 9% or premature mortality worldwide. The risk of a poor health outcome as a result of physical inactivity, or sedentary behaviour, is similar to the risk for smoking and obesity. However the constructs and definitions of physical activity and sedentary behaviour are ambiguous. The aim of this theme is to develop a model that can provide a unified framework for the terminology and constructs used and to apply this across range of fields from rehabilitation to public health. In addition we have been looking at accepted definitions and measurements of sedentary behaviour and testing this on population survey data. We are also planning an investigation of work based health interventions on physical behaviour.
Physical behaviour in people with dementia
Approximately two thirds of people with dementia live at home and one-third in residential care. With the increase in the ageing population, the number of people with dementia living in residential care is set to rise sharply. Current care home facilities will be unable to cope. We are currently looking at the use of body-worn sensors to monitor the physical behaviour patterns of person with dementia in their own home and use this information to make intelligent decisions about the person’s behaviour which could be communicated to carers and health care workers. This work is being conducted with Salford Institute for Dementia.
For a number of years we have been working on methods to characterise the behaviour of prosthetic feet (1, 2), allowing us to identify one of the key problems with passive devices, their inability to provide the positive work seen at the anatomical ankle at push-off (3). This work formed the background to an EPSRC project led by Professor David Howard in which we further developed our analysis methods (4) and demonstrated the potential for hydraulic technology to enable controlled storage, transfer between joints, and return of energy in lower limb prostheses (5). Our results have encouraged us to pursue further work in this area and we are also exploring exploitation routes.
Rig for characterisation of amputee independent prosthesis properties (AIPP).
We are taking a similar approach to the design and development of new upper limb prosthetic devices, focusing first on better understanding the problems with myoelectric prostheses. John Head’s PhD thesis investigated the role that poor socket fit can play in determining functional capability (6) and this work has been extended in Alix Chadwell’s PhD work (7).
Reaction time experimental setup used in Chadwell’s PhD.
Our group has a long standing interest in the design and development of improved functional electrical stimulation systems. The work dates back to the late 1990s when Professor Laurence Kenney worked in the Netherlands on the development and evaluation of an implantable drop foot stimulator (8), later commercialised under the trade name StimUStep. Since then we have worked on two projects to develop new FES systems. In the first project we worked with the Sheffield team, led by Professor Tony Barker and Dr Ben Heller, on the design of an array-based stimulator with automated setup for dropfoot correction (9), believed to be the world’s first CE marked system of its kind. The first ever take-home study of such a device was led by our group (10) and showed that the technology can be used by patients without technical support. More recently we have been working with Odstock Medical to develop an upper limb functional electrical stimulation system to enable FES-supported functional task practice (11). Through a series of NIHR-funded projects we have progressed to the stage of a regulatory-approved trial of the system.
Upper limb FES system developed by in a collaboration between our group and Odstock Medical.
This area of interest builds on the expertise of our newest member, Dr Gouwu Wei. His background is in advanced robotics and he applies state-of-the-art kinematics to the analysis and synthesis of human movement. He is working to design and develop affordable institutional/domestic assistive robots and rehabilitation devices based on the concept of reconfigurability.
The vast majority of biomechanics research concerned with gait stability has been on unassisted walking. This is surprising, given the high prevalence of walking aid use in the most vulnerable (older old), and because walking with a frame differs significantly from unassisted walking in a number of ways. These include the need to coordinate the movements of the device together with body and foot movements, and significant changes to the base of support over the ‘gait cycle’, both of which make the direct use of unassisted stability measures inappropriate. Through a series of internally and externally funded projects, we have developed a new and objective approach and associated instrumentation to characterising the stability of users of walking aids (1). To date three types of instrumented walking frames (“Smart Walkers”) have been developed and are currently used to assess walking aid users inside the lab and also in their own environment. The work is led by Dr Sibylle Thies, and supported by the PhD Pathways-to-Excellence student Eleonora Costamagna and postdoctoral researcher Alex Bates.
Instrumentation used for stability assessment of 4-wheeled rollator use, including "smart" rollator with integrated load cells, pressure sensing insoles inside the user's shoes, and 3D position tracking of relative foot-frame distance.
In a collaboration with Audrey Bowen (University of Manchester) we explored the question of whether FES to correct drop following stroke impacts on the attentional demands of walking http://usir.salford.ac.uk/29356/. We also work with psychologist (Dr. Adam Galpin), and a Cognitive Neuroscientist, (Dr. Emma Gowen, University of Manchester) to develop improved tools for the evaluation of upper limb prostheses. Specifically, we have used gaze tracking technology to understand patterns of visual attention while using upper limb prostheses (2) and are now carrying out work to characterise embodiment of prostheses.
Example screen shot from gaze tracking system video of a prosthesis user performing a functional task. Note the visual attention to the hand, shown by the location of the red circle.
As our work focuses on restoring functional movement capabilities, we have developed a range of tools based on wearable sensors to better evaluate these devices. Much of the early work, in collaboration with Liverpool University’s Dr Yannis Goulermas, focused on characterising the movement of the person themselves (3). More recently, and in recognition that the ultimate value of an assistive device to the user is reflected in how often and in which circumstances they choose to use their device, we have developed tools to capture this information. We are partners in a £1.8million EPSRC-funded project with University of Warwick, UCL and a number of other universities to develop a system for monitoring of assistive device use (http://www.aartbc.org/) (4). We have also developed tools to characterise upper limb prosthesis use in the real world (5). Alix Chadwell was awarded the prize for Best Student Presentation for her work on monitoring prosthesis use, when she presented at the prestigious Myoelectric Controls Symposium, hosted by the University of New Brunswick, Canada.
Example spiral plots of data collected over 7 consecutive days from 3 axis accelerometers, one worn on each wrist. Plots A and B show data from anatomically intact participants. Plots C and D show data from two users of myoelectric prostheses. More details are available here.
“A novel body-worn falls detection system: development and evaluation in the frail elderly population”
Peel Trust funded project which is exploring the use of a novel, posture based, falls detection system in a frail elderly population living in care homes.
“Development of a novel thigh-worn falls detection monitor”
Greater Manchester Academic Health Science funded project which explored the ability to detect a fall using changes in posture from the signals recorded using a thigh-worn sensor system.
“SENIORS USP (Seniors – Understanding Sedentary Patterns)”
MRC funded project in association with Glasgow Caledonian University and others looking at the determinants and predictors of sedentary behaviour and a longitudinal analysis in cohort studies.
“Early VERsus Later Augmented Physiotherapy (EVERLAP) compared with usual upper limb physiotherapy: an exploratory RCT of arm function after stroke”
A CSP funded project which is an exploratory randomised controlled trial (RCT) comparing usual physiotherapy with augmented arm physiotherapy, specifically aimed at improving arm function after stroke, provided either within 2 weeks (“early”) or at 3 months (“later”) after stroke. This is in association with Glasgow Caledonian University, novel activity outcomes are being developed for this.
“The influence of dog ownership on objective measures of free-living physical activity and sedentary behaviour in community-dwelling older adults”
A Waltham funded project aimed at evaluating the influence of dog ownership on health-enhancing activity patterns in community dwelling older adults (who are currently able to walk unaided) by objectively measuring free-living PA patterns and sedentary behaviour.
Although body-powered prostheses offer many potential advantages over powered devices, in terms of cost, maintenance and ease of use, there has been relatively little investment to improve their design. In this £1.4 million project we are working with partners at 3 other UK universities, the University of Jordan and Uganda to develop better low-cost, body-powered prostheses. Please click on the link above to find out more!
Fall-related injuries in older adults are a major and growing global health problem. Walking aids are designed to provide stability, yet their use has been reported as a major risk factor for falls [Deandrea 2010]. Their effectiveness is determined by how appropriately they are used, yet little guidance is offered to users. How they are used in real life situations is entirely unknown. Using a Smart Walker we previously developed for assessment of stability of walking frame use, we aim to:
The long-term aim is to ensure that people are prescribed appropriate walking aids and provided with better training in using these walking aids to reduce their falls-risk. Please click on the link above to find out more!
We previously develop a range of ‘smart’ walking frames (pick-up Zimmer frame, front-wheeled Zimmer frame, 4-wheeled rollator) which inform on usage patterns, body weight support, and stability. Our prototype systems are now being used in a number of studies of user stability. This project is concerned with end-user consultations (users of walking frames, clinicians, manufacturers) and market research, to prepare the route to clinical adoption for our ‘Smart Walkers’. Please click on the link above to find out more!
Rehabilitation technologies, such as wheelchairs and walking frames, are widely prescribed, yet we have a very poor understanding of how and in what circumstances people make use of them. This in turn limits our understanding of the effectiveness of such devices and makes it difficult for clinicians to prescribe correctly. In this project we are developing a platform to address this issue. Please click on the link above to find out more!
This feasibility study investigates whether it is possible to conduct a large randomised controlled trial comparing standard ankle-foot prostheses to a non-standard version. The project will run over two years, and 90 trans-tibial amputees will be recruited and randomly placed into one of two groups: either wearing their existing (standard) prosthesis or a non-standard prosthesis. Pain, health and well-being, daily walking distances and the amount of time per day during which they wear their prosthesis will be recorded. A Patient Advisory Group (PAG), Trial Management Group (TMG) and Trial Steering Group (TSG) will support the work. Please click on the link above to find out more!
Energy efficiency of prosthetic gait is generally lower than able-bodied gait. This project focuses on the development of novel prosthesis technologies to control the storage and release of energy during gait and thereby improve energy efficiency. Please click on the link above to find out more!
Functional electrical stimulation (FES) has been shown to have a positive impact on the recovery of the upper limb following a stroke. However, current FES technologies are limited in a number of ways. This project is developing a new system for therapists to quickly and easily set up controllers which will provide patients with stimulation to appropriate muscles over appropriate periods of a functional task. The project is a collaboration with Odstock Medical Ltd. Please click on the link above to find out more!
We welcome enquiries from able and highly motivated students with good first degrees in the following subjects:
We are interested in supervising students in relevant areas, including:
To give an idea of the kind of PhD research, please see some of our more recent theses:
We also are able to host internships for biomedical engineering students.