Gait Biomechanics Research Articles (Page 1)

Plantar fasciitis (PFS) is a leading cause of heel pain, yet its clinical course varies widely. Although plantar fascia thickness (PFT) is often used as a pain marker, its prognostic value remains unclear. Objective: This study investigates whether foot arch morphology underlies distinct biomechanical profiles in PFS patients, potentially explaining the variability in its presentation. Methods: The cross-sectional study included 30 patients with PFS and 10 healthy controls. PFS patients were classified by arch type (pes rectus, pes planus, pes cavus) using the Arch Height Index (AHI). Baseline comparisons between healthy controls and PFS subgroups assessed PFT, Foot Function Index (FFI), joint stiffness ratio, and gait parameters. Results: PFT differed across groups but was not significantly associated with FFI scores (p = 0.233). The pes cavus group exhibited a lower metatarsophalangeal (MTP) stiffness ratio compared with healthy (p < 0.05). Pes planus and pes rectus groups showed excessive pronation, and the pes cavus group showed limited ankle dorsiflexion, indicating distinct gait mechanisms (p < 0.05). Conclusions: Foot arch morphology influences gait biomechanics, stiffness, and PFT in individuals with PFS. Incorporating individual arch types into clinical decision-making may facilitate more personalized interventions and improve treatment outcomes.

Impact of age-related changes in the mechanical properties of ankle plantarflexor muscles on gait biomechanics and energetics: A systematic review and meta-analysis.

The primary purpose of this study was to determine the preoperative predictors of gait biomechanics 6 months after unilateral total knee arthroplasty (TKA). There were 126 participants (age 64.4 ± 7.1 years, 75 females) who underwent instrumented biomechanical assessments while walking at a self-selected pace preoperatively, 10 weeks after (post-rehabilitation), and 6 months after unilateral TKA. Outcomes were peak knee extension moment (pKEM), knee angle excursion, and vertical ground reaction force (vGRF) ratio (surgical/contralateral). Potential clinical, demographic, and biomechanical predictors were tested univariately and considered a candidate for the final model if p < 0.15. Each multivariate model initially contained all candidates, and backward selection was used to determine the final model. Greater 6-month surgical limb pKEM was predicted (r2 = 0.31) by greater preoperative pKEM (β = 0.44, p < 0.0001), better quadriceps activation (β = 0.23, p = 0.004), and male sex (β = -0.21, p = 0.009). Greater 6-month surgical knee excursion was predicted (r2 = 0.34) by greater preoperative excursion (β = 0.39, p < 0.0001), male sex (β = -0.28, p = 0.0007), and preoperative quadriceps strength (β = 0.16, p = 0.047). Six-month vGRF ratio was predicted (r2 = 0.16) by preoperative vGRF ratio (β = 0.37, p < 0.0001) and study treatment group (β = 0.18, p = 0.03). Preoperative biomechanical variables at post-rehabilitation were also the strongest predictors of 6-month biomechanics. Statement of Clinical Significance: The strongest and most consistent predictor of gait biomechanics 6 months after TKA was the respective preoperative gait biomechanics variable, which may have important clinical implications for surgical decision making and prehabilitation/rehabilitation strategies. Biofeedback targeting vGRF predicted vGRF symmetry, but no other gait parameters, suggesting targeted interventions are needed. Improving quadriceps strength and activation may also facilitate knee biomechanics.

Mental fatigue in older adults: A narrative review of subjective, behavioral, neurophysiological, and physical changes.

Background. Injuries to the Achilles tendon in men aged 20-40 years are most commonly caused by intensified physical activity leading to prolonged overload of the tendon. Most injuries affect the tendon’s proximal third, which is less vascularised. Surgery for Achilles tendon injuries aims to obtain the best possible gait biomechanics and quickly restore the patient’s functional performance. Clinical outcomes vary with the surgical technique used. This article presents the results of a study comparing the minimally invasive technique and the classical technique for primary repair of the Achilles tendon in men aged 20-40 years. Material and methods. A prospective clinical analysis was performed to investigate the treatment outcomes of 10 male patients aged 20-40 years and free from chronic medical conditions. The experimental group consisted of 5 men operated on using a minimally invasive technique in the form of a modified Webb-Bannister technique where the tendon is not sutured, but the tendon stumps are brought close together, resulting in better healing without the tendon being compressed. A control group consisted of 5 men who were subjected to conventional tendon repair.Results. A follow-up of one year found that both techniques of Achilles tendon repair produced positive clinical outcomes, with better effectiveness of the minimally invasive technique noted in the early phase of treatment.Conclusion. Men undergoing surgery for complete rupture of the Achilles tendon experience fewer complications related to surgical wound healing and achieve good mobility in the talocrural joint earlier when minimally invasive surgery is used as compared with conventional (classical) repair.

To understand the changes in muscle force control ability and its association to gait biomechanics following anterior cruciate ligament reconstruction (ACLR). Twenty-five participants, 9 months following ACLR, performed isometric quadriceps (20%, 40% and 100% maximum voluntary isometric contraction [MVIC]) and hamstring (20% and 40% MVIC) contractions on an isokinetic dynamometer, tracing a target line. Torque variability using coefficient of variation, and complexity using sample entropy were calculated. Knee moments and knee flexion excursion were calculated from walking gait. Two-way mixed model analyses of variance were used for between-limb comparisons and Pearson's correlations to evaluate the associations between force variables and gait biomechanics. Quadriceps and hamstring torque variability changed depending on the limb and the effort level. Quadriceps variability was higher in the ACLR limb only at maximum effort (p = 0.039, Cohen's d = 0.437). Hamstring variability showed no differences at 40% but lower torque variability (p = 0.035, Cohen's d = -0.448) at 20%. Muscle force complexity was consistently higher in the ACLR limb compared to the noninjured limb, regardless of effort level. Additionally, as effort increased, muscle force became less complex in both limbs. Quadriceps variability was negatively associated with knee moments (r = -0.410, p = 0.042, better force control = higher knee extension moments). Hamstring complexity was positively associated with knee flexion excursion (r = 0.417, p = 0.038). Maximal strength was not associated with any gait biomechanics. Quadriceps and hamstring force control ability are altered and associated with gait biomechanics at 9 months post-ACLR. Rehabilitation should include exercises focused on force control to potentially help restore gait biomechanics. Level IV.

The goal of this study was to examine the effects of spinal cord stimulation (SCS) on muscle activity during walking after lower-limb amputation. Amputation results in a loss of sensory feedback and alterations in gait biomechanics, including co-contractions of antagonist muscles about the knee and ankle, and reduced pelvic obliquity range-of-motion and pelvic drop. SCS can restore sensation in the missing limb, but its effects on muscle activation and gait biomechanics have not been studied in people with lower-limb amputation. This case study included a participant with transtibial amputation who was implanted percutaneously with SCS electrodes over the lumbosacral enlargement for 84 days. SCS was used during in-lab experiments to provide somatosensory feedback from the missing limb, relaying a sense of plantar pressure when the prosthesis was in the stance phase of the gait cycle. We used electromyography (EMG) to record muscle activity from the residual and intact limbs, and 3D motion capture to measure pelvic obliquity and knee and ankle joint angles. EMG signals were recorded during walking with and without SCS at early (Day 30) and late (Day 63) time points across the implant duration. During walking, co-contraction of knee antagonist muscles was reduced following multiple sessions of SCS-mediated sensory restoration. Additionally, the activation of the hip abductor (tensor fasciae latae) muscle increased activity during gait with SCS-mediated sensory restoration, which corresponded to an increase in pelvic obliquity range-of-motion and pelvic drop, towards normal. Restoring sensation in the missing limb using SCS altered muscle activity during walking led to improved coordination and pelvic motion in an individual with lower-limb amputation.

How many strides are needed for reliable markerless gait analysis?

IntroductionGait dysfunction is a pervasive and debilitating symptom in people with multiple sclerosis (pwMS), characterized by reduced walking speed, shorter stride length, increased gait variability, and compromised postural control, significantly reducing quality of life. The aim of this study is to examine the effects of various exercise modalities on gait biomechanics, evaluate the role of progressive training principles in optimizing outcomes, and provide an evidence-based framework for individualized gait rehabilitation in MS, with the goal of developing targeted exercise strategies to effectively address the multifactorial nature of gait impairments.ObjectiveThis narrative review critically examines the biomechanical outcomes of structured exercise interventions for gait rehabilitation in pwMS, focusing on kinematic (e.g., joint angles), kinetic (e.g., ground reaction forces), and spatiotemporal (e.g., stride length, gait speed) parameters. It also assesses the role of progressive training principles, such as overload and task specificity, in optimizing functional outcomes.MethodsA comprehensive literature search was conducted in PubMed, Web of Science, and Scopus (2005 to February 2025) following PRISMA guidelines. Randomized controlled trials (RCTs) and non-randomized trials evaluating structured exercise interventions targeting gait biomechanics in pwMS were included. Although this is a narrative review, a PRISMA-style flowchart was used to transparently illustrate the literature selection process.ResultsThe review included 15 RCTs and 6 non RCTs with sample sizes ranging from 8 to 50 participants, covering resistance training, aerobic conditioning, balance exercises, cognitive-motor training, and multimodal approaches. Key findings indicated that resistance training improved joint torque and stride length, aerobic training enhanced gait speed and endurance, and multimodal protocols yielded the most comprehensive biomechanical benefits.ConclusionHigh-intensity, task-specific training significantly improves gait biomechanics in pwMS, but the heterogeneity in study designs, small sample sizes, and limited follow-up periods highlight the need for more standardized RCTs. Personalized, progressive training remains essential for optimizing gait rehabilitation outcomes in this population.Supplementary InformationThe online version contains supplementary material available at 10.1186/s13102-025-01339-4.

Unicompartmental knee arthroplasty (UKA) may enable improved functional outcomes compared to total knee arthroplasty (TKA). This randomized controlled trial assessed pre- and postoperative patient reported outcome measures (PROMs) and knee joint gait biomechanics for UKA and TKA patients. Patients were allocated to UKA (Oxford Partial Knee, Biomet, USA) and TKA (Persona CR Knee System, Zimmer, USA) study arms. Patients completed the Oxford Knee Score (OKS) and Western Ontario & McMaster University Arthritis Index (WOMAC), as well as instrumented gait analysis before and 1-year after surgery. Measures of interest: OKS scores; WOMAC sub-scores; Patient-specific correlations and root mean squared errors (RMSE) of stance phase sagittal and coronal knee angles. Statistical analysis included linear mixed-effects models (PROMs; α = 0.0125) and multivariate analysis of variance (gait biomechanics; α = 0.05). A total of 38 patients were recruited (UKA n = 17; TKA n = 21). All PROMs improved significantly following surgery (n = 37, p < 0.001), regardless of surgical technique. A significant effect of surgical technique on gait biomechanics was observed (n = 30, F4,25, p = 0.010), where UKA patients displayed greater sagittal plane correlations [median(Q1,Q3) UKA 0.985 (0.967, 0.991), TKA 0.955 (0.942, 0.973)]; p = 0.018] and lower coronal plane RMSEs [UKA 3.6 (2.4,5.0)°, TKA 8.6 (5.1, 11.5)°; p = 0.002]. Although patient-reported outcomes improved similarly following UKA and TKA, UKA more closely preserved native knee kinematics as indicated by the greater similarity of sagittal gait patterns shapes and lower magnitude of coronal angle changes. CLINICAL SIGNIFICANCE: Greater preservation of patient-specific knee kinematics with UKA supports its use in appropriately selected patients and informs the design of targeted, functionally oriented rehabilitation protocols.

Effects of maximal speed locomotor training on spatiotemporal gait changes in individuals with chronic stroke: A secondary analysis of a randomized controlled trial.

Progress in prosthetics development have greatly improved everyday life of people with lower limb amputations. However, efficiently operating a prosthetic device requires a complex learning process, as users need to familiarize with the biomechanics of prosthetic-assisted gait. Both mental and physical workloads play a role in this process, with significant implications for prosthetic use and acceptance. In this perspective review, we explore the intricate relationships between these elements in lower limb prosthetic users and foster the discussion about the possible correlation between various metrics and their use in the fields of biomechanics, cognitive and physical fatigue. First, we describe all compensatory movements that may be performed during prosthetic-assisted gait. We then examine the two loads: mental workload (MWL) and physical load, which are both reflected in the metabolic cost required for prosthetic use. From this analysis, we envision that prosthetic gait could be regulated by different factors, namely, biomechanics, MWL and metabolism. The main goal of this perspective is to foster discussion across these three domains, defining all types of 'loads' imposed on the patient using objective and cross related descriptors. We argue that such descriptors should be analyzed through specific approaches and protocols in order to be quantified in absolute manner. Being able to univocally describe the single inference of these macro areas to bionic limbs use, could lead to new paradigms in the patient's rehabilitation process and in the design of future robotic prostheses.

Effects of a 12-week intrinsic foot muscle strengthening program (STIFF) on gait, balance and concerns about falling in physically active older adults: An assessor-blinded randomized-controlled trial.

Three-dimensional gait kinematics and muscle collagen remodeling in rats of different ages and diets subjected to high-intensity exercise.

Background:Patellofemoral instability (PFI) has several known anatomic factors, including trochlear dysplasia and patellar maltracking. While studies have documented altered lower-extremity gait biomechanics in patients with PFI, the relationship between these biomechanical abnormalities and anatomy has not been thoroughly investigated, particularly during sport-related tasks.Purpose/Hypothesis:The purpose of this study is to examine the associations between preoperative anatomic characteristics and lower-extremity kinematics at sports clearance in adolescents after medial patellofemoral ligament reconstruction for PFI. It was hypothesized that patellar maltracking, trochlear dysplasia, and frontal plane malalignment would strongly correlate with abnormal lower-extremity biomechanics.Study Design:Descriptive laboratory study.Methods:Patients aged 10 to 18 years who underwent primary medial patellofemoral ligament reconstruction for PFI between 2019 and 2023 were tested at sports clearance visits. Joint angles of the hip and knee were calculated during descent of a drop vertical jump. Preoperative radiographs and magnetic resonance imaging were utilized to record tibial tuberosity–trochlear groove (TT-TG) distance, tibial tubercle–posterior cruciate ligament (TT-PCL) distance, trochlear width (TW), trochlear sulcus depth (TSD), lateral inclination angle, patellar tilt angle (PTA), Caton-Deschamps Index (CDI), and femorotibial angle. Spearman correlations assessed relationships between preoperative anatomy and drop vertical jump kinematics.Results:In total, 17 participants were tested (8 male, 15 unilateral; mean ± SD age, 15.5 ± 1.4 years; height, 166.3 ± 11.4 cm; weight, 65.1 ± 19.4 kg; days after surgery, 199.9 ± 30.8). TT-PCL, TT-TG, and TSD were not significantly correlated with kinematics. Greater dynamic pelvic obliquity (r = 0.672; P = .004) and internal pelvic rotation (r = 0.508; P = .044) were positively correlated with femorotibial angle. Pelvic obliquity was negatively correlated with CDI (r = −0.710; P = .007). Greater severity of patellar malalignment and trochlear dysplasia (decreased TW, r = −0.486 [P = .048]; increased PTA, r = 0.689 [P = .002]) was associated with greater hip abduction. TW (r = 0.503; P = .040) and CDI (r = −0.608; P = .028) were also correlated with internal hip rotation. Greater knee flexion during landing was correlated with decreased PTA (r = −0.547; P = .023) and CDI (r = −0.560; P = .046). Greater dynamic knee valgus was positively correlated with TW (r = 0.483; P = .049), and greater internal knee rotation was positively correlated with lateral inclination angle (r = 0.513; P = .035).Conclusion:Larger degree of patellar maltracking, trochlear dysplasia, and frontal plane malalignment correlated to distinct biomechanical patterns during dynamic movements. Statistically significant associations were found with internal knee and hip rotation, pelvic instability, hip abduction, and knee stiffness. Conversely, TT-PCL, TT-TG, and TSD demonstrated no significant association with postoperative kinematic patterns in patients with PFI.Clinical Relevance:Understanding how anatomic abnormalities relate to postoperative biomechanics can help clinicians identify adolescents at risk for persistent movement deficits after medial patellofemoral ligament reconstruction. These findings highlight the importance of incorporating individualized anatomic considerations into postoperative rehabilitation and return-to-sport assessments.

Influencing factors on swing phase ground clearance in transfemoral prostheses - A biomechanical study.

Sports footwear is widely used across a range of physical activities. A key factor distinguishing running shoes from other types of footwear is the “drop,” the millimeter difference between the heel and the forefoot. This study aimed to analyze the influence of different drops (0, 5, and 10 mm) on ground reaction forces during walking and to examine the effects of sex and body mass index (BMI) under these conditions. An observational, descriptive, and cross-sectional study was conducted with 117 participants (56 men and 61 women). The Dinascan/IBV® dynamometric platform (Instituto de Biomecánica de Valencia, Valencia, Spain) was used to measure ground reaction forces during walking (braking, take-off, propulsion, and swing forces), walking speed, and stance time. The descriptive analysis revealed comparable values for the left and right limbs, with slightly higher values observed in the right limb. Statistically significant differences were found in stance time, braking force, and swing force between the 0 mm and 10 mm drop conditions. Take-off force showed highly significant differences when comparing the 0–5 mm and 0–10 mm drop conditions. Sex-based differences were observed in all variables at the initial proposed drop condition of 0 mm, except for walking speed, possibly due to anatomical and physiological differences. Significant differences were found in stance time at 0 mm drop, braking force, and propulsion force. Highly significant values were obtained for take-off force and during the swing phase. A strong correlation was found between ground reaction forces and BMI with the different proposed drops in all forces studied, except for the support force, where a moderate correlation was obtained. Although shoe drop was found to influence ground reaction forces in this study, it is one of several factors that affect gait biomechanics. Other footwear characteristics, such as sole stiffness, material composition, weight, and elasticity, also play important roles in walking performance. Therefore, shoe drop should be considered an important but not exclusive parameter when selecting footwear. However, these results are limited to healthy young adults and may not be generalizable to other age groups or populations.

Running gait biomechanics associated with hamstring and quadriceps strength profiles.

3D gait analysis in patients treated for high-grade tibial plateau fractures (Schatzker VI) with closed reduction and external fixation with circular frames.

ObjectiveThis study analyzes changes in gait biomechanics in children aged 3–5, exploring motor development patterns during this critical period.MethodsUsing the BTS SMART DX infrared system and Kistler 3D force plate, three-dimensional gait motion and ground reaction forces were collected from 3-, 4-, and 5-year-olds during walking. Inverse dynamics analysis with Anybody 7.4 software provided detailed joint moments, muscle forces, and joint angles. Coordination patterns of joint angles and moments, Lyapunov exponents, muscle force data, joint energy absorption, and power were further analyzed.ResultsJoint angle coordination patterns remained consistent across ages, while joint moment control patterns simplified from three to two with age, indicating progressive joint control development. Muscle strength, joint power, and gait stability improved with age, reflecting enhanced movement efficiency and adaptability to complex motor tasks.ConclusionGait control in 3-year-olds is immature and mainly hip- and knee-dependent. At 4 years, children show significant joint coordination changes with increased ankle involvement, marking a transitional phase. By age 5, children exhibit more complex and stable gait control, though still developing. Overall, gait stability and coordination increase with age, with 4 years as a critical developmental period and 5 years showing more refined control characteristics.