A Pressure-Pad-Embedded Treadmill Yields Time-Dependent Errors in Estimating Ground Reaction Force during Walking

Dynamics of Center of Pressure Trajectory in Gait: Unilateral Transfemoral Amputees Versus Non-Disabled Individuals

The primary goal of rehabilitation for individuals with lower limb amputation, particularly those with unilateral transfemoral amputation (uTFA), is to restore their ability to walk independently. Effective control of the center of pressure (COP) during gait is vital for maintaining balance and stability, yet it poses a significant challenge for individuals with uTFA. This study aims to study the COP during gait in individuals with uTFA and elucidate their unique compensatory strategies. This study involved 12 uTFA participants and age-matched non-disabled controls, with gait and COP trajectory data collected using an instrumented treadmill. Gait and COP parameters between the control limb (CL), prosthetic limb (PL), and intact limb (IL) were compared. Notably, the mediolateral displacement of COP in PL exhibited significant lateral displacement compared to the CL from 30% to 60% of the stance. In 20% to 45% of the stance, the COP forward speed of PL was significantly higher than that of the IL. Furthermore, during the initial 20% of the stance, the vertical ground reaction force of PL was significantly lower than that of IL. Additionally, individuals with uTFA exhibited a distinct gait pattern with altered duration of loading response, single limb support, pre-swing and swing phases, and step time. These findings indicate the adaptability of individuals with uTFA in weight transfer, balance control, and pressure distribution on gait stability. In conclusion, this study provides valuable insights into the unique gait dynamics and balance strategies of uTFA patients, highlighting the importance of optimizing prosthetic design, alignment procedures, and rehabilitation programs to enhance gait patterns and reduce the risk of injuries due to compensatory movements.

Application of vibration to the soles increases long-range correlations in the stride parameters during walking

Temporal fluctuations in the stride parameters during human walking exhibit long-range correlations, but these long-range correlations in the stride parameters decrease due to aging or neuromuscular diseases. These observations suggest that any quantified index of the long-range correlation can be regarded as an indicator of gait functionality. Considering the effect of task-relevant sensory feedback on augmenting human motor performance, we devised shoes with active insoles that could deliver noisy vibration to the soles of feet and assessed their efficacy in enhancing the long-range correlations in the stride parameters for healthy young adults. The vibration could be wirelessly controlled using a smartphone. The actuators, control unit, and battery in the devised shoes were light and embedded in the shoes. By virtue of this compactness, the shoes could be easily used for daily walking outside a laboratory. We performed walking experiments with 20 healthy adults and evaluated the effects of sub- and supra-threshold vibration on long-range correlations in stride interval and length. We performed detrended fluctuation analysis to quantify the long-range correlation of temporal changes in stride interval and length. We found that supra-threshold vibration, applied to the soles with the amplitude of 130 % of the sensory threshold, significantly increased the long-range correlations in stride interval and length by 10.3 % (p = 0.009) and 10.1 % (p = 0.021), respectively. On the other hand, sub-threshold vibration with the amplitude of 90 % of the sensory threshold had no significant effect. These results demonstrate that additional somatosensory feedback through barely detectable vibrations, which are supplied by compact shoes with active insoles, can enhance the indices of "healthy" complexity of locomotor function.

Feasibility of mitigating out-toeing gait using compression tights with inward-directing taping lines

Out-toeing gait may cause alterations in lower limb biomechanics that could lead to an increased risk of overuse injuries. Surgery and physical therapy are conventional methods for mitigating such gait, but they are costly and time-consuming. Wearable devices like braces and orthoses are used as affordable alternatives, but they apply non-negligible stress on the skin. Haptic feedback-delivering shoes were also recently developed, but they require actuators and power sources. The purpose of our study is to develop compression tights with inward directing taping lines that apply compression to lower limb muscles and segments to facilitate inward rotation of the foot, overcoming the drawbacks of previous methods. These compression tights were manufactured to fit the average height, leg length, hip girth, and waist girth of South Korean females in their twenties. The efficacy of these compression tights was evaluated by comparing walking kinematics and user satisfaction of 12 female dancers with an out-toeing gait under three conditions: wearing tights with taping lines, tights without taping lines, and basic bicycle shorts. The foot rotation angles and joint kinematics were recorded using a pressure-pad treadmill and motion capture system, respectively. Multiple pairwise comparisons revealed that the compression tights with inward-directing lines significantly reduced foot rotation angles (up to an average of 20.1%) compared with the bicycle shorts (p = 0.002 and 0.001 for dominant and non-dominant foot, respectively) or the compression tights without taping lines (p = 0.005 and p = 0.001 for dominant and non-dominant foot, respectively). Statistical parametric mapping revealed significant main effects of the tight type on joint kinematics. Also, t-tests revealed that the participants reported significantly higher ratings of perceived functionality and usability on the compression tights with inward-directing taping lines. In conclusion, we developed a comfortable and practical apparel-type wearable and demonstrated its short-term efficacy in mitigating out-toeing gait.

Taping-induced cutaneous stimulation to the ankle tendons reduces minimum toe clearance variability

Large variability of minimum toe clearance (MTC) leads to a higher risk of tripping. Visual feedback-based gait training systems have been used to regulate MTC distribution, but these systems are expensive and bulky. Furthermore, the effect of such training lasts only for a short period of time. Considering the efficacy of elastic adhesive tape-induced cutaneous stimulation to the ankle tendons in improving proprioception and movement detection, we hypothesize that application of tapes to the ankle tendons as a practical method for modifying MTC distribution. To test this hypothesis, we recruited 13 young and healthy adults and instructed them to walk on a treadmill under four conditions: no taping, taping the tibialis anterior tendon, taping the Achilles tendon, and taping both tendons. We measured MTC distribution, lower limb joint angles and muscle activations of the tibialis anterior and gastrocnemius medialis, and compared these outcomes under the four conditions. The application of elastic adhesive tape to the ankle tendons had no significant effect on the average MTC height, but tapes applied to the Achilles tendon and both tendons significantly reduced MTC variability. Taping decreased the variability of some lower limb joint angles, but taping did not induce significant changes in the activation levels of the shank muscles. These results demonstrate that elastic adhesive tape applied to the shank can reduce MTC variability with minimal resistance, inertia and cumbersomeness.

Quantification of Gait Stability During Incline and Decline Walking: The Responses of Required Coefficient of Friction and Dynamic Postural Index

This study aims to investigate the gait stability response during incline and decline walking for various surface inclination angles in terms of the required coefficient of friction (RCOF), postural stability index (PSI), and center of pressure (COP)-center of mass (COM) distance. A customized platform with different surface inclinations (0°, 5°, 7.5°, and 10°) was designed. Twenty-three male volunteers participated by walking on an inclined platform for each inclination. The process was then repeated for declined platform as well. Qualysis motion capture system was used to capture and collect the trajectories motion of ten reflective markers that attached to the subjects before being exported to a visual three-dimensional (3D) software and executed in Matlab to obtain the RCOF, PSI, as well as dynamic PSI (DPSI) and COP-COM distance parameters. According to the result for incline walking, during initial contact, the RCOF was not affected to inclination. However, it was affected during peak ground reaction force (GRF) starting at 7.5° towards 10° for both walking conditions. The most affected PSI was found at anterior-posterior PSI (APSI) even as low as 5° inclination during both incline and decline walking. On the other hand, DPSI was not affected during both walking conditions. Furthermore, COP-COM distance was most affected during decline walking in anterior-posterior direction. The findings of this research indicate that in order to decrease the risk of falling and manage the inclination demand, a suitable walking strategy and improved safety measures should be applied during slope walking, particularly for decline and anterior-posterior orientations. This study also provides additional understanding on the best incline walking technique for secure and practical incline locomotion.

Differences between Systems Using Optical and Capacitive Sensors in Treadmill-Based Spatiotemporal Analysis of Level and Sloping Gait

Modern technology has enabled researchers to analyze gait with great accuracy and in various conditions based on the needs of the trainees. The purpose of the study was to investigate the agreement between systems equipped with optical and capacitive sensors in the analysis of treadmill-based level and sloping gait. The spatiotemporal parameters of gait were measured in 30 healthy college-level students during barefoot walking on 0% (level), -10% and -20% (downhill) and +10% and +20% (uphill) slopes at hiking-related speeds using an optoelectric cell system and an instrumented treadmill. Inter-system agreement was assessed using the Intraclass Correlation Coefficients (ICCs) and the 95% limits of agreement. Our findings revealed excellent ICCs for the temporal and between moderate to excellent ICCs for the spatial parameters of gait. Walking downhill and on a 10% slope demonstrated better inter-system agreement compared to walking uphill and on a 20% slope. Inter-system agreement regarding the duration of gait phases was increased by increasing the number of LEDs used by the optoelectric cell system to detect the contact event. The present study suggests that systems equipped with optical and capacitive sensors can be used interchangeably in the treadmill-based spatiotemporal analysis of level and sloping gait.