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Children with hemiplegic cerebral palsy (hemi-CP) frequently experience deficits in dynamic balance, a crucial factor influencing gait function. This imbalance can manifest as temporal–spatial gait asymmetry, where movement patterns differ between the affected and less affected sides. This study investigated how temporal–spatial gait asymmetries and dynamic balance are associated in children with hemi-CP. Eighty-five children with hemi-CP (age: 13.27 ± 1.72 years) were included. The temporal (AITemporal) and spatial (AISpatial) gait asymmetry indices were, respectively, computed with reference to the swing time and step length of affected and less affected sides, which were collected through a 3D gait analysis. Measures of dynamic balance included the directional dynamic limit-of-stability (D-LOSdirectional) assessed across multiple directions (forward, rearward, affected, and less affected) and the overall dynamic limit-of-stability (D-LOSoverall) during static stance, in addition to the heel-to-heel base of support (BOSH-to-H) during walking, the dynamic gait index (DynGI), and the Timed Up and Down Stair (TUDS) test.The D-LOSoverall correlated negatively with the temporal (r = −0.437, p < 0.001) and spatial (r = −0.279, p = 0.009) asymmetries. The D-LOSdirectional (forward, rearward, affected, and less affected) correlated negatively with temporal asymmetry (r ranged from −0.219 to −0.411, all p < 0.05), but only the D-LOSdirectional rearward (r = −0.325, p = 0.002) and less affected (r = −0.216, p = 0.046) correlated with spatial asymmetry. The BOSH-to-H correlated positively with both temporal (r = 0.694, p < 0.001) and spatial (r = 0.503, p < 0.001) asymmetries. The variation in D-LOSoverall and BOSH-to-H accounted for 19.1% and 48.2%, respectively, of the variations in the temporal asymmetry and 7.8% and 25.3% of the variations in the spatial asymmetry. The findings of this study suggest that dynamic balance control is related to the magnitude of temporal–spatial gait asymmetries in children with hemi-CP. This evidence lays the groundwork for further research into the mechanism linking gait asymmetry and dynamic balance, potentially leading to a deeper understanding of these impairments, while also highlighting the need for longitudinal studies with the inclusion of a broader population to enhance the generalizability of the findings. [ABSTRACT FROM AUTHOR]

Challenges to postural stability emerge in the transition from locomotion to a standing posture as during gait termination, often accompanied by another task (e.g., opening a door), which may complicate control. However, less is known about postural control during terminating gait while engaged in a secondary manual task. What are the changes in postural control when terminating gait with and without a prehension task? In a cross-sectional design, 15 healthy young adults (M=8, F=7; 27±2 years; 69±13 kg; 171±8 cm) underwent both a single task gait termination (GTO) and dual task (gait termination plus reaching; GTR). Postural Time-to-Contact (TtC) was measured using Center of Pressure (CoP) and the sternum position in anterior-posterior (AP) and medial-lateral (ML) directions over two different phases: preparatory phase and stabilization phase. Five successful trials were recorded to obtain a mean TtC. For statistical analysis of TtC, a two-tailed paired t -test was used (p =.05) as normality was satisfied. For the preparatory phase, there were no differences for the CoP, but TtC of the sternum position in AP was shorter in GTR than GTO (p =.001). Meanwhile, for the stabilization phase, TtCs of both the CoP and sternum position were longer in GTR in both AP and ML directions (p's <.001). We suggest that for the preparatory phase, the shorter TtC of the sternum position with intact TtC of the CoP in GTR indicates that healthy young individuals are flexible, in that they smoothly integrate CoP control with the upper body demands required to also perform the prehension task. Meanwhile, for the stabilization phase, the longer TtC in dual termination and prehension task indicates that the perturbation imposed by the prehension movement did not result in reduced stabilization when returning to an upright posture. • Time-to-Contact (TtC) stability boundaries was assessed during gait termination. • Prehension combined with gait termination reduces TtC during the preparatory phase. • This reduction was observed for the trunk but not the center of pressure. • The addition of a manual task led to better stabilization after gait termination. • Longer TtC in the dual task may result from greater awareness of stability limits. [ABSTRACT FROM AUTHOR]

Older adults, as well as those with certain neurological disorders, may compensate for poor neural control of postural stability by widening their base of foot support while walking. However, the extent to which this wide-based gait improves postural stability or affects postural control strategies has not been explored. People with idiopathic Parkinson's disease (iPD, n = 72), frontal gait disorders (FGD, n = 16), and healthy older adults (n = 32) performed walking trials at their preferred speed over an 8-m-long, instrumented walkway. People with iPD were tested in their OFF medication state. Analyses of covariance were performed to determine the associations between stride width and measures of lateral stability control. People with FGD exhibited a wide-based gait compared to both healthy older adults and iPD. An increased stride width was associated with an increase in lateral margin of stability in FGD. Unlike healthy older adults or iPD, people with FGD did not externally rotate their feet (toe-out angle) or shift their center of pressure laterally to aid lateral dynamic stability during walking but slowed their gait instead to increase stability. By adopting a slow, wide-based gait, people with FGD take advantage of the passive, pendular mechanics of walking. [ABSTRACT FROM AUTHOR]

Systematically review literature addressing the effects of changes in base of support (BoS) configuration and characteristics of support surface (SS) on postural control of children with cerebral palsy (CP). We conducted a tailored electronic database search in PubMed/Web of Science/SCOPUS/Embase. We identified 15 studies meeting inclusion criteria. The extant literature suggests that when children with CP experience changes in BoS and SS, they engage in fewer adaptive postural control responses than typically developing children. Documented response patterns of children with CP in the literature might guide the selection and development of rehabilitation strategies to appropriately facilitate or challenge postural control in children with CP. [ABSTRACT FROM AUTHOR]

Introduction: It is crucial to comprehend the interplay between the center of mass (CoM) and base of support (BoS) in elderly individuals’ body movements, as it could have implications for fall prevention.Methods: The purpose of this study is to characterize age-related differences using the instantaneous location of the CoM and CoM velocity vector in relation to the dynamically changing BoS during walking. Thirty subjects participated in the experiments. Derivation formulas of feasible stability region and age-related statistical analyses were proposed.Results: The stability margin and distance to centroid for elderly group were found to be significantly different from the young group (p < 0.05). At heel strike, while the CoMv distance was similar for age-based groups (p > 0.05), older individuals demonstrated a greater CoMv distance to the border than the younger at right limb, which suggesting age-related differences in momentum control. In addition, Bland-Altman analysis indicated that the validity was substantial, making it feasible to capture stride-to-stride variability.Discussion: The CoM trajectories and feasible stability region could provide a better understanding of human momentum control, underlying mechanisms of body instability and gait imbalance.

Children with hemiplegic cerebral palsy (hemi-CP) frequently experience deficits in dynamic balance, a crucial factor influencing gait function. This imbalance can manifest as temporal–spatial gait asymmetry, where movement patterns differ between the affected and less affected sides. This study investigated how temporal–spatial gait asymmetries and dynamic balance are associated in children with hemi-CP. Eighty-five children with hemi-CP (age: 13.27 ± 1.72 years) were included. The temporal (AITemporal) and spatial (AISpatial) gait asymmetry indices were, respectively, computed with reference to the swing time and step length of affected and less affected sides, which were collected through a 3D gait analysis. Measures of dynamic balance included the directional dynamic limit-of-stability (D-LOSdirectional) assessed across multiple directions (forward, rearward, affected, and less affected) and the overall dynamic limit-of-stability (D-LOSoverall) during static stance, in addition to the heel-to-heel base of support (BOSH-to-H) during walking, the dynamic gait index (DynGI), and the Timed Up and Down Stair (TUDS) test.The D-LOSoverall correlated negatively with the temporal (r = −0.437, p < 0.001) and spatial (r = −0.279, p = 0.009) asymmetries. The D-LOSdirectional (forward, rearward, affected, and less affected) correlated negatively with temporal asymmetry (r ranged from −0.219 to −0.411, all p < 0.05), but only the D-LOSdirectional rearward (r = −0.325, p = 0.002) and less affected (r = −0.216, p = 0.046) correlated with spatial asymmetry. The BOSH-to-H correlated positively with both temporal (r = 0.694, p < 0.001) and spatial (r = 0.503, p < 0.001) asymmetries. The variation in D-LOSoverall and BOSH-to-H accounted for 19.1% and 48.2%, respectively, of the variations in the temporal asymmetry and 7.8% and 25.3% of the variations in the spatial asymmetry. The findings of this study suggest that dynamic balance control is related to the magnitude of temporal–spatial gait asymmetries in children with hemi-CP. This evidence lays the groundwork for further research into the mechanism linking gait asymmetry and dynamic balance, potentially leading to a deeper understanding of these impairments, while also highlighting the need for longitudinal studies with the inclusion of a broader population to enhance the generalizability of the findings.

Quantitative evaluation of human stability using foot pressure/force measurement hardware and motion capture (mocap) technology is expensive, time consuming, and restricted to the laboratory. We propose a novel image-based method to estimate three key components for stability computation: Center of Mass (CoM), Base of Support (BoS), and Center of Pressure (CoP). Furthermore, we quantitatively validate our image-based methods for computing two classic stability measures, CoMtoCoP and CoMtoBoS distances, against values generated directly from laboratory-based sensor output (ground truth) using a publicly available, multi-modality (mocap, foot pressure, two-view videos), ten-subject human motion dataset. Using Leave One Subject Out (LOSO) cross-validation, experimental results show: 1) our image-based CoM estimation method (CoMNet) consistently outperforms state-of-the-art inertial sensor-based CoM estimation techniques; 2) stability computed by our image-based method combined with insole foot pressure sensor data produces consistent, strong, and statistically significant correlation with ground truth stability measures (CoMtoCoP r = 0.79 p < 0.001, CoMtoBoS r = 0.75 p < 0.001); 3) our fully image-based estimation of stability produces consistent, positive, and statistically significant correlation on the two stability metrics (CoMtoCoP r = 0.31 p < 0.001, CoMtoBoS r = 0.22 p < 0.043). Our study provides promising quantitative evidence for the feasibility of image-based stability evaluation in natural environments.

The analysis of the stability of human gait may be effectively performed when estimates of the base of support are available. The base of support area is defined by the relative position of the feet when they are in contact with the ground and it is closely related to additional parameters such as step length and stride width. These parameters may be determined in the laboratory using either a stereophotogrammetric system or an instrumented mat. Unfortunately, their estimation in the real world is still an unaccomplished goal. This study aims at proposing a novel, compact wearable system, including a magneto-inertial measurement unit and two time-of-flight proximity sensors, suitable for the estimation of the base of support parameters. The wearable system was tested and validated on thirteen healthy adults walking at three self-selected speeds (slow, comfortable, and fast). Results were compared with the concurrent stereophotogrammetric data, used as the gold standard. The root mean square errors for the step length, stride width and base of support area varied from slow to high speed between 10–46 mm, 14–18 mm, and 39–52 cm2, respectively. The mean overlap of the base of support area as obtained with the wearable system and with the stereophotogrammetric system ranged between 70% and 89%. Thus, this study suggested that the proposed wearable solution is a valid tool for the estimation of the base of support parameters out of the laboratory. [ABSTRACT FROM AUTHOR]

Quantitative evaluation of human stability using foot pressure/force measurement hardware and motion capture (mocap) technology is expensive, time consuming, and restricted to the laboratory. We propose a novel image-based method to estimate three key components for stability computation: Center of Mass (CoM), Base of Support (BoS), and Center of Pressure (CoP). Furthermore, we quantitatively validate our image-based methods for computing two classic stability measures, CoMtoCoP and CoMtoBoS distances, against values generated directly from laboratory-based sensor output (ground truth) using a publicly available, multi-modality (mocap, foot pressure, two-view videos), ten-subject human motion dataset. Using Leave One Subject Out (LOSO) cross-validation, experimental results show: 1) our image-based CoM estimation method (CoMNet) consistently outperforms state-of-the-art inertial sensor-based CoM estimation techniques; 2) stability computed by our image-based method combined with insole foot pressure sensor data produces consistent, strong, and statistically significant correlation with ground truth stability measures (CoMtoCoP r = 0.79 p < 0.001, CoMtoBoS r = 0.75 p < 0.001); 3) our fully image-based estimation of stability produces consistent, positive, and statistically significant correlation on the two stability metrics (CoMtoCoP r = 0.31 p < 0.001, CoMtoBoS r = 0.22 p < 0.043). Our study provides promising quantitative evidence for the feasibility of image-based stability evaluation in natural environments. [ABSTRACT FROM AUTHOR]

Freezing of gait (FOG) is a sudden episodic inability to produce effective stepping despite the intention to walk. It typically occurs during gait initiation (GI) or modulation and may lead to falls. We studied the anticipatory postural adjustments (imbalance, unloading, and stepping phase) at GI in 23 patients with Parkinson's disease (PD) and FOG (PDF), 20 patients with PD and no previous history of FOG (PDNF), and 23 healthy controls (HCs). Patients performed the task when off dopaminergic medications. The center of pressure (CoP) displacement and velocity during imbalance showed significant impairment in both PDNF and PDF, more prominent in the latter patients. Several measurements were specifically impaired in PDF patients, especially the CoP displacement along the anteroposterior axis during unloading. The pattern of segmental center of mass (SCoM) movements did not show differences between groups. The standing postural profile preceding GI did not correlate with outcome measurements. We have shown impaired motor programming at GI in Parkinsonian patients. The more prominent deterioration of unloading in PDF patients might suggest impaired processing and integration of somatosensory information subserving GI. The unaltered temporal movement sequencing of SCoM might indicate some compensatory cerebellar mechanisms triggering time-locked models of body mechanics in PD. [ABSTRACT FROM AUTHOR]

Abstract Background The Margin of Stability (MoS) is a widely used objective measure of dynamic stability during gait. Increasingly, researchers are using the MoS to assess the stability of pathological populations to gauge their stability capabilities and coping strategies, or as an objective marker of outcome, response to treatment or disease progression. The objectives are; to describe the types of pathological gait that are assessed using the MoS, to examine the methods used to assess MoS and to examine the way the MoS data is presented and interpreted. Methods A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines (PRISMA) in the following databases: Web of Science, PubMed, UCL Library Explore, Cochrane Library, Scopus. All articles measured the MoS of a pathologically affected adult human population whilst walking in a straight line. Extracted data were collected per a prospectively defined list, which included: population type, method of data analysis and model building, walking tasks undertaken, and interpretation of the MoS. Results Thirty-one studies were included in the final review. More than 15 different clinical populations were studied, most commonly post-stroke and unilateral transtibial amputee populations. Most participants were assessed in a gait laboratory using motion capture technology, whilst 2 studies used instrumented shoes. A variety of centre of mass, base of support and MoS definitions and calculations were described. Conclusions This is the first systematic review to assess use of the MoS and the first to consider its clinical application. Findings suggest the MoS has potential to be a helpful, objective measurement in a variety of clinically affected populations. Unfortunately, the methodology and interpretation varies, which hinders subsequent study comparisons. A lack of baseline results from large studies mean direct comparison between studies is difficult and strong conclusions are hard to make. Further work from the biomechanics community to develop reporting guidelines for MoS calculation methodology and a commitment to larger baseline studies for each pathology is welcomed.

The analysis of the stability of human gait may be effectively performed when estimates of the base of support are available. The base of support area is defined by the relative position of the feet when they are in contact with the ground and it is closely related to additional parameters such as step length and stride width. These parameters may be determined in the laboratory using either a stereophotogrammetric system or an instrumented mat. Unfortunately, their estimation in the real world is still an unaccomplished goal. This study aims at proposing a novel, compact wearable system, including a magneto-inertial measurement unit and two time-of-flight proximity sensors, suitable for the estimation of the base of support parameters. The wearable system was tested and validated on thirteen healthy adults walking at three self-selected speeds (slow, comfortable, and fast). Results were compared with the concurrent stereophotogrammetric data, used as the gold standard. The root mean square errors for the step length, stride width and base of support area varied from slow to high speed between 10–46 mm, 14–18 mm, and 39–52 cm2, respectively. The mean overlap of the base of support area as obtained with the wearable system and with the stereophotogrammetric system ranged between 70% and 89%. Thus, this study suggested that the proposed wearable solution is a valid tool for the estimation of the base of support parameters out of the laboratory.

Spatio-temporal gait parameters such as step width, cadence, stride length, and walking speed contribute to dynamic stability. Several studies have investigated the role of gait parameters in maintaining balance. However, in these studies, subjects were instructed to alter their gait. This intentional alteration has the potential to create error in the results, as subjects are not walking with a natural and comfortable gait. In consideration of this, the sample chosen in this study consisted of patients who had undergone a knee replacement. Such individuals naturally have gait parameters that differ from normal subjects. The primary objective of this study was to develop regression models that predict and measure gait stability in both the anterior-posterior and medio-lateral directions based on gait parameters. The maximum deviation of the extrapolated center of mass from the border of the base of support was the measure of gait stability. A forward stepwise multiple regression analysis was conducted to develop both models. In testing the goodness of fit of models, the values of coefficient of determination, standard error of estimates, and root mean square error were calculated. Both models showed sufficient values of goodness of fit. To improve walking stability and minimize falls, fall-prone people should walk with an adequate base-of-support area, and with lower cadence and speed. The results of this study contribute to an understanding of gait patterns and their relationship to walking stability and to how gait strategies might be taught in physical therapy programs to minimize the risk of falls.

Introduction: It is crucial to comprehend the interplay between the center of mass (CoM) and base of support (BoS) in elderly individuals' body movements, as it could have implications for fall prevention. Methods: The purpose of this study is to characterize age-related differences using the instantaneous location of the CoM and CoM velocity vector in relation to the dynamically changing BoS during walking. Thirty subjects participated in the experiments. Derivation formulas of feasible stability region and age-related statistical analyses were proposed. Results: The stability margin and distance to centroid for elderly group were found to be significantly different from the young group ( p < 0.05). At heel strike, while the CoMv distance was similar for age-based groups ( p > 0.05), older individuals demonstrated a greater CoMv distance to the border than the younger at right limb, which suggesting age-related differences in momentum control. In addition, Bland-Altman analysis indicated that the validity was substantial, making it feasible to capture stride-to-stride variability. Discussion: The CoM trajectories and feasible stability region could provide a better understanding of human momentum control, underlying mechanisms of body instability and gait imbalance., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Liang.)

Background: It is known that even under static conditions a backpack wearer will need to make some adjustments to maintain postural stability. There is a paucity of research exploring the impact of altering the position of the feet with imposed loads of variable distance from the posterior midline., Objective: Therefore, the aim of this study was to determine if changes in the horizontal position of a fixed load when wearing a backpack affect specific variables derived from foot tracings of males and females standing with their self-selected natural feet position., Methods: 150 healthy volunteer participants were instructed to adopt a natural stance across four conditions: Backpack with no weight, backpack with a weight (5% of body mass) placed at 0 cm, 20 cm, and 40 cm distance from the posterior body. Foot tracings were made for each condition. Base of Support (BoS), Feet Width (FW), and Feet Opening Angle (FOA) were calculated., Results: The BoS significantly decreased in loaded conditions (0 cm, 20 cm and 40 cm) compared to unloaded. This was supported by FW and FOA significant findings that once the load was imposed the response was to approximate the feet and reduce 'toeout'., Conclusion: This reaction of people to reduce their BoS in response to added backpack load appears counter intuitive and raises the question of whether this is maladaptive. Clarification by further investigation will inform backpack wearers to counter this instinctive response to load and increase postural stability.

This study investigated timing and coordination during the swing phase of swing leg, body center of mass (CoM) and head during walking people with multiple sclerosis (MS; n = 19) and controls (n = 19). The MS group showed differences in swing phase timing at all speeds. At imposed but not preferred speeds, the MS group had less time to prepare for entry into the unstable equilibrium, as the CoM entered this phase of swing earlier. Time-to-contact coupling, quantifying the coordination between the CoM and the swing foot, was not different between groups. The projection of head motion on the ground occurred earlier after toe-off and was positioned closer to the body in the MS group, illustrating increased reliance on visual exproprioception in which vision of the body in relation to the surface of support is established. Finally, prospective control, linking head movements to the swing foot time-to-contact and next step landing area, was impaired in the MS group at higher gait speeds. [ABSTRACT FROM AUTHOR]

Time-to-contact (TtC) is an alternative measure of postural stability to center of pressure (CoP) velocity. TtC is based on both spatial and temporal aspects of CoP displacement, definition of the boundary shape, and quantity of minima analyzed. Three boundary shapes and three minima selection methods were used to compute TtC during bipedal quiet standing. The results suggest that there is a strong correlation between TtC values obtained using each of the calculation methods (r ⩾ .73) and mean CoP velocity (r ⩾ -.70). TtC was significantly affected by boundary shape and minima selection method. This limits the ability to compare absolute values, but relative levels of stability computed using TtC can be compared due to strong correlations. Given the task parameters studied, mean CoP velocity may even be adequate to assess levels of stability. Future studies are needed to examine the generalizability of these findings for different groups and task parameters. [ABSTRACT FROM AUTHOR]

The present study investigated whether expertise in fencing influences the onset of postural preparation during the fencing lunge and how it changes under different performance conditions. We also questioned if the onset of feedforward control can be categorized into one of the postural phases: anticipatory or early postural adjustment. Eight elite fencers and nine physical education students performed an attack with a lunge in self-paced and reaction time conditions from three different initial stance widths. The onset of the center of pressure (COP) displacement and EMG activities for the tibialis anterior (TA) of both limbs were recorded. The results show that expertise in fencing delays the onset of the activity of TA of the front leg and the onset of COP displacement during fencing lunge performance in comparison to controls. Additionally, in contrast to the control group, fencers produce typical APA patterns in the activation of TA under different performance conditions, delayed reaction time in comparison to self-initiated lunging, and constant time of APA onset under different widths of stance. According to different times and functions of TA activity and COP displacement in lunging, we propose to address them as anticipatory postural adjustment and early postural adjustment, respectively.

Background: The Margin of Stability (MoS) is a widely used objective measure of dynamic stability during gait. Increasingly, researchers are using the MoS to assess the stability of pathological populations to gauge their stability capabilities and coping strategies, or as an objective marker of outcome, response to treatment or disease progression. The objectives are; to describe the types of pathological gait that are assessed using the MoS, to examine the methods used to assess MoS and to examine the way the MoS data is presented and interpreted.Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines (PRISMA) in the following databases: Web of Science, PubMed, UCL Library Explore, Cochrane Library, Scopus. All articles measured the MoS of a pathologically affected adult human population whilst walking in a straight line. Extracted data were collected per a prospectively defined list, which included: population type, method of data analysis and model building, walking tasks undertaken, and interpretation of the MoS.Results: Thirty-one studies were included in the final review. More than 15 different clinical populations were studied, most commonly post-stroke and unilateral transtibial amputee populations. Most participants were assessed in a gait laboratory using motion capture technology, whilst 2 studies used instrumented shoes. A variety of centre of mass, base of support and MoS definitions and calculations were described.Conclusions: This is the first systematic review to assess use of the MoS and the first to consider its clinical application. Findings suggest the MoS has potential to be a helpful, objective measurement in a variety of clinically affected populations. Unfortunately, the methodology and interpretation varies, which hinders subsequent study comparisons. A lack of baseline results from large studies mean direct comparison between studies is difficult and strong conclusions are hard to make. Further work from the biomechanics community to develop reporting guidelines for MoS calculation methodology and a commitment to larger baseline studies for each pathology is welcomed. [ABSTRACT FROM AUTHOR]

The present study investigated whether expertise in fencing influences the onset of postural preparation during the fencing lunge and how it changes under different performance conditions. We also questioned if the onset of feedforward control can be categorized into one of the postural phases: anticipatory or early postural adjustment. Eight elite fencers and nine physical education students performed an attack with a lunge in self-paced and reaction time conditions from three different initial stance widths. The onset of the center of pressure (COP) displacement and EMG activities for the tibialis anterior (TA) of both limbs were recorded. The results show that expertise in fencing delays the onset of the activity of TA of the front leg and the onset of COP displacement during fencing lunge performance in comparison to controls. Additionally, in contrast to the control group, fencers produce typical APA patterns in the activation of TA under different performance conditions, delayed reaction time in comparison to self-initiated lunging, and constant time of APA onset under different widths of stance. According to different times and functions of TA activity and COP displacement in lunging, we propose to address them as anticipatory postural adjustment and early postural adjustment, respectively. [ABSTRACT FROM AUTHOR]

Background: The role of the measurements of postural stability in the context of screening for ankle sprain risk is still equivocal. Transient characteristics of body sway have been suggested as an alternative or an improvement to traditional whole-trial analyses.Research Question: Are transient characteristics of body sway sensitive to the history of ankle sprain?.Methods: The assessment of 30-s single-leg body sway was performed on a group of 93 athletes from basketball, soccer, tennis and running who reported at least 1 ankle sprain in the last 12 months, while a group of 244 athletes from the same disciplines served as a control group without an ankle sprain reported for the same time period. We considered the mean center-of-pressure (CoP) velocity, CoP amplitude and CoP frequency. In addition to traditional whole-trial variables, we calculated the relative differences between the 1 st and the 2nd (DIF_21) and 1 st and 3rd (DIF_31) 10-s time intervals within the whole trial.Results: The indexes of transient characteristics of body sway (i.e., the DIF_21 and DIF_31) were in trivial or weak correlations with whole-trial variables (all r ≤ 0.29). Athletes with ankle sprain history exhibited smaller CoP ML velocity (p = 0.002) and larger CoP ML frequency (p = 0.001). In the injured group, the injured leg exhibited lower total and medial-lateral (ML) CoP velocity (p = 0.005-0.040), as well as lower CoP ML amplitude (p = 0.002) and higher CoP ML frequency (p = 0.010). The transient characteristics of body sway (DIF_21 and DIF_31) were very similar between the groups and between the injured and uninjured legs.Significance: Transient characteristics of body sway do not appear to differentiate the athletes with and without a history of ankle sprain. Further research is needed to confirm if the transient characteristics of body sway could be used for detection of risk of falls in older adults or assessment of athletic performance. [ABSTRACT FROM AUTHOR]

Postural instability, in particular at gait initiation (GI), and resulting falls are a major determinant of poor quality of life in subjects with Parkinson’s disease (PD). Still, the contribution of the basal ganglia and dopamine on the feedforward postural control associated with this motor task is poorly known. In addition, the influence of anthropometric measures (AM) and initial stance condition on GI has never been consistently assessed. The biomechanical resultants of anticipatory postural adjustments contributing to GI [imbalance (IMB), unloading (UNL), and stepping phase) were studied in 26 unmedicated subjects with idiopathic PD and in 27 healthy subjects. A subset of 13 patients was analyzed under standardized medication conditions and the striatal dopaminergic innervation was studied in 22 patients using FP-CIT and SPECT. People with PD showed a significant reduction in center of pressure (CoP) displacement and velocity during the IMB phase, reduced first step length and velocity, and decreased velocity and acceleration of the center of mass (CoM) at toe off of the stance foot. All these measurements correlated with the dopaminergic innervation of the putamen and substantially improved with levodopa. These results were not influenced by anthropometric parameters or by the initial stance condition. In contrast, most of the measurements of the UNL phase were influenced by the foot placement and did not correlate with putaminal dopaminergic innervation. Our results suggest a significant role of dopamine and the putamen particularly in the elaboration of the IMB phase of anticipatory postural adjustments and in the execution of the first step. The basal ganglia circuitry may contribute to defining the optimal referent body configuration for a proper initiation of gait and possibly gait adaptation to the environment.

Purpose: Cerebral Palsy (CP) can negatively affect dynamic stability in children with spastic diplegic Cerebral Palsy during walking. This condition results in a high risk of falling. There is limited evidence regarding the dynamic stability of children with Cerebral Palsy. Thus, this study aimed to investigate the dynamic stability of children with spastic diplegic Cerebral Palsy, compared to typically developed children during walking. Methods: Sixteen children including 8 with spastic diplegic Cerebral Palsy and 8 normal ones with an age range of 5 to 8 years participated in this quasi-experimental study. A Qualysis motion analysis system capturing at a frequency of 100 Hz was used to record data. Qualysis software and Visual3D software were utilized for data extraction. Data analysis was conducted using the Independent t-test with P

Previous studies suggest that visual information is essential for balance and stability of locomotion. We investigated whether visual deprivation is met with active reactions tending to minimize worsening balance and stability during walking in humans. We evaluated effects of vision on kinetic characteristics of walking on a treadmill-ground reaction forces (GRFs) and shifts in the center of mass (COM). Young adults (n = 10) walked on a treadmill at a comfortable speed. We measured three orthogonal components of GRFs and COM shifts during no-vision (NV) and full-vision (FV) conditions. We also computed the dynamic balance index (DN)—the perpendicular distance from the projection of center of mass (pCOM) to the inter-foot line (IFL) normalized to half of the foot length. Locally weighted regression smoothing with alpha-adjusted serial T tests was used to compare GRFs and DN between two conditions during the entire stance phase. Results showed significant differences in GRFs between FV and NV conditions in vertical and ML directions. Variability of peak forces of all three components of GRF increased in NV condition. We also observed significant increase in DN for NV condition in eight out of ten subjects. The pCOM was kept within BOS during walking, in both conditions, suggesting that body stability was actively controlled by adjusting three components of GRFs during NV walking to minimize stability loss and preserve balance. [ABSTRACT FROM AUTHOR]

Background/Objectives: The purpose of this study was to identify the highest activation in Vastus Medialis (VMO), Vastus Lateralis (VL) and Rectus Femoris (RF) while performing various squat exercises to create an effective exercising method. Method/Statistical Analysis: 40 healthy subjects (males 23, females 17) from S University were recruited. Subjects performed four different types of squats; General Squats (GS), Instability Squats on an unstable surface (IS), Knee Adduction Squats (KAS), and Wall squats (WS). The difference in the activation of VMO, VLO and RF were recorded during the various exercises were analyzed and recorded with the EMG. Findings: Measurements of all the experiments were analyzed using one-way ANOVA. Within these results, RF showed the most activation during (WS) and the least activation during (KAS). However, there were no significant differences found between (GS) and (IS). VLO showed the most activation during (GS). On the other hand, there were no significant differences found within (IS) and (WS). In addition to our results, VMO showed the least activation during (KAS). All three muscles displayed different activation patterns during each squat exercise. Improvements/Applications: Considering these findings, this study may help to design a more effective exercise for specific muscles when strengthening the leg muscles. [ABSTRACT FROM AUTHOR]

• Older children (6 to 11 years old) showed a multisensory integration advantage compared to their younger counterparts (3 to 6 years old). • The relation between anthropometric parameters (e.g., height, leg length, weight) and posture revealed a shifting pattern across development. For younger children, these parameters were positively related to postural stability. This relation likely arises due to body size being an indexed of general motor skill and experience. • For older children, body size parameters were non-significantly related to postural stability. This non-significant relation between body size and posture for older children can be seen as a developmental transition from childlike to adultlike balance control. Children's ability to maintain balance requires effective integration of multisensory and biomechanical information. The current project examined the interaction between such sensory inputs, manipulating visual input (presence vs. absence), haptic (somatosensory) input (presence vs. absence of contact with a stable or unstable finger support surface), and biomechanical (sensorimotor) input (varying stance widths). Analyses of mean velocity of the center of pressure and the percentage stability gain highlighted the role of varying multisensory inputs in postural control. Developmentally, older children (6–11 years) showed a multisensory integration advantage compared with their younger counterparts (3–5.9 years), with the impact of varying sensory inputs more closely akin to that seen in adults. Subsequent analyses of the impact of anthropometric individual difference parameters (e.g., height, leg length, weight, areas of base of support) revealed a shifting pattern across development. For younger children, these parameters were positively related to postural stability across experimental conditions (i.e., increasing body size was related to increasing postural control). This pattern transitioned for older children, who showed a nonsignificant relation between body size and balance. Interestingly, because adults show a negative relation between anthropometric factors and stability (i.e., increasing body size is related to decreasing postural control), this shift for the older children can be seen as a developmental transition from child-like to adult-like balance control. [ABSTRACT FROM AUTHOR]

Background: Photogrammetry is often used to evaluate standing static postural alignment. Patients are often instructed to self-select a natural feet position but it's unclear whether this position can be consistently replicated across repeated assessments., Objective: To determine whether people can replicate a self-selected natural feet position in upright standing across three sessions on different days., Design: Between days test-retest reliability., Setting: University laboratory., Methods: Three variables - Base of Support (BoS), Foot Width (FW), Feet Opening Angle (FOA) - were measured from foot tracings of 150 participants (18-30 years) using established procedures. BoS data were assessed for systematic bias (Analysis of Variance), and absolute (Coefficient of Variation - CV%) and relative (Intraclass Correlation Coefficient - ICC) reliability., Results: There was systematic bias in the BoS data across the three testing sessions. The CV% for the BoS data was 15.2%. The ICC (95% CI) for the BoS data was 0.84 (0.79-0.87). There were moderate-large correlations between the BoS and both FOA and FW respectively within each session., Conclusion: If clinicians want to allow patients to use their self-selected natural feet position for repeated photogrammetric assessment of their static postural alignment it would be better to standardise the position of the feet, for example, by creating a tracing of a patient's self-selected natural feet position., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Human postural control is a fundamental ability for static and dynamic tasks, especially in hiper- and hipo-functional populations, such as the elderly. The Equimetrix is a clinical device developed to assess both the base of support (BoS) and the center of mass (CoM) dynamics, thus allowing their use as new evaluation and training tools. This study aims to perform a criteria based validation of Equimetrix by comparing the BoS and CoM data with gold-standard equipment. A motion capture system, force platform, and pressure mat were used to calculate the CoM, center of pressure (CoP) and BoS during bipedal, unipedal, feet together and full tandem stances. Results demonstrate an excellent reliability of Equimetrix in terms of spatial accuracy of the CoM, although over-estimating the CoM height. Differences were found when comparing Mean velocity Path with the CoM, but not with the CoP, indicating a lower reliability in time-based parameters. The Equimetrix presents a tendency to overestimate the BoS, with mixed reliability values, which may be related to the different size of sensing elements between the Equimetrix and the pressure sensing mat. These are encouraging results that should be further explored during dynamic tasks.

Background/Objectives: The purpose of this study is to propose the effective posture of bridge exercise by comparing and analyzing the muscle activity of the internal oblique abdominal, external oblique abdominal, rectus abdominal and transverses abdominals, when performing bridge exercise with visual blocking and varying the stance. Method/Statistical analysis: Muscle activity was measured by EMG. the study conducted a study of 30 people who do not have neurological disorder such as fracture, damage to the muscle and ligament, etc. for past 6 months For the experimental group, the stance was set to 100%, 50% and 150% of the shoulder width, the muscle activation was measured total 6 exercises by dividing into visual blocking and the stance and all the measured values were analyzed using ANOVA repeated measurement. Findings: In the results of this study, all the internal oblique abdominal, external oblique abdominal, rectus abdominal and transverses abdominals showed higher muscle activation during the bridge exercise with visual blocking and representing significant difference. When the bridge exercise was performed with the stance of 50% shoulder width, the muscle activation was the highest and the difference by muscle according to the breadth of foot was varied. Improvements/Applications: In conclusion, it is deemed that the bridge exercise with visual blocking and narrow foot width will be the more effective posture to improve the muscle activation and to stabilize the body. [ABSTRACT FROM AUTHOR]

The potential of miniature inertial sensors for human balance and gait analysis appears promising. Base of support (BOS), together with its interaction with center of mass, is a critical indicator in above mentioned research fields. This study aims to evaluate the accuracy of Xsens MVN BIOMECH, a commercial widely used inertial sensor-based motion capture system, for measuring static BOS and examine the effect of different task complexity on the accuracy. Eleven young males participated in this study and went through eleven different experimental tasks. Results showed there were considerable errors in estimating BOS area (error ranged from –12.6% to +64.6%) from Xsens MVN and a large error in foot separation distance when there was knee flexion. The estimated BOS area from MVN was smaller than the ground truth from footprint when there was no knee flexion, and larger when there was knee flexion, and it increased monotonically along with the knee flexion angles. Wrongly estimated foot separations, mainly caused by knee flexion, and the initial system estimation error on BOS, were two major reasons for error and instability of BOS estimation. The findings suggested that caution should be taken when using Xsens MVN BIOMECH to estimate BOS and foot position-related measurements, especially for postures/motions with knee flexion. [ABSTRACT FROM AUTHOR]

Daily living activities are dynamic, requiring spinal motion through space. Current assessment of spinal deformities is based on static measurements from full-spine standing radiographs. Tools to assess dynamic stability during gait might be useful to enhance the standard evaluation. The aim of this study was to evaluate gait dynamic imbalance in patients with spinal deformity using the dynamic stability margin (DSM). Twelve normal subjects and 17 patients with spinal deformity were prospectively recruited. A kinematic 3D gait analysis was performed for the control group (CG) and the spinal deformity group (SDG). The DSM (distance between the extrapolated center of mass and the base of support) and time-distance parameters were calculated for the right and left side during gait. The relationship between DSM and step length was assessed using three variables: gait stability, symmetry, and consistency. Variables' accuracy was validated by a discriminant analysis. Patients with spinal deformity exhibited gait instability according to the DSM (0.25m versus 0.31m) with decreased velocity (1.1ms-1 versus 1.3ms-1) and decreased step length (0.32m versus 0.38m). According to the discriminant analysis, gait stability was the more accurate variable (area under the curve AUC=0.98) followed by gait symmetry and consistency. However, gait consistency showed 100% of specificity, sensitivity, and accuracy of precision. The DSM showed that patients with spinal malalignment exhibit decreased gait stability, symmetry, and consistency besides gait time-distance parameter changes. Additional work is required to determine how to apply the DSM for preoperative and postoperative spinal deformity management. [ABSTRACT FROM AUTHOR]

Background: There is evidence that Botulinum Toxin-A (BTX-A) reduces focal spasticity associated with equinovarus to improve gait in patients poststroke. However, there is little research examining whether gait improvements are maintained after the effectiveness period of BTX-A injections. The purpose of this observational study was to determine whether there was a difference in gait parameters in three patients before BTX-A injection versus four and ten weeks after. Case Series: Three women, ages 63, 60, and 42 postischemic stroke with hemiparesis and equinovarus underwent measurements for: plantar flexor spasticity, ankle dorsiflexion ROM, temporal–spatial gait parameters, and gait endurance. All participants improved in ankle ROM. At week 10, spasticity had returned to initial measurement levels in participants A and C. Base of support and step length symmetry ratios did not improve following injections. Participants A and B, who received physical therapy during the study, showed modest gains in gait endurance and velocity. Conclusion: Although BTX-A injections improved spasticity, this improvement did not translate to gait outcomes. Addition of physical therapy interventions appeared to improve gait outcomes in this case series. We suggest future randomized control studies to compare effects of physical therapy alone to BTX-A combined with physical therapy on gait outcomes. [ABSTRACT FROM AUTHOR]

Stepping strategies following external perturbations from different directions is investigated in this work. We analysed the effect of the perturbation angle as well as the level of awareness of individuals and characterised steps out of the sagittal plane between Loaded Side Steps (LSS), Unloaded Medial Steps (UMS) and Unloaded Crossover Steps (UCS). A novel experimental paradigm involving perturbations in different directions was performed on a group of 21 young adults (10 females, 11 males, 20-38 years). Participants underwent 30 randomised perturbations along 5 different angles with different levels of awareness of the upcoming perturbations (with and without wearing a sensory impairment device) for a total of 1260 recorded trials. Results showed that logistic models based on the minimal values of the Margin of Stability (MoS) or on the minimal values of the Time to boundary (Ttb) performed the best in the sagittal plane. However, their accuracy stayed above 79% regardless of the perturbation angle or level of awareness. Regarding the effect of the experimental condition, evidences of different balance recovery behaviours due to the variation of perturbation angles were exposed, but no significant effect of the level of awareness was observed. Finally, we proposed the Distance to Foot boundary (DtFb) as a relevant quantity to characterise the stepping strategies in response to perturbations out of the sagittal plane., 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.)