Use of a backpack alters gait initiation of high school students

A two-stage disto-proximal braking modality to interrupt gait initiation in healthy adults

The purpose of this investigation was to determine the effect of unexpected gait termination in able-bodied participants during gait initiation on spatiotemporal and stance limb biomechanical parameters. Twenty-one healthy adults took part in this study and were divided into two groups based on the natural anterior or posterior incline of their trunk. Each participant performed 15 random trials of gait initiation: 10 trials with a Go signal and 5 with Go-&-Stop signals. Spatiotemporal parameters were assessed between the Go signal and the first heel contact. Ankle, knee, and hip joint moments were calculated in the sagittal plane. Free moment and impulse were also calculated for the stance limb. Spatiotemporal parameters were not influenced by the mean trunk inclination (p > 0.05), but participants with a forwardly-inclined trunk presented higher hip extension moments (p < 0.05). Unexpected stopping required smaller ankle and knee moments compared to the Go condition (p < 0.05). The hip extension moments appeared to be independent of gait initiation conditions (p > 0.05). The capacity of able-bodied people to interrupt their gait initiation relied on a two-stage disto-proximal braking modality involving explosive motor patterns at the ankle and hip joints. Such a pattern could be altered in vulnerable people, and further studies are needed to investigate this. This study determined a clinical method applicable as a functional protocol to assess and improve the postural control of people suffering from a lack of motor modulation during crucial transient tasks. Such tasks are essential in activities of daily living.

The Impact of Load Style Variation on Gait Recognition Based on sEMG Images Using a Convolutional Neural Network

Surface electromyogram (sEMG) signals are widely employed as a neural control source for lower-limb exoskeletons, in which gait recognition based on sEMG is particularly important. Many scholars have taken measures to improve the accuracy of gait recognition, but several real-time limitations affect its applicability, of which variation in the load styles is obvious. The purposes of this study are to (1) investigate the impact of different load styles on gait recognition; (2) study whether good gait recognition performance can be obtained when a convolutional neural network (CNN) is used to deal with the sEMG image from sparse multichannel sEMG (SMC-sEMG); and (3) explore whether the control system of the lower-limb exoskeleton trained by sEMG from part of the load styles still works efficiently in a real-time environment where multiload styles are required. In addition, we discuss an effective method to improve gait recognition at the levels of the load styles. In our experiment, fifteen able-bodied male graduate students with load (20% of body weight) and using three load styles (SBP = backpack, SCS = cross shoulder, SSS = straight shoulder) were asked to walk uniformly on a treadmill. Each subject performed 50 continuous gait cycles under three speeds (V3 = 3 km/h, V5 = 5 km/h, and V7 = 7 km/h). A CNN was employed to deal with sEMG images from sEMG signals for gait recognition, and back propagation neural networks (BPNNs) and support vector machines (SVMs) were used for comparison by dealing with the same sEMG signal. The results indicated that (1) different load styles had remarkable impact on the gait recognition at three speeds under three load styles (p < 0.001); (2) the performance of gait recognition from the CNN was better than that from the SVM and BPNN at each speed (84.83%, 81.63%, and 83.76% at V3; 93.40%, 88.48%, and 92.36% at V5; and 90.1%, 86.32%, and 85.42% at V7, respectively); and (3) when all the data from three load styles were pooled as testing sets at each speed, more load styles were included in the training set, better performance was obtained, and the statistical analysis suggested that the kinds of load styles included in training set had a significant effect on gait recognition (p = 0.002), from which it can be concluded that the control system of a lower-limb exoskeleton trained by sEMG using only some load styles is not sufficient in a real-time environment.

A biomechanical study of load carriage by two paired subjects in response to increased load mass

The biomechanics of load carriage has been studied extensively with regards to single individuals, yet not so much with regards to collective transport. We investigated the biomechanics of walking in 10 paired individuals carrying a load that represented 20%, 30%, or 40% of the aggregated body-masses. We computed the energy recovery rate at the center of mass of the system consisting of the two individuals plus the carried load in order to test to what extent the pendulum-like behavior and the economy of the gait were affected. Joint torque was also computed to investigate the intra- and inter-subject strategies occurring in response to this. The ability of the subjects to move the whole system like a pendulum appeared rendered obvious through shortened step length and lowered vertical displacements at the center of mass of the system, while energy recovery rate and total mechanical energy remained constant. In parallel, an asymmetry of joint moment vertical amplitude and coupling among individuals in all pairs suggested the emergence of a leader/follower schema. Beyond the 30% threshold of increased load mass, the constraints at the joint level were balanced among individuals leading to a degraded pendulum-like behavior.

Mediolateral postural stability when carrying asymmetric loads during stair negotiation

The purpose of this study was to assess postural stability in the medial-lateral (ML) direction when carrying unilateral and bilateral loads during stair negotiation. Twenty-four healthy young adults were instructed to ascend and descend a three step staircase under three load conditions: no load, 20% body mass (BM) bilateral load, and 20% BM unilateral load. A modified time-to-contact (TTC) method was proposed to evaluate postural stability during stair negotiation. Carrying unilateral loads required more rapid postural adjustments as evidenced by lower minimum ML TTC and ML TTC percentage as compared bilateral loads and no load during stair descent. In addition, lower ML TTC and TTC percentage were found for loaded limb stance for stair descent. Taken together, unilateral loads and the loaded leg during stair descent are of concern when considering postural stability during load carriage. These results illustrate differing postural control challenges for stair ascent and descent during load carriage.

Accuracy and Reliability of Onset Detection Algorithms in Gait Initiation for Healthy Controls and Participants With Parkinson's Disease

Accurate and reliable detection of the onset of gait initiation is essential for the correct assessment of gait. Thus, this study was aimed at evaluation of the reliability and accuracy of 3 different center of pressure-based gait onset detection algorithms: A displacement baseline-based algorithm (method 1), a velocity baseline-based algorithm (method 2), and a velocity extrema-based algorithm (method 3). The center of pressure signal was obtained during 10 gait initiation trials from 16 healthy participants and 3 participants with Parkinson's disease. Intrasession and absolute reliability of each algorithm was assessed using the intraclass correlation coefficient and the coefficient of variation of center of pressure displacement during the postural phase of gait initiation. The accuracy was evaluated using the time error of the detected onset by each algorithm relative to that of visual inspection. The authors' results revealed that although all 3 algorithms had high to very high intrasession reliabilities in both healthy subjects and subjects with Parkinson's disease, methods 2 and 3 showed significantly better absolute reliability than method 1 in healthy controls (P = .001). Furthermore, method 2 outperformed the other 2 algorithms in both healthy subjects and subjects with Parkinson's disease with an overall accuracy of 0.80. Based on these results, the authors recommend using method 2 for accurate and reliable gait onset detection.

Carrying asymmetric loads while walking on an uneven surface

BACKGROUND

Individuals often carry asymmetric loads over challenging surfaces such as uneven or irregular terrain, which may require a higher demand for postural control than walking on an even surface.

RESEARCH QUESTION

The purpose of this study was to assess postural stability in the medial-lateral (ML) direction while carrying unilateral versus bilateral loads when walking on even versus uneven surfaces.

METHODS

Nineteen healthy young adults walked on even and uneven surface treadmills under three load conditions: no load, 20% body weight (BW) bilateral load, and 20% BW unilateral load. A Pedar in-shoe pressure system (Novel, Munich, Germany) was used to evaluate center of pressure (COP)-based parameters.

RESULTS

Carrying 20% BW bilateral or unilateral loads significantly increased double support ratio. In addition, carrying a 20% BW unilateral load significantly increased coefficient of variation (CV) of double support ratio, CV of ML COP excursion, and CV of ML COP velocity. Walking on an uneven surface significantly increased double support ratio, ML COP excursion, ML COP velocity, and CV of double support ratio. When carrying a 20% BW unilateral load, unloaded limb stance had significantly increased double support ratio and ML COP velocity, although it appears that the loaded limb may be used to make step-by-step adjustments as evidenced by the higher CV of ML COP velocity.

SIGNIFICANCE

Unilateral load carriage, walking on uneven surfaces, and unloaded leg stance are of particular concern when considering postural stability.