Gait Strategies Research Articles

Age-Related Differences in the Functional Demand Placed on the Lumbar Spine during Walking in Healthy Older versus Younger Men.

Age-related declines in the musculoskeletal system may place additional demands on the lumbar spine during everyday activities such as walking. This study aimed to investigate age-related differences in the functional demand (FD) of walking on the lumbar spine in older and younger adults. A motion analysis system with integrated force plates was used to acquire kinematic and kinetic data on 12 older (67.3 ± 6.0 years) and 12 younger (24.7 ± 3.1 years) healthy men during walking at a self-selected speed along a 10 m walkway. Isokinetic dynamometry was used to acquire the maximal joint moment capacity of the lumbar spine. The FD of the lumbar spine was calculated as the muscle moment during key phases of the gait cycle (GC) relative to the maximum moment capacity of the lumbar spine. The difference in FD between age groups was not significant (p = 0.07) and there were no significant differences between the young group (YG) and older group (OG) for any individual phase in the GC. Despite the lack of statistical significance, the results indicate that a practical difference may exist, as walking was approximately 20% more functionally demanding on the lumbar spine in the OG compared to the YG. Therefore, older adults may employ modified gait strategies to reduce mechanical load whilst walking to fall within the limits of their maximal force-producing capacity in the lumbar spine, which may have implications for injury risk.

Advancing Legged Wall Climbing Robot Performance Through Dynamic Contact-Integrated Climbing Model

Abstract Climbing robots have gained significance in hazardous and steep terrains, yet adapting to complex environments remains a challenge. Inspired by nature's climbers, this paper introduces a climbing dynamics model that integrates foot-end contact forces, crucial for safe and efficient wall climbing. Drawing insights from animal locomotion and biomechanics, we present a comprehensive dynamic model for quadruped robots. Our model, built upon multibody dynamics and a dynamic contact model based on spiny claw mechanisms, accurately simulates robot forces and motion during climbing, even predicting failure scenarios. Experimental validation further establishes model accuracy. This study advances climbing robot research by addressing attachment interaction dynamics and provides valuable insights for optimizing robot structural design and gait strategies.

Characteristics of limb kinematics in the gait disorders of post-stroke patients

Post-stroke gait disorders involve altered lower limb kinematics. Recently, the endpoint of the lower limb has been used as a control variable to understand gait kinematics better. In a cross-sectional study of sixty-seven post-stroke patients, the limb extension angle and effective limb length during gait were used as input variables with a mixed Gaussian model-based probabilistic clustering approach to identify five distinct clusters. Each cluster had unique characteristics related to motor paralysis, spasticity, balance ability, and gait strategy. Cluster 1 exhibited high limb extension angle and length values, indicating increased spasticity. Cluster 2 had moderate extension angles and high limb lengths, indicating increased spasticity and reduced balance ability. Cluster 3 had low limb extension angles and high limb length, indicating reduced balance ability, more severe motor paralysis, and increased spasticity. Cluster 4 demonstrated high extension angles and short limb lengths, with a gait strategy that prioritized stride length in the component of gait speed. Cluster 5 had moderate extension angles and short limb lengths, with a gait strategy that prioritized cadence in the component of gait speed. These findings provide valuable insights into post-stroke gait impairment and can guide the development of personalized and effective rehabilitation strategies.

Age and beta amyloid deposition impact gait speed, stride length, and gait smoothness while transitioning from an even to an uneven walking surface in older adults

BackgroundCapturing a measure of movement quality during a complex walking task may indicate the earliest signs of detrimental changes to the brain due to beta amyloid (Aβ) deposition and be a potential differentiator of older adults at elevated and low risk of developing Alzheimer's disease. This study aimed to determine: 1) age-related differences in gait speed, stride length, and gait smoothness while transitioning from an even to an uneven walking surface, by comparing young adults (YA) and older adults (OA), and 2) if gait speed, stride length, and gait smoothness in OA while transitioning from an even to an uneven walking surface is influenced by the amount of Aβ deposition present in an OA's brain. MethodsParticipants included 56 OA (>70 years of age) and 29 YA (25–35 years of age). In OA, Aβ deposition in the brain was quantified by PET imaging. All participants completed a series of cognitive assessments, a functional mobility assessment, and self-report questionnaires. Then participants performed two sets of walking trials on a custom-built walkway containing a mixture of even and uneven surface sections, including three trials with a grass uneven surface and three trials with a rocks uneven surface. Gait data were recorded using a wireless inertial measurement unit system. Stride length, gait speed, and gait smoothness (i.e., log dimensionless lumbar jerk) in the anteroposterior (AP), mediolateral (ML), and vertical (VT) directions were calculated for each stride. Outcomes were retained for five stride locations immediately surrounding the surface transition. ResultsOA exhibited slower gait (Grass: p < 0.001; Rocks: p = 0.006), shorter strides (Grass: p < 0.001; Rocks: p = 0.008), and smoother gait (Grass AP: p < 0.001; Rocks AP: p = 0.002; Rocks ML: p = 0.02) than YA, but they also exhibited greater reductions in gait speed and stride length than YA while transitioning to the uneven grass and rocks surfaces. Within the OA group, those with greater Aβ deposition exhibited decreases in smoothness with age (Grass AP: p = 0.02; Rocks AP: p = 0.03; Grass ML: p = 0.04; Rocks ML: p = 0.03), while those with lower Aβ deposition exhibited increasing smoothness with age (Grass AP: p = 0.01; Rocks AP: p = 0.02; Grass ML: p = 0.08; Rocks ML: p = 0.07). Better functional mobility was associated with less smooth gait (Grass ML: p = 0.02; Rocks ML: p = 0.05) and with less variable gait smoothness (Grass and Rocks AP: both p = 0.04) in the OA group. ConclusionThese results suggest that, relative to YA, OA may be adopting more cautious, compensatory gait strategies to maintain smoothness when approaching surface transitions. However, OA with greater Aβ deposition may have limited ability to adopt compensatory gait strategies to increase the smoothness of their walking as they get older because of neuropathological changes altering the sensory integration process and causing worse dynamic balance (i.e., jerkier gait). Functional mobility, in addition to age and Aβ deposition, may be an important factor of whether or not an OA chooses to employ compensatory strategies to prioritize smoothness while walking and what type of compensatory strategy an OA chooses.

Mechanical load applied by Intraosseous Transcutaneous Amputation Prosthesis (ITAP) during walking on level and sloped treadmill: A case study

This proof of concept study presents a method to collect and analyse kinetic data from one participant with a transfemoral amputation fitted with a percutaneous osseointegrated implant walking on a level and sloped treadmill. We describe the construction of and results from a bespoke wireless six axis load cell built into one participant's prosthetic assembly. The load cell does not clinically compromise the participant in any way and is an initial milestone in the development of a light-weight wireless load cell for use with percutaneous osseointegrated implants. In this case, it is the first time that kinetic data from a participant fitted with an Intraosseous Transcutaneous Amputation Prosthesis has been published. We propose that the data can be used to model the load transfer to the host bone, with several clinically significant applications. The raw dynamic data are made available and quasi-static load cases for each functional phase of gait are presented. Peak forces obtained in the medio-lateral (X), cranio-caudal (Y) and antero-posterior (Z) axes over level ground respectively were -243.8 N (0.24 BW), 1321.5 N (1.31 BW) and -421.8 N (0.42 BW); uphill were -141.0 N (0.14 BW), 1604.2 N (1.59 BW), -498.1 N (0.49 BW); downhill were -206.0 N (0.20 BW), 1103.9 N (1.09 BW), -547.2 N (0.54 BW). The kinetics broadly followed able bodied gait patterns with some gait strategies consistent in participants with other implant designs or prosthetic socket connections, for example offloading the artificial limb downhill.

Fourier Analysis of the Vertical Ground Reaction Force During Walking: Applications for Quantifying Differences in Gait Strategies.

Time series biomechanical data inform our understanding of normal gait mechanics and pathomechanics. This study examines the utility of different quantitative methods to distinguish vertical ground reaction forces (VGRFs) from experimentally distinct gait strategies. The goals of this study are to compare measures of VGRF data-using the shape factor method and a Fourier series-based analysis-to (1)describe how these methods reflect and distinguish gait patterns and (2)determine which Fourier series coefficients discriminate normal walking, with a relatively stiff-legged gait, from compliant walking, using deep knee flexion and limited vertical oscillation. This study includes a reanalysis of previously presented VGRF data. We applied the shape factor method and fit 3- to 8-term Fourier series to zero-padded VGRF data. We compared VGRF renderings using Euclidean L2 distances and correlations stratified by gait strategy. Euclidean L2 distances improved with additional harmonics, with limited improvement after the seventh term. Euclidean L2 distances were greater in shape factor versus Fourier series renderings. In the 8 harmonic model, amplitudes of 9 Fourier coefficients-which contribute to VGRF features including peak and local minimum amplitudes and limb loading rates-were different between normal and compliant walking. The results suggest that Fourier series-based methods distinguish between gait strategies.

Nonlinear Modeling Analysis of Stabilization Behavior of Robotic Gait Control System Based on Image Processing Techniques

Abstract Existing robot gait control methods have problems such as high gait energy consumption and difficulty in generating optimal gait strategies. This paper designs a robot gait automatic control system based on the X86 platform and robot sensor interface. The main board of the robot controller is designed based on CISC, which ensures high stability and anti-interference capabilities. The information provided by ultrasonic sensors and infrared sensors is used to adjust and execute the robot’s trajectory, action sequence, and gait. To extract the target in the gait image, the frame difference algorithm is employed, and the phase and amplitude factors are collected after the Radon and Fourier-Mellin transform to identify gait characteristics for robot gait recognition. The robot’s two-dimensional spatial dynamics model is constructed continuously, and its dynamics equations are derived. The residual fusion technique is used to combine image data with sensor data. A system for stabilizing gait control has been designed. The tracking error rate of the robot is not more than ±10% in general, and a variety of gait patterns can be used to cross the obstacles, which verifies the effectiveness of the designed system for realizing the gait control and performance of the robot.

Influence of Visual Augmented Feedback on Walking Speed Perception in Immersive Virtual Reality

Abstract In virtual reality (VR), established perception–action relationships break down because of conflicting and ambiguous sensorimotor inputs, inducing walking velocity underestimations. Here, we explore the effects of realigning perceptual sensory experiences with physical movements via augmented feedback on the estimation of virtual speed. We hypothesized that providing feedback about speed would lead to concurrent perceptual improvements and that these alterations would persist once the speedometer was removed. Ten young adults used immersive VR to view a virtual hallway translating at a series of fixed speeds. Participants were tasked with matching their walking speed on a self-paced treadmill to the optic flow in the environment. Information regarding walking speed accuracy was provided during augmented feedback trials via a real-time speedometer. We measured resulting walking velocity errors, as well as kinematic gait parameters. We found that the concordance between the virtual environment and gait speeds was higher when augmented feedback was provided during the trial. Furthermore, we observed retention effects beyond the intervention period via demonstrated smaller errors in speed perception accuracy and stronger concordance between perceived and actual speeds. Together, these results highlight a potential role for augmented feedback in guiding gait strategies that deviate away from predefined internal models of locomotion.

Muscle coactivation during gait in children with and without cerebral palsy

BackgroundChildren with Cerebral Palsy (CP) walk with an uncoordinated gait compared to Typically Developing (TD) children. This behavior may reflect greater muscle co-activation in the lower limb; however, findings are inconsistent, and the determinants of this construct are unclear. Research objectives(i) Compare lower-limb muscle co-activation during gait in children with, and without CP, and (ii) determine the extent to which muscle co-activation is influenced by electromyography normalization procedures and Gross Motor Function Classification System (GMFCS) class. MethodsAn electromyography system measured muscle activity in the rectus femoris, semitendinosus, gastrocnemius, and tibialis anterior muscles during walking in 46 children (19 CP, 27 TD). Muscle co-activation was calculated for the tibialis anterior-gastrocnemius (TA-G), rectus femoris-gastrocnemius (RF-G), and rectus femoris-semitendinosus (RF-S) pairings, both using root mean squared (RMS)-averaged and dynamically normalized data, during stance and swing. Mann-Whitney U and independent t-tests examined differences in muscle co-activation by group (CP vs. TD) and GMFCS class (CP only), while mean difference 95% bootstrapped confidence intervals compared electromyography normalization procedures. ResultsUsing dynamically normalized data, the CP group had greater muscle co-activation for the TA-G and RF-G pairs during stance (p < 0.01). Using RMS-averaged data, the CP group had greater muscle co-activation for TA-G (stance and swing, p < 0.01), RF-G (stance, p < 0.05), and RF-S (swing, p < 0.01) pairings. Muscle co-activation calculated with dynamically normalized, compared to RMS-averaged data, were larger in the RF-S and RF-G (stance) pairs, but smaller during swing (RF-G). Children with CP classified as GMFCS II had greater muscle co-activation during stance in the TA-G pair (p < 0.05). SignificanceGreater muscle co-activation observed in children with CP during stance may reflect a less robust gait strategy. Although data normalization procedures influence muscle co-activation ratios, this behavior was observed independent of normalization technique.

The Effects of Structural Characteristics of the Rollator on the Elderly’s Gait Strategies in Various Walking Environments

A rollator, one of the most widely used among walking assistance devices, can assist the elderly with stable walking in their daily lives. In this study, we investigated how the structural characteristics of two types of rollators affect the upper and lower extremity muscle activity and plantar pressure of the elderly in various walking environments. We quantified muscle activity (upper and lower limbs) and plantar pressure (mean force, peak pressure, and contact area) of 11 older adults walking in various environments (flat, obstacle, uneven, and sloped terrain) using two types of rollators. Upper extremity muscle activity was highest in the obstacle terrain and the uneven terrain, and a significant difference was found due to the structural differences of the rollator. Additionally, it was observed that lower extremity muscle activity and plantar pressure patterns appeared in accordance with the gait strategy to maintain stability in an unstable or inclined walking environment. In other words, it was confirmed that the weight of the rollator, the size of the wheel, grip type, and the auxiliary tools had a great effect on the upper and lower extremity muscle activity and plantar pressure of the elderly during walking. From the results of this study, it can be suggested that it is absolutely necessary to consider the biomechanical characteristics of the elderly and the structure of the rollator, which appear differently depending on the walking environment, in the development of walking aids. In the future, more clinical data will be collected, and based on this a rollator that can safely assist the elderly in various walking environments will be developed.

Consistency of muscle activation signatures across different walking speeds

BackgroundUsing a machine learning algorithm, individuals can be accurately identified from their muscle activation patterns during gait, leading to the concept of individual muscle activation signatures. Research questionAre muscle activation signatures robust across different walking speeds? MethodsWe used an open dataset containing electromyographic (EMG) signals from 8 lower limb muscles in 50 asymptomatic adults walking at 5 speeds (extremely slow, very slow, slow, spontaneous, and fast). A machine learning approach classified the EMG profiles based on similar (intra-speed classification) or different (inter-speed classification) walking speeds as training and testing conditions. ResultsIntra-speed median classification rates of muscle activation profiles increased with walking speed, from 92 % for extremely slow, to 100 % for self-selected fast walking conditions. Inter-speed median classification rates increased when the speed of the training condition was closer to that of the testing condition. Higher median classification rates were found across slow, spontaneous, and fast walking speed conditions, from 56 % to 96 %, compared with classification rates involving extremely and very slow walking speed conditions, from 6 % to 62 %. SignificanceOur findings reveal that i) muscle activation signatures are detectable for a large range of walking speeds, even those involving different gait strategies (intra-speed median classification rates from 92 % to 100 %), and ii) muscle activation signatures observed during very low walking speeds are not consistent with those observed at higher speeds, suggesting a difference in motor control strategy. Caution should therefore be exercised when assessing gait deviations of a slow walking patient against a normative database obtained at higher speed. Identifying the robustness of individual muscle activation signatures across different movements could help in detecting changes in motor control, otherwise difficult to detect on classical time-varying EMG patterns.

Dual-Task Training Effects on Mobility of Older Adults Residents of Porto Alegre: Pilot Study

Introduction: Balance deficit during gait is a factor that affects older people’s mobility. It’s related to an increased risk of falls, hospitalization, and mortality. Regular physical activity is an easy and low-cost strategy to improve older adults’s functional mobility. Dual-task training is also suggested to improve balance and has been highlighted in the new World Guidelines for Falls Prevention and Management for Older Adults. Objective: This study aimed to evaluate the effects of dual-task training on functional mobility of community-dwelling older adults. Methodology: Volunteers over 60 years old were submitted to a 24-weeks exercise routine associated with dual-task challenges. On the first 12 weeks of muscular training, based on The High Intensity Functional Exercise (HIFE) Program was applied. On the following 12 weeks, cognitive challenges and dual-task exercises were added to the exercise protocol. Functional mobility was evaluated by different gait strategies (Figure 8 Walking Test, Tandem Gait Test, 10 Meter Walk Test), in admission, after 12 weeks, and at the end of 24 weeks intervention protocol. Results: Seven participants achieved the preestablished protocol length. The mean values showed that the time of execution has diminished in Tandem Gait Test and Figure 8 Walking Test, when comparing the first and the last evaluations. Conclusion: The results of the study indicate that possible dual-task exercise is an effective way to improve older adults’s gait.

Impaired foot vibration sensitivity is related to altered plantar pressures during walking in people with multiple sclerosis

Balance and mobility impairment are two of the most common and debilitating symptoms among people with multiple sclerosis (MS). Somatosensory symptoms, including reduced plantar cutaneous sensation, have been identified in this cohort. Given the importance of the somatosensory system in gait, it is likely that impaired plantar sensation may play a role in the walking adaptations commonly observed in people with MS, including decreased stride length and increased stride width and dual support time, often described as a cautious gait strategy. Understanding the contributions of plantar sensation to these alterations may provide targets for interventions that seek to improve sensory feedback and normalize gait patterns. This cross-sectional study determined whether individuals with MS who demonstrate reduced sensitivity of the plantar surfaces also demonstrate altered plantar pressure distributions during walking compared to a control cohort.Twenty individuals with MS and twenty age- and sex-matched control participants walked barefoot at preferred and three matched speeds. Participants walked across a walkway with an embedded pressure plate used to quantify pressures within ten plantar zones. In addition, vibration perception thresholds were assessed at four sites on the plantar surface.Individuals with MS demonstrated increased peak total plantar pressures compared to control participants, that increased with walking speed. For the MS group, plantar pressures were higher on the less sensitive foot, although pressures on both feet exceeded those of the control cohort. Positive correlations between vibration perception threshold and peak total pressure were evident, although generally stronger in the MS cohort.A relationship between plantar vibration sensitivity and pressure could indicate that individuals with MS seek to increase plantar sensory feedback during walking. However, because proprioception may also be impaired, increased plantar pressure could result from inaccurate foot placement. Interventions targeting improved somatosensation may have the potential to normalize gait patterns and should be investigated.

DIFFERENCES IN LOWER LIMB INTERSEGMENTAL CO-ORDINATION IN TOTAL KNEE ARTHROPLASTY DURING THE GAIT

The study compared thigh-shank and shank-foot coordination during gait before and after total knee arthroplasty (TKA) with controls (CTRL).Twenty-seven patients (male=15/female=12; age=63.2±6.9 years) were evaluated one month prior to and twelve months after surgery, and compared to 27 controls (male=14/female=13; age=62.2±4.3). The participants were outfitted with a full-body marker set. Gait speed (normalized by leg length) was calculated. The time series of the thigh, shank, and foot orientation in relation to the laboratory coordinate system were extracted. The coordination between the thigh-shank and shank-foot in the sagittal plane were calculated using a vector coding technique. The coupling angles were categorized into four coordination patterns. The stance phase was divided into thirds: early, mid, and late stance. The frequency of each pattern and gait speed were compared using a one-way ANOVA with a post-hoc Bonferroni correction.Walking speed and shank-foot coordination showed no differences between the groups. The thigh-shank showed differences. The pre-TKA group showed a more in-phase pattern compared to the CTRL group during early-stance. During mid-stance, the pre- and post-TKA presented a more in-phase pattern compared to the CTRL group. Regarding shank-foot coordination, the groups presented an in-phase and shank pattern, with more shank phase during mid-stance and more in-phase during late-stance.The pre-TKA group showed greater differences than the post-TKA compared to the controls. The more in-phase pattern in the pre- and post-TKA groups could relate to a reduced capacity for the thigh that leads the movement. During mid-stance in normal gait, the knee is extending, where the thigh and shank movements are in opposite directions. The in-phase results in the TKA groups indicate knee stiffness during the stance phase, which may relate to a muscular deficit or a gait strategy to reduce joint stress.

Speeding up: Discrete mediolateral perturbations increased self-paced walking speed in young and older adults

BackgroundIn uncertain environments and with increasing age humans often walk slower while taking shorter, quicker, and wider steps, reflective of a cautious gait. Understanding when humans opt to use a cautious gait and the differences in gait strategies used as people age could be examined with perturbations on a self-paced treadmill that allows participants to adjust their walking speed. Adding varying degrees of unpredictability, an inherent element of real-world walking could also improve understanding of when specific gait strategies are used. Research questionWe investigated how healthy young and older adults adjust their gait strategies when responding to perturbations of varying unpredictability. We hypothesized that more unpredictable perturbations would produce more cautious gait strategies and be more pronounced in older adults than young adults. MethodsTen young and ten older adults walked on a self-paced treadmill with discrete mediolateral treadmill shift perturbations. We changed the shift magnitude and/or the timing of the perturbations during the gait cycle to vary perturbation unpredictability. We analyzed walking speed and step kinematics from treadmill and motion capture data. ResultsSurprisingly, participants walked faster not slower for the conditions with perturbations. Even more surprising older adults walked faster overall than young adults. As expected, participants took faster and wider steps for the most unpredictable perturbation but also took longer steps which was not expected. Step kinematic variability and average step width also increased as perturbation unpredictability increased suggesting that the more unpredictable conditions demanded greater balance control. Additionally, older adults had greater step kinematic variability, highlighted further using detrended step length variability, compared to young adults SignificanceOverall, these findings provide new insights about gait strategies and suggest that perturbations such as discrete mediolateral treadmill shifts can potentially be designed to encourage participants to walk faster if it is beneficial.

Spatiotemporal Parameters of Gait Among Adolescent Athletes with Concussion When Performing a Visuospatial Cognitive Task.

Adolescent athletes aged 10 to 19 years are at the highest risk of experiencing sport-related concussions (SRCs). Despite the known deficits and battery of assessments following concussion, postural stability during dual-task gait remains understudied in this population. The purpose of this study was to evaluate the dual-task cost (DTC) in adolescents with an acute or chronic SRC compared to reference values from healthy athlete peers for spatiotemporal parameters of gait during walking with and without a concurrent visuospatial memory task presented on a hand-held tablet. Researchers hypothesized that adolescents during the acute phase of concussion would be likely to experience a greater DTC compared to healthy peers in at least one spatiotemporal parameter of gait when walking within the dual-task paradigm. Cross-sectional, observational cohort design. Adolescents with concussion were recruited to participate. Subjects were divided into acute and chronic categories based on significant differences in the neuropsychological function after a period of 28 days. They walked at a self-selected speed along the 5.186-meter GAITRite® Walkway System with and without a concurrent visuospatial cognitive task presented on a hand-held tablet. Outcomes included normalized velocity (m/s), step length (m), and double limb (DLS) and single limb support (SLS) (defined as the percent of a gait cycle [%GC]). The data were then compared to the previously published reference values established using the same methods in the healthy athlete participants for all spatiotemporal parameters of gait. Data was collected on 29 adolescent athletes with SRC. Among males (15.53+/-1.12 years) with SRC, 20% of acute and 10% of chronic cases experienced a greater DTC compared to healthy athlete reference values. A similarly increased DTC was experienced by 83% of acute and 29% of chronic SRC cases for females (15.58+/-1.16 years). Adolescent athletes with concussion may continue demonstrating deficits in gait capabilities even in the chronic phase, and compensatory gait strategies were not the same between males and females. Dual-task cost assessment using the GAITRite® may be a valuable adjunct to comprehensive analysis of gait following SRC. 2.

Using the MouseWalker to Quantify Locomotor Dysfunction in a Mouse Model of Spinal Cord Injury.

The execution of complex and highly coordinated motor programs, such as walking and running, is dependent on the rhythmic activation of spinal and supra-spinal circuits. After a thoracic spinal cord injury, communication with upstream circuits is impaired. This, in turn, leads to a loss of coordination, with limited recovery potential. Hence, to better evaluate the degree of recovery after the administration of drugs or therapies, there is a necessity for new, more detailed, and accurate tools to quantify gait, limb coordination, and other fine aspects of locomotor behavior in animal models of spinal cord injury. Several assays have been developed over the years to quantitatively assess free-walking behavior in rodents; however, they usually lack direct measurements related to stepping gait strategies, footprint patterns, and coordination. To address these shortcomings, an updated version of the MouseWalker, which combines a frustrated total internal reflection (fTIR) walkway with tracking and quantification software, is provided. This open-source system has been adapted to extract several graphical outputs and kinematic parameters, and a set of post-quantification tools can be to analyze the output data provided. This manuscript also demonstrates how this method, allied with already established behavioral tests, quantitatively describes locomotor deficits following spinal cord injury.

Determining the optimal gait modification strategy for patients with knee osteoarthritis: Trunk lean or medial thrust?

BackgroundThe gait modification strategies Trunk Lean and Medial Thrust have been shown to reduce the external knee adduction moment (EKAM) in patients with knee osteoarthritis which could contribute to reduced progression of the disease. Which strategy is most optimal differs between individuals, but the underlying mechanism that causes this remains unknown. Research questionWhich gait parameters determine the optimal gait modification strategy for individual patients with knee osteoarthritis? MethodsForty-seven participants with symptomatic medial knee osteoarthritis underwent 3-dimensional motion analysis during comfortable gait and with two gait modification strategies: Medial Thrust and Trunk Lean. Kinematic and kinetic variables were calculated. Participants were then categorized into one of the two subgroups, based on the modification strategy that reduced the EKAM the most for them. Multiple logistic regression analysis with backward elimination was used to investigate the predictive nature of dynamic parameters obtained during comfortable walking on the optimal modification gait strategy. ResultsFor 68.1 % of the participants, Trunk Lean was the optimal strategy in reducing the EKAM. Baseline characteristics, kinematics and kinetics did not differ significantly between subgroups during comfortable walking. Changes to frontal trunk and tibia angles correlated significantly with EKAM reduction during the Trunk Lean and Medial Thrust strategies, respectively. Regression analysis showed that MT is likely optimal when the frontal tibia angle range of motion and peak knee flexion angle in early stance during comfortable walking are high (R2Nagelkerke = 0.12). SignificanceOur regression model based solely on kinematic parameters from comfortable walking contained characteristics of the frontal tibia angle and knee flexion angle. As the model explains only 12.3 % of variance, clinical application does not seem feasible. Direct assessment of kinetics seems to be the most optimal strategy for selecting the most optimal gait modification strategy for individual patients with knee osteoarthritis.

Effect of Load Carriage Lifestyle on Kinematics and Kinetics of Gait.

Backpacks are commonly worn by many people for multiple purposes. This study investigated the effects of habitual wearing of backpacks on lower limb kinematics and kinetics. Fourteen participants were recruited for analysis. All participants performed four randomly assigned scenarios, including running and walking at speeds of 3.5 and 1.5 m/s, respectively, with and without load carriage. The motion analysis system and force plate were used to investigate the lower limb kinematics and kinetics. A paired sample t-test was performed for statistical measurement with a significance level of α = .05. The results indicated that active force, breaking force, impact peak, loading rate, active peak, maximum braking, hip flexion, and hip range of motion were substantially higher under load carriage conditions than under walking condition, however, time to peak was lower. Conversely, during load carriage running, active force, braking impulse, time to peak, ankle plantarflexion, and ankle range of motion were all higher than those during running. Carrying a backpack weighing 10% of the body weight induced different foot strike patterns at both speeds; during load carriage walking, the hip tended to flex more; whereas, during load carriage running, the ankle tended to flex more. In conclusion, human body seems to adopt different gait strategies during load carriage walking and running. That is, the hip strategy is used during walking, while the ankle strategy is used during running.

Gait strategies for individuals with knee osteoarthritis when transitioning between floor and stair walking.

Objective: Individuals with knee osteoarthritis are at higher risk for falls during transitions between floor and stair walking due to their reduced lower extremity function. However, the adjust gait characteristics of knee osteoarthritis subjects for dealing with stair transitions have not been explored. We aimed to investigate gait strategies in individuals with knee osteoarthritis compared to age-matched individuals without knee OA during the transition between walking on floor and stairs. Method: Gait of 30 individuals with knee osteoarthritis and 30 individuals without knee osteoarthritis during floor-to-stair and stair-to-floor walking transitions were accessed using a 3D motion capture system. Foot-tread clearance, and angles of lower extremity joints and trunk at Foot-tread clearance timepoint were analyzed by using biomechanical software (Visual 3D). Results: Compared with asymptomatic control group, the knee osteoarthritis group demonstrated no difference in vertical Foot-tread clearance and horizontal Foot-tread clearance during stair transitions. However, ankle dorsiflexion (p = 0.01) decreased, hip flexion (p = 0.02) and trunk lateral tilt (p = 0.02) increased in knee osteoarthritis group during the stair ascent transition. Moreover, trunk lateral tilt to the support side (p = 0.003) and pelvic rotation (p = 0.03) increased, while hip abduction of the swing leg (p = 0.03) decreased during the stair descent transition in individuals with knee osteoarthritis. Conclusion: Increased trunk lateral tilt and altered angle of hip may be a strategy utilized by individuals with knee OA to increase the foot clearance ability and compensate for the disease-related loss of lower extremity strength, range of motion, and balance. However, compensatory manifestations, such as the increased lateral tilt of the trunk and movement of the gravity center may enhance the risk of falls and result in more abnormal knee joint loading.