Generalizability of foot placement control strategies during unperturbed and perturbed gait

Control of foot placement is an essential strategy for maintaining balance during walking. During unperturbed, steady-state walking, foot placement can be accurately described as a linear function of the body's centre of mass (CoM) state at midstance. However, it is uncertain if this mapping from CoM state to foot placement generalizes to larger perturbations that could potentially cause falls. Recovery from these perturbations may require reactive control strategies not observed during unperturbed walking. Here, we used unpredictable changes in treadmill belt speed to assess the generalizability of foot placement mappings identified during unperturbed walking. We found that foot placement mappings generalized poorly from unperturbed to perturbed walking and differed for forward perturbation versus backward perturbation. We also used the singular value decomposition of the mapping matrix to reveal that people were more sensitive to backward versus forward perturbations. Together, these results indicate that a single linear mapping cannot describe the foot placement control during both forward and backward losses of balance induced by treadmill belt speed perturbations. Better characterization of human balance control strategies could improve our understanding of why different neuromotor disorders result in heightened fall risk and inform the design of controllers for balance-assisting devices.

Consequences of changing planned foot placement on balance control and forward progress

While walking humans generally plan foot placement two steps in advance. However, it is often necessary to rapidly alter foot placement position just before stepping due to the appearance of a new obstacle. While humans are quite capable of rapidly altering foot placement position, such changes can have major effects on centre of mass dynamics. We investigated how rapid changes to planned foot placement impact centre of mass dynamics, and how such changes influence the control of balance and forward progress, during both straight- and turning-gait. Thirteen young adults walked along a virtually projected walkway with precision footholds oriented either in a straight line or with a single 60°, 90° or 120° turn. On a subset of trials, participants were required to rapidly avoid stepping on select footholds. We found that if the centre of mass was disrupted such that it interfered with task success (i.e. staying upright and continuing along the planned path), walkers were more likely to sacrifice forward progress than the upright stability. Further, walkers appear to control centre of mass dynamics differently following inhibited steps during step turns than during spin turns, which may reflect a larger threat to task success when spin turns are interrupted.

Generalizability of foot-placement control strategies during unperturbed and perturbed gait

Control of foot placement is an essential strategy for maintaining balance during walking. During unperturbed, steady-state walking, foot placement can be accurately described as a linear function of the body's center of mass state at midstance. However, it is uncertain if this mapping from center of mass state to foot placement generalizes to larger perturbations that may be more likely to cause falls. These perturbations may cause balance disturbances and generate reactive control strategies not observed during unperturbed walking. Here, we used unpredictable changes in treadmill speed to assess the generalizability of foot placement mappings identified during unperturbed walking. We found that foot placement mappings generalized poorly from unperturbed to perturbed walking and differed for forward versus backward perturbations. We also used singular value decomposition of the mapping matrix to reveal that people were more sensitive to backward versus forward perturbations. Together, these results indicate that control of foot placement during losses of balance differs from the control strategies used during unperturbed walking. Better characterization of human balance control strategies could improve our understanding of why different neuromotor disorders result in heightened fall risk and inform the design of controllers for balance-assisting devices.

Asymmetry measures for quantification of mechanisms contributing to dynamic stability during stepping-in-place gait

The goal of this study is to introduce and to motivate the use of new quantitative methods to improve our understanding of mechanisms that contribute to the control of dynamic balance during gait. Dynamic balance refers to the ability to maintain a continuous, oscillating center-of-mass (CoM) motion of the body during gait even though the CoM frequently moves outside of the base of support. We focus on dynamic balance control in the frontal plane or medial-lateral (ML) direction because it is known that active, neurally-mediated control mechanisms are necessary to maintain ML stability. Mechanisms that regulate foot placement on each step and that generate corrective ankle torque during the stance phase of gait are both known to contribute to the generation of corrective actions that contribute to ML stability. Less appreciated is the potential role played by adjustments in step timing when the duration of the stance and/or swing phases of gait can be shortened or lengthened to allow torque due to gravity to act on the body CoM over a shorter or longer time to generate corrective actions. We introduce and define four asymmetry measures that provide normalized indications of the contribution of these different mechanisms to gait stability. These measures are 'step width asymmetry', 'ankle torque asymmetry', 'stance duration asymmetry', and 'swing duration asymmetry'. Asymmetry values are calculated by comparing corresponding biomechanical or temporal gait parameters from adjacent steps. A time of occurrence is assigned to each asymmetry value. An indication that a mechanism is contributing to ML control is obtained by comparing asymmetry values to the ML body motion (CoM angular position and velocity) at the time points associated with the asymmetry measures. Example results are demonstrated with measures obtained during a stepping-in-place (SiP) gait performed on a stance surface that either remained fixed and level or was pseudorandomly tilted to disturb balance in the ML direction. We also demonstrate that the variability of asymmetry measures obtained from 40 individuals during unperturbed, self-paced SiP were highly correlated with corresponding coefficient of variation measures that have previously been shown to be associated with poor balance and fall risk.

Between a Walk and a Hard Place: How Stepping Patterns Change While Navigating Environmental Obstacles

Maintaining a consistent relationship between each footfall and the body's motion is a key mechanism to maintain balance while walking. However, environmental features, for example, puddles/obstacles, impose additional constraints on foot placement. This study investigated how healthy young individuals alter foot placements to simultaneously manage body-centric and environmental constraints during an obstacle-crossing task. Consistent step length promotes balance for all steps, whereas accurate foot placement around the obstacle is essential to avoid a trip. While crossing an obstacle, any error in positioning one foot relative to the obstacle can be compensated by selecting the placement of the subsequent step. However, compensation will necessarily alter step length from its average value. The interstep covariance index computed from two consecutive foot placements was used to quantify this tradeoff between body-centric and environmental constraints for six consecutive steps while approaching, crossing, and resuming unobstructed gait after crossing the obstacle. The index declined only when either one or both feet were adjacent to the obstacle. The decline was driven in part by a tendency toward higher step length variability. Thus, changes in the stepping patterns to address the environmental constraint occurred at the cost of the body-centric constraint. However, the step length never ceased to be controlled; the interstep covariance index was positive for all steps. Overall, participants adapted foot placement control to account for the larger threat to balance. The environmental constraint was prioritized only when a potential trip posed greater threat to balance compared with the threat posed by variable step length.

Walking Cadence Affects the Recruitment of the Medial-Lateral Balance Mechanisms

We have previously identified three balance mechanisms that young healthy adults use to maintain balance while walking. The three mechanisms are: (1) The lateral ankle mechanism, an active modulation of ankle inversion/eversion in stance; (2) The foot placement mechanism, an active shift of the swing foot placement; and (3) The push-off mechanism, an active modulation of the ankle plantarflexion angle during double stance. Here we seek to determine whether there are changes in neural control of balance when walking at different cadences and speeds. Twenty-one healthy young adults walked on a self-paced treadmill while immersed in a 3D virtual reality cave, and periodically received balance perturbations (bipolar galvanic vestibular stimulation) eliciting a perceived fall to the side. Subjects were instructed to match two cadences specified by a metronome, 110 bpm (High) and 80 bpm (Low), which in this experiment, led to faster and slower gait speeds, respectively. The results indicate that subjects altered the use of the balance mechanisms at different cadences. The lateral ankle mechanism was used more in the Low condition, while the foot placement mechanism was used more in the High condition. There was no difference in the use of the push-off mechanism between cadence conditions. These results suggest that neural control of balance is altered when gait characteristics, such as cadence change, suggesting a flexible balance response that is sensitive to the constraints of the gait cycle. We speculate that the use of the balance mechanisms may be a factor resulting in well-known characteristics of gait in populations with compromised balance control, such as slower gait speed in older adults or higher cadence in people with Parkinson's disease.

Control of human gait stability through foot placement

During human walking, the centre of mass (CoM) is outside the base of support for most of the time, which poses a challenge to stabilizing the gait pattern. Nevertheless, most of us are able to walk without substantial problems. In this review, we aim to provide an integrative overview of how humans cope with an underactuated gait pattern. A central idea that emerges from the literature is that foot placement is crucial in maintaining a stable gait pattern. In this review, we explore this idea; we first describe mechanical models and concepts that have been used to predict how foot placement can be used to control gait stability. These concepts, such as for instance the extrapolated CoM concept, the foot placement estimator concept and the capture point concept, provide explicit predictions on where to place the foot relative to the body at each step, such that gait is stabilized. Next, we describe empirical findings on foot placement during human gait in unperturbed and perturbed conditions. We conclude that humans show behaviour that is largely in accordance with the aforementioned concepts, with foot placement being actively coordinated to body CoM kinematics during the preceding step. In this section, we also address the requirements for such control in terms of the sensory information and the motor strategies that can implement such control, as well as the parts of the central nervous system that may be involved. We show that visual, vestibular and proprioceptive information contribute to estimation of the state of the CoM. Foot placement is adjusted to variations in CoM state mainly by modulation of hip abductor muscle activity during the swing phase of gait, and this process appears to be under spinal and supraspinal, including cortical, control. We conclude with a description of how control of foot placement can be impaired in humans, using ageing as a primary example and with some reference to pathology, and we address alternative strategies available to stabilize gait, which include modulation of ankle moments in the stance leg and changes in body angular momentum, such as rapid trunk tilts. Finally, for future research, we believe that especially the integration of consideration of environmental constraints on foot placement with balance control deserves attention.

The effect of a reduced first step width on starting block and first stance power and impulses during an athletic sprint start

This study investigated how manipulating first step width affects 3D external force production, centre of mass (CoM) motion and performance in athletic sprinting. Eight male and 2 female competitive sprinters (100m PB: 11.03 ± 0.36 s male and 11.6 ± 0.45 s female) performed 10 maximal effort block starts. External force and three-dimensional kinematics were recorded in both the block and first stance phases. Five trials were performed with the athletes performing their preferred technique (Skating) and five trials with the athletes running inside a 0.3 m lane (Narrow). By reducing step width from a mean of 0.31 ± 0.06 m (Skating) to 0.19 ± 0.03 m (Narrow), reductions were found between the two styles in medial block and medial 1st stance impulses, 1st stance anterior toe-off velocity and mediolateral motion of the CoM. No differences were found in block time, step length, stance time, average net resultant force vector, net anteroposterior impulse nor normalised external power. Step width correlated positively with medial impulse but not with braking nor net anteroposterior impulse. Despite less medially directed forces and less mediolateral motion of the CoM in the Narrow trials, no immediate improvement to performance was found by restricting step width.

Benchmarking Stability of Bipedal Locomotion Based on Individual Full Body Dynamics and Foot Placement Strategies-Application to Impaired and Unimpaired Walking

The principles underlying smooth and effortless human walking while maintaining stability as well as the ability to quickly respond to unexpected perturbations result from a plethora of well-balanced parameters, most of them yet to be determined. In this paper, we investigate criteria that may be useful for benchmarking stability properties of human walking. We perform dynamic reconstructions of human walking motions of unimpaired subjects and subjects walking with transfemoral prostheses from motion capture recordings using optimal control. We aim at revealing subject-specific strategies in applying dynamics in order to maintain steady gait considering irregularities such as deviating gait patterns or asymmetric body segment properties. We identify foot placement with respect to the Instantaneous Capture Point as the strategy globally applied by the subjects to obtain steady gait and propose the Residual Orbital Energy as a measure allowing for benchmarking human-like gait toward confident vs. cautious gait.

Foot Placement Modulation Diminishes for Perturbations Near Foot Contact

Whenever a perturbation occurs during walking we have to maintain our balance using the recovery strategies that are available to us. Foot placement adjustment is often considered an important recovery strategy. However, because this strategy takes time it is likely a poor option if the foot is close to contact at the instant a perturbation occurs. The main goal of this study is to gain a better understanding of how humans deal with balance perturbations during walking if foot placement adjustments are constrained by time. Ten healthy subjects walked on an instrumented treadmill and received mediolateral and anteroposterior pelvis perturbations at various instances during the single support phase. The results show that foot placement modulation in the first recovery step following anteroposterior perturbations is fairly invariant of the perturbation magnitude and direction, regardless of the onset instance. For mediolateral perturbations, foot placement adjustments strongly modulate with the perturbation magnitude and direction, but these effects diminish when the perturbation onset is closer to the instant of foot contact. For most perturbations the first recovery step was consistent across subjects for all onset instances. However, in the second step various strategies arose that were not consistent across subjects, nor within subjects, especially for perturbations applied close to foot contact. Despite these different strategies, the COP location following foot contact strongly related to the COM velocity throughout these strategies. The results show that humans have various ways to compensate for limited availability of a foot placement strategy, with strategy selection highly dependent on the instant during the gait phase at which the perturbation is applied.

Gaze and the Control of Foot Placement When Walking in Natural Terrain

Human locomotion through natural environments requires precise coordination between the biomechanics of the bipedal gait cycle and the eye movements that gather the information needed to guide foot placement. However, little is known about how the visual and locomotor systems work together to support movement through the world. We developed a system to simultaneously record gaze and full-body kinematics during locomotion over different outdoor terrains. We found that not only do walkers tune their gaze behavior to the specific information needed to traverse paths of varying complexity but that they do so while maintaining a constant temporal look-ahead window across all terrains. This strategy allows walkers to use gaze to tailor their energetically optimal preferred gait cycle to the upcoming path in order to balance between the drive to move efficiently and the need to place the feet in stable locations. Eye movements and locomotion are intimately linked in a way that reflects the integration of energetic costs, environmental uncertainty, and momentary informational demands of the locomotor task. Thus, the relationship between gaze and gait reveals the structure of the sensorimotor decisions that support successful performance in the face of the varying demands of the natural world.

Effect of foot placements during sit to stand transition on timed up and go test in stroke subjects: A cross sectional study

BACKGROUND & OBJECTIVE

Timed up and go (TUG) test is been used as a screening tool for the assessment of risk of falling in individuals following stroke. Though TUG test is a quick test, it has fair sensitivity compared to other tests. This study was carried out to obtain and compare test scores for different types of foot placements during sit to stand transition in stroke subjects.

METHOD

A Cross-sectional study with purposive sampling included 28 post stroke subjects who were able to walk 6 meter with or without assistance. Timed Up and Go test was carried out with four different types of foot placements and scores were recorded. The data were compared using Kruskal-Wallis One way analysis of variance and Wilcoxon signed ranks test.

RESULT

There were comparable differences between asymmetric 1 test strategy which involved affected extremity to be placed behind the unaffected and other test strategies (Z = -4.457,-3.848,-4.458; p = 0.000).

CONCLUSION

The initial foot placements during sit to stand transition influenced the time taken to complete the test which was significantly higher in asymmetric 1 strategy, Incorporation of the initial foot placement mainly asymmetric 1 strategy into conventional TUG test would help in identifying accurately the subject's functional mobility and postural stability.

Walking with wider steps changes foot placement control, increases kinematic variability and does not improve linear stability

Walking humans respond to pulls or pushes on their upper body by changing where they place their foot on the next step. Usually, they place their foot further along the direction of the upper body perturbation. Here, we examine how this foot placement response is affected by the average step width during walking. We performed experiments with humans walking on a treadmill, both normally and at five different prescribed step widths. We prescribed step widths by requiring subjects to step on lines drawn on the treadmill belt. We inferred a linear model between the torso marker state at mid-stance and the next foot position. The coefficients in this linear model (which are analogous to feedback gains for foot placement) changed with increasing step width as follows. The sideways foot placement response to a given sideways torso deviation decreased. The fore-aft foot placement response to a given fore-aft torso deviation also decreased. Coupling between fore-aft foot placement and sideways torso deviations increased. These changes in foot placement feedback gains did not significantly affect walking stability as quantified by Floquet multipliers (which estimate how quickly the system corrects a small perturbation), despite increasing foot placement variance and upper body motion variance (kinematic variability).

The critical phase for visual control of human walking over complex terrain

To walk efficiently over complex terrain, humans must use vision to tailor their gait to the upcoming ground surface without interfering with the exploitation of passive mechanical forces. We propose that walkers use visual information to initialize the mechanical state of the body before the beginning of each step so the resulting ballistic trajectory of the walker's center-of-mass will facilitate stepping on target footholds. Using a precision stepping task and synchronizing target visibility to the gait cycle, we empirically validated two predictions derived from this strategy: (1) Walkers must have information about upcoming footholds during the second half of the preceding step, and (2) foot placement is guided by information about the position of the target foothold relative to the preceding base of support. We conclude that active and passive modes of control work synergistically to allow walkers to negotiate complex terrain with efficiency, stability, and precision.

Foot placement control and gait instability among people with stroke

Gait instability is a common problem following stroke, as evidenced by increases in fall risk and fear of falling. However, the mechanism underlying gait instability is currently unclear. We recently found that young, healthy humans use a consistent gait stabilization strategy of actively controlling their mediolateral foot placement based on the concurrent mechanical state of the stance limb. In the present work, we tested whether people with stroke (n = 16) and age-matched controls (n = 19) used this neuromechanical strategy. Specifically, we used multiple linear regressions to test whether (1) swing phase gluteus medius (GM) activity was influenced by the simultaneous state of the stance limb and (2) mediolateral foot placement location was influenced by swing phase GM activity and the mechanical state of the swing limb at the start of the step. We found that both age-matched controls and people with stroke classified as having a low fall risk (Dynamic Gait Index [DGI] score >19) essentially used the stabilization strategy previously described in young controls. In contrast, this strategy was disrupted for people with stroke classified as higher fall risk (DGI </=19), particularly for steps taken with the paretic limb. These results suggest that a reduced ability to appropriately control foot placement may contribute to poststroke instability.

Stepping in the direction of the fall: the next foot placement can be predicted from current upper body state in steady-state walking

During human walking, perturbations to the upper body can be partly corrected by placing the foot appropriately on the next step. Here, we infer aspects of such foot placement dynamics using step-to-step variability over hundreds of steps of steady-state walking data. In particular, we infer dependence of the 'next' foot position on upper body state at different phases during the 'current' step. We show that a linear function of the hip position and velocity state (approximating the body center of mass state) during mid-stance explains over 80% of the next lateral foot position variance, consistent with (but not proving) lateral stabilization using foot placement. This linear function implies that a rightward pelvic deviation during a left stance results in a larger step width and smaller step length than average on the next foot placement. The absolute position on the treadmill does not add significant information about the next foot relative to current stance foot over that already available in the pelvis position and velocity. Such walking dynamics inference with steady-state data may allow diagnostics of stability and inform biomimetic exoskeleton or robot design.

The biomechanics of walking shape the use of visual information during locomotion over complex terrain

The aim of this study was to examine how visual information is used to control stepping during locomotion over terrain that demands precision in the placement of the feet. More specifically, we sought to determine the point in the gait cycle at which visual information about a target is no longer needed to guide accurate foot placement. Subjects walked along a path while stepping as accurately as possible on a series of small, irregularly spaced target footholds. In various conditions, each of the targets became invisible either during the step to the target or during the step to the previous target. We found that making targets invisible after toe off of the step to the target had little to no effect on stepping accuracy. However, when targets disappeared during the step to the previous target, foot placement became less accurate and more variable. The findings suggest that visual information about a target is used prior to initiation of the step to that target but is not needed to continuously guide the foot throughout the swing phase. We propose that this style of control is rooted in the biomechanics of walking, which facilitates an energetically efficient strategy in which visual information is primarily used to initialize the mechanical state of the body leading into a ballistic movement toward the target foothold. Taken together with previous studies, the findings suggest the availability of visual information about the terrain near a particular step is most essential during the latter half of the preceding step, which constitutes a critical control phase in the bipedal gait cycle.

Foot placement of the equine forelimb: Relationship between foot conformation, foot placement and movement asymmetry

REASONS FOR PERFORMING STUDY

Hoof conformation, foot placement and movement asymmetry are routinely assessed as part of the lameness examination. However, to date, few studies have described these parameters, or the interplay between them, in the general horse population.

OBJECTIVES

To assess foot conformation and foot placement in the forelimbs of a group of general purpose horses and investigate the relationships between foot placement, foot conformation and movement asymmetry.

STUDY DESIGN

Observational cross-sectional study.

METHODS

Forty-three horses were included in the study. Measurements were taken from photographs of each forelimb to assess foot conformation. Video footage was recorded simultaneously from perpendicular cameras at both walk and trot and used to categorise foot placement. Inertial sensor data were used to assess head movement asymmetry in trot.

RESULTS

There was a high degree of variation in foot placement between and within horses, but a 'lateral heel' placement was most common in walk and a 'lateral' placement most common in trot. Foot placement was associated with dorsal and palmar hoof angles but there was no relationship between foot placement and the other conformation parameters, nor with movement asymmetry. Moderate negative correlations were found between several of the conformation parameters and movement asymmetry.

CONCLUSIONS

A relationship exists between foot conformation and movement asymmetry with decreasing hoof width and hoof length related to increasing amount of movement asymmetry. In the population of horses studied here--deemed to be 'well functioning' by their owners/riders--foot placement was found to be independent of movement asymmetry and, to a large extent, independent of foot conformation.