Interjoint coordination in lower limbs during different movements in humans

Comparison of inter-joint coordination strategies during activities of daily living with prosthetic and anatomical limbs

While healthy individuals have redundant degrees of freedom of the joints, they coordinate their multi-joint movements such that the redundancy is effectively reduced. Achieving high inter-joint coordination may be difficult for upper limb prosthesis users due to the lack of proprioceptive feedback and limited motion of the terminal device. This study compared inter-joint coordination between prosthesis users and individuals without limb loss during different upper limb activities of daily living (ADLs). Nine unilateral prosthesis users (five males) and nine age- and sex-matched controls without limb loss completed three unilateral and three bilateral ADLs. Principal component analysis was applied to the three-dimensional motion trajectories of the trunk and arms to identify coordinative patterns. For each ADL, we quantified the cumulative variance accounted for (VAF) of the first five principal components (pcs), which was the lowest number of pcs that could achieve 90% VAF in control limb movements across all ADLs (5 ≤ n ≤ 9). The VAF was lower for movements involving a prosthesis compared to those completed by controls across all ADLs (p < 0.001). The pc waveforms were similar between movements involving a prosthesis and movements completed by control participants for pc1 (r > 0.78, p < 0.001). The magnitude of the relationship for pc2 and pc3 differed between ADLs, with the strongest correlation for symmetric bilateral ADLs (0.67 ≤ r ≤ 0.97, p < 0.001). Collectively, this study demonstrates that activities of daily living were completed with distinct coordination strategies in prosthesis users compared to individuals without limb loss. Future work should explore how device features, such as the availability of sensory feedback or motorized wrist joints influence multi-joint coordination.

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.

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.

Gait Synergy Analysis and Modeling on Amputees and Stroke Patients for Lower Limb Assistive Devices

The concept of synergy has drawn attention and been applied to lower limb assistive devices such as exoskeletons and prostheses for improving human–machine interaction. A better understanding of the influence of gait kinematics on synergies and a better synergy-modeling method are important for device design and improvement. To this end, gait data from healthy, amputee, and stroke subjects were collected. First, continuous relative phase (CRP) was used to quantify their synergies and explore the influence of kinematics. Second, long short-term memory (LSTM) and principal component analysis (PCA) were adopted to model interlimb synergy and intralimb synergy, respectively. The results indicate that the limited hip and knee range of motions (RoMs) in stroke patients and amputees significantly influence their synergies in different ways. In interlimb synergy modeling, LSTM (RMSE: 0.798° (hip) and 1.963° (knee)) has lower errors than PCA (RMSE: 5.050° (hip) and 10.353° (knee)), which is frequently used in the literature. Further, in intralimb synergy modeling, LSTM (RMSE: 3.894°) enables better synergy modeling than PCA (RMSE: 10.312°). In conclusion, stroke patients and amputees perform different compensatory mechanisms to adapt to new interlimb and intralimb synergies different from healthy people. LSTM has better synergy modeling and shows a promise for generating trajectories in line with the wearer’s motion for lower limb assistive devices.

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.

Hip Joint Kinematic Covariation During Gait Before and 1-Year After Hip Arthroscopic Surgery for Femoroacetabular Impingement Syndrome

The primary aim of this study was to determine if the three-dimensional (3D) hip joint motion coordination during gait changes after arthroscopic surgery for femoroacetabular impingement syndrome (FAIS). Three-dimensional hip joint kinematic data were collected with a 12-camera motion capture system. Five trials of level walking were collected preoperatively (PRE) and at 1-year postoperatively (POST) in 8 patients diagnosed with FAIS and at a single time point in 8 healthy controls. Planar covariation analysis was performed to quantify the 3D hip joint motion coordination strategy during gait. Independent sample's t-test were used to determine differences between the FAIS group at the preoperative time point (PRE) and healthy controls. Paired samples t-tests were used to determine differences between the PRE and POST time points within the FAIS group. The %VAF by PC 1 for the FAIS group at the PRE time point was significantly less than that of healthy controls (PRE: 77.2 ± 8.7% vs. Control: 96.1 ± 2.8%; p = 0.0001), and the % VAF of the second PC (PC2) was significantly greater [PRE: 22.8 (8.7)%; Control: 3.9 (2.8)%; p = 0.0001]. No differences in %VAF were found between the PRE and POST time points within the FAIS group for PC1 [PRE: 77.2 (8.7)% vs. POST: 79.3 (11.1)%; p = 0.472] or PC2 [PRE: 22.7 (8.7)%; POST: 20.7 (11.1)%; p = 0.472]. Significant differences in the plane specific contribution to the 3D motion coordination strategy were found between the FAIS patients at the PRE and POST time points for the sagittal plane [PRE: 5.6 (2.7) vs. POST: 0.91 (6.1); p = 0.012] and frontal plane [PRE: −10.4 (2.2) and −1.5 (6.3); p = 0.005]. Patients with FAIS demonstrated a more complex coordination strategy of 3D hip joint motion than controls and this strategy remains unchanged after hip arthroscopic surgery despite changes in the plane specific contribution to this strategy. These findings indicate that motor control impairments in FAIS patients do exist and seem to persist for at least 1 year after hip arthroscopic surgery.

Synergy-based knee angle estimation using kinematics of thigh

BACKGROUND

Lower limb assistive devices have been developed to help amputees or stroke patients. To precisely mimic the required function, researchers focused on how to estimate/predict the required knee angle for knee devices.

RESEARCH QUESTION

The objective is to estimate the motion of the human knee joint during walking using the kinematics of wearer's thigh measured by a single Inertial Measurement Unit (IMU). The hypotheses are that the proposed method can precisely estimate knee angle and have good universality on different subjects, speeds and strides.

METHOD

8 healthy subjects walked on the level ground at three different speeds. An IMU mounted on the thigh was employed to collect the kinematic information of the thigh including angular velocities and accelerations. A long short-term memory (LSTM) neural network model was adopted to model intra-limb synergy between the motion of thigh and the knee joint. Such that with the trained LSTM model, the knee angle can be precisely predicted.

RESULTS

Compared with the existing studies, the proposed approach based on an LSTM model has better estimation performance. The average RMSE for eight subjects can be limited to 3.89°. The proposed method has speed and stride adaptability.

SIGNIFICANCE

The proposed method is promising to generate a desired and harmonious knee trajectory in line with thigh motion for assistive robotic devices.

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.

Lower Limb Inter-Joint Coordination of Unilateral Transfemoral Amputees: Implications for Adaptation Control

The gait of transfemoral amputees can be made smoother by adjusting the inter-joint coordination of both lower limbs. In this study, we compared the inter-joint coordination of the amputated and non-amputated limbs of unilateral amputees to able-bodied controls. Eight amputees and eight able-bodied control participants were recruited. Walking speed, stance–swing time ratio, joint angle, joint angular velocity, and inter-joint coordination parameters—including continuous relative phase (CRP) and decomposition index (DI)—of the lower-limb joint pairs in stance and swing phases were investigated. Similarity of the CRP between groups was evaluated using cross-correlation measures and root-mean-square, and the variability of the CRP was examined by deviation phase (DP). There were significant differences between the amputated limbs and controls in CRP of hip–knee and knee–ankle in stance and swing, DP of knee–ankle and hip–ankle in stance, and DI of hip–knee in swing. For the non-amputated limbs, there were significant differences in CRP and DP of knee–ankle, and DI of hip–knee in swing compared to controls. The amputees utilized unique inter-joint coordination patterns for both limbs—particularly the hip joint—to compensate for the support-capability impairment due to limb salvage and ensure foot placement accuracy.

Feasibility of Synergy-Based Exoskeleton Robot Control in Hemiplegia

Here, we present a study on exoskeleton robot control based on inter-limb locomotor synergies using a robot control method developed to target hemiparesis. The robot control is based on inter-limb locomotor synergies and kinesiological information from the non-paretic leg and a walking aid cane to generate motion patterns for the assisted leg. The developed synergy-based system was tested against an autonomous robot control system in five patients with hemiparesis and varying locomotor abilities. Three of the participants were able to walk using the robot. Results from these participants showed an improved spatial symmetry ratio and more consistent step length with the synergy-based method compared with that for the autonomous method, while the increase in the range of motion for the assisted joints was larger with the autonomous system. The kinematic synergy distribution of the participants walking without the robot suggests a relationship between each participant's synergy distribution and his/her ability to control the robot: participants with two independent synergies accounting for approximately 80% of the data variability were able to walk with the robot. This observation was not consistently apparent with conventional clinical measures such as the Brunnstrom stages. This paper contributes to the field of robot-assisted locomotion therapy by introducing the concept of inter-limb synergies, demonstrating performance differences between synergy-based and autonomous robot control, and investigating the range of disability in which the system is usable.

Does a not-so-recent ankle sprain influence interjoint coordination during walking?

BACKGROUND

Ankle sprains are common joint injuries in daily and sports activities, whose underlying mechanisms have been amply studied. If joint structures are directly damaged, neuromuscular activity can be affected, particularly in the time domain. This study aims to establish whether previous ankle injury correlates with changes in the inter-joint synergy of the entire lower limb and in the muscle activity pattern during walking.

METHODS

Three-dimensional walking-gait analysis was conducted on twenty-four adults. Ten of them had never suffered from ankle sprain; fourteen had suffered from ankle sprain at least once during the three preceding years. Continuous Relative Phase (CRP) between the moving limbs assessed inter-joint coordination, and muscular activity was recorded by EMG.

FINDINGS

CRP between ankle and knee and between ankle and hip indicates that both joints moved in tight synchronization in the same direction on the injured side, whereas there was a time lag between joints on the healthy side for each sprained participants or on both side for the control group. Start-time and/or duration of muscular activity of tibialis anterior, soleus and peroneus longus occurred earlier and were longer on the injured side, respectively.

INTERPRETATION

Our findings suggest that ankle sprain modifies inter-joint coordination and muscular activity of the injured limb, inducing not an entirely new pattern of coordination but an alteration of the existing pattern. CRP revealed slight modifications in the extant inter-joint coordination which may not be captured by other kinematic variables, which opens perspectives on therapy and relapse prevention.

INTERSEGMENTAL COORDINATION IN LOWER EXTREMITIES AND MULTI-SEGMENTAL SPINE DURING DIFFERENT ACTIVITIES OF DAILY LIVING

Background: Human movement consists of numerous degrees of freedom (DOF). How the nervous system (NS) computes the appropriate command to coordinate these DOFs to finish specific tasks is still hotly debated. One common way to simplify the redundant DOFs is to coordinate multiple DOFs by combining them into units or synergies. The present study aimed to investigate the kinematic complexity of five activities of daily living (ADLs) and to detect the amount of kinematic synergy during every ADL and the relationship of the motion pattern between these ADLs. Method: Twenty-six able-bodied male individuals performed level walking, stair climbing, trunk bending, ipsilateral pick-up and contralateral pick-up in sequence. The segmental excursion of the thorax, upper lumbar, lower lumbar, pelvis, thigh and shank was calculated. Principal component analysis (PCA) was applied to determine the motion pattern of every ADL. Result: In the sagittal plane, trunk bending, ipsilateral pick-up and contralateral pick-up could be simplified by using one principal component (PC) with more than 95% variance accounted for (VAF). In addition, the motion pattern of every PC was similar among the three ADLs. Moreover, the angles between the vectors representing the first PC of the three ADLs were all less than 10[Formula: see text]. Level walking and stair climbing needed at least two PCs to reach 95% VAF. In addition, the motion pattern was different between the two ADLs. Moreover, the angle between the first PC of the two ADLs was around 90[Formula: see text]. In the coronal plane, the five ADLs except contralateral pick-up arrived at 90% VAF with two PCs. The motion pattern and the angle between the first PC both demonstrated larger differences among the five ADLs. Conclusion: Two PCs were essential to represent level walking and stair climbing, indicating a complex control strategy used by the NS. Trunk bending, ipsilateral pick-up and contralateral pick-up could be described with one PC in the sagittal plane, showing a strong coupling and simple motion pattern. In addition, the motion pattern varied considerably among these ADLs. The outcomes of this study can help clinicians to select suitable ADLs for the patients with various joint or disc diseases and to conduct corresponding functional test and rehabilitation.

Gait Phase Recognition for Lower-Limb Exoskeleton with Only Joint Angular Sensors

Gait phase is widely used for gait trajectory generation, gait control and gait evaluation on lower-limb exoskeletons. So far, a variety of methods have been developed to identify the gait phase for lower-limb exoskeletons. Angular sensors on lower-limb exoskeletons are essential for joint closed-loop controlling; however, other types of sensors, such as plantar pressure, attitude or inertial measurement unit, are not indispensable.Therefore, to make full use of existing sensors, we propose a novel gait phase recognition method for lower-limb exoskeletons using only joint angular sensors. The method consists of two procedures. Firstly, the gait deviation distances during walking are calculated and classified by Fisher’s linear discriminant method, and one gait cycle is divided into eight gait phases. The validity of the classification results is also verified based on large gait samples. Secondly, we build a gait phase recognition model based on multilayer perceptron and train it with the phase-labeled gait data. The experimental result of cross-validation shows that the model has a 94.45% average correct rate of set (CRS) and an 87.22% average correct rate of phase (CRP) on the testing set, and it can predict the gait phase accurately. The novel method avoids installing additional sensors on the exoskeleton or human body and simplifies the sensory system of the lower-limb exoskeleton.

Control strategies for active lower extremity prosthetics and orthotics: a review

: Technological advancements have led to the development of numerous wearable robotic devices for the physical assistance and restoration of human locomotion. While many challenges remain with respect to the mechanical design of such devices, it is at least equally challenging and important to develop strategies to control them in concert with the intentions of the user.This work reviews the state-of-the-art techniques for controlling portable active lower limb prosthetic and orthotic (P/O) devices in the context of locomotive activities of daily living (ADL), and considers how these can be interfaced with the user's sensory-motor control system. This review underscores the practical challenges and opportunities associated with P/O control, which can be used to accelerate future developments in this field. Furthermore, this work provides a classification scheme for the comparison of the various control strategies.As a novel contribution, a general framework for the control of portable gait-assistance devices is proposed. This framework accounts for the physical and informatic interactions between the controller, the user, the environment, and the mechanical device itself. Such a treatment of P/Os--not as independent devices, but as actors within an ecosystem--is suggested to be necessary to structure the next generation of intelligent and multifunctional controllers.Each element of the proposed framework is discussed with respect to the role that it plays in the assistance of locomotion, along with how its states can be sensed as inputs to the controller. The reviewed controllers are shown to fit within different levels of a hierarchical scheme, which loosely resembles the structure and functionality of the nominal human central nervous system (CNS). Active and passive safety mechanisms are considered to be central aspects underlying all of P/O design and control, and are shown to be critical for regulatory approval of such devices for real-world use.The works discussed herein provide evidence that, while we are getting ever closer, significant challenges still exist for the development of controllers for portable powered P/O devices that can seamlessly integrate with the user's neuromusculoskeletal system and are practical for use in locomotive ADL.

Intralimb joint coordination of the lower extremities in resistance training exercises

To facilitate the greatest transfer of improvements to athletic performance or daily activity, the resistance training exercises employed by athletic or recreationally trained individuals must be selected considering biomechanical similarity to meet the specific demands of their sport or activity. The purpose of this study was to compare intralimb joint coordination in eight experienced lifters performing three conventional strength-training exercises: the forward lunge, the dead lift, and the forward step-up. Lower-extremity angular displacement curves, maximum joint excursions, and mean absolute relative phases were determined. Results revealed general in-phase, interjoint relationships while comparing exercises. Forward lunge interjoint relationships were more out-of-phase when compared with the other two exercises. It is suggested that in-phase coordination was the predominant pattern employed while performing the closed kinetic chain exercises normally used in strength training, in particular for knee-hip relationship. Nevertheless the forward component of movement can change the coordination strategy when performing lunges.

Differences in kinematic control of ankle joint motions in people with chronic ankle instability

BACKGROUND

People with chronic ankle instability display different ankle joint motions compared to healthy people. The purpose of this study was to investigate the strategies used to control ankle joint motions between a group of people with chronic ankle instability and a group of healthy, matched controls.

METHODS

Kinematic data were collected from 11 people with chronic ankle instability and 11 matched control subjects as they performed a single-leg land-and-cut maneuver. Three-dimensional ankle joint angles were calculated from 100 ms before, to 200 ms after landing. Kinematic control of the three rotational ankle joint degrees of freedom was investigated by simultaneously examining the three-dimensional co-variation of plantarflexion/dorsiflexion, toe-in/toe-out rotation, and inversion/eversion motions with principal component analysis.

FINDINGS

Group differences in the variance proportions of the first two principal components indicated that the angular co-variation between ankle joint motions was more linear in the control group, but more planar in the chronic ankle instability group. Frontal and transverse plane motions, in particular, contributed to the group differences in the linearity and planarity of angular co-variation.

INTERPRETATIONS

People with chronic ankle instability use a different kinematic control strategy to coordinate ankle joint motions during a single-leg landing task. Compared to the healthy group, the chronic ankle instability group's control strategy appeared to be more complex and involved joint-specific contributions that would tend to predispose this group to recurring episodes of instability.

Weightlifting performance is related to kinematic and kinetic patterns of the hip and knee joints

The purpose of this study was to investigate the correlations between biomechanical outcome measures and weightlifting performance. Joint kinematics and kinetics of the hip, knee, and ankle were calculated while 10 subjects performed a clean at 85% of 1 repetition maximum (1RM). Kinematic and kinetic time-series patterns were extracted with principal components analysis. Discrete scores for each time-series pattern were calculated and used to determine how each pattern was related to body mass-normalized 1RM. Two hip kinematic and 2 knee kinetic patterns were significantly correlated with relative 1RM. The kinematic patterns captured hip and trunk motions during the first pull and hip joint motion during the movement transition between the first and second pulls. The first kinetic pattern captured a peak in the knee extension moment during the second pull. The second kinetic pattern captured a spatiotemporal shift in the timing and amplitude of the peak knee extension moment. The kinematic results suggest that greater lift mass was associated with steady trunk position during the first pull and less hip extension motion during the second-knee bend transition. Further, the kinetic results suggest that greater lift mass was associated with a smaller knee extensor moments during the first pull, but greater knee extension moments during the second pull, and an earlier temporal transition between knee flexion-extension moments at the beginning of the second pull. Collectively, these results highlight the importance of controlled trunk and hip motions during the first pull and rapid employment of the knee extensor muscles during the second pull in relation to weightlifting performance.

Complementary limb motion estimation for the control of active knee prostheses

To restore walking after transfemoral amputation, various actuated exoprostheses have been developed, which control the knee torque actively or via variable damping. In both cases, an important issue is to find the appropriate control that enables user-dominated gait. Recently, we suggested a generic method to deduce intended motion of impaired or amputated limbs from residual human body motion. Based on interjoint coordination in physiological gait, statistical regression is used to estimate missing motion. In a pilot study, this complementary limb motion estimation (CLME) strategy is applied to control an active knee exoprosthesis. A motor-driven prosthetic knee with one degree of freedom has been realized, and one above-knee amputee has used it with CLME. Performed tasks are walking on a treadmill and alternating stair ascent and descent. The subject was able to walk on the treadmill at varying speeds, but needed assistance with the stairs, especially to descend. The promising results with CLME are compared with the subject's performance with her own prosthesis, the C-Leg from Otto Bock.

Kinematic and kinetic synergies of the lower extremities during the pull in olympic weightlifting

The purpose of this study was to identify multijoint lower extremity kinematic and kinetic synergies in weightlifting and compare these synergies between joints and across different external loads. Subjects completed sets of the clean exercise at loads equal to 65, 75, and 85% of their estimated 1-RM. Functional data analysis was used to extract principal component functions (PCF's) for hip, knee, and ankle joint angles and moments of force during the pull phase of the clean at all loads. The PCF scores were then compared between joints and across loads to determine how much of each PCF was present at each joint and how it differed across loads. The analyses extracted two kinematic and four kinetic PCF's. The statistical comparisons indicated that all kinematic and two of the four kinetic PCF's did not differ across load, but scaled according to joint function. The PCF's captured a set of joint- and load-specific synergies that quantified biomechanical function of the lower extremity during Olympic weightlifting and revealed important technical characteristics that should be considered in sports training and future research.

Variant and invariant patterns embedded in human locomotion through whole body kinematic coordination

Step length, cadence and joint flexion all increase in response to increases in gradient and walking speed. However, the tuning strategy leading to these changes has not been elucidated. One characteristic of joint variation that occurs during walking is the close relationship among the joints. This property reduces the number of degrees of freedom and seems to be a key issue in discussing the tuning strategy. This correlation has been analyzed for the lower limbs, but the relation between the trunk and lower body is generally ignored. Two questions about posture during walking are discussed in this paper: (1) whether there is a low-dimensional restriction that determines walking posture, which depends not just on the lower limbs but on the whole body, including the trunk and (2) whether some simple rules appear in different walking conditions. To investigate the correlation, singular value decomposition was applied to a measured walking pattern. This showed that the whole movement can be described by a closed loop on a two-dimensional plane in joint space. Furthermore, by investigating the effect of the walking condition on the decomposed patterns, the position and the tilt of the constraint plane was found to change significantly, while the loop pattern on the constraint plane was shown to be robust. This result indicates that humans select only certain kinematic characteristics for adapting to various walking conditions.

Motion Intention Analysis-Based Coordinated Control for Amputee-Prosthesis Interaction

To study amputee-prosthesis (AP) interaction, a novel reconfigurable biped robot was designed and fabricated. In homogeneous configuration, two identical artificial legs (ALs) were used to simulate the symmetrical lower limbs of a healthy person. Linear inverted pendulum model combining with ZMP stability criterion was used to generate the gait trajectories of ALs. To acquire interjoint coordination for healthy gait, rate gyroscopes were mounted on CoGs of thigh and shank of both legs. By employing principal component analysis, the measured angular velocities were processed and the motion synergy was obtained in the final. Then, one of two ALs was replaced by a bionic leg (BL), and the biped robot was changed into heterogeneous configuration to simulate the AP coupling system. To realize symmetrical stable walking, master/slave coordinated control strategy is proposed. According to information acquired by gyroscopes, BL recognized the motion intention of AL and reconstructed its kinematic variables based on interjoint coordination. By employing iterative learning control, gait tracking of BL to AL was archived. Real environment robot walking experiments validated the correctness and effectiveness of the proposed scheme.

Reference trajectory generation for rehabilitation robots: complementary limb motion estimation

For gait rehabilitation robots, an important question is how to ensure stable gait, while avoiding any interaction forces between robot and human in case the patient walks correctly. To achieve this, the definition of "correct" gait needs to adapted both to the individual patient and to the situation. Recently, we proposed a method for online trajectory generation that can be applied for hemiparetic subjects. Desired states for one (disabled) leg are generated online based on the movements of the other (sound) leg. An instantaneous mapping between legs is performed by exploiting physiological interjoint couplings. This way, the patient generates the reference motion for the affected leg autonomously. The approach, called Complementary Limb Motion Estimation (CLME), is implemented on the LOPES gait rehabilitation robot and evaluated with healthy subjects in two different experiments. In a previously described study, subjects walk only with one leg, while the robot's other leg acts as a fake prosthesis, to simulate complete loss of function in one leg. This study showed that CLME ensures stable gait. In a second study, to be presented in this paper, healthy subjects walk with both their own legs to assess the interference with self-determined walking. Evaluation criteria are: Power delivered to the joints by the robot, electromyography (EMG) distortions, and kinematic distortions, all compared to zero torque control, which is the baseline of minimum achievable interference. Results indicate that interference of the robot is lower with CLME than with a fixed reference trajectory, mainly in terms of lowered exchanged power and less alteration of EMG. This implies that subjects can walk more naturally with CLME, and they are assisted less by the robot when it is not needed. Future studies with patients are yet to show whether these properties of CLME transfer to the clinical domain.

Balance control and adaptation of kinematic synergy in aging adults during forward trunk bending

The present study focuses on the organization of kinematic synergy and its adaptation to an unstable support surface during upper trunk movements in aging adults. Seven healthy aging adults (49-66 years old) were instructed to bend the trunk forward (the head and the trunk together) by about 40 degrees and to stabilize their final position, in the standard condition (both feet on the ground), and on a seesaw swinging in the sagittal plane. Kinematic synergy was quantified by performing a principal components analysis on the hip, knee and ankle angle changes during the movement. The results indicate that trunk bending was represented by a single component (PC1) in both conditions, indicating a strong coupling between the angle changes during the movement. The results also show a reorganization of the contribution of PC1 to the three angles when the balance constraints are increased in the seesaw condition. It is concluded that kinematic synergy is preserved during trunk bending in aging adults, regardless of the support conditions. It can also be adapted when the balance constraints are increased by changing the ratio between the angles, indicating a modification of interjoint coordination without modifying the movement's trajectory.

Coordination of thumb joints during opposition

Thumb opposition plays a vital role in hand function. Kinematically, thumb opposition results from composite movements from multiple joints moving in multiple directions. The purpose of this study was to examine the coordination of thumb joints during opposition tasks. A total of 15 female subjects with asymptomatic hands were studied. Three-dimensional angular kinematics of the carpometacarpal (CMC), metacarpophalangeal (MCP) and interphalangeal (IP) joints were obtained by a marker-based motion analysis system. Thumb opposition revealed coordination among joints in a specific direction (inter-joint coordination) and among different directions within a joint (intra-joint coordination). In particular, linear couplings existed between the flexion and pronation at the CMC joint, and between the flexion of the CMC joint and flexion of the MCP joint. Principal component analysis showed that only two principal components adequately represented the thumb opposition data of seven movement directions. A term functional degrees of freedom by virtue of principal component analysis was proposed to uncover the extent of movement coordination in functional tasks.

Kinematic synergy adaptation to an unstable support surface and equilibrium maintenance during forward trunk movement

The aim of this investigation was to study the adaptation to an unstable support surface of kinematic synergy responsible for equilibrium control during upper trunk movements. Eight adult subjects were asked to bend their upper trunk forward to an angle of 35 degrees and then to hold the final position for 3 s, first in a standard condition, with two feet on the ground and the second, on a rocking platform swinging in the sagittal plane. The movement characteristics (duration, amplitude, and mean angular velocity of the trunk), the time course of the antero-posterior center of mass (CM) shift during the movement, and the EMG pattern of the main muscles involved in the movement were studied under the two experimental conditions. Kinematic synergy was quantified by performing a principal component analysis on the hip, knee, and ankle angle changes occurring during the movement. The results indicate that (1) the CM shift from the very onset of the movement remains controlled during performance of the forward trunk movement when the equilibrium constraints were increased; (2) the principal component analysis of the hip, knee, and ankle angle changes occurring during the movement showed a transition from one principal component (PC(1)) in the standard condition to two components in the rocking platform condition; (3) the greatest contribution of PC(1) (weight coefficients) was located at the hip level in both the standard and rocking platform conditions, while the greatest contribution of PC(2) in the rocking platform condition was located at the ankle level; and (4) the EMG pattern underlying kinematic synergy is modified. It is concluded that a simple adaptation of kinematic synergy by changing the weight coefficients of each pair of joints participating in the movement is no longer sufficient when the equilibrium constraints increase and, rather, disturbs equilibrium. The CNS has to provide two parallel controls, one to perform the trunk movement and the other to preserve equilibrium.

How to extend the elbow with a weak or paralyzed triceps: control of arm kinematics for aiming in C6-C7 quadriplegic patients

This study aims to investigate how quadriplegic patients with a C6-C7 spinal lesion coordinate their upper limb to extend the elbow despite the paralysis or weakness of the triceps brachii, and what is the effect of a surgical musculotendinous transfer. For this purpose, aiming movements in a wide workspace were recorded in seven healthy subjects and in patients with incomplete (five cases) or complete (eight cases) triceps paralysis and after musculotendinous transfer (eight cases). We used four electromagnetic field sensors to quantify hand trajectory and to compute the angles describing the rotations at the scapula, glenohumeral joint, elbow and wrist (10 degrees of freedom). Extent and smoothness of the hand trajectories and hand velocity profiles were surprisingly similar between healthy subjects and quadriplegic patients. The reduction of elbow extension observed in patients was compensated by rotations distributed across several degrees of freedom including the scapula. Principal components analysis showed that the joint rotations could be summarized by an additive combination of two synergies, respectively orientating and stretching out the limb, which explained similar amounts of variance in healthy subjects and in patients. The participations of degrees of freedom in the synergies were roughly similar in the different groups of subjects, the main difference concerning scapular medial-lateral rotation, which seems to be critical in patients with a complete triceps paralysis. This demonstrates that elbow extension in quadriplegic patients is due to anticipated mechanical interaction coupling between upper limb segments. We propose that the persisting (incomplete paralysis) or restored (musculotendinous transfer) elbow extensor strength may act by stabilizing the elbow. This counterintuitive preservation of limb kinematics for horizontal aiming movements in quadriplegic patients despite the drastic changes in muscle action provoked by paralysis and/or by surgery strongly suggests that the motor system does not primarily control forces but the morphological aspects of movement, via joint rotation synergies.

Kinematic and Kinetic Constraints on Arm, Trunk, and Leg Segments in Target-Reaching Movements

We studied target reaching tasks involving not only the arms but also the trunk and legs, which necessitated some trunk flexion. Such tasks can be successfully completed using an infinite number of combinations of segment motions due to the inherent kinematic redundancy with the excessive degrees of freedom (DOFs). Sagittal plane motions of six segments (shank, thigh, pelvis, trunk, humerus, and forearm) and dynamic torques of six joints (ankle, knee, hip, lumbar, shoulder, and elbow) were analyzed separately by principal component (PC) analyses to determine if there was a commonality among the shapes of the respective waveforms. Additionally, PC analyses were used to probe for constraining relationships among the 1) relative magnitudes of segment excursions and 2) the peak-to-peak dynamic joint torques. In summary, at the kinematic level, the tasks are simplified by the use of a single common waveform for all segment excursions with 89.9% variance accounted for (VAF), but with less fixed relationships among the relative scaling of the magnitude of segment excursions (62.2% VAF). However, at the kinetic level, the time course of the dynamic joint torques are not well captured by a single waveform (72.7% VAF), but the tasks are simplified by relatively fixed relationships among the scaling of dynamic joint torque magnitudes across task conditions (94.7% VAF). Taken together, these results indicate that, while the effective DOFs in a multi-joint task are reduced differently at the kinematic and kinetic levels, they both contribute to simplifying the neural control of these tasks.

Interjoint coordination in lower limbs in patients with a rupture of the anterior cruciate ligament of the knee joint

Previous studies of movement kinematics in patients with a ruptured anterior cruciate ligament (ACL) have focused on changes in angular displacement in a single joint, usually flexion/extension of the knee. In the present study, we investigated the effect of an ACL injury on the overall limb interjoint coordination. We asked healthy and chronic ACL-deficient male subjects to perform eight types of movements: forward squats, backward squats, sideways squats, squats on one leg, going up a step, going down a step, walking three steps, and stepping in place. Depending on the movement concerned, we applied principal component (PC) analysis to 3 or 4 degrees of freedom (DFs): thigh flexion/extension, knee flexion/extension, ankle flexion/extension, thigh abduction/adduction. The first three DFs were investigated in all movements. PC analysis identifies linear combinations of DFs. Movements with a fixed ratio between DFs are thus described by only one PC or synergy. PCs were computed for the entire movement as well as for the period of time when the foot was in contact with the ground. For both the control and the injured groups, two synergies (PC vectors) usually accounted for more than 95% of the DFs' angular excursions. It was possible to describe 95-99% of some movements using only one synergy. Compared to control subjects, injured subjects employed different synergies for going up a step, walking three steps, squatting sideways, and squatting forward, both in the injured and uninjured legs. Those movements may thus be more indicative of injury than other movements. Although ACL-deficiency did not increase asymmetry (angle between the PCs of the same movement performed on the right and the left sides), this result is not conclusive because of the comparatively low number of subjects who participated in the study. However, the finding that synergies in both legs of patients were different from those in control subjects for going up a step and walking three steps suggests that interjoint coordination was affected for both legs, so that the asymmetry index might have been preserved despite the injury. There was also a relationship between the asymmetry index for squatting on one leg, squatting forward, walking three steps and some of the outcomes of the knee injury and osteoarthritis outcome score (pain, symptoms, activities of daily living, sport and recreation function, and knee-related quality of life). This suggests that significant differences in the asymmetry index could be obtained if more severely-injured patients participated in this study. It is possible that subjects compensated for their mechanical deficiencies by modifying muscle activation patterns. Synergies were not only modified in injured subjects, but also rearranged: the percentage of movement explained by the first PC was different for the injured and/or uninjured legs of patients, as compared to the legs of the control group, for going up a step, going down a step, walking three steps, and squatting forward. We concluded that the analysis of interjoint coordination may be efficient in characterizing motor deficits in people with knee injuries.

Tuning of a Basic Coordination Pattern Constructs Straight-Ahead and Curved Walking in Humans

We tested the hypothesis that common principles govern the production of the locomotor patterns for both straight-ahead and curved walking. Whole body movement recordings showed that continuous curved walking implies substantial, limb-specific changes in numerous gait descriptors. Principal component analysis (PCA) was used to uncover the spatiotemporal structure of coordination among lower limb segments. PCA revealed that the same kinematic law accounted for the coordination among lower limb segments during both straight-ahead and curved walking, in both the frontal and sagittal planes: turn-related changes in the complex behavior of the inner and outer limbs were captured in limb-specific adaptive tuning of coordination patterns. PCA was also performed on a data set including all elevation angles of limb segments and trunk, thus encompassing 13 degrees of freedom. The results showed that both straight-ahead and curved walking were low dimensional, given that 3 principal components accounted for more than 90% of data variance. Furthermore, the time course of the principal components was unchanged by curved walking, thereby indicating invariant coordination patterns among all body segments during straight-ahead and curved walking. Nevertheless, limb- and turn-dependent tuning of the coordination patterns encoded the adaptations of the limb kinematics to the actual direction of the walking body. Absence of vision had no significant effect on the intersegmental coordination during either straight-ahead or curved walking. Our findings indicate that kinematic laws, probably emerging from the interaction of spinal neural networks and mechanical oscillators, subserve the production of both straight-ahead and curved walking. During locomotion, the descending command tunes basic spinal networks so as to produce the changes in amplitude and phase relationships of the spinal output, sufficient to achieve the body turn.