Effect of stable and unstable load carriage on walking gait variability,dynamic stability and muscle activity of older adults

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

An application of principal component analysis for lower body kinematics between loaded and unloaded walking

Load carriage is a very common daily activity at home and in the workplace. Generally, the load is in the form of an external load carried by an individual, it could also be the excessive body mass carried by an overweight individual. To quantify the effects of carrying extra weight, whether in the form of an external load or excess body mass, motion capture data were generated for a diverse subject set. This consisted of twenty-three subjects generating one hundred fifteen trials for each loading condition. This study applied principal component analysis (PCA) to motion capture data in order to analyze the lower body gait patterns for four loading conditions: normal weight unloaded, normal weight loaded, overweight unloaded and overweight loaded.PCA has been shown to be a powerful tool for analyzing complex gait data. In this analysis, it is shown that in order to quantify the effects of external loads and/or for both normal weight and overweight subjects, the first principal component (PC1) is needed. For the work in this paper, PCs were generated from lower body joint angle data. The PC1 of the hip angle and PC1 of the ankle angle are shown to be an indicator of external load and BMI effects on temporal gait data.     

Use of a backpack alters gait initiation of high school students

We assessed how backpack carriage influences the gait initiation (GI) process in high school students, who extensively use backpacks. GI involves different dynamics from gait itself, while the excessive use of backpacks can result in adverse effects. 117 high school students were evaluated in three experimental conditions: no backpack (NB), bilateral backpack (BB), and unilateral backpack (UB). Two force plates were used to acquire ground reaction forces (GRFs) and moments for each foot separately. Center of pressure (COP) scalar variables were extracted, and statistical parametric mapping analysis was performed over the entire COP/GRFs time series. GI anticipatory postural adjustments (APAs) were reduced and were faster in backpack conditions; medial–lateral COP excursion was smaller in this phase. The uneven distribution of the extra load in the UB condition led to a larger medial–lateral COP shift in the support-foot unloading phase, with a corresponding vertical GRF change that suggests a more pronounced unloading swing foot/loading support foot mechanism. The anterior–posterior GRFs were altered, but the COP was not. A possible explanation for these results may be the forward trunk lean and the center of mass proximity of the base of support boundary, which induced smaller and faster APA, increased swing foot/support foot weight transfer, and increased load transfer to the first step.     

Gait synchronized force modulation during the stance period of one limb achieved by an active partial body weight support system

Our purpose was to demonstrate the ability of an actively controlled partial body weight support (PBWS) system to provide gait synchronized support during the stance period of a single lower extremity while examining the affect of such a support condition on gait asymmetry. Using an instrumented treadmill and a motion capture system, we compared gait parameters of twelve healthy elderly subjects (age 65-80 years) during unsupported walking to those while walking with 20% body weight support provided during only the stance period of the right limb. Specifically, we examined peak three-dimensional ground reaction force (GRF) data and the symmetry of lower extremity sagittal plane joint angles and of time and distance parameters. A reduction in all three GRF components was observed for the supported limb during modulated support. Reductions observed in the vertical GRF were comparable to the desired 20% support level. Additionally, GRF components examined for the unsupported limb during modulated support were consistently similar to those measured during unsupported walking. Modulated support caused statistically significant increases in asymmetry for knee flexion during stance (increased 5.9%), hip flexion during late swing (increased 9.1%), and the duration of single limb support (increased 2.8%). However, the observed increases were similar or considerably less than the natural variability in the asymmetry of these parameters during unsupported walking. The ability of the active PBWS device to provide unilateral support may offer new and possibly improved applications of PBWS rehabilitation for patients with unilateral walking deficits such as hemiparesis or orthopaedic injury.     

The effect of an on-body assistive device on transverse plane trunk coordination during a load carriage task

Load carriage is a physically demanding task that is often required of employees in many different occupations. The Mover's Assistive Device (MAD) is an on-body ergonomic assistive device designed to help professional movers transfer boxes during two techniques of hand-held load carriage: anterior carriage and posterior carriage. The purpose of this study was to examine the intersegment coordination between the trunk and pelvis as well as the trunk and box, since coordination may be a mechanism to reduce the amount of stress exerted on the back during load carriage. Thirteen males completed a hand-held load carriage task in a laboratory setting using two popular techniques employed by professional movers (anterior/posterior), with and without the assistance of the Mover's Assistive Device (MAD); resulting in a total of four conditions. Triads of retro-reflective markers tracked the angular positions of the trunk, pelvis and the load being carried. Intersegment coordination between the trunk-pelvis and the box-trunk were measured using continuous relative phase angles in the transverse plane of motion. No trunk coordination differences were observed across carrying techniques (anterior/posterior); however, under all conditions users walked with a near in-phase coordination pattern, which is believed to help reduce the risk of injury. MAD use resulted in decreased perceived discomfort and more in-phase coordination between the trunk-pelvis, which may help reduce injury risk when carrying loads either anteriorly or posteriorly.     

Effects of load carriage and fatigue on gait characteristics

The objective of this study was to determine the main and interactive effects of load carriage and fatigue on gait characteristics. Twelve young male participants were recruited in this study. Fatiguing protocol involved a running exercise, and fatigue was considered to be induced when the participants first gave an RPE rating at or above 17. Gait data were collected when the participants walked on a medical treadmill at their self-selected comfortable speed, both before and right after the fatiguing exercise. Different back-carrying loads (i.e. 0, 7.5, and 15 kg) were applied separately to the participants during the walking trials. Gait variability measures and kinematic measures were used to quantify gait characteristics. The results showed that gait width variability, hip range of motion, and trunk range of motion increased with fatigue and with the application of the heavy load. These findings suggest that both fatigue and load carriage compromise gait. Findings from this study can help better understand how fatigue and load carriage affect gait, and further aid in developing interventions that are able to minimize fall risks especially with the application of fatigue and/or external load.     

Computational evaluation of load carriage effects on gait balance stability

Evaluating the effects of load carriage on gait balance stability is important in various applications. However, their quantification has not been rigorously addressed in the current literature, partially due to the lack of relevant computational indices. The novel Dynamic Gait Measure (DGM) characterizes gait balance stability by quantifying the relative effects of inertia in terms of zero-moment point, ground projection of center of mass, and time-varying foot support region. In this study, the DGM is formulated in terms of the gait parameters that explicitly reflect the gait strategy of a given walking pattern and is used for computational evaluation of the distinct balance stability of loaded walking. The observed gait adaptations caused by load carriage (decreased single support duration, inertia effects, and step length) result in decreased DGM values (p < 0.0001), which indicate that loaded walking motions are more statically stable compared with the unloaded normal walking. Comparison of the DGM with other common gait stability indices (the maximum Floquet multiplier and the margin of stability) validates the unique characterization capability of the DGM, which is consistently informative of the presence of the added load.     

Modulation of force transmission to the head while carrying a backpack load at different walking speeds

This study was designed to investigate the capability of the joints and segments to reduce transmission of forces during load carriage. Eleven subjects were required to carry a backpack loaded with 40% of their body weight and to walk at 6 speeds increasing from 0.6 to 1.6 ms(-1) in increments of 0.2 ms(-1), and then decreasing in the same manner. Subjects were filmed in 3-dimensions, but analysis of shock transmission ratio (TR) was limited to the sagittal plane. Shock transmission was measured as the ratio of peak vertical accelerations (ankle:head, ankle:knee, and knee:head) measured immediately following foot strike. TR for all ratios increased significantly as a function of increasing speed. TR from the ankle to the head showed no significant increase as a function of load carriage, but did increase as a function of load in transmission from knee to head. A significant interaction effect revealed that during load carriage at the higher speeds the acceleration of the ankle and knee decreased below that for the unloaded conditions. These findings suggest that the potentially injurious effects of previously observed increased ground reaction forces and increased joint stiffness while walking with loads are offset by adaptations in the gait pattern that maintain force transmission at acceptable levels. Increased variability in the acceleration of the head and in the transmission ratios suggest a potentially destabilizing effect of load carriage on the head trajectory.     

Men and women adopt similar walking mechanics and muscle activation patterns during load carriage

Although numerous studies have investigated the effects of load carriage on gait mechanics, most have been conducted on active military men. It remains unknown whether men and women adapt differently to carrying load. The purpose of this study was to compare the effects of load carriage on gait mechanics, muscle activation patterns, and metabolic cost between men and women walking at their preferred, unloaded walking speed. We measured whole body motion, ground reaction forces, muscle activity, and metabolic cost from 17 men and 12 women. Subjects completed four walking trials on an instrumented treadmill, each five minutes in duration, while carrying no load or an additional 10%, 20%, or 30% of body weight. Women were shorter (p<0.01), had lower body mass (p=0.01), and had lower fat-free mass (p=0.02) compared to men. No significant differences between men and women were observed for any measured gait parameter or muscle activation pattern. As load increased, so did net metabolic cost, the duration of stance phase, peak stance phase hip, knee, and ankle flexion angles, and all peak joint extension moments. The increase in the peak vertical ground reaction force was less than the carried load (e.g. ground force increased approximately 6% with each 10% increase in load). Integrated muscle activity of the soleus, medial gastrocnemius, lateral hamstrings, vastus medialis, vastus lateralis, and rectus femoris increased with load. We conclude that, despite differences in anthropometry, men and women adopt similar gait adaptations when carrying load, adjusted as a percentage of body weight.     

How do load carriage and walking speed influence trunk coordination and stride parameters?

To determine the effects of load carriage and walking speed on stride parameters and the coordination of trunk movements, 12 subjects walked on a treadmill at a range of walking speeds (0.6-1.6 m s(-1)) with and without a backpack containing 40% of their body mass. It was hypothesized that compared to unloaded walking, load carriage decreases transverse pelvic and thoracic rotation, the mean relative phase between pelvic and thoracic rotations, and increases hip excursion. In addition, it was hypothesized that these changes would coincide with a decreased stride length and increased stride frequency. The findings supported the hypotheses. Dimensionless analyses indicated that there was a significantly larger contribution of hip excursion and smaller contribution of transverse plane pelvic rotation to increases in stride length during load carriage. In addition, there was a significant effect of load carriage on the amplitudes of transverse pelvic and thoracic rotation and the relative phase of pelvic and thoracic rotation. It was concluded that the shorter stride length and higher stride frequency observed when carrying a backpack is the result of decreased pelvic rotation. During unloaded walking, increases in pelvic rotation contribute to increases in stride length with increasing walking speed. The decreased pelvic rotation during load carriage requires an increased hip excursion to compensate. However, the increase in hip excursion is insufficient to fully compensate for the observed decrease in pelvis rotation, requiring an increase in stride frequency during load carriage to maintain a constant walking speed.     

External loading alters trunk kinematics and lower extremity muscle activity in a distribution-specific manner during sitting and rising from a chair

BackgroundExcess body mass alters gait biomechanics in a distribution-specific manner. The effects of adding mass centrally or peripherally on biomechanics during sitting and rising from a chair are unknown.MethodsMotion analysis and lower extremity EMG were measured for fifteen healthy, normal weight subjects during sit-to-stand (SitTS) and stand-to-sit (StandTS) from a chair under unloaded (UN), centrally loaded (CL), and peripherally loaded (PL) conditions.ResultsCompared to UN, PL significantly increased support width (SitTS and StandTS), increased peak trunk flexion velocity (SitTS), and trended to increase peak trunk flexion angle (SitTS). During StandTS, CL significantly reduced peak trunk flexion compared to UN and PL. EMG activity of the semitendinosus, vastus lateralis and/or medialis was significantly increased in CL compared to UN during SitTS and StandTS.ConclusionsAdding mass centrally or peripherally induces contrasting biomechanical strategies to successfully sit or rise from a chair. CL limits trunk flexion and increases knee extensor muscle activity whereas; PL increases support width and trunk flexion, thus preventing increased EMG activity.     

Dynamic analysis of load carriage biomechanics during level walking

This paper describes an investigation into the biomechanical effects of load carriage dynamics on human locomotion performance. A whole body, inverse dynamics gait model has been developed which uses only kinematic input data to define the gait cycle. To provide input data, three-dimensional gait measurements have been conducted to capture whole body motion while carrying a backpack. A nonlinear suspension model is employed to describe the backpack dynamics. The model parameters for a particular backpack system can be identified using a dynamic load carriage test-rig. Biomechanical assessments have been conducted based on combined gait and pack simulations. It was found that the backpack suspension stiffness and damping have little effect on human locomotion energetics. However, decreasing suspension stiffness offers important biomechanical advantages. The peak values of vertical pack force, acting on the trunk, and lower limb joint loads are all moderated. This would reduce shoulder strap pressures and the risk of injury when heavy loads are carried.     

Resonance-based oscillations could describe human gait mechanics under various loading conditions

The oscillatory behavior of the center of mass (CoM) and the corresponding ground reaction force (GRF) of human gait for various gait speeds can be accurately described in terms of resonance using a spring–mass bipedal model. Resonance is a mechanical phenomenon that reflects the maximum responsiveness and energetic efficiency of a system. To use resonance to describe human gait, we need to investigate whether resonant mechanics is a common property under multiple walking conditions. Body mass and leg stiffness are determinants of resonance; thus, in this study, we investigated the following questions: (1) whether the estimated leg stiffness increased with inertia, (2) whether a resonance-based CoM oscillation could be sustained during a change in the stiffness, and (3) whether these relationships were consistently observed for different walking speeds. Seven healthy young subjects participated in over-ground walking trials at three different gait speeds with and without a 25-kg backpack. We measured the GRFs and the joint kinematics using three force platforms and a motion capture system. The leg stiffness was incorporated using a stiffness parameter in a compliant bipedal model that best fitted the empirical GRF data. The results showed that the leg stiffness increased with the load such that the resonance-based oscillatory behavior of the CoM was maintained for a given gait speed. The results imply that the resonance-based oscillation of the CoM is a consistent gait property and that resonant mechanics may be useful for modeling human gait.     

Effect of load on preferred speed and cost of transport.

Horses have a tendency to utilize a relatively narrow set of speeds near the middle of a much broader range they are capable of using within a particular gait, i.e., a preferred speed. Possible explanations for this behavior include minimizing musculoskeletal stresses and maximizing metabolic economy. If metabolic economy (cost of transport, CT) and preferred speeds are linked, then shifts in CT should produce shifts in preferred speed. To test this hypothesis, preferred speed was measured in trotting horses (n = 7) unloaded on the level and loaded with 19% of their body weight on the level. The preferred speed on the level was 3.33 +/- 0.09 (SE) m/s, and this decreased to 3.13 +/- 0.11 m/s when loaded. In both conditions (no load and load), the rate of O2 consumption (n = 3) was a curvilinear function of speed that produced a minimum CT (i.e., speed at which trotting is most economical). When unloaded, the speed at which CT was minimum was very near the preferred speed. With a load, CT decreased and the minimum was also near the preferred speed of horses while carrying a load.     

How do rocker-soled shoes influence the knee adduction moment in people with knee osteoarthritis? An analysis of biomechanical mechanisms

The primary objective was to examine mechanisms behind previously observed changes in the knee adduction moment (KAM) with rocker-soled shoes, in participants sub-grouped according to whether they experienced an immediate decrease, or increase, in peak KAM. In subgroups where frontal plane knee ground reaction force (GRF) lever-arm emerged as a significant predictor, a secondary aim was to examine biomechanical factors that contributed to change in this parameter. Thirty individuals with symptomatic, radiographic knee osteoarthritis (OA) underwent 3D gait analysis in unstable rocker-soled shoes and non-rocker-soled shoes. Multiple regression analyses, within each subgroup, examined relationships between changes in frontal plane knee-GRF lever arm and frontal plane resultant GRF magnitude and changes in peak KAM and KAM impulse between shoe conditions. In the subgroup that decreased peak KAM with rocker-soled shoes (n = 23), change in knee-GRF lever arm and frontal plane GRF magnitude at peak KAM together were significant predictors of change in peak KAM; however, only change in mean knee-GRF lever arm significantly predicted change in KAM impulse. Decreased medial GRF magnitude, increased lateral trunk lean towards the stance limb and reduced varus/increased valgus hip-knee-ankle angle were associated with a lower knee-GRF lever arm in this group, with rocker-soled shoes. In contrast, none of the independent variables predicted changes in KAM in the subgroup who increased peak KAM with rocker-soled shoes (n = 7).     

下肢优势侧和非优势侧相同负重往返跑对青年学员平衡能力的影响

目的：本研究评定运动强度相同,不同运动量下肢优势侧和非优势侧相同负重往返跑对青年学员平衡能力产生的影响。方法：10名健康男性受试者平均年龄（20.80±2.04）岁,身高（173.99±2.87）cm。采用随机交互设计,10名受试者分别完成4次单侧负重往返跑：优势侧20 m×5、非优势侧20 m×5、优势侧20 m×10和非优势侧20 m×10,分别在运动后即刻和运动后20 min进行平衡能力测试,并记录R-R间期。结果：与安静状态相比,运动后,HR、EPOC和TRIMP值均显著增加（P<0.01）,优势侧和非优势20 m×10 EPOC和TRIMP值显著大于20 m×5（P<0.01）。与安静值相比,优势侧和非优势侧20 m×5和20 m×10运动后即刻,整体、前后和左右方向摆动均显著增加（P<0.05）,20 m×10优势侧和非优势侧左右方向摆动程度均显著高于20 m×5（P<0.05）,但优势侧和非优势侧之间不存在显著差异（P>0.05）,表现出对称性的变化;此外,恢复期20 min内均迅速回落到安静值（P>0.05）。结论：运动后即刻平衡能力受到干扰;运动量增加,左右方向损害程度增加;优势侧和非优势侧平衡能力的变化相似,可能存在交互效应。     

Biomechanical mechanism of lateral trunk lean gait for knee osteoarthritis patients

The biomechanical mechanism of lateral trunk lean gait employed to reduce external knee adduction moment (KAM) for knee osteoarthritis (OA) patients is not well known. This mechanism may relate to the center of mass (COM) motion. Moreover, lateral trunk lean gait may affect motor control of the COM displacement. Uncontrolled manifold (UCM) analysis is an evaluation index used to understand motor control and variability of the motor task. Here we aimed to clarify the biomechanical mechanism to reduce KAM during lateral trunk lean gait and how motor variability controls the COM displacement. Twenty knee OA patients walked under two conditions: normal and lateral trunk lean gait conditions. UCM analysis was performed with respect to the COM displacement in the frontal plane. We also determined how the variability is structured with regards to the COM displacement as a performance variable. The peak KAM under lateral trunk lean gait was lower than that under normal gait. The reduced peak KAM observed was accompanied by medially shifted knee joint center, shortened distance of the center of pressure to knee joint center, and shortened distance of the knee–ground reaction force lever arm during the stance phase. Knee OA patients with lateral trunk lean gait could maintain kinematic synergy by utilizing greater segmental configuration variance to the performance variable. However, the COM displacement variability of lateral trunk lean gait was larger than that of normal gait. Our findings may provide clinical insights to effectively evaluate and prescribe gait modification training for knee OA patients.     

The influence of different lower seat height on the muscular stress during squatting for a ground level job

Work requiring extremely body flexion is strongly associated with a high incidence of musculoskeletal injuries often reported during adopting squatting. In this study, the influence of different lower seat heights on the muscular stress in squatting on a stool (SS) were examined in comparison with fully squatting (FS). Fourteen healthy Indonesian males were recruited in the experiment. Two-dimensional body kinematics, ground reaction force (GRF) and electromyography (EMG) data were collected as subjects performed forward movement under four squatting height conditions which were FS and SS at 10 cm, 15 cm and 20 cm seat height. The results demonstrated that the change from FS to SS primarily affected the segmental angular flexions and muscular activities in the upper and lower limbs. GRF data showed that the SS conditions delivered 24% body weight onto the seat. The change of FS to SS showed significantly decrease in muscular load of the rectus femoris and tibialis anterior. In contrast, the soleus and gastrocnemius increased the activities as the seat height increased. The type of task that required the hand to handle the object on the ground level affected the trunk to be more flexed as the seat height increased. The findings of this study suggest that the use of a lower seat stool of a proper height seems to be a sub-optimal solution considering the change of muscular load associated with the discomfort in a squatting posture.     

Ground reaction forces during human locomotion on railroad ballast

Locomotion over ballast surfaces provides a unique situation for investigating the biomechanics of gait. Although much research has focused on level and sloped walking on a smooth, firm surface in order to understand the common kinematic and kinetic variables associated with human locomotion, the literature currently provides few if any discussions regarding the dynamics of locomotion on surfaces that are either rocky or uneven. The purpose of this study was to investigate a method for using force plates to measure the ground reaction forces (GRFs) during gait on ballast. Ballast is a construction aggregate of unsymmetrical rock used in industry for the purpose of forming track bed on which railway ties are laid or in yards where railroad cars are stored. It is used to facilitate the drainage of water and to create even running surfaces. To construct the experimental ballast surfaces, 31.75 mm (1 1/4 in.) marble ballast at depths of approximately 63.5 mm (2.5 in.) or 101.6 mm (4 in.) were spread over a carpeted vinyl tile walkway specially designed for gait studies. GRF magnitudes and time histories from a force plate were collected under normal smooth surface and under both ballast surface conditions for five subjects. GRF magnitudes and time histories during smooth surface walking were similar to GRF magnitudes and time histories from the two ballast surface conditions. The data presented here demonstrate the feasibility of using a force plate system to expand the scope of biomechanical analyses of locomotion on ballast surfaces.