Whole-body Kinematics Research Articles

Comprehensive quantitative investigation of arm swing during walking at various speed and surface slope conditions

Previous studies have shown that inclusion of arm swing in gait rehabilitation leads to more effective walking recovery in patients with walking impairments. However, little is known about the correct arm-swing trajectories to be used in gait rehabilitation given the fact that changes in walking conditions affect arm-swing patterns. In this paper we present a comprehensive look at the effects of a variety of conditions on arm-swing patterns during walking. The results describe the effects of surface slope, walking speed, and physical characteristics on arm-swing patterns in healthy individuals. We propose data-driven mathematical models to describe arm-swing trajectories. Thirty individuals (fifteen females and fifteen males) with a wide range of height (1.58–1.91m) and body mass (49–98kg), participated in our study. Based on their self-selected walking speed, each participant performed walking trials with four speeds on five surface slopes while their whole-body kinematics were recorded. Statistical analysis showed that walking speed, surface slope, and height were the major factors influencing arm swing during locomotion. The results demonstrate that data-driven models can successfully describe arm-swing trajectories for normal gait under varying walking conditions. The findings also provide insight into the behavior of the elbow during walking.

Effect of sagittal plane mechanics on ACL strain during jump landing.

The relationships between non-contact anterior cruciate ligament injuries and the underlying biomechanics are still unclear, despite large quantities of academic research. The purpose of this research was to study anterior cruciate ligament strain during jump landing by investigating its correlation with sagittal plane kinetic/kinematic parameters and by creating an empirical model to estimate the maximum strain. Whole-body kinematics and ground reaction forces were measured from seven subjects performing single leg jump landing and were used to drive a musculoskeletal model that estimated lower limb muscle forces. These muscle forces and kinematics were then applied on five instrumented cadaver knees using a dynamic knee simulator system. Correlation analysis revealed that higher ground reaction force, lower hip flexion angle and higher hip extension moment among others were correlated with higher peak strain (p < 0.05). Multivariate regression analyses revealed that intrinsic anatomic factors account for most of the variance in strain. Among the extrinsic variables, hip and trunk flexion angles significantly contributed to the strain. The empirical relationship developed in this study could be used to predict the relative strain between jumps of a participant and may be beneficial in developing training programs designed to reduce an athlete's risk of injury. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1636-1644, 2016.

Joint torques in a freely walking insect reveal distinct functions of leg joints in propulsion and posture control.

Determining the mechanical output of limb joints is critical for understanding the control of complex motor behaviours such as walking. In the case of insect walking, the neural infrastructure for single-joint control is well described. However, a detailed description of the motor output in form of time-varying joint torques is lacking. Here, we determine joint torques in the stick insect to identify leg joint function in the control of body height and propulsion. Torques were determined by measuring whole-body kinematics and ground reaction forces in freely walking animals. We demonstrate that despite strong differences in morphology and posture, stick insects show a functional division of joints similar to other insect model systems. Propulsion was generated by strong depression torques about the coxa-trochanter joint, not by retraction or flexion/extension torques. Torques about the respective thorax-coxa and femur-tibia joints were often directed opposite to fore-aft forces and joint movements. This suggests a posture-dependent mechanism that counteracts collapse of the leg under body load and directs the resultant force vector such that strong depression torques can control both body height and propulsion. Our findings parallel propulsive mechanisms described in other walking, jumping and flying insects, and challenge current control models of insect walking.

Double-Poling Biomechanics of Elite Cross-country Skiers: Flat versus Uphill Terrain.

In light of the recent revolutionary change in the use of the double-poling (DP) technique in cross-country skiing, our purpose was to compare the associated kinetics and kinematics on flat (DPflat) and uphill terrain (DPup), as well as to identify factors that determine performance. Thirteen elite male cross-country skiers completed two incremental speed tests (Vpeak) involving roller skiing with the DP technique at moderate (13 and 24 km·h) and high speed (15 and 28.5 km·h) on a treadmill that was flat (1°) or tilted uphill (7°). Pole forces and three-dimensional whole-body kinematics were monitored simultaneously. In comparison to DPflat, during DPup, swing times were much shorter (-48%) and peak pole forces greater (+13%) and generated later during the poling phase (+68%), with higher impulses for all force components (+87%-123%). Furthermore, pole forces were 18% more effectively oriented for propulsion. During DPup, the skiers demonstrated more flexed elbows, as well as shoulder angles that were less flexed in the forward direction and less abducted throughout the poling phase, together with more highly flexed knee and ankle joints, a more upright thorax, less flexed hips, and a shortened backward swing after pole off. With DPup, the skiers raised their center of mass 25% more, attaining maximal heel raise and maximal vertical position at a timepoint closer to pole plant compared with flat. On the uphill incline, the magnitude of Vpeak was positively related to body mass, relative pole length (% body height), and magnitude of heel raise. The present findings provide novel insights into the coordination, kinetics and kinematics of elite skiers while DP on flat and uphill terrain.

Decoding bipedal locomotion from the rat sensorimotor cortex

Objective. Decoding forelimb movements from the firing activity of cortical neurons has been interfaced with robotic and prosthetic systems to replace lost upper limb functions in humans. Despite the potential of this approach to improve locomotion and facilitate gait rehabilitation, decoding lower limb movement from the motor cortex has received comparatively little attention. Here, we performed experiments to identify the type and amount of information that can be decoded from neuronal ensemble activity in the hindlimb area of the rat motor cortex during bipedal locomotor tasks. Approach. Rats were trained to stand, step on a treadmill, walk overground and climb staircases in a bipedal posture. To impose this gait, the rats were secured in a robotic interface that provided support against the direction of gravity and in the mediolateral direction, but behaved transparently in the forward direction. After completion of training, rats were chronically implanted with a micro-wire array spanning the left hindlimb motor cortex to record single and multi-unit activity, and bipolar electrodes into 10 muscles of the right hindlimb to monitor electromyographic signals. Whole-body kinematics, muscle activity, and neural signals were simultaneously recorded during execution of the trained tasks over multiple days of testing. Hindlimb kinematics, muscle activity, gait phases, and locomotor tasks were decoded using offline classification algorithms. Main results. We found that the stance and swing phases of gait and the locomotor tasks were detected with accuracies as robust as 90% in all rats. Decoded hindlimb kinematics and muscle activity exhibited a larger variability across rats and tasks. Significance. Our study shows that the rodent motor cortex contains useful information for lower limb neuroprosthetic development. However, brain–machine interfaces estimating gait phases or locomotor behaviors, instead of continuous variables such as limb joint positions or speeds, are likely to provide more robust control strategies for the design of such neuroprostheses.

Diverse anguilliform swimming kinematics in Pacific hagfish (Eptatretusstoutii) and Atlantic hagfish (Myxineglutinosa)

Anguilliform mode swimmers pass waves of lateral bending down their elongate bodies to propel forward. Hagfishes (Myxinidae) are classified as anguilliform swimmers, but their unique habits and reduced morphology—including a flexible body lacking a vertebral column—have the potential to translate into unique swimming behaviour within this broad classification. Their roles as active scavengers and hunters can require considerable bouts of swimming, yet quantitative data on hagfish locomotion are limited. Here, we aim to provide a more complete mechanistic understanding of hagfish swimming by quantifying whole-body kinematics of steady swimming in Pacific hagfish (Eptatretus stoutii (Lockington, 1878)) and Atlantic hagfish (Myxine glutinosa L., 1758), species from the two main lineages of Myxinidae. We analyzed high-speed video of hagfishes swimming at voluntary swim speeds and found that both species swim using high-amplitude undulatory waves. Swim speed is generally frequency-modulated, but patterns in wave speed, wavelength, and amplitude along the body and across swim speeds are variable, implying versatile mechanisms for the control of swim speed in these highly flexible fishes. We propose mechanistic explanations for this kinematic variability and compare hagfish with other elongate swimmers, demonstrating that the hagfish’s rich locomotory repertoire adds variety to the already diverse set of locomotory kinematics found in anguilliform swimmers.

Three-dimensional Force and Kinematic Interactions in V1 Skating at High Speeds.

To describe the detailed kinetics and kinematics associated with use of the V1 skating technique at high skiing speeds and to identify factors that predict performance. Fifteen elite male cross-country skiers performed an incremental roller-skiing speed test (Vpeak) on a treadmill using the V1 skating technique. Pole and plantar forces and whole-body kinematics were monitored at four submaximal speeds. The propulsive force of the "strong side" pole was greater than that of the "weak side" (P < 0.01), but no difference was observed for the legs. The poles generated approximately 44% of the total propulsion, being more effective than the legs in this respect (∼59% vs 11%, P < 0.001). Faster skiers exhibited more well-synchronized poling, exhibited more symmetric edging by and forces from the legs, and were more effective in transformation of resultant forces into propulsion. Cycle length was not correlated with either Vpeak or the impulse of total propulsive forces. The present findings provide novel insights into the coordination, kinetics, and kinematics of the arm and leg motion by elite athletes while V1 skating at high speeds. The faster skiers exhibit more symmetric leg motion on the "strong" and "weak" sides, as well as more synchronized poling. With respect to methods, the pressure insoles and three-dimensional kinematics in combination with the leg push-off model described here can easily be applied to all skating techniques, aiding in the evaluation of skiing techniques and comparison of effectiveness.

Influence of the marker set on the reconstruction of the whole-body kinematics

En biom&#233;canique du mouvement humain, la coh&#233;rence des donn&#233;es cin&#233;matiques est cruciale afin d&#8217;assurer une interpr&#233;tation ad&#233;quate des variables calcul&#233;es. Le set de marqueurs est un param&#232;tre qui peut influencer la reconstruction cin&#233;matique articulaire. Ainsi, le but de cette &#233;tude &#233;tait d&#8217;&#233;valuer l&#8217;influence de trois sets de marqueurs pour estimer la cin&#233;matique &#224; partir de trois crit&#232;res de performance&#160;: la pr&#233;cision de la reconstruction, la modification de la cin&#233;matique articulaire et la rapidit&#233; de reconstruction. En comparaison avec le set de marqueur A comprenant le plus grand nombre de marqueur, les r&#233;sultats indiquent que la diminution du nombre de marqueur a pour cons&#233;quence une modification croissante de la cin&#233;matique articulaire associ&#233;e &#224; une diminution du temps de calcul. Les donn&#233;es issues de toutes d&#233;marches biom&#233;caniques comportant des variables cin&#233;matiques en donn&#233;es d&#8217;entr&#233;e doivent &#234;tre analys&#233;es avec prudence lorsque le set de marqueur comprend un faible nombre de marqueurs.

Protective balance and startle responses to sudden freefall in standing humans

The aim of the present study was to investigate whether or not startle reactions contribute to the whole body postural responses following sudden freefall in standing humans. Nine healthy participants stood atop a moveable platform and received externally-triggered (EXT) and selftriggered (SLF) drop perturbations of the support surface. Electromyographic (EMG) activity was recorded bilaterally over the sternocleidomastoid (SCM), deltoid (DLT), biceps brachii (BIC), medial gastrocnemius (GAS), and tibialis anterior (TA) muscles. Whole-body kinematics were also recorded with motion analysis. Rapid phasic activation of SCM during the first trial response (FTR) was seen for all participants for EXT and for 56% of subjects for SLF. Reductions in EMG amplitude between the EXT FTR and later trial responses for SCM, DLT, and BIC and reduced arm movement acceleration indicative of habituation occurred and exceeded adaptive reductions for SLF. These findings suggested that a startle reflex contributes to the exaggerated postural FTR observed during externally-triggered whole-body free falls.

Occupant Kinematics in Laboratory Rollover Tests: PMHS Response.

The objective of the current study was to characterize the whole-body kinematic response of restrained PMHS in controlled laboratory rollover tests. A dynamic rollover test system (DRoTS) and a parametric vehicle buck were used to conduct 36 rollover tests on four adult male PMHS with varied test conditions to study occupant kinematics during the rollover event. The DRoTS was used to drop/catch and rotate the test buck, which replicated the occupant compartment of a typical mid-sized SUV, around its center of gravity without roof-to-ground contact. The studied test conditions included a quasi-static inversion (4 tests), an inverted drop and catch that produced a 3 g vertical deceleration (4 tests), a pure dynamic roll at 360 degrees/second (11 tests), and a roll with a superimposed drop and catch produced vertical deceleration (17 tests). Each PMHS was restrained with a three-point belt and was tested in both leading-side and trailing-side front-row seating positions. Whole-body kinematics were measured using a 3D motion capture system that quantified occupant displacement relative to the vehicle buck for the X-axis (longitudinal), Y-axis (lateral), and Z-axis (vertical) directions. Additionally the spine was divided into five segments to describe intrasegmental kinematics of the spine, including segment rotations as well as spinal extension and compression. The reported data represent the most complete set of kinematic response targets for a restrained occupant in a variety of dynamic rollover conditions, and are immediately useful for efforts to evaluate and improve existing ATDs and computational models for use in the rollover crash environment.

Hip muscle loads during running at various step rates.

Controlled laboratory study, cross-sectional. Objectives To characterize hip muscle forces and powers during running, and to determine how these quantities change when altering step rate for a given running speed. Hip musculature has been implicated in a variety of running-related injuries and, as such, is often the target of rehabilitation interventions, including resistance exercises and gait retraining. The differential contributions of the hip muscles to the task of running are not well understood, and may be important for recognizing the biomechanical mechanisms of running-related injuries and refining current treatment and prevention strategies. Thirty healthy participants ran at their preferred speed at 3 different step rates: 90%, 100%, and 110% of their preferred step rate. Whole-body kinematics and ground reaction forces were recorded. A 3-D musculoskeletal model was used to estimate muscle forces needed to produce the measured joint accelerations. Forces and powers of each muscle were compared across step-rate conditions. Peak force produced by the gluteus medius during running was substantially greater than that of any other hip muscle, with the majority of muscles displaying a period of negative work immediately preceding positive work. The higher running step rate led to an increase in hip flexor, hamstring, and hip extensor loading during swing, but, conversely, substantially diminished peak force and work during loading response for several hip muscles, including the gluteal muscles and piriformis. Increasing running step rate for a given running speed heightened hamstring and gluteal muscle loading in late swing, while decreasing stance-phase loading in the gluteal muscles and piriformis. These results may enable clinicians to support and refine current treatment strategies, including exercise prescription and gait retraining for running-related injuries.

Pre-impact fall detection: optimal sensor positioning based on a machine learning paradigm.

The aim of this study was to identify the best subset of body segments that provides for a rapid and reliable detection of the transition from steady walking to a slipping event. Fifteen healthy young subjects managed unexpected perturbations during walking. Whole-body 3D kinematics was recorded and a machine learning algorithm was developed to detect perturbation events. In particular, the linear acceleration of all the body segments was parsed by Independent Component Analysis and a Neural Network was used to classify walking from unexpected perturbations. The Mean Detection Time (MDT) was 351±123 ms with an Accuracy of 95.4%. The procedure was repeated with data related to different subsets of all body segments whose variability appeared strongly influenced by the perturbation-induced dynamic modifications. Accordingly, feet and hands accounted for most data information and the performance of the algorithm were slightly reduced using their combination. Results support the hypothesis that, in the framework of the proposed approach, the information conveyed by all the body segments is redundant to achieve effective fall detection, and suitable performance can be obtained by simply observing the kinematics of upper and lower distal extremities. Future studies are required to assess the extent to which such results can be reproduced in older adults and in different experimental conditions.

The influence of ankle muscle activation on postural sway during quiet stance

Although balance during quiet standing is postulated to be influenced by multiple factors, including ankle stiffness, it is unclear how different mechanisms underlying increases in stiffness affect balance control. Accordingly, this study examined the influence of muscle activation and passive ankle stiffness increases on the magnitude and frequency of postural sway. Sixteen young adults participated in six quiet stance conditions including: relaxed standing, four muscle active conditions (10%, 20%, 30% and 40% maximum voluntary contraction (MVC)), and one passive condition wearing an ankle foot orthotic (AFO). Kinetics were collected from a force plate, while whole-body kinematics were collected with a 12-sensor motion capture system. Bilateral electromyographic signals were recorded from the tibialis anterior and medial gastrocnemius muscles. Quiet stance sway amplitude (range and root mean square) and frequency (mean frequency and velocity) in the sagittal plane were calculated from time-varying centre of gravity (COG) and centre of pressure (COP) data. Compared to the relaxed standing condition, metrics of sway amplitude were significantly increased (between 37.5 and 63.2%) at muscle activation levels of 30% and 40% MVC. Similarly, frequency measures increased between 30.5 and 154.2% in the 20–40% MVC conditions. In contrast, passive ankle stiffness, induced through the AFO, significantly decreased sway amplitude (by 23–26%), decreased COG velocity by 13.8%, and increased mean COP frequency by 24.9%. These results demonstrate that active co-contraction of ankle musculature (common in Parkinson’s Disease patients) may have differential effects on quiet stance balance control compared to the use of an ankle foot orthotic (common for those recovering from stroke).

Using ecological whole body kinematics to evaluate effects of medication adjustment in Parkinson disease.

Functional motor impairments including mobility are major reasons for clinical intervention and medication adjustment in symptomatic therapy for Parkinson's disease (PD). Outcome measures used to assess the impact of medication are mostly based on patients' memory or diaries which, considering the gaps between visits, are neither objective nor very reliable. Investigating the feasibility of using movement features extracted from ecological whole-body kinematics recordings to measure the quantitative and qualitative changes in multiple aspects of mobility after medication changes in PD. Eleven patients with PD (PwPD) performed mobility tasks in their own home, wearing a full body wireless inertial sensing based motion capture system. Three scripted walking tasks (walking, fast walking, and walk turns) were examined at baseline and two weeks after medication changes. Clinical scales, including investigator-rated clinical global impression of improvement (CGI-I), were collected at both visits. Out of 59 recorded body joint variables, five were identified as pertinent. Changes were represented in vector space as a plot of mean versus peak amplitude. Regression analysis was used to predict clinical improvement or worsening based on these vector features. The predictors were able to explain (>98.5% of variance) patients' clinical global impression of improvement, thus correctly predicting 5 cases of improvement and 2 cases of worsening. This study provided a method of extracting clinically meaningful reports from ecological kinematic data showing changes after drug adjustments. The results are presented using a novel concept called change space that may be more understandable for clinical staff.

Spatial co-ordination of foot contacts in unrestrained climbing insects.

Animals that live in a spatially complex environment such as the canopy of a tree, constantly need to find reliable foothold in three-dimensional (3D) space. In multi-legged animals, spatial co-ordination among legs is thought to improve efficiency of finding foothold by avoiding searching-movements in trailing legs. In stick insects, a 'targeting mechanism' has been described that guides foot-placement of hind- and middle legs according to the position of their leading ipsilateral leg. So far, this mechanism has been shown for standing and tethered walking animals on horizontal surfaces. Here, we investigate the efficiency of this mechanism in spatial limb co-ordination of unrestrained climbing animals. For this, we recorded whole-body kinematics of freely climbing stick insects and analysed foot placement in 3D space. We found that touch-down positions of adjacent legs were highly correlated in all three spatial dimensions, revealing 3D co-ordinate transfer among legs. Furthermore, targeting precision depended on the position of the leading leg. A second objective was to test the importance of sensory information transfer between legs. For this, we ablated a proprioceptive hair field signaling the levation of the leg. After ablation, the operated leg swung higher and performed unexpected searching movements. Furthermore, targeting of the ipsilateral trailing leg was less precise in anteroposterior and dorsoventral directions. Our results reveal that the targeting mechanism is used by unrestrained climbing stick insects in 3D space and that information from the trochanteral hair field is used in ipsilateral spatial co-ordination among legs.

Influence of the marker set on the reconstruction of the whole-body kinematics

En biomecanique du mouvement humain, la coherence des donnees cinematiques est cruciale afin d’assurer une interpretation adequate des variables calculees. Le set de marqueurs est un parametre qui peut influencer la reconstruction cinematique articulaire. Ainsi, le but de cette etude etait d’evaluer l’influence de trois sets de marqueurs pour estimer la cinematique a partir de trois criteres de performance : la precision de la reconstruction, la modification de la cinematique articulaire et la rapidite de reconstruction. En comparaison avec le set de marqueur A comprenant le plus grand nombre de marqueur, les resultats indiquent que la diminution du nombre de marqueur a pour consequence une modification croissante de la cinematique articulaire associee a une diminution du temps de calcul. Les donnees issues de toutes demarches biomecaniques comportant des variables cinematiques en donnees d’entree doivent etre analysees avec prudence lorsque le set de marqueur comprend un faible nombre de marqueurs.

Subject-specific knee joint geometry improves predictions of medial tibiofemoral contact forces

Estimating tibiofemoral joint contact forces is important for understanding the initiation and progression of knee osteoarthritis. However, tibiofemoral contact force predictions are influenced by many factors including muscle forces and anatomical representations of the knee joint. This study aimed to investigate the influence of subject-specific geometry and knee joint kinematics on the prediction of tibiofemoral contact forces using a calibrated EMG-driven neuromusculoskeletal model of the knee. One participant fitted with an instrumented total knee replacement walked at a self-selected speed while medial and lateral tibiofemoral contact forces, ground reaction forces, whole-body kinematics, and lower-limb muscle activity were simultaneously measured. The combination of generic and subject-specific knee joint geometry and kinematics resulted in four different OpenSim models used to estimate muscle–tendon lengths and moment arms. The subject-specific geometric model was created from CT scans and the subject-specific knee joint kinematics representing the translation of the tibia relative to the femur was obtained from fluoroscopy. The EMG-driven model was calibrated using one walking trial, but with three different cost functions that tracked the knee flexion/extension moments with and without constraint over the estimated joint contact forces. The calibrated models then predicted the medial and lateral tibiofemoral contact forces for five other different walking trials. The use of subject-specific models with minimization of the peak tibiofemoral contact forces improved the accuracy of medial contact forces by 47% and lateral contact forces by 7%, respectively compared with the use of generic musculoskeletal model.

Stretch and activation of the human biarticular hamstrings across a range of running speeds

The human biarticular hamstrings [semimembranosus (SM), semitendinosus (ST) and biceps femoris long head (BF(LH))] have an important role in running. This study determined how hamstrings neuro-mechanical behaviour changed with faster running, and whether differences existed between SM, ST and BF(LH). Whole-body kinematics and hamstrings electromyographic (EMG) activity were measured from seven participants running at four discrete speeds (range: 3.4 ± 0.1 to 9.0 ± 0.7 m/s). Kinematic data were combined with a three-dimensional musculoskeletal model to calculate muscle-tendon unit (MTU) stretch and velocity. Activation duration and magnitude were determined from EMG data. With faster running, MTU stretch and velocity patterns remained similar, but maxima and minima significantly increased. The hamstrings were activated from foot-strike until terminal stance or early swing, and then again from mid-swing until foot-strike. Activation duration was similar with faster running, whereas activation magnitude significantly increased. Hamstrings activation almost always ended before minimum MTU stretch, and it always started before maximum MTU stretch. Comparing the hamstrings, maximum MTU stretch was largest for BF(LH) and smallest for ST irrespective of running speed, while the opposite was true for peak-to-peak MTU stretch. Furthermore, peak MTU shortening velocity was largest for ST and smallest for BF(LH) at all running speeds. Finally, for the two fastest running speeds, the amount of MTU stretch that occurred during terminal swing after activation had started was less for BF(LH) compared to SM and ST. Differences were evident in biarticular hamstrings neuro-mechanical behaviour during running. Such findings have implications for hamstrings function and injury.

Effects of Gradual Versus Sudden Training on the Cognitive Demand Required While Learning a Novel Locomotor Task

ABSTRACTThe cognitive demand required for a range of locomotor tasks has been described for a variety of populations. However, the effect of different training strategies on the cognitive demand required while learning novel locomotor tasks is not well understood and may inform physical rehabilitation. The authors examined whether two training strategies, gradual and sudden training, influenced the cognitive demand required while practicing a novel locomotor task, asymmetric split-belt treadmill walking. Simple reaction times and whole-body kinematics were recorded throughout practice. Gradual training resulted in significantly lower reaction times during much of training, suggesting that gradual training is less cognitively demanding than sudden training, possibly due to a reduction in error feedback or movement planning demands.

Postural Control In Quiet Standing With A Concurrent Cognitive Task In Psychotic Conditions

ABSTRACT Differences in postural control and performance between psychotic patients and healthy subjects were investigated using a dual task paradigm. Center of pressure (CoP) data and whole-body kinematics of the center of mass (CoM) were recorded during quiet standing with and without a backward counting task. Dual task response was similar in both groups: the magnitude of CoM-migration did not change, while CoP-CoM magnitude, a measure related to ankle joint torque, and CoP-frequency both increased. The magnitudes of migration for CoM and CoP-CoM were greater in patients during both conditions, while CoP-frequency was similar to control subjects. Our results suggest that exaggerated ankle joint torque relative to CoP-frequency caused greater postural sway in patients during both conditions.