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Understanding the intricacies of human movement coordination and variability during running is crucial to unraveling the dynamics of locomotion, identifying potential injury mechanisms and understanding skill development. Identification of minimum number of cycles for calculation of reliable coordination and its variability could help with better test organization and efficient assessment time. By adopting a cross-sectional study design, this study investigated the minimum required cycles for calculating hip-knee, hip-ankle and knee-ankle coordination and their variability using a continuous relative phase (CRP) method. Twenty-nine healthy adults ran on a treadmill at speeds of 9, 12.5, and 16 km.h−1 while 3D kinematic data of their lower limbs were recorded using 6 optoelectronic cameras. Using Intraclass Correlation Coefficient (ICC) analysis, reliability between CRP and its variability (CRPv) in different gait cycles (3, 5, 10, 20, 30) was assessed for each speed. A minimum of 10 cycles was required for CRP calculation across all speeds, whereas CRPv necessitated a minimum of 30 cycles for moderate to good reliability. While increasing the number of cycles improved ICC values for inter-joint CRP, the same trend was not consistently observed for CRPv, emphasizing the importance of separately assessing CRP and its variability metrics. [ABSTRACT FROM AUTHOR]

Mechanical testing of articular cartilage yields highly variable results, posing challenges for tissue characterization. Many factors cause variability, one is sample geometry. Using in-situ phase-contrast enhanced synchrotron micro-tomographs of cartilage samples while tested in unconfined compression (stress relaxation) our group found high variability in the mechanical response. Since all samples originated from a single bovine knee, they were assumed to share mechanical properties. Microscale tomography images showed geometric irregularities in samples that were not accounted for in the often assumed intended cylindrical shape. We aimed to determine the influence of sample shape on mechanical response in unconfined compression and how sample geometry affects identified mechanical properties. Using a parametric FE model incorporating geometric irregularities in a Design of Experiments approach, results were analysed with 2-way ANOVA. Furthermore, a material parameter fitting was done with multiple segmented sample-specific finite element models simultaneously to assess the influence of sample geometry on material parameters. Results revealed that the average inclined sample surface (4°) caused a 15 % decrease in reaction forces compared to the intended cylinder. Fitting multiple sample-specific geometries simultaneously altered material parameters between −70 to +159 % compared to the average model. Strikingly, initial fibril stiffness and permeability increased by 137 % and 159 %, while the root-mean-square error of the fit was reduced by ∼2/3 compared to using parameters from a cylindrical shape model. In conclusion, minor variability in sample geometry affects property characterization and can account for some of the inter-sample variability in the mechanical data for cartilage. [ABSTRACT FROM AUTHOR]

Three-dimensional gait analysis is the 'gold standard' for measurement and description of gait. Gait variability can arise from intrinsic and extrinsic factors and may vary between walking conditions. This study aimed to define the inter-trial and inter-session repeatability in gait analysis data of children with cerebral palsy (CP) who were walking in four conditions, namely barefoot or with ankle–foot orthosis (AFO), and overground or treadmill. Ten children with spastic CP (7♀; 9.9y ± 3.5y; GMFCS-level I-III) were included in this study. Overall, we found good to excellent intra-class correlation (ICC)-values and favourable standard error of measurement (SEM)-values for the inter-session Gait Profile Score (ICC = 0.85–0.98, SEM = 0.45–0.91°) and Gait Variable Scores (ICC = 0.85–0.99, SEM = 0.22–1.11°) for the lower-limb joints. Taking the total joint-range-of-motion into account, the knee joint showed the most repeatable motion (%SEM = 0.5–1.8 %), while ankle motions showed the lowest repeatability (%SEM = 0.8 %–3.0 %). For the continuous waveform data, only the ankle joint showed repeatability differences between walking conditions, namely, smaller SEM-values for the AFO-condition (mean inter-trial = 0.14°; mean inter-session = 1.121°) in comparison to the barefoot-condition (mean inter-trial = 0.55°; mean inter-session = 2.22°). For all the kinetic parameters, the treadmill conditions showed smaller SEM-values in comparison to the overground condition. In conclusion three-dimensional gait analysis was found to be reliable in all four walking conditions for children with CP. The resulting measurement errors can be used as a reference during clinical interpretations of gait analyses. Clinical trial registration number: Trial ID from an internationally recognized trial registry (ClinicalTrials.gov): NCT06355869 [ABSTRACT FROM AUTHOR]

Incorporating variability within gait retraining approaches has been proposed and shown to lead to positive changes. Specifically, submitting the individuals to walk in synchrony to cues that are temporally organized with a fractal-like patterns, promotes changes at the stride-to-stride fluctuations closer to those typically find in young adults. However, there is still a need to understand the underlying neuromuscular mechanisms associated to such improvement. Thus, this study aimed to investigate whether changes in the temporal structure of the variability in gait patterns are accompanied by changes in muscle activity patterns. Fourteen young individuals walked synchronized to one uncued (UNC) and three cued conditions: isochronous (ISO), fractal (FRC) and random (RND). Inter-stride intervals were determined from an accelerometer placed on the lateral malleoli. Inter-muscle peak intervals were obtained from the electromyographic signal from the gastrocnemius muscle. Fractal scaling, obtained through detrended fluctuation analysis, and coefficient of variation were calculated. Repeated measures ANOVAs were used to identify differences between conditions. Significant main effect was observed for both fractal scaling and coefficient of variation. Both shown no differences between UNC and FRC conditions, while ISO and RND were significantly lower compared to UNC and FRC conditions. In addition, a Pearson's Correlation was used to test the correlation between variables. A strong correlation was found the temporal structure of gait and muscle activity patterns. These findings strengthen the current literature regarding the incorporation of variability within cued approaches. Specifically, it shows that such an approach allows the modification of the neuromuscular processes underlying the stride-to-stride fluctuations. [ABSTRACT FROM AUTHOR]

The use of motor learning strategies may enhance rehabilitation outcomes of individuals with neurological injuries (e.g., stroke or cerebral palsy). A common strategy to facilitate learning of challenging tasks is to use sequential progression – i.e., initially reduce task difficulty and slowly increase task difficulty until the desired difficulty level is reached. However, the evidence related to the use of such sequential progressions to improve learning is mixed for functional skill learning tasks, especially considering situations where practice duration is limited. Here, we studied the benefits of sequential progression using a functional motor learning task that has been previously used in gait rehabilitation. Three groups of participants (N = 43) learned a novel motor task during treadmill walking using different learning strategies. Participants in the specific group (n = 21) practiced only the criterion task (i.e., matching a target template that was scaled-up by 30%) throughout the training. Participants in the sequential group (n = 11) gradually progressed to the criterion task (from 3% to 30% in increments of 3%), whereas participants in the random group (n = 11) started at 3% and progressed in random increments (involving both increases and decreases in task difficulty) to the criterion task. At the end of training, kinematic tracking performance on the criterion task was evaluated in all participants both with and without visual feedback. Results indicated that the tracking error was significantly lower in the specific group, and no differences were observed between the sequential and the random progression groups. The findings indicate that the amount of practice in the criterion task is more critical than the difficulty and variations of task practice when learning new gait patterns during treadmill walking. [ABSTRACT FROM AUTHOR]

During repetitive movement, low-back loading exposures are inherently variable in magnitude. The current study aimed to investigate how variation in successive compression exposures influences cumulative load tolerance in the spine. Forty-eight porcine cervical spine units were randomly assigned to one of six combinations of mean peak compression force (30%, 50%, 70% of the predicted tolerance) and loading variation (consistent peak amplitude, variable peak amplitude). Following preload and passive range-of-motion tests, specimens were positioned in a neutral posture and then cyclically loaded in compression until failure occurred or the maximum 12 h duration was reached. Specimens were dissected to classify macroscopic injury and measurements of cumulative load, cycles, and height loss sustained at failure were calculated. Statistical comparisons were made between loading protocols within each normalized compression group. A significant loading variation × compression interaction was demonstrated for cumulative load (p = 0.026) and cycles to failure (p = 0.021). Cumulative compression was reduced under all normalized compression loads (30% p = 0.016; 50% p = 0.030; 70% p = 0.020) when variable loading was incorporated. The largest reduction was by 33% and occurred in the 30% compression group. The number of sustained cycles was reduced by 31% (p = 0.017), 72% (p = 0.030), and 76% (p = 0.009) under normalized compression loads of 30%, 50%, and 70%, respectively. These findings suggest that variation in compression exposures interact to reduce cumulative compression tolerance of the spine and could elevate low-back injury risk during time-varying repetitive tasks. [ABSTRACT FROM AUTHOR]

Abstract This study proposed a revision to the Rosenstein's method of numerical calculation of the largest Lyapunov exponent (LyE) to make it more robust to noise. To this aim, the effect of increasing number of initial neighboring points on the LyE value was investigated and compared to values obtained by filtering the time series. Both simulated (Lorenz and passive dynamic walker) and experimental (human walking) time series were used to calculate the LyE. The number of initial neighbors used to calculate LyE for all time series was 1 (the original Rosenstein's method), 2, 3, 4, 5, 10, 15, 20, 25, and 30 data points. The results demonstrated that the LyE graph reached a plateau at the 15-point neighboring condition implying that the LyE values calculated using at least 15 neighboring points were consistent. The proposed method could be used to calculate more consistent LyE values in experimental time series acquired from biological systems where noise is omnipresent. [ABSTRACT FROM AUTHOR]

Abstract To prevent falls, control of the swing foot during walking is crucial. Recently, some studies demonstrated that the coordinated movement of lower limbs by kinematic synergy is important for stable walking. However, no study has been carried out to reveal the relation between falls and kinematic synergy, and it is unclear whether fall history alters the kinematic synergy. Thus, the purpose of this study was to test the effects of fall history on kinematic synergy using uncontrolled manifold (UCM) analysis. Older adults were divided into two groups: older adults without fall history (non-fallers, n = 14) and older adults with fall history of at least one fall in the 12 months prior to the measurements (fallers, n = 10). Subjects walked at their own comfortable speed on a pathway and kinematic data were collected. UCM analysis was performed to assess how variability of segmental configurations in the frontal plane, the mediolateral and vertical directions, affects the frontal trajectory of the swing foot. Fallers had a greater variability of segmental configurations than non-fallers in all phases. In the mediolateral direction, the kinematic synergy in fallers was significantly greater than that in non-fallers during the early and late swing phases. On the other hands, fallers continuously had greater kinematic synergy compared to non-fallers in the vertical direction. The results revealed that fall history increased the kinematic synergy, although fallers needed a greater variability of segmental configurations as a compensatory strategy to ensure kinematic synergy. [ABSTRACT FROM AUTHOR]

The study aims to investigate the effects of different loads and speed during running on inter- and intra-individual muscle force amplitudes, variabilities and coordination patterns. Nine healthy participants ran on an instrumentalized treadmill with an empty weight vest at two velocities (2.6 m/s and 3.3 m/s) or while carrying three different loads (4.5, 9.1, 13.6 kg) at 2.6 m/s while kinematics and kinetics were synchronously recorded. The major lower limb muscle forces were estimated using a musculoskeletal model. Muscle force amplitudes and variability, as well as coordination patterns were compared at the group and at the individual level using respectively statistical parametric mapping and covariance matrices combined with multidimensional scaling. Increasing the speed or the load during running increased most of the muscle force amplitudes (p < 0.01). During the propulsion phase, increasing the load increased muscle force variabilities around the ankle joint (modification of standard deviation up to 5% of body weight (BW), p < 0.05) while increasing the speed decreased variability for almost all the muscle forces (up to 10% of BW, p < 0.05). Each runner has a specific muscle force coordination pattern signature regardless of the different experimental conditions (p < 0.05). Yet, this individual pattern was slightly adapted in response to a change of speed or load (p < 0.05). Our results suggest that adding load increases the amplitude and variability of muscle force, but an increase in running speed decreases the variability. These findings may help improve the design of military or trail running training programs and injury rehabilitation by progressively increasing the mechanical load on anatomical structures. [ABSTRACT FROM AUTHOR]

Walking humans often navigate complex, varying walking paths. To reduce falls, we must first determine how older adults purposefully vary their steps in contexts that challenge balance. Here, 20 young (21.7±2.6 yrs) and 18 older (71.6±6.0 yrs) healthy adults walked on virtual paths that slowly narrowed (from 45 cm to as narrow as 5 cm). Participants could switch onto an "easier" path whenever they chose. We applied our Goal Equivalent Manifold framework to quantify how participants adjusted their lateral stepping variability and step-to-step corrections of step width and lateral position as these paths narrowed. We also extracted these characteristics at the locations where participants switched paths. As paths narrowed, all participants reduced their lateral stepping variability, but older adults less so. To stay on the narrowing paths, young adults increasingly corrected step-to-step deviations in lateral position more, by correcting step-to-step deviations in step width less. Conversely, as older adults also increasingly corrected lateral position deviations, they did so without sacrificing correcting step-to-step deviations in step width, presumably to preserve balance. While older adults left the narrowing paths sooner, several of their lateral stepping characteristics remained similar to those of younger adults. Older adults largely maintained overall walking performance per se, but they did so by changing how they balanced the competing stepping regulation requirements intrinsic to the task: maintaining position vs. step width. Thus, balancing how to achieve multiple concurrent stepping goals while walking provides older adults the flexibility they need to appropriately adapt their stepping on continuously narrowing walking paths., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

As humans walk or run, external (environmental) and internal (physiological) disturbances induce variability. How humans regulate this variability from stride-to-stride can be critical to maintaining balance. One cannot infer what is “controlled” based on analyses of variability alone. Assessing control requires quantifying how deviations are corrected across consecutive movements. Here, we assessed walking and running, each at two speeds. We hypothesized differences in speed would drive changes in variability, while adopting different gaits would drive changes in how people regulated stepping. Ten healthy adults walked/ran on a treadmill under four conditions: walk or run at comfortable speed, and walk or run at their predicted walk-to-run transition speed. Time series of relevant stride parameters were analyzed to quantify variability and stride-to-stride error-correction dynamics within a Goal-Equivalent Manifold (GEM) framework. In all conditions, participants’ stride-to-stride control respected a constant-speed GEM strategy. At each consecutively faster speed, variability tangent to the GEM increased (p ≤ 0.031), while variability perpendicular to the GEM decreased (p ≤ 0.044). There were no differences (p ≥ 0.999) between gaits at the transition speed. Differences in speed determined how stepping variability was structured, independent of gait, confirming our first hypothesis. For running versus walking, measures of GEM-relevant statistical persistence were significantly less (p ≤ 0.004), but showed minimal-to-no speed differences (0.069 ≤ p ≤ 0.718). When running, people corrected deviations both more quickly and more directly, each indicating tighter control. Thus, differences in gait determined how stride-to-stride fluctuations were regulated , independent of speed, confirming our second hypothesis. [ABSTRACT FROM AUTHOR]

Load carriage perturbs the neuromuscular system, which can be impaired due to ageing. The ability to counteract perturbations is an indicator of neuromuscular function but if the response is insufficient the risk of falls will increase. However, it is unknown how load carriage affects older adults. Fourteen older adults (65 ± 6 years) attended a single visit during which they performed 4 min of walking in 3 conditions, unloaded, stable backpack load and unstable backpack load. During each walking trial, 3-dimensional kinematics of the lower limb and trunk movements and electromyographic activity of 6 lower limb muscles were recorded. The local dynamic stability (local divergence exponents), joint angle variability and spatio-temporal variability were determined along with muscle activation magnitudes. Medio-lateral dynamic stability was lower (p = 0.018) and step width (p = 0.019) and step width variability (p = 0.015) were greater in unstable load walking and step width variability was greater in stable load walking (p = 0.009) compared to unloaded walking. However, there was no effect on joint angle variability. Unstable load carriage increased activity of the Rectus Femoris (p = 0.001) and Soleus (p = 0.043) and stable load carriage increased Rectus Femoris activity (p = 0.006). These results suggest that loaded walking alters the gait of older adults and that unstable load carriage reduces dynamic stability compared to unloaded walking. This can potentially increase the risk of falls, but also offers the potential to use unstable loads as part of fall prevention programmes. [ABSTRACT FROM AUTHOR]

Background Variability in joint kinematics is necessary for adaptability and response to everyday perturbations; however, intrinsic neuromotor changes secondary to stroke often cause abnormal movement patterns. How these abnormal movement patterns relate to joint kinematic variability and its influence on post-stroke walking impairments is not well understood. Objective The purpose of this study was to evaluate the movement variability at the individual joint level in the paretic and non-paretic limbs of individuals post-stroke. Methods Seven individuals with hemiparesis post-stroke walked on a treadmill for two minutes at their self-selected speed and the average speed of the six-minute walk test while kinematics were recorded using motion-capture. Variability in hip, knee, and ankle flexion/extension angles during walking were quantified with the Lyapunov exponent (LyE). Interlimb differences were evaluated. Results The paretic side LyE was higher than the non-paretic side at both self-selected speed (Hip: 50%; Knee: 74%), and the average speed of the 6-min walk test (Hip: 15%; Knee: 93%). Conclusion Differences in joint kinematic variability between limbs of persons post-stroke supports further study of the source of non-paretic limb deviations as well as the clinical implications of joint kinematic variability in persons post-stroke. The development of bilaterally-targeted post-stroke gait interventions to address variability in both limbs may promote improved outcomes. [ABSTRACT FROM AUTHOR]

Vision, as queen of the senses, plays a critical role in guiding locomotion. Little is known about the effects of vision on gait coordination in terms of variability. The uncontrolled manifold (UCM) approach offers a window to the structure of motor variability that has been difficult to obtain from the traditional correlation analysis. In this study, we used the UCM analysis to quantify how the lower limb motion is coordinated to control the center of mass (COM) while walking under different visual conditions. We also probed how synergy strength evolved along the stance phase. Ten healthy participants walked on the treadmill with and without visual information. Leg joint angle variance with respect to the whole-body COM was partitioned into good (i.e., the one that kept the COM) and bad (i.e., the one that changed the COM) variances. We observed that after vision was eliminated, both variances increased throughout the stance phase while the strength of the synergy (the normalized difference between the two variances) decreased significantly and even reduced to zero at heel contact. Thus, walking with restricted vision alters the strength of the kinematic synergy to control COM in the plane of progression. We also found that the strength of this synergy varied across different walking phases and gait events in both visual conditions. We concluded that the UCM analysis can quantify altered coordination of COM when vision is blocked and sheds insights on the role of vision in the synergistic control of locomotion. [ABSTRACT FROM AUTHOR]

Soft tissue artefacts (STA) are a major error source in skin marker-based measurement of human movement, and are difficult to eliminate non-invasively. The current study quantified in vivo the STA of skin markers on the thigh and shank during cycling, and studied the effects of knee angles and pedal resistance by using integrated 3D fluoroscopy and stereophotogrammetry. Fifteen young healthy adults performed stationary cycling with and without pedal resistance, while the marker data were measured using a motion capture system, and the motions of the femur and tibia/fibula were recorded using a bi-plane fluoroscopy-to-CT registration method. The STAs with respect to crank and knee angles over the pedaling cycle, as well as the within-cycle variations, were obtained and compared between resistance conditions. The thigh markers showed greater STA than the shank ones, the latter varying linearly with adjacent joint angles, the former non-linearly with greater within-cycle variability. Both STA magnitudes and within-cycle variability were significantly affected by pedal resistance ( p < 0.05). The STAs appeared to be composed of one component providing the stable and consistent STA patterns and another causing their variations. Mid-segment markers experienced smaller STA ranges than those closer to a joint, but tended to have greater variations primarily associated with pedal resistance and muscle contractions. The current data will be helpful for a better choice of marker positions for data collection, and for developing methods to compensate for both stable and variation components of the STA. [ABSTRACT FROM AUTHOR]

Although human gait is often assumed to be periodic, significant variability exists. This variability appears to provide different information than the underlying periodic signal, particularly about fall risk. Most studies on variability have either used step-to-step metrics such as stride duration or point-wise standard deviations, neither of which explicitly capture the joint-level variability as a function of time. This work demonstrates that a second-order Fourier series for stance joints and a first-order Fourier series for swing joints can accurately capture the variability in joint angles as a function of time on a per-step basis for overground walking at the self-selected speed. It further demonstrates that a total of seven normal distributions, four linear relationships, and twelve continuity constraints can be used to describe how the Fourier series vary between steps. The ability of the proposed method to create curves that match human joint-level variability was evaluated both qualitatively and quantitatively using randomly generated curves. [ABSTRACT FROM AUTHOR]

The present study investigated lower limb joint work, lower limb joint energy transport and intra-subject variation of the joint dynamics during countermovement jumps in children and adults. Twelve healthy men and eleven healthy boys performed ten maximal countermovement jumps. Three dimensional kinematics and kinetics were recorded in synchrony. Hip, knee and ankle joint eccentric and concentric work, joint energy transfer, intra-subject variation of joint moment, joint power and joint moment components were calculated. The children had lower eccentric and concentric hip work and lower eccentric knee work but no group difference was observed in the concentric knee joint work and ankle joint work. Eccentric hip and knee joint energy transfer and concentric hip joint energy transfer were higher in adults. The children had higher intra-subject variation in the eccentric and concentric hip joint work, hip joint moment and hip and knee joint power. Higher intra-subject variation was observed in horizontal joint reaction force components for the children and higher intra-subject variation in the segment angular inertia components was observed for the adults. The joint dynamics of children during countermovement jumps were less efficient in producing proximal joint work, transferring energy through joint centres and characterized by a higher intra-subject variation. [ABSTRACT FROM AUTHOR]

In the present study we compared the performance of three different estimations of local dynamic stability λ to distinguish between the dynamics of the daily-life walking of elderly fallers and non-fallers. The study re-analyses inertial sensor data of 3-days daily-life activity originally described by Weiss et al. (2013) . The data set contains inertial sensor data from 39 older persons who reported less than 2 falls and 31 older persons who reported two or more falls the previous year. 3D-acceleration and 3D-velocity signals from walking epochs of 50 s were used to reconstruct a state space using three different methods. Local dynamic stability was estimated with the algorithms proposed by Rosenstein et al. (1993) , Kantz (1994) , and Ihlen et al. (2012a) . Median λ s assessed by Ihlen׳s and Kantz׳ algorithms discriminated better between elderly fallers and non-fallers (highest AUC=0.75 and 0.73) than Rosenstein׳s algorithm (highest AUC=0.59). The present results suggest that the ability of λ to distinguish between fallers and non-fallers is dependent on the parameter setting of the chosen algorithm. Further replication in larger samples of community-dwelling older persons and different patient groups is necessary before including the suggested parameter settings in fall risk assessment and prediction models. [ABSTRACT FROM AUTHOR]

Complexity of human physiology and physical behavior has been suggested to decrease with aging and disease and make older adults more susceptible to falls. The present study investigates complexity in daily life walking in community-dwelling older adult fallers and non-fallers measured by a 3D inertial accelerometer sensor fixed to the lower back. Complexity was expressed using new metrics of entropy: refined composite multiscale entropy (RCME) and refined multiscale permutation entropy (RMPE). The study re-analyses data of 3 days daily-life activity originally described by Weiss et al. (2013) . The data set contains inertial sensor data from 39 older persons reporting less than 2 falls and 32 older persons reporting two or more falls during the previous year. The RCME and the RMPE were derived for trunk acceleration and velocity signals from walking epochs of 50 s using mean and variance coarse graining of the signals. Discriminant abilities of the entropy metrics were assessed using a partial least square discriminant analysis. Both RCME and RMPE successfully distinguished between the daily-life walking of the fallers and non-fallers (AUC>0.8) and performed better than the 35 conventional gait features investigated by Weiss et al. (2013) . Higher complexity was found in the vertical and mediolateral directions in the non-fallers for both entropy metrics. These findings suggest that RCME and RMPE can be used to improve the assessment of fall risk in older people. [ABSTRACT FROM AUTHOR]

Humans continually adapt their movements as they walk on different surfaces, avoid obstacles, etc. External (environmental) and internal (physiological) noise-like disturbances, and the responses that correct for them, each contribute to locomotor variability. This variability may sometimes be detrimental (perhaps increasing fall risk), or sometimes beneficial (perhaps reflecting exploration of multiple task solutions). Here, we determined how humans regulated stride-to-stride fluctuations in walking when presented different task goals that allowed them to exploit inherent redundancies in different ways. Fourteen healthy adults walked on a treadmill under each of four conditions: constant speed only (SPD), constant speed and stride length (LEN), constant speed and stride time (TIM), or constant speed, stride length, and stride time (ALL). Multiple analyses tested competing hypotheses that participants might attempt to either equally satisfy all goals simultaneously, or instead adopt systematic intermediate strategies that only partly satisfied each individual goal. Participants exhibited similar average stepping behavior, but significant differences in variability and stride-to-stride serial correlations across conditions. Analyses of the structure of stride-to-stride fluctuation dynamics demonstrated humans resolved the competing goals presented not by minimizing errors equally with respect to all goals, but instead by trying to only partly satisfy each goal. Thus, humans exploit task redundancies even when they are explicitly removed from the task specifications. These findings may help identify when variability is predictive of, or protective against, fall risk. They may also help inform rehabilitation interventions to better exploit the positive contributions of variability, while minimizing the negative. [ABSTRACT FROM AUTHOR]

Derived from inverted pendulum dynamics, mediolateral Margin of Stability (MoS ML) is a mechanically-grounded measure of instantaneous frontal-plane stability. However, average MoS ML measures yield paradoxical results. Gait pathologies or perturbations often induce larger (supposedly "more stable") average MoS ML , despite clearly de stabilizing factors. However, people do not walk "on average" – they walk (and sometimes lose balance) one step at a time. We assert the paradox arises because averaging MoS ML discards crucial step-to-step dynamics. We present a framework unifying the inverted pendulum with Goal-Equivalent Manifold (GEM) analyses. We identify in the pendulum's center-of-mass dynamics constant- MoS ML manifolds, including one candidate "stability GEM" signifying the goal to maintain some constant MoS ML ∗ . We used this framework to assess step-to-step MoS ML dynamics of humans walking in destabilizing environments. While goal-relevant deviations were readily corrected, people did not exploit equifinality by allowing deviations to persist along this GEM. Thus, maintaining a constant MoS ML ∗ is inconsistent with observed step-to-step fluctuations in center-of-mass states. Conversely, the extent to which participants regulated fluctuations in mediolateral foot placements strongly predicted their regulation of center-of-mass fluctuations. Thus, center-of-mass dynamics may arise in directly as a consequence of regulating mediolateral foot placements. To help resolve the paradox caused by averaging MoS ML , we present a new statistic, Probability of Instability (PoI L), used here to predict lateral instability likelihood. Participants exhibited increased PoI L when de stabilized (p = 9.45 × 10−34), despite exhibiting larger ("more stable") average MoS ML (p = 1.70 × 10−15). Thus, PoI L correctly captured people's increased risk of losing lateral balance, whereas average MoS ML did not. PoI L also helps explain why people's average MoS ML increased in destabilizing contexts. [ABSTRACT FROM AUTHOR]

Research has indicated that human walking is more unstable in the secondary, rather than primary plane of progression. However, the mechanisms of controlling dynamic stability in different planes of progression during running remain unknown. The aim of this study was to compare variability (standard deviation and coefficient of variation) and dynamic stability (sample entropy and local divergence exponent) in anterior–posterior and medio-lateral directions in forward and lateral running patterns. For this purpose, fifteen healthy, male participants ran in a forward and lateral direction on a treadmill at their preferred running speeds. Coordinate data of passive reflective markers attached to body segments were recorded using a motion capture system. Results indicated that: (1) there is lower dynamic stability in the primary plane of progression during both forward and lateral running suggesting that, unlike walking, greater control might be required to regulate dynamic stability in the primary plane of progression during running, (2) as in walking, the control of stability in anterior–posterior and medio-lateral directions of running is dependent on the direction of progression, and (3), quantifying magnitude of variability might not be sufficient to understand control mechanisms in human movement and directly measuring dynamic stability could be an appropriate alternative. [ABSTRACT FROM AUTHOR]

A repetitive sit-to-stand (STS) task is often used as a fatiguing protocol. Although post-fatigue reductions in muscle strength have been frequently used to indicate fatigue, little is known about changes in body movement during the fatiguing process. This study examined changes in variability of hip-knee and knee-ankle coordination during the STS fatiguing course in 15 young (age: 26.7 ± 5.8 years; 9 females, 6 males) and 15 older adults (age: 69.3 ± 5.7 years; 9 females, 6 males). Participants were asked to perform repetitive STS movements until exhaustion or for 30 min at a self-selected pace. Motion data from 3 consecutive STS cycles were extracted from every minute during the entire fatiguing course and time normalized to STS duration and dummy coded as five stages: 0–20, 20–40, 40–60, 60–80, and 80–100% of the course. Outcome variables were hip-knee and knee-ankle inter-joint coordination variabilities. A 2*5 mixed-effect ANOVA was used to examine changes in variability during different stages of the course in young and older adults. No Age × Time interactions were found in either hip-knee or knee-ankle coordination variability. The hip-knee coordinative variability significantly increased along the STS fatiguing course regardless of age, and the knee-ankle variability from standing to sitting was also higher at the ending, when compared to the beginning, of the fatiguing protocol. The impact of fatigue during repetitive STS protocol is not only limited to a force production decline but also manifested as increased coordinative variability, which could be considered as a fatigue indicator. [ABSTRACT FROM AUTHOR]

The primary purpose of this study was to systematically evaluate and compare the predictive power of falls for a battery of stability indices, obtained during normal walking among community-dwelling older adults. One hundred and eighty seven community-dwelling older adults participated in the study. After walking regularly for 20 strides on a walkway, participants were subjected to an unannounced slip during gait under the protection of a safety harness. Full body kinematics and kinetics were monitored during walking using a motion capture system synchronized with force plates. Stability variables, including feasible-stability-region measurement, margin of stability, the maximum Floquet multiplier, the Lyapunov exponents (short- and long-term), and the variability of gait parameters (including the step length, step width, and step time), were calculated for each subject. Sensitivity of predicting slip outcome (fall vs. recovery) was examined for each stability variable using logistic regression. Results showed that the feasible-stability-region measurement predicted fall incidence among these subjects with the highest sensitivity (68.4%). Except for the step width (with an sensitivity of 60.2%), no other stability variables could differentiate fallers from those who did not fall for the sample included in this study. The findings from the present study could provide guidance to identify individuals at increased risk of falling using the feasible-stability-region measurement or variability of the step width. [ABSTRACT FROM AUTHOR]

Segmental bone defect animal models are often used for evaluating the bone regeneration performance of bone substituting biomaterials. Since bone regeneration is dependent on mechanical loading, it is important to determine mechanical load transfer after stabilization of the defect and to study the effects of biomaterial stiffness on the transmitted load. In this study, we assess the mechanical load transmitted over a 6 mm femur defect that is stabilized with an internal PEEK fixation plate. Subsequently, three types of selective laser melted porous titanium implants with different stiffness values were used to graft the defect (five specimens per group). In one additional group, the defect was left empty. Micro strain gauges were used to measure strain values at four different locations of the fixation plate during external loading on the femoral head. The load sharing between the fixation plate and titanium implant was highly variable with standard deviations of measured strain values between 31 and 93% of the mean values. As a consequence, no significant differences were measured between the forces transmitted through the titanium implants with different elastic moduli. Only some non-significant trends were observed in the mean strain values that, consistent with the results of a previous finite element study, implied the force transmitted through the implant increases with the implant stiffness. The applied internal fixation method does not standardize mechanical loading over the defect to enable detecting small differences in bone regeneration performances of bone substituting biomaterials. In conclusion, the fixation method requires further optimization to reduce the effects of the operative procedure and make the mechanical loading more consistent and improve the overall sensitivity of this rat femur defect model. [ABSTRACT FROM AUTHOR]

Healthy humans display a preference for walking at a stride frequency dependent on the inertial properties of their legs. Walking at preferred stride frequency (PSF) is predicted to maximize local dynamic stability, whereby sensitivity to intrinsic perturbations arising from natural variability inherent in biological motion is minimized. Previous studies testing this prediction have employed different variability measures, but none have directly quantified local dynamic stability by computing maximum finite-time Lyapunov exponent (ƛMax), which quantifies the rate of divergence of nearby trajectories in state space. Here, ten healthy adults walked 45 m overground while sagittal motion of both knees was recorded via electrogoniometers. An auditory metronome prescribed 7 different frequencies relative to each individual's PSF (PSF; + 5, + 10, + 15 strides/min). Stride frequencies were performed under both freely adopted speed (FS) and controlled speed (CS: set at the speed of PSF trials) conditions. Local dynamic stability was maximal (ƛMax was minimal) at the PSF, becoming less stable for higher and lower stride frequencies. This occurred under both FS and CS conditions, although controlling speed further reduced local dynamic stability at non-preferred stride frequencies. In contrast, measures of variability revealed effects of stride frequency and speed conditions that were distinct from ƛMax. In particular, movement regularity computed by approximate entropy (ApEn) increased for slower walking speeds, appearing to depend on speed rather than stride frequency. The cadence freely adopted by humans has the benefit of maximizing local dynamic stability, which can be interpreted as humans tuning to their resonant frequency of walking. [ABSTRACT FROM AUTHOR]

Anterior Cruciate Ligament (ACL) injuries commonly occur when attention is simultaneously on the environment (other players, objects) and maintaining neuromuscular control. Therefore, our purpose was to investigate lower-extremity coordination following ACLR during a run-to-cut with ecological validity to sport competition. Sixteen male basketball players with ACLR (20.8 ± 3.42 years, time since surgery: 9.5 ± 2.4 months) were contrasted with 16 healthy male control basketball players (21.3 ± 3.17 years) during a run-to-cut maneuver under two conditions: 1) standard, run and initiate a ∼40° side-cut and 2) simulated sport, run-to-cut with the presence of a defender and engaged in a dual-task to intercept a ball. Lower limb kinematics were used to calculate continuous relative phase metrics for evaluation of coordination pattern and variability. Independent t -test and effect size were used to evaluate the difference between the two groups and across condition via change score. The simulated sports cutting maneuver coordination patterns were significantly different between groups for hip-ankle, hip-knee, knee-knee, and knee-ankle coupling (p <.05). Only hip-knee coupling had a significant condition change score (p =.01) with ACLR increasing (51.8 ± 79.1%) and healthy controls (−16.04 ± 64.1%) decreasing hip flexion-extension and keen abduction-adduction coupling. There was no significant difference in normal cut coordination between groups. The addition of simulated sport visual attention and dual task motor planning during the run-to-cut might elicit different lower limb movement patterns in ACLR athletes compared to the healthy counterparts, potentially contributing to the elevated reinjury risk in those with ACLR history when returning to sport. [ABSTRACT FROM AUTHOR]

Essential tremor (ET) is a common tremor disorder affecting postural/action tremor of the upper extremities and midline. Recent research revealed a cerebellar-Iike deficit during tandem gait in persons with ET, though spatiotemporal variability during normal gait in ET has been relatively ignored. The first purpose of this study was to investigate gait variability magnitude and structure in ET as compared to healthy older adults (HOA). To address this issue, 11 ET and 11 age-matched HOAs walked on a treadmill for 5 min at preferred walking speeds. HOAs walked for an additional minute while speed-matched to an ET participant. The second purpose was to describe the clinical correlates of gait variability in this population. To address this aim, 31 persons with ET walked on a treadmill for 5 min and completed the Fahn-Tolosa-Marin Tremor Rating Scale. Gait variability magnitude was derived by calculating coefficients of variation in stride length, stride time, step length, step time, and step width. Gait variability structure was derived using a detrended fluctuation analysis technique. At preferred walking speeds, ET participants walked significantly slower with significantly increased variability magnitude in all five spatiotemporal gait parameters. At speed-matched walking, ET participants exhibited significantly higher step width variability. Gait variability structure was not different between groups. We also observed that gait variability magnitude was predicted by severity of upper extremity and midline tremors. This study revealed that self-selected gait in ET is characterized by high variability that is associated with tremor severity in the upper extremity and midline. [ABSTRACT FROM AUTHOR]

Human walking requires active neuromuscular control to ensure stability in the lateral direction, which inflicts a certain metabolic load. The magnitude of this metabolic load has previously been investigated by means of passive external lateral stabilization via spring-like cords. In the present study, we applied this method to test two hypotheses: ( 1 ) the effect of external stabilization on energy cost depends on the stiffness of the stabilizing springs, and ( 2 ) the energy cost for balance control, and consequently the effect of external stabilization on energy cost, depends on walking speed. Fourteen healthy young adults walked on a motor driven treadmill without stabilization and with stabilization with four different spring stiffnesses ( between 760 and 1820 N m _ 1 ) at three walking speeds (70%, 100%, and 130% of preferred speed). Energy cost was calculated from breath-by-breath oxygen consumption. Gait parameters (mean and variability of step width and stride length, and variability of trunk accelerations) were calculated f r om kinematic data. On average external stabilization led to a decrease in energy cost of 6% (p < 0.005) as well as a decrease in step width (24%; p < 0.001), step width variability (41%; p < 0.001) and variability of medio-lateral trunk acceleration (12.5%; p < 0.005). Increasing stabilizer stiffness increased the effects on both energy cost and medio-lateral gait parameters up to a stiffness of 1260 N m _ 1 . Contrary to expectations, the effect of stabilization was independent of walking speed (p=0.111). These results show that active lateral stabilization during walking involves an energetic cost, which is independent of walking speed. [ABSTRACT FROM AUTHOR]

The electromyographic (EMG) signal is known to show large intra-subject and inter-subject variability. Adaptation to, and preparation for, the heel-strike event have been hypothesized to be major sources of EMG variability in walking. The aim of this study was to assess these hypotheses using a principal component analysis (PCA). Two waveform shapes with distinct characteristic features were proposed based on conceptual considerations of how the neuro-muscular system might prepare for, or adapt to, the heel-strike event. PCA waveforms obtained from knee muscle EMG signals were then compared with the predicted characteristic features of the two proposed waveforms. Surface EMG signals were recorded for ten healthy adult female subjects during level walking at a self-selected speed, for the following muscles; rectus femoris, vastus medialis, vastus lateralis, semitendinosus, and biceps femoris. For a period of 200 ms before and after heel-strike, EMG power was extracted using a wavelet transformation (19-395 Hz). The resultant EMG waveforms (18 per subject) were submitted to intrasubject and inter-subject PCA. In all analyzed muscles, the shapes of the first and second principal component (PC-) vectors agreed well with the predicted waveforms. These two PC-vectors accounted for 50-60% of the overall variability, in both inter-subject and intra-subject analyses. It was also found that the shape of the first PC-vector was consistent between subjects, while higher-order PC-vectors differed between subjects. These results support the hypothesis that adaptation to, and preparation for, a variable heel-strike event are both major sources of EMG variability in walking. [ABSTRACT FROM AUTHOR]

Abstract: Several methods derived from nonlinear time series analysis have been suggested to quantify stability in human gait kinematics. One of these methods is the definition of the maximum finite time Lyapunov exponent (λ) that quantifies how the system responds to infinitesimal perturbations. However, there are fundamental limitations to the conventional definition of λ for gait kinematics. First, exponential increase in initial perturbations cannot be assumed since real-life perturbations of gait kinematics are finite sized. Second, the transitions between single and double support phase within each stride cycle define two distinct dynamical regimes that may not be captured by a single λ. The present article presents a new method to quantify intra-stride changes λ(t) in local dynamical stability and employs the method to 3D lower extremity gait kinematics in 10 healthy adults walking on a treadmill at 3 different speeds. All participants showed an intra-stride change in λ(t) in the transition between single and double support phase. The intra-stride change reflected an both a increase and decrease in λ(t) at heel strike and toe off, respectively, with increased gait speed. Furthermore, a close relationship was found between the intra-stride change in standard deviation of foot velocity in the anterior–posterior direction and the intra-stride change of the initial perturbations. The present results indicate that local dynamical stability has gait phase-dependent changes that are not identified by conventional computation of a single λ. [Copyright &y& Elsevier]

Abstract: Gait adaptations are persistent after total hip arthroplasty and can depend on the type of surgery. This study focused on two surgical approaches: anterior and lateral. To analyze gait adaptations, biomechanical analyses usually employ an a priori selection of the parameters that leads to incomplete or redundant information. In contrast, Principal Component Analysis (PCA) provides an efficient transformation of the dataset by automatically identifying the major sources of variability. The purpose of this study was to investigate differences in level-walking among three groups of participants using PCA: patients undergoing an anterior surgical approach, patients undergoing a lateral surgical approach, and healthy controls. Biomechanical descriptions of the extracted principal components aided in the interpretation of the statistically significant results obtained from multivariate analysis of covariance (MANCOVA) tests. A point system was introduced to summarize the results and guide the interpretation. PCA captured reduced magnitude in sagittal and frontal moments in the anterior approach group, and reduced sagittal peaks angle in the lateral group, as previously found with traditional analyses. PCA also identified significant pattern delays in the anterior group, unnoticed in previous studies. In conclusion, neither surgical approach restored normal gait functionality because lower extremity kinetics and kinematics alterations persisted at 300-day follow-up after the surgery, regardless of the technique. [Copyright &y& Elsevier]

Abstract: Clinical studies demonstrate substantial variation in kinematic and functional performance within the total knee replacement (TKR) patient population. Some of this variation is due to differences in implant design, surgical technique and component alignment, while some is due to subject-specific differences in joint loading and anatomy that are inherently present within the population. Combined finite element and probabilistic methods were employed to assess the relative contributions of implant design, surgical, and subject-specific factors to overall tibiofemoral (TF) and patellofemoral (PF) joint mechanics, including kinematics, contact mechanics, joint loads, and ligament and quadriceps force during simulated squat, stance-phase gait and stepdown activities. The most influential design, surgical and subject-specific factors were femoral condyle sagittal plane radii, tibial insert superior–inferior (joint line) position and coronal plane alignment, and vertical hip load, respectively. Design factors were the primary contributors to condylar contact mechanics and TF anterior–posterior kinematics; TF ligament forces were dependent on surgical factors; and joint loads and quadriceps force were dependent on subject-specific factors. Understanding which design and surgical factors are most influential to TKR mechanics during activities of daily living, and how robust implant designs and surgical techniques must be in order to adequately accommodate subject-specific variation, will aid in directing design and surgical decisions towards optimal TKR mechanics for the population as a whole. [Copyright &y& Elsevier]

Abstract: Purpose: Evidence concerning the alteration of knee function during landing suffers from a lack of consensus. This uncertainty can be attributed to methodological flaws, particularly in relation to the statistical analysis of variable human movement data. The aim of this study was to compare single-subject and group analyses in detecting changes in knee stiffness and coordination during step landing that occur independent of an experimental intervention. Methods: A group of healthy men (N=12) stepped-down from a knee-high platform for 60 consecutive trials, each trial separated by a 1-minute rest. The magnitude and within-participant variability of sagittal stiffness and coordination of the landing knee were evaluated with both group and single-subject analyses. Results: The group analysis detected significant changes in knee coordination. However, the single-subject analyses detected changes in all dependent variables, which included increases in variability with task repetition. Between-individual variation was also present in the timing, size and direction of alterations. Conclusion: The results have important implications for the interpretation of existing information regarding the adaptation of knee mechanics to interventions such as fatigue, footwear or landing height. It is proposed that a participant''s natural variation in knee mechanics should be analysed prior to an intervention in future experiments. [Copyright &y& Elsevier]

Abstract: Movement variability has become an important field of research and has been studied to gain a better understanding of the neuro-muscular control of human movements. In addition to studies investigating “amplitude variability” there are a growing number of studies assessing the “temporal variability” in movements by applying non-linear analysis techniques. One limitation of the studies available to date is that they quantify variability features in specific, pre-selected biomechanical or physiological variables. In many cases it remains unclear if and to what degree these pre-selected variables quantify characteristics of the whole body movement. This technical note proposes to combine two analysis techniques that have already been applied for gait analysis in order to quantify variability features in walking with variables whose significance for the whole movements are known. Gait patterns were recorded using a full-body marker set on the subjects whose movements were captured with a standard motion tracing system. For each time frame the coordinates of all markers were interpreted as a high-dimensional “posture vector”. A principal component analysis (PCA) conducted on these posture vectors identified the main one-dimensional movement components of walking. Temporal variability of gait was then quantified by calculating the maximum Lyapunov Exponent (LyE) of these main movement components. The effectiveness of this approach was demonstrated by determining differences in temporal variability between walking in unstable shoes and walking in a normal athletic-type control shoe. Several additional conceptual and practical advantages of this combination of analysis methods were discussed. [Copyright &y& Elsevier]

Abstract: Gait asymmetry analyses are beneficial from clinical, coaching and technology perspectives. Quantifying overall athlete asymmetry would be useful in allowing comparisons between participants, or between asymmetry and other factors, such as sprint running performance. The aim of this study was to develop composite kinematic and kinetic asymmetry scores to quantify athlete asymmetry during maximal speed sprint running. Eight male sprint trained athletes (age 22±5 years, mass 74.0±8.7kg and stature 1.79±0.07m) participated in this study. Synchronised sagittal plane kinematic and kinetic data were collected via a CODA motion analysis system, synchronised to two Kistler force plates. Bilateral, lower limb data were collected during the maximal velocity phase of sprint running (velocity=9.05±0.37ms−1). Kinematic and kinetic composite asymmetry scores were developed using the previously established symmetry angle for discrete variables associated with successful sprint performance and comparisons of continuous joint power data. Unlike previous studies quantifying gait asymmetry, the scores incorporated intra-limb variability by excluding variables from the composite scores that did not display significantly larger (p<0.05) asymmetry than intra-limb variability. The variables that contributed to the composite scores and the magnitude of asymmetry observed for each measure varied on an individual participant basis. The new composite scores indicated the inter-participant differences that exist in asymmetry during sprint running and may serve to allow comparisons between overall athlete asymmetry with other important factors such as performance. [Copyright &y& Elsevier]

Abstract: Typical healthy walking displays greater variability in the mediolateral direction compared to the anteroposterior direction. This greater variability is thought to represent increased uncertainty in movement. As a result, it has been postulated that the mediolateral direction of gait requires more active control by the central nervous system while the anteroposterior direction is controlled through passive actions. However, this theory has only been tested on gait where progression occurs in the anteroposterior direction. Therefore, the purpose of this study was to investigate how the amount of variability is affected if progression occurs in the mediolateral direction using a lateral stepping gait. Results showed the anteroposterior direction had a significantly greater amount of variability than the mediolateral direction (p<0.001). The results do not support current models of a partition of active control to different anatomical planes. Rather, it seems that other physical entities involved in motion, such as momentum and inertia, are able to decrease the dependence on active control from the central nervous system. In a lateral stepping gait, such physical entities were no longer assisting in the anteroposterior direction but had a larger impact in the mediolateral direction as it was the direction of progression. As a result variability in the anteroposterior direction increased. Thus, it is possible to infer increased reliance on active control from the central nervous system in the direction orthogonal to progression. [Copyright &y& Elsevier]

Abstract: Investigating inter-joint coordination at different walking speeds in young and elderly adults could provide insights to age-related changes in neuromuscular control of gait. We examined effects of walking speed and age on the pattern and variability of inter-joint coordination. Gait analyses of 10 young and 10 elderly adults were performed with different self-selected speeds, including a preferred, faster, and slower speed. Continuous relative phase (CRP), derived from phase planes of two adjacent joints, was used to assess the inter-joint coordination. CRP patterns were examined with cross-correlation measures and root-mean-square (RMS) differences when comparing ensemble mean curves of the faster or slower speed to preferred speed walking. Variability of coordination for each participant was assessed with the average value of all standard deviations calculated for each data point over a gait cycle from all CRP curves, namely the deviation phase (DP). For hip–knee CRP pattern, RMS differences were significantly greater between the slower and preferred walking speeds than between the faster and preferred walking speeds in young adults, but this was not found in elderly adults. Significant group differences in RMS differences and cross-correlation measures were detected in hip–knee CRP patterns between the slower and preferred walking speeds. No significant walking speed or age effects were detected for the knee–ankle CRP. Significant walking speed effects were also detected in hip–knee DP values. However, no significant group differences were detected for all three speeds. These findings suggested that young and elder adults compromise changes of walking speed with different neuromuscular control strategies. [Copyright &y& Elsevier]

Abstract: Measures calculated from unperturbed walking patterns, such as variability measures and maximum Floquet multipliers, are often used to study the stability of walking. However, it is unknown if, and to what extent, these measures correlate to the probability of falling. We studied whether in a simple model of human walking, i.e., a passive dynamic walker, the probability of falling could be predicted from maximum Floquet multipliers, kinematic state variability, and step time variability. We used an extended version of the basic passive dynamic walker with arced feet and a hip spring. The probability of falling was manipulated by varying the foot radius and hip spring stiffness, or varying these factors while co-varying the slope to keep step length constant. The simulation data indicated that Floquet multipliers and kinematic state variability correlated inconsistently with probability of falling. Step time variability correlated well with probability of falling, but a more consistent correlation with the probability of falling was found by calculating the variability of the log transform of the step time. Our findings speak against the use of maximum Floquet multipliers and suggest instead that variability of critical variables may be a good predictor of the probability to fall. [Copyright &y& Elsevier]

Abstract: This study proposes a method to assess foot placement during walking using an ambulatory measurement system consisting of orthopaedic sandals equipped with force/moment sensors and inertial sensors (accelerometers and gyroscopes). Two parameters, lateral foot placement (LFP) and stride length (SL), were estimated for each foot separately during walking with eyes open (EO), and with eyes closed (EC) to analyze if the ambulatory system was able to discriminate between different walking conditions. For validation, the ambulatory measurement system was compared to a reference optical position measurement system (Optotrak). LFP and SL were obtained by integration of inertial sensor signals. To reduce the drift caused by integration, LFP and SL were defined with respect to an average walking path using a predefined number of strides. By varying this number of strides, it was shown that LFP and SL could be best estimated using three consecutive strides. LFP and SL estimated from the instrumented shoe signals and with the reference system showed good correspondence as indicated by the RMS difference between both measurement systems being 6.5±1.0mm (mean ±standard deviation) for LFP, and 34.1±2.7mm for SL. Additionally, a statistical analysis revealed that the ambulatory system was able to discriminate between the EO and EC condition, like the reference system. It is concluded that the ambulatory measurement system was able to reliably estimate foot placement during walking. [ABSTRACT FROM AUTHOR]

Abstract: People at risk of falling exhibit increased gait variability, which may predict future falls. However, the causal mechanisms underlying these correlations are not well known. Increased neuronal noise associated with aging likely leads to increased gait variability, which could in turn lead to increased fall risk. This paper presents a model of how changes in neuromuscular noise independently affect gait variability and probability of falling, and aims to determine the extent to which changes in gait variability directly predict fall risk. We used a dynamic walking model that incorporates a lateral step controller to maintain lateral stability. Noise was applied to this controller to approximate neuromuscular noise in humans. Noise amplitude was varied between low amplitudes that did not induce falls and high amplitudes for which the model always fell. With increases in noise amplitude, the model fell more often and after fewer steps. Gait variability increased with noise amplitude and predicted increased probability of falling. Importantly, these relationships were not linear. At either low gait variability or very high gait variability, small increases in noise and variability affected probability of falling very little. Conversely, at intermediate noise and/or variability levels, the same small increases resulted in large increases in probability of falling. Our results validate the idea that age-related increases in neuromuscular noise likely play a direct contributing role in increasing fall risk. However, neuromuscular noise remains only one of many important factors that need to be considered. These findings have important implications for fall prevention research and practice. [Copyright &y& Elsevier]

Abstract: Variability in the spatio-temporal coordination of human movement kinematics is often assessed by vector coding and continuous relative phase (CRP). To facilitate appropriate comparisons between the findings of studies that have used different techniques to assess variability, the purposes of this study were: (1) to determine if both vector coding and CRP behave according to dynamical systems theories on variability and state space transitions; and (2) to determine if trends in coordination variability during movement are consistent when using either vector coding or CRP. We present both a theoretical case (the Lorenz Attractor) and two experimental cases (rearfoot–forefoot coupling during overground walking for 22 subjects; the effect of treadmill speed on thigh-leg coupling for five subjects). In the theoretical case, variability quantified by CRP agreed with dynamical systems theory on state space transitions more so than variability quantified by vector coding. In experimental cases, this distinction was less clear, although CRP appeared to be a more conservative metric for variability. The magnitudes (all p<0.001) and timings (all p<0.04) of peaks in variability during the stance phase of overground walking depended on whether vector coding or CRP was used for two couplings. Similar distinctions were observed for peaks during the stride cycle of treadmill locomotion (all effect sizes >2.8). However, changes in the average variability during the stride cycle as speed increased were consistent for both methods (all effect sizes <0.2). The results suggest that comparisons between the findings of studies that have quantified variability using CRP and those that have used vector coding should be made with caution. [Copyright &y& Elsevier]

Abstract: Thanks to decades of research, gait analysis has become an efficient tool. However, mainly due to the price of the motion capture systems, standard gait laboratories have the capability to measure only a few consecutive steps of ground walking. Recently, wearable systems were proposed to measure human motion without volume limitation. Although accurate, these systems are incompatible with most of existing calibration procedures and several years of research will be necessary for their validation. A new approach consisting of using a stationary system with a small capture volume for the calibration procedure and then to measure gait using a wearable system could be very advantageous. It could benefit from the knowledge related to stationary systems, allow long distance monitoring and provide new descriptive parameters. The aim of this study was to demonstrate the potential of this approach. Thus, a combined system was proposed to measure the 3D lower body joints angles and segmental angular velocities. It was then assessed in terms of reliability towards the calibration procedure, repeatability and concurrent validity. The dispersion of the joint angles across calibrations was comparable to those of stationary systems and good reliability was obtained for the angular velocities. The repeatability results confirmed that mean cycle kinematics of long distance walks could be used for subjects’ comparison and pointed out an interest for the variability between cycles. Finally, kinematics differences were observed between participants with different ankle conditions. In conclusion, this study demonstrated the potential of a mixed approach for human movement analysis. [ABSTRACT FROM AUTHOR]

Abstract: The present investigation examined the variability of sitting postural movement in relation to the development of perceived discomfort by means of linear and nonlinear analysis. Nine male subjects participated in this study. Discomfort ratings, kinetic and kinematics data were recorded during prolonged sitting. Body part discomfort index, displacement of the center of pressure (COP) in anterior–posterior and medial–lateral directions as well as lumbar curvature were calculated. Mean, standard deviation and sample entropy values were extracted from COP and lumbar curvature signals. Standard deviation and sample entropy were used to assess the degree of variability and complexity of sitting. A correlation analysis was performed to determine the correlation of each parameter with discomfort. There were no correlations between discomfort and any of the mean values. On the contrary, the standard deviations of the COP displacement in both directions and lumbar curvature were positively correlated to discomfort, whereas sample entropies were negatively correlated. The present study suggests that the increase in degree of variability and the decrease in complexity of sitting postural control are interrelated with the increase in perceived discomfort. Finally, the present study underlined the importance of quantifying motor variability for understanding the biomechanics of seated posture. [Copyright &y& Elsevier]

Abstract: Walking on uneven surfaces or while undergoing perturbations has been associated with increased gait variability in both modeling and human studies. Previous gait research involving continuous perturbations has focused on sinusoidal oscillations, which can result in individuals predicting the perturbation and/or entraining to it. Therefore, we examined the effects of continuous, pseudo-random support surface and visual field oscillations on 12 healthy, young participants. Participants walked in a virtual reality environment under no perturbation (NOP), anterior–posterior (AP) walking surface and visual oscillation and mediolateral (ML) walking surface and visual oscillation conditions. Participants exhibited shorter (p≤0.005), wider (p<0.001) and faster (p<0.001) steps relative to NOP during ML perturbations and shorter (p≤0.005) and wider (p<0.001) steps during AP perturbations. Step length variability and step width variability both increased relative to NOP during all perturbation conditions (p<0.001) but exhibited greater increases for the ML perturbations (p<0.001). Participants exhibited greater trunk position variability and trunk velocity variability in the ML direction than in the AP direction during ML perturbations relative to NOP (p<0.001). Significantly greater variability in the ML direction indicates that to maintain stability, participants needed to exert greater control in the ML direction. This observation is consistent with prior modeling predictions. The large and consistent responses observed during ML visual and walking surface perturbations suggest potential for application during gait training and patient assessment. [Copyright &y& Elsevier]

Abstract: The purpose of this study was to determine the reliability of investigating electromyography (EMG) of selected leg muscles during walking. Tibialis posterior and peroneus longus EMG activity were recorded via intramuscular electrodes. Tibialis anterior and medial gastrocnemius EMG activity were recorded with surface electrodes. Twenty-eight young adults attended two test-sessions approximately 15 days apart. Relative and absolute measures of reliability were calculated for EMG timing and amplitude parameters during specific phases of the gait cycle. Maximum contractions and sub-maximal contractions were obtained via maximum isometric voluntary contractions and a very fast walking speed, respectively. Time of peak EMG amplitude for all muscles displayed relatively narrow limits of random error. However, reliability of peak and root mean square amplitude parameters for tibialis posterior and peroneus longus displayed unacceptably wide limits of random error, regardless of the normalisation reference technique. Whilst some amplitude parameters for tibialis anterior and medial gastrocnemius displayed good to excellent relative reliability, the corresponding values for absolute error were generally large. Timing and amplitude EMG parameters for all muscles displayed low to moderate coefficient of variation within each test session (range: 7–25%). Overall, between-participant variability was minimised with sub-maximal normalisation values. These results demonstrate that re-application of electrodes results in large random error between sessions, particularly with tibialis posterior and peroneus longus. Researchers planning studies of these muscles with a repeated-test design (e.g. to evaluate the effect of an intervention) must consider whether this level of error is acceptable. [Copyright &y& Elsevier]

Abstract: Seventeen healthy elderly and 17 young adults walked and crossed obstacles of different heights, while sagittal angles (x) and angular velocities (x′) of each joint were measured and their phase angles (ϕ) calculated as tan−1(x′/x). Relative phase angles (RPA) were also obtained, i.e., ϕ hip−knee and ϕ knee−ankle. The standard deviations of the RPA curve points were averaged to obtain deviation phase (DP) values for the stance and swing phase for each obstacle height. Both groups had similar RPA patterns, for both the leading and the trailing limb. The elderly were found to cross obstacles with increased leading toe-clearance, but unaltered inter-joint coordination patterns. During the leading limb crossing, greater variability of the inter-joint coordination, correlated to the increased toe-clearance, indicates that aging increases the variability of the way the lower limb joints are controlled during obstacle-crossing. The elderly did not change the pattern and variability of the inter-joint coordination during the trailing limb crossing, possibly because it is relatively easy for the elderly to meet the mechanical demands despite increased age-related organismic constraints. The normal baseline inter-joint coordination data in the healthy aging population will be useful for future identification of coordination impairments and evaluation of subsequent treatment in those patients with diseases who may have an increased risk of falling. [Copyright &y& Elsevier]

Abstract: Fifteen elderly subjects with bilateral medial knee osteoarthritis (OA) and 15 healthy elderly subjects walked and crossed obstacles with heights of 10%, 20%, and 30% of their leg lengths while sagittal angles and angular velocities of each joint were measured and their phase angles (ϕ) calculated. Continuous relative phase (CRP) were also obtained, i.e., ϕ hip−knee and ϕ knee−ankle. The standard deviations of the CRP curve points were averaged to obtain deviation phase (DP) values for the stance and swing phases. Significant differences between the OA and control groups were found in several of the peak and crossing angles, and angular velocities at the knee and ankle. Both groups had similar CRP patterns, and the DP values of the hip–knee and knee–ankle CRP curves were not significantly different between the two groups. Despite significant changes in the joint kinematics, knee OA did not significantly change the way the motions of the lower limb joints are coordinated during obstacle-crossing. It appears that the OA groups adopted a particular biomechanical strategy among all possible strategies that can accommodate the OA-induced changes of the knee mechanics using unaltered inter-joint coordination control. This enabled the OA subjects to accommodate reliably the mechanical demands related to bilateral knee OA in the sagittal plane during obstacle-crossing. Maintaining normal and reliable inter-joint coordination may be considered a goal of therapeutic intervention, and the patterns and variability of inter-joint coordination can be used for the evaluation of treatment effects. [Copyright &y& Elsevier]

Abstract: Several efforts have been made to study gait stability using measures derived from nonlinear time-series analysis. The maximum finite time Lyapunov exponent (λ max) quantifies how a system responds to an infinitesimally small perturbation. Recent studies suggested that slow walking leads to lower λ max values, and thus is more stable than fast walking, but these studies suffer from methodological limitations. We studied the effects of walking speed on the amount of kinematic variability and stability in human walking. Trunk motions of 15 healthy volunteers were recorded in 3D during 2min of treadmill walking at different speeds. From those time series, maximum Lyapunov exponents, indicating short-term and long-term divergence (λ S-stride and λ L-stride), and mean standard deviation (MeanSD) were calculated. λ S-stride showed a linear decrease with increasing speed for forward–backward (AP) movements and quadratic effects (inverted U-shaped) for medio-lateral (ML) and up–down (VT) movements. λ L-stride showed a quadratic effect (inverted U-shaped) of walking speed for AP movements, a linear decrease for ML movements, and a linear increase for VT movements. Moreover, positive correlations between λ S and MeanSD were found for all directions, while λ L-stride and MeanSD were correlated negatively in the AP direction. The different effects of walking speed on λ S-stride and λ L-stride for the different planes suggest that slow walking is not necessarily more stable than fast walking. The absence of a consistent pattern of correlations between λ L-stride and MeanSD over the three directions suggests that variability and stability reflect, at least to a degree, different properties of the dynamics of walking. [Copyright &y& Elsevier]