Predicted threshold against backward balance loss following a slip in gait

The purpose of this study was to use a 7-link, moment-actuated human model to predict, at liftoff of the trailing foot in gait, the threshold of the center of mass (COM) velocity relative to the base of support (BOS) required to prevent backward balance loss during single stance recovery from a slip. Five dynamic optimization problems were solved to find the minimum COM velocities that would allow the simulation to terminate with the COM above the BOS when the COM started 0.25, 0.5, 0.75, 1.0, and 1.25 foot lengths behind the heel of the stance foot (i.e., behind the BOS). The initial joint angles of the model were based on averaged data from experimental trials. Foot-ground contact was modeled using 16 visco-elastic springs distributed under the stance foot. Slipping was modeled by setting the sliding coefficient of friction of these springs to 0.02. The forward velocity of the COM necessary to avoid a backward balance loss is nearly two times larger under slip conditions under non-slip conditions. The predicted threshold for backward balance loss following a slip agreed well with experimental data collected from 99 young adults in response to 927 slips during walking. In all trials in which a subject's COM had a velocity below the predicted threshold, the subject's recovery foot landed posterior to the slipping foot as predicted. Finally, combining experimental data with optimization, we verified that the 7-link model could more accurately predict gait stability than a 2-link model.     

Predicted threshold against backward balance loss in gait

The purpose of this study was to determine the minimum forward center of mass (COM) velocity required to prevent backward loss of balance in gait as function of the initial COM position. We hypothesized that these threshold values would be different from those previously published for standing because of the postural differences between gait and standing. To investigate this issue, we constructed a seven-link, nine-degree-of-freedom biomechanical model and employed dynamic optimization to estimate these threshold values under two initial postural conditions: (1) the posture at the beginning of swing phase (i.e., at toe-off), and (2) symmetric bipedal standing. In particular, for a range of possible COM positions posterior to the base of support (BOS), simulated annealing was used to search for the minimum velocity that could carry the COM into the BOS and avoid backward loss of balance. We found that the stability boundary against backward balance loss in walking had a similar overall trend as that previously published for standing. In general, the minimal COM velocity necessary to prevent a backward loss of balance in walking was greater than that in symmetric bipedal standing, and the difference could approach 30% or more when the COM started 0.5 and 1.0 foot-lengths behind the BOS. These discrepancies suggest that simpler biomechanical models, while being more efficient and easier to employ, may not always be adequate for exploring stability limits of humans.     

Adaptive control of center of mass (global) motion and its joint (local) origin in gait

Dynamic gait stability can be quantified by the relationship of the motion state (i.e. the position and velocity) between the body center of mass (COM) and its base of support (BOS). Humans learn how to adaptively control stability by regulating the absolute COM motion state (i.e. its position and velocity) and/or by controlling the BOS (through stepping) in a predictable manner, or by doing both simultaneously following an external perturbation that disrupts their regular relationship. Post repeated-slip perturbation training, for instance, older adults learned to forward shift their COM position while walking with a reduced step length, hence reduced their likelihood of slip-induced falls. How and to what extent each individual joint influences such adaptive alterations is mostly unknown. A three-dimensional individualized human kinematic model was established. Based on the human model, sensitivity analysis was used to systematically quantify the influence of each lower limb joint on the COM position relative to the BOS and the step length during gait. It was found that the leading foot had the greatest effect on regulating the COM position relative to the BOS; and both hips bear the most influence on the step length. These findings could guide cost-effective but efficient fall-reduction training paradigm among older population.     

Thresholds for step initiation induced by support-surface translation: a dynamic center-of-mass model provides much better prediction than a static model

The need to initiate a step in order to recover balance could, in theory, be predicted by a static model based solely on displacement of the center of mass (COM) with respect to the base of support (BOS), or by a dynamic model based on the interaction between COM displacement and velocity. The purpose of this study was to determine whether the dynamic model provides better prediction than the static model regarding the need to step in response to moving-platform perturbation. The COM phase plane trajectories were determined for 10 healthy young adults for trials where the supporting platform was translated at three different acceleration levels in anterior and posterior directions. These trajectories were compared with the thresholds for step initiation predicted by the static and dynamic COM models. A single-link-plus-foot biomechanical model was employed to mathematically simulate termination of the COM movement, without stepping, using the measured platform acceleration as the input. An optimization routine was used to determine the stability boundaries in COM state space so as to establish the dynamic thresholds where a compensatory step must be initiated in order to recover balance. In the static model, the threshold for step initiation was reached if the COM was displaced beyond the BOS limits. The dynamic model showed substantially better accuracy than the static model in predicting the need to step in order to recover balance: 71% of all stepping responses predicted correctly by the dynamic model versus only 11% by the static model. These results support the proposition that the central nervous system must react to and control dynamic effects, i.e. COM velocity, as well as COM displacement in order to maintain stability with respect to the existing BOS without stepping.     

Simulated movement termination for balance recovery: can movement strategies be sought to maintain stability in the presence of slipping or forced sliding?

Slipping during various kinds of movement often leads to potentially dangerous incidents of falling. The purpose of this study was to determine whether there was evidence to support the theory that movement strategies could be used by individuals to regain stability during an episode of slipping and whether forced sliding from a moving platform accurately simulated the effect of slipping on stability and balance. A single-link-plus-foot biomechanical model was used to mathematically simulate base of support (BOS) translation and body segment rotation during movement termination in sagittal plane. An optimization routine was used to determine region of stability [defined at given COM locations as the feasible range of horizontal velocities of the center of mass (COM) of human subject that can be reduced to zero with respect to the BOS while still allowing the COM to traverse within the BOS limits]. We found some 30% overlap in the region of stability for slipping and non-slipping conditions. This finding supports the theory that movement strategies can be sought for restoring stability and balance even if slipping unexpectedly occurs. We also found that forced sliding produces effects on stability that are similar to those of slipping, indicated by over 50% overlap in the regions of stability for the two conditions. In addition, forced sliding has distinctive effects on stability, including a "shift" of the region of stability extended beyond the BOS in the direction of sliding. These findings may provide quantifiable guidance for balance training aimed at reducing fall incidents under uncertain floor surface conditions.     

Predicted region of stability for balance recovery: motion at the knee joint can improve termination of forward movement

Earlier experimental studies on balance recovery following perturbation have identified two discrete strategies commonly employed by humans, i.e. hip and ankle strategies. It has hence been implied that the knee joint plays a relatively minor role in balance recovery. The purpose of this study was to determine whether the size of the feasible stability region (FSR) would be affected by allowing knee motion in sagittal plane movement termination. The FSR was defined as the feasible range of anterior velocities of the center of mass (COM) of a human subject that could be reduced to zero with the final COM position within the base of support (BOS) limits. The FSR was computed using a four-segment biomechanical model and optimization routine based on Simulated Annealing algorithm for three scenarios: unrestricted knee motion (UK), restricted knee motion (RK), and unrestricted knee motion with an initial posture that matches RK (UKM). We found that movement termination could benefit little from UK condition when the COM (x_COM) was initially located in the forefoot region [0.00 (toe) >x_COM−0.50 (mid-foot)] with no more than a 17% increase in FSR compared to RK. The effect of knee motion increased in the rear foot region with a 25% increase in FSR at x_COM=−1 (heel). Close to half of this difference (12%) was attributable to the knee-related restriction on initial posture and the rest to movement termination per se. These findings illustrated a theoretical role of knee motion in standing humans’ repertoire of effective posture responses, which include hip and ankle strategies and their variants for balance recovery with stationary BOS.     

Amplitude effects of medio-lateral mechanical and visual perturbations on gait

Falls during walking are a major contributor to accidental deaths and injuries that can result in debilitating hospitalization costs, lost productivity, and diminished quality of life. To reduce these losses, we must develop a more profound understanding of the characteristic responses to perturbations similar to those encountered in daily life. This study addresses this issue by building on our earlier studies that examined mechanical and visual perturbations in the same environment by applying the same continuous pseudo-random perturbations at multiple (3 mechanical, 5 visual) amplitudes. Walking variability during mechanical perturbations increased significantly with amplitude for all subjects and differences as measured by variabilities of step width, COM position, and COM velocity. These parameters were the only ones sensitive to the presence of visual perturbations, but none of them changed significantly with perturbation amplitude. Additionally, visual perturbation effects were far less consistent across participants, with several who were essentially unaffected by visual perturbations at any level. The homogeneity of the mechanical perturbation effects demonstrates that human responses to mechanical perturbations are similar because they are driven by kinetics that require similar corrections that must be made in order to maintain balance. Conversely, responses to visual perturbations are driven by the perceived need to make corrections and this perception is not accurate enough to produce amplitude-related corrections, even for a single participant, nor is this perception consistent across individuals. This latter finding is likely to be relevant to future visual perturbation studies and the diagnosis and rehabilitation of gait and balance disorders.     

Dynamic stability and compensatory stepping responses during anterior gait–slip perturbations in people with chronic hemiparetic stroke

To examine the control of dynamic stability and characteristics of the compensatory stepping responses to an unexpected anterior gait slip induced under the non-involved limb in people with hemi-paretic stroke (PwHS) and to examine any resulting adaptive changes in these on the second slip due to experience from prior slip exposure. Ten PwHS experienced overground slip (S1) during walking on the laboratory walkway after 5–8 regular walking (RW) trials followed by a second consecutive slip trial (S2). The slip outcome (backward loss of balance, BLOB and no loss of balance, NLOB) and COM state (i.e. its COM position and velocity) stability were examined between the RW and S1 and S1 and S2 at touchdown (TD) of non-involved limb and at liftoff (LO) of the contralateral limb. At TD there was no difference in stability between RW and S1, however at LO, subjects demonstrated a lower stability on S1 than RW resulting in a 100% backward loss of balance (BLOB) with compensatory stepping response (recovery step, RS, 4/10 or aborted step, AS, 6/10). On S2, although there was no change in stability at TD, there was a significant improvement in stability at LO with a 40% decrease in BLOB. There was also a change in step strategy with a decrease in AS response (60% to 35%, p<0.05) which was replaced by an increase in the ability to step (increased compensatory step length, p<0.05) either via a recovery step or a walkover step. PwHS have the ability to reactively control COM state stability to decrease fall-risk upon a novel slip; prior exposure to a slip did not significantly alter feedforward control but improved the ability to use such feedback control for improved slip outcomes.     

Can sacral marker approximate center of mass during gait and slip-fall recovery among community-dwelling older adults?

Falls are prevalent in older adults. Dynamic stability of body center of mass (COM) is critical for maintaining balance. A simple yet accurate tool to evaluate COM kinematics is essential to examine the COM stability. The purpose of this study was to determine the extent to which the COM position derived from body segmental analysis can be approximated by a single (sacral) marker during unperturbed (regular walking) and perturbed (gait-slip) gait. One hundred eighty seven older adults experienced an unexpected slip after approximately 10 regular walking trials. Two trials, the slip trial and the preceding regular walking trial, monitored with a motion capture system and force plates, were included in the present study. The COM positions were calculated by using the segmental analysis method wherein, the COM of all body segments was calculated to further estimate the body COM position. These body COM positions were then compared with those of the sacral marker placed at the second sacral vertebra for both trials. Results revealed that the COM positions were highly correlated with those of the sacrum׳s over the time intervals investigated for both walking (coefficient of correlation R>0.97) and slip (R>0.90) trials. There were detectable kinematic difference between the COM and the sacral for both trials. Our results indicated that the sacral marker can be used as a simple approximation of body COM for regular walking, and to somewhat a lesser extent, upon a slip. The benefits from the simplicity appear to overweigh the limitations in accuracy.     

Margins of stability in young adults with traumatic transtibial amputation walking in destabilizing environments

Understanding how lower-limb amputation affects walking stability, specifically in destabilizing environments, is essential for developing effective interventions to prevent falls. This study quantified mediolateral margins of stability (MOS) and MOS sub-components in young individuals with traumatic unilateral transtibial amputation (TTA) and young able-bodied individuals (AB). Thirteen AB and nine TTA completed five 3-min walking trials in a Computer Assisted Rehabilitation ENvironment (CAREN) system under each of three test conditions: no perturbations, pseudo-random mediolateral translations of the platform, and pseudo-random mediolateral translations of the visual field. Compared to the unperturbed trials, TTA exhibited increased mean MOS and MOS variability during platform and visual field perturbations (p<0.010). AB exhibited increased mean MOS during visual field perturbations and increased MOS variability during both platform and visual field perturbations (p<0.050). During platform perturbations, TTA exhibited significantly greater values than AB for mean MOS (p<0.050) and MOS variability (p<0.050); variability of the lateral distance between the center of mass (COM) and base of support at initial contact (p<0.005); mean and variability of the range of COM motion (p<0.010); and variability of COM peak velocity (p<0.050). As determined by mean MOS and MOS variability, young and otherwise healthy individuals with transtibial amputation achieved lateral stability similar to that of their able-bodied counterparts during unperturbed and visually-perturbed walking. However, based on mean and variability of MOS, unilateral transtibial amputation was shown to have affected lateral walking stability during platform perturbations.     

Effects of perturbation magnitude on dynamic stability when walking in destabilizing environments

External perturbations applied to the walking surface or visual field can challenge an individual's ability to maintain stability during walking. Accurately quantifying and predicting changes in stability during walking will further our understanding of how individuals respond to challenges encountered during daily life and guide the development of assessments and rehabilitation interventions for individuals at increased risk of falling. This study is the first to determine how orbital and local dynamic stability metrics, including maximum Floquet multipliers and local divergence exponents, change in response to continuous mediolateral visual and surface perturbations of different amplitudes. Eleven healthy individuals walked in a fully immersive virtual environment. Participants completed two 3-min walking trials each under the following nine conditions: no perturbations, surface perturbations at each of 3 amplitudes, and visual perturbations at each of 5 amplitudes. All perturbations were applied as continuous pseudo-random oscillations. During both surface and visual perturbations, individuals were significantly more orbitally and locally unstable compared to un-perturbed walking. As walking surface perturbation amplitudes increased, individuals were more orbitally (but not locally) unstable. As visual perturbation amplitudes increased, individuals were more locally (but not orbitally) unstable between lower and higher amplitudes. Overall, these dynamic stability metrics were much less sensitive to changes in perturbation amplitudes than to differences between un-perturbed and perturbed walking, or to differences between mechanical and visual perturbations. This suggests that the type of perturbation(s) applied has a far greater impact than the magnitude of those perturbations in determining the response that will be elicited.     

Effects of obesity on dynamic stability control during recovery from a treadmill-induced slip among young adults

This study sought to investigate the effects of obesity on falls and dynamic stability control in young adults when subject to a standardized treadmill-induced gait-slip. Forty-four young adults (21 normal-weight and 23 obese) participated in this study. After their muscle strength was assessed at the right knee under maximum voluntary isometric (flexion and extension) contractions, participants were moved to an ActiveStep treadmill. Following 5 normal walking trials on the treadmill, all participants encountered an identical and unexpected slip defined as a perturbation in the anterior direction with the magnitude of 24-cm slip distance and 2.4-m/s peak slip velocity. The trials were categorized as a fall or recovery based on the reliance of the subject on external support following the slip. Compared with the normal-weight group, the obese group demonstrated less relative muscle strength and fell more responding to the slip (78.3% vs. 40.0%, p=0.009). After adjusting the body height and gender, the results indicated that the obese group was 19.1-time (95% confidence interval: [2.06, 177.36]) more prone to a fall than the normal-weight group when experiencing the same treadmill-induced slip. The obese group showed significantly impaired dynamic stability after slip possibly due to the inability of controlling the trunk segment׳s backward lean movement. Obesity measurements explained more slip outcome variance than did the strength measurements (53.4% vs. 18.1%). This study indicates that obesity most likely influences the ability to recover from slip perturbations. It is important to develop interventions to improve the capability of balance recovery among individuals with obesity.     

Control of center of mass motion state through cuing and decoupling of spontaneous gait parameters in level walking

Can the center of mass (COM) motion state, i.e., its position and velocity relative to the base of support (BOS), which dictate gait stability, be predictably controlled by the global gait parameters of step length and gait speed, or by extension, cadence? The precise relationships among step length and gait speed, and the COM motion state are unknown, partially due to the interdependence between step length and gait speed and the difficulty in independent control of both parameters during spontaneous level walking. The purposes of this study were to utilize simultaneous audio-visual cuing to independently manipulate step length and gait speed, and to determine the extent to which the COM position and velocity can be subsequently controlled. Fifty-six young adults were trained at one of the three gait patterns in which both the step length and gait speed were targeted simultaneously. The results showed that the cuing could successfully “decouple” gait speed from step length. Although this approach did yield reliable control of the COM velocity through manipulation of gait speed (R²=0.97), the manipulation of step length yielded less precise control of COM position (R²=0.60). This latter control appears to require manipulation of an additional degree-of-freedom at the local segment level, such that the inclusion of trunk inclination with step length improved the prediction of COM position (R²=0.80).     

Anticipation of direction and time of perturbation modulates the onset latency of trunk muscle responses during sitting perturbations

Trunk muscles are responsible for maintaining trunk stability during sitting. However, the effects of anticipation of perturbation on trunk muscle responses are not well understood. The objectives of this study were to identify the responses of trunk muscles to sudden support surface translations and quantify the effects of anticipation of direction and time of perturbation on the trunk neuromuscular responses. Twelve able-bodied individuals participated in the study. Participants were seated on a kneeling chair and support surface translations were applied in the forward and backward directions with and without direction and time of perturbation cues. The trunk started moving on average approximately 40 ms after the perturbation. During unanticipated perturbations, average latencies of the trunk muscle contractions were in the range between 103.4 and 117.4 ms. When participants anticipated the perturbations, trunk muscle latencies were reduced by 16.8 ± 10.0 ms and the time it took the trunk to reach maximum velocity was also reduced, suggesting a biomechanical advantage caused by faster muscle responses. These results suggested that trunk muscles have medium latency responses and use reflexive mechanisms. Moreover, anticipation of perturbation decreased trunk muscles latencies, suggesting that the central nervous system modulated readiness of the trunk based on anticipatory information.     

Dynamic stability of superior vs. inferior body segments in individuals with transtibial amputation walking in destabilizing environments

Interestingly, young and highly active people with lower limb amputation appear to maintain a similar trunk and upper body stability during walking as able-bodied individuals. Understanding the mechanisms underlying how this stability is achieved after lower-leg amputation is important to improve training regimens for improving walking function in these patients. This study quantified how superior (i.e., head, trunk, and pelvis) and inferior (i.e., thigh, shank, and feet) segments of the body respond to continuous visual or mechanical perturbations during walking. Nine persons with transtibial amputation (TTA) and 12 able-bodied controls (AB) walked on a 2 m×3 m treadmill in a Computer Assisted Rehabilitation Environment (CAREN). Subjects were perturbed by continuous pseudo-random mediolateral movements of either the treadmill platform or the visual scene. TTA maintained a similar local and orbital stability in their superior body segments as AB throughout both perturbation types. However, for their inferior body segments, TTA subjects exhibited greater dynamic instability during perturbed walking. In TTA subjects, these increases in instability were even more pronounced in their prosthetic limb compared to their intact leg. These findings demonstrate that persons with unilateral lower leg amputation maintain upper body stability in spite of increased dynamic instability in their impaired lower leg. Thus, transtibial amputation does significantly impair sensorimotor function, leading to substantially altered dynamic movements of their lower limb segments. However, otherwise relatively healthy patients with unilateral transtibial amputation appear to retain sufficient remaining sensorimotor function in their proximal and contralateral limbs to adequately compensate for their impairment.     

Dynamic balance control during sit-to-stand movement: an examination with the center of mass acceleration

The purpose of this study was to establish the region of stability of balance control using the center of mass (COM) acceleration and to characterize age-related differences during sit-to-stand (STS) movement. Whole body motion data were collected from 10 young and 10 elderly subjects while performing STS at their self-selected manners. In addition, young subjects were asked to perform another block of trials with their trunk purposely bent forward prior to seat-off. With the use of a single-link-plus-foot inverted pendulum model, boundaries for the region of stability were determined based on the COM position at seat-off and its instantaneous velocity or its peak acceleration (ROSv or ROSa, respectively). No significant group differences were detected in COM velocities at seat-off. However, peak COM accelerations differed significantly between groups and conditions. This suggested that even though a similar COM momentum was observed at seat-off, this momentum was controlled differently prior to seat-off. Young and elderly subjects utilized similar strategies but with different COM acceleration profiles to perform STS. Furthermore, data from an elderly subject who complained of difficulty in STS during the experiment were located outside the forward boundary of the ROSa, demonstrating a potential use of ROSa to differentiate individuals with declined balance control ability. The ROSa could provide insights into how the COM is controlled prior to seat-off, which may allow us to better identify elderly individuals who are most likely at a risk for imbalance or falls.     

Minimal step length necessary for recovery of forward balance loss with a single step

Although the boundary conditions necessary to trigger a step in reaction to a forward balance loss have been predicted in previous research, the relationship between minimal step length needed for balance recovery with this single step and the center of mass (COM) motion state (i.e., its position and velocity) remains unknown. The purpose of this paper was to present a theoretical framework within which the minimal step length needed for balance recovery can be estimated. We therefore developed a simplified four-segment sagittal model of human body stepping for balance recovery. The work-energy principle of the Newtonian mechanics was employed in the simulation to determine the amount of excess mechanical energy that can be absorbed as a function of step length and the corresponding eccentric joint work that can be generated in a single step. We found that an increase in initial forward velocity and a greater forward shift of the COM require a corresponding increase in the minimal step length needed for balance recovery. Furthermore, the minimal step length is also a function of the muscle strength at the ankle: the lower the muscle strength, the greater the minimal step length required. Our theoretical framework reduces the complexity associated with previous studies relying on forward dynamics and iterative optimization processes. This method may also be applied to study aspects of balance control such as the prevention of balance loss in the posterior or mediolateral direction.     

Alteration in community-dwelling older adults' level walking following perturbation training

While perturbation training is promising in reducing fall-risk among older adults, its impact on altering their spontaneous gait pattern has not been investigated. The purpose of this study was to determine to what extent older adults' gait pattern would be affected by exposure to repeated slips. Seventy-three community-dwelling older adults (age: 72.6±5.4 years) underwent 24 repeated-slip exposure induced by unannounced unlocking and relocking of low-friction sections of a 7-m pathway upon which they walked. Full body kinematics and kinetics were recorded during the training. The gait parameters and the center of mass (COM) stability against backward balance loss were compared before and after the training. The results revealed that the training reduced fall incidence from 43.8% upon the novel slip to 0 at the end of training. After the training, subjects significantly improved gait stability by forward positioning of their COM relative to the base of support without altering gait speed. This forward COM shift resulted from a shortened step at the end of single stance and forward trunk leaning during double stance. They also adopted flat foot landing with knee flexed at touchdown (with an average change of 6.9 and 4.1 degrees, respectively). The perturbation training did alter community-dwelling older adults' spontaneous gait pattern. These changes enabled them to improve their volitional control of stability and their resistance to unpredictable and unpreventable slip-related postural disturbance.     

Walking variability during continuous pseudo-random oscillations of the support surface and visual field

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.     

Similar sensorimotor transformations control balance during standing and walking

Standing and walking balance control in humans relies on the transformation of sensory information to motor commands that drive muscles. Here, we evaluated whether sensorimotor transformations underlying walking balance control can be described by task-level center of mass kinematics feedback similar to standing balance control. We found that delayed linear feedback of center of mass position and velocity, but not delayed linear feedback from ankle angles and angular velocities, can explain reactive ankle muscle activity and joint moments in response to perturbations of walking across protocols (discrete and continuous platform translations and discrete pelvis pushes). Feedback gains were modulated during the gait cycle and decreased with walking speed. Our results thus suggest that similar task-level variables, i.e. center of mass position and velocity, are controlled across standing and walking but that feedback gains are modulated during gait to accommodate changes in body configuration during the gait cycle and in stability with walking speed. These findings have important implications for modelling the neuromechanics of human balance control and for biomimetic control of wearable robotic devices. The feedback mechanisms we identified can be used to extend the current neuromechanical models that lack balance control mechanisms for the ankle joint. When using these models in the control of wearable robotic devices, we believe that this will facilitate shared control of balance between the user and the robotic device.