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Motor function outcome in postnatal insult-related cerebral palsy

Fauzi AA, Mustafah NM, Zohdi WN

J Pediatr Rehabil Med, 2013;6(3):181-4.
PMID: 24240839 DOI: 10.3233/PRM-130251

The Gross Motor Function Classification System (GMFCS) was developed to establish uniform communication between healthcare providers, patients, and the patients' families. It is also used to prognosticate the outcome of motor function. Based on previous reports, prognostication of ambulation status in cerebral palsy is based on the motor development curve, which shows a plateau at a certain known age.

Matched MeSH terms: Gait*
Identifying gait asymmetry using gyroscopes--a cross-correlation and Normalized Symmetry Index approach

Gouwanda D, Senanayake SM

J Biomech, 2011 Mar 15;44(5):972-8.
PMID: 21306714 DOI: 10.1016/j.jbiomech.2010.12.013

Injury to a lower limb may disrupt natural walking and cause asymmetrical gait, therefore assessing the gait asymmetry has become one of the important procedures in gait analysis. This paper proposes the use of wireless gyroscopes as a new instrument to determine gait asymmetry. It also introduces two novel approaches: normalized cross-correlations (Cc(norm)) and Normalized Symmetry Index (SI(norm)). Cc(norm) evaluates the waveform patterns generated by the lower limb in each gait cycle. SI(norm) provides indications on the timing and magnitude of the bilateral differences between the limbs while addressing the drawbacks of the conventional methods. One-way ANOVA test reveals that Cc(norm) can be considered as single value indicator that determines the gait asymmetry (p<0.01). The experiment results showed that SI(norm) in asymmetrical gait were different from normal gait. SI(norm) in asymmetrical gait were found to be approximately 20% greater than SI(norm) in normal gait during pre-swing and initial swing.

Matched MeSH terms: Gait*
Aerial and Terrestrial Patterns: A Novel Approach to Analyzing Human Running

Gindre C, Lussiana T, Hebert-Losier K, Mourot L

Int J Sports Med, 2016 Jan;37(1):25-9.
PMID: 26509380 DOI: 10.1055/s-0035-1555931

Biomechanical parameters are often analyzed independently, although running gait is a dynamic system wherein changes in one parameter are likely to affect another. Accordingly, the Volodalen® method provides a model for classifying running patterns into 2 categories, aerial and terrestrial, using a global subjective rating scoring system. We aimed to validate the Volodalen® method by verifying whether the aerial and terrestrial patterns, defined subjectively by a running coach, were associated with distinct objectively-measured biomechanical parameters. The running patterns of 91 individuals were assessed subjectively using the Volodalen® method by an expert running coach during a 10-min running warm-up. Biomechanical parameters were measured objectively using the OptojumpNext® during a 50-m run performed at 3.3, 4.2, and 5 m·s(-1) and were compared between aerial- and terrestrial-classified subjects. Longer contact times and greater leg compression were observed in the terrestrial compared to the aerial runners. The aerial runners exhibited longer flight time, greater center of mass displacement, maximum vertical force and leg stiffness than the terrestrial ones. The subjective categorization of running patterns was associated with distinct objectively-quantified biomechanical parameters. Our results suggest that a subjective holistic assessment of running patterns provides insight into the biomechanics of running gaits of individuals.

Matched MeSH terms: Gait/physiology*
A state-of-the-art review of foot pressure

Zulkifli SS, Loh WP

Foot Ankle Surg, 2020 Jan;26(1):25-32.
PMID: 30600155 DOI: 10.1016/j.fas.2018.12.005

The science of foot pressure studies the forces acting on the bottom and different regions of the foot along with the pressure exerted on the plantar surface with the interacting surface in contact. The information derived gave impact to human biomechanical assessment on body balance and ergonomics posture during gait. Various experiments designed at generating foot pressure data returns only with limited knowledge generated. Obviously, the procedure for experiment design needs to be properly understood from the foot morphology aspects; healthiness, footwear, surface in contact, load and forces impacts, and the foot sensitivity as well as the specification for the foot pressure. This paper reviews the proper preliminary experimental setups for foot pressure measurement analysis during static or dynamic gait. The strength and limitations of recent devices used and considerable variables are also discussed. The overall review explains that the comfortable natural gait in relation to the aspects of sensitivity, load, time duration, and stability are the standard considerations for plantar pressure experiments.

Matched MeSH terms: Gait/physiology*
Fulltext Predictor index of functional limb length discrepancy

Singh VA, Ramalingam S, Haseeb A, Yasin NFB

J Orthop Surg (Hong Kong), 2020 7 23;28(2):2309499020941659.
PMID: 32696708 DOI: 10.1177/2309499020941659

INTRODUCTION: Limb length discrepancy (LLD) of lower extremities is underdiagnosed due to compensatory mechanisms during locomotion. The natural course of compensation leads to biomechanical alteration in human musculoskeletal system leading to adverse effects. General consensus accepts LLD more than 2 cm as significant to cause biomechanical alteration. No studies were conducted correlating height and lower extremities true length (TL) to signify LLD. Examining significant LLD in relation to height and TL using dynamic gait analysis with primary focus on kinematics and secondary focus on kinetics would provide an objective evaluation method.
METHODOLOGY: Forty participants with no evidence of LLD were recruited. Height and TL were measured. Reflective markers were attached at specific points in lower extremity and subjects walked in gait lab at a self-selected normal walking pace with artificial LLDs of 0, 1, 2, 3, and 4 cm simulated using shoe raise. Accommodation period of 30 min was given. Infrared cameras were used to capture the motion. Primary kinematic (knee flexion and pelvic obliquity (PO)) and secondary kinetic (ground reaction force (GRF)) were measured at right heel strike and left heel strike. Functional adaptation was analyzed and the postulated predictor indices (PIs) were used as a screening tool using height, LLD, and TL to notify significance.
RESULTS: There was a significant knee flexion component seen in height category of less than 170 cm. There was significant difference between LLD 3 cm and 4 cm. No significant changes were seen in PO and GRF. PIs of LLD/height and LLD/TL were analyzed using receiver operating characteristic curve. LLD/height as a PI with value of 1.75 was determined with specificity of 80% and sensitivity of 76%.
CONCLUSION: A height of less than 170 cm has significant changes in relation to LLD. PI using LLD/height appears to be a promising tool to identify patients at risk.

Matched MeSH terms: Gait/physiology*
Orthoses versus gait retraining: Immediate response in improving physical performance measures in healthy and medial knee osteoarthritic adults

Khan SJ, Khan SS, Usman J, Mokhtar AH, Abu Osman NA

Proc Inst Mech Eng H, 2020 Jul;234(7):749-757.
PMID: 32459132 DOI: 10.1177/0954411920924525

The conservative techniques of treating knee osteoarthritis (kOA) include wearing orthoses such as knee braces and laterally wedged insoles and applying gait modification techniques such as toe-in gait and toe-out gait. This study aimed at assessing the immediate effects of these techniques in improving physical function of healthy and kOA participants. Five Osteoarthritis Research Society International (OARSI) recommended performance-based tests were randomly applied to measure physical function: (1) 30-second chair stand test (30CST), (2) 40-m (4 × 10) fast-paced walk test (40FPW), (3) stair climb test (SCT), (4) timed up and go test (TUGT) and (5) 6-minute walk test (6MWT) during a single-visit on 20 healthy and 20 kOA patients (age: 59.5 ± 7.33 and 61.5 ± 8.63 years, BMI: 69.95 ± 9.86 and 70.45 ± 8.80 kg/m2). The interventions included natural gait, toe-out gait, toe-in gait, laterally wedged insoles and knee brace. Analysis was performed through repeated-measures ANOVA and independent sample t-test. 30CST and TUGT showed no significant differences for the five test conditions (p > 0.05). Toe-out showed profound effects via pairwise comparison in impairing the physical function while knee brace improved it during 40FPW, SCT and 6MWT. In general, all the tested conservative techniques except laterally wedged insoles had immediate effects on physical performance measures in both healthy and medial knee osteoarthritis participants. The valgus knee brace improved the parameters the most, while toe-out gait impaired them the most. Future studies can develop strategies for improving gait retraining methods on the basis of issues identified by this study.

Matched MeSH terms: Gait/physiology*
Do subjective assessments of running patterns reflect objective parameters?

Lussiana T, Gindre C, Mourot L, Hébert-Losier K

Eur J Sport Sci, 2017 Aug;17(7):847-857.
PMID: 28488928 DOI: 10.1080/17461391.2017.1325072

Running patterns are often categorized into subgroups according to common features before data analysis and interpretation. The Volodalen® method is a simple field-based tool used to classify runners into aerial or terrestrial using a 5-item subjective rating scale. We aimed to validate the Volodalen® method by quantifying the relationship between its subjective scores and 3D biomechanical measures. Fifty-four runners ran 30 s on a treadmill at 10, 12, 14, 16, and 18 km h-1 while their kinematics were assessed subjectively using the Volodalen® method and objectively using 3D motion capture. For each runner and speed, two researchers scored the five Volodalen® items on a 1-to-5 scale, which addressed vertical oscillation, upper-body motion, pelvis and foot position at ground contact, and footstrike pattern. Seven 3D biomechanical parameters reflecting the subjective items were also collected and correlated to the subjective scores. Twenty-eight runners were classified as aerial and 26 as terrestrial. Runner classification did not change with speed, but the relative contribution of the biomechanical parameters to the subjective classification was speed dependent. The magnitude of correlations between subjective and objective measures ranged from trivial to very large. Five of the seven objective parameters significantly differed between aerial and terrestrial runners, and these parameters demonstrated the strongest correlations to the subjective scores. Our results support the validity of the Volodalen® method, whereby the visual appreciation of running gait reflected quantifiable objective parameters. Two minor modifications to the method are proposed to simplify its use and improve agreement between subjective and objective measures.

Matched MeSH terms: Gait*
Psychometric properties of measures of gait quality and walking performance in young people with Cerebral Palsy: A systematic review

Zanudin A, Mercer TH, Jagadamma KC, van der Linden ML

Gait Posture, 2017 10;58:30-40.
PMID: 28711651 DOI: 10.1016/j.gaitpost.2017.07.005

Availability of outcome measures (OMs) with robust psychometric properties is an essential prerequisite for the evaluation of interventions designed to address gait deterioration in young people with Cerebral Palsy (CP). This review evaluates evidence for the reliability, validity and responsiveness of outcome measures of gait quality and walking performance in young people with CP. A systematic search was performed in MEDLINE, CINAHL, PubMed and Scopus. Articles that met the eligibility criteria were selected. Methodological quality of studies was independently rated by two raters using the modified COnsensus-based Standard for the selection of health status Measurement INstruments checklist. Strength of evidence was rated using standardised guidelines. Best evidence synthesis was scored according to Cochrane criteria. Fifty-one articles reporting on 18 distinct OMs were included for review. Best evidence synthesis indicated a moderate to strong evidence for the reliability for OMs of walking performance but conflicting evidence for the reliability of OMs of gait quality. The evidence for responsiveness for all OMs included in this review was rated as 'unknown'. The limitations of using the modified COSMIN scoring for small sample sizes are acknowledged. Future studies of high methodological quality are needed to explore the responsiveness of OMs assessing gait quality and walking performance in young people with CP.

Matched MeSH terms: Gait/physiology*
The analysis of three-dimensional ground reaction forces during gait in children with autism spectrum disorders

Hasan CZC, Jailani R, Md Tahir N, Ilias S

Res Dev Disabil, 2017 Jul;66:55-63.
PMID: 28284567 DOI: 10.1016/j.ridd.2017.02.015

Minimal information is known about the three-dimensional (3D) ground reaction forces (GRF) on the gait patterns of individuals with autism spectrum disorders (ASD). The purpose of this study was to investigate whether the 3D GRF components differ significantly between children with ASD and the peer controls. 15 children with ASD and 25 typically developing (TD) children had participated in the study. Two force plates were used to measure the 3D GRF data during walking. Time-series parameterization techniques were employed to extract 17 discrete features from the 3D GRF waveforms. By using independent t-test and Mann-Whitney U test, significant differences (p<0.05) between the ASD and TD groups were found for four GRF features. Children with ASD demonstrated higher maximum braking force, lower relative time to maximum braking force, and lower relative time to zero force during mid-stance. Children with ASD were also found to have reduced the second peak of vertical GRF in the terminal stance. These major findings suggest that children with ASD experience significant difficulties in supporting their body weight and endure gait instability during the stance phase. The findings of this research are useful to both clinicians and parents who wish to provide these children with appropriate treatments and rehabilitation programs.

Matched MeSH terms: Gait*
Fulltext Opsoclonus

Amin OS, Shwani SS

BMJ Case Rep, 2017 Feb 15;2017.
PMID: 28202488 DOI: 10.1136/bcr-2017-219433
Matched MeSH terms: Gait Ataxia/complications*
The largest Lyapunov exponent of gait in young and elderly individuals: A systematic review

Mehdizadeh S

Gait Posture, 2018 Feb;60:241-250.
PMID: 29304432 DOI: 10.1016/j.gaitpost.2017.12.016

The largest Lyapunov exponent (LyE) is an accepted method to quantify gait stability in young and old adults. However, a range of LyE values has been reported in the literature for healthy young and elderly adults in normal walking. Therefore, it has been impractical to use the LyE as a clinical measure of gait stability. The aims of this systematic review were to summarize different methodological approaches of quantifying LyE, as well as to classify LyE values of different body segments and joints in young and elderly individuals during normal walking. The Pubmed, Ovid Medline, Scopus and ISI Web of Knowledge databases were searched using keywords related to gait, stability, variability, and LyE. Only English language articles using the Lyapunov exponent to quantify the stability of healthy normal young and old subjects walking on a level surface were considered. 102 papers were included for full-text review and data extraction. Data associated with the walking surface, data recording method, sampling rate, walking speed, body segments and joints, number of strides/steps, variable type, filtering, time-normalizing, state space dimension, time delay, LyE algorithm, and the LyE values were extracted. The disparity in implementation and calculation of the LyE was from, (i) experiment design, (ii) data pre-processing, and (iii) LyE calculation method. For practical implementation of LyE as a measure of gait stability in clinical settings, a standard and universally accepted approach of calculating LyE is required. Therefore, future studies should look for a standard and generalized procedure to apply and calculate LyE.

Matched MeSH terms: Gait/physiology*
A robust real-time gait event detection using wireless gyroscope and its application on normal and altered gaits

Gouwanda D, Gopalai AA

Med Eng Phys, 2015 Feb;37(2):219-25.
PMID: 25619613 DOI: 10.1016/j.medengphy.2014.12.004

Gait events detection allows clinicians and biomechanics researchers to determine timing of gait events, to estimate duration of stance phase and swing phase and to segment gait data. It also aids biomedical engineers to improve the design of orthoses and FES (functional electrical stimulation) systems. In recent years, researchers have resorted to using gyroscopes to determine heel-strike (HS) and toe-off (TO) events in gait cycles. However, these methods are subjected to significant delays when implemented in real-time gait monitoring devices, orthoses, and FES systems. Therefore, the work presented in this paper proposes a method that addresses these delays, to ensure real-time gait event detection. The proposed algorithm combines the use of heuristics and zero-crossing method to identify HS and TO. Experiments involving: (1) normal walking; (2) walking with knee brace; and (3) walking with ankle brace for overground walking and treadmill walking were designed to verify and validate the identified HS and TO. The performance of the proposed method was compared against the established gait detection algorithms. It was observed that the proposed method produced detection rate that was comparable to earlier reported methods and recorded reduced time delays, at an average of 100 ms.

Matched MeSH terms: Gait*
Fulltext Effects of powered ankle-foot orthoses mass distribution on lower limb muscle forces-a simulation study

Marconi G, Gopalai AA, Chauhan S

Med Biol Eng Comput, 2023 May;61(5):1167-1182.
PMID: 36689083 DOI: 10.1007/s11517-023-02778-2

This simulation study aimed to explore the effects of mass and mass distribution of powered ankle-foot orthoses, on net joint moments and individual muscle forces throughout the lower limb. Using OpenSim inverse kinematics, dynamics, and static optimization tools, the gait cycles of ten subjects were analyzed. The biomechanical models of these subjects were appended with ideal powered ankle-foot orthoses of different masses and actuator positions, as to determine the effect that these design factors had on the subject's kinetics during normal walking. It was found that when the mass of the device was distributed more distally and posteriorly on the leg, both the net joint moments and overall lower limb muscle forces were more negatively impacted. However, individual muscle forces were found to have varying results which were attributed to the flow-on effect of the orthosis, the antagonistic pairing of muscles, and how the activity of individual muscles affect each other. It was found that mass and mass distribution of powered ankle-foot orthoses could be optimized as to more accurately mimic natural kinetics, reducing net joint moments and overall muscle forces of the lower limb, and must consider individual muscles as to reduce potentially detrimental muscle fatigue or muscular disuse. OpenSim modelling method to explore the effect of mass and mass distribution on muscle forces and joint moments, showing potential mass positioning and the effects of these positions, mass, and actuation on the muscle force integral.

Matched MeSH terms: Gait/physiology
Fulltext Machine Learning-Based Diabetic Neuropathy and Previous Foot Ulceration Patients Detection Using Electromyography and Ground Reaction Forces during Gait

Haque F, Reaz MBI, Chowdhury MEH, Ezeddin M, Kiranyaz S, Alhatou M, et al.

Sensors (Basel), 2022 May 05;22(9).
PMID: 35591196 DOI: 10.3390/s22093507

Diabetic neuropathy (DN) is one of the prevalent forms of neuropathy that involves alterations in biomechanical changes in the human gait. Diabetic foot ulceration (DFU) is one of the pervasive types of complications that arise due to DN. In the literature, for the last 50 years, researchers have been trying to observe the biomechanical changes due to DN and DFU by studying muscle electromyography (EMG) and ground reaction forces (GRF). However, the literature is contradictory. In such a scenario, we propose using Machine learning techniques to identify DN and DFU patients by using EMG and GRF data. We collected a dataset from the literature which involves three patient groups: Control (n = 6), DN (n = 6), and previous history of DFU (n = 9) and collected three lower limb muscles EMG (tibialis anterior (TA), vastus lateralis (VL), gastrocnemius lateralis (GL)), and three GRF components (GRFx, GRFy, and GRFz). Raw EMG and GRF signals were preprocessed, and different feature extraction techniques were applied to extract the best features from the signals. The extracted feature list was ranked using four different feature ranking techniques, and highly correlated features were removed. In this study, we considered different combinations of muscles and GRF components to find the best performing feature list for the identification of DN and DFU. We trained eight different conventional ML models: Discriminant analysis classifier (DAC), Ensemble classification model (ECM), Kernel classification model (KCM), k-nearest neighbor model (KNN), Linear classification model (LCM), Naive Bayes classifier (NBC), Support vector machine classifier (SVM), and Binary decision classification tree (BDC), to find the best-performing algorithm and optimized that model. We trained the optimized the ML algorithm for different combinations of muscles and GRF component features, and the performance matrix was evaluated. Our study found the KNN algorithm performed well in identifying DN and DFU, and we optimized it before training. We found the best accuracy of 96.18% for EMG analysis using the top 22 features from the chi-square feature ranking technique for features from GL and VL muscles combined. In the GRF analysis, the model showed 98.68% accuracy using the top 7 features from the Feature selection using neighborhood component analysis for the feature combinations from the GRFx-GRFz signal. In conclusion, our study has shown a potential solution for ML application in DN and DFU patient identification using EMG and GRF parameters. With careful signal preprocessing with strategic feature extraction from the biomechanical parameters, optimization of the ML model can provide a potential solution in the diagnosis and stratification of DN and DFU patients from the EMG and GRF signals.

Matched MeSH terms: Gait/physiology
Fulltext Mechanism and design analysis of articulated ankle foot orthoses for drop-foot

Alam M, Choudhury IA, Bin Mamat A

ScientificWorldJournal, 2014;2014:867869.
PMID: 24892102 DOI: 10.1155/2014/867869

Robotic technologies are being employed increasingly in the treatment of lower limb disabilities. Individuals suffering from stroke and other neurological disorders often experience inadequate dorsiflexion during swing phase of the gait cycle due to dorsiflexor muscle weakness. This type of pathological gait, mostly known as drop-foot gait, has two major complications, foot-slap during loading response and toe-drag during swing. Ankle foot orthotic (AFO) devices are mostly prescribed to resolve these complications. Existing AFOs are designed with or without articulated joint with various motion control elements like springs, dampers, four-bar mechanism, series elastic actuator, and so forth. This paper examines various AFO designs for drop-foot, discusses the mechanism, and identifies limitations and remaining design challenges. Along with two commercially available AFOs some designs possess promising prospective to be used as daily-wear device. However, the design and mechanism of AFO must ensure compactness, light weight, low noise, and high efficiency. These entailments present significant engineering challenges to develop a new design with wide consumer adoption.

Matched MeSH terms: Gait Disorders, Neurologic/therapy*
Motor control on gait performance among individuals with lower crossed syndrome: A scoping review

Zahari Z, Naga DNA, Bukry SA

Med J Malaysia, 2024 Mar;79(Suppl 1):168-175.
PMID: 38555902

INTRODUCTION: Lower Cross Syndrome (LCS) is a prevalent condition that manifests as muscular tension due to the asymmetry in the strength of the lower extremity muscles. This imbalance could be due to the tautness of the iliopsoas, rectus femoris, tensor fascia latae, adductor group, gastrocnemius, and soleus muscles. LCS causes a postural imbalance in the individual, which triggers low back pain (LBP). When LCS is present alongside LBP, may cause the upper body to sway more in the transverse plane and at the lumbar level, making walking and termination of gait (GT) more difficult. However, the evidence of motor control and gait performance is scarce with inconclusive findings. Thus, this study aimed to review motor control on gait performance among individuals with lower crossed syndrome. This review is conducted to determine the motor control on gait performance in patients with LCS and how the conditions affect gait.
MATERIALS AND METHODS: The databases Google Scholar, Science Direct, ResearchGate, PubMed, and Scopus were searched to identify potentially relevant documents. The keywords used for the search included "motor control" OR "motor learning" OR" core stability" AND "lower crossed syndrome" AND "gait". The search includes articles published between 1970 and 2022 and written in English. It is excluded when the paper is not a full-text article. After finding the articles, the information was extracted, including author, year of publication, country, objective, type of study, and motor control analysis summary.
RESULTS: There were 107 articles retrieved from the search. but only seventeen articles were included for analysis. The finding demonstrates that LCS may associate with LBP and reduces the motor control of the core muscle stability which indirectly influences gait performance.
CONCLUSIONS: This study suggests that individuals with LCS will have an alteration in their gait. However, there is still insufficient information on motor control in gait performance among lower crossed syndrome. Further research is needed to find what factors that may contribute to the adaptation of motor control in gait among LCS population.

Matched MeSH terms: Gait/physiology
Effects of a Multicomponent Exercise and Therapeutic Lifestyle (CERgAS) Intervention on Gait Function in Lower-Income Urban-Dwelling Older Adults: A Cluster Randomized Controlled Trial

Loh DA, Naqiah Hairi N, Mohd Hairi F, Peramalah D, Kandiben S, Abd Hamid MAI, et al.

J Aging Phys Act, 2023 Aug 01;31(4):531-540.
PMID: 36509091 DOI: 10.1123/japa.2022-0047

This study aims to determine the effectiveness of a multicomponent exercise and therapeutic lifestyle (CERgAS) intervention at improving gait speed among older people in an urban poor setting in Malaysia. A total of 249 participants were divided into the intervention (n = 163) and control (n = 86) groups. The mean (SD) age of participants was 67.83 (6.37) and consisted of 88 (35.3%) males and 161 (64.7%) females. A generalized estimating equation with an intention-to-treat analysis was used to measure gait speed at four time points, baseline (T0), 6 weeks (T1), 3 months postintervention (T2), and 6 months postintervention (T3). The results showed significant changes for time between T0 and T3 (mean difference = 0.0882, p = .001), whereas no significant association were found for group (p = .650) and interaction (p = .348) effects. A 6-week intervention is inadequate to improve gait speed. Future efforts should introduce physical activity monitoring and increase exercise duration, frequency, and intensity.

Matched MeSH terms: Gait*
Fulltext A man with febrile illness and difficulty in walking

Das Gupta E

Malays Fam Physician, 2008;3(1):51.
PMID: 25606113
Matched MeSH terms: Gait Disorders, Neurologic
Effect of knee pad on kicking a ball and gait analysis

K. Kadirgama, Z. Taha, A.R. Ismail, Azrul Hisham, A. Zulkifli, Nasrul Hadi, et al.

Movement Health & Exercise, 2013;2(1):41-46.
MyJurnal

Wearing kneepads is the best defence against occupational knee injury. It has been reported that the use of knee pads can reduce injuries and increase performance. Knee pads provide protection by disbursing pressure on the knees and preventing puncture wounds. This study focuses on the effect of knee pads on muscle activity and gait analysis. As a case study, measurement of muscle activities whilst kicking a ball was conducted. The normalized mean of the EMG data shows that the vastus lateralis and vastus medialis muscles are highly active when wearing a knee pad. Gait analysis was conducted on six subjects with and without wearing knee pad. Results shows that wearing knee pads increases the force (950 '— 1150N) acting on the ground, compared with not wearing knee pads (800 —900 N).

Matched MeSH terms: Gait
A triple compound pendulum model to analyse the effect of an ankle-foot orthosis on swing phase kinematics

Marconi G, Gopalai AA, Chauhan S

Med Eng Phys, 2023 Feb;112:103951.
PMID: 36842774 DOI: 10.1016/j.medengphy.2023.103951

Powered ankle-foot orthoses can be utilised to overcome gait abnormalities such as foot drop; however, normal gait is rarely restored with compensatory gait patterns arising and prevalence of gait asymmetry. Therefore, this study aims to determine the effect of orthosis mass and mass distribution on the swing phase of gait, to understand residual gait asymmetry with orthosis use. Using a triple compound pendulum model, which accounts for mass distribution of the limb and orthosis, the swing phase of gait is simulated in terms of natural dynamics and the effect of an orthosis on kinematic parameters is quantitatively determined. It was found that additional mass causes faster and shorter steps on the affected side due to rapid knee extension and reduced hip flexion, with particular actuator positions and natural cadence causing varying severity of these effects. Our study suggests that this model could be used as a preliminary design tool to identify subject specific optimum orthosis mass distribution of a powered ankle-foot orthosis, without the need for motion data or experimental trials. This optimisation intends to more accurately mimic natural swing phase kinematics, consequently allowing for the reduction in severity of gait asymmetry and the potential to improve rehabilitative outcomes.

Matched MeSH terms: Gait

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