Gait & Posture

OBJECTIVE: We aimed to systematically evaluate the walking efficiency of lower limb exoskeleton gait orthosis and mechanical gait orthosis in patients with spinal cord injury. DATA SOURCES: Databases searched included: Web of Science, MEDLINE, Cochrane Library and Google Scholar. STUDY SELECTION: Articles published in English from 1970 to 2022 investigating the impact of lower limb exoskeleton gait orthosis versus mechanical gait orthosis on gait outcomes in patients with spinal cord injury were considered...

BACKGROUND: Past work has identified relationships between postural stability and joint kinematics during balance and sit-to-stand tasks. However, this work has not been extended to a thorough examination of these relationships during gait, and how these relationships change with age. An improved understanding of age-related changes in these relationships during gait is necessary to identify early predictors of gait impairments and implement targeted interventions to prevent functional decline in older adulthood...

BACKGROUND: Bilateral vertical ground reaction force (VGRF) and knee extension moment asymmetries are commonly observed during jumping and landing tasks following anterior cruciate ligament (ACL) reconstructions (ACLR) in collegiate athletes. Kinetic asymmetries during landings are associated with increased ACL re-injury risk. Efforts have been made to predict bilateral kinetic asymmetries using trunk kinematics during squats but not during jump-landings. RESEARCH QUESTION: To determine the correlations between trunk kinematics (medial-lateral shoulder positions, medial-lateral hip positions, and lateral trunk bending angles) and bilateral kinetic asymmetries (VGRF and knee extension moments) during double-leg jump-landings in collegiate athletes following ACLR...

BACKGROUND: Anatomical custom-made prostheses, thanks to computer-aided design and 3D-printing technology, help improve osseointegration and reduce mechanical complications in bone reconstructions following bone tumors. A recent quantitative analysis of long-term recovery in patients with 3D-printed reconstructions following pelvic tumor surgery showed asymmetries in ground reaction forces between limbs during different motor activities, while standing very good motor performance and quality of life...

BACKGROUND: Work-related low-back disorders (WLBDs) are one of the most frequent and costly musculoskeletal conditions. It has been showed that WLBDs may occur when intervertebral or torso equilibrium is altered by a biomechanical perturbations or neuromuscular control error. The capacity to react to such disturbances is heavily determined by the spinal stability, provided by active and passive tissues and controlled by the central nervous system. RESEARCH QUESTION: This study aims to investigate trunk stability through the Lyapunov's maximum exponent during repetitive liftings in relation to risk level, as well as to evaluate its ability to discriminate these risk levels...

BACKGROUND: Therapeutic decisions for patients with adolescent idiopathic scoliosis (AIS) are mostly based on static measurements performed on two-dimensional standing full-spine radiographs. However, the trunk plays an essential role in the human locomotion, and the functional consequences during daily activities of this specific and common spinal deformity are not factored in. RESEARCH QUESTION: Does patients with AIS have specific gait patterns based on spatio-temporals parameters measurements ? METHODS: 90 AIS patients (aged 10-18 years) with preoperative simplified gait analysis were retrospectively included for analysis between 2017 and 2020...

BACKGROUND: Kinesio taping can effectively strengthen weakened muscles, increase walking speed, and improve dynamic balance in hemiplegic patients, but its effect on lower-limb coordination is not clear. Improving lower-limb coordination in hemiplegic patients can decrease risk of fall during walking. RESEARCH QUESTION: This study utilized continuous relative phase to depict the pattern and variability of lower-limb coordination in hemiplegic patients and healthy subjects during walking, and investigate whether it has the acute effect of Kinesio Taping on lower-limb coordination in hemiplegic patients during walking...

BACKGROUND: The gait modification strategies Trunk Lean and Medial Thrust have been shown to reduce the external knee adduction moment (EKAM) in patients with knee osteoarthritis which could contribute to reduced progression of the disease. Which strategy is most optimal differs between individuals, but the underlying mechanism that causes this remains unknown. RESEARCH QUESTION: Which gait parameters determine the optimal gait modification strategy for individual patients with knee osteoarthritis? METHODS: Forty-seven participants with symptomatic medial knee osteoarthritis underwent 3-dimensional motion analysis during comfortable gait and with two gait modification strategies: Medial Thrust and Trunk Lean...

BACKGROUND: The walking knee kinematic results of generalized joint hypermobility (GJH) subjects were controversial in previous studies. We proposed that this could be related to the knee statuses of GJH subjects with/without knee hyperextension (KH) and assumed that there are significant sagittal knee kinematic differences between GJH subjects with/without KH during gait. RESEARCH QUESTION: Do GJH subjects with KH exhibit significantly different kinematic characteristics than those without KH during walking? METHODS: 35 GJH subjects without KH, 34 GJH subjects with KH, and 30 healthy controls were recruited in this study...

BACKGROUND: Adequate postural strategies have a pivotal role in ensuring balance during the performance of daily or sport activities. These strategies are responsible for the management of center of mass kinematics and depend on the magnitude of perturbations and posture assumed by a subject. RESEARCH QUESTION: Are there differences in postural performance after a standardized balance training performed in sitting versus standing posture in healthy subjects? Does a standardized unilateral balance training with the dominant or non-dominant limb improve balance on trained and untrained limbs in healthy subjects? METHODS: Seventy-five healthy subjects reporting a right-leg dominance were randomized into a Sitting, Standing, Dominant, Non-dominant or Control groups...

BACKGROUND: The local divergence exponent (LDE) has been used to assess gait stability in people with multiple sclerosis (pwMS). Although previous studies have consistently found that stability is lower in pwMS, inconsistent methodologies have been used to assess patients with a broad range of disability levels. QUESTIONS: What sensor location and movement direction(s) are better able to classify pwMS at early stages of the disease? METHODS: 49 pwMS with EDSS ≤ 2...

BACKGROUND: A good dynamic balance control and stable gait played an important role in the daily ambulation, especially for older adults with sensorimotor degeneration. This study aimed to systematically review the effects and potential mechanisms of mechanical vibration-based stimulation (MVBS) on dynamic balance control and gait characteristics in healthy young and older adults. METHOD: Five bioscience and engineering databases, including MEDLINE via PubMed, CINAHL via EBSCO, Cochrane Library, Scopus, and Embase, were searched until September 4th, 2022...

BACKGROUND: Children with cerebral palsy often show deviating calf muscle activation patterns during gait, with excess activation during early stance and insufficient activation during push-off. RESEARCH QUESTION: Can children with cerebral palsy improve their calf muscle activation patterns during gait using one session of biofeedback-driven gaming? METHODS: Eighteen children (6-17 y) with spastic cerebral palsy received implicit game-based biofeedback on electromyographic activity of the calf muscle (soleus or gastrocnemius medialis) while walking on a treadmill during one session...

BACKGROUND: The mechanical consequences of the motor actions used to maintain upright standing balance can be discriminated in two mechanisms: i) moving the center of pressure (CoP) within the base of support (M1); and ii) modifying the whole-body angular momentum (M2). Since the contribution of M2 to the whole-body CoM acceleration increases with postural constraints, a postural analysis focusing only on the CoP trajectory (i.e. M1) could ignore the majority of the control actions in challenging postural tasks...

BACKGROUND: Lower extremity muscle fatigue affects gait stability and increases the probability of injuries in the elderly. RESEARCH QUESTION: How does prolonged walking-induced fatigue affect lower limb muscle activity, plantar pressure distribution, and tripping risk? METHODS: Eighteen elderly adults walked fast on a treadmill for 60 minutes at a fixed speed. The plantar pressure was measured with an in-shoe monitoring system, eight lower limb muscles were monitored using surface electromyography, and foot movements were tracked by a motion capture analysis system...

BACKGROUND: Children with Cerebral Palsy (CP) have altered anticipatory postural adjustments (APAs) during gait initiation. These APAs may affect dynamic balance in tasks such as stepping. RESEARCH QUESTIONS: How are APAs in children with CP affected during stepping to precise targets? How do children with CP modulate APAs when stepping to medial and lateral targets? What is the association between APAs and symptom severity, movement quality and impairment profile? METHOD: Children undertook a stepping task to laterally and medially placed targets with either leg, in a randomised order...

BACKGROUND: Ultrasonography with motion analysis enables dynamic imaging of medial gastrocnemius (MG) muscles and tendons during gait. This revealed pathological muscle-tendon dynamics in children with spastic cerebral palsy (CP) compared to typically developing (TD) children. However, wearing an ultrasound probe on the lower leg could interfere with gait and bias muscle length changes observed with ultrasound. RESEARCH QUESTION: Does wearing an ultrasound probe on the MG influence gait in children with CP and TD children? METHODS: Eighteen children with spastic CP and 16 age-matched TD children walked at comfortable walking speed on an instrumented treadmill...

BACKGROUND: Persistent concussion symptoms (PCS) negatively affects common activities of daily living including deficits in both single and dual-task (DT) gait. DT gait deficits are present post-concussion; however, task prioritization and the effects of differing cognitive challenge remain unexplored in the PCS population. RESEARCH QUESTION: The purpose of this study was to investigate single and dual-task gait performance in individuals with persistent concussion symptoms and to identify task priorization strategies during DT trials...

BACKGROUND: Knee osteoarthritis (OA) is a chronic condition affecting the entire joint and surrounding tissue, resulting in pain, stiffness and impaired movement. Recent studies have suggested the use of physical performance tests, such as the six-minute walk test (6MWT) to assess joint function for those with knee OA. This study assessed lower limb sagittal plane joint angles during a 6MWT for people with mild-moderate knee OA. METHODS: Thirty-one participants (18 male, 13 female; 62...

BACKGROUND: Gait asymmetry, negative psychological factors and quadriceps strength deficits are common after anterior cruciate ligament reconstruction (ACLR). Whether quadriceps strength and psychological factors have impacts on multiplanar knee kinematics remains unclear. RESEARCH QUESTION: What are the relationships of multiplanar knee kinematics during the gait cycle and psychological readiness to quadriceps strength after ACLR? METHOD: In total, 45 patients were enrolled in this study at 8...