Kinematic coordination in human gait: relation to mechanical energy cost

Analyzing Instantaneous Energy in Bipedal Walking of Baboons: A Model for Exploring the Evolutionary Transition Toward Efficient Bipedalism in Hominins

OBJECTIVE

Non-human primates exhibit bipedal walking with a typical "bent-hip, bent-knee" posture, incurring additional energy costs as shown by studies using electromyography and mechanical analysis. During the evolution of habitual bipedalism in hominins, this mode underwent a gradual refinement, culminating in the genus Homo. To explore energy conservation mechanisms and the influence of kinematics during occasional bipedal walking, we investigated energy dynamics within different body segments in an ontogenetic sample of baboons.

MATERIALS AND METHODS

Kinematic and morphometric data from 17 baboons, including mature and immature individuals, were initially collected at the CNRS Primatology station (France). We calculated the potential and kinetic (rotational and translational) energies of various body segments over 40 strides, followed by a comparison with human data.

RESULTS

Age-related kinematic differences influence energy recovery percentages in baboons, particularly in the shank and trunk segments. While significant differences can be observed between baboons and humans, such as in the trunk, arm, and foot segments, similarities exist in the thigh and shank segments, with the thigh being the primary segment for substantial energy transfer. Unlike humans, baboons lack an optimal speed range for energy recovery.

DISCUSSION

We present a model for energy recovery in flexed bipedal walking. While baboon bipedalism is inefficient in energy recovery, minor trunk motion adjustments could greatly enhance efficiency. These subtle refinements have the potential to increase energy recovery rates, making bipedalism more practical for regular use. From an evolutionary perspective, such improvements would be particularly noteworthy considering other challenging activities like climbing and arboreal quadrupedalism.

Interlimb coordination is not strictly controlled during walking

In human walking, the left and right legs move alternately, half a stride out of phase with each other. Although various parameters, such as stride frequency and length, vary with walking speed, the antiphase relationship remains unchanged. In contrast, during walking in left-right asymmetric situations, the relative phase shifts from the antiphase condition to compensate for the asymmetry. Interlimb coordination is important for adaptive walking and we expect that interlimb coordination is strictly controlled during walking. However, the control mechanism remains unclear. In the present study, we derived a quantity that models the control of interlimb coordination during walking using two coupled oscillators based on the phase reduction theory and Bayesian inference method. The results were not what we expected. Specifically, we found that the relative phase is not actively controlled until the deviation from the antiphase condition exceeds a certain threshold. In other words, the control of interlimb coordination has a dead zone like that in the case of the steering wheel of an automobile. It is conjectured that such forgoing of control enhances energy efficiency and maneuverability. Our discovery of the dead zone in the control of interlimb coordination provides useful insight for understanding gait control in humans.

Heel-to-toe drop effects on biomechanical and muscle synergy responses during uphill walking

Uphill walking is a common task encountered in daily life, with steeper inclines potentially imposing greater biomechanical and neuromuscular demands on the human body. The heel-to-toe drop (HTD) in footwear may influence the biomechanical and neuromuscular pattern of uphill walking; but the impact remains unclear. Adjustments in HTD can modulate biomechanical and neuromuscular patterns, mitigating the demands and optimizing the body's response to different inclinations. We hypothesize that adjustments in HTD can modulate biomechanical and neuromuscular patterns, mitigating the demands and optimizing the body's response to different inclinations. Nineteen healthy men walked on an adjustable slope walkway, with varied inclinations (6°, 12°, 20°) and HTD shoes (10mm, 25mm, 40 mm), while the marker positions, ground reaction forces and electromyography data were collected. Our study reveals that gait temporo-spatial parameters are predominantly affected by inclination over HTD. Inclination has a more pronounced effect on kinematic variables, while both inclination and HTD significantly modulate kinetic and muscle synergy parameters. This study demonstrates that an increase in the inclination leads to changes in biomechanical and neuromuscular responses during uphill walking and the adjustment of HTD can modulate these responses during uphill walking. However, the present study suggests that an increased HTD may lead to elevated loads on the knee joint and these adverse effects need more attention.

Human arm redundancy: a new approach for the inverse kinematics problem

The inverse kinematics (IK) problem addresses how both humans and robotic systems coordinate movement to resolve redundancy, as in the case of arm reaching where more degrees of freedom are available at the joint versus hand level. This work focuses on which coordinate frames best represent human movements, enabling the motor system to solve the IK problem in the presence of kinematic redundancies. We used a multi-dimensional sparse source separation method to derive sets of basis (or source) functions for both the task and joint spaces, with joint space represented by either absolute or anatomical joint angles. We assessed the similarities between joint and task sources in each of these joint representations, finding that the time-dependent profiles of the absolute reference frame's sources show greater similarity to corresponding sources in the task space. This result was found to be statistically significant. Our analysis suggests that the nervous system represents multi-joint arm movements using a limited number of basis functions, allowing for simple transformations between task and joint spaces. Additionally, joint space seems to be represented in an absolute reference frame to simplify the IK transformations, given redundancies. Further studies will assess this finding's generalizability and implications for neural control of movement.

Kinematics and mechanical changes with step frequency at different running speeds

PURPOSE

Running at a given speed can be achieved by taking large steps at a low frequency or on the contrary by taking small steps at a high frequency. The consequences of a change in step frequency, at a fixed speed, affects the stiffness of the lower limb differently. In this study, we compared the running mechanics and kinematics at different imposed step frequencies (from 2 step s-1 to 3.6 step s-1) to understand the relationship between kinematic and kinetic parameters.

METHODS

Eight recreational male runners ran on a treadmill at 5 different speeds and 5 different step frequencies. The lower-limb segment motion and the ground reaction forces were recorded. Mechanical powers, general gait parameters, lower-limb movements and coordination were investigated.

RESULTS

At low step frequencies, in order to limit the magnitude of the ground reaction force, the vertical stiffness is reduced and thus runners deviate from an elastic rebound. At high step frequencies, the stiffness is increased and the elastic rebound is optimised in its ability to absorb and restore energy during the contact phase.

CONCLUSION

We studied the consequences of a change in step frequency on the bouncing mechanics of running. We showed that the lower limb stiffness and the intersegmental coordination of the lower-limb segments are affected by running step frequency rather than speed. The runner rather adapts their lower limb stiffness to match a step frequency for a given speed than the opposite.

Gait asymmetry in children with Duchenne muscular dystrophy: evaluated through kinematic synergies and muscle synergies of lower limbs

BACKGROUND

Gait is a complex, whole-body movement that requires the coordinated action of multiple joints and muscles of our musculoskeletal system. In the context of Duchenne muscular dystrophy (DMD), a disease characterized by progressive muscle weakness and joint contractures, previous studies have generally assumed symmetrical behavior of the lower limbs during gait. However, such a symmetric gait pattern of DMD was controversial. One aspect of this is criticized, because most of these studies have primarily focused on univariate variables, rather than on the coordination of multiple body segments and even less investigate gait symmetry under a motor synergy of view.

METHODS

We investigated the gait pattern of 20 patients with DMD, compared to 18 typical developing children (TD) through 3D Gait Analysis. Kinematic and muscle synergies were extracted with principal component analysis (PCA) and non-negative matrix factorization (NNMF), respectively. The synergies extracted from the left and right sides were compared with each other to obtain a symmetry value. In addition, bilateral spatiotemporal variables of gait, such as stride length, percentage of stance and swing phase, step length, and percentage of double support phase, were used for calculating the symmetry index (SI) to evaluate gait symmetry as well.

RESULTS

Compared with the TD group, the DMD group walked with decreased gait velocity (both p < 0.01), stride length (both p < 0.01), and step length (both p < 0.001). No significant difference was found between groups in SI of all spatiotemporal parameters extracted between the left and right lower limbs. In addition, the DMD group exhibited lower kinematic synergy symmetry values compared to the TD group (p < 0.001), while no such significant group difference was observed in symmetry values of muscle synergy.

CONCLUSIONS

The findings of this study suggest that DMD influences, to some extent, the symmetry of synergistic movement of multiple segments of lower limbs, and thus kinematic synergy appears capable of discriminating gait asymmetry in children with DMD when conventional spatiotemporal parameters are unchanged.

Unraveling age-related impairment of the neuromuscular system: exploring biomechanical and neurophysiological perspectives

With extended life expectancy, the quality of life of elders is a priority. Loss of mobility, increased morbidity and risks of falls have dramatic individual and societal impacts. Here we consider the age-related modifications of gait, from a biomechanical and neurophysiological perspective. Among the many factors of frailty involved (e.g., metabolic, hormonal, immunological), loss of muscle strength and neurodegenerative changes inducing slower muscle contraction may play a key role. We highlight that the impact of the multifactorial age-related changes in the neuromuscular systems results in common features of gait in the immature gait of infants and older adults. Besides, we also consider the reversibility of age-related neuromuscular deterioration by, on the one hand, exercise training, and the other hand, novel techniques such as direct spinal stimulation (tsDCS).

Use of planar covariation in lower limb kinematics to characterize adaptations of running after cycling in elite triathletes

Purpose

To characterize alterations of lower limb intersegmental coordination during the acute phase of running after cycling among highly trained triathletes using an analysis of planar covariation.

Methods

Nine highly trained triathletes completed a control run (CR) and a run after transitioning from cycling exercise (transition run, or TR condition) on a motorized treadmill at a self-selected pace. Sagittal plane kinematics were recorded using a 3D Vicon motion capture system. Intersegmental coordination of the thigh, shank and foot segments of the right lower limb and run loop planarity were calculated during running before cycling and at four different times after the end of cycling.

Results

PCA showed a significant within-subject phase shift of the run loop planarity (F = 6.66, P = 0.01). Post hoc analysis showed significance median differences increase for u _3t parameter between CR_SS vs. TR₃₀ (P = 0.01), TR_t1/2 (P = 0.01) and TR_MRT (P = 0.01). No difference for u _3t parameter existed between CR_SS vs. TR_SS.

Conclusion

Prior variable-cadence, moderate intensity cycling has a significant effect on run loop planarity and therefore intersegmental coordination during the acute transition phase among highly trained triathletes. However, alterations to lower limb coordination are corrected by the 3rd minute after the beginning of the post cycle run. We suggest that planar covariation can be used as a more sensitive measure of cycling-induced variations in running to characterize adaptation in elite and importantly, developing athletes.

Age-related differences in gait symmetry obtained from kinematic synergies and muscle synergies of lower limbs during childhood

The age-related changes of gait symmetry in healthy children concerning individual joint and muscle activation data have previously been widely studied. Extending beyond individual joints or muscles, identifying age-related changes in the coordination of multiple joints or muscles (i.e., muscle synergies and kinematic synergies) could capture more closely the underlying mechanisms responsible for gait symmetry development. To evaluate the effect of age on the symmetry of the coordination of multiple joints or muscles during childhood, we measured gait symmetry by kinematic and EMG data in 39 healthy children from 2 years old to 14 years old, divided into three equal age groups: preschool children (G1; 2.0-5.9 years), children (G2; 6.0-9.9 years), pubertal children (G3; 10.0-13.9 years). Participants walked barefoot at a self-selected walking speed during three-dimensional gait analysis (3DGA). Kinematic synergies and muscle synergies were extracted with principal component analysis (PCA) and non-negative matrix factorization (NNMF), respectively. The synergies extracted from the left and right sides were compared with each other to obtain a symmetry value. Statistical analysis was performed to examine intergroup differences. The results showed that the effect of age was significant on the symmetry values extracted by kinematic synergies, while older children exhibited higher kinematic synergy symmetry values compared to the younger group. However, no significant age-related changes in symmetry values of muscle synergy were observed. It is suggested that kinematic synergy of lower joints can be asymmetric at the onset of independent walking and showed improving symmetry with increasing age, whereas the age-related effect on the symmetry of muscle synergies was not demonstrated. These data provide an age-related framework and normative dataset to distinguish age-related differences from pathology in children with neuromotor disorders.

Relation between Step-To-Step Transition Strategies and Walking Pattern in Older Adults

In older adults, two different modes of step-to-step transition have been observed: an anticipated mode when the redirection of the centre of mass of the body (COM) begins before double stance and another when the transition begins during double stance. However, the impact of transition mode on gait kinetics and kinematics has not been investigated. Age and step-to-step-transition-related differences in intersegmental coordination and in the COM trajectory during walking were identified. Fifteen young (24.1 ± 0.7 y.o.) and thirty-six older adults (74.5 ± 5.0 y.o.) walked on a treadmill at 1.11 m s−1 and 1.67 m s−1. Lower-limb motion and ground reaction force were recorded. The COM dynamics were evaluated by measuring the pendulum-like exchange of the COM energies. While all young adults and 21 of the older adults used an anticipated transition, 15 older adults presented a non-anticipated transition. Previously documented changes of intersegmental coordination with age were accentuated in older adults with non-anticipated transition (p < 0.001). Moreover, older adults with non-anticipated transition had a smaller pendulum-like energy exchange than older adults with anticipated transition (p = 0.03). The timing of COM redirection is linked to kinematic and mechanic modification of gait and could potentially be used as a quantitative assessment of age-related decline in gait.

Characterization and Categorization of Various Human Lower Limb Movements Based on Kinematic Synergies

A proper movement categorization reduces the complexity of understanding or reproducing human movements in fields such as physiology, rehabilitation, and robotics, through partitioning a wide variety of human movements into representative sub-motion groups. However, how to establish a categorization (especially a quantitative categorization) for various human lower limb movements is rarely investigated in literature and remains challenging due to the diversity and complexity of the lower limb movements (diverse gait modes and interaction styles with the environment). Here we present a quantitative categorization for the various lower limb movements. To this end, a similarity measure between movements was first built based on limb kinematic synergies that provide a unified and physiologically meaningful framework for evaluating the similarities among different types of movements. Then, a categorization was established via hierarchical cluster analysis for thirty-four lower limb movements, including walking, running, hopping, sitting-down-standing-up, and turning in different environmental conditions. According to the movement similarities, the various movements could be divided into three distinct clusters (cluster 1: walking, running, and sitting-down-standing-up; cluster 2: hopping; cluster 3: turning). In each cluster, cluster-specific movement synergies were required. Besides the uniqueness of each cluster, similarities were also found among part of the synergies employed by these different clusters, perhaps related to common behavioral goals in these clusters. The mix of synergies shared across the clusters and synergies for specific clusters thus suggests the coexistence of the conservation and augmentation of the kinematic synergies underlying the construction of the diverse and complex motor behaviors. Overall, the categorization presented here yields a quantitative and hierarchical representation of the various lower limb movements, which can serve as a basis for the understanding of the formation mechanisms of human locomotion and motor function assessment and reproduction in related fields.

Control of Mammalian Locomotion by Somatosensory Feedback

When animals walk overground, mechanical stimuli activate various receptors located in muscles, joints, and skin. Afferents from these mechanoreceptors project to neuronal networks controlling locomotion in the spinal cord and brain. The dynamic interactions between the control systems at different levels of the neuraxis ensure that locomotion adjusts to its environment and meets task demands. In this article, we describe and discuss the essential contribution of somatosensory feedback to locomotion. We start with a discussion of how biomechanical properties of the body affect somatosensory feedback. We follow with the different types of mechanoreceptors and somatosensory afferents and their activity during locomotion. We then describe central projections to locomotor networks and the modulation of somatosensory feedback during locomotion and its mechanisms. We then discuss experimental approaches and animal models used to investigate the control of locomotion by somatosensory feedback before providing an overview of the different functional roles of somatosensory feedback for locomotion. Lastly, we briefly describe the role of somatosensory feedback in the recovery of locomotion after neurological injury. We highlight the fact that somatosensory feedback is an essential component of a highly integrated system for locomotor control. © 2021 American Physiological Society. Compr Physiol 11:1-71, 2021.

Neuromuscular Age-Related Adjustment of Gait When Moving Upwards and Downwards

Locomotor movements are accommodated to various surface conditions by means of specific locomotor adjustments. This study examined underlying age-related differences in neuromuscular control during level walking and on a positive or negative slope, and during stepping upstairs and downstairs. Ten elderly and eight young adults walked on a treadmill at two different speeds and at three different inclinations (0°, +6°, and −6°). They were also asked to ascend and descend stairs at self-selected speeds. Full body kinematics and surface electromyography of 12 lower-limb muscles were recorded. We compared the intersegmental coordination, muscle activity, and corresponding modifications of spinal motoneuronal output in young and older adults. Despite great similarity between the neuromuscular control of young and older adults, our findings highlight subtle age-related differences in all conditions, potentially reflecting systematic age-related adjustments of the neuromuscular control of locomotion across various support surfaces. The main distinctive feature of walking in older adults is a significantly wider and earlier activation of muscles innervated by the sacral segments. These changes in neuromuscular control are reflected in a reduction or lack of propulsion observed at the end of stance in older adults at different slopes, with the result of a delay in the timing of redirection of the centre-of-mass velocity and of an unanticipated step-to-step transition strategy.

Clarifying the Biomechanical Concept of Coordination Through Comparison With Coordination in Motor Control

Coordination is a multidisciplinary concept in human movement science, particularly in the field of biomechanics and motor control. However, the term is not used synonymously by researchers and has substantially different meanings depending on the studies. Therefore, it is necessary to clarify the meaning of coordination to avoid confusion. The meaning of coordination in motor control from computational and ecological perspectives has been clarified, and the meanings differed between them. However, in biomechanics, each study has defined the meaning of the term and the meanings are diverse, and no study has attempted to bring together the diversity of the meanings of the term. Therefore, the purpose of this study is to provide a summary of the different meanings of coordination across the theoretical landscape and clarify the meaning of coordination in biomechanics. We showed that in biomechanics, coordination generally means the relation between elements that act toward the achievement of a motor task, which we call biomechanical coordination. We also showed that the term coordination used in computational and ecological perspectives has two different meanings, respectively. Each one had some similarities with biomechanical coordination. The findings of this study lead to an accurate understanding of the concept of coordination, which would help researchers formulate their empirical arguments for coordination in a more transparent manner. It would allow for accurate interpretation of data and theory development. By comprehensively providing multiple perspectives on coordination, this study intends to promote coordination studies in biomechanics.

Walking with robot-generated haptic forces in a virtual environment: a new approach to analyze lower limb coordination

Background

Walking with a haptic tensile force applied to the hand in a virtual environment (VE) can induce adaptation effects in both chronic stroke and non-stroke individuals. These effects are reflected in spatiotemporal outcomes such as gait speed. However, the concurrent kinematic changes occurring in bilateral lower limb coordination have yet to be explored.

Methods

Chronic stroke participants were stratified based on overground gait speed into lower functioning (LF < 0.8 m/s, N = 7) and higher functioning (HF ≥ 0.8 m/s, N = 7) subgroups. These subgroups and an age-matched control group (N = 14, CG) walked on a self-paced treadmill in a VE with either robot-generated haptic leash forces delivered to the hand and then released or with an instrumented cane. Walking in both leash (10 and 15 N) and cane conditions were compared to pre-force baseline values to evaluate changes in lower limb coordination outcomes.

Results

All groups showed some kinematic changes in thigh, leg and foot segments when gait speed increased during force and post-force leash as well as cane walking. These changes were also reflected in intersegmental coordination and 3D phase diagrams, which illustrated increased intersegmental trajectory areas (p < 0.05) and angular velocity. These increases could also be observed when the paretic leg transitions from stance to swing phases while walking with the haptic leash. The Sobolev norm values accounted for both angular position and angular velocity, providing a single value for potentially quantifying bilateral (i.e. non-paretic vs paretic) coordination during walking. These values tended to increase (p < 0.05) proportionally for both limbs during force and post-force epochs as gait speed tended to increase.

Conclusions

Individuals with chronic stroke who increased their gait speed when walking with tensile haptic forces and immediately after force removal, also displayed moderate concurrent changes in lower limb intersegmental coordination patterns in terms of angular displacement and velocity. Similar results were also seen with cane walking. Although symmetry was less affected, these findings appear favourable to the functional recovery of gait. Both the use of 3D phase diagrams and assigning Sobolev norm values are potentially effective for detecting and quantifying these coordination changes.

Gait Kinetic and Kinematic Changes in Chronic Low Back Pain Patients and the Effect of Manual Therapy: A Randomized Controlled Trial

Patients with chronic back pain as a result of degenerated disc disease, besides pain, also present with impaired gait. The purpose of the article was to evaluate kinetic and kinematic characteristics during gait analysis in patients with chronic low back pain as a result of degenerated disc disease, before and after the application of physiotherapy, including manual therapy techniques. Seventy-five patients suffering from chronic low back pain were randomly divided into 3 groups of 25 each. Each group received five sessions (one per week) of interventions with the first group receiving manual therapy treatment, the second a sham treatment and the third, classic physiotherapy (stretching exercises, TENS and massage). The effectiveness of each treatment was evaluated using an optoelectronic system for recording and analysis of gait (kinetic and kinematic data). Patients overall showed an impaired gait pattern with a difference in kinetic and kinematic data between the left and the right side. Following the application of the above-named interventions, only the group that received manual therapy showed a tendency towards symmetry between the right and left side. In patients suffering from chronic low back pain as a result of degenerated disc disease, the application of five manual therapy sessions seems to produce a tendency towards symmetry in gait.

Function of the crocodilian anterior cruciate ligaments

The anterior cruciate ligament (ACL) is an important knee stabilizer that prevents the anterior subluxation of the tibia. Extant crocodiles have two ACLs, the ACL major and minor, yet their functional roles are unclear. We here examined in-situ forces within the ACL major and minor in saltwater crocodiles (Crocodylus porosus) with a 6-degree-of-freedom robotic testing system under the following loading conditions: (a) 30 N anterior tibial load at 150°, 120°, and 90° knee extension; (b) 1 Nm internal/external torque at 150° and 120° knee extension; (c) 30 N anterior tibial load +1 Nm internal/external torque at 150° and 120° knee extension. The In-situ force in the ACL minor was significantly higher than that of the ACL major in response to anterior tibial load at 90° knee extension, and anterior tibial load + external torque at both 150° and 120° knee extension. Meanwhile, the force in the ACL major was significantly higher than that of the ACL minor in response to internal torque at 120° knee extension, and anterior tibial load + internal torque at 150° knee extension. The present results showed that the ACL minor and major of saltwater crocodiles have different functions. In response to anterior tibial load + internal/external torques, either of two ACLs reacted to opposing directions of knee rotation. These suggest that two ACLs are essential for walking with long axis rotation of the knee in crocodiles.

Early Development of Locomotor Patterns and Motor Control in Very Young Children at High Risk of Cerebral Palsy, a Longitudinal Case Series

The first years of life might be critical for encouraging independent walking in children with cerebral palsy (CP). We sought to identify mechanisms that may underlie the impaired development of walking in three young children with early brain lesions, at high risk of CP, via comprehensive instrumented longitudinal assessments of locomotor patterns and muscle activation during walking. We followed three children (P1–P3) with early brain lesions, at high risk of CP, during five consecutive gait analysis sessions covering a period of 1 to 2 years, starting before the onset of independent walking, and including the session during the first independent steps. In the course of the study, P1 did not develop CP, P2 was diagnosed with unilateral and P3 with bilateral CP. We monitored the early development of locomotor patterns over time via spatiotemporal gait parameters, intersegmental coordination (estimated via principal component analysis), electromyography activity, and muscle synergies (determined from 11 bilateral muscles via nonnegative matrix factorization). P1 and P2 started to walk independently at the corrected age of 14 and 22 months, respectively. In both of them, spatiotemporal gait parameters, intersegmental coordination, muscle activation patterns, and muscle synergy structure changed from supported to independent walking, although to a lesser extent when unilateral CP was diagnosed (P2), especially for the most affected leg. The child with bilateral CP (P3) did not develop independent walking, and all the parameters did not change over time. Our exploratory longitudinal study revealed differences in maturation of locomotor patterns between children with divergent developmental trajectories. We succeeded in identifying mechanisms that may underlie impaired walking development in very young children at high risk of CP. When verified in larger sample sizes, our approach may be considered a means to improve prognosis and to pinpoint possible targets for early intervention.

Common kinematic synergies of various human locomotor behaviours

Humans show a variety of locomotor behaviours in daily living, varying in locomotor modes and interaction styles with the external environment. However, how this excellent motor ability is formed, whether there are some invariants underlying various locomotor behaviours and simplifying their generation, and what factors contribute to the invariants remain unclear. Here, we find three common kinematic synergies that form the six joint motions of one lower limb during walking, running, hopping and sitting-down-standing-up (movement variance accounted for greater than 90%), through identifying the coordination characteristics of 36 lower limb motor tasks in diverse environments. This finding supports the notion that humans simplify the generation of various motor behaviours through re-using several basic motor modules, rather than developing entirely new modules for each behaviour. Moreover, a potential link is also found between these synergies and the unique biomechanical characteristics of the human musculoskeletal system (muscular-articular connective architecture and bone shape), and the patterns of inter-joint coordination are consistent with the energy-saving mechanism in locomotion by using biarticular muscles as efficient mechanical energy transducers between joints. Altogether, our work helps understand the formation mechanisms of human locomotion from a holistic viewpoint and evokes inspirations for the development of artificial limbs imitating human motor ability.

Coordination between motor and cognitive tasks in dual task gait

BACKGROUND

Dual Task (DT) paradigms are frequently used by researchers and clinicians to examine the integrity of motor processes in many movement disorders. However, the mechanism of this interaction is not fully understood. Therefore, the aim of this study was to examine the within-stride interactions between cognitive and motor processes during dual task gait (DT).

RESEARCH QUESTION

Do healthy young adults coordinate gait with secondary task processing? If so, is cognitive task processing capability associated with the coordination observed?

METHODS

Nineteen healthy young adults walked for two minutes on a motorized treadmill whilst counting backwards in sevens from three-digit numbers. The coordination of calculation verbalizations with gait parameters were assessed across six phases of the gait cycle. Mid verbalization time points (VER_Mid) were used as points of high cognitive processing of the dual task and compared with the end of the verbalizations (VER_End) as points of low cognitive processing.

RESULTS

VER_Mid and VER_End did not systematically occur in any phase of the gait cycle. However, 10/19 and 9/19 participants showed non-random distributions of verbalizations for VER_Mid and VER_End time points respectively (p < 0.01), indicating that these walkers coordinated gait with the cognitive task. Analysis of subgroups of Verbalization Coordinators and Non-Coordinators showed slower verbalization response durations (VRD) for VER_Mid Coordinators compared to VER_Mid Non-Coordinators, indicating that VER_Mid Coordinators found the cognitive tasks more demanding. No differences were found in VRD for VER_End Coordinators and VER_End Non-Coordinators.

SIGNIFICANCE

It was found that cognitive processing is coordinated with gait phases in some but not all healthy young adults during DT gait. When demands on cognitive processes are high, healthy young adults coordinate cognitive processing with phases of gait. Analysis of within-stride coordination may be of use for studying clinical conditions where gait and attentional cognition performance breaks down.

Asymptomatic Genu Recurvatum reshapes lower limb sagittal joint and elevation angles during gait at different speeds

BACKGROUND

Kinematic characteristics of walking with an asymptomatic genu recurvatum are currently unknown. The objective of this study is to characterize the lower limb sagittal joint and elevation angles during walking in participants with asymptomatic genu recurvatum and compare it with control participants without knee deformation at different speeds.

METHODS

The spatio-temporal parameters and kinematics of the lower limb were recorded using an optoelectronic motion capture system in 26 participants (n = 13 with genu recurvatum and n = 13 controls). The participants walked on an instrumented treadmill during five minutes at three different speeds: slow, medium and fast.

RESULTS

Participants with genu recurvatum showed several significant differences with controls: a narrower step width, a greater maximum hip joint extension angle, a greater knee joint extension angle at mid stance, a lower maximum knee joint flexion angle during the swing phase, and a greater ankle joint extension angle at the end of the gait cycle. Participants with genu recurvatum had a greater minimum thigh elevation angle, a greater maximum foot elevation angle, and a change in the orientation of the covariance plane. Walking speed had a significant effect on nearly all lower limb joint and elevation angles, and covariance plane parameters.

CONCLUSION

Our findings show that genu recurvatum reshapes lower limb sagittal joint and elevation angles during walking at different speeds but preserves the covariation of elevation angles along a plane during both stance and swing phases and the rotation of this plane with increasing speed.

Age-related changes in the neuromuscular control of forward and backward locomotion

Previous studies found significant modification in spatiotemporal parameters of backward walking in healthy older adults, but the age-related changes in the neuromuscular control have been considered to a lesser extent. The present study compared the intersegmental coordination, muscle activity and corresponding modifications of spinal montoneuronal output during both forward and backward walking in young and older adults. Ten older and ten young adults walked forward and backward on a treadmill at different speeds. Gait kinematics and EMG activity of 14 unilateral lower-limb muscles were recorded. As compared to young adults, the older ones used shorter steps, a more in-phase shank and foot motion, and the activity profiles of muscles innervated from the sacral segments were significantly wider in each walking condition. These findings highlight age-related changes in the neuromuscular control of both forward and backward walking. A striking feature of backward walking was the differential organization of the spinal output as compared to forward gait. In addition, the resulting spatiotemporal map patterns also characterized age-related changes of gait. Finally, modifications of the intersegmental coordination with aging were greater during backward walking. On the whole, the assessment of backward walk in addition to routine forward walk may help identifying or unmasking neuromuscular adjustments of gait to aging.

A wearable motion capture device able to detect dynamic motion of human limbs

Limb motion capture is essential in human motion-recognition, motor-function assessment and dexterous human-robot interaction for assistive robots. Due to highly dynamic nature of limb activities, conventional inertial methods of limb motion capture suffer from serious drift and instability problems. Here, a motion capture method with integral-free velocity detection is proposed and a wearable device is developed by incorporating micro tri-axis flow sensors with micro tri-axis inertial sensors. The device allows accurate measurement of three-dimensional motion velocity, acceleration, and attitude angle of human limbs in daily activities, strenuous, and prolonged exercises. Additionally, we verify an intra-limb coordination relationship exists between thigh and shank in human walking and running, and establish a neural network model for it. Using the intra-limb coordination model, dynamic motion capture of human lower limbs including thigh and shank is tactfully implemented by a single shank-worn device, which simplifies the capture device and reduces cost. Experiments in strenuous activities and long-time running validate excellent performance and robustness of the wearable device in dynamic motion recognition and reconstruction of human limbs.

Current wearable motion capture technologies are unable to accurately detect dynamic motion of human limbs due to drift and instability problems. Here, the authors report a wearable motion capture device combining tri-axis velocity sensor and inertial sensors for accurate 3D limb motion capture.

Locomotor patterns during obstacle avoidance in children with cerebral palsy

Previous studies mainly evaluated the neuromuscular pattern generation in cerebral palsy (CP) during unobstructed gait. Here we characterized impairments in the obstacle task performance associated with a limited adaptation of the task-relevant muscle module timed to the foot lift during obstacle crossing. Impaired task performance in children with CP may reflect basic developmental deficits in the adaptable control of gait when the locomotor task is superimposed with the voluntary movement.

Emergence of Different Gaits in Infancy: Relationship Between Developing Neural Circuitries and Changing Biomechanics

How does gait-specific pattern generation evolve in early infancy? The idea that neural and biomechanical mechanisms underlying mature walking and running differ to some extent and involve distinct spinal and supraspinal neural circuits is supported by various studies. Here we consider the issue of human gaits from the developmental point of view, from neonate stepping to adult mature gaits. While differentiating features of the walk and run are clearly distinct in adults, the gradual and progressive developmental bifurcation between the different gaits suggests considerable sharing of circuitry. Gaits development and their biomechanical determinants also depend on maturation of the musculoskeletal system. This review outlines the possible overlap in the neural and biomechanical control of walking and running in infancy, supporting the idea that gaits may be built starting from common, likely phylogenetically conserved elements. Bridging connections between movement mechanics and neural control of locomotion could have profound clinical implications for technological solutions to understand better locomotor development and to diagnose early motor deficits. We also consider the neuromuscular maturation time frame of gaits resulting from active practice of locomotion, underlying plasticity of development.

Effects of Nordic Walking on Gait Symmetry in Mild Parkinson’s Disease

Individuals with Parkinson’s disease (PD) have gait asymmetries, and exercise therapy may reduce the differences between more and less affected limbs. The Nordic walking (NW) training may contribute to reducing the asymmetry in upper and lower limb movements in people with PD. We compared the effects of 11 weeks of NW aerobic training on asymmetrical variables of gait in subjects with mild PD. Fourteen subjects with idiopathic PD, age: 66.8 ± 9.6 years, and Hoehn and Yard stage of 1.5 points were enrolled. The kinematic analysis was performed pre and post-intervention. Data were collected at two randomized walking speeds (0.28 m·s−1 and 0.83 m·s−1) during five minutes on the treadmill without poles. The more affected and less affected body side symmetries (threshold at 5% between sides) of angular kinematics and spatiotemporal gait parameters were calculated. We used Generalized Estimating Equations with Bonferroni post hoc (α = 0.05). Maximal flexion of the knee (p = 0.007) and maximal abduction of the hip (p = 0.041) were asymmetrical pre and became symmetrical post NW intervention. The differences occurred in the knee was less affected and the hip was more affected. We concluded that 11 weeks of NW training promoted similarities in gait parameters and improved knee and hip angular parameters for PD subjects.

Closing the Wearable Gap—Part IV: 3D Motion Capture Cameras Versus Soft Robotic Sensors Comparison of Gait Movement Assessment

The purpose of this study was to use 3D motion capture and stretchable soft robotic sensors (SRS) to collect foot-ankle movement on participants performing walking gait cycles on flat and sloped surfaces. The primary aim was to assess differences between 3D motion capture and a new SRS-based wearable solution. Given the complex nature of using a linear solution to accurately quantify the movement of triaxial joints during a dynamic gait movement, 20 participants performing multiple walking trials were measured. The participant gait data was then upscaled (for the SRS), time-aligned (based on right heel strikes), and smoothed using filtering methods. A multivariate linear model was developed to assess goodness-of-fit based on mean absolute error (MAE; 1.54), root mean square error (RMSE; 1.96), and absolute R2 (R2; 0.854). Two and three SRS combinations were evaluated to determine if similar fit scores could be achieved using fewer sensors. Inversion (based on MAE and RMSE) and plantar flexion (based on R2) sensor removal provided second-best fit scores. Given that the scores indicate a high level of fit, with further development, an SRS-based wearable solution has the potential to measure motion during gait- based tasks with the accuracy of a 3D motion capture system.

Data-driven spectral analysis for coordinative structures in periodic human locomotion

Living organisms dynamically and flexibly operate a great number of components. As one of such redundant control mechanisms, low-dimensional coordinative structures among multiple components have been investigated. However, structures extracted from the conventional statistical dimensionality reduction methods do not reflect dynamical properties in principle. Here we regard coordinative structures in biological periodic systems with unknown and redundant dynamics as a nonlinear limit-cycle oscillation, and apply a data-driven operator-theoretic spectral analysis, which obtains dynamical properties of coordinative structures such as frequency and phase from the estimated eigenvalues and eigenfunctions of a composition operator. Using segmental angle series during human walking as an example, we first extracted the coordinative structures based on dynamics; e.g. the speed-independent coordinative structures in the harmonics of gait frequency. Second, we discovered the speed-dependent time-evolving behaviours of the phase by estimating the eigenfunctions via our approach on the conventional low-dimensional structures. We also verified our approach using the double pendulum and walking model simulation data. Our results of locomotion analysis suggest that our approach can be useful to analyse biological periodic phenomena from the perspective of nonlinear dynamical systems.

Variant and Invariant Spatiotemporal Structures in Kinematic Coordination to Regulate Speed During Walking and Running

Humans walk, run, and change their speed in accordance with circumstances. These gaits are rhythmic motions generated by multi-articulated movements, which have specific spatiotemporal patterns. The kinematic characteristics depend on the gait and speed. In this study, we focused on the kinematic coordination of locomotor behavior to clarify the underlying mechanism for the effect of speed on the spatiotemporal kinematic patterns for each gait. In particular, we used seven elevation angles for the whole-body motion and separated the measured data into different phases depending on the foot-contact condition, that is, single-stance phase, double-stance phase, and flight phase, which have different physical constraints during locomotion. We extracted the spatiotemporal kinematic coordination patterns with singular value decomposition and investigated the effect of speed on the coordination patterns. Our results showed that most of the whole-body motion could be explained by only two sets of temporal and spatial coordination patterns in each phase. Furthermore, the temporal coordination patterns were invariant for different speeds, while the spatial coordination patterns varied. These findings will improve our understanding of human adaptation mechanisms to tune locomotor behavior for changing speed.

Effect of walking speed on the intersegmental coordination of lower-limb segments in elderly adults

BACKGROUND

Ageing brings profound changes in walking gait. For example, older adults reduce the modification of pelvic and trunk kinematics with walking speed. However, the modification of the coordination between lower-limb segments with age has never been investigated across various controlled speeds.

RESEARCH QUESTION

Is the effect of speed on the intersegmental coordination different between elderly and young adults?

METHODS

Nineteen senior and eight young adults walked on a treadmill at speeds ranging from 0.56 to 1.94 m s^-1. The motion of the lower-limb segments in the sagittal plane was recorded by cinematography. When the angles of the thigh, shank and foot during a stride are plotted one versus the other, they describe loops constraint on a plane. The coordination between lower-limb segments was thus evaluated by performing a principal component analysis between the thigh, shank and foot elevation angles. The effect of speed and age on the intersegmental coordination was examined using a two-level linear mixed model ANOVA.

RESULTS

In both age groups the orientation of the plane changes with speed, due to a more in-phase shank and foot motion. However, the effect of speed on the covariation plane is lessened with age.

SIGNIFICANCE

Our results demonstrate that there is an age-related specific adjustment of the intersegmental coordination to speed. In particular, older adults restrict their repertoire of angular segment motion. These differences in coordination are mainly related to different foot-shank coordination.

The Rise of Elite Short-Course Triathlon Re-Emphasises the Necessity to Transition Efficiently from Cycling to Running

Transitioning efficiently between cycling and running is considered an indication of overall performance, and as a result the cycle–run (C–R) transition is one of the most researched areas of triathlon. Previous studies have thoroughly investigated the impact of prior cycling on running performance. However, with the increasing number of short-course events and the inclusion of the mixed relay at the 2020 Tokyo Olympics, efficiently transitioning from cycle–run has been re-emphasised and with it, any potential limitations to running performance among elite triathletes. This short communication provides coaches and sports scientists a review of the literature detailing the negative effects of prior variable-cycling on running performance experienced among elite, short-course and Olympic distance triathletes; as well as discussing practical methods to minimise any negative impact of cycling on running performance. The current literature suggests that variable-cycling negatively effects running ability in at least some elite triathletes and that improving swimming performance, drafting during cycling and C–R training at race intensity could improve an athlete’s triathlon running performance. It is recommended that future research clearly define the performance level, competitive format of the experimental population and use protocols that are specific to the experimental population in order to improve the training and practical application of the research findings.

Locomotor coordination in patients with Hereditary Spastic Paraplegia

Locomotion is a complex behaviour that requires the coordination of multiple body segments and muscle groups. Here we investigated how the weakness and spasticity in individuals with Hereditary Spastic Paraplegia (HSP) affect the coordination patterns of the lower limbs. We analysed kinematics and electromyographic (EMG) activity from 12 leg muscles in 21 persons with HSP and 20 control subjects at matched walking speeds. To assess the locomotor coordination, we examined the covariation between thigh, shank and foot elevation angles by means of principal component analysis and the modular organization of EMG patterns using the non-negative matrix factorization algorithm. The characteristic features of the HSP gait consisted in changes of the elevation angles covariation, the shape of the gait loop, reduced range of motion of the distal segments and significantly lower foot lift. The EMG factorization analysis revealed a comparable structure of the motor output between HSP and control groups, but significantly wider basic temporal patterns associated with muscles innervated from the sacral spinal segments in HSP. Overall, the applied methodology highlighted the impact of the corticospinal degeneration and spasticity on the coordination of distal limb segments and basic muscle modules associated with distal spinal segments.

Intersegmental coordination patterns are differently affected in Parkinson's disease and cerebellar ataxia

The law of intersegmental coordination (Borghese et al. 1996) may be altered in pathological conditions. Here we investigated the contribution of the basal ganglia (BG) and the cerebellum to lower limb intersegmental coordination by inspecting the plane's orientation and other parameters pertinent to this law in patients with idiopathic Parkinson's disease (PD) or cerebellar ataxia (CA). We also applied a mathematical model that successfully accounts for the intersegmental law of coordination observed in control subjects (Barliya et al. 2009). In the present study, we compared the planarity index (PI), covariation plane (CVP) orientation, and CVP orientation predicted by the model in 11 PD patients, 8 CA patients, and two groups of healthy subjects matched for age, height, weight, and gender to each patient group (Ctrl_PD and Ctrl_CA). Controls were instructed to alter their gait speed to match those of their respective patient group. PD patients were examined after overnight withdrawal of anti-parkinsonian medications (PD-off-med) and then on medication (PD-on-med). PI was above 96% in all gait conditions in all groups suggesting that the law of intersegmental coordination is preserved in both BG and cerebellar pathology. However, the measured and predicted CVP orientations rotated in PD-on-med and PD-off-med compared with Ctrl_PD and in CA vs. Ctrl_CA. These rotations caused by PD and CA were in opposite directions suggesting differences in the roles of the BG and cerebellum in intersegmental coordination during human locomotion. NEW & NOTEWORTHY Kinematic and muscular synergies may have a role in overcoming motor redundancies, which may be reflected in intersegmental covariation. Basal ganglia and cerebellar networks were suggested to be involved in crafting and modulating synergies. We thus compared intersegmental coordination in Parkinson's disease and cerebellar disease patients and found opposite effects in some aspects. Further research integrating muscle activities as well as biomechanical and neural control modeling are needed to account for these findings.

A kinematic synergy for terrestrial locomotion shared by mammals and birds

Locomotion of tetrapods on land adapted to different environments and needs resulting in a variety of different gait styles. However, comparative analyses reveal common principles of limb movement control. Here, we report that a kinematic synergy involving the planar covariation of limb segment motion holds in 54 different animal species (10 birds and 44 mammals), despite large differences in body size, mass (ranging from 30 g to 4 tonnes), limb configuration, and amplitude of movements. This kinematic synergy lies at the interface between the neural command signals output by locomotor pattern generators, the mechanics of the body center of mass and the external environment, and it may represent one neuromechanical principle conserved in evolution to save mechanical energy.

Animals have evolved very different body shapes and styles of movement that are adapted to their needs in the habitats they live in. For example, mice, lions and many other animals use four limbs to walk, while humans and birds only use two limbs.

The styles animals use to walk also differ in terms of how long each foot is on the ground during a single stride, and for four-legged animals, in how long a forefoot lags behind the hindfoot on the same side of the body during the stride. Yet, there are general principles in how walking is organized that are shared between animals of vastly different shapes and sizes. Many animals save energy during walking by swinging the center of their body mass back and forth like a pendulum.

Networks of neurons are responsible for controlling how and when animals move, and these networks have similar architectures and patterns of activity in many different mammals and birds. How do signals from the nervous system regulate the position of the center of body mass while an animal walks?

Here, Catavitello et al. addressed this question by analyzing how over 50 different species of birds and mammals walked around in zoo enclosures and other semi-natural or natural environments. The species studied ranged in size from mice weighing around 30 grams to elephants weighing around 4 tonnes. The team also studied human volunteers walking on treadmills.

The experiments show that all the species studied coordinate their limbs in the same way, so that the angle to which a particular segment of a limb can bend varies together with the angles that the other limb segments bend. This coordination implies that the movement of the center of body mass is regulated and energy is saved.

Along with providing new insight into how walking evolved, these findings may aid research into new approaches to treat walking impairments in humans and other animals.

Graded forward and backward walking at a matched intensity on cardiorespiratory responses and postural control

BACKGROUND

While several studies compare backward walking (BW) and forward walking (FW) in terms of heart rate (HR) and rating of perceived exertion (RPE), workload (VO₂) was not matched to control for intensity levels (Hooper et al. [1]). Moreover, acute effects of inclined BW on postural control and ankle musculature has not been investigated. This study was designed to compare cardiovascular, metabolic and perceptual responses, changes in center of pressure (COP) motion, and muscle activation of tibialis anterior (TA) and gastrocnemius (GM) to control quiet stance posture immediately following inclined BW and FW at a matched intensity.

METHODS

Seventeen healthy young adults completed three lab sessions 7-14 days apart. Session one, maximal oxygen consumption (VO_2max) was measured using open-circuit spirometry for each participant. Session two, participants performed BW for 15-min. Session three, participants performed FW for 15-min at matched intensity of BW. Surface electromyography (SEMG) measured the muscular activity of the TA and GM during bilateral stance on a force plate for 30 s prior to and immediately following BW and FW under both eyes open (EO), and eyes closed (EC) conditions.

RESULTS

HR, VCO₂, RER and RPE were significantly greater during BW compared to FW. Increased muscle activation and COP motion was elicited immediately following BW compared to FW under EO and EC.

CONCLUSION

Results of this study indicate BW requires greater cardiovascular, metabolic, perceptual and neuromuscular demands than FW, which may cause postural instability particularly to those with compromised balance. While there are benefits to BW in rehabilitation settings, these factors should be considered when prescribing BW for training and/or rehabilitation exercise program (Duffell et al. [2], Warnica et al. [3]).

Effect of walking in footwear with varying heel sole differentials on shank and foot segment kinematics

BACKGROUND

When walking in footwear with a positive "heel sole differential", the sagittal kinematics of the base of the footwear appear to mimic normal barefoot foot kinematics, creating an "effective foot," yet sagittal shank, thigh, and trunk kinematics appear to remain unchanged. These observations have not been quantified.

OBJECTIVES

To quantify these observations by assessing the effect of different heel sole differentials on sagittal shank and foot segment kinematics of able-bodied walking.

STUDY DESIGN

Cross-sectional study.

METHODS

Gait data from 10 nondisabled females were collected while they walked with no-heel (mean heel sole differential = 0 (standard deviation = 0) mm), mid-heel (mean heel sole differential = 37 (standard deviation = 10) mm), and high-heel shoes (mean heel sole differential = 71 (standard deviation = 17) mm) to calculate the shank-to-vertical angle and foot-to-horizontal angle.

RESULTS

There were no significant differences between shoe conditions in stride lengths ( p = 0.056) or shank kinematics between 0% and 50% gait cycle ( p = 0.079). There were significant differences in foot kinematics ( p = 0.000), with foot segment angle increasing with increasing heel sole differential.

CONCLUSION

The ankle joint and actual foot segment adapt their kinematics to maintain consistent shank kinematics. The finding that heel sole differential and foot segment angle can be varied without influencing shank segment kinematics has implications for orthotic and prosthetic practice. Clinical relevance Heel sole differentials of footwear can be varied without implications for shank kinematics, which is relevant for both orthotics and prosthetics. Assessments and interventions with varying heel sole differential footwear may be helpful in patients with short calf muscle or restricted ankle motion who may walk more normally if an appropriate heel sole differential were provided.

Kinematic patterns while walking on a slope at different speeds

During walking, the elevation angles of the thigh, shank, and foot (i.e., the angle between the segment and the vertical) covary along a characteristic loop constrained on a plane. Here, we investigate how the shape of the loop and the orientation of the plane, which reflect the intersegmental coordination, change with the slope of the terrain and the speed of progression. Ten subjects walked on an inclined treadmill at different slopes (between -9° and +9°) and speeds (from 0.56 to 2.22 m/s). A principal component analysis was performed on the covariance matrix of the thigh, shank, and foot elevation angles. At each slope and speed, the variance accounted for by the two principal components was >99%, indicating that the planar covariation is maintained. The two principal components can be associated to the limb orientation (PC1*) and the limb length (PC2*). At low walking speeds, changes in the intersegmental coordination across slopes are characterized mainly by a change in the orientation of the covariation plane and in PC2* and to a lesser extent, by a change in PC1*. As speed increases, changes in the intersegmental coordination across slopes are more related to a change in PC1 *, with limited changes in the orientation of the plane and in PC 2*. Our results show that the kinematic patterns highly depend on both slope and speed. NEW & NOTEWORTHY In this paper, changes in the lower-limb intersegmental coordination during walking with slope and speed are linked to changes in the trajectory of the body center of mass. Modifications in the kinematic pattern with slope depend on speed: at slow speeds, the net vertical displacement of the body during each step is related to changes in limb length and orientation. When speed increases, the vertical displacement is mostly related to a change in limb orientation.

Recovery and compensation after robotic assisted gait training in chronic stroke survivors

Background: Gait re-education is a primary rehabilitation goal after stroke. In the last decades, robots with different mechanical structures have been extensively used in the clinical practice for gait training of stroke survivors. However, the effectiveness of robotic training is still controversial, especially for chronic subjects. In this study, we investigated the short-term effects of gait training assisted by an endpoint robot in a population of chronic stroke survivors.Methods: Subjects were evaluated before and after training with clinical scales and instrumented gait analysis. Our primary outcome indicator was the walking speed. Next, we investigated the changes in kinetic and kinematic gait patterns as well as the intersegmental coordination at the level of the lower limbs.Results: Most subjects improved their speed in over-ground walking, by modifying the temporal more than the spatial gait parameters. These changes led to an improvement in the ankle power for both sides and to a slight reduction of the inclination of the pelvis during the swing phase, mainly due to a decreased knee flexion and an increased hip extension on the unimpaired leg.Conclusions: These results indicate that the proposed training induced mainly a functional change rather than an improvement of the quality of gait.Implication for RehabilitationGait re-education is a primary goal in stroke rehabilitation.Nowadays several robotic devices for gait rehabilitation are used in the clinical practice, but their effectiveness is controversial, especially for chronic survivors.After a 20-session training with an endpoint robot the chronic stroke survivors showed an improvement in overground gait speed.The increased gait speed was mainly due to functional changes of the temporal parameters and of the kinetic variables at the level of both ankle joints, as well as to a reduction of compensatory strategies observable in the unimpaired side.

Intersegmental kinematics coordination in unilateral peripheral and central origin: Effect on gait mechanism?

BACKGROUND

The gait mechanism requires an efficient intersegmental coordination in order to ensure the displacement of the body while simultaneously maintaining the postural stability. However, intersegmental coordination may be disrupted by neurological or orthopaedic involvement, this increasing the metabolic cost associated with excessive or prolonged muscle co-contraction.

RESEARCH QUESTION

Our aim was to evaluate and to understand how hip OA affects lower limbs coordination during gait by using the kinematic segmental covariation law method and predict the energy expenditure.

METHODS

In order to evaluate the influence of unilateral alteration of the lower limbs on the gait mechanism, three groups namely 63 hip osteoarthritis patients, 65 chronic hemiparetic stroke patients and 72 healthy subjects performed an instrumented gait analysis. The subjects had to walk barefoot for at least 3 min at a self-selected speed on a force measuring motor-driven treadmill. The biomechanical variables (kinematic, kinetic and energetical cost) were simultaneously recorded.

RESULTS

The comparison between the three groups was tested using a repeated measure ANOVA. All biomechanical parameters show significant differences between the 3 groups highlighting the gait alteration for the patients groups. However, the energetic cost remains normal in the hip osteoarthritis group despite of the alteration of the other variables. A multivariate analysis allowed to identify the independent variables affecting more specifically their gait mechanisms.

SIGNIFICANCE

This study showed the importance of quantitative functional evaluation in order to better understand the impact of hip osteoarthritis on the gait mechanism. The biomechanical analysis provides objective evidence of the altered gait mechanism and more particularly of the intersegmental coordination in these patients. This gait analysis is therefore an interesting tool in the functional evaluation of the patient to better guide the diagnosis.

Reshaping of Gait Coordination by Robotic Intervention in Myelopathy Patients After Surgery

The Ossification of the Posterior Longitudinal Ligament (OPLL) is an idiopathic degenerative spinal disease which may cause motor deficit. For patients presenting myelopathy or severe stenosis, surgical decompression is the treatment of choice; however, despite adequate decompression residual motor impairment is found in some cases. After surgery, there is no therapeutic approach available for this population. The Hybrid Assistive Limb® (HAL) robot suit is a unique powered exoskeleton designed to predict, support, and enhance the lower extremities performance of patients using their own bioelectric signals. This approach has been used for spinal cord injury and stroke patients where the walking performance improved. However, there is no available data about gait kinematics evaluation after HAL therapy. Here we analyze the effect of HAL therapy in OPLL patients in acute and chronic stages after decompression surgery. We found that HAL therapy improved the walking performance for both groups. Interestingly, kinematics evaluation by the analysis of the elevation angles of the thigh, shank, and foot by using a principal component analysis showed that planar covariation, plane orientation, and movement range evaluation improved for acute patients suggesting an improvement in gait coordination. Being the first study performing kinematics analysis after HAL therapy, our results suggest that HAL improved the gait coordination of acute patients by supporting the relearning process and therefore reshaping their gait pattern.

Human Locomotion in Hypogravity: From Basic Research to Clinical Applications

We have considerable knowledge about the mechanisms underlying compensation of Earth gravity during locomotion, a knowledge obtained from physiological, biomechanical, modeling, developmental, comparative, and paleoanthropological studies. By contrast, we know much less about locomotion and movement in general under sustained hypogravity. This lack of information poses a serious problem for human space exploration. In a near future humans will walk again on the Moon and for the first time on Mars. It would be important to predict how they will move around, since we know that locomotion and mobility in general may be jeopardized in hypogravity, especially when landing after a prolonged weightlessness of the space flight. The combination of muscle weakness, of wearing a cumbersome spacesuit, and of maladaptive patterns of locomotion in hypogravity significantly increase the risk of falls and injuries. Much of what we currently know about locomotion in hypogravity derives from the video archives of the Apollo missions on the Moon, the experiments performed with parabolic flight or with body weight support on Earth, and the theoretical models. These are the topics of our review, along with the issue of the application of simulated hypogravity in rehabilitation to help patients with deambulation problems. We consider several issues that are common to the field of space science and clinical rehabilitation: the general principles governing locomotion in hypogravity, the methods used to reduce gravity effects on locomotion, the extent to which the resulting behavior is comparable across different methods, the important non-linearities of several locomotor parameters as a function of the gravity reduction, the need to use multiple methods to obtain reliable results, and the need to tailor the methods individually based on the physiology and medical history of each person.

Knee Motion Generation Method for Transfemoral Prosthesis Based on Kinematic Synergy and Inertial Motion

Previous research has shown that the effective use of inertial motion (i.e., less or no torque input at the knee joint) plays an important role in achieving a smooth gait of transfemoral prostheses in the swing phase. In our previous research, a method for generating a timed knee trajectory close to able-bodied individuals, which leads to sufficient clearance between the foot and the floor and the knee extension, was proposed using the inertial motion. Limb motions are known to correlate with each other during walking. This phenomenon is called kinematic synergy. In this paper, we measure gaits in level walking of able-bodied individuals with a wide range of walking velocities. We show that this kinematic synergy also exists between the motions of the intact limbs and those of the knee as determined by the inertial motion technique. We then propose a new method for generating the motion of the knee joint using its inertial motion close to the able-bodied individuals in mid-swing based on its kinematic synergy, such that the method can adapt to the changes in the motion velocity. The numerical simulation results show that the proposed method achieves prosthetic walking similar to that of able-bodied individuals with a wide range of constant walking velocities and termination of walking from steady-state walking. Further investigations have found that a kinematic synergy also exists at the start of walking. Overall, our method successfully achieves knee motion generation from the initiation of walking through steady-state walking with different velocities until termination of walking.

Planar covariance of upper and lower limb elevation angles during hand-foot crawling in healthy young adults

Habitual quadrupeds have been shown to display a planar covariance of segment elevation angle waveforms in the fore and hind limbs during many forms of locomotion. The purpose of the current study was to determine if humans generate similar patterns in the upper and lower limbs during hand-foot crawling. Nine healthy young adults performed hand-foot crawling on a treadmill at speeds of 1, 2, and 3 km/h. A principal component analysis (PCA) was applied to the segment elevation angle waveforms for the upper (upper arm, lower arm, and hand) and lower (thigh, shank, and foot) limbs separately. The planarity of the elevation angle waveforms was determined using the sum of the variance explained by the first two PCs and the orientation of the covariance plane was quantified using the direction cosines of the eigenvector orthogonal to the plane, projected upon each of the segmental semi-axes. Results showed that planarity of segment elevation angles was maintained in the upper and lower limbs (explained variance >97%), although a slight decrease was present in the upper limb when crawling at 3 km/h. The orientation of the covariance plane was highly limb-specific, consistent with animal studies and possibly related to the functional neural control differences between the upper and lower limbs. These results may suggest that the motor patterns stored in the central nervous system for quadrupedal locomotion may be retained through evolution and may still be exploited when humans perform such tasks.