Regression analysis of gait parameters with speed in normal children walking at self-selected speeds

Characterization of the ankle dynamic joint stiffness as a function of gait speed for overground and treadmill walking

The ankle dynamic joint stiffness (DJS), defined as the slope of the joint angle-moment plot, measures the resistance of the ankle joint to movement when the foot is in contact with the ground. DJS helps to stabilize the ankle joint, and its characterization helps to identify gait pathology and assist foot prosthesis design. This study analyzes the available gait dynamics data to obtain ankle DJS parameters for population groups according to age, gender, and gait speed for overground and treadmill walking. This study classified the groups into five walking speeds normalized using the Froude number. Herein, 12 ankle DJS parameters were determined. These include four linear segments: controlled plantar flexion (CP), early response phase (ERP), large response phase (LRP), and descending phase (DP), their corresponding turning points, the net mechanical work, the absorbed work, and the loop direction. Ankle dynamics data for 92 individuals was collected from two gait data repositories. The analysis reveals a notable disparity in stiffness values between overground and treadmill gait. Specifically, the CP stiffness is significantly higher for overground gait. In contrast, the DP stiffness displays an opposing pattern, with higher values observed during treadmill walking. A negative stiffness for LRP was found at fast speeds for all groups. The sorted data, analysis tools, and findings of this study are meant to help practitioners design prosthetic and rehabilitation devices based on age, gender, and walking environment at different gait speeds.

Computation of physiological loading induced interstitial fluid motion in muscle standardized femur: Healthy vs. osteoporotic bone

BACKGROUND AND OBJECTIVES

Physiological loading-induced mechanical environments regulate bone modeling and remodeling. Thus, loading-induced normal strain is typically considered a stimulus to osteogenesis. However, several studies noticed new bone formation near the sites of minimal normal strain, e.g., the neutral axis of bending in long bones, which raises a question on how bone mass is maintained near these sites. Secondary mechanical components such as shear strain and interstitial fluid flow also stimulate bone cells and regulate bone mass. However, the osteogenic potential of these components is not well established. Accordingly, the present study estimates the distribution of physiological muscle loading-induced mechanical environments such as normal strain, shear strain, pore pressure, and interstitial fluid flow in long bones.

METHODS

A poroelastic finite element muscle standardized femur (MuscleSF) model is developed to compute the distribution of the mechanical environment as a function of bone porosities associated with osteoporotic and disuse bone loss.

RESULTS

The results indicate the presence of higher shear strain and interstitial fluid motion near the minimal strain sites, i.e., the neutral axis of bending of femoral cross-sections. This suggests that secondary stimuli may maintain the bone mass at these locations. Pore pressure and interstitial fluid motion reduce with the increased porosity associated with bone disorders, possibly resulting in diminished skeletal mechano-sensitivity to exogenous loading.

CONCLUSIONS

These outcomes present a better understanding of mechanical environment-mediated regulation of site-specific bone mass, which can be beneficial in developing prophylactic exercise to prevent bone loss in osteoporosis and muscle disuse.

Children with autism display altered ankle strategies when changing speed during over-ground gait

BACKGROUND

Examining gait mechanics when altering speed has been used in various clinical populations to understand the pervasiveness of neurological impairments. Few studies have examined whether different gait mechanics exist when altering speed in children with Autism Spectrum Disorder, although autism may present as a movement disorder due to abnormalities in the central nervous system. Most autism gait-related research has used preferred walking speed, while different speeds may yield discernible patterns that can be used for future interventions. The purpose of this study was to examine kinematic strategies used by children with autism in preferred, fast, and slow walking speeds.

METHODS

Three-dimensional kinematic data were obtained on 14 children (aged 8-17 years) during preferred, fast, and slow walking. Hip, knee, and ankle angular joint positions were examined at loading response, pre-swing, and terminal swing sub-phases due to their importance on forward propulsion and weight transfer. Repeated measures analyses of variance (α = 0.05) were used to test for statistical differences and effect sizes were interpreted with Cohen's d.

FINDINGS

Although significant differences were observed for each joint and sub-phase, the left and right ankle joints during pre-swing displayed the most consistent differences among conditions (p < 0.001, and p < 0.001), respectively. Additionally, the left ankle displayed a moderate effect size (η² = 0.71) and the right ankle displayed a large effect size (η² = 0.80).

INTERPRETATIONS

These findings reveal that the ankle joint, during pre-swing, is the primary kinematic strategy used by children with autism when altering gait speed, whereas previous evidence suggests that the hip joint was the primary strategy.

Parametric generation of three-dimensional gait for robot-assisted rehabilitation

For robot-assisted rehabilitation and assessment of patients with motor dysfunction, the parametric generation of their normal gait as the input for the robot is essential to match with the features of the patient to a greater extent. In addition, the gait needs to be in three-dimensional space, which meets the physiological structure of the human better, rather than only on a sagittal plane. Thus, a method for the parametric generation of three-dimensional gait based on the influence of the motion parameters and structure parameters is presented. First, the three-dimensional gait kinematic of participants is collected, and trajectories of ankle joint angle and ankle center position are calculated. Second, for the trajectories, gait features are extracted including gait events indicating the physiological features of walking gait, in addition to extremes indicating the geometrical features of the trajectories. Third, regression models are derived after using leave-one-out cross-validation for model optimization. Finally, cubic splines are fitted between the predicted gait features to generate the trajectories for a full gait cycle. It is inferred that the generated curves match the measured curves well. The method presented herein gives an important reference for research into lower limb rehabilitation robots.

Comparison of predicted kinetic variables between Parkinson's disease patients and healthy age-matched control using a depth sensor-driven full-body musculoskeletal model

BACKGROUND

Abnormalities in gait kinetics in patients with Parkinson's disease (PD) who have suffer from gait impairment have been noted using a conventional inverse dynamic analysis derived by marker-based motion capture system and force plate, which are typically mounted in the laboratory floor. Despite the high accuracy of this approach in tracking markers' trajectories and acquiring ground reaction forces (GRFs), its dependence on laboratory-mounted equipment restricts its potential use in wider variety of clinical applications.

RESEARCH QUESTION

Would a full-body musculoskeletal model driven by a single depth sensor data only produce comparable gait kinetic parameters, including GRFs and lower extremity joints moments, for elderly participants, both healthy and those diagnosed with PD?

METHODS

Nine patients diagnosed with PD and 11 healthy age-matched control participants performed three over-ground gait trials. Full-body kinematic data were collected using a depth sensor and a musculoskeletal model have been constructed using AnyBody musculoskeletal modeling system to predict the three-dimensional GRFs and lower extremity joint moments. Predicted kinetic parameters for both PD and control groups were compared during the braking and propulsive phases of the gait cycle. In addition, ensemble curve analysis with 90% confidence intervals were constructed to compare between group differences across the stance phase of the gait cycle.

RESULTS

The findings of this study showed that the PD exhibited a significantly lower braking peak vertical GRF and propulsion peak horizontal GRF while no significant between-group differences were found in peak lower extremity joint moments. However, the PD showed significant alterations in lower extremity joint moments during the early and late phases of stance, which indicate a difference in ambulation strategy.

SIGNIFICANCE

The proposed method adopting full-body musculoskeletal model driven by a depth sensor data proves that it has the potential to be a portable and cost-effective gait analysis tool in the clinical setting.

Age-Related Changes in Smoothness of Gait of Healthy Children and Early Adolescents

In this study, we acquired and processed trunk accelerations during level walking in 85 children aged 8-13 years to calculate spatio-temporal parameters and Harmonic Ratio (HR), which is a metrics representative of gait smoothness and step-to-step symmetry. The results show that while spatio-temporal parameters remain unchanged once normalized considering individuals' anthropometry, significantly higher values of HR for both the antero-posterior and vertical directions were found in participants aged 12-13 with respect to those of 8-9. This indicates an improvement of gait symmetry, which suggests that the gait maturation process is still ongoing for the age ranges tested here.

Test of two prediction methods for minimum and maximum values of gait kinematics and kinetics data over a range of speeds

BACKGROUND

Minimum and maximum values of gait kinematics and kinetics data are commonly used to quantitatively describe a walking pattern.

RESEARCH QUESTION

The purposes of this study were to determine the effect of speed on the minimum and maximum values of gait kinematics and kinetics variables and to test two prediction methods for the estimation of these minimum and maximum values at different gait speeds.

METHODS

An open dataset with the data of 24 healthy adults (age: 27.6 ± 4.4 years, height: 171.1 ± 10.5 cm, body mass: 68.4 ± 12.2 kg) walking on a treadmill at eight gait speeds was employed in this study. The minimum and maximum angles and moments of the hip, knee, and ankle joints were extracted from speed-dependent prediction curves solely for the minimum and maximum values (PEAK method) and from speed-dependent prediction curves for the entire gait cycle (CYCLE method). The overall error, computed as the root-mean-square error (RMSE), for the minimum and maximum values predicted by these two methods were compared with the experimental true values.

RESULTS

The RMSEs for the joint angles were PEAK: 3.86 ± 1.21°, CYCLE: 3.88 ± 1.18° and for the joint moments were PEAK: 0.129 ± 0.052 Nm/kg, CYCLE: 0.131 ± 0.052 Nm/kg.

SIGNIFICANCE

The two prediction methods tested can be used to estimate the minimum and maximum values of biomechanical gait variables at a certain speed.

Prediction of ground reaction forces while walking in water

Despite being a key concept in rehabilitation, controlling weight-bearing load while walking, following lower limb injury is very hard to achieve. Walking in water provides an opportunity to prescribe load for people who have pain, weakness or weight bearing restrictions related to stages of healing. The aim of this experimental study was to evaluate and validate regression models for predicting ground reaction forces while walking in water. One hundred and thirty seven individuals (24±5 years, 1.71±0.08 m and 68.7±12.5 kg) were randomly assigned to a regression group (n = 113) and a validation group (n = 24). Trials were performed at a randomly assigned water depth (0.75 to 1.35 m), and at a self-selected speed. Independent variables were: immersion ratio, velocity, body mass, and waist, thigh and leg circumferences. Stepwise regression was used for the prediction of ground reaction forces and validation included agreement and consistency statistical analyses. Data from a force plate were compared with predicted data from the created model in the validation group. Body mass, immersion ratio, and velocity independently predicted 95% of the vertical and resultant ground reaction force variability, while, together, velocity and thigh circumference explained 81% of antero-posterior ground reaction force variability. When tested against the data measured in validation samples, the models output resulted in statistically similar values, intraclass correlation coefficients ranging from 0.88 to 0.90 and standard errors of measurement, 11.8 to 42.3 N. The models introduced in this study showed good predictive performance in our evaluation procedures and may be considered valid in the prediction of vertical, antero-posterior and resultant ground reaction forces while walking in water. All predictive variables can be easily determined in clinical practice. Future studies should focus on the validation of these models in specific populations.

Effects of walking speed on gait biomechanics in healthy participants: a systematic review and meta-analysis

BACKGROUND

Understanding the effects of gait speed on biomechanical variables is fundamental for a proper evaluation of alterations in gait, since pathological individuals tend to walk slower than healthy controls. Therefore, the aim of the study was to perform a systematic review of the effects of gait speed on spatiotemporal parameters, joint kinematics, joint kinetics, and ground reaction forces in healthy children, young adults, and older adults.

METHODS

A systematic electronic search was performed on PubMed, Embase, and Web of Science databases to identify studies published between 1980 and 2019. A modified Quality Index was applied to assess methodological quality, and effect sizes with 95% confidence intervals were calculated as the standardized mean differences. For the meta-analyses, a fixed or random effect model and the statistical heterogeneity were calculated using the I² index.

RESULTS

Twenty original full-length studies were included in the final analyses with a total of 587 healthy individuals evaluated, of which four studies analyzed the gait pattern of 227 children, 16 studies of 310 young adults, and three studies of 59 older adults. In general, gait speed affected the amplitude of spatiotemporal gait parameters, joint kinematics, joint kinetics, and ground reaction forces with a decrease at slow speeds and increase at fast speeds in relation to the comfortable speed. Specifically, moderate-to-large effect sizes were found for each age group and speed: children (slow, - 3.61 to 0.59; fast, - 1.05 to 2.97), young adults (slow, - 3.56 to 4.06; fast, - 4.28 to 4.38), and older adults (slow, - 1.76 to 0.52; fast, - 0.29 to 1.43).

CONCLUSIONS

This review identified that speed affected the gait patterns of different populations with respect to the amplitude of spatiotemporal parameters, joint kinematics, joint kinetics, and ground reaction forces. Specifically, most of the values analyzed decreased at slower speeds and increased at faster speeds. Therefore, the effects of speed on gait patterns should also be considered when comparing the gait analysis of pathological individuals with normal or control ones.

How normal is normal: Consequences of stride to stride variability, treadmill walking and age when using normative paediatric gait data

Background: In the process of 3D-gait analysis interpretation, gait deviations in children with cerebral palsy are identified through comparison with reference data of typically developing children (TD). Generally, TD-data are presented based on averaged normalized curves of numerous strides for different ages and walking velocities. In patients however, often only a limited number of strides are available which are compared to group-averaged reference curves. Research question: To investigate the consequences of ignoring stride-to-stride variation when averaged normalized curves are used as a reference paediatric dataset. To illustrate implications for clinical practice, we investigated how many individual strides of TD-children would be classified as abnormal, when compared to averaged normalized curves from the reference group, and how this is affected by age and treadmill versus overground walking. Methods: Ninety TD-datasets were collected. Children (4-18y) walked on a 10 m-walkway (n = 49) or instrumented treadmill (n = 41). Joint kinematic and kinetic curves and clinically relevant outcome parameters were established. Individual strides were considered abnormal if they exceeded the group average more than 2SD. In addition, the Edinburgh Visual Gait Score, Gait Profile Score (GPS) and stride-to-stride variability were calculated. Generalized estimation equation analyses were used to investigate effects of age, overground/treadmill and their interaction. Results: Of all 2532 analysed strides, on average 28% were classified as abnormal for joint kinematic curves, 50% for moments, and 51% for powers. Younger children showed a greater percentage of abnormal strides, greater GPS and more variability (p < 0.001). The effect of age was similar between treadmill and overground, but variability was lower on the treadmill. Significance: Our findings indicate that due to stride-to-stride variability, even in TD-children a substantial number of strides can be classified as abnormal, when compared to group averaged normalized curves. Consequently, in patients, comparing a single stride to such a reference curve may lead to potential overestimation of gait deviations.

Gait Profile Score in able-bodied and post-stroke individuals adjusted for the effect of gait speed

BACKGROUND

The Gait Profile Score (GPS) measures the quality of an individual's walking by calculating the difference between the kinematic pattern and the average walking pattern of healthy individuals.

RESEARCH QUESTIONS

The purposes of this study were to quantify the effect of speed on the GPS and to determine whether the prediction of gait patterns at a specific speed would make the GPS outcome insensitive to gait speed in the evaluation of post-stroke individuals.

METHODS

The GPS was calculated for able-bodied individuals walking at different speeds and for the comparison of post-stroke individuals with able-bodied individuals using the original experimental data (standard GPS) and the predicted gait patterns at a given speed (GPS velocity, GPS^v). We employed standard gait analysis for data collection of the subjects. Sixteen participants with a stroke history were recruited for the post-stroke group, and 15 age-matched, able-bodied participants formed the control group.

RESULTS

Gait speed significantly affects the GPS and the method to predict the gait patterns at any speed is able to mitigate the effects of gait speed on the GPS. Overall, the gap between the GPS and GPS^v values across the post-stroke individuals was small (0.5° on average, range from 0.0° to 1.4°) and not statistically significant. However, there was a significant negative linear relationship in the absolute difference between the GPS and GPS^v values for the participants of the post-stroke group with gait speed, indicating that a larger difference between the speeds of the post-stroke participant and the reference dataset resulted in a larger difference between the GPS and GPS^v.

SIGNIFICANCE

The modified version of the GPS, the GPS^v, is effective in reducing the impact of gait speed on GPS; however, the observed difference between the two methods was only around 1° for the slowest individuals in comparison to the reference dataset.

A prediction method of speed-dependent walking patterns for healthy individuals

BACKGROUND

Gait speed is one of the main biomechanical determinants of human movement patterns. However, in clinical gait analysis, the effect of gait speed is generally not considered, and people with disabilities are usually compared with able-bodied individuals even though disabled people tend to walk slower.

RESEARCH QUESTIONS

This study proposes a simple way to predict the gait pattern of healthy individuals at a specific speed.

METHODS

The method consists of creating a reference database for a range of gait speeds, and the gait-pattern prediction is implemented as follows: 1) the gait cycle is discretized from 0 to 100% for each variable, 2) a first or second-order polynomial is used to adjust the values of the reference dataset versus the corresponding gait speeds for each instant of the gait cycle to obtain the parameters of the regression, and 3) these regression parameters are then used to predict the new values of the gait pattern at any specific speed. Twenty-four healthy adults walked on the treadmill at eight different gait speeds, where the gait pattern was obtained by a 3D motion capture system and an instrumented treadmill.

RESULTS

Overall, the predicted data presented good agreement with the experimental data for the joint angles and joint moments.

SIGNIFICANCE

These results demonstrated that the proposed prediction method can be used to generate more unbiased reference data for clinical gait analysis and might be suitably applied to other speed-dependent human movement patterns.

A gyroscopic advantage: phylogenetic patterns of compensatory movements in frogs

Head and eye compensatory movements known as vestibulo-ocular and vestibulo-cervical reflexes are essential to stay orientated in space while moving. We have used a previously developed methodology focused on the detailed mathematical description of head compensatory movements in frogs without the need for any surgical procedures on the examined specimens. Our comparative study comprising 35 species of frogs from different phylogenetic backgrounds revealed species-specific head compensatory abilities ensuring gaze stabilization. Moreover, we found a strong phylogenetic signal highlighting the great ability of compensatory head movements in families of Pyxicephalidae and Rhacophoridae from the Natatanura group. By contrast, families of Dendrobatidae and Microhylidae exhibited only poor or no head compensatory movements. Contrary to our expectation, the results did not corroborate an ecomorphological hypothesis anticipating a close relationship between ecological parameters and the head compensatory movements. We did not find any positive association between more complex (3D structured, arboreal or aquatic) habitats or more saltatory behavior and elevated abilities of head compensatory movements. Moreover, we found compensatory movements in most basal Archeobatrachia, giving an indication of common ancestry of these abilities in frogs that are variously pronounced in particular families. We hypothesize that the uncovered proper gaze stabilization during locomotion provided by the higher head compensatory abilities can improve or even enable visual perception of the prey. We interpret this completely novel finding as a possible gyroscopic advantage in a foraging context. We discuss putative consequences of such advanced neuromotor skills for diversification and ecological success of the Natatanura group.

Rate of Angular Momentum in ZMP Using Efficient DH-Based Recursive Lagrangian

Dynamic balance has to be maintained during motions of biped systems when their feet are in contact with the ground. As a necessary condition, this indicates that the calculated zero moment point (ZMP) position should be within the specified foot support region throughout the entire motion. A critical term in the ZMP formulation is the rate of angular momentum (RAM) for each link, which should be evaluated accurately and efficiently in motion planning and simulations. In this study, we propose a recursive Lagrangian method based on Denavit–Hartenberg convention to calculate the RAM for each link and the corresponding sensitivity. This method allows the evaluation of each link’s dynamic contribution to the ZMP position. The effectiveness of the proposed approach is demonstrated by simulating bipedal motions of walking and running along with their comparison against existing approaches (direct method and global force method). The accurate RAM calculation in ZMP based on the proposed approach resulted in the improved motion trajectories and reliable ground reaction forces for high-speed bipedal motion predictions.

An Efficient Inverse Dynamics Optimization Formulation for Musculoskeletal Motion Prediction

In this study, an inverse dynamics optimization formulation and solution procedure is developed for musculoskeletal simulations. The proposed method has three main features: high order recursive B-spline interpolation, partition of unity, and inverse dynamics formulation. First, joint angle and muscle force profiles are represented by recursive B-splines. The formula for high order recursive B-spline derivatives are derived for state variables calculation. Second, partition of unity is used to handle the multi-contact indeterminacy between human and environment during the motion. The global forces and moments are distributed to each contacting point through the corresponding partition ratio. Third, joint torques are inversely calculated from equations of motion based on state variables and contacts to avoid numerical integration of equations of motion. Therefore, the design variables for the optimization problem are joint angle control points, muscle force control points, knot vector, and partition ratios for contacting points. The sum of muscle stress/activity squared is minimized as the cost function. The constraints are imposed for human physical constraints and task-based constraints. The proposed formulation is demonstrated by simulating a trajectory planning problem of a planar musculoskeletal arm with six muscles. In addition, the gait motion of a two-dimensional musculoskeletal model with sixteen muscles is also optimized by using the approach developed in this paper. The gait optimal solution is obtained in about 1 minute CPU time. The predicted kinematics, kinetics, and muscle forces have general trends that are similar to those reported in the literature.

A mixed linear modelling characterisation of gender and speed related changes in spatiotemporal and kinematic characteristics of gait across a wide speed range in healthy adults

In exploring the relationship between the kinematics of gait and speed of progression individual variation in patterns and gender differences have not always been adequately taken into account. In the current study mixed linear modelling was used to isolate changes with speed from those associated with individual variation and gender. Three-dimensional motion analysis of 20 participants (10M/10F, 25.7 ± 5.1 years) walking at a wide range of speeds (normalised speeds 0.10-0.55 ∼0.41-2.26 m/s) was recorded (775 walks). Spatiotemporal (speed, cadence, step length, percentage of single and double support) and kinematic characteristics (pelvis through ankle) were determined. Significant between participant differences were highlighted in both intercept and slope of relationships. In addition females exhibiting different peak pelvic tilt and obliquity, hip flexion and internal rotation and ankle dorsiflexion compared to males. Spatiotemporal parameters exhibited non-linear relationships with normalised speed (R²> 0.5). Kinematic features exhibited significant relationships with normalised speed, varying from linear to cubic, from very weak to strong in fit (0.010 > R²> 0.672). Mixed linear modelling highlighted gender dependent, speed related changes in addition to inter-individual variation. Gender and speed are both important determinants of gait patterns, however, individual variations remain.

THE EFFECT OF TRANSIENT LOADING ON A FOOT-ORTHOTIC USING TEMPORAL PARAMETERS OF GAIT

This study describes a method for performing transient finite element analysis (FEA) of an assistive device using experimental parameters obtained from gait analysis. A subject displaying pathologic gait, owing to lower limb deformity, was chosen for gait study. Using CAD tools, a remedial orthotic device was designed, which is expected to improve the gait of the subject. The orthotic model was subjected to static and transient loading conditions obtained from gait study, using an FEA tool. The stress ‘hot’ zones between the two modes of analysis are studied. In addition, the experimental gait data of a healthy control group were recorded to perform univariate regression studies for predicting the peak values of the normal forces, and validated by comparing with those available in the literature. The values thus obtained may be used for static behavioral analysis of assistive devices. From the FEA results, it can be conclusively said that the orthotic model is capable of sustaining gait cycle loading. The regression studies suggest the possibility of using anthropometric data to predict gait forces and subsequently perform static and transient loading analysis of assistive devices.

Preliminary Assessment of a Compliant Gait Exoskeleton

Current commercial wearable gait exoskeletons contain joints with stiff actuators that cannot adapt to unpredictable environments. These actuators consume a significant amount of energy, and their stiffness may not be appropriate for safe human-machine interactions. Adjustable compliant actuators are being designed and implemented because of their ability to minimize large forces due to shocks, to safely interact with the user, and to store and release energy in passive elastic elements. Introduction of such compliant actuation in gait exoskeletons, however, has been limited by the larger power-to-weight and volume ratio requirement. This article presents a preliminary assessment of the first compliant exoskeleton for children. Compliant actuation systems developed by our research group were integrated into the ATLAS exoskeleton prototype. The resulting device is a compliant exoskeleton, the ATLAS-C prototype. The exoskeleton is coupled with a special standing frame to provide balance while allowing a semi-natural gait. Experiments show that when comparing the behavior of the joints under different stiffness conditions, the inherent compliance of the implemented actuators showed natural adaptability during the gait cycle and in regions of shock absorption. Torque tracking of the joint is achieved, identifying the areas of loading response. The implementation of a state machine in the control of knee motion allowed reutilization of the stored energy during deflection at the end of the support phase to partially propel the leg and achieve a more natural and free swing.

Prospective Evaluation of Postural Control and Gait in Pediatric Patients with Cancer After a 4-Week Inpatient Rehabilitation Program

OBJECTIVE

The aim of the study was to investigate the effects of a 4-wk inpatient rehabilitation program on postural control and gait in pediatric patients with cancer.

DESIGN

Eighty-eight patients with brain tumors (n = 59) and bone/soft tissue sarcomas (n = 29) were evaluated. Postural control was assessed examining the velocity of the center of pressure and single-leg stance time on a pressure distribution platform. Walk ratio, a measure of neuromotor control, was used to evaluate intervention effects on gait.

RESULTS

Repeated measures analysis of variance showed improvements in postural control measures, indicated by a decrease in velocity of center of pressure of -0.4 cm/sec (F1,80 = 7.175, P = 0.009, ηp = 0.082) and increase in single-leg stance time (mean [median] = 1.1 [2.6] sec, respectively; F1,80 = 12.617, P = 0.001, ηp = 0.136). Walk ratio increased by 0.2 mm/steps per min (F1,82 = 3.766, P = 0.056, ηp = 0.044). Mean changes in dependent variables did not differ between both patient groups (P > 0.05).

CONCLUSIONS

The results indicate benefits of an inpatient rehabilitation program comprising standard physical therapy as well as aquatic and hippo therapy on postural control and gait after treatment of pediatric patients with cancer.

EVALUATION AND PREDICTION OF HUMAN GAIT PARAMETERS USING UNIVARIATE, MULTIVARIATE AND STEPWISE STATISTICAL METHODS

This research was carried out to establish the relationship between human anthropometric data and corresponding gait variables. A group comprising 35 participants (18 male and 17 female) was selected for the current study. The study consisted of trials in which each participant was asked to walk the length of the instrumented walkway (Kistler’s force platform inset) at a self-selected speed. Using a four-camera motion analysis system, the kinematic and kinetic parameters of each trial were calculated. The peak values obtained from the data curves were used to generate the necessary regression fits. In order to establish the correlation between the anthropometric data of human and the gait parameters, the univariate, multivariate and stepwise fits were generated. Further, the statistical methods were employed to evaluate the [Formula: see text], [Formula: see text] and [Formula: see text]-values for each fit. The current multivariate study indicates an increasing trend in [Formula: see text] values and decreasing trend for [Formula: see text]-values when compared with the univariate fits and the results follow the expected line.

Influence of walking speed on gait parameters of bipedal locomotion in rhesus monkeys

BACKGROUND

The primate model of bipedal locomotion has been extensively used to study human evolution and played a critical role in exploring the pathological mechanisms of human neurologic disease and spinal cord injury. Speed has great influence on both walking posture and gait parameters in human walking; however, how speed changes the gait pattern of bipedal locomotion in primates remains unclear.

METHODS

We chose six adult female rhesus monkeys (Macaca mulatta) and collected the gait parameters of these animals during their treadmill locomotion over a wide range of speed. Using a 3D motion analysis system, we studied the spatiotemporal characteristics of the gait pattern.

RESULTS AND CONCLUSIONS

We have built an efficient and time-saving primate model and shown that speed significantly impacts kinematic parameters. This may present a thorough description of speed-related changes in the gait pattern of rhesus and shed light on the control of bipedal locomotion in primates.

Gait six month and one-year after computer assisted Femur First THR vs. conventional THR. Results of a patient- and observer- blinded randomized controlled trial

A prospective randomized controlled trial is presented that is used to compare gait performance between the computer assisted Femur First (CAS FF) operation method and conventional THR (CON). 60 patients underwent a 3D gait analysis of the lower extremity at pre-operative, 6 months post-operative and twelve months post-operative. Detailed verification experiments were facilitated to ensure the quality of data as well as to avoid over-interpreting of the data. The results confirm a similar data-quality as reported in the literature. Walking speed, range of motion and symmetry thereof improved over the follow-up period, without significant differences between the groups. While all parameters do significantly increase over the follow-up period for both groups, there were no significant differences between them at any given time-point. Patients undergoing CAS FF showed a trend to improved hip flexion angle indicating a possible long-term benefit.

From normal to fast walking: Impact of cadence and stride length on lower extremity joint moments

This study aimed to clarify the influence of various speeding strategies (i.e. adjustments of cadence and stride length) on external joint moments. This study investigated the gait of 52 healthy subjects who performed self-selected normal and fast speed walking trials in a motion analysis laboratory. Subjects were classified into three separate groups based on how they increased their speed from normal to fast walking: (i) subjects who increased their cadence, (ii) subjects who increased their stride length and (iii) subjects who simultaneously increased both stride length and cadence. Joint moments were calculated using inverse dynamics and then compared between normal and fast speed trials within and between three groups using spatial parameter mapping. Individuals who increased cadence, but not stride length, to walk faster did not experience a significant increase in the lower limb joint moments. Conversely, subjects who increased their stride length or both stride length and cadence, experienced a significant increase in all joint moments. Additionally, our findings revealed that increasing the stride length had a higher impact on joint moments in the sagittal plane than those in the frontal plane. However, both sagittal and frontal plane moments were still more responsive to the gait speed change than transverse plane moments. This study suggests that the role of speed in altering the joint moment patterns depends on the individual's speed-regulating strategy, i.e. an increase in cadence or stride length. Since the confounding effect of walking speed is a major consideration in human gait research, future studies may investigate whether stride length is the confounding variable of interest.

Does muscle coactivation influence joint excursions during gait in children with and without hemiplegic cerebral palsy? Relationship between muscle coactivation and joint kinematics

BACKGROUND

The theoretical role of muscle coactivation is to stiffen joints. The aim of this study was to assess the relationship between muscle coactivation and joint excursions during gait in children with and without hemiplegic cerebral palsy.

METHODS

Twelve children with hemiplegic cerebral palsy and twelve typically developing children underwent gait analysis at three different gait speeds. Sagittal hip, knee, and ankle kinematics were divided into their main components corresponding to joint excursions. A coactivation index was calculated for each excursion from the electromyographic envelopes of the rectus femoris/semitendinosus, vastus medialis/semitendinosus, or tibialis anterior/soleus muscles. Mixed linear analyses of covariance modeled joint excursions as a function of the coactivation index and limb.

FINDINGS

In typically developing children, increased coactivation was associated with reduced joint excursion for 8 of the 14 linear models (hip flexion, knee loading, knee extension in stance, knee flexion in swing, ankle plantarflexion from initial contact to foot-flat, ankle dorsiflexion in stance and in swing). Conversely, ankle plantarflexion excursion at push-off increased with increasing tibialis anterior/soleus coactivation. In the involved limbs of the children with cerebral palsy, knee loading, ankle plantarflexion at push off, and ankle dorsiflexion in swing decreased, while hip extension increased, with increasing muscle coactivation.

INTERPRETATION

The relationships between muscle coactivation and joint excursion were not equally distributed in both groups, and predominant in typically developing children. The results suggest that excessive muscle coactivation is not a cause of stiff-knee gait in children with hemiplegic cerebral palsy, but appears to be related to spastic drop foot.

Effect of walking speed on gait sub phase durations

Gait phase durations are important spatiotemporal parameters in different contexts such as discrimination between healthy and pathological gait and monitoring of treatment outcomes after interventions. Although gait phases strongly depend on walking speed, the influence of different speeds has rarely been investigated in literature. In this work, we examined the durations of the stance sub phases and the swing phase for 12 different walking speeds ranging from 0.6 to 1.7 m/s in 21 healthy subjects using infrared cinematography and an instrumented treadmill. We separated the stance phase into loading response, mid stance, terminal stance and pre-swing phase and we performed regression modeling of all phase durations with speed to determine general trends. With an increasing speed of 0.1m/s, stance duration decreased while swing duration increased by 0.3%. All distinct stance sub phases changed significantly with speed. These findings suggest the importance of including all distinct gait sub phases in spatiotemporal analyses, especially when different walking speeds are involved.

Gait parameters database for young children: The influences of age and walking speed

BACKGROUND

Reference databases are mandatory in orthopaedics because they enable the detection of gait abnormalities in patients. Such databases rarely include data on children under seven years of age. In young children, gait is principally influenced by age and walking speed. The influence of the age-speed interaction has not been well established. Therefore, the objective of the present study is to propose normative values for biomechanical gait parameters in children taking into account age, walking speed, and the age-speed interaction.

METHODS

Gait analyses were performed on 106 healthy children over a large age range (between one and seven years of age) during gait trials at a self-selected speed. From these gait cycles, biomechanical parameters, such as the joint angles and joint power of the lower limbs, were computed. Specific peak values and the times of occurrence of each biomechanical gait parameter were identified. Linear regressions are proposed for studying the influence of age, walking speed and the age-speed interaction.

FINDINGS

Most of the regressions achieved good accuracy in fitting the curve peaks and times of occurrence, and the normal reference targets of biomechanical parameters could be deduced from these regressions. The biomechanical gait parameters of a pathological case were plotted against the normal reference targets to illustrate the relevance of the proposed targeting method.

INTERPRETATION

The normal reference targets for biomechanical gait parameters based on age-speed regressions in a large database might help clinicians detect gait abnormalities in children from one to seven years of age.

Walking dynamic similarity induced by a combination of Froude and Strouhal dimensionless numbers: Modela-w

The aim of this study was to assess the accuracy of a new dimensionless number associating Froude (Nfr) and Strouhal (Str) called Modela-w to induce walking dynamic similarity among humans of different sizes. Nineteen subjects walked in three experimental conditions: (i) constant speed, (ii) similar speed (Nfr) and (iii) similar speed and similar step frequency (Modela-w). The dynamic similarity was evaluated from scale factors computed with anthropometric, temporal, kinematic and kinetic data and from the decrease of the variability of the parameters expressed in their dimensionless form. Over a total of 36 dynamic parameters, dynamic similarity from scale factors was met for 11 (mean r = 0.51), 22 (mean r = 0.52) and 30 (mean r = 0.69) parameters in the first, the second and the third experimental conditions, respectively. Modela-w also reduced the variability of the dimensionless preceding parameters compared to the other experimental conditions. This study shows that the combination of Nfr and Str called Modela-w ensures dynamic similarity between different-sized subjects and allows scientists to impose similar experimental conditions removing all anthropometric effects.

The use of regression and normalisation for the comparison of spatio-temporal gait data in children

Spatio-temporal parameters (STPs) are fundamental gait measures often used to compare children of different ages or gait ability. In the first case, non-dimensional normalisation (ND) of STPs using either leg-length or height is frequently conducted even though the process may not remove known inter-subject variability. STPs of children with and without disability can be compared through matched databases or using regression driven prediction. Unfortunately, database assignment is largely arbitrary and previous regressions have employed too few parameters to be successful. Therefore, the aims of this study were to test how well actual and ND STPs could be predicted from anthropometrics and speed and to assess if self-selected speed could be predicted from anthropometrics using multivariate regression in a cohort of eighty-nine typically developing children. Equations were validated on an extraneous dataset. We found that equations for actual step length, stride length, and cadence explained more than 84% of the variance compared to their ND counterparts. Moreover, only leg-length ND versions of these parameters were linearly proportional to speed. Prediction of single and double limb support times was weaker (R(2)=0.69 and 0.72, respectively) and we were unable to predict self-selected speed (R(2)<0.16) suggesting the use of anthropometrics is inappropriate for this purpose. Validation was successful for most STPs except in children lying near or outside the normal ranges and for gait speed. Clinically, regression could be used to quantify the difference between a patient's actual and theoretical STPs, allowing for monitoring of progress pre- and post intervention.

The effects of foot geometric properties on the gait of planar bipeds walking under HZD-based control

It has been hypothesized by many that foot design can influence gait. This idea was investigated in both simulation and hardware for the five-link, planar biped ERNIE controlled under the Hybrid Zero Dynamics paradigm. The effects of walking speed, foot radius, and foot center of curvature location on gait efficiency and kinematics were investigated in a full factorial study of gaits optimized using a work-based objective function. In most cases, the simulation correctly predicted the trends observed in hardware, indicating that simulation can be used for foot design. As expected, increasing walking speed decreased the energetic efficiency. The dominant effect of speed on joint kinematics was to alter the timing of the peak hip flexion. Increasing foot radius up to the length of the shank improved the energetic efficiency and increased the range of motion of the hip and knee joints. Shifting the foot center of curvature location forward altered the energetic efficiency in a manner that interacted with changes in foot radius. The energetically optimal foot center of curvature location was coincident with the shank for a large foot radius and shifted far in front of the shank for a small foot radius. In all cases, the forward shift increased the range of motion of the hip and knee joints. Therefore, a robot designer can achieve similar energetic benefits across a range of speeds with either a larger radius foot or a smaller radius foot whose center of curvature is located forward of the shank.

Speed-dependent reference joint trajectory generation for robotic gait support

For the control of actuated orthoses, or gait rehabilitation robotics, kinematic reference trajectories are often required. These trajectories, consisting of joint angles, angular velocities and accelerations, are highly dependent on walking-speed. We present and evaluate a novel method to reconstruct body-height and speed-dependent joint trajectories. First, we collected gait kinematics in fifteen healthy (middle) aged subjects (47-68), at a wide range of walking-speeds (0.5-5 kph). For each joint trajectory multiple key-events were selected (among which its extremes). Second, we derived regression-models that predict the timing, angle, angular velocity and acceleration for each key-event, based on walking-speed and the subject׳s body-height. Finally, quintic splines were fitted between the predicted key-events to reconstruct a full gait cycle. Regression-models were obtained for hip ab-/adduction, hip flexion/extension, knee flexion/extension and ankle plantar-/dorsiflexion. Results showed that the majority of the key-events were dependent on walking-speed, both in terms of timing and amplitude, whereas the body-height had less effect. The reconstructed trajectories matched the measured trajectories very well, in terms of angle, angular velocity and acceleration. For the angles the RMSE between the reconstructed and measured trajectories was 2.6°. The mean correlation coefficient between the reconstructed and measured angular trajectories was 0.91. The method and the data presented in this paper can be used to generate speed-dependent gait patterns. These patterns can be used for the control of several robotic gait applications. Alternatively they can assist the assessment of pathological gait, where they can serve as a reference for "normal" gait.

Walking speed related joint kinetic alterations in trans-tibial amputees: impact of hydraulic 'ankle' damping

BACKGROUND

Passive prosthetic devices are set up to provide optimal function at customary walking speed and thus may function less effectively at other speeds. This partly explains why joint kinetic adaptations become more apparent in lower-limb amputees when walking at speeds other than customary. The present study determined whether a trans-tibial prosthesis incorporating a dynamic-response foot that was attached to the shank via an articulating hydraulic device (hyA-F) lessened speed-related adaptations in joint kinetics compared to when the foot was attached via a rigid, non-articulating attachment (rigF).

METHODS

Eight active unilateral trans-tibial amputees completed walking trials at their customary walking speed, and at speeds they deemed to be slow-comfortable and fast-comfortable whilst using each type of foot attachment. Moments and powers at the distal end of the prosthetic shank and at the intact joints of both limbs were compared between attachment conditions.

RESULTS

There was no change in the amount of intact-limb ankle work across speed or attachment conditions. As speed level increased there was an increase on both limbs in the amount of hip and knee joint work done, and increases on the prosthetic side were greater when using the hyA-F. However, because all walking speed levels were higher when using the hyA-F, the intact-limb ankle and combined joints work per meter travelled were significantly lower; particularly so at the customary speed level. This was the case despite the hyA-F dissipating more energy during stance. In addition, the amount of eccentric work done per meter travelled became increased at the residual knee when using the hyA-F, with increases again greatest at customary speed.

CONCLUSIONS

Findings indicate that a trans-tibial prosthesis incorporating a dynamic-response foot reduced speed-related changes in compensatory intact-limb joint kinetics when the foot was attached via an articulating hydraulic device compared to rigid attachment. As differences between attachment conditions were greatest at customary speed, findings indicate a hydraulic ankle-foot device is most effectual at the speed it is set-up for.

Age-related changes in spatiotemporal characteristics of gait accompany ongoing lower limb linear growth in late childhood and early adolescence

Walking gait is generally held to reach maturity, including walking at adult-like velocities, by 7-8 years of age. Lower limb length, however, is a major determinant of gait, and continues to increase until 13-15 years of age. This study used a sample from the Fels Longitudinal Study (ages 8-30 years) to test the hypothesis that walking with adult-like velocity on immature lower limbs results in the retention of immature gait characteristics during late childhood and early adolescence. There was no relationship between walking velocity and age in this sample, whereas the lower limb continued to grow, reaching maturity at 13.2 years in females and 15.6 years in males. Piecewise linear mixed models regression analysis revealed significant age-related trends in normalized cadence, initial double support time, single support time, base of support, and normalized step length in both sexes. Each trend reached its own, variable-specific age at maturity, after which the gait variables' relationships with age reached plateaus and did not differ significantly from zero. Offsets in ages at maturity occurred among the gait variables, and between the gait variables and lower limb length. The sexes also differed in their patterns of maturation. Generally, however, immature walkers of both sexes took more frequent and relatively longer steps than did mature walkers. These results support the hypothesis that maturational changes in gait accompany ongoing lower limb growth, with implications for diagnosing, preventing, and treating movement-related disorders and injuries during late childhood and early adolescence.

Hearing loss and gait speed among older adults in the United States

BACKGROUND

Previous studies have suggested that hearing loss, which is highly prevalent but undertreated in older adults, may be associated with gait and physical functioning. Determining if hearing loss is independently associated with gait speed is critical toward understanding whether hearing rehabilitative interventions could help mitigate declines in physical functioning in older adults.

METHODS

We analyzed cross-sectional data from the 1999 to 2002 cycles of the National Health and Nutritional Examination Survey during which participants 50-69 years (n=1180) underwent hearing and gait speed assessments. Hearing was defined by a pure tone average of hearing thresholds at 0.5-4kHz tones in the better-hearing ear. Gait speed was obtained in a timed 20-ft (6.1m) walk. Linear and logistic regression models were used to examine the association between hearing loss and gait speed while adjusting for demographic and cardiovascular risk factors. Analyses incorporated sampling weights to yield results generalizable to the U.S. population.

RESULTS

In a model adjusted for demographic and cardiovascular risk factors, a hearing loss was associated with slower gait speed (-0.05m/s per 25dB of hearing loss [95% CI: -0.09 to -0.02]) and an increased odds of having a gait speed <1.0m/s (OR=2.0 per 25dB of hearing loss, 95% CI: 1.2-3.3). The reduction in gait speed associated with a 25dB hearing loss was equivalent to that associated with an age difference of approximately 12 years.

CONCLUSIONS

Greater hearing loss is independently associated with slower gait speed. Further studies investigating the mechanistic basis of this association and whether hearing rehabilitative interventions could affect gait and physical functioning are needed.

Variables associated with level of disability in working individuals with nonacute low back pain: a cross-sectional investigation

STUDY DESIGN

Single-site, exploratory, cross-sectional design.

OBJECTIVE

To identify variables associated with disability related to low back pain (LBP), as measured by the modified Oswestry Low Back Pain Disability Questionnaire (mOSW), in a sample of working adults with nonacute LBP.

BACKGROUND

Compared to acute LBP, there is little information available in the literature to identify variables associated with LBP-related disability in working individuals with stage 2 and stage 3 LBP.

METHODS

Data analyzed were from working individuals with nonacute LBP (n = 235). The response variable was dichotomized by mOSW score (less than 20 or 20 or greater), and the regressor variables included 27 self-report, sociodemographic, impairment-based, and kinematic measures used to assess individuals with LBP. Logistic regression was used to identify variables associated with mOSW.

RESULTS

One hundred eleven subjects had a mOSW score of 20 or greater, and 124 subjects had a mOSW score of less than 20. Logistic regression analysis identified 4 variables associated with LBP-related disability (mOSW): duration of LBP (P = .006), numeric pain rating (P<.0001), Fear-Avoidance Beliefs Questionnaire physical activity subscale (P = .0007), and limits of stability movement velocity in the forward direction (P = .02). The best model had an R2(u) of 0.25.

CONCLUSION

The odds of LBP-related disability (mOSW) in this sample of nonacute working individuals were found to increase with longer duration of LBP, higher numeric pain rating scores, higher Fear-Avoidance Beliefs Questionnaire physical activity subscale scores, and slower limits of stability movement velocity in the forward direction. The identification of limits of stability movement velocity is a novel finding that may support a link between sensorimotor balance deficits and disability in working individuals with nonacute LBP.

A novel walking speed estimation scheme and its application to treadmill control for gait rehabilitation

Background

Virtual reality (VR) technology along with treadmill training (TT) can effectively provide goal-oriented practice and promote improved motor learning in patients with neurological disorders. Moreover, the VR + TT scheme may enhance cognitive engagement for more effective gait rehabilitation and greater transfer to over ground walking. For this purpose, we developed an individualized treadmill controller with a novel speed estimation scheme using swing foot velocity, which can enable user-driven treadmill walking (UDW) to more closely simulate over ground walking (OGW) during treadmill training. OGW involves a cyclic acceleration-deceleration profile of pelvic velocity that contrasts with typical treadmill-driven walking (TDW), which constrains a person to walk at a preset constant speed. In this study, we investigated the effects of the proposed speed adaptation controller by analyzing the gait kinematics of UDW and TDW, which were compared to those of OGW at three pre-determined velocities.

Methods

Ten healthy subjects were asked to walk in each mode (TDW, UDW, and OGW) at three pre-determined speeds (0.5 m/s, 1.0 m/s, and 1.5 m/s) with real time feedback provided through visual displays. Temporal-spatial gait data and 3D pelvic kinematics were analyzed and comparisons were made between UDW on a treadmill, TDW, and OGW.

Results

The observed step length, cadence, and walk ratio defined as the ratio of stride length to cadence were not significantly different between UDW and TDW. Additionally, the average magnitude of pelvic acceleration peak values along the anterior-posterior direction for each step and the associated standard deviations (variability) were not significantly different between the two modalities. The differences between OGW and UDW and TDW were mainly in swing time and cadence, as have been reported previously. Also, step lengths between OGW and TDW were different for 0.5 m/s and 1.5 m/s gait velocities, and walk ratio between OGS and UDW was different for 1.0 m/s gait velocities.

Conclusions

Our treadmill control scheme implements similar gait biomechanics of TDW, which has been used for repetitive gait training in a small and constrained space as well as controlled and safe environments. These results reveal that users can walk as stably during UDW as TDW and employ similar strategies to maintain walking speed in both UDW and TDW. Furthermore, since UDW can allow a user to actively participate in the virtual reality (VR) applications with variable walking velocity, it can induce more cognitive activities during the training with VR, which may enhance motor learning effects.

The effects of low arched feet on lower limb gait kinematics in children

BACKGROUND

The effects of foot posture on the dynamic function of the lower limb during gait remains relatively unknown.

OBJECTIVES

The purpose of this study was to investigate lower limb kinematics between the normal and low arched foot during the gait cycle, particularly in the transverse plane.

METHOD

Twenty-four children, twelve with normal and twelve with low arched feet, aged 11-12 years underwent a lower limb three dimensional gait analysis. Temporo-spatial parameters and patterns and ranges of motion of kinematic data were examined for the pelvis, hip, knee and ankle throughout the gait cycle.

RESULTS

Overall, there were very few differences found in the kinematics of the lower limbs between the normal and low arched group. Increased external hip rotation (6-7°) in the low arched group was the only bilateral significant difference (p<0.05) between the two foot groups. No significant differences existed in any temporo-spatial parameters between the two groups.

CONCLUSIONS

The increased external hip rotation and greater external foot progression angle in the low arched foot highlights the need to examine gait comprehensively to establish cause or effect of these differences observed and hence determine appropriate treatment.

Is age or speed the predominant factor in the development of trunk movement in normally developing children?

BACKGROUND

Gait analysis is an increasingly used tool in the evaluation of neurological or orthopaedic problems in children. A good insight into age-related changes in normal paediatric gait is necessary to evaluate gait inefficiency caused by pathological walking patterns in children. However, no systematic evaluation of the normal development of trunk movement has yet been made.

METHODS

Data of n=85 healthy children were available. They were asked to walk at self selected speed. The gait data were measured with the Vicon Plug-In-Gait model, including the trunk. We assessed gait cycles of thorax, spine and pelvis in the sagittal, frontal and transverse plane, respectively, stratified by age (categories: <4, 4-6, 7-9, 10-12 and 13-16 years) as well as by normalized speed (≤ 0.40, 0.41-0.49, ≥ 0.50).

RESULTS

The sagittal thorax and spine movement was found to be gradually and significantly associated with age, but less so with speed, indicating that, with increasing age, children tend to lean their trunk forward relative to both the global co-ordinate system and the pelvis. In contrast, the frontal and transverse parameters of spine and pelvic movement seemed to depend mainly on speed, not age.

CONCLUSION

Our study shows that age dependency has to be considered with respect to sagittal thorax and spine movements. This finding might be of great importance with respect to the identification of pathological patterns in trunk movement.

THE EFFECT OF LOAD CARRIAGE AMONG PRIMARY SCHOOL BOYS: A PRELIMINARY STUDY

Backpack carrying is a considerable daily "occupational" load among schoolchildren. Most of the research on children's backpacks have focused on gait pattern and trunk forward lean; only a few researches have investigated the impact of backpack carrying on children using the measurements of static posture and gait kinetics. This study investigated the changes in ground reaction force (GRF) and trunk inclination among primary students when carrying heavy backpacks. A randomized controlled experimental study was conducted on seven boys aged between 9 and 11 years old with a similar body mass index. Observations were done when the boys were carrying school bags of 0% (as control), 10%, 15%, and 20% of their own body weight while walking normally. Data acquisition was carried out using force platforms and a 3D motion analysis system. A significant difference in GRF at a load of 20% of body weight was found: the vertical GRF increased almost three times when loads increased up to 20% of body weight compared to 10% of body weight. The anterior–posterior GRFs were asymmetrical when loads were increased. When carrying a load of 15% of body weight, all of the seven subjects adopted a compensatory trunk inclination. The emphasis on GRF and trunk inclination suggests that the safest load applied does not exceed 15% of body weight.

A multiple-task gait analysis approach: kinematic, kinetic and EMG reference data for healthy young and adult subjects

Standard clinical gait analysis protocols usually limit to test self-selected speed gait: this approach is generally valid and permits time and cost saving. Yet, the literature evidences suggest that some pathologies (especially at onset or subclinical level) may not primarily affect plain gait, but more demanding locomotor tasks. In the present study we therefore propose a multiple-task gait analysis protocol including: self-selected, increased and decreased speed gait; walking on toes; walking on heels; step ascending and step descending, and apply it to 40 healthy subjects (20 aged 6-17, 20 aged 22-72) thus building extensive reference data set. Published studies already report normative data for some of these tasks, but inhomogeneously (due to different collecting methods and biomechanical models, population characteristics, nature of data). We verify a good correlation between our results and those presented by Schwartz et al. (2008) [12] in their study providing extensive data on the effect of walking speed on the gait of healthy children. In discussing the results, the rationale and effectiveness of each task is confirmed, and we supply an electronic addendum with comprehensive kinematic, kinetic and electromyographic normative data for the considered population, along with a set of reference parameters and related statistical analysis, as a premise for further applications on pathological subjects.

The characterisation of gait patterns of people with multiple sclerosis

BACKGROUND

There are relatively few reports describing gait patterns in multiple sclerosis (MS) and most are confined to the analysis of temporal distance parameters with some assessment of joint range of motion. The aim of this study was to perform a biomechanical characterisation of gait patterns among people with MS across a wide range of severity of ambulatory impairment.

METHODS

Sixteen patients with MS were recruited for this study. Initially, the spasticity of lower limb muscle groups was measured and ambulatory ability was graded. Patients were then placed in two groups based on the level of severity of ambulatory ability. Kinematic, kinetic and EMG gait data from both MS groups were then compared to a control group of 10 healthy subjects.

RESULTS

Patients with MS in both groups were found to walk with reduced gait speed, reduced maximum hip and knee extension, ankle plantarflexion angle and propulsive force compared to the control group. In general, the same gait impairments were found in both MS groups compared to the control group, and were greater for the more severely affected MS patient group.

INTERPRETATION

This study highlights typical gait patterns of people with MS and provides an indication of common pathways in the degeneration of ambulatory ability as a consequence of disease progression. This information should enable improved clinical treatment of ambulation, as well as the prescription, or even design, of appropriate assistive devices.

Predição da força de reação do solo durante a corrida na água

Este estudo visou desenvolver um modelo para a predição da força de reação do solo na corrida subaquática. Participaram 20 sujeitos (9 homens e 11 mulheres), que realizaram corrida subaquática em dois níveis de imersão e três velocidades. Para cada sujeito foram coletadas seis passagens válidas em cada condição, com a utilização de uma plataforma subaquática de força. O modelo para predição da força foi construído por regressão linear múltipla. Foram consideradas variáveis dependentes a componente vertical e a componente ântero-posterior da força de reação do solo. As variáveis imersão, sexo, velocidade, massa corporal, densidade corporal e percentual de gordura foram consideradas independentes. Permaneceu no modelo final de regressão para a componente vertical a velocidade (p<0,001), enquanto no modelo da componente ântero-posterior permaneceram a velocidade, a imersão e a massa corporal (todas com p<0,001). O modelo preditivo para a componente ântero-posterior da força de reação do solo pode ser considerado satisfatório (o coeficiente de determinação ajustado foi 0,79). Entretanto, o modelo para a componente vertical não pode ser recomendado para a predição dessa variável durante a corrida na água (coeficiente encontrado 0,18). Ressalva-se que o modelo preditivo criado aplica-se a sujeitos com características semelhantes (idade e medidas antropométricas) às dos participantes do estudo.

Comparison of functional regression and nonfunctional regression approaches to the study of the walking velocity effect in force platform measures

The effect of walking velocity on force platform measures is examined by means of functional regression and nonfunctional regression analyses. The two techniques are compared using a data set of ground reaction forces. Functional data analysis avoids the need to identify significant points, and provides more information along the waveform.

Contributions of muscles and passive dynamics to swing initiation over a range of walking speeds

Stiff-knee gait is a common walking problem in cerebral palsy characterized by insufficient knee flexion during swing. To identify factors that may limit knee flexion in swing, it is necessary to understand how unimpaired subjects successfully coordinate muscles and passive dynamics (gravity and velocity-related forces) to accelerate the knee into flexion during double support, a critical phase just prior to swing that establishes the conditions for achieving sufficient knee flexion during swing. It is also necessary to understand how contributions to swing initiation change with walking speed, since patients with stiff-knee gait often walk slowly. We analyzed muscle-driven dynamic simulations of eight unimpaired subjects walking at four speeds to quantify the contributions of muscles, gravity, and velocity-related forces (i.e. Coriolis and centrifugal forces) to preswing knee flexion acceleration during double support at each speed. Analysis of the simulations revealed contributions from muscles and passive dynamics varied systematically with walking speed. Preswing knee flexion acceleration was achieved primarily by hip flexor muscles on the preswing leg with assistance from biceps femoris short head. Hip flexors on the preswing leg were primarily responsible for the increase in preswing knee flexion acceleration during double support with faster walking speed. The hip extensors and abductors on the contralateral leg and velocity-related forces opposed preswing knee flexion acceleration during double support.

The Effects of Walking Speed on Multisegment Foot Kinematics in Adults

Multisegment foot models provide researchers more-detailed information regarding foot mechanics compared with single rigid body foot models. Previous work has shown that walking speed significantly affects sagittal plane ankle motion. It is important to distinguish changes in intersegment foot mechanics following treatment that are due to clinical intervention versus those due to walking speed alone. Foot and ankle kinematics were collected on 24 adults walking at 5 speeds. Significant differences were seen at the ankle using a single rigid body foot model, as well as at the hindfoot and forefoot using a multisegment foot model, with all motions exhibiting a shift toward plantar flexion and decreased stance time with increasing speed. When evaluating foot mechanics using a multisegment foot model across groups or conducting intrasubject comparison over time/treatments, it is imperative that walking speed be accounted for or controlled.

A normative sample of gait and hopping on one leg parameters in children 7-12 years of age

BACKGROUND

Accomplishment of a series of successive hops is an advanced motor skill and requires adequate timing and coordination. Hopping on one leg performance might therefore be a more sensitive test with higher discriminatory power than ordinary gait in evaluating motor competence both in healthy and diseased children.

OBJECTIVE

The purpose of the study was to develop a normative sample on walking at a normalized speed of 1.5 m/s and hopping on one leg parameters in children 7-12 years of age, and to evaluate the influence of age and gender on the different parameters.

METHOD

360 girls and boys between 7 and 12 years participated in the study. All data were collected using the GAITRite system. The children were instructed to walk at four different speeds and to hop on either leg with as long serial jumps as possible across the whole walkway.

RESULTS

There was an increase in absolute step length of 15% from 7 to 12 years of age. However, for normalized step length there was no increase. The total increase in absolute and normalized hop length from 7 to 12 years was 64% and 36%, respectively. Multiple regression analysis displayed a significant increase for absolute and normalized hopping length with age.

CONCLUSION

While step length only showed a small increase from 7 to 12 years of age, hop length showed significant increase both in absolute and normalized values. The variability, however, was large, indicating that a normative sample of hop length measurements includes a wide range of values for each age group.