The effect of sex, stature, and limb length on the preferred walk-to-run transition speed

BACKGROUND

The preferred walk-to-run transition speed (PTS) for healthy adults is approximately 2 m∙s^-1, however, PTS is influenced by anthropometric factors. Yet despite known sex differences in anthropometrics, studies have reported no sex differences in PTS.

RESEARCH QUESTION

Do stature and limb length affect PTS in the same way for both male and female healthy adults?

METHODS

Thirty-seven (19 female) non-injured adults volunteered for this study. Participants completed a walk-to-run transition protocol, where the treadmill speed was increased from 1.2 m∙s^-1 to 2.2 m∙s^-1, in increments of 0.1 m∙s^-1 every two minutes. An independent t-test compared PTS between sexes. Multiple regression analysis determined the effect of sex and stature and sex and limb length on PTS.

RESULTS

Female participants transitioned at a lower PTS than male participants (1.8 (0.2) m∙s^-1 versus 1.9 (0.1) m∙s^-1; p ≤ 0.026). Sex and stature explained 19% of the variance in PTS, while sex and limb length explained 21% of the variance. Including interactions increased the variance explained by 23% and 2% for sex and stature and sex and limb length, respectively. The significant interaction between sex and stature showed PTS was inversely proportional to stature for male participants but directly proportional for female participants.

SIGNIFICANCE

These findings suggest that the extent to which stature and limb length influence the preferred transition speed may differ between sexes.

Relationship between attachment site of tibialis anterior muscle and shape of tibia: anatomical study of cadavers

BACKGROUND

Tibialis anterior (TA) muscle is the largest dorsiflexor of the ankle joint and plays an important role during gait movement. However, descriptions of the TA attachment site are inconsistent even among major anatomy textbooks, and its origin, especially the attachment site for the tibia, has not been reported in detail. This study is the first experimental attempt to investigate the origin of the TA in detail, paying particular attention to the relationship with the shape of the tibia, including sex differences.

METHODS

Forty legs (20 males, 20 females) from twenty Japanese cadavers were examined. Gross anatomical examination of the TA's attachment site to the tibia and the tibia's shape was performed.

RESULTS

The location of the distal end of the TA's attachment on tibia was significantly more distal in males than in females (p < 0.01). The anterior border of the tibia had a gentle S-like curve, with a medially convex curve in the proximal region and a laterally convex curve in the distal region in frontal plane. The most protruding point of the distal curve of the anterior border located significantly more proximal in females than in males (p = 0.02).

CONCLUSIONS

There were sex differences in the distal end of the attachment site on tibia of the TA and the shape of the tibia. Consequently, the variations in the attachment site of TA were considered to provide for differences in function of TA. In males, the TA may enable advantageous power exertion, whereas in females it may work efficiently for dorsiflexion of ankle, respectively. Sex differences in TA's attachment site and the shape of the tibia may be involved in gait movement as well as frequency of lower leg disorders such as chronic exertional compartment syndrome.

Acute Effects of Gait Interventions on Tibial Loads During Running: A Systematic Review and Meta-analysis

Introduction

Changing running technique or equipment can alter tibial loads. The efficacy of interventions to modify tibial loads during running is yet to be synthesised and evaluated. This article reviewed the effect of running technique and footwear interventions on tibial loading during running.

Methods

Electronic databases were searched using terms relevant to tibial load and running. Interventions were categorised according to their approach (i.e., footwear; barefoot running; speed; surface; overground versus treadmill; orthotics, insoles and taping; and technique); if necessary, further subgrouping was applied to these categories. Standardised mean differences (SMDs) with 95% confidence intervals (CIs) for changes in tibial loading were calculated and meta-analyses performed where possible.

Results

Database searches yielded 1617 articles, with 36 meeting the inclusion criteria. Tibial loading increased with (1) barefoot running (SMD 1.16; 95% CI 0.50, 1.82); (2) minimalist shoe use by non-habitual users (SMD 0.89; 95% CI 0.40, 1.39); (3) motion control shoe use (SMD 0.46; 95% CI 0.07, 0.84); (4) increased stride length (SMD 0.86; 95% CI 0.18, 1.55); and (5) increased running speed (SMD 1.03; 95% CI 0.74, 1.32). Tibial loading decreased when (1) individuals ran on a treadmill versus overground (SMD − 0.83; 95% CI − 1.53, − 0.12); and (2) targeted biofeedback was used (SMD − 0.93; 95% CI − 1.46, − 0.41).

Conclusions

Running barefoot, in motion control shoes or in unfamiliar minimalist shoes, and with an increased stride length increases tibial loads and may increase the risk of a tibial stress injury during periods of high training load. Adopting interventions such as running on a treadmill versus overground, and using targeted biofeedback during periods of high loads could reduce tibial stress injury.

Does the preferred walk-run transition speed on steep inclines minimize energetic cost, heart rate or neither?

As walking speed increases, humans choose to transition to a running gait at their preferred transition speed (PTS). Near that speed, it becomes metabolically cheaper to run rather than to walk and that defines the energetically optimal transition speed (EOTS). Our goals were to determine: (1) how PTS and EOTS compare across a wide range of inclines and (2) whether the EOTS can be predicted by the heart rate optimal transition speed (HROTS). Ten healthy, high-caliber, male trail/mountain runners participated. On day 1, subjects completed 0 and 15 deg trials and on day 2, they completed 5 and 10 deg trials. We calculated PTS as the average of the walk-to-run transition speed (WRTS) and the run-to-walk transition speed (RWTS) determined with an incremental protocol. We calculated EOTS and HROTS from energetic cost and heart rate data for walking and running near the expected EOTS for each incline. The intersection of the walking and running linear regression equations defined EOTS and HROTS. We found that PTS, EOTS and HROTS all were slower on steeper inclines. PTS was slower than EOTS at 0, 5 and 10 deg, but the two converged at 15 deg. Across all inclines, PTS and EOTS were only moderately correlated. Although EOTS correlated with HROTS, EOTS was not predicted accurately by heart rate on an individual basis.

Paired nonlinear behavior of active and passive joint torques associated with preparation for walk-to-run gait transition

This study investigated the lower extremity torque's active and passive features during the walk-to-run gait transition with continuously increased walking speed. Fourteen volunteers participated in the experiment. Kinematic and kinetic data were collected synchronously. Five strides leading up the gait transition were examined. Peaks of the passive (e.g., contact) and active (e.g., generalized muscle torques), along with net joint torque, and time to peak torques exhibited significant differences at the last stride before gait transition, compared to the first four strides, at the ankle, knee, and hip joints, respectively. Selected peak joint active and passive torques showed significant and opposite trends at critical events within a stride cycle: such ankle joint right after heel-contact, knee joint during weight acceptance, and both hip and knee joints right before toe-off. The magnitude and the corresponding time to active and passive peak torque changed in a nonlinear pattern before the transition from walk to run. The lower extremity segment-interaction during gait transition appeared to be an active reorganization exemplified by the interaction between the lower extremity's active and passive torque components.

Why do we transition from walking to running? Energy cost and lower leg muscle activity before and after gait transition under body weight support

BACKGROUND

Minimization of the energetic cost of transport (CoT) has been suggested for the walk-run transition in human locomotion. More recent literature argues that lower leg muscle activities are the potential triggers of the walk-run transition. We examined both metabolic and muscular aspects for explaining walk-run transition under body weight support (BWS; supported 30% of body weight) and normal walking (NW), because the BWS can reduce both leg muscle activity and metabolic rate.

METHODS

Thirteen healthy young males participated in this study. The energetically optimal transition speed (EOTS) was determined as the intersection between linear CoT and speed relationship in running and quadratic CoT-speed relationship in walking under BWS and NW conditions. Preferred transition speed (PTS) was determined during constant acceleration protocol (velocity ramp protocol at 0.00463 m·s-2 = 1 km·h-1 per min) starting from 1.11 m·s-1. Muscle activities and mean power frequency (MPF) were measured using electromyography of the primary ankle dorsiflexor (tibialis anterior; TA) and synergetic plantar flexors (calf muscles including soleus) before and after the walk-run transition.

RESULTS

The EOTS was significantly faster than the PTS under both conditions, and both were faster under BWS than in NW. In both conditions, MPF decreased after the walk-run transition in the dorsiflexor and the combined plantar flexor activities, especially the soleus.

DISCUSSION

The walk-run transition is not triggered solely by the minimization of whole-body energy expenditure. Walk-run transition is associated with reduced TA and soleus activities with evidence of greater slow twitch fiber recruitment, perhaps to avoid early onset of localized muscle fatigue.

Rapid predictive simulations with complex musculoskeletal models suggest that diverse healthy and pathological human gaits can emerge from similar control strategies

Physics-based predictive simulations of human movement have the potential to support personalized medicine, but large computational costs and difficulties to model control strategies have limited their use. We have developed a computationally efficient optimal control framework to predict human gaits based on optimization of a performance criterion without relying on experimental data. The framework generates three-dimensional muscle-driven simulations in 36 min on average—more than 20 times faster than existing simulations—by using direct collocation, implicit differential equations and algorithmic differentiation. Using this framework, we identified a multi-objective performance criterion combining energy and effort considerations that produces physiologically realistic walking gaits. The same criterion also predicted the walk-to-run transition and clinical gait deficiencies caused by muscle weakness and prosthesis use, suggesting that diverse healthy and pathological gaits can emerge from the same control strategy. The ability to predict the mechanics and energetics of a broad range of gaits with complex three-dimensional musculoskeletal models will allow testing novel hypotheses about gait control and hasten the development of optimal treatments for neuro-musculoskeletal disorders.

Combined Hip Angle Variability and RPE Could Determine Gait Transition in Elite Race Walkers

The aim of this study was to investigate the role of energy cost in locomotion, specifically the rate of perceived exertion and movement variability in gait transition for eight race walkers (RW) and seven nonrace walkers (NRW). We hypothesized that a group of correlated variables could serve as combined triggers. Participants performed a preferred transition speed (PTS) test, exhibiting a higher PTS for RW (10.35 ± 0.28 km/hr) than for NRW (7.07 ± 0.69 km/hr), because RW engaged in race walking before switching to running. None of the variables increased before transition and dropped in PTS, which challenged the hypothesis of a unique transition variable in gait transitions. Principal component analysis showed that combined hip angle variability and rate of perceived exertion could determine gait transitions in elite RW and NRW. Thus, human gait transition may be triggered by a pool of determinant variables, rather than by a single factor.

Modulation of joint and limb mechanical work in walk-to-run transition steps in humans

Surprisingly little information exists of the mechanics in the steps initializing the walk-to-run transition (WRT) in humans. Here, we assess how mechanical work of the limbs (vertical and horizontal) and the individual joints (ankle, knee and hip) are modulated as humans transition from a preferred constant walking velocity (v_walk) to a variety of running velocities (v_run; ranging from a sprint to a velocity slower than v_walk). WRTs to fast v_run values occur nearly exclusively through positive horizontal limb work, satisfying the goal of forward acceleration. Contrary to our hypothesis, however, positive mechanical work remains above that at v_walk even when decelerating. In these WRTs to slow running, positive mechanical work is remarkably high and is comprised nearly exclusively of vertical limb work. Vertical-to-horizontal work modulation may represent an optimization for achieving minimal and maximal v_run, respectively, while fulfilling an apparent necessity for energy input when initiating WRTs. Net work of the WRT steps was more evenly distributed across the ankle, knee and hip joints than expected. Absolute positive mechanical work exhibited a clearer modulation towards hip-based work at high accelerations (>3 m s^-2), corroborating previous suggestions that the most proximal joints are preferentially recruited for locomotor tasks requiring high power and work production. In WRTs to very slow v_run values, high positive work is nevertheless done at the knee, indicating that modulation of joint work is not only dependent on the amount of work required but also the locomotor context.

The role of plantigrady and heel-strike in the mechanics and energetics of human walking with implications for the evolution of the human foot

Human bipedal locomotion is characterized by a habitual heel-strike (HS) plantigrade gait, yet the significance of walking foot-posture is not well understood. To date, researchers have not fully investigated the costs of non-heel-strike (NHS) walking. Therefore, we examined walking speed, walk-to-run transition speed, estimated locomotor costs (lower limb muscle volume activated during walking), impact transient (rapid increase in ground force at touchdown) and effective limb length (ELL) in subjects (n=14) who walked at self-selected speeds using HS and NHS gaits. HS walking increases ELL compared with NHS walking since the center of pressure translates anteriorly from heel touchdown to toe-off. NHS gaits led to decreased absolute walking speeds (P=0.012) and walk-to-run transition speeds (P=0.0025), and increased estimated locomotor energy costs (P<0.0001) compared with HS gaits. These differences lost significance after using the dynamic similarity hypothesis to account for the effects of foot landing posture on ELL. Thus, reduced locomotor costs and increased maximum walking speeds in HS gaits are linked to the increased ELL compared with NHS gaits. However, HS walking significantly increases impact transient values at all speeds (P<0.0001). These trade-offs may be key to understanding the functional benefits of HS walking. Given the current debate over the locomotor mechanics of early hominins and the range of foot landing postures used by nonhuman apes, we suggest the consistent use of HS gaits provides key locomotor advantages to striding bipeds and may have appeared early in hominin evolution.

Physiological strain to prolonged exercise bouts at the walk-run transition speeds depends on locomotion mode in healthy untrained men

This study compared the physiological strain induced by prolonged walking and running performed at the walk-run transition speed (WRTS) in healthy untrained men. Twenty volunteers (age: 28 ± 5.01 years; height: 174.0 ± 0.3 cm; body mass: 74.5 ± 0.6 kg) underwent the following: (a) ramp-incremental maximal cardiopulmonary exercise test (CPET); (b) specific protocol to detect the WRTS; and (c) two 30-min walking and running bouts at WRTS (mean ± SD: 6.9 ± 0.06 km/h). Expired gases were collected during exercise bouts via the metabolic cart. A significant effect of locomotion mode (F = 4.8, P < 0.001) was observed with running resulting in higher cardiorespiratory responses than walking at the WRTS (oxygen uptake: mean difference = 0.26 L/min; pulmonary ventilation: mean difference = 5.53 L/min; carbon dioxide output: mean difference = 0.32 L/min; heart rate: mean difference = 13 beats/min; total energy expenditure: mean difference = 59 kcal). The rating of perceived exertion was similar across locomotion modes (mean difference = 0.3; P = 0.490). In conclusion, running promoted greater cardiorespiratory responses than walking at the WRTS in untrained healthy men. These data might have practical impact on aerobic training performed at intensities corresponding to WRTS.

Acute and Long-Term Effects of Multidirectional Treadmill Training on Gait and Balance in Parkinson Disease

BACKGROUND

Treadmill training has been shown to be a promising rehabilitation strategy for improving gait and balance in persons with Parkinson disease (PD). Most studies have involved only forward walking as an intervention. The effects of multidirectional treadmill (forward, backward, and left and right sideways) on gait and balance have not been reported.

OBJECTIVE

To investigate the acute and long-term effects of multidirectional treadmill training (MDTT) on gait and balance in persons with PD, and to determine the optimal training duration.

DESIGN

Single group, repeated-measures design.

SETTING

Research laboratory in a hospital.

PARTICIPANTS

Ten persons with PD (mean age 65.9 ± 7.4 years; average disease duration 3.90 ± 2.18 years).

INTERVENTIONS

MDTT was used. Participants walked forward, backward, and left and right sideways for 5-7 minutes in each direction at their fastest tolerated speed. The training was 3 days per week continuously for 8 weeks.

MAIN OUTCOME MEASUREMENTS

Gait speed, cadence, and stride length of forward, backward and sideways walks; time and number of steps to turn 360°; and the timed 5-step test and Timed Up-and-Go (TUG) test were performed after the first session of MDTT and every 2 weeks. Effect size of MDTT on each gait and balance variable was measured every 2 weeks for 8 weeks to determine the optimal training duration. Gait and balance variables after the first session of MDTT were compared to the baseline values (pre-MDTT) to study the acute effect of MDTT.

RESULTS

Stride length of forward, backward, and sideways walks improved immediately after 1 session of MDTT (P = .031, .012, and .001, respectively). The number of steps to turn and the timed 5-step test score decreased after the first session (P = .016, and .010, respectively). Six weeks of training was found to yield the largest mean effect size of all gait and balance variables. At 6 weeks of MDTT, gait speed of all walking directions (P = .001-.031), stride length of backward (P < .005) and sideways (P = .001) walks, cadence of sideways walk (P = .036), number of steps to turn (P = .014), and timed 5-step test (P = .033) improved from pre-MDTT measures.

CONCLUSIONS

MDTT immediately improved gait and balance in persons with PD. Six weeks of MDTT might be the optimal training duration to improve gait and balance in the long term.

LEVEL OF EVIDENCE

IV.

Biomechanics of the human walk-to-run gait transition in persons with unilateral transtibial amputation

Propulsive force production (indicative of intrinsic force-length-velocity characteristics of the plantar flexor muscles) has been shown to be a major determinant of the human walk-to-run transition. The purpose of this work was to determine the gait transition speed of persons with unilateral transtibial amputation donning a passive-elastic prosthesis and assess whether a mechanical limit of their intact side plantar flexor muscles is a major determinant of their walk-to-run transition. We determined each individual׳s gait transition speed (GTS) via an incremental protocol and assessed kinetics and kinematics during walking at speeds 50%, 60%, 70%, 80%, 90%, 100%, 120%, and 130% of that gait transition speed (100%:GTS). Unilateral transtibial amputees transitioned between gaits at significantly slower absolute speeds than matched able-bodied controls (1.73±0.13 and 2.09±0.05m/s respectively, p<0.01). Peak anterior-posterior propulsive force increased with speed in controls until 100% of the preferred gait transition speed and decreased at greater speeds. A significant decrease in anterior-posterior propulsive force production was found at 120%GTS (110%: 0.27±0.04>120%: 0.23±0.05BW, p<0.05). In contrast, amputee subjects' intact side generated significantly higher peak anterior-posterior propulsive forces while walking at speeds above their preferred gait transition speed (100%: 0.28±0.04<110%: 0.30±0.04BW, p<0.05). Changes in propulsive force production were found to be a function of changes in absolute speed, rather than relative to the walk-to-run transition speed. Therefore, the walk-to-run transition in unilateral transtibial amputees is not likely dictated by propulsive force production or the force-length-velocity characteristics of the intact side plantar flexor muscles.

Modulation of work and power by the human lower-limb joints with increasing steady-state locomotion speed

We investigated how the human lower-limb joints modulate work and power during walking and running on level ground. Experimental data were recorded from seven participants for a broad range of steady-state locomotion speeds (walking at 1.59±0.09 m s(-1) to sprinting at 8.95±0.70 m s(-1)). We calculated hip, knee and ankle work and average power (i.e. over time), along with the relative contribution from each joint towards the total (sum of hip, knee and ankle) amount of work and average power produced by the lower limb. Irrespective of locomotion speed, ankle positive work was greatest during stance, whereas hip positive work was greatest during swing. Ankle positive work increased with faster locomotion until a running speed of 5.01±0.11 m s(-1), where it plateaued at ∼1.3 J kg(-1). In contrast, hip positive work during stance and swing, as well as knee negative work during swing, all increased when running speed progressed beyond 5.01±0.11 m s(-1). When switching from walking to running at the same speed (∼2.0 m s(-1)), the ankle's contribution to the average power generated (and positive work done) by the lower limb during stance significantly increased from 52.7±10.4% to 65.3±7.5% (P=0.001), whereas the hip's contribution significantly decreased from 23.0±9.7% to 5.5±4.6% (P=0.004). With faster running, the hip's contribution to the average power generated (and positive work done) by the lower limb significantly increased during stance (P<0.001) and swing (P=0.003). Our results suggest that changing locomotion mode and faster steady-state running speeds are not simply achieved via proportional increases in work and average power at the lower-limb joints.

The preferred walk to run transition speed in actual lunar gravity

Quantifying the preferred transition speed (PTS) from walking to running has provided insight into the underlying mechanics of locomotion. The dynamic similarity hypothesis suggests that the PTS should occur at the same Froude number across gravitational environments. In normal Earth gravity, the PTS occurs at a Froude number of 0.5 in adult humans, but previous reports found the PTS occurred at Froude numbers greater than 0.5 in simulated lunar gravity. Our purpose was to (1) determine the Froude number at the PTS in actual lunar gravity during parabolic flight and (2) compare it with the Froude number at the PTS in simulated lunar gravity during overhead suspension. We observed that Froude numbers at the PTS in actual lunar gravity (1.39±0.45) and simulated lunar gravity (1.11±0.26) were much greater than 0.5. Froude numbers at the PTS above 1.0 suggest that the use of the inverted pendulum model may not necessarily be valid in actual lunar gravity and that earlier findings in simulated reduced gravity are more accurate than previously thought.

Joint-level mechanics of the walk-to-run transition in humans

Two commonly proposed mechanical explanations for the walk-to-run transition (WRT) include the prevention of muscular over-exertion (effort) and the minimization of peak musculoskeletal loads and thus injury risk. The purpose of this study was to address these hypotheses at a joint level by analysing the effect of speed on discrete lower-limb joint kinetic parameters in humans across a wide range of walking and running speeds including walking above and running below the WRT speed. Joint work, peak instantaneous joint power, and peak joint moments in the sagittal and frontal plane of the ankle, knee and hip from eight participants were collected for 10 walking speeds (30-120% of their WRT) and 10 running speeds (80-170% of their WRT) on a force plate instrumented treadmill. Of the parameters analysed, three satisfied our statistical criteria of the 'effort-load' hypothesis of the WRT. Mechanical parameters that provide an acute signal (peak moment and peak power) were more strongly associated with the gait transition than parameters that reflect the mechanical function across a portion of the stride. We found that both the ankle (peak instantaneous joint power during swing) and hip mechanics (peak instantaneous joint power and peak joint moments in stance) can influence the transition from walking to running in human locomotion and may represent a cascade of mechanical events beginning at the ankle and leading to an unfavourable compensation at the hip. Both the ankle and hip mechanisms may contribute to gait transition by lowering the muscular effort of running compared with walking at the WRT speed. Although few of the examined joint variables satisfied our hypothesis of the WRT, most showed a general marked increase when switching from walking to running across all speeds where both walking and running are possible, highlighting the fundamental differences in the mechanics of walking and running. While not eliciting the WRT per se, these variables may initiate the transition between stable walking and running patterns. Those variables that were invariant of gait were predominantly found in the swing phase.

Tibialis anterior moment arm: effects of measurement errors and assumptions

Accurate estimates of tibialis anterior (TA) muscle force are important in many contexts. Two approaches commonly used to estimate moment arms are the tendon excursion (TE) and geometric (GEO) methods. Previous studies report poor agreement between the two approaches.

PURPOSE

The purposes of this study were to 1) assess the effect of methodological variations in the two methods of moment arm estimation and 2) determine how these variations affect agreement between the methods.

METHODS

TA moment arms were determined using TE and GEO. Errors associated with tendon stretch/hysteresis, talus rotation relative to the foot, and the location of the line of action were investigated.

RESULTS

For TE, large errors in moment arm estimates across the range of motion were found when tendon length changes (P = 0.001) were not corrected for. For GEO, the estimated moment arm was reduced at an ankle angle of -15° when discrepancies between talus and foot rotations were accounted for or when an alternative tendon line of action was used either separately (effect size (ES), 0.46 and 0.58, respectively; P > 0.05) or together (ES, 0.89; P > 0.05). TE-derived moment arms were smaller than GEO-derived moment arms (ES, 0.68-4.86, varying by angle) before accounting for sources of error. However, these differences decreased after error correction (ES, 0.09-1.20, P > 0.05). Nonetheless, the shape of the moment arm-joint angle relation was curvilinear for TE but linear for GEO.

CONCLUSIONS

Of all methodological modifications, accounting for tendon length changes had the largest effect on TA moment arm estimates. We conclude that the TE method is viable to determine TA moment arms as long as changes in tendon length are accounted for.

Kinematics and dynamics of burst transitions

Subjects (N = 14) were instructed to walk at comfortable walking speed and to start sprinting on an external (visual) stimulus. This is a burst transition. To accelerate maximally, different strategies can be used. The choice for a strategy was hypothesized to be (a) dependent of the body's dynamical status, which is in its turn dependent on the signal timing within the gait cycle; and (b) influenced by the performance and efficacy of the different strategies. Three-dimensional kinematics and ground reaction forces were used to discriminate between strategies and to calculate work (W(total)). Distance laser data yielded performance measures and the work related to the forward acceleration (W(objective)). Efficacy was calculated as the ratio of W(objective) to W(total). Subjects mainly used 2 strategies among others depending on the timing of the stimulus: (a) subjects placed their body center of mass (BCOM) in front of their center of pressure (COP) by tilting the trunk forward and flexing the knee, resulting in a sudden forward acceleration but a relatively fair efficacy; (b) subjects placed their COP behind their BCOM by placing the foot of the swing leg backward. This led to a high performance with high efficacy and was therefore the most ecologically relevant.

Forces and moments in knee-ankle-foot orthoses while walking on irregular surfaces: a case series study

BACKGROUND

Kinetic data provide important information about the mobility performance of individuals with lower limb impairments and their assistive devices; however, there is limited understanding of this in real-life environments.

OBJECTIVE

To evaluate the effect of real-life irregular surfaces on forces and moments in knee-ankle-foot orthoses.

METHODS

In this case series study, a load cell was used to measure the forces and moments at the knee joint of knee-ankle-foot orthoses of individuals with unilateral muscle weakness as a result of poliomyelitis while walking on different ground surfaces and at different speeds.

RESULTS

Significantly higher shear forces and external peak knee flexion moments were found when walking on irregular surfaces. In individual cases, certain irregular ground conditions elicited large increases in peak flexion moments (>50%) when compared to walking on smooth level ground. Forces and moments were significantly higher at faster walking speeds.

CONCLUSIONS

Higher external peak knee flexion moments during the stance phase suggest that greater demands for support and stability are placed on individuals and their assistive devices when negotiating real-life ground surfaces. Clinical relevance This study demonstrates that walking on irregular surfaces alters the loads placed on knee-ankle-foot orthoses and that the requirements for knee stabilization increase. This has important clinical implications on the design, prescription, and use of such devices given the structural and functional demands placed on them.

Changes in the Preferred Transition Speed With Added Mass to the Foot

This study was conducted to investigate whether adding mass to subjects’ feet affects the preferred transition speed (PTS), and to ascertain whether selected swing phase variables (maximum ankle dorsiflexion angular velocity, angular acceleration, joint moment, and joint power) are determinants of the PTS, based upon four previously established criteria. After the PTS of 24 healthy active male subjects was found, using an incremental protocol in loaded (2 kg mass added to each shoe) and unloaded (shoes only) conditions, subjects walked at three speeds (60%, 80%, and 100% of PTS) and ran at one speed (100% of PTS) on a motor-driven treadmill while relevant data were collected. The PTS of the unloaded condition (2.03 ± 0.12 m/s) was significantly greater (P< .05) than the PTS of the loaded condition (1.94 ± 0.13 m/s). Within both load conditions, all dependent variables increased significantly with walking speed, decreased significantly when gait changed to a run, and were assumed to provide the necessary input to signal a gait transition, fulfilling the requirements of the first three criteria, but only ankle angular velocity reached a critical level before the transition, satisfying all four criteria to be considered a determinant of the PTS.

Walking, running, and resting under time, distance, and average speed constraints: optimality of walk-run-rest mixtures

On a treadmill, humans switch from walking to running beyond a characteristic transition speed. Here, we study human choice between walking and running in a more ecological (non-treadmill) setting. We asked subjects to travel a given distance overground in a given allowed time duration. During this task, the subjects carried, and could look at, a stopwatch that counted down to zero. As expected, if the total time available were large, humans walk the whole distance. If the time available were small, humans mostly run. For an intermediate total time, humans often use a mixture of walking at a slow speed and running at a higher speed. With analytical and computational optimization, we show that using a walk-run mixture at intermediate speeds and a walk-rest mixture at the lowest average speeds is predicted by metabolic energy minimization, even with costs for transients-a consequence of non-convex energy curves. Thus, sometimes, steady locomotion may not be energy optimal, and not preferred, even in the absence of fatigue. Assuming similar non-convex energy curves, we conjecture that similar walk-run mixtures may be energetically beneficial to children following a parent and animals on long leashes. Humans and other animals might also benefit energetically from alternating between moving forward and standing still on a slow and sufficiently long treadmill.

Biomechanics of spontaneous overground walk-to-run transition

The purpose of the present study is to describe the biomechanics of spontaneous walk-to-run transitions (WRTs) in humans. After minimal instructions, 17 physical active subjects performed WRTs on an instrumented runway enabling measurement of speed, acceleration, spatiotemporal variables, ground reaction forces and 3D kinematics. The present study describes (1) the mechanical energy fluctuations of the body centre-of-mass (BCOM) as a reflection of the whole body dynamics and (2) the joint kinematics and kinetics. Consistent with previous research, the spatiotemporal variables show a sudden switch from walking to running in one transition step. During this step there is a sudden increase in forward speed, the so-called speed jump (0.42 m/s). At total body level, this is reflected in a sudden increase in energy of the BCOM (0.83 ± 0.14 J/kg) and an abrupt change from an out-of-phase to an in-phase organization of the kinetic and potential energy fluctuations. During the transition step a larger net propulsive impulse compared to the preceding and following steps is observed due to a decrease in the braking impulse. It is suggested that the altered landing configuration (prepared during the last 40% of the preceding swing) places the body in an optimal configuration to minimize this braking impulse. We hypothesize this configuration also evokes a reflex allowing a more powerful push off, which generates enough power to complete the transition and launch the first flight phase. This powerful push-off is also reflected in the vertical ground reaction force which suddenly changes to a running pattern.

Effects of pediatric obesity on joint kinematics and kinetics during 2 walking cadences

Shultz SP, Sitler MR, Tierney RT, Hillstrom HJ, Song J. Effects of pediatric obesity on joint kinematics and kinetics during 2 walking cadences.

OBJECTIVE

To determine whether differences existed in lower-extremity joint biomechanics during self-selected walking cadence (SW) and fast walking cadence (FW) in overweight- and normal-weight children.

DESIGN

Survey.

SETTING

Institutional gait study center.

PARTICIPANTS

Participants (N=20; mean age +/- SD, 10.4+/-1.6y) from referred and volunteer samples were classified based on body mass index percentiles and stratified by age and sex. Exclusion criteria were a history of diabetes, neuromuscular disorder, or recent lower-extremity injury.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Sagittal, frontal, and transverse plane angular displacements (degrees) and peak moments (newton meters) at the hip, knee, and ankle joints.

RESULTS

The level of significance was set at P less than .008. Compared with normal-weight children, overweight children had greater absolute peak joint moments at the hip (flexor, extensor, abductor, external rotator), the knee (flexor, extensor, abductor, adductor, internal rotator), and the ankle (plantarflexor, inverter, external/internal rotators). After including body weight as a covariate, overweight children had greater peak ankle dorsiflexor moments than normal-weight children. No kinematic differences existed between groups. Greater peak hip extensor moments and less peak ankle inverter moments occurred during FW than SW. There was greater angular displacement during hip flexion as well as less angular displacement at the hip (extension, abduction), knee (flexion, extension), and ankle (plantarflexion, inversion) during FW than SW.

CONCLUSIONS

Overweight children experienced increased joint moments, which can have long-term orthopedic implications and suggest a need for more nonweight-bearing activities within exercise prescription. The percent of increase in joint moments from SW to FW was not different for overweight and normal-weight children. These findings can be used in developing an exercise prescription that must involve weight-bearing activity.

Influence of treadmill acceleration on actual walk-to-run transition

When accelerating continuously, humans spontaneously change from a walking to a running pattern by means of a walk-to-run transition (WRT). Results of previous studies indicate that when higher treadmill accelerations are imposed, higher WRT-speeds can be expected. By studying the kinematics of the WRT at different accelerations, the underlying mechanisms can be unravelled. 19 young, healthy female subjects performed walk-to-run transitions on a constantly accelerating treadmill (0.1, 0.2 and 0.5 m s(-2)). A higher acceleration induced a higher WRT-speed, by effecting the preparation of transition, as well as the actual transition step. Increasing the acceleration caused a higher WRT-speed as a result of a greater step length during the transition step, which was mainly a consequence of a prolonged airborne phase. Besides this effect on the transition step, the direct preparation phase of transition (i.e. the last walking step before transition) appeared to fulfil specific constraints required to execute the transition regardless of the acceleration imposed. This highlights an important role for this step in the debate regarding possible determinants of WRT. In addition spatiotemporal and kinematical data confirmed that WRT remains a discontinuous change of gait pattern in all accelerations imposed. It is concluded that the walk-to-run transition is a discontinuous switch from walking to running which depends on the magnitude of treadmill belt acceleration.

Experimental study on the role of the ankle push off in the walk-to-run transition by means of a powered ankle-foot-exoskeleton

The goal of this study was to analyse the role of the plantarflexor muscles in the walk-to-run transition (WRT) by means of a powered ankle-foot-exoskeleton. 11 female subjects performed several WRT's on an accelerating treadmill while their plantarflexors were assisted or resisted during push off. The WRT speed was lower in the resist condition than in the control condition which reinforces hypotheses from previous simulations, descriptive and experimental studies. There was no increase in WRT speed in the assist condition which is in contrast to another study where the plantarflexor push off was assisted indirectly by a horizontal traction at waist level. The lack of effect from the assist condition in the present study is possibly due to the narrowly focused nature of the experimental manipulation.