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Syrett ED, Peterson CL, Darter BJ. The effect of impaired unilateral ankle propulsion on contralateral knee joint loading. Gait Posture 2024; 113:302-308. [PMID: 38986171 DOI: 10.1016/j.gaitpost.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 05/07/2024] [Accepted: 07/02/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND Impairments in unilateral ankle propulsion may result from restriction by an external device or pathology such as lower limb amputation. Models of gait suggest this reduction may lead to increased collisional force on the contralateral side, potentially increasing force through the knee and increasing the risk of knee pain or osteoarthritis. RESEARCH QUESTION How do restrictions in unilateral ankle propulsive force affect contralateral knee joint loading in otherwise healthy individuals? METHODS 18 individuals without impairment walked on a treadmill at 1.5 m/s for two conditions: one free of restrictions, and one where a randomized limb's ankle propulsive force was restricted using an off-the-shelf ankle-foot orthosis (AFO). Ankle propulsive power, lower extremity joint work, and ground reaction force variables were calculated for the final 3 gait cycles of each condition. Tibiofemoral joint contact force (TJCF) for the limb contralateral to the AFO was calculated through a standard OpenSim workflow utilizing the gait2392 model. Intra-limb pair-wise comparisons were made between conditions. RESULTS Compared to walking unrestricted, the limb wearing the AFO demonstrated a significant reduction in peak ankle propulsive power and positive ankle work by approximately 50 % each (p<0.01). With ankle restriction, the ipsilateral knee significantly increased positive work (p<0.01). The overall propulsion produced by that limb did not change between conditions, demonstrated by a lack of change in anterior ground reaction force impulse (p=0.11). The knee of the limb contralateral to the AFO did not display differences in any TJCF variable between conditions (all p>0.07). SIGNIFICANCE These results suggest a unilateral deficit in ankle propulsion will not increase contralateral knee joint forces in individuals who are able to use other joints of the limb to compensate for the loss of ankle function. However, further research should investigate this relationship in those who display pathologies that may prevent more proximal compensations.
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Affiliation(s)
- E Daniel Syrett
- Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA 23298, USA.
| | - Carrie L Peterson
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Benjamin J Darter
- Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA 23298, USA; Department of Research, Hunter Holmes McGuire Veteran Affairs Medical Center, Richmond, VA 23249, USA
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Baček T, Sun M, Liu H, Chen Z, Manzie C, Burdet E, Kulić D, Oetomo D, Tan Y. A biomechanics and energetics dataset of neurotypical adults walking with and without kinematic constraints. Sci Data 2024; 11:646. [PMID: 38890343 PMCID: PMC11189391 DOI: 10.1038/s41597-024-03444-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 05/30/2024] [Indexed: 06/20/2024] Open
Abstract
Numerous studies have explored the biomechanics and energetics of human walking, offering valuable insights into how we walk. However, prior studies focused on changing external factors (e.g., walking speed) and examined group averages and trends rather than individual adaptations in the presence of internal constraints (e.g., injury-related muscle weakness). To address this gap, this paper presents an open dataset of human walking biomechanics and energetics collected from 21 neurotypical young adults. To investigate the effects of internal constraints (reduced joint range of motion), the participants are both the control group (free walking) and the intervention group (constrained walking - left knee fully extended using a passive orthosis). Each subject walked on a dual-belt treadmill at three speeds (0.4, 0.8, and 1.1 m/s) and five step frequencies ( - 10% to 20% of their preferred frequency) for a total of 30 test conditions. The dataset includes raw and segmented data featuring ground reaction forces, joint motion, muscle activity, and metabolic data. Additionally, a sample code is provided for basic data manipulation and visualisation.
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Affiliation(s)
- Tomislav Baček
- The University of Melbourne, Department of Mechanical Engineering, 3010, Melbourne, Australia.
| | - Mingrui Sun
- The University of Melbourne, Department of Mechanical Engineering, 3010, Melbourne, Australia
| | - Hengchang Liu
- The University of Melbourne, Department of Mechanical Engineering, 3010, Melbourne, Australia
| | - Zhongxiang Chen
- Monash University, Faculty of Engineering, 3800, Melbourne, Australia
| | - Chris Manzie
- The University of Melbourne, Department of Electrical and Electronic Engineering, 3010, Melbourne, Australia
| | - Etienne Burdet
- Imperial College London, Department of Bioengineering, London, United Kingdom
| | - Dana Kulić
- Monash University, Faculty of Engineering, 3800, Melbourne, Australia
| | - Denny Oetomo
- The University of Melbourne, Department of Mechanical Engineering, 3010, Melbourne, Australia
| | - Ying Tan
- The University of Melbourne, Department of Mechanical Engineering, 3010, Melbourne, Australia
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McCain EM, Dalman MJ, Berno ME, Libera TL, Lewek MD, Sawicki GS, Saul KR. The influence of induced gait asymmetry on joint reaction forces. J Biomech 2023; 153:111581. [PMID: 37141689 PMCID: PMC10424665 DOI: 10.1016/j.jbiomech.2023.111581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 02/24/2023] [Accepted: 04/04/2023] [Indexed: 05/06/2023]
Abstract
Chronic injury- or disease-induced joint impairments result in asymmetric gait deviations that may precipitate changes in joint loading associated with pain and osteoarthritis. Understanding the impact of gait deviations on joint reaction forces (JRFs) is challenging because of concurrent neurological and/or anatomical changes and because measuring JRFs requires medically invasive instrumented implants. Instead, we investigated the impact of joint motion limitations and induced asymmetry on JRFs by simulating data recorded as 8 unimpaired participants walked with bracing to unilaterally and bilaterally restrict ankle, knee, and simultaneous ankle + knee motion. Personalized models, calculated kinematics, and ground reaction forces (GRFs) were input into a computed muscle control tool to determine lower limb JRFs and simulated muscle activations guided by electromyography-driven timing constraints. Unilateral knee restriction increased GRF peak and loading rate ipsilaterally but peak values decreased contralaterally when compared to walking without joint restriction. GRF peak and loading rate increased with bilateral restriction compared to the contralateral limb of unilaterally restricted conditions. Despite changes in GRFs, JRFs were relatively unchanged due to reduced muscle forces during loading response. Thus, while joint restriction results in increased limb loading, reductions in muscle forces counteract changes in limb loading such that JRFs were relatively unchanged.
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Affiliation(s)
| | | | | | - Theresa L Libera
- North Carolina State University, Raleigh, NC, USA; University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Michael D Lewek
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Pan YT, Kang I, Joh J, Kim P, Herrin KR, Kesar TM, Sawicki GS, Young AJ. Effects of Bilateral Assistance for Hemiparetic Gait Post-Stroke Using a Powered Hip Exoskeleton. Ann Biomed Eng 2023; 51:410-421. [PMID: 35963920 PMCID: PMC9867666 DOI: 10.1007/s10439-022-03041-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 07/28/2022] [Indexed: 01/26/2023]
Abstract
Hemiparetic gait due to stroke is characterized by an asymmetric gait due to weakness in the paretic lower limb. These inter-limb asymmetries increase the biomechanical demand and reduce walking speed, leading to reduced community mobility and quality of life. With recent progress in the field of wearable technologies, powered exoskeletons have shown great promise as a potential solution for improving gait post-stroke. While previous studies have adopted different exoskeleton control methodologies for restoring gait post-stroke, the results are highly variable due to limited understanding of the biomechanical effect of exoskeletons on hemiparetic gait. In this study, we investigated the effect of different hip exoskeleton assistance strategies on gait function and gait biomechanics of individuals post-stroke. We found that, compared to walking without a device, powered assistance from hip exoskeletons improved stroke participants' self-selected overground walking speed by 17.6 ± 2.5% and 11.1 ± 2.7% with a bilateral and unilateral assistance strategy, respectively (p < 0.05). Furthermore, both bilateral and unilateral assistance strategies significantly increased the paretic and non-paretic step length (p < 0.05). Our findings suggest that powered assistance from hip exoskeletons is an effective means to increase walking speed post-stroke and tuning the balance of assistance between non-paretic and paretic limbs (i.e., a bilateral strategy) may be most effective to maximize performance gains.
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Affiliation(s)
- Yi-Tsen Pan
- Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - Inseung Kang
- Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA.
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA.
| | - James Joh
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - Patrick Kim
- Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - Kinsey R Herrin
- Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA
- Institute for Robotics and Intelligent Machines, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - Trisha M Kesar
- Division of Physical Therapy, Emory University, Atlanta, GA, 30322, USA
- Department of Rehabilitation Medicine, Emory University, Atlanta, GA, 30307, USA
| | - Gregory S Sawicki
- Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA
- Institute for Robotics and Intelligent Machines, Georgia Institute of Technology, Atlanta, GA, 30332, USA
- School of Biological Science, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - Aaron J Young
- Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA
- Institute for Robotics and Intelligent Machines, Georgia Institute of Technology, Atlanta, GA, 30332, USA
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