Sensitivity of the Toe Height to Multijoint Angular Changes in the Lower Limbs During Unobstructed and Obstructed Gait.

Abstract

Tripping while walking is a main contributor to falls across the adult lifespan. Trip risk is proportional to variability in toe clearance. To determine the sources of this variability, the authors computed for 10 young adults the sensitivity of toe clearance to 10 bilateral lower limb joint angles during unobstructed and obstructed walking when the lead and the trail limb crossed the obstacle. The authors computed a novel measure-singular value of the appropriate Jacobian-as the combined toe clearance sensitivity to 4 groups of angles: all sagittal and all frontal plane angles and all swing and all stance limb angles. Toe clearance was most sensitive to the stance hip ab/adduction for unobstructed gait. For obstructed gait, sensitivity to other joints increased and matched the sensitivity to stance hip ab/adduction. Combined sensitivities revealed critical information that was not evident in the sensitivities to individual angles. The combined sensitivity to stance limb angles was 84% higher than swing limb angles. The combined sensitivity to the sagittal plane angles was lower than the sensitivity to the frontal plane angles during unobstructed gait, and this relation was reversed during obstacle crossing. The results highlight the importance of the stance limb joints and indicate that frontal plane angles should not be ignored.