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1

Wan, Xianglong, and Yoji Yamada. "Changes in the Determinism of the Gait Dynamics with the Intervention of a Robotic Walker." Applied Sciences 10, no. 14 (July 18, 2020): 4939. http://dx.doi.org/10.3390/app10144939.

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(1) Robotic walkers have gradually been developed over the last decade, and their use has caused changes in gait. However, detailed gait analyses during robotic walker-assisted walking have not been performed. In this study, we aim to identify the changes in determinism of gait dynamics owing to the intervention of a robotic walker. (2) Eleven healthy subjects participated in walking experiments under normal walking, rollator-assisted walking, and robotic walker-assisted walking conditions. We analyzed the measured trunk acceleration to derive the gait parameters, local scaling exponent (LSE, from correlation sum), and percentage of determinism (%DET, from recurrence plot). (3) The walking speed during rollator-assisted walking was significantly lower than that during robotic walker-assisted walking. Changes in the shape of the LSE along the anterior–posterior direction revealed the influence of the robotic walker at an individual level. The changes in %DET along the anterior–posterior direction were also significantly different between normal walking and robotic walker-assisted walking. (4) The rollator decreased the walking speed in comparison to normal walking. The changed LSE and reduced %DET imply reduced deterministic patterns and disturbance to the gait dynamics. The robotic walker only affects the gait dynamics in the anterior–posterior direction. Furthermore, the burden on the subjects was reduced during robotic walker-assisted walking.
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2

Priebe, Jonathon R., and Rodger Kram. "Why is walker-assisted gait metabolically expensive?" Gait & Posture 34, no. 2 (June 2011): 265–69. http://dx.doi.org/10.1016/j.gaitpost.2011.05.011.

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3

Pardo, R. D., D. A. Winter, and A. B. Deathe. "System for routine assessment of walker-assisted gait." Clinical Biomechanics 8, no. 2 (March 1993): 73–80. http://dx.doi.org/10.1016/s0268-0033(93)90036-h.

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4

Cifuentes, Carlos A., Camilo Rodriguez, Anselmo Frizera-Neto, Teodiano Freire Bastos-Filho, and Ricardo Carelli. "Multimodal Human–Robot Interaction for Walker-Assisted Gait." IEEE Systems Journal 10, no. 3 (September 2016): 933–43. http://dx.doi.org/10.1109/jsyst.2014.2318698.

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5

Sierra M., Sergio D. Sierra, Mario Garzón, Marcela Múnera, and Carlos A. Cifuentes. "Human–Robot–Environment Interaction Interface for Smart Walker Assisted Gait: AGoRA Walker." Sensors 19, no. 13 (June 30, 2019): 2897. http://dx.doi.org/10.3390/s19132897.

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Анотація:
The constant growth of the population with mobility impairments has led to the development of several gait assistance devices. Among these, smart walkers have emerged to provide physical and cognitive interactions during rehabilitation and assistance therapies, by means of robotic and electronic technologies. In this sense, this paper presents the development and implementation of a human–robot–environment interface on a robotic platform that emulates a smart walker, the AGoRA Walker. The interface includes modules such as a navigation system, a human detection system, a safety rules system, a user interaction system, a social interaction system and a set of autonomous and shared control strategies. The interface was validated through several tests on healthy volunteers with no gait impairments. The platform performance and usability was assessed, finding natural and intuitive interaction over the implemented control strategies.
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6

Davide, Conte, Baldan Francesco, Petrone Nicola, and Capelli Carlo. "Clinical walker-assisted gait analysis: Methodological and instrumental approach." Gait & Posture 33 (April 2011): S36—S37. http://dx.doi.org/10.1016/j.gaitpost.2010.10.044.

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7

Jailani, R., M. O. Tokhi, S. C. Gharooni, and B. S. K. K. Ibrahim. "FES-Assisted Walking with Spring Brake Orthosis: Simulation Studies." Applied Bionics and Biomechanics 8, no. 1 (2011): 115–26. http://dx.doi.org/10.1155/2011/350602.

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This paper presents a simulation of bipedal locomotion to generate stimulation pulses for activating muscles for paraplegic walking with wheel walker using functional electrical stimulation (FES) with spring brake orthosis (SBO). A new methodology for paraplegic gait, based on exploiting natural dynamics of human gait, is introduced. The work is a first effort towards restoring natural like swing phase in paraplegic gait through a new hybrid orthosis, referred to as spring brake orthosis (SBO). This mechanism simplifies the control task and results in smooth motion and more-natural like trajectory produced by the flexion reflex for gait in spinal cord injured subjects. SBO can eliminate reliance on the withdrawal reflex and foot-ground clearance without extra upper body effort. The stored energy in the spring of SBO is used to replace stimulation pulses in knee flexion and reduce total required torque for the paraplegic walking with wheel walker. The study is carried out with a model of humanoid with wheel walker using the Visual Nastran (Vn4D) dynamic simulation software. Stimulated muscle model of quadriceps is developed for knee extension. Fuzzy logic control (FLC) is developed in Matlab/Simulink to regulate the muscle stimulation pulse-width required to drive FES-assisted walking gait and the computed motion is visualised in graphic animation from Vn4D. The simulation results show that SBO can be successfully used with FES for paraplegic walking with wheel walker with all the advantages discussed over the current hybrid orthoses available.
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8

Ming, D., Z. J. Xue, H. Z. Qi, G. J. Zhang, L. L. Cheng, K. D. K. Luk, Y. R. Bai, et al. "Measurement of upper extremity joint moments in walker-assisted gait." IET Science, Measurement & Technology 3, no. 5 (September 1, 2009): 343–53. http://dx.doi.org/10.1049/iet-smt.2008.0130.

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9

Bachschmidt, R. A., G. F. Harris, and G. G. Simoneau. "Walker-assisted gait in rehabilitation: a study of biomechanics and instrumentation." IEEE Transactions on Neural Systems and Rehabilitation Engineering 9, no. 1 (March 2001): 96–105. http://dx.doi.org/10.1109/7333.918282.

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10

Sierra M, Sergio D., Marcela Múnera, Thomas Provot, Maxime Bourgain, and Carlos A. Cifuentes. "Evaluation of Physical Interaction during Walker-Assisted Gait with the AGoRA Walker: Strategies Based on Virtual Mechanical Stiffness." Sensors 21, no. 9 (May 7, 2021): 3242. http://dx.doi.org/10.3390/s21093242.

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Анотація:
Smart walkers are commonly used as potential gait assistance devices, to provide physical and cognitive assistance within rehabilitation and clinical scenarios. To understand such rehabilitation processes, several biomechanical studies have been conducted to assess human gait with passive and active walkers. Several sessions were conducted with 11 healthy volunteers to assess three interaction strategies based on passive, low and high mechanical stiffness values on the AGoRA Smart Walker. The trials were carried out in a motion analysis laboratory. Kinematic data were also collected from the smart walker sensory interface. The interaction force between users and the device was recorded. The force required under passive and low stiffness modes was 56.66% and 67.48% smaller than the high stiffness mode, respectively. An increase of 17.03% for the hip range of motion, as well as the highest trunk’s inclination, were obtained under the resistive mode, suggesting a compensating motion to exert a higher impulse force on the device. Kinematic and physical interaction data suggested that the high stiffness mode significantly affected the users’ gait pattern. Results suggested that users compensated their kinematics, tilting their trunk and lower limbs to exert higher impulse forces on the device.
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11

Villa-Parra, Ana Cecilia, Jessica Lima, Denis Delisle-Rodriguez, Laura Vargas-Valencia, Anselmo Frizera-Neto, and Teodiano Bastos. "Assessment of an Assistive Control Approach Applied in an Active Knee Orthosis Plus Walker for Post-Stroke Gait Rehabilitation." Sensors 20, no. 9 (April 26, 2020): 2452. http://dx.doi.org/10.3390/s20092452.

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The goal of this study is the assessment of an assistive control approach applied to an active knee orthosis plus a walker for gait rehabilitation. The study evaluates post-stroke patients and healthy subjects (control group) in terms of kinematics, kinetics, and muscle activity. Muscle and gait information of interest were acquired from their lower limbs and trunk, and a comparison was conducted between patients and control group. Signals from plantar pressure, gait phase, and knee angle and torque were acquired during gait, which allowed us to verify that the stance control strategy proposed here was efficient at improving the patients’ gaits (comparing their results to the control group), without the necessity of imposing a fixed knee trajectory. An innovative evaluation of trunk muscles related to the maintenance of dynamic postural equilibrium during gait assisted by our active knee orthosis plus walker was also conducted through inertial sensors. An increase in gait cycle (stance phase) was also observed when comparing the results of this study to our previous work. Regarding the kinematics, the maximum knee torque was lower for patients when compared to the control group, which implies that our orthosis did not demand from the patients a knee torque greater than that for healthy subjects. Through surface electromyography (sEMG) analysis, a significant reduction in trunk muscle activation and fatigability, before and during the use of our orthosis by patients, was also observed. This suggest that our orthosis, together with the assistive control approach proposed here, is promising and could be considered to complement post-stroke patient gait rehabilitation.
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12

Bachschmidt, Rebecca A., Gerald F. Harris, Guy G. Simoneau, and Jacqueline J. Wertsch. "A system for the analysis of upper body loads during walker-assisted gait." Gait & Posture 5, no. 2 (April 1997): 161–62. http://dx.doi.org/10.1016/s0966-6362(97)83391-7.

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13

Abellanas, A., A. Frizera, R. Ceres, and R. Raya. "Assessment of the laterality effects through forearm reaction forces in walker assisted gait." Procedia Chemistry 1, no. 1 (September 2009): 1227–30. http://dx.doi.org/10.1016/j.proche.2009.07.306.

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14

Yu, C. H., and Y. J. Chih. "Posterior walker assisted on gait performance in children with spastic diplegic cerebral palsy." Journal of Biomechanics 40 (January 2007): S516. http://dx.doi.org/10.1016/s0021-9290(07)70506-7.

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15

Kim, Seung Ki, Dongho Park, Beomki Yoo, Dain Shim, Joong-On Choi, Tae Young Choi, and Eun Sook Park. "Overground Robot-Assisted Gait Training for Pediatric Cerebral Palsy." Sensors 21, no. 6 (March 16, 2021): 2087. http://dx.doi.org/10.3390/s21062087.

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The untethered exoskeletal robot provides patients with the freest and realistic walking experience by assisting them based on their intended movement. However, few previous studies have reported the effect of robot-assisted gait training (RAGT) using wearable exoskeleton in children with cerebral palsy (CP). This pilot study evaluated the effect of overground RAGT using an untethered torque-assisted exoskeletal wearable robot for children with CP. Three children with bilateral spastic CP were recruited. The robot generates assistive torques according to gait phases automatically detected by force sensors: flexion torque during the swing phase and extension torque during the stance phase at hip and knee joints. The overground RAGT was conducted for 17~20 sessions (60 min per session) in each child. The evaluation was performed without wearing a robot before and after the training to measure (1) the motor functions using the gross motor function measure and the pediatric balance scale and (2) the gait performance using instrumented gait analysis, the 6-min walk test, and oxygen consumption measurement. All three participants showed improvement in gross motor function measure after training. Spatiotemporal parameters of gait analysis improved in participant P1 (9-year-old girl, GMFCS II) and participant P2 (13-year-old boy, GMFCS III). In addition, they walked faster and farther with lower oxygen consumption during the 6-min walk test after the training. Although participant P3 (16-year-old girl, GMFCS IV) needed the continuous help of a therapist for stepping at baseline, she was able to walk with the platform walker independently after the training. Overground RAGT using a torque-assisted exoskeletal wearable robot seems to be promising for improving gross motor function, walking speed, gait endurance, and gait efficiency in children with CP. In addition, it was safe and feasible even for children with severe motor impairment (GMFCS IV).
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16

Martins, Maria, Arlindo Elias, Carlos Cifuentes, Manuel Alfonso, Anselmo Frizera, Cristina Santos, and Ramón Ceres. "Assessment of walker-assisted gait based on Principal Component Analysis and wireless inertial sensors." Revista Brasileira de Engenharia Biomédica 30, no. 3 (September 2014): 220–31. http://dx.doi.org/10.1590/rbeb.2014.020.

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17

Frizera Neto, Anselmo, Juan A. Gallego, Eduardo Rocon, José L. Pons, and Ramón Ceres. "Extraction of user's navigation commands from upper body force interaction in walker assisted gait." BioMedical Engineering OnLine 9, no. 1 (2010): 37. http://dx.doi.org/10.1186/1475-925x-9-37.

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18

Konop, Katherine A., Kelly M. B. Strifling, Joseph Krzak, Adam Graf, and Gerald F. Harris. "Upper Extremity Joint Dynamics During Walker Assisted Gait: A Quantitative Approach Towards Rehabilitative Intervention." Journal of Experimental & Clinical Medicine 3, no. 5 (October 2011): 213–17. http://dx.doi.org/10.1016/j.jecm.2011.09.001.

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19

Konop, Katherine A. "Upper extremity kinetics and energy expenditure during walker-assisted gait in children with cerebral palsy." Acta Orthopaedica et Traumatologica Turcica 43, no. 2 (2009): 156–64. http://dx.doi.org/10.3944/aott.2009.156.

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20

Ming, Dong, Yanru Bai, Xiuyun Liu, Hongzhi Qi, Longlong Cheng, Baikun Wan, Yong Hu, Yatwa Wong, Keith D. K. Luk, and John C. Y. Leong. "A gait stability investigation into FES-assisted paraplegic walking based on the walker tipping index." Journal of Neural Engineering 6, no. 6 (November 17, 2009): 066007. http://dx.doi.org/10.1088/1741-2560/6/6/066007.

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21

Baniasad, Mina, Farzam Farahmand, Mokhtar Arazpour, and Hassan Zohoor. "Coordinated activities of trunk and upper extremity muscles during walker-assisted paraplegic gait: A synergy study." Human Movement Science 62 (December 2018): 184–93. http://dx.doi.org/10.1016/j.humov.2018.10.002.

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22

Kanazawa, Yoshikawa, Koseki, Takeuchi, and Mutsuzaki. "A Consecutive 25-Week Program of Gait Training, Using the Alternating Hybrid Assistive Limb (HAL®) Robot and Conventional Training, and Its Effects on the Walking Ability of a Patient with Chronic Thoracic Spinal Cord Injury: A Single Case Reversal Design." Medicina 55, no. 11 (November 18, 2019): 746. http://dx.doi.org/10.3390/medicina55110746.

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Background and Objectives: In this study, we examined the effect of a consecutive 25-week gait training program, consisting of 5-week alternating phases of Hybrid Assistive Limb (HAL)-assisted robot gait training and conventional gait training, on the walking ability of a 50-year-old man with a chronic thoracic spinal cord injury (SCI). Materials and Methods: Clinical features of this patient’s paraplegia were as follows: neurological level, T7; American Spinal Cord Injury Association Impairment Scale Score, C; Lower Extremity Motor Score, 20 points; Berg Balance Scale score, 15 points; and Walking Index for Spinal Cord Injury, 6 points. The patient completed a 100 m walk, under close supervision, using a walker and bilateral ankle-foot orthoses. The intervention included two phases: phase A, conventional walking practice and physical therapy for 5 weeks, and phase B, walking using the HAL robot (3 d/week, 30 min/session), combined with conventional physical therapy, for 5 weeks. A consecutive A-B-A-B-A sequence was used, with a 5-week duration for each phase. Results: The gait training intervention increased the maximum walking speed, cadence, and 2-min walking distance, as well as the Berg Balance and Walking Index for Spinal Cord Injury from 15 to 17 and 6 to 7, respectively. Walking speed, stride length, and cadence improved after phase A (but not B). Improved standing balance was associated with measured improvements in measured gait parameters. Conclusion: The walking ability of patients with a chronic SCI may be improved, over a short period by combining gait training, using HAL-assisted and conventional gait training and physical therapy.
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23

Baniasad, Mina, Farzam Farahmand, Mokhtar Arazpour, and Hassan Zohoor. "Role and Significance of Trunk and Upper Extremity Muscles in Walker-Assisted Paraplegic Gait: A Case Study." Topics in Spinal Cord Injury Rehabilitation 24, no. 1 (January 2018): 18–27. http://dx.doi.org/10.1310/sci16-00061.

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24

Martins, Maria, Lino Costa, Anselmo Frizera, Ramón Ceres, and Cristina Santos. "Hybridization between multi-objective genetic algorithm and support vector machine for feature selection in walker-assisted gait." Computer Methods and Programs in Biomedicine 113, no. 3 (March 2014): 736–48. http://dx.doi.org/10.1016/j.cmpb.2013.12.005.

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25

Fox, Emily J., Nicole J. Tester, Chetan P. Phadke, Preeti M. Nair, Claudia R. Senesac, Dena R. Howland, and Andrea L. Behrman. "Ongoing Walking Recovery 2 Years After Locomotor Training in a Child With Severe Incomplete Spinal Cord Injury." Physical Therapy 90, no. 5 (May 1, 2010): 793–802. http://dx.doi.org/10.2522/ptj.20090171.

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Background and Purpose The authors previously reported on walking recovery in a nonambulatory child with chronic, severe, incomplete cervical spinal cord injury (SCI) after 76 sessions of locomotor training (LT). Although clinical measures did not predict his recovery, reciprocal patterned leg movements developed, affording recovery of independent walking with a reverse rolling walker. The long-term functional limitations and secondary complications often associated with pediatric-onset SCI necessitate continued follow-up of children with SCI. Therefore, the purpose of this case report is to describe this child's walking function and musculoskeletal growth and development during the 2 years since his participation in an LT program and subsequent walking recovery. Case Description Following LT, the child attended elementary school as a full-time ambulator. He was evaluated 1 month (baseline), 1 year, and 2 years after LT. Examination of walking function included measures of walking independence, gait speed and spatiotemporal parameters, gait kinematics, and daily step activity. Growth and development were assessed by tracking his height, weight, incidence of musculoskeletal complications, and gross motor task performance. Outcomes Over the 2 years, the child continued to ambulate independently with a reverse rolling walker, increasing his fastest gait speed. Spatiotemporal and kinematic features of his walking improved, and daily step activity increased. Height and weight remained on their preinjury trajectory and within age-appropriate norms. The child experienced only minor musculoskeletal complications. Additionally, he gained the ability to use reciprocal patterned leg movements during locomotor tasks such as assisted stair climbing and independent tricycle pedaling. Conclusions Two years after recovery of walking, this child with incomplete SCI had maintained and improved his walking function and experienced age-appropriate growth and development.
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26

Lee, Sang-Yeol, Seon-Chill Kim, and Young-Ik Lee. "Effect of a modified grip angle of a walker on the wrist deviation angle, muscle activation and palmar load during walker-assisted gait in elderly people." Journal of Physical Therapy Science 29, no. 3 (2017): 405–8. http://dx.doi.org/10.1589/jpts.29.405.

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27

Alwan, Majd, Alexandre Ledoux, Glenn Wasson, Pradip Sheth, and Cunjun Huang. "Basic walker-assisted gait characteristics derived from forces and moments exerted on the walker's handles: Results on normal subjects." Medical Engineering & Physics 29, no. 3 (April 2007): 380–89. http://dx.doi.org/10.1016/j.medengphy.2006.06.001.

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28

Garcia A., Daniel E., Sergio D. Sierra M., Daniel Gomez-Vargas, Mario F. Jiménez, Marcela Múnera, and Carlos A. Cifuentes. "Semi-Remote Gait Assistance Interface: A Joystick with Visual Feedback Capabilities for Therapists." Sensors 21, no. 10 (May 19, 2021): 3521. http://dx.doi.org/10.3390/s21103521.

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The constant growth of pathologies affecting human mobility has led to developing of different assistive devices to provide physical and cognitive assistance. Smart walkers are a particular type of these devices since they integrate navigation systems, path-following algorithms, and user interaction modules to ensure natural and intuitive interaction. Although these functionalities are often implemented in rehabilitation scenarios, there is a need to actively involve the healthcare professionals in the interaction loop while guaranteeing safety for them and patients. This work presents the validation of two visual feedback strategies for the teleoperation of a simulated robotic walker during an assisted navigation task. For this purpose, a group of 14 clinicians from the rehabilitation area formed the validation group. A simple path-following task was proposed, and the feedback strategies were assessed through the kinematic estimation error (KTE) and a usability survey. A KTE of 0.28 m was obtained for the feedback strategy on the joystick. Additionally, significant differences were found through a Mann–Whitney–Wilcoxon test for the perception of behavior and confidence towards the joystick according to the modes of interaction (p-values of 0.04 and 0.01, respectively). The use of visual feedback with this tool contributes to research areas such as remote management of therapies and monitoring rehabilitation of people’s mobility.
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29

Hirano, Hirofumi, Kazuho Hirahara, Tetsuhiko Asakura, Tetsuro Shimozuru, Koki Kadota, Shizuya Kasamo, Masaru Shimohonji, Kanetaka Kimotsuki, and Masamichi Goto. "Hydrocephalus due to villous hypertrophy of the choroid plexus in the lateral ventricles." Journal of Neurosurgery 80, no. 2 (February 1994): 321–23. http://dx.doi.org/10.3171/jns.1994.80.2.0321.

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✓ A case is reported of hydrocephalus due to overproduction of cerebrospinal fluid (CSF) caused by villous hypertrophy of the choroid plexus in the lateral ventricles. A 7-year-old girl with mental retardation developed gait disturbance; hydrocephalus and a Dandy-Walker cyst were detected on computerized tomography. She was initially treated with a ventriculoperitoneal shunt; however, shunting failed to control the hydrocephalus. The excessive outflow of CSF suggested choroid plexus abnormality, and magnetic resonance (MR) imaging revealed enlargement of the choroid plexus in both lateral ventricles. The patient was therefore diagnosed as having hydrocephalus induced by overproduction of CSF, which was controlled by resection of the choroid plexus. Histological examination showed the structure typical of normal choroid plexus. This is a rare case of villous hypertrophy of the choroid plexus in which MR imaging assisted in the diagnosis.
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30

Possover, M. "Humans at the dawn of the in-body electrical nerve stimulation era." Facts, Views and Vision in ObGyn 14, no. 4 (December 30, 2022): 293–98. http://dx.doi.org/10.52054/fvvo.14.4.041.

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Background: The neuroprosthesis laparoscopic implantation technique for electric pelvic nerve stimulation was introduced to gynaecology over 15 years ago to treat intractable pelvic neuropathic pain. Following this first indication, other applications were developed, particularly in parapleology. The LION procedure developed to assist patients with paraplegia and common problems associated with inertia when confined to a wheelchair could find revolutionary applications in aging medicine and prevention. Material and Methods: Spinal cord injured patients who have undergone the Possover’s LION procedure. Main outcome measure: PubMed was systematically searched to identify peer-reviewed articles published in English that reported on LION procedure. Results: Three independent studies published recently (100 patients worldwide) have shown revolutionary recovery of supra-spinal control in patients with chronic spinal cord injury following pelvic nerves stimulation, with 70% of them establishing a walker/crutches-assisted gait. The same studies have also shown significant whole-body muscle-mass building, peripheral vasodilatation, and an unexpected improvement in bone mineral density. Conclusion: These ground-breaking findings could find revolutionary applications in aging medicine and the prevention of osteoporosis, with a huge impact on global public health. Humanity is on the cusp of an exciting new era following the introduction of the in-body electrical nerve stimulation technique. What’s new? In-body electrical nerve stimulation for recovery and/or control of human peripheral somatic and autonomic nervous systems.
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31

Koo, Kyo-in, and Chang Ho Hwang. "Five-day rehabilitation of patients undergoing total knee arthroplasty using an end-effector gait robot as a neuromodulation blending tool for deafferentation, weight offloading and stereotyped movement: Interim analysis." PLOS ONE 15, no. 12 (December 16, 2020): e0241117. http://dx.doi.org/10.1371/journal.pone.0241117.

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Deafferentation and weight offloading can increase brain and spinal motor neuron excitability, respectively. End-effector gait robots (EEGRs) can blend these effects with stereotyped movement-induced neuroplasticity. The authors aimed to evaluate the usefulness of EEGRs as a postoperative neuro-muscular rehabilitation tool. This prospective randomized controlled trial included patients who had undergone unilateral total knee arthroplasty (TKA). Patients were randomly allocated into two groups: one using a 200-step rehabilitation program in an EEGR or the other using a walker on a floor (WF) three times a day for five weekdays. The two groups were compared by electrophysiological and biomechanical methods. Since there were no more enrollments due to funding issues, interim analysis was performed. Twelve patients were assigned to the EEGR group and eight patients were assigned to the WF group. Although the muscle volume of the quadriceps and hamstring did not differ between the two groups, the normalized peak torque of the operated knee flexors (11.28 ± 16.04 Nm/kg) was improved in the EEGR group compared to that of the operated knee flexors in the WF group (4.25 ± 14.26 Nm/kg) (p = 0.04). The normalized compound motor action potentials of the vastus medialis (VM) and biceps femoris (BF) were improved in the EEGR group (p < 0.05). However, the normalized real-time peak amplitude and total, mean area under the curve of VM were decreased during rehabilitation in the EEGR group (p < 0.05). No significant differences were found between operated and non-operated knees in the EEGR group. Five-day EEGR-assisted rehabilitation induced strengthening in the knee flexors and the muscular reactivation of the BF and VM after TKA, while reducing the real-time use of the VM. This observation may suggest the feasibility of this technique: EEGR modulated the neuronal system of the patients rather than training their muscles. However, because the study was underpowered, all of the findings should be interpreted with the utmost caution.
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Maranesi, Elvira, Giovanni Renato Riccardi, Fabrizia Lattanzio, Mirko Di Rosa, Riccardo Luzi, Elisa Casoni, Nadia Rinaldi, Renato Baldoni, Valentina Di Donna, and Roberta Bevilacqua. "Randomised controlled trial assessing the effect of a technology-assisted gait and balance training on mobility in older people after hip fracture: study protocol." BMJ Open 10, no. 6 (June 2020): e035508. http://dx.doi.org/10.1136/bmjopen-2019-035508.

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IntroductionDeficits in balance and walking ability are relevant risk factors for falls during ageing. Moreover, falls are a risk factor for future falls, strongly associated with adverse health outcomes, such as fear of falling or fractures, particularly, hip fracture. For this reason, the development of prevention tools and innovative rehabilitation strategies is one of the main objectives in geriatrics. Effective interventions to promote hip recovery after hip fracture are characterised by intensive and repetitive movements. One treatment approach is to increase the number of steps during the rehabilitation sessions and to improve the balance and the endurance of the patients in the use of technological devices.Methods and analysisThis randomised controlled trial aimed to evaluate an innovative rehabilitation treatment of elderly patients with hip fractures. A total of 195 patients with hip fractures will be recruited and randomly divided into three groups: traditional rehabilitation programme, traditional rehabilitation programme plus TYMO system and traditional rehabilitation programme plus Walker View. Assessments will be performed at baseline, at the end of treatment, at 6 months, and at 1 and 2 years after the end of the treatment. Only subjects hospitalised 4 weeks prior to the beginning of the study will be taken into consideration. Twenty treatment sessions will be conducted, divided into three training sessions per week, for 7 weeks. The technological intervention group will carry out 30 min sessions of traditional therapy and 20 min of treatment with a technological device. The control group will perform traditional therapy sessions, each lasting 50 min. The primary outcomes are risk of falling, gait performance and fear of falling.Ethics and disseminationThe study was approved by the Istituto di Ricerca e Cura a Carattere Scientifica, Istituto Nazionale Ricovero e Cura Anziani Ethics Committee, with identification code number 19 014. Trial results will be submitted for publication in journals and conferences.Trial registration numberNCT04095338.
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Loterio, Flávia, and Teodiano Bastos-Filho. "Gait analysis assisted by robotic walker in patients with post-stroke hemiparesis." BMC Proceedings 8, S4 (October 2014). http://dx.doi.org/10.1186/1753-6561-8-s4-p267.

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"Kinematic synergies are recognizable in the walker-assisted gait of spinal cord injury patients." Gait & Posture 73 (September 2019): 207–8. http://dx.doi.org/10.1016/j.gaitpost.2019.07.107.

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Mahamud, Farid, Adzly Anuar, and Mohd Aidil Mohd Aini. "DESIGN OF WALKWAY RIG SYSTEM FOR GAIT MOTION TRACKING OF CHILDREN WITH CEREBRAL PALSY." Jurnal Teknologi 76, no. 7 (October 1, 2015). http://dx.doi.org/10.11113/jt.v76.5710.

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This paper reports the design of walkway rig system for gait motion tracking of children with cerebral palsy (CP) at Universiti Tenaga Nasional (UNITEN), Malaysia. The walkway rig consists of a modular walkway platform, adjustable parallel bar, and overhead gantry with body support harness system. The rig has been designed to support different modes of walking assistance depending on a subject’s walking capability. The modes of walking assistance are body weight support system, parallel bars along walkway, usage of walker, and human assisted. The key feature of this system lies in the flexibility of it to enable more options during gait motion tracking for CP children. System design and stress analysis were done using CAD software. The design is evaluated using virtual mannequins to check the functions and suitability for CP children. The evaluation shows that the proposed system is feasible to be implemented for CP children gait motion tracking.
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Jiménez, Mario F., Wandercleyson Scheidegger, Ricardo C. Mello, Teodiano Bastos, and Anselmo Frizera. "Bringing proxemics to walker-assisted gait: using admittance control with spatial modulation to navigate in confined spaces." Personal and Ubiquitous Computing, March 25, 2021. http://dx.doi.org/10.1007/s00779-021-01521-8.

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Mansi Dangare and Pratik Phansopkar. "WEARABLE ROBOTIC DEVICE DESIGNED TO IMPROVE MUSCULAR STRENGTH IN CEREBRALPALSY." Journal of Pharmaceutical Negative Results, October 17, 2022, 2989–95. http://dx.doi.org/10.47750/pnr.2022.13.s06.398.

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Cerebral palsy has traditionally been thought of as a mobility and gait issue caused by a non-progressive damage to the developing mind. While indicative usual symptoms may occur at an earlier age, the characteristics of this entity develop over time, and the particular cerebral palsy condition may not be recognized until the child is between the ages of 3 and 5. Crouch walk, and severe knee bending when moving, is one of the most prevalent indicators of cerebral palsy. Leg splints, muscle damage, physical therapy, and leg surgeries can all assist children with cerebral palsy enhance their walking skills. Current gait trainers are primarily concerned with managing full joint trajectories, avoiding postural control, and tailoring therapy to a specific patient. Robotic exoskeletons used for adult with total paralysis, this one did not walk for the participant. They used their muscle to walk and assisted robot. The hope is that the device which is use will strengthen a child’s muscle to improve unassisted walking. The use of the CP Walker, a revolutionary mechanical system for children with spastic palsy.
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Takekawa, Toru, Kazumi Kashiwabara, Naoki Yamada, Shu Watanabe, Midori Hama, Gentaro Hashimoto, Masahiro Abo, and Kyota Shinfuku. "Rehabilitation therapy for a severe case of coronavirus disease 2019: a case report." Journal of Medical Case Reports 16, no. 1 (September 2, 2022). http://dx.doi.org/10.1186/s13256-022-03559-5.

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Abstract Background Patients with severe coronavirus disease 2019 (COVID-19) infection require a long period of time to return to work and society due to significant physical weakness even after recovery. Here we report a patient with a history of nephrectomy who developed severe COVID-19 infection associated with muscle weakness but was able to return to society after rehabilitation therapy. Case presentation A Japanese man in his 40s was admitted to the hospital with PCR-based COVID-19 diagnosis. The respiratory condition worsened rapidly and was treated with extracorporeal membrane-assisted ventilation in the intensive case unit. On admission to the Rehabilitation Department on day T + 30 [T: day patient became febrile (38 °C)], he was unable to stand for a long time and used a walker. Rehabilitation therapy was postponed to prevent COVID-19 spread, but the patient was encouraged to exercise during isolation to improve trunk and lower extremity muscle strength. Physical therapy commenced on day T + 49 to improve gait and trunk and lower limb muscle strength. He was able to walk independently and later returned to work following discharge on day T + 53. A computed tomography scan showed an increase in psoas muscle volume from 276 before to 316 cm3 after physical therapy, together with a decrease in whole-body extracellular water:total body weight ratio from 0.394 to 0.389. Conclusions We have described the beneficial effects of rehabilitation therapy in a patient with severe COVID-19 infection. In addition to exercise, we believe that nutrition is even more important in increasing skeletal muscle mass. Rehabilitation therapy is recommended to enhance the return of severely ill COVID-19 patients to routine daily activity.
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Ryan, Robin, and Uncle Ossie Cruse. "Welcome to the Peoples of the Mountains and the Sea: Evaluating an Inaugural Indigenous Cultural Festival." M/C Journal 22, no. 3 (June 19, 2019). http://dx.doi.org/10.5204/mcj.1535.

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IntroductionFestivals, according to Chris Gibson and John Connell, are like “glue”, temporarily sticking together various stakeholders, economic transactions, and networks (9). Australia’s First Nations peoples see festivals as an opportunity to display cultural vitality (Henry 586), and to challenge a history which has rendered them absent (587). The 2017 Australia Council for the Arts Showcasing Creativity report indicates that performing arts by First Nations peoples are under-represented in Australia’s mainstream venues and festivals (1). Large Aboriginal cultural festivals have long thrived in Australia’s northern half, but have been under-developed in the south. Each regional happening develops a cultural landscape connected to a long and intimate relationship with the natural environment.The Far South East coast and mountainous hinterland of New South Wales is rich in pristine landscapes that ground the Yuin and Monaro Nations to Country as the Monaroo Bobberrer Gadu (Peoples of the Mountains and the Sea). This article highlights cross-sector interaction between Koori and mainstream organisations in producing the Giiyong (Guy-Yoong/Welcoming) Festival. This, the first large festival to be held within the Yuin Nation, took place on Aboriginal-owned land at Jigamy, via Eden, on 22 September 2018. Emerging regional artists joined national headline acts, most notably No Fixed Address (one of the earliest Aboriginal bands to break into the Australian mainstream music industry), and hip-hop artist Baker Boy (Danzal Baker, Young Australian of the Year 2019). The festival followed five years of sustained community preparation by South East Arts in association with Grow the Music, Twofold Aboriginal Corporation, the Eden Local Aboriginal Land Council, and its Elders. We offer dual understandings of the Giiyong Festival: the viewpoints of a male Yuin Elder wedded to an Australian woman of European descent. We acknowledge, and rely upon, key information, statistics, and photographs provided by the staff of South East Arts including Andrew Gray (General Manager), Jasmin Williams (Aboriginal Creative and Cultural Engagement Officer and Giiyong Festival Project Manager), and Kate Howarth (Screen Industry Development Officer). We are also grateful to Wiradjuri woman Alison Simpson (Program Manager at Twofold Aboriginal Corporation) for valuable feedback. As community leaders from First Nations and non-First Nations backgrounds, Simpson and Williams complement each other’s talents for empowering Indigenous communities. They plan a 2020 follow-up event on the basis of the huge success of the 2018 festival.The case study is informed by our personal involvement with community. Since the general population barely comprehends the number and diversity of Australia’s Indigenous ‘nations’, the burgeoning Indigenous festival movement encourages First Nations and non-First Nations peoples alike to openly and confidently refer to the places they live in according to Indigenous names, practices, histories, and knowledge. Consequently, in the mental image of a map of the island-continent, the straight lines and names of state borders fade as the colours of the Indigenous ‘Countries’ (represented by David Horton’s wall map of 1996) come to the foreground. We reason that, in terms of ‘regionality,’ the festival’s expressions of “the agency of country” (Slater 141) differ vastly from the centre-periphery structure and logic of the Australian colony. There is no fixed centre to the mutual exchange of knowledge, culture, and experience in Aboriginal Australia. The broader implication of this article is that Indigenous cultural festivals allow First Nations peoples cultures—in moments of time—to assume precedence, that is to ‘stitch’ back together the notion of a continent made up of hundreds of countries, as against the exploitative structure of ‘hub and region’ colonial Australia.Festival Concepts and ContextsHoward Becker observed that cultural production results from an interplay between the person of the artist and a multitude of support personnel whose work is not frequently studied: “It is through this network of cooperation that the art work we eventually see or hear comes to be and continues to be” (1). In assisting arts and culture throughout the Bega Valley, Eurobodalla, and Snowy Monaro, South East Arts delivers positive achievements in the Aboriginal arts and cultural sector. Their outcomes are significant in the light of the dispossession, segregation, and discrimination experienced by Aboriginal Australians. Michael Young, assisted by Indigenous authors Ellen Mundy and Debbie Mundy, recorded how Delegate Reserve residents relocating to the coast were faced with having their lives controlled by a Wallaga Lake Reserve manager or with life on the fringes of the towns in shacks (2–3). But as discovered in the records, “their retention of traditional beliefs, values and customs, reveal that the accommodation they were forced to make with the Europeans did not mean they had surrendered. The proof of this is the persistence of their belief in the value of their culture” (3–4). The goal of the Twofold Aboriginal Corporation is to create an inclusive place where Aboriginal people of the Twofold Bay Region can be proud of their heritage, connect with the local economy, and create a real future for their children. When Simpson told Williams of the Twofold Aboriginal Corporation’s and Eden Local Aboriginal Land Council’s dream of housing a large cultural festival at Jigamy, Williams rigorously consulted local Indigenous organisations to build a shared sense of community ownership of the event. She promoted the festival as “a rare opportunity in our region to learn about Aboriginal culture and have access to a huge program of Aboriginal musicians, dancers, visual artists, authors, academics, storytellers, cooks, poets, creative producers, and films” (McKnight).‘Uncle Ossie’ Cruse of Eden envisaged that the welcoming event would enliven the longstanding caring and sharing ethos of the Yuin-Monaro people. Uncle Ossie was instrumental in establishing Jigamy’s majestic Monaroo Bobberrer Gudu Keeping Place with the Eden Local Aboriginal Land Council in 1994. Built brick by brick by Indigenous workers, it is a centre for the teaching and celebration of Aboriginal culture, and for the preservation of artefacts. It represents the local community's determination to find their own solutions for “bridging the gap” by creating education and employment opportunities. The centre is also the gateway to the Bundian Way, the first Aboriginal pathway to be listed on the NSW State Heritage Register. Festival Lead-Up EventsEden’s Indigenous students learn a revived South Coast language at Primary and Secondary School. In 2015, Uncle Ossie vitally informed their input into The Black Ducks, a hip-hop song filmed in Eden by Desert Pea Media. A notable event boosting Koori musical socialisation was a Giiyong Grow the Music spectacle performed at Jigamy on 28 October 2017. Grow the Music—co-founded by Lizzy Rutten and Emily White—specialises in mentoring Indigenous artists in remote areas using digital recording equipment. Eden Marine High School students co-directed the film Scars as part of a programme of events with South East Arts and the Giiyong Festival 2018. The Eden Place Project and Campbell Page also create links between in- and out-of-school activities. Eden’s Indigenous students thus perform confidently at NAIDOC Week celebrations and at various festivals. Preparation and PersonnelAn early decision was made to allow free entry to the Giiyong Festival in order to attract a maximum number of Indigenous families. The prospect necessitated in-kind support from Twofold Aboriginal Corporation staff. They galvanised over 100 volunteers to enhance the unique features of Jigamy, while Uncle Ossie slashed fields of bushes to prepare copious parking space. The festival site was spatially focused around two large stages dedicated to the memory of two strong supporters of cultural creativity: Aunty Doris Kirby, and Aunty Liddy Stewart (Image 1). Image 1: Uncle Ossie Cruse Welcomes Festival-Goers to Country on the Aunty Liddy Stewart Stage. Image Credit: David Rogers for South East Arts, Reproduction Courtesy of South East Arts.Cultural festivals are peaceful weapons in a continuing ontological political contest (Slater 144). In a panel discussion, Uncle Ossie explained and defended the Makarrata: the call for a First Nations Voice to be enshrined in the Constitution.Williams also contracted artists with a view to capturing the past and present achievements of Aboriginal music. Apart from her brilliant centrepiece acts No Fixed Address and Baker Boy, she attracted Pitjantjatjara singer Frank Yamma (Image 2), Yorta Yorta singer/songwriter Benny Walker, the Central Desert Docker River Band, and Jessie Lloyd’s nostalgic Mission Songs Project. These stellar acts were joined by Wallaga Lake performers Robbie Bundle, Warren Foster, and Alison Walker as well as Nathan Lygon (Eden), Chelsy Atkins (Pambula), Gabadoo (Bermagui), and Drifting Doolgahls (Nowra). Stage presentations were technologically transformed by the live broadcast of acts on large screens surrounding the platforms. Image 2: Singer-Songwriter Frank Yamma Performs at Giiyong Festival 2018. Image Credit: David Rogers for South East Arts, Reproduction Courtesy of South East Arts.Giiyong Music and Dance Music and dance form the staple components of Indigenous festivals: a reflection on the cultural strength of ancient ceremony. Hundreds of Yuin-Monaro people once attended great corroborees on Mumbulla Mountain (Horton 1235), and oral history recorded by Janet Mathews evidences ceremonies at Fishy Flats, Eden, in the 1850s. Today’s highly regarded community musicians and dancers perform the social arrangements of direct communication, sometimes including their children on stage as apprentices. But artists are still negotiating the power structures through which they experience belonging and detachment in the representation of their musical identity.Youth gain positive identities from participating alongside national headline acts—a form of learning that propels talented individuals into performing careers. The One Mob Dreaming Choir of Koori students from three local schools were a popular feature (Image 3), as were Eden Marine student soloists Nikai Stewart, and Nikea Brooks. Grow the Music in particular has enabled these youngsters to exhibit the roots of their culture in a deep and touching way that contributes to their life-long learning and development. Image 3: The One Mob Dreaming Choir, Directed by Corinne Gibbons (L) and Chelsy Atkins (R). Image Credit: David Rogers for South East Arts, Reproduction Courtesy of South East Arts. Brydie-Leigh Bartleet describes how discourses of pride emerge when Indigenous Australian youth participate in hip-hop. At the Giiyong Festival the relationship between musical expression, cultural representation, and political positioning shone through the songs of Baker Boy and Gabadoo (Image 4). Channelling emotions into song, they led young audiences to engage with contemporary themes of Indigeneity. The drones launched above the carpark established a numerical figure close on 6,000 attendees, a third of whom were Indigenous. Extra teenagers arrived in time for Baker Boy’s evening performance (Williams), revealing the typical youthful audience composition associated with the hip-hop craze (Image 5).Image 4: Bermagui Resident Gabadoo Performs Hip-Hop at the Giiyong Festival. Image Credit: David Rogers for South East Arts, Reproduced Courtesy South East Arts.Image 5: A Youthful Audience Enjoys Baker Boy’s Giiyong Festival Performance. Image Credit: David Rogers for South East Arts, Reproduced Courtesy South East Arts.Wallaga Lake’s traditional Gulaga Dancers were joined by Bermagui’s Gadhu Dancers, Eden’s Duurunu Miru Dancers, and Narooma’s Djaadjawan Dancers. Sharon Mason founded Djaadjawan Dancers in 2015. Their cultural practice connects to the environment and Mingagia (Mother Earth). At their festival tent, dancers explained how they gather natural resources from Walbanja Country to hand-make traditional dance outfits, accessories, and craft. They collect nuts, seeds, and bark from the bush, body paint from ancient ochre pits, shells from beaches, and bird feathers from fresh roadkill. Duurunu Miru dancer/didjeriduist Nathan Lygon elaborates on the functions of the Far South East Coast dance performance tradition:Dance provides us with a platform, an opportunity to share our stories, our culture, and our way of being. It demonstrates a beautiful positivity—a feeling of connection, celebration, and inclusion. The community needs it. And our young people need a ‘space’ in which they can grow into the knowledge and practices of their culture. The festival also helped the wider community to learn more about these dimensions. (n.p.)While music and dance were at the heart of the festival, other traditional skills were included, for example the exhibitions mounted inside the Keeping Place featured a large number of visual artists. Traditional bush cooking took place near Lake Pambula, and yarn-ups, poetry, and readings were featured throughout the day. Cultural demonstrations in the Bunaan Ring (the Yuin name for a corroboree circle) included ‘Gum Leaf Playing.’ Robin Ryan explained how the Yuin’s use of cultural elements to entertain settlers (Cameron 79) led to the formation of the Wallaga Lake Gum Leaf Band. As the local custodian of this unique musical practice, Uncle Ossie performed items and conducted a workshop for numerous adults and children. Festival Feedback and Future PlanningThe Giiyong Festival gained huge Indigenous cultural capital. Feedback gleaned from artists, sponsors, supporters, volunteers, and audiences reflected on how—from the moment the day began—the spirit of so many performers and consumers gathered in one place took over. The festival’s success depended on its reception, for as Myers suggests: “It is the audience who create the response to performance and if the right chemistry is achieved the performers react and excel in their presentation” (59). The Bega District News, of 24 September 2018, described the “incredibly beautiful event” (n.p.), while Simpson enthused to the authors:I believe that the amount of people who came through the gates to attend the Giiyong Festival was a testament to the wider need and want for Aboriginal culture. Having almost double the population of Eden attend also highlights that this event was long overdue. (n.p.)Williams reported that the whole festival was “a giant exercise in the breaking down of walls. Some signed contracts for the first time, and all met their contracts professionally. National artists Baker Boy and No Fixed Address now keep in touch with us regularly” (Williams). Williams also expressed her delight that local artists are performing further afield this year, and that an awareness, recognition, and economic impact has been created for Jigamy, the Giiyong Festival, and Eden respectively:We believe that not only celebrating, but elevating these artists and Aboriginal culture, is one of the most important things South East Arts can do for the overall arts sector in the region. This work benefits artists, the economy and cultural tourism of the region. Most importantly it feeds our collective spirit, educates us, and creates a much richer place to live. (Giiyong Festival Report 1)Howarth received 150 responses to her post-event survey. All respondents felt welcome, included, and willing to attend another festival. One commented, “not even one piece of rubbish on the ground.” Vanessa Milton, ABC Open Producer for South East NSW, wrote: “Down to the tiniest detail it was so obvious that you understood the community, the audience, the performers and how to bring everyone together. What a coup to pull off this event, and what a gift to our region” (Giiyong Festival Report 4).The total running cost for the event was $257,533, including $209,606 in government grants from local, state, and federal agencies. Major donor Create NSW Regional Partnerships funded over $100,000, and State Aboriginal Affairs gave $6,000. Key corporate sponsors included Bendigo Bank, Snowy Hydro and Waterway Constructions, Local Land Services Bega, and the Eden Fisherman’s Club. Funding covered artists’ fees, staging, the hiring of toilets, and multiple generators, including delivery costs. South East Arts were satisfied with the funding amount: each time a new donation arrived they were able to invite more performers (Giiyong Festival Report 2; Gray; Williams). South East Arts now need to prove they have the leadership capacity, financial self-sufficiency, and material resources to produce another festival. They are planning 2020 will be similar to 2018, provided Twofold Aboriginal Corporation can provide extra support. Since South East Arts exists to service a wider area of NSW, they envisage that by 2024, they would hand over the festival to Twofold Aboriginal Corporation (Gray; Williams). Forthcoming festivals will not rotate around other venues because the Giiyong concept was developed Indigenously at Jigamy, and “Jigamy has the vibe” (Williams). Uncle Ossie insists that the Yuin-Monaro feel comfortable being connected to Country that once had a traditional campsite on the east side. Evaluation and ConclusionAlthough ostensibly intended for entertainment, large Aboriginal festivals significantly benefit the educational, political, and socio-economic landscape of contemporary Indigenous life. The cultural outpourings and dissemination of knowledges at the 2018 Giiyong Festival testified to the resilience of the Yuin-Monaro people. In contributing to the processes of Reconciliation and Recognition, the event privileged the performing arts as a peaceful—yet powerful truth-telling means—for dealing with the state. Performers representing the cultures of far-flung ancestral lands contributed to the reimagining of a First Nations people’s map representing hundreds of 'Countries.’It would be beneficial for the Far South East region to perpetuate the Giiyong Festival. It energised all those involved. But it took years of preparation and a vast network of cooperating people to create the feeling which made the 2018 festival unique. Uncle Ossie now sees aspects of the old sharing culture of his people springing back to life to mould the quality of life for families. Furthermore, the popular arts cultures are enhancing the quality of life for Eden youth. As the cross-sector efforts of stakeholders and volunteers so amply proved, a family-friendly, drug and alcohol-free event of the magnitude of the Giiyong Festival injects new growth into an Aboriginal arts industry designed for the future creative landscape of the whole South East region. AcknowledgementsMany thanks to Andrew Gray and Jasmin Williams for supplying a copy of the 2018 Giiyong Festival Report. We appreciated prompt responses to queries from Jasmin Williams, and from our editor Rachel Franks. We are humbly indebted to our two reviewers for their expert direction.ReferencesAustralian Government. Showcasing Creativity: Programming and Presenting First Nations Performing Arts. Australia Council for the Arts Report, 8 Mar. 2017. 20 May 2019 <https://tnn.org.au/2017/03/showcasing-creativity-programming-and-presenting-first-nations-performing-arts-australia-council/>.Bartleet, Brydie-Leigh. “‘Pride in Self, Pride in Community, Pride in Culture’: The Role of Stylin’ Up in Fostering Indigenous Community and Identity.” The Festivalization of Culture. Eds. Andy Bennett, Jodie Taylor, and Ian Woodward. New York: Routledge, 2014.Becker, Howard S. Art Worlds. 25th anniversary edition. Berkeley: U of California P, 2008.Brown, Bill. “The Monaroo Bubberer [Bobberer] Gudu Keeping Place: A Symbol of Aboriginal Self-determination.” ABC South East NSW, 9 Jul. 2015. 20 May 2019 <http://www.abc.net.au/local/photos/2015/07/09/4270480.htm>.Cameron, Stuart. "An Investigation of the History of the Aborigines of the Far South Coast of NSW in the 19th Century." PhD Thesis. Canberra: Australian National U, 1987. Desert Pea Media. The Black Ducks “People of the Mountains and the Sea.” <https://www.youtube.com/watch?v=8fbJNHAdbkg>.“Festival Fanfare.” Eden Magnet 28 June 2018. 1 Mar. 2019 <edenmagnet.com.au>.Gibson, Chris, and John Connell. Music Festivals and Regional Development in Australia. Aldershot: Ashgate, 2012.Gray, Andrew. Personal Communication, 28 Mar. 2019.Henry, Rosita. “Festivals.” The Oxford Companion to Aboriginal Art and Culture. Eds. Syvia Kleinert and Margot Neale. South Melbourne: Oxford UP, 586–87.Horton, David R. “Yuin.” Encyclopaedia of Aboriginal Australia. Ed. David R. Horton. Canberra: Aboriginal Studies Press, 1994.———. Aboriginal Australia Wall Map Compiled by David Horton. Aboriginal Studies Press, 1996.Lygon, Nathan. Personal Communication, 20 May 2019.Mathews, Janet. Albert Thomas Mentions the Leaf Bands That Used to Play in the Old Days. Cassette recorded at Wreck Bay, NSW on 9 July 1964 for the Australian Institute of Aboriginal and Torres Strait Islanders (AIATSIS). LAA1013. McKnight, Albert. “Giiyong Festival the First of Its Kind in Yuin Nation.” Bega District News 17 Sep. 2018. 1 Mar. 2019 <https://www.begadistrictnews.com.au/story/5649214/giiyong-festival-the-first-of-its-kind-in-yuin-nation/?cs=7523#slide=2>. ———. “Giiyong Festival Celebrates Diverse, Enduring Cultures.” Bega District News 24 Sep. 2018. 1 Mar. 2019 <https://www.begadistrictnews.com.au/story/5662590/giiyong-festival-celebrates-diverse-enduring-cultures-photos-videos/>.Myers, Doug. “The Fifth Festival of Pacific Arts.” Australian Aboriginal Studies 1 (1989): 59–62.Simpson, Alison. Personal Communication, 9 Apr. 2019.Slater, Lisa. “Sovereign Bodies: Australian Indigenous Cultural Festivals and Flourishing Lifeworlds.” The Festivalization of Culture. Eds. Andy Bennett, Jodie Taylor, and Ian Woodward. London: Ashgate, 2014. 131–46.South East Arts. "Giiyong Festival Report." Bega: South East Arts, 2018.———. Giiyong Grow the Music. Poster for Event Produced on Saturday, 28 Oct. 2017. Bega: South East Arts, 2017.Williams, Jasmin. Personal Communication, 28 Mar. 2019.Young, Michael, with Ellen, and Debbie Mundy. The Aboriginal People of the Monaro: A Documentary History. Sydney: NSW National Parks and Wildlife Service, 2000.
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Malatzky, Christina Amelia Rosa. ""Keeping It Real": Representations of Postnatal Bodies and Opportunities for Resistance and Transformation." M/C Journal 14, no. 6 (November 6, 2011). http://dx.doi.org/10.5204/mcj.432.

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Introduction Contrary to popular understandings of academia, the work of academics is intrinsically community driven, because scholarly inquiry is invariably about social life. Therefore, what occupies academic scholarship is in the interest of the broader populace, and we rely on the public to inform our work. The findings of academic work are simultaneously a reflection of the researcher, and the public. The research interests of contemporary cultural and social researchers inevitably, and often necessarily, reflect issues and activities that they encounter in their everyday lives. My own doctoral research into contemporary cultural discourses informing the expectations, and experiences of motherhood in regional Western Australia, reflects an academic, personal and community interest. The doctoral research drawn on in this paper, stresses the relevance of cultural research projects to the concerns and behaviours of the wider public. The enthusiasm with which participants responded to this project, and reported back about their feelings and actions following the interview was unexpected. The immediacy of the impact this project has had on assisting women to create and consider alternate discourses demonstrates the capacity of this work to inform and direct contemporary social, political and cultural debates surrounding the bodily expectations, and experiences of motherhood. The feminist inspired methodology adopted in this project facilitated my speaking to other women negotiating cultural ideals about what constitutes a "good mother" in contemporary regional Western Australia. It has the potential to open up conversations between women, and between women and men, as evidenced by subsequent responses from participants. By examining the impact of these cultural ideals with everyday women, this project provides a means for women, and men, to reflect, engage critically and ultimately re-shape these discourses to more accurately reveal the desires and aspirations of everyday Australian women. From my perspective, three discourses in particular, the Good Mother, the Superwoman, and the Yummy Mummy, inform the expectations and experiences of motherhood. The orthodox discourse of the 'Good Mother' understands motherhood as a natural feminine desire and it describes characteristics such as enduring love, care, patience and selflessness that are often presented as synonymous with motherhood. Women who can successfully juggle the expectations of being a 'good mother' and a dedicated professional worker, are 'superwomen'. Increasingly dominant is the expectation that following maternity, women should not look as if they have had a child at all; the discourse of the Yummy Mummy focused on in this paper. The relationships between these discourses are complex; "failure to perform" them adequately can result in women being labelled "bad mothers", either by themselves or others. Although these discourses are Western and globalising, they have a tangible effect locally. The cultural scripts they proscribe to are often contradictory; resulting in many women feeling conflicted. Despite some levels of critical engagement with these competing cultural agendas, the women in this study reflected, to differing degrees, their internalisation of the expectations that accompany these cultural scripts. The outcome of this work, and the process of producing it, has the capacity to influence the direction of current debates in Australia. Amongst others, the debate surrounding the contemporary cultural "presentation" of postnatal bodies, including what women should look like as mothers. The role of the media in shaping the current expectations surrounding the postnatal body, including the recently raised proposal that glossy magazines, and other forms of media, should have to declare incidences of Photoshopping, or other forms of photo enhancement, is one agenda that this project can influence. I explore the potential of this work to influence these debates through an examination of the impact of popularised fantasies on women's subjectivity, and feelings towards their postnatal bodies. An examination of the ways that some aspects of mothering are excluded from popular media sources highlights the capacity of this work to provide a practical means of sharing contemporary expectations and experiences of motherhood amongst women, those already mothering, and those intending to mother, and men. These debates have an impact on, and relevance for, the everyday lives of Australian women and men. Feminist Methodologies: Opportunities to Foster Mutual Understanding and Recognition of Shared Experience The motivating emphasis of feminist research is "women's lives and the questions they have about their own experiences" (Bloom 112). Consequently, a feminist methodology includes a concern with transformation and empowerment through the research practice (McRobbie, "Politics" 52). For Luff this reminds feminist researchers that their first duty is to "deal respectively with women's subjectivity, and indeed the inter-subjectivities of researcher and participants" (692). Olesen, in her account of feminist qualitative research, articulates that: the researcher too, has attributes, characteristics, a history, and gender, class, race and social attributes that enter the researcher interaction … in light of the multiple positions, selves, and identities at play in the research process, the subjectivity of the researcher, as much as that of the researched, became foregrounded. (226-7) This signifies for Olesen the indistinct boundary between researchers and researched (227), and for myself, signals the potential that feminist research praxis has for uniting the academic and broader, communities. According to Reinharz the interview has historically been the principle way in which feminists have pursued the active contribution of their participants in the construction of their research projects (Heyl 374). The research findings of this doctoral project are based on a series of interviews with nine intending to mother women, and twenty one already mothering women. The research questions were open-ended to allow participants to answer "in their own terms" (Jones 48). Participants were also encouraged to reflect on aspects of mothering, or plans to mother, that were most significant to them. Following Oakley (49) and others (Bloom 11) argument that there can be no intimacy between researcher and participant without reciprocity, while I chose not to express my personal disagreement to any statements made by participants, I self-consciously chose to answer any questions that participants directed to me. I did not attempt to hide my personal empathy with many of their accounts, and allowed for email follow up. By doing my upmost to position myself as a "validating listener" rather than a scrutinising judge, I allowed the women to reflect on the fact that their feelings were not necessarily unusual or "abnormal", and did not make them "bad mothers". In this way, both the process, and the final product of this work can provide a practical means for women to share some of their feelings, which are often excluded, or in some cases, vilified (Arendell 1196; O'Donohoe 14), in popular media outlets. The outcome of this work can contribute to an alternate space for everyday women to "be real" with both other mothers, and intending to mother women, and contribute to discourses of motherhood. Unreal Imagery and the Postnatal Body: Possibilities for Communication and Alteration Drawing on the principal example of the impact of unreal imagery, specifically images of airbrushed supermodels and celebrities, on the real experiences of motherhood by everyday Australian women, I propose that this project can foster further communications between intending to mother, and already mothering women, and their partners, about the realities, and misconceptions of motherhood; particularly, to share aspects of mothering that are excluded or marginalised in popular media representations. Through this process of validating the experiences of "real" everyday women, women, and men, can affect a break from, or at least critique, dominant discourses surrounding motherhood, and appreciate that there are a multiplicity of opinions, information, and ways of mothering. A dominant aspect of the "unreal" surrounding motherhood concerns the body and what women are led to believe their bodies can, and indeed, should, look like, postnatal. Unsurprisingly, the women in my study associated this "unreal" with Hollywood representations, and the increasing plethora of celebrity mums they encounter in the media. As McRobbie has suggested, a popular front page image for various celebrity chasing weekly magazines is the Yummy Mummy, "who can squeeze into size six jeans a couple of weeks after giving birth, with the help of a personal trainer", an image that has provided the perfect foundation for marketing companies to promote the arena of maternity as the next central cultural performance in terms of femininity, in which "high maintenance pampering techniques, as well as a designer wardrobe" ("Yummy") are essential. The majority of women in my study spoke about these images, and the messages they send. With few exceptions, the participants identified popular images surrounding mothering, and the expectations that accompany them, as unrealistic, and inaccurate. Several women reflected on the way that some aspects of their experience, which, in many cases, turned out to be shared experience, of mothering are excluded, or "hidden away", in popular media forms. For Rachel, popular media representations do not capture the "realness" of everyday experiences of motherhood: I was looking at all these not so real people … Miranda Kerr like breast feeding with her red stiletto's on and her red lipstick and I'm just like right you've got your slippers on and your pyjamas on and you're lucky to brush your teeth by lunchtime … I don't think they want to keep it real … It's not all giggles and smiles; there is uncontrollable crying in the middle of the night because you don't know what's wrong with them and you find out the next day that they've got an ear infection. You know where's all that, they miss out all that, it's all about the beautiful sleeping babies and you know the glam mums. (Rachel, aged 33, mother of one) The individual women involved in this study were personally implicated to differing degrees in these unreal images. For Penelope, these types of representations influenced her bodily expectations, and she identified this disjunction as the most significant in her mothering experience: I expected to pop straight back into my pre-maternity size, that for me was the hugest thing actually, like you see these ladies who six weeks after they've had their baby, look as good as before sort of thing, no stretch marks or anything like and then I thought if they can do it, I can do it sort of thing and it didn't work like that. (Penelope, aged 36, mother of four) Penelope's experience was not an unusual one, with the majority of women reporting similar feelings. The findings of this study concur with the outcomes reported by a recent United Kingdom survey of 2000 women, which found that 82 per cent were unhappy with their postnatal bodies, 77 per cent were "shocked by the changes to their body", and, more than nine out of ten agreed that "celebrity mothers' dramatic weight loss 'puts immense and unwelcome pressure on ordinary mums" (O'Donohoe 9). This suggests that celebrity images, and the expectations that accompany them, are having a widespread effect in the Western world, resulting in many women experiencing a sense of loss when it comes to their bodies. They must "get their bodies back", and may experience shame over the unattainability of this goal, which appears to be readily achievable for other women. To appreciate the implications of these images, and the power relations involved, these effects need to be examined on the local, everyday level. O'Donohoe discusses the role of magazines in funding this unreal imagery, and their fixation on high-profile Yummy Mummies, describing their coverage as "hyper-hypocritical" (9-10). On one hand, they play a leading role in the proliferation, promotion and reinforcement of the Yummy Mummy ideal, and the significant pressure this discourse places on women in the wider community. Whilst on the other hand they denigrate and vilify celebrity mums who are also increasingly pressured into this performance, labelling them as "weigh too thin" (cover of Famous magazine, Jan. 2011) and "too stressed to eat" (cover of OK magazine, June 2011). Gill and Arthurs observe how: the female celebrity body is under constant surveillance, policed for being too fat, too thin, having wrinkles or 'ugly hands' … 'ordinary' women's bodies are under similar scrutiny when they participate in the growing number of reality make-over shows in which … female participants are frequently humiliated and vilified. (444) An observation by one of my participants suggests the implications of these media trends on the lives of everyday women, and suggests that everyday women are inscrutably aware of the lack of alternative discourses: It's kind of like fashionable to talk about your body and what's wrong with it, it's not really, I don't know. You don't really say, check out, like god I've got good boobs and look at me, look how good I look. It's almost like, my boobs are sagging, or my bums too big, it's never anything really positive. (Daisy, aged 36, mother of two) The "fashionable" nature of body surveillance is further supported by the vast majority of women in this study who reported such behaviour. A preoccupation with the body as a source of identity that emphasises self-surveillance, self-monitoring, and self-discipline (Gill 155) is a central component to neoliberalism, and the Yummy Mummy phenomenon. As O'Donohoe surmises, maternity now requires high maintenance (3). O'Donohoe comments on the concern this generates amongst some women regarding their weight gain, leading to some cases of infant malnutrition as a consequence of dieting whilst pregnant (9). Whilst this is an extreme example, mothering women's anxiety over body image is a widespread concern as reflected in this study. This trend towards body surveillance suggests that the type of sexualisation Attwood describes as taking place in Western cultures, is present and influential amongst the women in this study. I concur with Attwood that this trend is supplementary to the intensification of neoliberalism, in which "the individual becomes a self-regulating unit in society" (xxiii). The body as a key site for identity construction, acts as a canvas, on which the cultural trend towards increasing sexualisation, is printed, and has implications for both feminine and maternal identities. The women in this study reported high incidences of body self-surveillance, with an emphasis on the monitoring of "weight". For many women, the disjuncture between the popularised "unreal", and the reality of their postnatal bodies resulted in feelings of shock and disappointment. For Teal, positive feelings and self-esteem were connected to her weight, and she discussed how she had to restrict weighing herself to once a week, at a particular time of day, to avoid distress: I'm trying to make it that I don't go on the scales, just once and week and like in the morning, because like I go at different times and like your weight does change a little bit during the day and your oh my goodness I've put on kilo! And feel awful and then next morning you weigh yourself and go good its back. (Teal, aged 25, mother of one) According to Foucault (Sawicki, Disciplining 68), the practice of self-surveillance teaches individuals to monitor themselves, and is one of the key normative operations of biopower, a process that attaches individuals to their identities. The habitual approach to weight monitoring by many of the women in this study suggests that the Yummy Mummy discourse is becoming incorporated into the identities of everyday mothering women, as a recognisable and dominant cultural script to perform, to differing degrees, and to varying grades of consciousness. A number of participants in this study worked in the fitness industry, and whilst I expected them to be more concerned about their bodies postnatal, because of the pressures they face in their workplaces to "look the part", the education they receive about their bodies gave them a realistic idea of what individual women can achieve, and they were among the most critical of weight monitoring practices. As several feminist and poststructuralist theorists suggest, disciplinary practices, such as self-surveillance, both underscore, and contribute to, contemporary cultural definitions of femininity. From a Foucauldian perspective, a woman in this context becomes "a self-policing subject, self-committed to a relentless self-surveillance" (Hekman 275). However, although for Foucault, total liberation is impossible, some parts of social life are more vulnerable to criticism than others, and we can change particular normalising practices (165). Creating alternate mothering discourses is one way to achieve this, and some women did reflect critically on these types of self-policing behaviours. A minority of women in this study recognised their body as "different" to before they had children. Rather than agonise over these changes, they accepted them as part of where they are in their lives right now: I'm not the same person that I was then, its different, I like I just sort of feel that change is good, it's okay to be different, it's okay for me look different, it's okay for my body to kind of wear my motherhood badges that's okay I feel happy about that. So I don't want it to look exactly the same, no I don't actually. (Corinne, aged 33, mother of four) As many of the women who have been in email contact with me since their interviews have expressed, the questions I asked have prompted them to reflect more consciously on many of these issues, and for some, to have conversations with loved ones. For me, this demonstrates that this project has assisted women, and the process of taking part has elicited conversations between more women, and importantly, between women and men, about these types of media representations, and the expectations they create. In response to a growing body of research into the effects of unrealistic imagery on women, particularly young women and the increasing rates of eating disorders amongst women (see for example Hudson et al.; Taylor et al.; Treasure) in Western communities, there has been debate in a number of Western countries, including the United Kingdom, France and Australia, over whether the practice of digitally altering photos in the media, should be legislated so that media outlets are required to declare when and how images have been altered. The media has not greeted this suggestion warmly. In response to calls for legislative action Jill Wanless, an associate editor at Look magazine, suggested that "sometimes readers want hyper-reality in a way—they want to be taken out of their own situation". The justification for "perfected" images, in this case, is the inferred distinction they create between the unreal and reality. However, the responses from the everyday women involved in this study suggest that their desire is not for "hyper reality", but rather for "realness" to be represented. As Corinne explains: Where's the mother on the front page of the magazine that says I took 11 months to lose my baby weight…I hate this fantasy world, where's the reality, where's our real mums, our real women who are out there going I agonise over dropping my kid in day care everyday when they cry, I hate it. That's real. Performativity, as an inextricable aspect of hyper reality, may be ignored by those with a vested interest in media production, but the roles that discourses such as the Yummy Mummy have in proliferating and creating the expectation of these performances, is of interest to both the community and cultural theorists. Conclusion The capacity to influence current cultural, political and social debates surrounding what women should look like as mothers in contemporary Western Australian society is important to explore. Using feminist methodologies in such work provides an opportunity to unite the academic and broader communities. By disassembling the boundary between researcher and researched, it is possible to encourage mutual understanding and the recognition of mutual experience amongst researcher, participants' and the wider community. Taking part in this research has elicited conversations between women, and men concerning their expectations, and experiences of parenthood. Most importantly, the outcome of this work has reflected a desire by local everyday women for the media to include their stories in the broader presentation of motherhood. In this sense, this project has, and can further, assist women in sharing aspects of their experiences that are frequently excluded from popular media representations, and present the multiplicity of mothering experiences, and what being a "good mother" can entail. Acknowledgements I would like to sincerely thank the following for their invaluable feedback on earlier drafts of this article: Dr Kathryn Trees, Yann Toussaint, Linda Warren and the anonymous M/C Journal reviewers. References Arendell, Terry. "Conceiving and Investigating Motherhood: The Decade's Scholarship." Journal of Marriage and the Family 62.4 (2000): 1192-207. Attwood, Feona. Mainstreaming Sex: The Sexualisation of Western Culture. London: I.B. Tauris, 2009. Bloom, Leslie. "Reflections from the Field: Locked in Uneasy Sisterhood: Reflections on Feminist Methodology and Research Relations." Anthropology & Education Quarterly 28.1 (1997): 111-22. Wanless, Jill. "Curb Airbrushed Images, Keep Bodies Real." CBS News World UK, 2010. 20 Sep. 2010 ‹http://www.cbsnews.com/stories/2010/09/20/world/main6884884.shtml›. Gill, Rosalind. Gender and the Media. Cambridge: Polity P, 2007. Gill, Rosalind, and Jane Arthurs. "Editors Introduction: New Femininities?" Feminist Media Studies 6.4 (2006): 443-51. Hekman, Susan. Feminist Interpretations of Michel Foucault. University Park: Pennsylvania State UP, 1996. Heyl, Barbara Sherman. "Ethnographic Interviewing." Handbook of Ethnography. Eds. Paul Atkinson, Amanda J. Coffey, Sara Delamont, John Lofland, and Lyn H. Lofland. London: Sage, 2001. 369-83. Hudson, James I., Eva Hiripi, Harrison G. Pope Jr., and Ronald C. Kessler. "The Prevalence and Correlates of Eating Disorders in the National Comorbidity Survey Replication." Biological Psychiatry 61.3 (2007). 348-58. Jones, Sue. "Depth Interviewing." Applied Qualitative Research. Ed. Robert Walker. Ashgate, 1985. 45-56. Luff, Donna. "Dialogue across the Divides: 'Moments of Rapport' and Power in Feminist Research with Anti-Feminist Women." Sociology 33.4 (1999): 687-703. McRobbie, Angela. "The Politics of Feminist Research: Between Talk, Text and Action." Feminist Review 12 (1982): 46-57. ———. "Yummy Mummies Leave a Bad Taste for Young Women: The Cult of Celebrity Motherhood Is Deterring Couples from Having Children Early. We Need to Rethink the Nanny Culture." The Guardian 2 Mar. 2006. Oakley, Ann. "Interviewing Women: A Contradiction in Terms." Doing Feminist Research. Ed. Helen Roberts. London: Routledge and Kegan Paul, 1981. 30-61. O'Donohoe, Stephanie. "Yummy Mummies: The Clamour of Glamour in Advertising to Mothers." Advertising & Society Review 7.3 (2006): 1-18. Olesen, Virginia. "Feminisms and Qualitative Research at and into the Millennium." Handbook of Qualitative Research. Eds. Norman Denzin and Yvonna Lincoln. London: Sage, 2000. 215-55. Sawicki, Jana. Disciplining Foucault: Feminism, Power, and the Body. New York: Routledge, 1991. ———. "Feminism, Foucault, and 'Subjects' of Power and Freedom." Feminist Interpretations of Michel Foucault. Ed. Susan J. Hekman, University Park: Pennsylvania State UP, 1996. 159-210. Taylor, C. Barr, et al. "The Adverse Effect of Negative Comments about Weight and Shape for Family and Siblings on Women at High Risk for Eating Disorders." Paediatrics 118 (2006): 731-38. Treasure, Janet. "An Image Is Worth a Thousand Words of Public Health." Brazilian Journal of Psychiatry 56.1 (2007): 7-8.
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