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1.
The aim of this study was to quantify the effects of step length and step frequency on lower-limb muscle function in walking. Three-dimensional gait data were used in conjunction with musculoskeletal modeling techniques to evaluate muscle function over a range of walking speeds using prescribed combinations of step length and step frequency. The body was modeled as a 10-segment, 21-degree-of-freedom skeleton actuated by 54 muscle-tendon units. Lower-limb muscle forces were calculated using inverse dynamics and static optimization. We found that five muscles – GMAX, GMED, VAS, GAS, and SOL – dominated vertical support and forward progression independent of changes made to either step length or step frequency, and that, overall, changes in step length had a greater influence on lower-limb joint motion, net joint moments and muscle function than step frequency. Peak forces developed by the uniarticular hip and knee extensors, as well as the normalized fiber lengths at which these muscles developed their peak forces, correlated more closely with changes in step length than step frequency. Increasing step length resulted in larger contributions from the hip and knee extensors and smaller contributions from gravitational forces (limb posture) to vertical support. These results provide insight into why older people with weak hip and knee extensors walk more slowly by reducing step length rather than step frequency and also help to identify the key muscle groups that ought to be targeted in exercise programs designed to improve gait biomechanics in older adults.  相似文献   

2.
The purpose of this study was to evaluate whether preoperative gait adaptations persist one year after THR in the same set of subjects. The hypothesis tested was that hip dynamic range of motion and peak external moments during walking return to normal after THR. Hip kinematics and kinetics were measured for 28 subjects before and one year after THR and compared to those of 25 subjects with radiographically normal hips. All THR subjects improved clinically after surgery with Harris hip scores improving from 33-85 (average 53) to 61-100 (average 95) (sign test p<0.001). Preoperatively dynamic hip range of motion (ROM), and all peak external moments were reduced compared to normal (Mann-Whitney p< or =0.040). Improvement was seen in the ROM and all but the frontal plane, and external rotation peak moments (Friedman p< or =0.023). The preoperative and postoperative values of the ROM, and peak flexion, abduction and external rotation moments were all significantly correlated (Spearman p<0.020) indicating a possible learned effect from before THR surgery. Postoperative THR subjects continued to have a significantly lower than normal ROM, and peak adduction and peak internal rotation moments (Mann-Whitney p< or =0.003). Despite good to excellent clinical functional outcome, gait in THR patients does not return to normal by one year after surgery. Aggressive muscle strengthening is currently not emphasized after THR surgery. Some THR patients may benefit from more intensive rehabilitation before and after surgery.  相似文献   

3.
The purpose of the present study was to determine the effects of orthoses designed to support the forefoot and rearfoot on the kinematics and kinetics of the lower extremity joints during walking. Fifteen participants volunteered for this study. Kinematic and kinetic variables during overground walking were compared with the participants wearing sandals without orthoses or sandals with orthoses. Orthoses increased knee internal abduction moment during late stance and knee abduction angular impulse, and reduced the medial ground reaction force during late stance, adduction free moment, forefoot eversion angle, ankle inversion moment and angular impulse, hip adduction angle, hip abduction moment, and hip external rotation moment and angular impulse (p<0.05). Orthoses decreased the torsional forces on the lower extremity and reduced the loading at the hip during walking. These findings combined with our previous studies and those of others suggest that forefoot abnormalities are critically important in influencing lower extremity kinematics and kinetics, and may underlie some non-traumatic lower extremity injuries.  相似文献   

4.
Given its tri-planar action at the hip, strengthening of gluteus maximus (GMAX) has been advocated as part of rehabilitation and injury prevention protocols for various musculoskeletal conditions. However, recruitment of GMAX during weight-bearing strengthening exercises can be challenging owing to the muscular redundancy at the hip for a given joint motion. The current study sought to determine if a 1-week activation program could result in greater GMAX recruitment during functional strengthening exercises. Pre- and post-training surface electromyography were collected from 12 healthy participants as they performed double- and single-leg squats. Between testing sessions, participants completed a GMAX activation training program consisting of isometric exercises with band resistance (twice per day for 7 days). Following the 1-week activation program, GMAX recruitment was found to increase by 57% during the double-leg squat (p = 0.005, Cohen’s r = 0.73) and 53% during the single-leg squat (p = 0.006, Cohen’s r = 0.70). Implementation of an initial GMAX activation program should be considered to facilitate neuromuscular adaptations that facilitate utilization of GMAX during hip strengthening exercises.  相似文献   

5.
Post-stroke individuals often exhibit abnormal kinematics, including increased pelvic obliquity and hip abduction coupled with reduced knee flexion. Prior examinations suggest these behaviors are expressions of abnormal cross-planar coupling of muscle activity. However, few studies have detailed the impact of gait-retraining paradigms on three-dimensional joint kinematics. In this study, a cross-tilt walking surface was examined as a novel gait-retraining construct. We hypothesized that relative to baseline walking kinematics, exposure to cross-tilt would generate significant changes in subsequent flat-walking joint kinematics during affected limb swing. Twelve post-stroke participants walked on a motorized treadmill platform during a flat-walking condition and during a 10-degree cross-tilt with affected limb up-slope, increasing toe clearance demand. Individuals completed 15 min of cross-tilt walking with intermittent flat-walking catch trials and a final washout period (5 min). For flat-walking conditions, we examined changes in pelvic obliquity, hip abduction/adduction and knee flexion kinematics at the spatiotemporal events of swing initiation and toe-off, and the kinematic event of maximum angle during swing. Pelvic obliquity significantly reduced at swing initiation and maximum obliquity in the final catch trial and late washout. Knee flexion significantly increased at swing initiation, toe-off, and maximum flexion across catch trials and late washout. Hip abduction/adduction was not significantly influenced following cross-tilt walking. Significant decrease in the rectus femoris and medial hamstrings muscle activity across catch trials and late washout was observed. Exploiting the abnormal features of post-stroke gait during retraining yielded desirable changes in muscular and kinematic patterns post-training.  相似文献   

6.
Biomechanics of overground vs. treadmill walking in healthy individuals.   总被引:1,自引:0,他引:1  
The goal of this study was to compare treadmill walking with overground walking in healthy subjects with no known gait disorders. Nineteen subjects were tested, where each subject walked on a split-belt instrumented treadmill as well as over a smooth, flat surface. Comparisons between walking conditions were made for temporal gait parameters such as step length and cadence, leg kinematics, joint moments and powers, and muscle activity. Overall, very few differences were found in temporal gait parameters or leg kinematics between treadmill and overground walking. Conversely, sagittal plane joint moments were found to be quite different, where during treadmill walking trials, subjects demonstrated less dorsiflexor moments, less knee extensor moments, and greater hip extensor moments. Joint powers in the sagittal plane were found to be similar at the ankle but quite different at the knee and hip joints. Differences in muscle activity were observed between the two walking modalities, particularly in the tibialis anterior throughout stance, and in the hamstrings, vastus medialis and adductor longus during swing. While differences were observed in muscle activation patterns, joint moments and joint powers between the two walking modalities, the overall patterns in these behaviors were quite similar. From a therapeutic perspective, this suggests that training individuals with neurological injuries on a treadmill appears to be justified.  相似文献   

7.
The purposes of this study was to test a mechanism to reduce the knee adduction moment by testing the hypothesis that increased medio-lateral trunk sway can reduce the knee adduction moment during ambulation in healthy subjects, and to examine the possibility that increasing medio-lateral trunk sway can produce similar potentially adverse secondary gait changes previously associated with reduced knee adduction moments in patients with knee osteoarthritis. Nineteen healthy adults performed walking trials with normal and increased medio-lateral trunk sway at a self-selected normal walking speed. Standard gait analysis was used to calculate three-dimensional lower extremity joint kinematics and kinetics. Knee and hip adduction moments were lower (-65.0% and -57.1%, respectively) for the increased medio-lateral trunk sway trials than for the normal trunk sway trials. Knee flexion angle at heel-strike was 3 degrees higher for the increased than for the normal trunk sway trials. Knee and hip abduction moments were higher for the increased medio-lateral trunk sway trials, and none of the other variables differed between the two conditions. Walking with increased medio-lateral trunk sway substantially reduces the knee adduction moment during walking in healthy subjects without some of the adverse secondary effects such as increased axial loading rates at the major joints of the lower extremity. This result supports the potential of using gait retraining for walking with increased medio-lateral trunk sway as treatment for patients with degenerative joint disease such as medial compartment knee osteoarthritis.  相似文献   

8.
The pirouette turn is often initiated in neutral and externally rotated hip positions by dancers. This provides an opportunity to investigate how dancers satisfy the same mechanical objectives at the whole-body level when using different leg kinematics. The purpose of this study was to compare lower extremity control strategies during the turn initiation phase of pirouettes performed with and without hip external rotation. Skilled dancers (n=5) performed pirouette turns with and without hip external rotation. Joint kinetics during turn initiation were determined for both legs using ground reaction forces (GRFs) and segment kinematics. Hip muscle activations were monitored using electromyography. Using probability-based statistical methods, variables were compared across turn conditions as a group and within-dancer. Despite differences in GRFs and impulse generation between turn conditions, at least 90% of each GRF was aligned with the respective leg plane. A majority of the net joint moments at the ankle, knee, and hip acted about an axis perpendicular to the leg plane. However, differences in shank alignment relative to the leg plane affected the distribution of the knee net joint moment when represented with respect to the shank versus the thigh. During the initiation of both turns, most participants used ankle plantar flexor moments, knee extensor moments, flexor and abductor moments at the push leg׳s hip, and extensor and abductor moments at the turn leg׳s hip. Representation of joint kinetics using multiple reference systems assisted in understanding control priorities.  相似文献   

9.
Hip and knee functions are intimately connected and reduced hip abductor function might play a role in development of knee osteoarthritis (OA) by increasing the external knee adduction moment during walking. The purpose of this study was to test the hypothesis that reduced function of the gluteus medius (GM) muscle would lead to increased external knee adduction moment during level walking in healthy subjects. Reduced GM muscle function was induced experimentally, by means of intramuscular injections of hypertonic saline that produced an intense short-term muscle pain and reduced muscle function. Isotonic saline injections were used as non-painful control. Fifteen healthy subjects performed walking trials at their self-selected walking speed before and immediately after injections, and again after 20 min of rest, to ensure pain recovery. Standard gait analyses were used to calculate three-dimensional trunk and lower extremity joint kinematics and kinetics. Surface electromyography (EMG) of the glutei, quadriceps, and hamstring muscles were also measured. The peak GM EMG activity had temporal concurrence with peaks in frontal plane moments at both hip and knee joints. The EMG activity in the GM muscle was significantly reduced by pain (?39.6%). All other muscles were unaffected. Peaks in the frontal plane hip and knee joint moments were significantly reduced during pain (?6.4% and ?4.2%, respectively). Lateral trunk lean angles and midstance hip joint adduction and knee joint extension angles were reduced by ?1°. Thus, the gait changes were primarily caused by reduced GM function. Walking with impaired GM muscle function due to pain significantly reduced the external knee adduction moment. This study challenge the notion that reduced GM function due to pain would lead to increased loads at the knee joint during level walking.  相似文献   

10.
Angular momentum is highly regulated over the gait cycle and is important for maintaining dynamic stability and control of movement. However, little is known regarding how angular momentum is regulated on irregular surfaces, such as slopes, when the risk of falling is higher. This study examined the three-dimensional whole-body angular momentum patterns of 30 healthy subjects walking over a range of incline and decline angles. The range of angular momentum was either similar or reduced on decline surfaces and increased on incline surfaces relative to level ground, with the greatest differences occurring in the frontal and sagittal planes. These results suggest that angular momentum is more tightly controlled during decline walking when the risk of falling is greater. In the frontal plane, the range of angular momentum was strongly correlated with the peak hip and knee abduction moments in early stance. In the transverse plane, the strongest correlation occurred with the knee external rotation peak in late stance. In the sagittal plane, all external moment peaks were correlated with the range of angular momentum. The peak ankle plantarflexion, knee flexion and hip extension moments were also strongly correlated with the sagittal-plane angular momentum. These results highlight how able-bodied subjects control angular momentum differently on sloped surfaces relative to level walking and provide a baseline for comparison with pathological populations that are more susceptible to falling.  相似文献   

11.
It has been suggested that the uniquely large gluteus maximus (GMAX) muscles were an important adaptation during hominin evolution based on numerous anatomical differences between humans and extant apes. GMAX electromyographic (EMG) signals have been quantified for numerous individual movements, but not across the range of locomotor gaits and speeds for the same subjects. Thus, comparing relative EMG amplitudes between these activities has not been possible. We assessed the EMG activity of the gluteal muscles during walking, running, sprinting, and climbing. To gain further insight into the function of the gluteal muscles during locomotion, we measured muscle activity during walking and running with external devices that increased or decreased the need to control either forward or backward trunk pitch. We hypothesized that 1) GMAX EMG activity would be greatest during sprinting and climbing and 2) GMAX EMG activity would be modulated in response to altered forward trunk pitch demands during running. We found that GMAX activity in running was greater than walking and similar to climbing. However, the activity during sprinting was much greater than during running. Further, only the inferior portion of the GMAX had a significant change with altered trunk pitch demands, suggesting that the hip extensors have a limited contribution to the control of trunk pitch movements during running. Overall, our data suggest that the large size of the GMAX reflects its multifaceted role during rapid and powerful movements rather than as a specific adaptation for a single submaximal task such as endurance running. Am J Phys Anthropol 153:124–131, 2014. © 2013 Wiley Periodicals, Inc.  相似文献   

12.
Reduced walking capacity, a hallmark of chronic heart failure (CHF), is strongly correlated with hospitalization and morbidity. The aim of this work was to perform a detailed biomechanical gait analysis to better identify mechanisms underlying reduced walking capacity in CHF. Inverse dynamic analyses were conducted in CHF patients and age- and exercise level-matched control subjects on an instrumented treadmill at self-selected treadmill walking speeds and at speeds representing +20% and –20% of the subjects’ preferred speed. Surprisingly, no difference in preferred speed was observed between groups, possibly explained by an optimization of the mechanical cost of transport in both groups (the mechanical cost to travel a given distance; J/kg/m). The majority of limb kinematics and kinetics were also similar between groups, with the exception of greater ankle dorsiflexion angles during stance in CHF. Nevertheless, over two times greater ankle plantarflexion work during stance and per distance traveled is required for a given triceps surae muscle volume in CHF patients. This, together with a greater reliance on the ankle compared to the hip to power walking in CHF patients, especially at faster speeds, may contribute to the earlier onset of fatigue in CHF patients. This observation also helps explain the high correlation between triceps surae muscle volume and exercise capacity that has previously been reported in CHF. Considering the key role played by the plantarflexors in powering walking and their association with exercise capacity, our findings strongly suggest that exercise-based rehabilitation in CHF should not omit the ankle muscle group.  相似文献   

13.
Walking with increased ankle pushoff decreases hip muscle moments   总被引:1,自引:1,他引:0  
In a simple bipedal walking model, an impulsive push along the trailing limb (similar to ankle plantar flexion) or a torque at the hip can power level walking. This suggests a tradeoff between ankle and hip muscle requirements during human gait. People with anterior hip pain may benefit from walking with increased ankle pushoff if it reduces hip muscle forces. The purpose of our study was to determine if simple instructions to alter ankle pushoff can modify gait dynamics and if resulting changes in ankle pushoff have an effect on hip muscle requirements during gait. We hypothesized that changes in ankle kinetics would be inversely related to hip muscle kinetics. Ten healthy subjects walked on a custom split-belt force-measuring treadmill at 1.25m/s. We recorded ground reaction forces and lower extremity kinematic data to calculate joint angles and internal muscle moments, powers and angular impulses. Subjects walked under three conditions: natural pushoff, decreased pushoff and increased pushoff. For the decreased pushoff condition, subjects were instructed to push less with their feet as they walked. Conversely, for the increased pushoff condition, subjects were instructed to push more with their feet. As predicted, walking with increased ankle pushoff resulted in lower peak hip flexion moment, power and angular impulse as well as lower peak hip extension moment and angular impulse (p<0.05). Our results emphasize the interchange between hip and ankle kinetics in human walking and suggest that increased ankle pushoff during gait may help to compensate for hip muscle weakness or injury and reduce hip joint forces.  相似文献   

14.
It has long been held that hip abduction compensates for reduced swing-phase knee flexion angle, especially in those after stroke. However, there are other compensatory motions such as pelvic obliquity (hip hiking) that could also be used to facilitate foot clearance with greater energy efficiency. Our previous work suggested that hip abduction may not be a compensation for reduced knee flexion after stroke. Previous study applied robotic knee flexion assistance in people with post-stroke Stiff-Knee Gait (SKG) during pre-swing, finding increased abduction despite improved knee flexion and toe clearance. Thus, our hypothesis was that hip abduction is not a compensation for reduced knee flexion. We simulated the kinematics of post-stroke SKG on unimpaired individuals with three factors: a knee orthosis to reduce knee flexion, an ankle-foot orthosis commonly worn by those post-stroke, and matching gait speeds. We compared spatiotemporal measures and kinematics between experimental factors within healthy controls and with a previously recorded cohort of people with post-stroke SKG. We focused on frontal plane motions of hip and pelvis as possible compensatory mechanisms. We observed that regardless of gait speed, knee flexion restriction increased pelvic obliquity (2.8°, p < 0.01) compared to unrestricted walking (1.5°, p < 0.01), but similar to post-stroke SKG (3.4°). However, those with post-stroke SKG had greater hip abduction (8.2°) compared to unimpaired individuals with restricted knee flexion (4.2°, p < 0.05). These results show that pelvic obliquity, not hip abduction, compensates for reduced knee flexion angle. Thus, other factors, possibly neural, facilitate exaggerated hip abduction observed in post-stroke SKG.  相似文献   

15.
The purpose of this study was to examine lower extremity kinetics and muscle activity during backward slope walking to clarify the relationship between joint moments and powers and muscle activity patterns observed in forward slope walking. Nine healthy volunteers walked backward on an instrumented ramp at three grades (-39% (-21 degrees ), 0% (level), +39% (+21 degrees )). EMG activity was recorded from major lower extremity muscles. Joint kinetics were obtained from kinematic and force platform data. The knee joint moment and power generation increased significantly during upslope walking; hip joint moment and power absorption increased significantly during downslope walking. When compared to data from forward slope walking, these backward walking data suggest that power requirements of a task dictate the muscle activity pattern needed to accomplish that movement. During downslope walking tasks, power absorption increased and changes in muscle activity patterns were directly related to the changes in the joint moment patterns. In contrast, during upslope walking tasks, power generation increased and changes in the muscle activity were related to the changes in the joint moments only at the 'primary' joint; at adjacent joints the changes in muscle activity were unrelated to the joint moment pattern. The 'paradoxical' changes in the muscle activity at the adjacent joints are possibly related to the activation of biarticular muscles required by the increased power generation at the primary joint. In total, these data suggest that changing power requirements at a joint impact the control of muscle activity at that and adjacent joints.  相似文献   

16.
The increased use of gait analysis has raised the need for a better understanding of how walking speed and demographic variations influence asymptomatic gait. Previous analyses mainly reported relationships between subsets of gait features and demographic measures, rendering it difficult to assess whether gait features are affected by walking speed or other demographic measures. The purpose of this study was to conduct a comprehensive analysis of the kinematic and kinetic profiles during ambulation that tests for the effect of walking speed in parallel to the effects of age, sex, and body mass index. This was accomplished by recruiting a population of 121 asymptomatic subjects and analyzing characteristic 3-dimensional kinematic and kinetic features at the ankle, knee, hip, and pelvis during walking trials at slow, normal, and fast speeds. Mixed effects linear regression models were used to identify how each of 78 discrete gait features is affected by variations in walking speed, age, sex, and body mass index. As expected, nearly every feature was associated with variations in walking speed. Several features were also affected by variations in demographic measures, including age affecting sagittal-plane knee kinematics, body mass index affecting sagittal-plane pelvis and hip kinematics, body mass index affecting frontal-plane knee kinematics and kinetics, and sex affecting frontal-plane kinematics at the pelvis, hip, and knee. These results could aid in the design of future studies, as well as clarify how walking speed, age, sex, and body mass index may act as potential confounders in studies with small populations or in populations with insufficient demographic variations for thorough statistical analyses.  相似文献   

17.
Knee varus position and motion have been correlated with increased medial knee loading during gait. The purpose of this study is to determine whether runners with excessive varus excursion (EVE) at the knee demonstrate frontal plane knee and hip kinetics that are different from those of runners with normal varus excursion (NVE). Twelve runners with EVE were compared with 12 NVE subjects using three-dimensional kinematics and kinetics. Frontal plane angles and moments were compared at the knee and hip. Runners with EVE had significantly greater abductor moment of the knee (p = .004) and lower peak abductor moment of the hip (p = .047). Runners with EVE demonstrate knee and hip mechanics thought to be associated with increased medial tibiofemoral loading. Further understanding of how changing hip abductor moments may affect changes in knee abductor moments during running may potentially lead to interventions that augment long-term risk of injury.  相似文献   

18.
The purpose of this study was to determine if females and males use different hip and knee mechanics when walking with standardized military-relevant symmetric loads. Fifteen females and fifteen males walked on a treadmill for 2-min at a constant speed under three symmetric load conditions (unloaded: 1.71 kg, medium: 15 kg, heavy: 26 kg). Kinematic and kinetics of the hip and knee were calculated in the sagittal and frontal planes of the dominant limb. In females, hip abduction moments (normalized to total mass) and sagittal knee excursion decreased with increased load (p ≤ 0.024). In males, hip frontal excursion and adduction angle increased with load (p ≤ 0.003). Females had greater peak hip adduction angle than males in the unloaded and medium load conditions (p ≤ 0.036). Across sex, sagittal hip and knee excursion, peak knee extension angle, and peak hip and knee flexion angles increased with increased load (p ≤ 0.005). When normalized to body mass, all peak joint moments increased with each load (p ≤ 0.016) except peak hip adduction moment. When normalized to total mass, peak hip adduction moment and knee flexion, extension, and adduction moments decreased with each load (p < 0.001). While hip frontal plane kinetic alterations to load were only noted in females, kinematic changes were noted in males at the hip and females at the knee. Differences in strategies may increase the risk of hip and knee injuries in females compared to males. This study noted load and sex effects that were previously undetected, highlighting the importance of using military-relevant standardized loads and investigating frontal plane adaptations.  相似文献   

19.
Gender differences in the incidence of symptomatic hip osteoarthritis (OA), changes in hip cartilage volume and hip joint space and rates hip arthroplasty of older people are reported in the literature. As the rate of progression of OA is in part mechanically modulated it is possible that this gender bias may be related to inherent differences (if they exist) in walking mechanics between older males and females. The purpose of this study was to examine potential mechanisms for gender differences in hip joint mechanics during walking by testing the hypotheses that females would exhibit higher hip flexion, adduction and internal rotation moments but not significantly greater normalized ground reaction forces (GRFs). Forty-two healthy subjects (21 male, 21 female), ages 50–79 yr were recruited for gait analysis. In support of the hypotheses, greater external hip adduction and internal rotation along with hip extension moments were found for females compared to males after normalizing for body size for all self-selected walking speeds. Differences in walking style (kinematics) were the main determinants in the joint kinetic differences as no differences in the normalized GRFs were found. As external joint moments are surrogate measures of the joint contact forces, the results of this study suggest the hip joint stress for the female population is higher compared to male population. This is in favor of a hypothesis that the increased joint contact stress in a female population could contribute to a greater joint degeneration at the hip in females as compared with males.  相似文献   

20.
The purpose of this study was to quantify how the predicted muscle function would change in a muscle-driven forward simulation of normal walking when changing the number of degrees of freedom in the model. Muscle function was described by individual muscle contributions to the vertical acceleration of the center of mass (COM). We built a two-dimensional (2D) sagittal plane model and a three-dimensional (3D) model in OpenSim and used both models to reproduce the same normal walking data. Perturbation analysis was applied to deduce muscle function in each model. Muscle excitations and contributions to COM support were compared between the 2D and 3D models. We found that the 2D model was able to reproduce similar joint kinematics and kinetics patterns as the 3D model. Individual muscle excitations were different for most of the hip muscles but ankle and knee muscles were able to attain similar excitations. Total induced vertical COM acceleration by muscles and gravity was the same for both models. However, individual muscle contributions to COM support varied, especially for hip muscles. Although there is currently no standard way to validate muscle function predictions, a 3D model seems to be more appropriate for estimating individual hip muscle function.  相似文献   

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