Swing Phase Research Articles

Active Adaptive Strategies of Mallard Feet in Response to Changes in Wetness and Compactness of the Sand Terrain.

Mallards (Anas platyrhynchos) exhibit exceptional locomotive abilities in diverse terrains, such as beaches, swamps, and tidal flats. This capability is primarily attributed to their unique webbed toe structure and cooperative locomotion posture of their feet. Therefore, this study aims to further delve into the active adaptive strategies of mallard feet in response to diverse external environmental conditions. Six adult male mallards were selected for this research. Their locomotion on sandy surfaces with differing wetness levels and varying degrees of compaction were captured using a high-speed camera, and analysis of instantaneous and continuous changes in the primary joint angles of the mallards' feet, including the toe-webbed opening and closing angles, the tarsometatarsal-phalangeal joint (TMTPJ), and the intertarsal joint (ITJ). It was found that on loose sandy surfaces, increasing wetness expanded the ground contact area of the mallards' feet. This led to greater flexion at the TMTPJ joint during mid-stance, accompanied by decreased flexion of the ITJ during touch-down and mid-stance. Conversely, on compacted sand, increasing wetness resulted in a reduced foot effect area and lessened ITJ flexion at both touch-down and mid-stance. Furthermore, on looser sand, the ground contact area of the mallards' feet decreased, with an increase in ITJ buckling at touch-down. During the swing phase, sand wetness and compactness effected minimally on the feet of the mallards. On dry and loose sand ground, mallards will contract their second and fourth toes with webbing upon ground contact, covering and compacting the sand beneath, while increasing ITJ flexion to mitigate sinking. This adaptation reduces the energy expended on sand and enhances body stability. In wet and compacted sand conditions, mallards expand their second and fourth toes upon ground contact and reduce ITJ flexion. Therefore, this coordinated foot and ITJ locomotion offers mallards a natural advantage when moving on various environmental media.

Effects of walking speeds on lower extremity kinematic synergy in toe vertical position control: An experimental study.

This study aimed to investigate whether lower limb joints mutually compensate for each other, resulting in motor synergy that suppresses toe vertical position fluctuation, and whether walking speeds affect lower limb synergy. Seventeen male university students walked at slow (0.85 ± 0.04 m/s), medium (1.43 ± 0.05 m/s) and fast (1.99 ± 0.06 m/s) speeds on a 15-m walkway while lower limb kinematic data were collected. Uncontrolled manifold analysis was used to quantify the strength of synergy. Two-way (speed × phase) repeated-measures analysis of variance was used to analyze all dependent variables. A significant speed-by-phase interaction was observed in the synergy index (SI) (P < .001). At slow walking speeds, subjects had greater SI during mid-swing (P < .001), while at fast walking speeds, they had greater SI during early-swing (P < .001). During the entire swing phase, fast walking exhibited lower SI values than medium (P = .005) and slow walking (P = .027). Kinematic synergy plays a crucial role in controlling toe vertical position during the swing phase, and fast walking exhibits less synergy than medium and slow walking. These findings contribute to a better understanding of the role of kinematic synergy in gait stability and have implications for the development of interventions aimed at improving gait stability and reducing the risk of falls.

GAIT DISORDERS IN THE ELDERLY AND THE RISK OF FALLS

Falls are the leading cause of injury in people over 65 in the United States. In 2018, 27.5% of seniors over age 65 reported at least one fall in the past year and 10.2% had injuries after a fall in the past year. One feature of walking that has been used to identify people who are at risk for falling is gait unsteadiness. An unsteady gait pattern will be characterized with greater kinematics variability. Decreasing variability of walking patterns may help to prevent falls by achieving a more stable gait pattern, thus improving the control of the whole-body position and by reducing the mediolateral momentum of the centre of mass. Walking more slowly, with a higher STF and shorter STL, may help to stabilize the gait pattern and allow greater adjustment and flexibility to changes in walking conditions (increasing or decreasing walking speed), especially in patients with history of falls. Compared with the elderly with no history of falls, elderly people who are at risk for falls will have the following characteristics of gait: decreased ankle plantar flexion and hip extension during push-off, increased hip flexion during the swing phase, reduced mediolateral sway and decreased reaction time. Key words: elderly falls, gait analysis.

Synergic control of the minimum toe clearance in young and older adults during foot swing on treadmill walking in different speeds

BackgroundThe vertical toe position at minimum toe clearance (MTC) in the swing phase is critical for walking safety. Consequently, the joints involved should be strictly controlled and coordinated to stabilize the foot at MTC. The uncontrolled manifold (UCM) hypothesis framework has been used to determine the existence of synergies that stabilize relevant performance variables during walking. However, no study investigated the presence of a multi-joint synergy stabilizing the foot position at MTC and the effects of age and walking speed on this synergy. Research questionsIs there a multi-joint synergy stabilizing MTC during treadmill walking? Does it depend on the persons’ age and walking speed? MethodsKinematic data from 23 young and 15 older adults were analyzed using the UCM approach. The participants walked on a treadmill at three speeds: slow, self-selected, and fast. The sagittal and frontal joint angles from the swing and stance legs and pelvis obliquity were used as motor elements and the vertical toe position at MTC was the performance variable. The variances in the joint space that affected (VORT, ‘bad’ variance) and did not affect (VUCM, ‘good’ variance) the toe position at MTC and the synergy index (ΔV) were computed. ResultsThe ΔV>0 was revealed for all subjects. Walking speed did not affect ΔV in older adults, whereas ΔV reduced with speed in young adults. ΔV was higher for older than for young adults at self-selected and fast speeds, owing to a lower VORT in the older group. SignificanceThe vertical toe position at MTC was stabilized by a strong multi-joint synergy. In older adults, this synergy was stronger, as they were better at limiting VORT than young adults. Reduced VORT in older adults could be caused by more constrained walking, which may be associated with anxiety due to walking on a treadmill.

Dopamine improves defective cortical and muscular connectivity during bilateral control of gait in Parkinson’s disease

Parkinson’s Disease (PD)-typical declines in gait coordination are possibly explained by weakness in bilateral cortical and muscular connectivity. Here, we seek to determine whether this weakness and consequent decline in gait coordination is affected by dopamine levels. To this end, we compare cortico-cortical, cortico-muscular, and intermuscular connectivity and gait outcomes between body sides in people with PD under ON and OFF medication states, and in older adults. In our study, participants walked back and forth along a 12 m corridor. Gait events (heel strikes and toe-offs) and electrical cortical and muscular activities were measured and used to compute cortico-cortical, cortico-muscular, and intermuscular connectivity (i.e., coherences in the alpha, beta, and gamma bands), as well as features characterizing gait performance (e.g., the step-timing coordination, length, and speed). We observe that people with PD, mainly during the OFF medication, walk with reduced step-timing coordination. Additionally, our results suggest that dopamine intake in PD increases the overall cortico-muscular connectivity during the stance and swing phases of gait. We thus conclude that dopamine corrects defective feedback caused by impaired sensory-information processing and sensory-motor integration, thus increasing cortico-muscular coherences in the alpha bands and improving gait.

Enhancing accuracy and convenience of golf swing tracking with a wrist-worn single inertial sensor

In this study, we address two technical challenges to enhance golf swing trajectory accuracy using a wrist-worn inertial sensor: orientation estimation and drift error mitigation. We extrapolated consistent sensor orientation from specific address-phase signal segments and trained the estimation with a convolutional neural network. We then mitigated drift error by applying a constraint on wrist speed at the address, backswing top, and finish, and ensuring that the wrist's finish displacement aligns with a virtual circle on the 3D swing plane. To verify the proposed methods, we gathered data from twenty male right-handed golfers, including professionals and amateurs, using a driver and a 7-iron. The orientation estimation error was about 60% of the baseline, comparable to studies requiring additional sensor information or calibration poses. The drift error was halved and the single-inertial-sensor tracking performance across all swing phases was about 17 cm, on par with multimodal approaches. This study introduces a novel signal processing method for tracking rapid, wide-ranging motions, such as a golf swing, while maintaining user convenience. Our results could impact the burgeoning field of daily motion monitoring for health care, especially with the increasing prevalence of wearable devices like smartwatches.

Analysis of Gait Pattern Affected by Various Disease : A Review

Gait is pattern of walking of individual, is unique pattern of a person. The gait pattern is affected by various disease, ill condition of a person. In this review article we discuss about various diseases by which gait of an individual gets affected. Some disease are ; Parkinson's disease (PD) is a degenerative brain disorder causing shuffled gait, impaired balance, and freezing of gait. Morquio A syndrome, a group of disorders called mucopolysaccharidosis, can lead to vision, hearing, bone, brain, and heart problems. The anterior cruciate ligament (ACL) is a key stabilizer in the knee, and a torn ACL can cause instability when walking or changing directions. Examination of the gait pattern of a those person who having a disease such as ; Parkinson’s disease, Morquio A syndrome, Anterior Crucial Ligament, etc. In normal human the Gait Cycle has two phases ; Stance and swing phase. The stance phase covers approx 60% gait cycle and swing phase covers remaining 40% of gait cycle. In further studies we can analysis on how this cycle varies in abnormal walking.These review article summarises about gait pattern affected by various diseases. Study of gait pattern used for solving criminal cases as we can recognize various abnormalities a person may have by the analysis of his or her gait pattern. It is used as secondary evidence. By using gait pattern we can find out individuals age, sex, and height.

Swing-phase detection of locomotive mode transitions for smooth multi-functional robotic lower-limb prosthesis control.

Robotic lower-limb prostheses, with their actively powered joints, may significantly improve amputee users' mobility and enable them to obtain healthy-like gait in various modes of locomotion in daily life. However, timely recognition of the amputee users' locomotive mode and mode transition still remains a major challenge in robotic lower-limb prosthesis control. In the paper, the authors present a new multi-dimensional dynamic time warping (mDTW)-based intent recognizer to provide high-accuracy recognition of the locomotion mode/mode transition sufficiently early in the swing phase, such that the prosthesis' joint-level motion controller can operate in the correct locomotive mode and assist the user to complete the desired (and often power-demanding) motion in the stance phase. To support the intent recognizer development, the authors conducted a multi-modal gait data collection study to obtain the related sensor signal data in various modes of locomotion. The collected data were then segmented into individual cycles, generating the templates used in the mDTW classifier. Considering the large number of sensor signals available, we conducted feature selection to identify the most useful sensor signals as the input to the mDTW classifier. We also augmented the standard mDTW algorithm with a voting mechanism to make full use of the data generated from the multiple subjects. To validate the proposed intent recognizer, we characterized its performance using the data cumulated at different percentages of progression into the gait cycle (starting from the beginning of the swing phase). It was shown that the mDTW classifier was able to recognize three locomotive mode/mode transitions (walking, walking to stair climbing, and walking to stair descending) with 99.08% accuracy at 30% progression into the gait cycle, well before the stance phase starts. With its high performance, low computational load, and easy personalization (through individual template generation), the proposed mDTW intent recognizer may become a highly useful building block of a prosthesis control system to facilitate the robotic prostheses' real-world use among lower-limb amputees.

A novel method for accurate division of the gait cycle into seven phases using shank angular velocity

BackgroundAccurate detection of gait events is crucial for gait analysis, enabling the assessment of gait patterns and abnormalities. Inertial measurement unit (IMU) sensors have gained traction for event detection, mainly focusing on initial contact (IC) and toe-off (TO) events. However, effective detection of other key events such as heel rise (HR), feet adjacent (FA), and tibia vertical (TBV) is essential for comprehensive gait analysis. Research questionCan a novel IMU-based method accurately detect HR, TO, FA, and TBV events, and how does its performance compare with existing methods? MethodsWe developed and validated an IMU-based method using cumulative mediolateral shank angular velocity (CSAV) for event detection. A dataset of nearly 25,000 gait cycles from healthy adults walking at varying speeds and footwear conditions was used for validation. The method’s accuracy was assessed against force plate and motion capture data and compared with existing TO detection methods. ResultsThe CSAV method demonstrated high accuracy in detecting TO, FA, and TBV events and moderate accuracy in HR event detection. Comparisons with existing TO detection methods showcased superior performance. The method's stability across speed and shoe variations underscored its robustness. SignificanceThis study introduces a highly accurate IMU-based method for detecting gait events needed to divide the gait cycle into seven phases. The effectiveness of the CSAV method in capturing essential events across different scenarios emphasizes its potential applications. Although HR event detection can be further improved, the precision of the CSAV method in TO, FA, and TBV detection advance the field. This study bridges a critical gap in IMU-based gait event detection by introducing a method for subdividing the swing phase into its subphases. Further research can focus on refining HR detection and expanding the method’s utility across diverse gait contexts, thereby enhancing its clinical and scientific significance.

Comparison of muscle activity of the lower limbs while running on different treadmill models.

Treadmill running is a common method of exercise and to study human locomotion. Research has examined the kinematics and kinetics of overground and treadmill running, but there has been less focus on the levels of muscle activity during treadmill running. We investigated if muscle activity is different while running overground compared to running on a variety of treadmills. A total of 11 healthy individuals ran at 3 speeds (2.6, 3.6, 4.5 m/s) under 4 different running conditions (3 treadmills, overground). The three treadmills included a typical home exercise treadmill, a midsize commercial research treadmill, and a large, instrumented research treadmill. Surface EMG of the tibialis anterior (TA), gastrocnemius medialis (GM), rectus femoris (RF) and biceps femoris (BF) muscles were measured for each running condition. The integrated EMG was computed for each running condition for the stance and swing phase, as well as 100 ms before and after the heel-strike. Friedman analysis revealed significant effects during the stance phase for GM and RF at all speeds, such that muscle activation was lower on the treadmills relative to overground. During the stance phase at faster speeds, the muscle activity was higher for the TA and lower for the BF while running on the different treadmills compared to overground running. Before heel-strike, the TA was significantly less active during treadmill compared to overground running at 2.6 m/s and the RF showed significantly higher activity at 3.6 m/s and 4.5 m/s while running on the different treadmills. Summarizing, differences were mainly observed between the different treadmill conditions relative to overground running. Muscle activation differences between the different treadmill conditions were observed at faster running speeds for RF during the pre-heel-strike phase only. Different types of treadmills with different mechanical properties affects the muscle activity during stance phase as well as in preparation to heel-strike. Additionally, the muscle activity is greater during overground compared to treadmill running during the stance phase for the GM, BF, and RF.

Analysis of windlass mechanism according to one walking cycle.

[Purpose] This study aimed to calculate the windlass mechanism in one walking cycle (WC) using the medial longitudinal arch (MLA) height and compare its mechanism with joint moments, angles, and center of gravity movement. [Participants and Methods] The study analyzed the gait of 20 healthy adults (14 males, six females) using a three-dimensional motion analyzer to calculate several parameters. [Results] In the terminal stance, the MLA height reached 20.6 ± 6.0 mm (minimum value) at 49% WC. Simultaneously, the ankle dorsiflexion angle, ankle internal plantarflexion moment, and forward shift of the center of gravity reached the maximum values. At 62% WC, the MLA height was 26.8 ± 4.8 mm and reached maximum during the stance phase, indicating a windlass mechanism. Additionally, the MLA height was 61.7 ± 22.7 mm at 69% WC, indicating an MLA spiking phenomenon. [Conclusion] The MLA height was lowest at 49% WC due to reverse windlass mechanism. Although the windlass mechanism was activated at 62% WC, it was functionally equivalent to the swing phase. Push-off was impossible during the swing phase. At 69% WC, the swing phase showed a second windlass mechanism.

Neuronal mechanisms regulating locomotion in adult Drosophila.

The coordinated action of multiple leg joints and muscles is required even for the simplest movements. Understanding the neuronal circuits and mechanisms that generate precise movements is essential for comprehending the neuronal basis of the locomotion and to infer the neuronal mechanisms underlying several locomotor-related diseases. Drosophila melanogaster provides an excellent model system for investigating the neuronal circuits underlying motor behaviors due to its simple nervous system and genetic accessibility. This review discusses current genetic methods for studying locomotor circuits and their function in adult Drosophila. We highlight recently identified neuronal pathways that modulate distinct forward and backward locomotion and describe the underlying neuronal control of leg swing and stance phases in freely moving flies. We also report various automated leg tracking methods to measure leg motion parameters and define inter-leg coordination, gait and locomotor speed of freely moving adult flies. Finally, we emphasize the role of leg proprioceptive signals to central motor circuits in leg coordination. Together, this review highlights the utility of adult Drosophila as a model to uncover underlying motor circuitry and the functional organization of the leg motor system that governs correct movement.

Effects of Static Hamstring Stretching on Maximal Sprint Speed and Relationship With Nordic Hamstring Strength.

This study aimed to determine the acute effects of static stretching of the hamstrings on maximal sprint speed and its spatiotemporal variables and lower-limb kinematics during the late swing phase, as well as the relationship with Nordic hamstring strength. The study had a within-participant experimental design. Sixteen healthy male college sprinters were asked to sprint 80m without static stretching and with static stretching of the hamstrings for 4 × 30s per leg before the sprint; both conditions were counterbalanced. The knee flexion peak torque was measured using the Nordic hamstring. The differences between no static stretching and static stretching as well as their relationship with Nordic hamstring strength were investigated. The results showed that the touchdown distance (p = .036) significantly increased following static stretching. Although not significant, maximal sprint speed decreased (p = .086), and the theoretical hamstring length (difference between knee angle and hip angle) at ipsilateral touchdown was greater (p = .069) following static stretching. In addition, a lower peak torque of the Nordic hamstring resulted in a more significant decrease in maximal sprint speed following static stretching. Therefore, static stretching of the hamstring just before sprinting may increase the theoretical hamstring length during the late swing phase at maximal sprint speed and induce kinematics that increases the hamstring strain injury risk. Moreover, it is suggested that improving the Nordic hamstring strength may help minimize the negative effects of static stretching on the hamstrings.

BP neural network-based analysis of the applicability of NMF in side-step cutting

BackgroundAlthough the spatio-temporal structure of muscle activation in cutting have been studied extensively, including time-varying motor primitives and time-invariant motor modules under various conditions, the factorisation methods suitable for cutting are unclear, and the extent to which each factorisation method loses information about movement during dimensionality reduction is uncertain. Research questionTo clarify the extent to which NMF, PCA and ICA retain information about movement when downscaling, and to explore the factorisation method suitable for cutting. MethodsThe kinematic data during cutting was captured with a Vicon motion capture system, from which the kinematic features of the pelvic centre of mass were calculated. NMF, PCA and ICA were used to obtain muscle synergies based on sEMG of the cutting at different angles, respectively. A back propagation neural network was constructed using temporal component of synergy as input and the kinematics data of pelvic as output. Calculation of the Hurst index using fractal analysis based on the temporal component of muscle synergy. ResultsThe quality of sEMG reconstruction is significantly higher with ICA (P < 0.01) than with NMF and PCA for the cutting. The NMF reconstruction has a high degree of preservation of movement, whereas the ICA loses movement information about the most of the swing phase, and the PCA loses information related to the change of direction. Hurst index less than 0.5 for all three angles of cutting. SignificanceNMF is suitable for extracting muscle synergies in all directions of cutting. Information related to movement may be lost when using PCA and ICA to extract the synergy of cutting. The high individual variability of muscle synergy in cutting may be responsible for the loss of movement information in muscle synergy.

Investigating the Effects of a Kinematic Gait Parameter-Based Haptic Cue on Toe Clearance in Parkinson's Patients.

Recurrent falls pose a significant challenge for Parkinson's disease (PD) patients and are a leading cause of disability in this population. One contributing factor to these recurring falls is the reduced minimum toe clearance (mTC). Preventing such falls by enhancing mTC has become an important goal in gait training among PD patients. In this paper, we propose a wearable cueing-based novel gait training device in anticipation of improved mTC. The cueing device records the foot strike angle (FSA) and cues the participants if the FSA is observed above a threshold. The patients with PD (n = 8) were recruited and asked to walk under two conditions: (a) with cue and (b) without cue at a self-selected speed during the ON medication state. Kinetic and kinematic gait parameters such as vertical ground reaction force, center of pressure, toe clearance, and FSA were recorded. A Mann-Whitney U test showed a significant increase (p < 0.001) in the toe clearance (within 34% to 64% of the swing phase from the toe-off instance) and FSA, from 87.60mm and - 5.43degrees respectively during without cue to 94.29mm and 2.93degrees respectively during with cue walking condition except in one subject. These findings support the potential incorporation of an FSA-based cueing device for toe clearance improvement among PD patients. In addition, the wearable setup supports the cueing device applicability outside laboratory and home settings.

Evaluating an advanced system with flexible dielectric insole and inertial sensors for post-ACL reconstruction assessment

ObjectiveThis study aims to validate an integrated system combining capacitive pressure-sensing insoles with wearable inertial sensors to evaluate rehabilitation progress after ACL reconstruction. MethodsA total of 60 participants were recruited. The study proceeded in three stages: initial evaluation of the pressure sensors' sensitivity, then durability, accuracy assessment, and kinematics, and finally the return-to-play evaluation for post-ACL reconstruction patients. The study analyzed various gait parameters, jump tests (single-leg jumps, triple hops, and crossover hops), and the Limb Symmetry Index (LSI). ResultsThe study found comparable cadence rates (63.68 ± 3.72 steps/min for the integrated system vs. 59.73 ± 3.18 steps/min for Vicon), walking speeds (61.38±2.72 m/min vs. 64.92 ± 2.13 m/min), and step lengths (113.63 ± 9.12 cm vs. 114.26 ± 8.35 cm), the stance phase (61.18 ± 1.89% vs. 62.15 ± 2.25 %) and swing phase (33.14 ± 2.19% vs. 32.72 ± 1.92 %) measurements, along with peak joint angles for the ankle (18.2 ± 2.9° vs. 19.1 ± 2.3°), knee (63.3 ± 4.1° vs. 65.1 ± 4.4°), and hip (21.1 ± 3.4° vs. 22.5 ± 3.2°). Results from jump tests and the Limb Symmetry Index (LSI) were also analyzed. ConclusionThe integrated system offers a novel approach in evaluating lower extremity biomechanics post-ACL reconstruction, showing significant potential for improvement in sports medicine rehabilitation.

Lower Extremity Kinematic and Kinetic Characteristics as Effects on Running Economy of Recreational Runners.

This study aimed to determine associations between running economy (RE) and running sagittal plane kinematic and kinetic parameters. A total of 30 male recreational runners (age: 21.21 ± 1.22 yr, V̇O 2max : 54.61 ± 5.42 mL·kg -1 ·min -1 ) participated in two separate test sessions. In the first session, the participant's body composition and RE at 10 and 12 km·h -1 were measured. In the second session, measurements were taken for the sagittal plane of hip, knee, and ankle angles and range of motion (ROM), as well as ground reaction force. Moderate correlations were found between lower energy costs at 12 km·h -1 and smaller hip flexion at toe-off ( r = 0.373) as well as smaller peak hip flexion during stance ( r = 0.397). During the swing phase, lower energy costs at 10 km·h -1 were moderately correlated with smaller peak knee flexion and smaller knee flexion and extension ROM ( r = 0.366-0.443). Lower energy costs at 12 km·h -1 were moderately correlated with smaller peak hip and knee flexion as well as knee extension ROM ( r = 0.369-0.427). In terms of kinetics, there was a moderate correlation between higher energy costs at 10 km·h -1 and larger peak active force, as well as larger peak braking and propulsion force ( r = -0.470-0.488). Lower energy costs at 12 km·h -1 were moderately to largely correlated with smaller peak impact and braking force ( r = 0.486 and -0.500, respectively). Regarding the statistical parametric mapping analysis, most outcomes showed associations with RE at 10 km·h -1 , including knee flexion (42.5%-65.5% of the gait cycle), ankle plantarflexion (32.5%-36% of the gait cycle), active force (30.5%-35% of the stance phase), and propulsion force (68%-72.5% of the stance phase). Lower energy costs at 12 km·h -1 were correlated with smaller hip flexion (5.5%-12% and 66.5%-74%) and smaller knee flexion (57%-57.5%) during the running gait cycle. This study indicates that biomechanical factors are associated with RE in recreational runners. To design effective training methods to improve RE, coaches and runners should focus on the sagittal plane kinematics of the hip, knee, and ankle, as well as lower vertical and horizontal kinetic parameters.

Can gait patterns be explained by joint structure in people with and without radiographic knee osteoarthritis? Data from the IMI-APPROACH cohort

ObjectiveTo determine the association between joint structure and gait in patients with knee osteoarthritis (OA).MethodsIMI-APPROACH recruited 297 clinical knee OA patients. Gait data was collected (GaitSmart®) and OA-related joint measures determined from knee radiographs (KIDA) and MRIs (qMRI/MOAKS). Patients were divided into those with/without radiographic OA (ROA). Principal component analyses (PCA) were performed on gait parameters; linear regression models were used to evaluate whether image-based structural and demographic parameters were associated with gait principal components.ResultsTwo hundred seventy-one patients (age median 68.0, BMI 27.0, 77% female) could be analyzed; 149 (55%) had ROA. PCA identified two components: upper leg (primarily walking speed, stride duration, hip range of motion [ROM], thigh ROM) and lower leg (calf ROM, knee ROM in swing and stance phases). Increased age, BMI, and radiographic subchondral bone density (sclerosis), decreased radiographic varus angle deviation, and female sex were statistically significantly associated with worse lower leg gait (i.e. reduced ROM) in patients without ROA (R2 = 0.24); in ROA patients, increased BMI, radiographic osteophytes, MRI meniscal extrusion and female sex showed significantly worse lower leg gait (R2 = 0.18). Higher BMI was significantly associated with reduced upper leg function for non-ROA patients (R2 = 0.05); ROA patients with male sex, higher BMI and less MRI synovitis showed significantly worse upper leg gait (R2 = 0.12).ConclusionStructural OA pathology was significantly associated with gait in patients with clinical knee OA, though BMI may be more important. While associations were not strong, these results provide a significant association between OA symptoms (gait) and joint structure.

The Difference in the Assessment of Knee Extension/Flexion Angles during Gait between Two Calibration Methods for Wearable Goniometer Sensors.

Frontal and axial knee motion can affect the accuracy of the knee extension/flexion motion measurement using a wearable goniometer. The purpose of this study was to test the hypothesis that calibrating the goniometer on an individual's body would reduce errors in knee flexion angle during gait, compared to bench calibration. Ten young adults (23.2 ± 1.3 years) were enrolled. Knee flexion angles during gait were simultaneously assessed using a wearable goniometer sensor and an optical three-dimensional motion analysis system, and the absolute error (AE) between the two methods was calculated. The mean AE across a gait cycle was 2.4° (0.5°) for the on-body calibration, and the AE was acceptable (<5°) throughout a gait cycle (range: 1.5-3.8°). The mean AE for the on-bench calibration was 4.9° (3.4°) (range: 1.9-13.6°). Statistical parametric mapping (SPM) analysis revealed that the AE of the on-body calibration was significantly smaller than that of the on-bench calibration during 67-82% of the gait cycle. The results indicated that the on-body calibration of a goniometer sensor had acceptable and better validity compared to the on-bench calibration, especially for the swing phase of gait.

Improving the reliability of underwater gait analysis using wearable pressure and inertial sensors.

This work addresses the lack of reliable wearable methods to assess walking gaits in underwater environments by evaluating the lateral hydrodynamic pressure exerted on lower limbs. Sixteen healthy adults were outfitted with waterproof wearable inertial and pressure sensors. Gait analysis was conducted on land in a motion analysis laboratory using an optoelectronic system as reference, and subsequently underwater in a rehabilitation swimming pool. Differences between the normalized land and underwater gaits were evaluated using temporal gait parameters, knee joint angles and the total water pressure on the lower limbs. The proposed method was validated against the optoelectronic system on land; gait events were identified with low bias (0.01s) using Bland-Altman plots for the stride time, and an acceptable error was observed when estimating the knee angle (10.96° RMSE, Bland-Altman bias -2.94°). The kinematic differences between the land and underwater environments were quantified, where it was observed that the temporal parameters increased by more than a factor of two underwater (p<0.001). The subdivision of swing and stance phases remained consistent between land and water trials. A higher variability of the knee angle was observed in water (CV = 60.75%) as compared to land (CV = 31.02%). The intra-subject variability of the hydrodynamic pressure on the foot ([Formula: see text] = 39.65%) was found to be substantially lower than that of the knee angle (CVz = 67.69%). The major finding of this work is that the hydrodynamic pressure on the lower limbs may offer a new and more reliable parameter for underwater motion analysis as it provided a reduced intra-subject variability as compared to conventional gait parameters applied in land-based studies.