A dynamic foot model for predictive simulations of human gait reveals causal relations between foot structure and whole-body mechanics

The unique structure of the human foot is seen as a crucial adaptation for bipedalism. The foot's arched shape enables stiffening the foot to withstand high loads when pushing off, without compromising foot flexibility. Experimental studies demonstrated that manipulating foot stiffness has considerable effects on gait. In clinical practice, altered foot structure is associated with pathological gait. Yet, experimentally manipulating individual foot properties (e.g. arch height or tendon and ligament stiffness) is hard and therefore our understanding of how foot structure influences gait mechanics is still limited. Predictive simulations are a powerful tool to explore causal relationships between musculoskeletal properties and whole-body gait. However, musculoskeletal models used in three-dimensional predictive simulations assume a rigid foot arch, limiting their use for studying how foot structure influences three-dimensional gait mechanics. Here, we developed a four-segment foot model with a longitudinal arch for use in predictive simulations. We identified three properties of the ankle-foot complex that are important to capture ankle and knee kinematics, soleus activation, and ankle power of healthy adults: (1) compliant Achilles tendon, (2) stiff heel pad, (3) the ability to stiffen the foot. The latter requires sufficient arch height and contributions of plantar fascia, and intrinsic and extrinsic foot muscles. A reduced ability to stiffen the foot results in walking patterns with reduced push-off power. Simulations based on our model also captured the effects of walking with anaesthetised intrinsic foot muscles or an insole limiting arch compression. The ability to reproduce these different experiments indicates that our foot model captures the main mechanical properties of the foot. The presented four-segment foot model is a potentially powerful tool to study the relationship between foot properties and gait mechanics and energetics in health and disease.

Tapping into the human spinal locomotor centres with transspinal stimulation

Human locomotion is controlled by spinal neuronal networks of similar properties, function, and organization to those described in animals. Transspinal stimulation affects the spinal locomotor networks and is used to improve standing and walking ability in paralyzed people. However, the function of locomotor centers during transspinal stimulation at different frequencies and intensities is not known. Here, we document the 3D joint kinematics and spatiotemporal gait characteristics during transspinal stimulation at 15, 30, and 50 Hz at sub-threshold and supra-threshold stimulation intensities. We document the temporal structure of gait patterns, dynamic stability of joint movements over stride-to-stride fluctuations, and limb coordination during walking at a self-selected speed in healthy subjects. We found that transspinal stimulation (1) affects the kinematics of the hip, knee, and ankle joints, (2) promotes a more stable coordination at the left ankle, (3) affects interlimb coordination of the thighs, and (4) intralimb coordination between thigh and foot, (5) promotes greater dynamic stability of the hips, (6) increases the persistence of fluctuations in step length variability, and lastly (7) affects mechanical walking stability. These results support that transspinal stimulation is an important neuromodulatory strategy that directly affects gait symmetry and dynamic stability. The conservation of main effects at different frequencies and intensities calls for systematic investigation of stimulation protocols for clinical applications.

Impact of pronated foot on energetic behavior and efficiency during walking

BACKGROUND

The longitudinal arch of the foot acts like a spring during stance and contributes to walking efficiency. Pronated foot characterized by a collapsed medial longitudinal arch may have the impaired spring-like function and poor walking efficiency. However, the differences in the energetic behavior during walking between individuals with pronated foot and neutral foot have not been considered.

RESEARCH QUESTION

How does the energetic behavior within the foot and proximal lower limb joints in pronated foot affect walking efficiency?

METHODS

Twenty-one healthy young adults were classified into neutral foot and pronated foot based on the Foot Posture Index score. All subjects walked across the floor and attempted to have the rearfoot and forefoot segments contact separate force plates to analyze the forces acting on isolated regions within the foot. Kinematic and kinetic data were recorded by a three-dimensional motion capture system. The hip, knee, ankle, and mid-tarsal joint power was quantified using a 6-degree-of-freedom joint power method. To qualify total power within all structures of the foot and forefoot, we used a unified deformable segment analysis. Additionally, we calculated the center of mass power to quantify the total power of the whole body RESULTS: There is no difference in the mid-tarsal joint work between the pronated foot and neutral foot. On the other hand, pronated foot exhibited greater net negative work at structures distal to the forefoot during walking. Additionally, pronated foot exhibited less net positive work at the ankle and center of mass during walking compared to neutral foot.

SIGNIFICANCE

Individuals with pronated foot generate the mid-tarsal joint work by increasing the work absorbed at structures distal to the forefoot, which results in reduced energy efficiency during walking. That energy inefficiency may reduce positive work at the ankle and affect the walking efficiency in individuals with pronated foot.

Chasing footprints in time - reframing our understanding of human foot function in the context of current evidence and emerging insights

In this narrative review we evaluate foundational biomechanical theories of human foot function in light of new data acquired with technology that was not available to early researchers. The formulation and perpetuation of early theories about foot function largely involved scientists who were medically trained with an interest in palaeoanthropology, driven by a desire to understand human foot pathologies. Early observations of people with flat feet and foot pain were analogized to those of our primate ancestors, with the concept of flat feet being a primitive trait, which was a driving influence in early foot biomechanics research. We describe the early emergence of the mobile adaptor-rigid lever theory, which was central to most biomechanical theories of human foot function. Many of these theories attempt to explain how a presumed stiffening behaviour of the foot enables forward propulsion. Interestingly, none of the subsequent theories have been able to explain how the foot stiffens for propulsion. Within this review we highlight the key omission that the mobile adaptor-rigid lever paradigm was never experimentally tested. We show based on current evidence that foot (quasi-)stiffness does not actually increase prior to, nor during propulsion. Based on current evidence, it is clear that the mechanical function of the foot is highly versatile. This function is adaptively controlled by the central nervous system to allow the foot to meet the wide variety of demands necessary for human locomotion. Importantly, it seems that substantial joint mobility is essential for this function. We suggest refraining from using simple, mechanical analogies to explain holistic foot function. We urge the scientific community to abandon the long-held mobile adaptor-rigid lever paradigm, and instead to acknowledge the versatile and non-linear mechanical behaviour of a foot that is adapted to meet constantly varying locomotory demands.

Tapping Into Skeletal Muscle Biomechanics for Design and Control of Lower Limb Exoskeletons: A Narrative Review

Lower limb exoskeletons and exosuits ("exos") are traditionally designed with a strong focus on mechatronics and actuation, whereas the "human side" is often disregarded or minimally modeled. Muscle biomechanics principles and skeletal muscle response to robot-delivered loads should be incorporated in design/control of exos. In this narrative review, we summarize the advances in literature with respect to the fusion of muscle biomechanics and lower limb exoskeletons. We report methods to measure muscle biomechanics directly and indirectly and summarize the studies that have incorporated muscle measures for improved design and control of intuitive lower limb exos. Finally, we delve into articles that have studied how the human-exo interaction influences muscle biomechanics during locomotion. To support neurorehabilitation and facilitate everyday use of wearable assistive technologies, we believe that future studies should investigate and predict how exoskeleton assistance strategies would structurally remodel skeletal muscle over time. Real-time mapping of the neuromechanical origin and generation of muscle force resulting in joint torques should be combined with musculoskeletal models to address time-varying parameters such as adaptation to exos and fatigue. Development of smarter predictive controllers that steer rather than assist biological components could result in a synchronized human-machine system that optimizes the biological and electromechanical performance of the combined system.

Biomechanical Tradeoffs in Foot Function From Variations in Shoe Design

There is debate and confusion over how to evaluate the biomechanical effects of running shoe design. Here, we use an evolutionary perspective to analyze how key design features of running shoes alter the evolved biomechanics of the foot, creating a range of tradeoffs in force production and transmission that may affect performance and vulnerability to injury.

Mechanics of the human foot during walking on different slopes

When humans walk on slopes, the ankle, knee, and hip joints modulate their mechanical work to accommodate the mechanical demands. Yet, it is unclear if the foot modulates its work output during uphill and downhill walking. Therefore, we quantified the mechanical work performed by the foot and its subsections of twelve adults walked on five randomized slopes (-10°, -5°, 0°, +5°, +10°). We estimated the work of distal-to-hindfoot and distal-to-forefoot structures using unified deformable segment analysis and the work of the midtarsal, ankle, knee, and hip joints using a six-degree-of-freedom model. Further, using a geometric model, we estimated the length of the plantar structures crossing the longitudinal arch while accounting for the first metatarsophalangeal wrapping length. We hypothesized that compared to level walking, downhill walking would increase negative and net-negative work magnitude, particularly at the early stance phase, and uphill walking would increase the positive work, particularly at the mid-to-late stance phase. We found that downhill walking increased the magnitude of the foot's negative and net-negative work, especially during early stance, highlighting its capacity to absorb impacts when locomotion demands excessive energy dissipation. Notably, the foot maintained its net dissipative behavior between slopes; however, the ankle, knee, and hip shifted from net energy dissipation to net energy generation when changing from downhill to uphill. Such results indicate that humans rely more on joints proximal to the foot to modulate the body's total mechanical energy. Uphill walking increased midtarsal's positive and distal-to-forefoot negative work in near-equal amounts. That coincided with the prolonged lengthening and delayed shortening of the plantar structures, resembling a spring-like function that possibly assists the energetic demands of locomotion during mid-to-late stance. These results broaden our understanding of the foot's mechanical function relative to the leg's joints and could inspire the design of wearable assistive devices that improve walking capacity.

Atypical triceps surae force and work patterns underlying gait in children with cerebral palsy

The purpose of this study was to quantitatively assess Achilles tendon mechanical behavior during gait in children with cerebral palsy (CP). We used a newly designed noninvasive sensor to measure Achilles tendon force in 11 children with CP (4F, 8-16 years old) and 15 typically developing children (controls) (9F, 8-17 years old) during overground walking. Mechanical work loop plots (force-displacement plots) were generated by combining muscle-tendon kinetics, kinematics, and EMG activity to evaluate the Achilles tendon work generated about the ankle. Work loop patterns in children with CP were substantially different than those seen in controls. Notably, children with CP showed significantly diminished work production at their preferred speed compared to controls at their preferred speed and slower speeds. Despite testing a heterogeneous population of children with CP, we observed a homogenous spring-like muscle-tendon behavior in these participants. This is in contrast with control participants who used their plantar flexors like a motor during gait. Statement of Clinical Significance: These data demonstrate the potential for using skin-mounted sensors to objectively evaluate muscle contributions to work production in pathological gait.

Kinetic energy absorption differences during drop jump between athletes with and without radiological signs of knee osteoarthritis: Two years post anterior cruciate ligament reconstruction

BACKGROUND

Patients demonstrate decreased knee loading and energy absorption after anterior cruciate ligament reconstruction (ACLR). This study aimed to determine the differences in the contribution of joints to the absorbed energy between athletes with and without radiological signs of knee OA 2 years after ACLR during drop jump (DJ) landing from 20, 30, and 40 cm.

METHODS

Forty-one (level I/II) athletes 2 years after ACLR participated in this cross-sectional study and completed motion analysis testing of DJ. Proportional contribution of the joints (foot, ankle, knee, and hip) to the absorbed energy were computed. Posterior-anterior bent-knee radiographs were completed and graded in the medial compartment of the reconstructed knee using the Kellgren-Lawrence (KL) system (OA group: KL ≥2; Non-OA group: KL<2) RESULTS: Thirteen (31.7%) athletes showed radiological signs of knee OA in the medial compartment. There was a significant joint-by-group-by-limb interaction for the contribution of joints to absorbed energy during DJ 40 cm (p ≤ 0.019) and a joint-by-group interaction for the contribution of joints during DJ 20 cm (p = 0.018). The OA group had a lower involved knee (p = 0.043) and higher involved hip contributions (p = 0.014) compared to the Non-OA group, and the non-involved knee (p = 0.007). While the Non-OA group had a lower involved ankle contribution (p = 0.045) compared to their non-involved ankle during DJ 40 cm. The OA group also had higher involved hip contribution than the Non-OA group (p = 0.010), lower involved knee (p = 0.002), and higher involved hip contribution than the non-involved limb during DJ 20 cm.

SIGNIFICANCE

The OA group may have adopted a compensatory pattern characterized by a decreased involved knee and increased involved hip to attenuate absorbed energy compared to the Non-OA group and their non-involved limb. The contribution of joints to the absorbed energy during DJ landing might be used as an assessment tool to identify patients with radiological signs of knee OA after ACLR.

Methods of Estimating Foot Power and Work in Standing Vertical Jump

Experimental motion capture studies have commonly considered the foot as a single rigid body even though the foot contains 26 bones and 30 joints. Various methods have been applied to study rigid body deviations of the foot. This study compared 3 methods: distal foot power (DFP), foot power imbalance (FPI), and a 2-segment foot model to study foot power and work in the takeoff phase of standing vertical jumps. Six physically active participants each performed 6 standing vertical jumps from a starting position spanning 2 adjacent force platforms to allow ground reaction forces acting on the foot to be divided at the metatarsophalangeal (MTP) joints. Shortly after movement initiation, DFP showed a power absorption phase followed by a power generation phase. FPI followed a similar pattern with smaller power absorption and a larger power generation compared to DFP. MTP joints primarily generated power in the 2-segment model. The net foot work was -4.0 (1.0) J using DFP, 1.8 (1.1) J using FPI, and 5.1 (0.5) J with MTP. The results suggest that MTP joints are only 1 source of foot power and that differences between DFP and FPI should be further explored in jumping and other movements.

Foot arch rigidity in walking: In vivo evidence for the contribution of metatarsophalangeal joint dorsiflexion

Human foot rigidity is thought to provide a more effective lever with which to push against the ground. Tension of the plantar aponeurosis (PA) with increased metatarsophalangeal (MTP) joint dorsiflexion (i.e., the windlass mechanism) has been credited with providing some of this rigidity. However, there is growing debate on whether MTP joint dorsiflexion indeed increases arch rigidity. Further, the arch can be made more rigid independent of additional MTP joint dorsiflexion (e.g., when walking with added mass). The purpose of the present study was therefore to compare the influence of increased MTP joint dorsiflexion with the influence of added mass on the quasi-stiffness of the midtarsal joint in walking. Participants walked with a rounded wedge under their toes to increase MTP joint dorsiflexion in the toe-wedge condition, and wore a weighted vest with 15% of their body mass in the added mass condition. Plantar aponeurosis behavior, foot joint energetics, and midtarsal joint quasi-stiffness were compared between conditions to analyze the mechanisms and effects of arch rigidity differences. Midtarsal joint quasi-stiffness was increased in the toe-wedge and added mass conditions compared with the control condition (both p < 0.001). In the toe-wedge condition, the time-series profiles of MTP joint dorsiflexion and PA strain and force were increased throughout mid-stance (p < 0.001). When walking with added mass, the time-series profile of force in the PA did not increase compared with the control condition although quasi-stiffness did, supporting previous evidence that the rigidity of the foot can be actively modulated. Finally, more mechanical power was absorbed (p = 0.006) and negative work was performed (p < 0.001) by structures distal to the rearfoot in the toe-wedge condition, a condition which displayed increased midtarsal joint quasi-stiffness. This indicates that a more rigid foot may not necessarily transfer power to the ground more efficiently.

Which lower limb joints compensate for destabilizing energy during walking in humans?

Current approaches to investigating stabilizing responses during locomotion lack measures that both directly relate to perturbation demands and are shared across different levels of description (i.e. joints and legs). Here, we investigated whether mechanical energy could serve as a 'common currency' during treadmill walking with transient unilateral belt accelerations. We hypothesized that by delivering perturbations in either early or late stance, we could elicit net negative or positive work, respectively, from the perturbed leg at the leg/treadmill interface, which would dictate the net demand at the overall leg level. We further hypothesized that of the lower limb joints, the ankle would best reflect changes in overall leg work. On average across all seven participants and 222 perturbations, we found early stance perturbations elicited no change in net work performed by the perturbed leg on the treadmill, but net positive work by the overall leg, which did not support our hypotheses. Conversely, late stance perturbations partially supported our hypotheses by eliciting positive work at the leg/treadmill interface, but no change in net work by the overall leg. In support of our final hypothesis, changes in perturbed ankle work, in addition to contralateral knee work, best reflected changes in overall leg work.

Adaptations for bipedal walking: Musculoskeletal structure and three-dimensional joint mechanics of humans and bipedal chimpanzees (Pan troglodytes)

Humans are unique among apes and other primates in the musculoskeletal design of their lower back, pelvis, and lower limbs. Here, we describe the three-dimensional ground reaction forces and lower/hindlimb joint mechanics of human and bipedal chimpanzees walking over a full stride and test whether: 1) the estimated limb joint work and power during the stance phase, especially the single-support period, is lower in humans than bipedal chimpanzees, 2) the limb joint work and power required for limb swing is lower in humans than in bipedal chimpanzees, and 3) the estimated total mechanical power during walking, accounting for the storage of passive elastic strain energy in humans, is lower in humans than in bipedal chimpanzees. Humans and bipedal chimpanzees were compared at matched dimensionless and dimensional velocities. Our results indicate that humans walk with significantly less work and power output in the first double-support period and the single-support period of stance, but markedly exceed chimpanzees in the second double-support period (i.e., push-off). Humans generate less work and power in limb swing, although the species difference in limb swing power was not statistically significant. We estimated that total mechanical positive 'muscle fiber' work and power were 46.9% and 35.8% lower, respectively, in humans than in bipedal chimpanzees at matched dimensionless speeds. This is due in part to mechanisms for the storage and release of elastic energy at the ankle and hip in humans. Furthermore, these results indicate distinct 'heel strike' and 'lateral balance' mechanics in humans and bipedal chimpanzees and suggest a greater dissipation of mechanical energy through soft tissue deformations in humans. Together, our results document important differences between human and bipedal chimpanzee walking mechanics over a full stride, permitting a more comprehensive understanding of the mechanics and energetics of chimpanzee bipedalism and the evolution of hominin walking.

Bilateral vs. Paretic-Limb-Only Ankle Exoskeleton Assistance for Improving Hemiparetic Gait: A Case Series

People with lower-limb hemiparesis have impaired function on one side of the body that affects their walking ability. Wearable robotic assistance has been investigated to treat hemiparetic gait by applying assistance to the paretic limb. In this exploratory case series, we sought to compare the effects of bilateral vs. paretic-limb-only ankle exoskeleton assistance on walking performance in a case series of three heterogeneous presentations of lower-limb hemiparesis. A secondary goal was to validate the use of a real-time ankle-moment-adaptive exoskeleton control system for effectively assisting hemiparetic gait; the ankle moment controller accuracy ranged from 72 - 90% across all conditions and participants. Compared to walking without the device, both paretic-limb-only and bilateral assistance resulted in greater average total ankle power (up to 72%), improved treadmill walking efficiency (up to 28%), and increased over-ground walking distance (up to 41%). All participants achieved a more symmetrical, efficient gait pattern with bilateral assistance, indicating that assisting both limbs may be more beneficial than assisting only the paretic side in people with hemiparetic gait. The results of this case series are intended to inform future clinical studies and exoskeleton designs in a wide range of patient populations.

The Effects of Wobbling Mass Components on Joint Dynamics During Running

Soft tissue moves relative to the underlying bone during locomotion. Research has shown that soft tissue motion has an effect on aspects of the dynamics of running; however, little is known about the effects of soft tissue motion on the joint kinetics. In the present study, for a single subject, soft tissue motion was modeled using wobbling components in an inverse dynamics analysis to access the effects of the soft tissue on joint kinetics at the knee and hip. The added wobbling components had little effect on the knee joint kinetics, but large effects on the hip joint kinetics. In particular, the hip joint power and net negative and net positive mechanical work at the hip was greatly underestimated when calculated with the model without wobbling components compared with that of the model with wobbling components. For example, for low-frequency wobbling conditions, the magnitude of the peak hip joint moments were 50% greater when computed accounting the wobbling masses compared with a rigid body model, while for high-frequency wobbling conditions, the peaks were within 15%. The present study suggests that soft tissue motion should not be ignored during inverse dynamics analyses of running.

Influence of metatarsophalangeal joint stiffness on take-off performances and lower-limb biomechanics in jump manoeuvres

Forefoot and toes are prominent regions for locomotion and individual metatarsophalangeal joint (MTPJ) stiffness may be linked to jump take-off mechanics and performances. However, little is known about the relationships between MTPJ stiffness and take-off related variables. This study examined the relationship between individual MTPJ stiffness and biomechanical variables under various vertical countermovement jumps (CMJ) conditions. We measured MTPJ stiffness on 21 male university basketball players and then asked them to perform jumps under single, consecutive and running CMJ conditions. Pearson's correlation coefficient was employed to examine the relationships between MTP passive stiffness and each jumping performance, ground reaction force (GRF) and joint kinematic and kinetic variables. The results indicated that MTPJ stiffness significantly correlated with maximum jump height (r = 0.49, moderate), peak take-off velocity (r = 0.47, moderate), peak take-off ankle plantarflexion moment (r = 0.68, strong), peak dorsiflexion moment (r = 0.60, strong) and peak take-off ankle power (r = 0.44, moderate) in consecutive CMJ. Only a moderate correlation between MTPJ stiffness and peak MTPJ extension take-off velocity (r = -0.46, moderate) was determined in a single CMJ. There were no significant correlations found in running CMJ conditions. These findings imply that higher MTPJ stiffness of participants was related to improved jump performances in consecutive jumps.

Mechanical work accounts for most of the energetic cost in human running

The metabolic cost of human running is not well explained, in part because the amount of work performed actively by muscles is largely unknown. Series elastic tissues such as tendon can save energy by performing work passively, but there are few direct measurements of the active versus passive contributions to work in running. There are, however, indirect biomechanical measures that can help estimate the relative contributions to overall metabolic cost. We developed a simple cost estimate for muscle work in humans running (N = 8) at moderate speeds (2.2–4.6 m/s) based on measured joint mechanics and passive dissipation from soft tissue deformations. We found that even if 50% of the work observed at the lower extremity joints is performed passively, active muscle work still accounts for 76% of the net energetic cost. Up to 24% of this cost compensates for the energy lost in soft tissue deformations. The estimated cost of active work may be adjusted based on assumptions of multi-articular energy transfer, elasticity, and muscle efficiency, but even conservative assumptions yield active work costs of at least 60%. Passive elasticity can reduce the active work of running, but muscle work still explains most of the overall energetic cost.

Effects of restriction of forefoot rocker functions by immobilisation of metatarsophalangeal joints on kinematics and kinetics during walking

OBJECTIVE

This study was conducted to investigate the effects of restriction of forefoot rocker (FFR) functions by immobilisation of unilateral metatarsophalangeal joints (MPJs) on kinematic and kinetic factors during walking.

METHODS

Eighteen healthy young adults participated in this study. To immobilise the MPJs of the right leg, an aluminium sole plate (AS) was fixed on the sole of the foot. Kinematic and kinetic data were collected while each subject walked at a comfortable speed with the AS and without.

RESULTS

In the AS condition, the walking speed and contralateral step length were significantly decreased, and an asymmetrical centre of mass (COM) movement was observed. The range of plantarflexion motion and positive work by the ankle joint were decreased markedly during the late stance of the AS limb. In contrast, maximum hip and knee flexion angles in the swing phase of the AS limb and positive work by the bilateral hip joints over the gait cycle were increased.

CONCLUSIONS

The results suggested that MPJ immobilisation may result in marked motion limitation of ankle plantarflexion and inhibition of push-off by the ankle joint despite no restrictions on the ankle joint. These changes may interfere with gait speed and a smooth and symmetrical COM shift during walking.

Reducing stiffness of shock-absorbing pylon amplifies prosthesis energy loss and redistributes joint mechanical work during walking

BACKGROUND

A shock-absorbing pylon (SAP) is a modular prosthetic component designed to attenuate impact forces, which unlike traditional pylons that are rigid, can compress to absorb, return, or dissipate energy. Previous studies found that walking with a SAP improved lower-limb prosthesis users' comfort and residual limb pain. While longitudinal stiffness of a SAP has been shown to affect gait kinematics, kinetics, and work done by the entire lower limb, the energetic contributions from the prosthesis and the intact joints have not been examined. The purpose of this study was to determine the effects of SAP stiffness and walking speed on the mechanical work contributions of the prosthesis (i.e., all components distal to socket), knee, and hip in individuals with a transtibial amputation.

METHODS

Twelve participants with unilateral transtibial amputation walked overground at their customary (1.22 ± 0.18 ms^-1) and fast speeds (1.53 ± 0.29 ms^-1) under four different levels of SAP stiffness. Power and mechanical work profiles of the leg joints and components distal to the socket were quantified. The effects of SAP stiffness and walking speed on positive and negative work were analyzed using two-factor (stiffness and speed) repeated-measure ANOVAs (α = 0.05).

RESULTS

Faster walking significantly increased mechanical work from the SAP-integrated prosthesis (p < 0.001). Reducing SAP stiffness increased the magnitude of prosthesis negative work (energy absorption) during early stance (p = 0.045) by as much as 0.027 Jkg^-1, without affecting the positive work (energy return) during late stance (p = 0.159), suggesting a damping effect. This energy loss was partially offset by an increase in residual hip positive work (as much as 0.012 Jkg^-1) during late stance (p = 0.045). Reducing SAP stiffness also reduced the magnitude of negative work on the contralateral sound limb during early stance by 11-17% (p = 0.001).

CONCLUSIONS

Reducing SAP stiffness and faster walking amplified the prostheses damping effect, which redistributed the mechanical work, both in magnitude and timing, within the residual joints and sound limb. With its capacity to absorb and dissipate energy, future studies are warranted to determine whether SAPs can provide additional user benefit for locomotor tasks that require greater attenuation of impact forces (e.g., load carriage) or energy dissipation (e.g., downhill walking).

The transverse arch in the human feet: A narrative review of its evolution, anatomy, biomechanics and clinical implications

The dominant characteristics of the human foot are its shock-absorbing capability during walking or gait cycle and its adaptation to uneven surfaces. On the stance phase of the gait, the foot has to be flexible at first for shock absorption and adapt to the terrain; whereas, during the propulsive phase, it has to be dynamically rigid to function as a lever. Foot flexibility and rigidity are mainly controlled at the subtalar and midtarsal joints by tendons and ligaments. The subtalar joint is part of the longitudinal arch, but the midtarsal joint along with the tarsometatarsal joint are components of the transverse arch. However, the existence and functional role of transverse arch in human was challenged by some authors. But recent studies have revealed that the transverse arch has a predominant role in midfoot stiffness (Venkadeshan et al., 2020, & Holowoka et al., 2017). This midfoot stiffness allows the human foot to store elastic energy at the time of heel strike, which is utilized during the push-off mechanism for propulsion, thus making bipedalism more energy-efficient. Moreover, the transverse arch allows the longitudinal arch to be flexible like a lever and, at the same time, makes the arch of the foot rigid to behave like a stiff spring lever. Understanding the role of the transverse arch is obligatory to study the biomechanics of foot injuries and Charcot or diabetic foot. Studies on diabetic foot have shown that the modulation of transverse arch biomechanics and off-loading modalities would improve outcomes in the form of wound-healing and prevention of re-ulceration.

Soft tissue deformations explain most of the mechanical work variations of human walking

Humans perform mechanical work during walking, some by leg joints actuated by muscles, and some by passive, dissipative soft tissues. Dissipative losses must be restored by active muscle work, potentially in amounts sufficient to cost substantial metabolic energy. The most dissipative, and therefore costly, walking conditions might be predictable from the pendulum-like dynamics of the legs. If this behavior is systematic, it may also predict the work distribution between active joints and passive soft tissues. We therefore tested whether the overall negative work of walking, and the fraction due to soft tissue dissipation, are both predictable by a simple dynamic walking model across a wide range of conditions. The model predicts whole-body negative work from the leading leg's impact with ground (termed the Collision), to increase with the squared product of walking speed and step length. We experimentally tested this in humans (N=9) walking in 26 different combinations of speed (0.7 - 2.0 m·s-1) and step length (0.5 - 1.1 m), with recorded motions and ground reaction forces. Whole-body negative Collision work increased as predicted (R2=0.73), with a consistent fraction of about 63% (R2=0.88) due to soft tissues. Soft tissue dissipation consistently accounted for about 56% of the variation in total whole-body negative work, across a wide range of speed and step length combinations. During typical walking, active work to restore dissipative losses could account for 31% of the net metabolic cost. Soft tissue dissipation, not included in most biomechanical studies, explains most of the variation in negative work of walking, and could account for a substantial fraction of the metabolic cost.

The effects of footplate stiffness on push-off power when walking with posterior leaf spring ankle-foot orthoses

BACKGROUND

Many studies on ankle-foot orthoses investigated the optimal stiffness around the ankle, while the effect of footplate stiffness has been largely ignored. This study investigated the effects of ankle-foot orthosis footplate stiffness on ankle-foot push-off power during walking in able-bodied persons.

METHODS

Twelve healthy participants walked at a fixed speed (1.25 m·s^-1) on an instrumented treadmill in four conditions: shod and with a posterior leaf-spring orthosis with a flexible, stiff or rigid footplate. For each trial, ankle kinematics and kinetics were averaged over one-minute walking. Separate contributions of the ankle joint complex and distal hindfoot to total ankle-foot power and work were calculated using a deformable foot model.

FINDINGS

Peak ankle joint power was significantly higher with the rigid footplate compared to the flexible and stiff footplate and not different from shod walking. The stiff footplate increased peak hindfoot power compared to the flexible and rigid footplate and shod walking. Total ankle-foot power showed a significant increase with increasing footplate stiffness, where walking with the rigid footplate was comparable to shod walking. Similar effects were found for positive mechanical work.

INTERPRETATION

A rigid footplate increases the lever of the foot, resulting in an increased ankle moment and energy storage and release of the orthosis' posterior leaf-spring as reflected in higher ankle joint power. This effect dominates the power generation of the foot, which was highest with the intermediate footplate stiffness. Future studies should focus on how tuning footplate stiffness could contribute to optimizing ankle-foot orthosis efficacy in clinical populations.

A passive mechanism for decoupling energy storage and return in ankle-foot prostheses: A case study in recycling collision energy

Individuals with lower limb amputation experience reduced ankle push-off work in the absence of functional muscles spanning the joint, leading to decreased walking performance. Conventional energy storage and return (ESR) prostheses partially compensate by storing mechanical energy during midstance and returning this energy during the terminal stance phase of gait. These prostheses can provide approximately 30% of the push-off work performed by a healthy ankle-foot during walking. Novel prostheses that return more normative levels of mechanical energy may improve walking performance. In this work, we designed a Decoupled ESR (DESR) prosthesis which stores energy usually dissipated at heel-strike and loading response, and returns this energy during terminal stance, thus increasing the mechanical push-off work done by the prosthesis. This decoupling is achieved by switching between two different cam profiles that produce distinct, nonlinear torque-angle mechanics. The cams automatically interchange at key points in the gait cycle via a custom magnetic switching system. Benchtop characterization demonstrated the successful decoupling of energy storage and return. The DESR mechanism was able to capture energy at heel-strike and loading response, and return it later in the gait cycle, but this recycling was not sufficient to overcome mechanical losses. In addition to its potential for recycling energy, the DESR mechanism also enables unique mechanical customizability, such as dorsiflexion during swing phase for toe clearance, or increasing the rate of energy release at push-off.

Speed-Related Energy Flow and Joint Function Change During Human Walking

During human walking, mechanical energy transfers between segments via joints. Joint mechanics of the human body are coordinated with each other to adapt to speed change. The aim of this study is to analyze the functional behaviors of major joints during walking, and how joints and segments alter walking speed during different periods (collision, rebound, preload, and push-off) of stance phase. In this study, gait experiment was performed with three different self-selected speeds. Mechanical works of joints and segments were determined with collected data. Joint function indices were calculated based on net joint work. The results show that the primary functional behaviors of joints would not change with altering walking speed, but the function indices might be changed slightly (e.g., strut functions decrease with increasing walking speed). Waist acts as strut during stance phase and contributes to keep stability during collision when walking faster. Knee of stance leg does not contribute to altering walking speed. Hip and ankle absorb more mechanical energy to buffer the strike during collision with increasing walking speed. What is more, hip and ankle generate more energy during push-off with greater motion to push distal segments forward with increasing walking speed. Ankle also produces more mechanical energy during push-off to compensate the increased heel-strike collision of contralateral leg during faster walking. Thus, human may utilize the cooperation of hip and ankle during collision and push-off to alter walking speed. These findings indicate that speed change in walking leads to fundamental changes to joint mechanics.

Torque Curve Optimization of Ankle Push-Off in Walking Bipedal Robots Using Genetic Algorithm

Ankle push-off occurs when muscle–tendon units about the ankle joint generate a burst of positive power at the end of stance phase in human walking. Ankle push-off mainly contributes to both leg swing and center of mass (CoM) acceleration. Humans use the amount of ankle push-off to induce speed changes. Thus, this study focuses on determining the faster walking speed and the lowest energy efficiency of biped robots by using ankle push-off. The real-time-space trajectory method is used to provide reference positions for the hip and knee joints. The torque curve during ankle push-off, composed of three quintic polynomial curves, is applied to the ankle joint. With the walking distance and the mechanical cost of transport (MCOT) as the optimization goals, the genetic algorithm (GA) is used to obtain the optimal torque curve during ankle push-off. The results show that the biped robot achieved a maximum speed of 1.3 m/s, and the ankle push-off occurs at 41.27−48.34% of the gait cycle. The MCOT of the bipedal robot corresponding to the high economy gait is 0.70, and the walking speed is 0.54 m/s. This study may further prompt the design of the ankle joint and identify the important implications of ankle push-off for biped robots.

The Impact of Locomotor Speed on the Human Metatarsophalangeal Joint Kinematics

This paper aims to further our previous study to investigate the effect of speed on the human metatarsophalangeal (MP) joint kinematics during running on level ground. The 3D motion of the foot segments was captured by a twelve-camera motion analysis system, and the ground reaction forces and moments were recorded by using a six-force plate array. The relative movement between the tarsometatarsi (hindfoot) and phalanges (forefoot) segments were recorded to obtain the 3D orientation and position of the functional axis (FA) of the MP joint. The results show that the FA locates about an average of 19% foot length (FL) anterior to the anatomical axis (AA) across all running speeds, and is also 4.8% FL inferior to the AA during normal and fast run. Similar to walking, the functional axis is more oblique than the anatomical axis with a more anterior–inferior orientation across all the running speeds. This suggests that representing MP joint with the AA may mislead the calculation of joint moment/power and muscle moment arms in both running and walking gait. Compared with previous study, we found that walking and running speeds have statistically significant effects on the position of the FA. The functional axis moves frontward to a more anterior position when the speed increases during walking and running. It transfers upward in the superior direction with increasing speed of walking, but moves more toward the inferior position when the velocity increased further to running. Also, the orientation of FA in sagittal plane became more oblique toward the vertical direction as the speed increased. This may help in moderating the muscular effort, increase the muscle EMA and improve the locomotor performance. These results would contribute to understanding the in vivo biomechanical function of the MP joint and also the foot propulsion during human locomotion.

The effects of shoe upper construction on mechanical ankle joint work during lateral shuffle movements

Lateral shuffles are common movements in sports and are facilitated by the hip, knee, and ankle joints. Shoe uppers can change ankle kinetics during walking and running. However, it is not known how shoe upper modifications affect ankle kinetics during shuffling. The purpose of this study was to investigate the effects of shoe upper construction on mechanical ankle joint work during shuffling. It was hypothesized that a shoe with a reinforced upper will result in decreased negative ankle joint work. Twenty participants performed Maximal (MLST) and Submaximal Lateral Shuffle Tests (90% of MLST) in footwear with a minimal (MU) and reinforced upper (RU). Ground reaction forces and ankle kinematics were collected to compute ankle joint work. Performing lateral shuffles in the RU condition resulted in significantly reduced positive (MU: 0.62 ± 0.16 J/kg, RU: 0.55 ± 0.16 J/kg; p = 0.001, d = 0.44) and negative (MU: -0.60 ± 0.20 J/kg, RU: -0.53 ± 0.19 J/kg; p = 0.004, d = 0.41) ankle work. A decrease in positive and negative work could be a performance benefit, enabling the athlete to perform the same movement with a lower energy cost. More extreme upper interventions may yield even larger performance benefits.

Neural Network Based Contact Force Control Algorithm for Walking Robots

Walking algorithms using push-off improve moving efficiency and disturbance rejection performance. However, the algorithm based on classical contact force control requires an exact model or a Force/Torque sensor. This paper proposes a novel contact force control algorithm based on neural networks. The proposed model is adapted to a linear quadratic regulator for position control and balance. The results demonstrate that this neural network-based model can accurately generate force and effectively reduce errors without requiring a sensor. The effectiveness of the algorithm is assessed with the realistic test model. Compared to the Jacobian-based calculation, our algorithm significantly improves the accuracy of the force control. One step simulation was used to analyze the robustness of the algorithm. In summary, this walking control algorithm generates a push-off force with precision and enables it to reject disturbance rapidly.

Theoretical justification for distal foot power equation

The distal foot power equation is a simple yet powerful tool for estimating the power dissipation or generation within the foot even while modeling it as a rigid body. It was introduced over two decades ago, but has seen a resurgence of use in recent years. Nevertheless, the theoretical justification for this formula has thus far been limited. It is difficult to properly use any equation and interpret the results from analyses using it without a solid understanding of how it is derived as well as its underlying assumptions. In this communication, a thorough derivation of the distal foot power equation is provided first for the case where the foot is interacting with a rigid ground without sliding and then second generalized for situations when the foot may slide relative to a deformable ground surface. For the first case, the derivation makes clear that distal foot power represents the power due to the deviation of the foot from a rigid body state for the portion of the foot between its mass center (or other point of reference) and the center of pressure. For the second case, distal foot power represents not only the internal deformation power of the foot, but also the power due to sliding of the foot on the ground and the power due to deformation of the ground near the point of contact.

Walking with added mass magnifies salient features of human foot energetics

The human foot serves numerous functional roles during walking, including shock absorption and energy return. Here, we investigated walking with added mass to determine how the foot would alter its mechanical work production in response to a greater force demand. Twenty-one healthy young adults walked with varying levels of added body mass: 0%, +15% and +30% (relative to their body mass). We quantified mechanical work performed by the foot using a unified deformable segment analysis and a multi-segment foot model. We found that walking with added mass tended to magnify certain features of the foot's functions. Magnitudes of both positive and negative mechanical work, during stance in the foot, increased when walking with added mass. Yet, the foot preserved similar amounts of net negative work, indicating that the foot dissipates energy overall. Furthermore, walking with added mass increased the foot's negative work during early stance phase, highlighting the foot's role as a shock-absorber. During mid to late stance, the foot produced greater positive work when walking with added mass, which coincided with greater work from the structures spanning the midtarsal joint (i.e. arch). While this study captured the overall behavior of the foot when walking with varying force demands, future studies are needed to further determine the relative contribution of active muscles and elastic tissues to the foot's overall energy.

Impact of elastic ankle exoskeleton stiffness on neuromechanics and energetics of human walking across multiple speeds

BACKGROUND

Elastic ankle exoskeletons with intermediate stiffness springs in parallel with the human plantarflexors can reduce the metabolic cost of walking by ~ 7% at 1.25 m s- 1. In a move toward 'real-world' application, we examined whether the unpowered approach has metabolic benefit across a range of walking speeds, and if so, whether the optimal exoskeleton stiffness was speed dependent. We hypothesized that, for any walking speed, there would be an optimal ankle exoskeleton stiffness - not too compliant and not too stiff - that minimizes the user's metabolic cost. In addition, we expected the optimal stiffness to increase with walking speed.

METHODS

Eleven participants walked on a level treadmill at 1.25, 1.50, and 1.75 m s- 1 while we used a state-of-the-art exoskeleton emulator to apply bilateral ankle exoskeleton assistance at five controlled rotational stiffnesses (kexo = 0, 50, 100, 150, 250 Nm rad- 1). We measured metabolic cost, lower-limb joint mechanics, and EMG of muscles crossing the ankle, knee, and hip.

RESULTS

Metabolic cost was significantly reduced at the lowest exoskeleton stiffness (50 Nm rad- 1) for assisted walking at both 1.25 (4.2%; p = 0.0162) and 1.75 m s- 1 (4.7%; p = 0.0045). At these speeds, the metabolically optimal exoskeleton stiffness provided peak assistive torques of ~ 0.20 Nm kg- 1 that resulted in reduced biological ankle moment of ~ 12% and reduced soleus muscle activity of ~ 10%. We found no stiffness that could reduce the metabolic cost of walking at 1.5 m s- 1. Across all speeds, the non-weighted sum of soleus and tibialis anterior activation rate explained the change in metabolic rate due to exoskeleton assistance (p < 0.05; R2 > 0.56).

CONCLUSIONS

Elastic ankle exoskeletons with low rotational stiffness reduce users' metabolic cost of walking at slow and fast but not intermediate walking speed. The relationship between the non-weighted sum of soleus and tibialis activation rate and metabolic cost (R2 > 0.56) indicates that muscle activation may drive metabolic demand. Future work using simulations and ultrasound imaging will get 'under the skin' and examine the interaction between exoskeleton stiffness and plantarflexor muscle dynamics to better inform stiffness selection in human-machine systems.

Gearing Up the Human Ankle-Foot System to Reduce Energy Cost of Fast Walking

During locomotion, the human ankle-foot system dynamically alters its gearing, or leverage of the ankle joint on the ground. Shifting ankle-foot gearing regulates speed of plantarflexor (i.e., calf muscle) contraction, which influences economy of force production. Here, we tested the hypothesis that manipulating ankle-foot gearing via stiff-insoled shoes will change the force-velocity operation of plantarflexor muscles and influence whole-body energy cost differently across walking speeds. We used in vivo ultrasound imaging to analyze fascicle contraction mechanics and whole-body energy expenditure across three walking speeds (1.25, 1.75, and 2.0 m/s) and three levels of foot stiffness. Stiff insoles increased leverage of the foot upon the ground  (p < 0.001), and increased dorsiflexion range-of-motion (p < 0.001). Furthermore, stiff insoles resulted in a 15.9% increase in average force output (p < 0.001) and 19.3% slower fascicle contraction speed (p = 0.002) of the major plantarflexor (Soleus) muscle, indicating a shift in its force-velocity operating region. Metabolically, the stiffest insoles increased energy cost by 9.6% at a typical walking speed (1.25 m/s, p = 0.026), but reduced energy cost by 7.1% at a fast speed (2.0 m/s, p = 0.040). Stiff insoles appear to add an extra gear unavailable to the human foot, which can enhance muscular performance in a specific locomotion task.

Ultrasound imaging links soleus muscle neuromechanics and energetics during human walking with elastic ankle exoskeletons

Unpowered exoskeletons with springs in parallel to human plantar flexor muscle-tendons can reduce the metabolic cost of walking. We used ultrasound imaging to look 'under the skin' and measure how exoskeleton stiffness alters soleus muscle contractile dynamics and shapes the user's metabolic rate during walking. Eleven participants (4F, 7M; age: 27.7 ± 3.3 years) walked on a treadmill at 1.25 m s-1 and 0% grade with elastic ankle exoskeletons (rotational stiffness: 0-250 Nm rad-1) in one training and two testing days. Metabolic savings were maximized (4.2%) at a stiffness of 50 Nm rad-1. As exoskeleton stiffness increased, the soleus muscle operated at longer lengths and improved economy (force/activation) during early stance, but this benefit was offset by faster shortening velocity and poorer economy in late stance. Changes in soleus activation rate correlated with changes in users' metabolic rate (p = 0.038, R2 = 0.44), highlighting a crucial link between muscle neuromechanics and exoskeleton performance; perhaps informing future 'muscle-in-the loop' exoskeleton controllers designed to steer contractile dynamics toward more economical force production.

The foot is more than a spring: human foot muscles perform work to adapt to the energetic requirements of locomotion

The foot has been considered both as an elastic mechanism that increases the efficiency of locomotion by recycling energy, as well as an energy sink that helps stabilize movement by dissipating energy through contact with the ground. We measured the activity of two intrinsic foot muscles, flexor digitorum brevis (FDB) and abductor hallucis (AH), as well as the mechanical work performed by the foot as a whole and at a modelled plantar muscle-tendon unit (MTU) to test whether these passive mechanics are actively controlled during stepping. We found that the underlying passive visco-elasticity of the foot is modulated by the muscles of the foot, facilitating both dissipation and generation of energy depending on the mechanical requirements at the centre of mass (COM). Compared to level ground stepping, the foot dissipated and generated an additional -0.2 J kg^-1 and 0.10 J kg^-1 (both p < 0.001) when stepping down and up a 26 cm step respectively, corresponding to 21% and 10% of the additional net work performed by the leg on the COM. Of this compensation at the foot, the plantar MTU performed 30% and 89% of the work for step-downs and step-ups, respectively. This work occurred early in stance and late in stance for stepping down respectively, when the activation levels of FDB and AH were increased between 69 and 410% compared to level steps (all p < 0.001). These findings suggest that the energetic function of the foot is actively modulated by the intrinsic foot muscles and may play a significant role in movements requiring large changes in net energy such as stepping on stairs or inclines, accelerating, decelerating and jumping.

The effects of ankle stiffness on mechanics and energetics of walking with added loads: a prosthetic emulator study

BACKGROUND

The human ankle joint has an influential role in the regulation of the mechanics and energetics of gait. The human ankle can modulate its joint 'quasi-stiffness' (ratio of plantarflexion moment to dorsiflexion displacement) in response to various locomotor tasks (e.g., load carriage). However, the direct effect of ankle stiffness on metabolic energy cost during various tasks is not fully understood. The purpose of this study was to determine how net metabolic energy cost was affected by ankle stiffness while walking under different force demands (i.e., with and without additional load).

METHODS

Individuals simulated an amputation by using an immobilizer boot with a robotic ankle-foot prosthesis emulator. The prosthetic emulator was controlled to follow five ankle stiffness conditions, based on literature values of human ankle quasi-stiffness. Individuals walked with these five ankle stiffness settings, with and without carrying additional load of approximately 30% of body mass (i.e., ten total trials).

RESULTS

Within the range of stiffness we tested, the highest stiffness minimized metabolic cost for both load conditions, including a ~ 3% decrease in metabolic cost for an increase in stiffness of about 0.0480 Nm/deg/kg during normal (no load) walking. Furthermore, the highest stiffness produced the least amount of prosthetic ankle-foot positive work, with a difference of ~ 0.04 J/kg from the highest to lowest stiffness condition. Ipsilateral hip positive work did not significantly change across the no load condition but was minimized at the highest stiffness for the additional load conditions. For the additional load conditions, the hip work followed a similar trend as the metabolic cost, suggesting that reducing positive hip work can lower metabolic cost.

CONCLUSION

While ankle stiffness affected the metabolic cost for both load conditions, we found no significant interaction effect between stiffness and load. This may suggest that the importance of the human ankle's ability to change stiffness during different load carrying tasks may not be driven to minimize metabolic cost. A prosthetic design that can modulate ankle stiffness when transitioning from one locomotor task to another could be valuable, but its importance likely involves factors beyond optimizing metabolic cost.

Energetics of Walking With a Robotic Knee Exoskeleton

The authors tested 4 young healthy subjects walking with a powered knee exoskeleton to determine if it could reduce the metabolic cost of locomotion. Subjects walked with a backpack loaded and unloaded, on a treadmill with inclinations of 0° and 15°, and outdoors with varied natural terrain. Participants walked at a self-selected speed (average 1.0 m/s) for all conditions, except incline treadmill walking (average 0.5 m/s). The authors hypothesized that the knee exoskeleton would reduce the metabolic cost of walking uphill and with a load compared with walking without the exoskeleton. The knee exoskeleton reduced metabolic cost by 4.2% in the 15° incline with the backpack load. All other conditions had an increase in metabolic cost when using the knee exoskeleton compared with not using the exoskeleton. There was more variation in metabolic cost over the outdoor walking course with the knee exoskeleton than without it. Our findings indicate that powered assistance at the knee is more likely to decrease the metabolic cost of walking in uphill conditions and during loaded walking rather than in level conditions without a backpack load. Differences in positive mechanical work demand at the knee for varying conditions may explain the differences in metabolic benefit from the exoskeleton.

The Motion of Body Center of Mass During Walking: A Review Oriented to Clinical Applications

Human walking is usually conceived as the cyclic rotation of the limbs. The goal of lower-limb movements, however, is the forward translation of the body system, which can be mechanically represented by its center of mass (CoM). Lower limbs act as struts of an inverted pendulum, allowing minimization of muscle work, from infancy to old age. The plantar flexors of the trailing limbs have been identified as the main engines of CoM propulsion. Motion of the CoM can be investigated through refined techniques, but research has been focused on the fields of human and animal physiology rather than clinical medicine. Alterations in CoM motion could reveal motor impairments that are not detectable by clinical observation. The study of the three-dimensional trajectory of the CoM motion represents a clinical frontier. After adjusting for displacement due to the average forward speed, the trajectory assumes a figure-eight shape (dubbed the “bow-tie”) with a perimeter about 18 cm long. Its lateral size decreases with walking velocity, thus ensuring dynamic stability. Lateral redirection appears as a critical phase of the step, requiring precise muscle sequencing. The shape and size of the “bow-tie” as functions of dynamically equivalent velocities do not change from child to adulthood, despite anatomical growth. The trajectory of the CoM thus appears to be a promising summary index of both balance and the neural maturation of walking. In asymmetric gaits, the affected lower limb avoids muscle work by pivoting almost passively, but extra work is required from the unaffected side during the next step, in order to keep the body system in motion. Generally, the average work to transport the CoM across a stride remains normal. In more demanding conditions, such as walking faster or uphill, the affected limb can actually provide more work; however, the unaffected limb also provides more work and asymmetry between the steps persists. This learned or acquired asymmetry is a formerly unsuspected challenge to rehabilitation attempts to restore symmetry. Techniques of selective loading of the affected side, which include constraining the motion of the unaffected limb or forcing the use of the affected limb on split-belt treadmills which impose a different velocity and power to either limb, are now under scrutiny.

Multiphase and Multivariable Linear Controllers That Account for the Joint Torques in Normal Human Walking

OBJECTIVE

The objective of this paper is to investigate whether a small number of sequentially composed multivariable linear controllers can be used to recover a defining relation between the joint torques, angles, and velocities hidden in the walking data of multiple human subjects.

METHODS

We solve a mixed integer programming problem that defines the optimal multivariable and multiphase relation between the torques, angles, and velocities for the hip, knee, and ankle joints.

RESULTS

Using the data of seven healthy subjects, we show that the aforementioned relation can be remarkably well represented by four sequentially composed and independently activated multivariable linear controllers; the controllers account for [Formula: see text] (mean ± sem) of the variance in the joint torques across subjects, and [Formula: see text] of the variance for a new subject. We further show that each controller is associated with one of the four phases of the gait cycle, separated by toe-off and heel-strike.

CONCLUSION

The proposed controller generalizes previously developed multiphase single variable, and single phase multivariable controllers, to a multiphase multivariable controller that better explains the walking data of multiple subjects, and better generalizes to new subjects.

SIGNIFICANCE

Our result provides strong support to extend previously developed decoupled single joint controllers to coupled multijoint multivariable controllers for the control of human assistive and augmentation devices.

Increasing step width reduces the requirements for subtalar joint moments and powers

The subtalar joint (STJ) contributes to the absorption and generation of mechanical energy (and power) during walking to maintain frontal plane stability. Previous observational studies have suggested that there may be a relationship between step width and STJ supination moment. This study directly tests the hypothesis that walking with a step width greater than preferred would reduce STJ moments, energy absorption, and power generation requirements, while increasing energy absorption at the hip during initial contact. Participants (n = 12, 7 females) were asked to walk on an instrumented treadmill at a constant velocity and cadence at a range of fixed step widths ranging from 0.1 to 0.4 times leg length (L). Walking at step widths greater than preferred (0.149 ± 0.04 L) reduced peak STJ moments at initial contact and propulsion which subsequently reduced the negative and positive work performed at the STJ. There was a 43% reduction in energy absorption (negative work) and approximately 30% decrease in positive work at the STJ as step width increased from 0.1 L to 0.4 L. An increase in energy absorption at the knee and hip was evident with an increase in step width during initial contact, although minimal mechanical changes were observed at the proximal joints during propulsion. These results suggest an increase in step width reduces the forces generated by muscles at the STJ across stance and is therefore likely to be beneficial in the prevention and treatment of their injuries. In terms of rehabilitation, the increase in mechanical costs occurring due to an increase in energy absorption by the hip and knee is of minimal concern.

Effects of foot pronation on the lower limb sagittal plane biomechanics during gait

BACKGROUND

Increased foot pronation may compromise ankle plantarflexion moment during the stance phase of gait, which may overload knee and hip.

RESEARCH QUESTION

This study investigated the influence of increased foot pronation on lower limbs angular displacement, internal moments and power in the sagittal plane and ground reaction force and center of pressure displacement during the stance phase of gait.

METHODS

Kinematic and kinetic data of 22 participants (10 women and 12 men) were collected while they walked wearing flat (control condition) and laterally wedged sandals to induce foot pronation (inclined condition). We used principal component analysis for data reduction and dependent t-test to compare differences between conditions with α = 0.05.

RESULTS

The inclined condition increased forefoot range of motion (p < 0.001; effect size = 0.73); increased ankle plantarflexion angle (p < 0.001; effect size = 0.96); reduced ankle plantarflexion moment in mid and terminal stance phases and delayed and increased ankle plantarflexion moment in late stance (p < 0.001; effect size = 0.72); increased range of ankle power during late stance (p = 0.006; effect size = 0.56); reduced knee range of moment (p < 0.001; effect size = 0.76); increased range of knee power in early stance and reduced knee power generation in late stance (p = 0.005; effect size = 0.56); reduced the anterior displacement of the center of pressure (p < 0.001; effect size = 0.82) and increased the ground reaction force in the anterior direction (p = 0.003; effect size = 0.60).

SIGNIFICANCE

Increased foot pronation compromises lower limb mechanics in the sagittal plane during the stance phase of gait. These findings are explained by the fact that foot pronation increases foot segments flexibility and compromises foot lever arm function during the stance of gait.

Lower-limb joint work and power are modulated during load carriage based on load configuration and walking speed

Soldiers regularly transport loads weighing >20 kg at slow speeds for long durations. These tasks elicit high energetic costs through increased positive work generated by knee and ankle muscles, which may increase risk of muscular fatigue and decrease combat readiness. This study aimed to determine how modifying where load is borne changes lower-limb joint mechanical work production, and if load magnitude and/or walking speed also affect work production. Twenty Australian soldiers participated, donning a total of 12 body armor variations: six different body armor systems (one standard-issue, two commercially available [cARM1-2], and three prototypes [pARM1-3]), each worn with two different load magnitudes (15 and 30 kg). For each armor variation, participants completed treadmill walking at two speeds (1.51 and 1.83 m/s). Three-dimensional motion capture and force plate data were acquired and used to estimate joint angles and moments from inverse kinematics and dynamics, respectively. Subsequently, hip, knee, and ankle joint work and power were computed and compared between armor types and walking speeds. Positive joint work over the stance phase significantly increased with walking speed and carried load, accompanied by 2.3-2.6% shifts in total positive work production from the ankle to the hip (p < 0.05). Compared to using cARM1 with 15 kg carried load, carrying 30 kg resulted in significantly greater hip contribution to total lower-limb positive work, while knee and ankle work decreased. Substantial increases in hip joint contributions to total lower-limb positive work that occur with increases in walking speed and load magnitude highlight the importance of hip musculature to load carriage walking.