Hip Moments Research Articles

Effect of increased pushoff during gait on hip joint forces

Anterior acetabular labral tears and anterior hip pain may result from high anteriorly directed forces from the femur on the acetabulum. While providing more pushoff is known to decrease sagittal plane hip moments, it is unknown if this gait modification also decreases hip joint forces. The purpose of this study was to determine if increasing pushoff decreases hip joint forces. Nine healthy subjects walked on an instrumented force treadmill at 1.25m/s under two walking conditions. For the natural condition, subjects were instructed to walk as they normally would. For the increased pushoff condition, subjects were instructed to “push more with your foot when you walk”. We collected motion data of markers placed on the subjects׳ trunk and lower extremities to capture trunk and leg kinematics and ground reaction force data to determine joint moments. Data were processed in Visual3D to produce the inverse kinematics and model scaling files. In OpenSim, the generic gait model (Gait2392) was scaled to the subject, and hip joint forces were calculated for the femur on the acetabulum after computing the muscle activations necessary to reproduce the experimental data.The instruction to “push more with your foot when you walk” reduced the maximum hip flexion and extension moment compared to the natural condition. The average reduction in the hip joint forces were 12.5%, 3.2% and 9.6% in the anterior, superior and medial directions respectively and 2.3% for the net resultant force. Increasing pushoff may be an effective gait modification for people with anterior hip pain.

The strengths and weaknesses of inverted pendulum models of human walking

An investigation into the kinematic and kinetic predictions of two “inverted pendulum” (IP) models of gait was undertaken. The first model consisted of a single leg, with anthropometrically correct mass and moment of inertia, and a point mass at the hip representing the rest of the body. A second model incorporating the physiological extension of a head–arms–trunk (HAT) segment, held upright by an actuated hip moment, was developed for comparison. Simulations were performed, using both models, and quantitatively compared with empirical gait data. There was little difference between the two models’ predictions of kinematics and ground reaction force (GRF). The models agreed well with empirical data through mid-stance (20–40% of the gait cycle) suggesting that IP models adequately simulate this phase (mean error less than one standard deviation). IP models are not cyclic, however, and cannot adequately simulate double support and step-to-step transition. This is because the forces under both legs augment each other during double support to increase the vertical GRF. The incorporation of an actuated hip joint was the most novel change and added a new dimension to the classic IP model. The hip moment curve produced was similar to those measured during experimental walking trials. As a result, it was interpreted that the primary role of the hip musculature in stance is to keep the HAT upright. Careful consideration of the differences between the models throws light on what the different terms within the GRF equation truly represent.

Muscle strategies for leg extensions on a “Reformer” apparatus

Considering the kinematics of leg extensions performed on a Reformer apparatus, one would expect high activation of hip and knee extensor muscle groups. However, because of the bi-articular nature of some lower limb muscles, and the possibility to vary the direction of force application on the Reformer bar, muscles can be coordinated theoretically in a variety of ways and still achieve the desired outcome. Hence, the aim of this study was to determine the knee and hip moments during leg extensions performed on the Reformer apparatus and to estimate the forces in individual muscles crossing these joints using static optimization. Fifteen subjects performed leg extensions exercises on the Reformer apparatus using an individually chosen resistance. To our big surprise, we found that subjects performed the exercise using two conceptually different strategies (i) the first group used simultaneous hip and knee extension moments, (ii) while the second group used simultaneous hip flexion and knee extension moments to perform the exercise. These different strategies were achieved by changing the direction of the resultant force applied by the subject’s feet on the Reformer bar. While leg extensions on the Reformer apparatus have been thought to strengthen the hip and knee extensors muscles, our results demonstrate that patients can perform the exercise in a different and unexpected way. In order to control the hip and knee moments and achieve the desired outcome of the exercise, the direction of force application on the Reformer bar must be controlled carefully.

Does osseointegrated transfemoral amputation prostheses increase the hip joint moment?

Does osseointegrated transfemoral amputation prostheses increase the hip joint moment?

Asymmetry of lower limb joint loading in advanced knee osteoarthritis

Summary Statement This study provides preliminary evidence that people with knee osteoarthritis have greater asymmetry in joint loading than healthy controls. Altered loading of the contralateral limb may signify increased risk of injury to other lower limb joints in knee osteoarthritis. Introduction Compensatory overloading of other lower limb joints is a potential reason for the non-random evolution of osteoarthritis (OA). In individuals with knee OA altered joint loading exists of the contralateral cognate joints. However, previous studies have neglected the temporal features of asymmetry in joint loading. The study aimed to identify the amount and temporal features of asymmetry in lower limb joint loading in advanced knee OA. Patients and Methods Participants (n=15) were awaiting primary unilateral total knee replacement for OA (age 67.0 SD 8.9 years, height 1.66 SD 0.13 m, mass 84.2 SD 15.8 kg, BMI 30.7 SD 6.2 kg/m2, median KL grade 4). Data were compared to asymptomatic age and sex matched controls. Kinematic and kinetic data during walking was acquired with 12 cameras (VICON MX-F20) and two Kistler force platforms at 100 Hz and 400 Hz respectively. Data were analysed in Visual3D (C-Motion Inc., USA). Asymmetry was computed in MatLab using a recently published symmetry index (SI) and symmetry function (SF). Variables (computed using inverse dynamics) were the peak external moments (%BW∗Height) of the hip, knee and ankle. Differences between means of the SI variables in the OA and control groups were compared using Student's t-tests. Discrete variables were also compared between limbs (paired t-test) or between the affected limb and matched control limb. Effect sizes (Cohen's d ) for the differences were also computed. Results A significant between group difference (OA and control) for SI was observed for the transverse plane ankle joint moment (16.1 SD 8.0 vs. 10.4 SD 4.8 d = 0.8 p = 0.049). A large effect size for the sagittal plane knee joint moment (22.9 SD 12.1 vs. 12.7 SD 5.1 d = 1.1 p = 0.178) and a medium effect size for the transverse plane hip joint moment (26.4 SD 15.9 vs. 16.6 SD 9.0 d = 0.7 p = 0.098) were observed. The unaffected limb (OA group) had higher peak hip flexion (5.76 SD 1.49 vs.5.32 SD 1.51 p = 0.041) and internal rotation moments (−0.67 SD 0.34 vs. −0.41 SD 0.18 d = 0.004) and a lower ankle inversion moment (0.16 SD 0.14 vs. 0.34 SD 0.24 d = 0.9 p = 0.030) compared to the affected limb. Only the difference in the first peak knee adduction moment for the affected and matched control limb was statistically significant (−2.65 SD 1.38 vs. −2.16 SD 1.16 d = 0.7 p = 0.031). Discussion and Conclusion This study provides preliminary evidence of more asymmetry in joint moments of the lower limb in people with knee OA compared to controls. Further investigation with a larger sample is required to verify these findings. Altered loading of the contralateral cognate joints may signify increased risk of injury at the hip and ankle and highlights the need for monitoring of other lower limb joints in knee OA.

Sit-to-stand transfer mechanics in healthy older adults: a comprehensive investigation of a portable lifting-seat device

Purpose: To evaluate lower extremity mechanics and muscle activation associated with the sit-to-stand transfer using a portable lifting-seat device and to compare these data to an unassisted transfer in healthy young and older adults. Methods: Bilateral lower extremity and low back musculature electromyography, three-dimensional leg and trunk motion, and ground reaction forces were recorded from 10 young (mean age = 25) and 10 older (mean age = 69) adults during five trials of (i) no assist and (ii) assisted transfers. Data were time normalized to represent the period of seat-off to standing. Peak sagittal plane joint angles, moments, and muscle activity profiles were calculated. Analysis of variance models was used to test for main effects and interactions (α = 0.05). Results: Trunk, hip, and knee angles were significantly reduced and dorsiflexion increased with assisted transfer (p < 0.05). Peak hip and ankle joint moments were reduced (p < 0.05) and no change found in knee moments (p > 0.05). Peak muscle activity was lower during the assisted transfer (p < 0.05). Seat device effects were similar between age groups. Older adults used higher relative muscle activation. Conclusion: Variables indicative of sit-to-stand functional demand were reduced with lifting-seat device use. Data provide a framework for future recommendations on product prescription, use, and research pertaining to the advancement of adaptive seating.Implications for RehabilitationHip and trunk mechanical demands, and muscle activation were reduced with portable lifting seat device use.Greater ankle dorsiflexion was found with portable lifting seat device use, suggesting this range of motion should be considered when prescribing this device.Healthy older and younger adults used similar knee and trunk joint mechanics yet older adults completed the sit-to-stand trials with greater lower extremity and low back muscle activation.

Letter to the Editor: Joint Moments in the Joint Coordinate System, Euler or Dual Euler Basis

Letter to the Editor: Joint Moments in the Joint Coordinate System, Euler or Dual Euler Basis

How Reliable Are Lower-Limb Kinematics and Kinetics during a Drop Vertical Jump?

As drop vertical jumps (DVJ) are widely used as a screening task, the assessment of the reliability of lower-limb biomechanical parameters during DVJ is important. The aim of this study was to assess the reliability of the kinematic and kinetic peak values as well as of the waveforms for lower-limb parameters obtained with the Liverpool John Moores University biomechanical model (LJMU model) during performance of DVJ. The reliability was analyzed by calculating the intertrial (o(trial)), intersession (o(sess)), and intertherapist (o(ther)) errors of hip and knee joint parameters in a repeated-measures design including two therapists and a total of six sessions. The results showed o(trial) that ranged from 1.1° to 3.5° for all peak kinematic parameters and from 3.6 to 12.9 N · m for all peak kinetic parameters. The o of the peak values ranged from 1.9° to 5.7° for all angles and from 5.4 to 19.8 N · m for the hip and knee joint moments in all planes. The o(sess) of the peak values ranged from 2.7° to 6.4° for all angles and from 5.8 to 22.4 N · m for all moments. Most of the kinematic and kinetic peak parameters had o(ther-trial) ≤ 2.0° and 4.3 N · m, respectively, suggesting a small extrinsic variability. Furthermore, the entire waveforms also showed a rather high o(trial) relative to other types of variability. The present findings indicated that DVJ kinetics and kinematics show small extrinsic variability. The reported errors are useful for clinical interpretation processes of DVJ performance as screening task for injury risk and rehabilitation outcome taking into consideration the different types of measurement error over time.

Strength Training Affects Lower Extremity Gait Kinematics, Not Kinetics, in People With Diabetic Polyneuropathy

Increased forefoot loading in diabetic polyneuropathy plays an important role in the development of plantar foot ulcers and can originate from alterations in muscle strength, joint moments and gait pattern. The current study evaluated whether strength training can improve lower extremity joint moments and spatiotemporal gait characteristics in patients with diabetic polyneuropathy. An intervention group receiving strength training during 24 weeks and a control group receiving no intervention. Measurements were performed in both groups at t=0, t=12, t=24 and t=52 weeks at an individually preferred and standardized imposed gait velocity. The strength training did not affect the maximal amplitude of hip, knee and ankle joint moments, but did result in an increase in stance phase duration, stride time and stride length of approximately 5%, during the imposed gait velocity. In addition, both groups increased their preferred gait velocity over one year. Future longitudinal studies should further explore the possible effects of strength training on spatiotemporal gait characteristics. The current study provides valuable information on changes in gait velocities and the progressive lower extremity problems in patients with polyneuropathy.

Computed tomography-based joint locations affect calculation of joint moments during gait when compared to scaling approaches

Hip joint moments are an important parameter in the biomechanical evaluation of orthopaedic surgery. Joint moments are generally calculated using scaled generic musculoskeletal models. However, due to anatomical variability or pathology, such models may differ from the patient's anatomy, calling into question the accuracy of the resulting joint moments. This study aimed to quantify the potential joint moment errors caused by geometrical inaccuracies in scaled models, during gait, for eight test subjects. For comparison, a semi-automatic computed tomography (CT)-based workflow was introduced to create models with subject-specific joint locations and inertial parameters. 3D surface models of the femora and hemipelves were created by segmentation and the hip joint centres and knee axes were located in these models. The scaled models systematically located the hip joint centre (HJC) up to 33.6 mm too inferiorly. As a consequence, significant and substantial peak hip extension and abduction moment differences were recorded, with, respectively, up to 23.1% and 15.8% higher values in the image-based models. These findings reaffirm the importance of accurate HJC estimation, which may be achieved using CT- or radiography-based subject-specific modelling. However, obesity-related gait analysis marker placement errors may have influenced these results and more research is needed to overcome these artefacts.

Compensatory turning strategies while walking in patients with hip osteoarthritis

The ability to change directions while walking is an integral component of adaptive locomotor behavior. Patients with hip osteoarthritis (OA) experience prolonged hip dysfunction. Gait compensation adopted by the patients with hip OA may become more pronounced while they turn. The purposes of this study were to identify the turning strategy while walking in patients with hip OA, and to examine the relationship between the turning strategy and the patient’s functional level. Fourteen patients with hip OA and 13 age-matched healthy controls were recruited. The hip, knee, and ankle joint angles and moments, and the foot progression angle were measured under three walking conditions (straight walking, 45° step turn, and 45° crossover turn), and the gait variables for each walking condition were compared between the 2 groups. The relationship between the increasing rate of knee and ankle joint moments in the turning to the straight walking and the functional point in the Harris hip score (HHS) was examined. The OA group showed decreased hip flexion, extension, and abduction angles, and hip flexion moment during the step turn, and decreased hip flexion, extension, and adduction angles, and hip abduction moment during the crossover turn. Furthermore, the ankle plantarflexion moment and the change in the foot angle during the stance phase were significantly increased during the crossover turn in the OA group. The increasing rate of the ankle plantarflexion moment correlated significantly with the functional point in the HHS. Patients with hip OA rely primarily on the ankle plantarflexors to compensate for the hip dysfunction while changing the walking direction.

A comparison of dorsal and heel plate foot tracking methods on lower extremity dynamics

The primary method to model ankle motion during inverse dynamic calculations of the lower limb is through the use of skin-mounted markers, with the foot modeled as a rigid segment. Motion of the foot is often tracked via the use of a marker cluster triad on either the dorsum, or heel, of the foot/shoe. The purpose of this investigation was to evaluate differences in calculated lower extremity dynamics during the stance phase of gait between these two tracking techniques. In an analysis of 7 subjects, it was found that sagittal ankle angles and sagittal ankle, hip and knee moments were strongly correlated between the two conditions, however, there was a significant difference in peak ankle plantar flexion and dorsiflexion angles. Frontal ankle angles were only moderately correlated and there was a significant difference in peak ankle eversion and inversion, resulting in moderate correlations in frontal plane moments and a significant difference in peak hip adductor moments. We demonstrate that the technique used to track the foot is an important consideration in interpreting lower extremity dynamics for clinical and research purposes.

Peak hip and knee joint moments during a sit-to-stand movement are invariant to the change of seat height within the range of low to normal seat height

BackgroundPrevious studies have consistently reported that decreasing seat height increases the peak hip and knee joint moments; however, these findings may not apply to biomechanical changes at very low seat heights. The purpose of this study, therefore, was to examine the effect of a large range of seat heights on peak joint moments of the lower limb during a sit-to-stand (STS) movement.MethodsEight healthy young subjects participated in this experiment. Each subject was instructed to stand up from six seat heights (10, 20, 30, 40, 50 and 60 cm). Joint moments were calculated with an inverse dynamics method. The sum of the hip and knee joint moments was used as the index to indicate the mechanical load of the STS movement. The effect of seat height on the mechanical load was examined with both analytical and experimental approaches.ResultsThrough the analytical approach, it was revealed that the mechanical load of STS movements from low and normal seat heights (10 to 40 cm) always reaches its peak at or near the posture in which the thigh is horizontally positioned. This finding indicates that the peak value is invariant between the low and normal seat heights. Similar results were also found in the experimental approach. There were few significant differences in the peak mechanical load and the peak hip and knee joint moments between the low and normal seat heights, while they differed significantly between the low and high seat heights.ConclusionsThis study concluded that, while the peak mechanical load and the peak hip and knee joint moments increase inversely to seat height within the range of high to normal seat height (60 to 40 cm), they are invariant to the change of seat height within the range of low to normal seat height (10 to 40 cm). These findings are useful for the design of chair, the improvement in the evaluation standard of minimum sit-to-stand height tests and the development of new muscular strength test.

1P2-U03 シートを使ったベッド上介助動作の熟練度合いが股関節モーメントに与える影響の解析(移動知と身体性システム科学)

In the manufacturing industry, sports, and care nursing, conventional skill education is inefficient because it has been conducted face-to-face and skills have not been elucidated. In order to solve this problem, effective service of skill education is necessary. We focused on bed care motion for patients who laid down on their beds and are aiming to develop a new skill education service for care motion which can prevent the outbreak of lumbago. In this study, based on the expert skills which were elucidated in our previous research, the motion was analyzed using three dimensional musculoskeletal model how different motion between experts and non-experts. In particular, we calculate hip moment with measured data from expert motion and non-expert motion because hip flex moment is related to lumbago. Our results show expert motion reduces hip moment compared to non-expert motion.

Plantarflexion moment is a contributor to step length after-effect following walking on a split-belt treadmill in individuals with stroke and healthy individuals.

To assess plantarflexion moment and hip joint moment after-effects following walking on a split-belt treadmill in healthy individuals and individuals post-stroke. Cross-sectional study. Ten healthy individuals (mean age 57.6 years (standard deviation; SD 17.2)) and twenty individuals post-stroke (mean age 49.3 years (SD 13.2)). Participants walked on an instrumented split-belt treadmill under 3 gait periods: i) baseline (tied-belt); ii) adaptation (split-belt); and iii) post-adaptation (tied-belt). Participants post-stroke performed the protocol with the paretic and nonparetic leg on the faster belt when belts were split. Kinematic data were recorded with the Optotrak system and ground reaction forces were collected via the instrumented split-belt treadmill. In both groups, the fast plantarflexion moment was reduced and the slow plantarflexion moment was increased from mid-stance to toe-off in the post-adaptation period. Significant relationships were found between the plantarflexion moment and contralateral step length. Split-belt treadmills could be useful for restoring step length symmetry in individuals post-stroke who present with a longer paretic step length because the use of this type of intervention increases paretic plantarflexion moments. This intervention might be less recommended for individuals post-stroke with a shorter paretic step length because it reduces the paretic plantarflexion moment.

Coronal plane socket stability during gait in persons with transfemoral amputation: Pilot study.

Little research describes which transfemoral socket design features are important for coronal plane stability, socket comfort, and gait. Our study objectives were to (1) relate socket comfort during gait to a rank order of changes in ischial containment (IC) and tissue loading and (2) compare socket comfort during gait when tissue loading and IC were systematically manipulated. Six randomly assigned socket conditions (IC and tissue compression) were assessed: (1) IC and high, (2) IC and medium, (3) IC and low, (4) no IC and high, (5) no IC and medium, and (6) no IC and low. For the six subjects in this study, there was a strong, negative relationship between comfort and changes in IC and tissue loading (rho = -0.89). With the ischium contained, tissue loading did not influence socket comfort (p = 0.47). With no IC, the socket was equally comfortable with high tissue loading (p = 0.36) but the medium (p = 0.04) and low (p = 0.02) tissue loading conditions decreased comfort significantly. Coronal plane hip moments, lateral trunk lean, step width, and walking speed were invariant to changes in IC and/or tissue loading. Our results suggest that in an IC socket, medial tissue loading mattered little in terms of comfort. Sockets without IC required high tissue loading to be as comfortable as those with IC, while suboptimal tissue loading compromised comfort.

Effect of compensatory trunk movements on knee and hip joint loading during gait in children with different orthopedic pathologies

Ipsilateral trunk lean toward the affected stance limb has been identified as a compensatory mechanism to unload the hip joint. However, this altered gait pattern increases the lever arm around the knee joint by shifting the ground reaction vector more lateral to the knee joint center, which could be sufficient to deform the lateral compartment of the knee. The purpose of the present study was to show the effect of ipsilateral trunk lean on hip and knee joint moments in the frontal plane in 132 young patients with different orthopedic diagnosis. Linear correlations between ipsilateral trunk lean and the external knee and/or hip adduction moment were detected for patients with Legg–Calvé–Perthes disease (LCPD), arthrogryposis multiplex congenita, myelomeningocele, and unilateral cerebral palsy (CP). In contrast, children with bilateral CP did not show such a relationship due to an increased internal foot placement. In comparison to the hip joint, the effect of ipsilateral trunk lean in patients with LCPD is obviously more pronounced in the knee joint. The valgus thrust of the knee could initiate degenerative changes by placing altered loads on regions of the articular cartilage that were previously conditioned for different load levels. The results suggest that the ipsilateral trunk lean should not be considered and recommended as unloading mechanism for the hip joint on its own but also as a potential increased joint loading of the lateral knee compartment. Therefore, an acceptable therapy concept for limping patients should aim for an inconspicuous gait pattern with a reduced trunk movement.

Gait pattern in 9-11-year-old children with generalized joint hypermobility compared with controls; a cross-sectional study

BackgroundTo study differences in gait patterns in 10-year-old children with Generalized Joint Hypermobility (GJH) and with no GJH (NGJH).MethodsA total of 37 children participated (19 GJH, 18 NGJH, mean age 10.2 (SD 0.5) years). Inclusion criteria for GJH were a Beighton score of ≥5, with at least one hypermobile knee joint; for NGJH a Beighton score of ≤4, and no hypermobile knees and for both groups no knee pain during the previous week. All children were recorded by five video cameras, while they walked across three force platforms. Net joint moments were calculated in 3D by inverse dynamics and peak values provided input to statistical analyses.ResultsIn the frontal plane, children with GJH had a significantly lower peak knee abductor moment and peak hip abductor moment. In the sagittal plane, the peak knee flexor moment and the peak hip extensor moment were significantly lower in the GJH group although the absolute difference was small.ConclusionsThe walking pattern was the same for children with GJH and for healthy children, as there were no differences in kinematics, but it was, however, performed with different kinetics. Children with GJH walked with lower ankle, knee and hip joint moments compared to children with NGJH. However, the clinical importance of these differences during normal gait is unknown. To obtain this knowledge, children with GJH must be followed longitudinally.Trial registrationThe study was approved by the Committee on Biomedical Research Ethics for Copenhagen and Frederiksberg, Denmark (jnr. KF01-2006-178).

The effect of perturbing body segment parameters on calculated joint moments and muscle forces during gait

This study examined the effect of body segment parameter (BSP) perturbations on joint moments calculated using an inverse dynamics procedure and muscle forces calculated using computed muscle control (CMC) during gait. BSP (i.e. segment mass, center of mass location (com) and inertia tensor) of the left thigh, shank and foot of a scaled musculoskeletal model were perturbed. These perturbations started from their nominal value and were adjusted to ±40% in steps of 10%, for both individual as well as combined perturbations in BSP. For all perturbations, an inverse dynamics procedure calculated the ankle, knee and hip moments based on an identical inverse kinematics solution. Furthermore, the effect of applying a residual reduction algorithm (RRA) was investigated. Muscle excitations and resulting muscle forces were calculated using CMC. The results show only a limited effect of an individual parameter perturbation on the calculated moments, where the largest effect is found when perturbing the shank com (MScom,shank, the ratio of absolute difference in torque and relative parameter perturbation, is maximally −7.81Nm for hip flexion moment). The additional influence of perturbing two parameters simultaneously is small (MSmass+com,thigh is maximally 15.2Nm for hip flexion moment). RRA made small changes to the model to increase the dynamic consistency of the simulation (after RRA MScom,shank is maximally 5.01Nm). CMC results show large differences in muscle forces when BSP are perturbed. These result from the underlying forward integration of the dynamic equations.

Positive and negative work during walking in children with cerebral palsy

Introduction:Walking velocity (WV) is known to influence different gait parameters [1,2]. Muscle length (ML) and especially lengthening velocity (MLV) increase with WV. Spasticity on the otherhand is associatedwith reducedMLandMLV [1]. Spasticmuscles show an increased coupling between EMG activity and MLV [3]. Therefore, we described the effect of walking speed on spastic hamstrings, with a focus on ML, MLV and EMG. Patients/materials and methods: 49 Children with CP (9.8±3 years)with aModified Ashworth Score≥1.5 for the hamstrings and 14 TD children (10.5±2.4 years) received a 3D lower limb gait analysis, including kinematics, kinetics (8 camera Vicon system), EMG of 8 muscles bilateral (Cometa, Wave EMG) and a clinical examination. They were instructed to walk at self-selected speed, faster and as fast as possible without running. To compare both groups, a linear regression model was created which resulted in two nondimensional gait velocities (v1, v2), used to compare a large set of parameters. Difference scores (DS) between both velocities were calculated. Statistical analysis was done using the Mann-Whitney U test. Results: During stance at both velocities, the CP group showed more knee flexion at IC (p<0.001) and duringmid stance (p<0.01), increasing with WV. The knee ROM during shock absorption was higher in the TD group. EMG activity in early stance phase was significantly higher in the CP group at v2 (p<0.05), corresponding to an increasing maximum hip moment (H1) in CP children, which was not seen in the TD group (DS: p=0.001). During swing, the maximum angular extension velocity was significantly higher in the TD group compared to the CP group at v1 and v2 (p<0.005), increasing with WV. Maximum MLV showed similar results, with a significant DS (p<0.005) indicating a higher increase in the TD group. No difference was seen in the maximum ML between both groups,while total range ofMLwas significantly higher in TD group at both speeds, with increasing length range at higher WV. EMG activity in swing showed significantly higher activity at v1 for the CP group, but not at v2. Discussion and conclusions: The effect of WV on knee kinematics at IC and mid stance are in accordance to Schwartz [2] and similar for TD and CP children. The increasing hamstrings activity in CP in early stance may be explained by the biomechanical demands (hip moment). In contrast with TD children who mainly use the gastrocnemius at late stance (push-off) to increase WV. In swing, TD children are capable of increasing their angular velocity and MLV more than children with CP. Van der Krogt [1] reported similar results. This confirms the fact that, although CP children are able to increase their MLV, they prefer to stay under their spastic threshold velocity during self-selectedWV. The TD group increases their EMG swing phase activity similar as CP children. This can be explained by a higher angular velocity due to the increased WV, demanding more eccentric contraction of the hamstrings to slow down knee extension motion. The difference in influence of WV on spastic hamstrings compared to TD children seems to be most pronounced on MLV, and less on EMG activity. Compared to the influence of WV on the spastic gastrocnemius, the latter showed an increase in EMG activity in swing, which was not seen in the TD group [4].