Contributions of proximal and distal moments to axial tibial rotation during walking and running

The purpose of this study was to determine the cause and effect relationship between tibial internal rotation and pronation of the foot during walking and heel-toe running. This would allow predictions of orthotic effectiveness in reducing knee pain related to excessive internal tibial rotation. Kinematic and force plate data were collected from twenty subjects performing ten running and ten walking trials across a force plate. Using a least-squares algorithm, attitude matrices for each segment in each frame were obtained and the angular velocity vector of the tibia was calculated. The intersegmental moment at the ankle was calculated from ground reaction force and kinematic data, and the power flow from foot to tibia associated with axial tibial rotation was calculated. In walking, all subjects exhibited a clear power flow from tibia to foot during most of the stance phase, indicating that the foot was following the body. This suggests that the use of foot orthoses to reduce knee pain associated with tibial rotation during walking will not be successful. During running, power flow was also mainly proximal to distal, but there were brief periods of opposite power flow. There was more variability between subjects during running, with five subjects having large distal to proximal power flow peaks. These observations may explain and support previous work that has found variable clinical effects of orthoses between patients.     

Variability of the impact transient during repeated barefoot walking trials

Most studies of human gait assume that the normal gait patterns are consistent and therefore that it is adequate to assess the baseline condition once. However, recent research has brought this assumption into question. The purpose of this study is to evaluate the repeatability of components of the ground reaction force, peak force loading rate and percent of ground reaction force at impact above 60Hz, across repeated walking trials throughout the experiment. Twenty-two subjects walked barefoot 10 times across a force platform interspersed between trial blocks of three different shod conditions. We used traditional grouped data analysis (ANOVA) as well as a more novel single-subject analysis. The grouped analysis revealed one statistically significant comparison between barefoot trials for the root mean square greater than 60Hz variable. The single-subject analysis revealed that approximately 5% of the barefoot trials were significantly different for each of the peak force loading rate and percent of impact transient signal above 60Hz variables. We suggest that these results, from both data analysis techniques, are not biologically relevant because the magnitudes of most of the changes were not large enough to have a biological significance (peak force loading rate differences less than 50%, and less than 0.05-fold differences in the percent of the ground reaction force above 60Hz). In conclusion, our data suggest that baseline impact force measurements during walking are stable and do not need to be recorded between experimental conditions in walking studies.     

An ultrasound based non-invasive method for the measurement of intrinsic foot kinematics during gait

Soft tissue artefact (STA) and marker placement variability are sources of error when measuring the intrinsic kinematics of the foot. This study aims to demonstrate a non-invasive, combined ultrasound and motion capture (US/MC) technique to directly measure foot skeletal motion. The novel approach is compared to a standard motion capture protocol. Fourteen participants underwent instrumented barefoot analysis of foot motion during gait. Markers were attached to foot allowing medial longitudinal arch angle and navicular height to be determined. For the US/MC technique, the navicular marker was replaced by an ultrasound transducer which was secured to the foot allowing the skeletal landmark to be imaged. Ultrasound cineloops showing the location of the navicular tuberosity during the walking trials were synchronised with motion capture measurements and markers mounted on the probe allowed the true position of the bony landmark to be determined throughout stance phase. Two discrete variables, minimum navicular height and maximum MLA angle, were compared between the standard and US/MC protocols. Significant differences between minimum navicular height (P=0.004, 95% CI (1.57, 6.54)) and maximum medial longitudinal arch angle (P=0.0034, 95% CI (13.8, 3.4)) were found between the measurement methods. The individual effects of STA and marker placement error were also assessed. US/MC is a non-invasive technique which may help to provide more accurate measurements of intrinsic foot kinematics.     

Determining the centre of pressure during walking and running using an instrumented treadmill

In this paper, a new method of determining spatial and temporal gait parameters by using centre of pressure (CoP) data is presented. A treadmill is used which was developed to overcome limitations of regular methods for the analysis of spatio-temporal gait parameters and ground reaction forces during walking and running. The design of the treadmill is based on the use of force transducers underneath a separate left and right plate, which together form the treadmill walking surface. The results of test procedures and measurements show that accurate recordings of vertical ground reaction force can be obtained. These recordings enable a separate analysis of vertical ground reaction forces during double support phases in walking, and the analysis of changes in the centre of pressure (CoP) position during subsequent foot placements. From the CoP data, temporal gait parameters (e.g. duration of left/right support and swing phases) and spatial gait parameters (i.e. left/right step lengths and widths) can be derived.     

Estimating the complete ground reaction forces with pressure insoles in walking

This study presented a method to estimate the complete ground reaction forces from pressure insoles in walking. Five male subjects performed 10 walking trials in a laboratory. The complete ground reaction forces were collected during a right foot stride by a force plate at 1000Hz. Simultaneous plantar pressure data were collected at 100Hz by a pressure insole system with 99 sensors covering the whole plantar area. Stepwise linear regressions were performed to individually reconstruct the complete ground reaction forces in three directions from the 99 individual pressure data until redundancy among the predictors occurred. An additional linear regression was performed to reconstruct the vertical ground reaction force by the sum of the value of the 99 pressure sensors. Five other subjects performed the same walking test for validation. Estimated ground reaction forces in three directions were calculated with the developed regression models, and were compared with the real data recorded from force plate. Accuracy was represented by the correlation coefficient and the root mean square error. Results showed very good correlation in anterior-posterior (0.928) and vertical (0.989) directions, and reasonable correlation in medial-lateral direction (0.719). The root mean square error was about 12%, 5% and 28% of the peak recorded value. Future studies should aim to generalize the methods or to establish specific methods to other subjects, patients, motions, footwear and floor conditions. The method gives an extra option to study an estimation of the complete ground reaction forces in any environment without the constraints from the number and location of force plates.     

An MRI-compatible foot-loading device for assessment of internal tissue deformation

It is well known that mechanical forces acting within the soft tissues of the foot can contribute to the formation of neuropathic ulcers in people with diabetes. Presently, only surface measurements of plantar pressure are used clinically to estimate risk status due to mechanical loading. It is currently not known how surface measurements relate to the three-dimensional (3-D) internal stress/strain state of the foot. This article describes the development of a foot-loading device that allows for the direct observation of the internal deformation of foot tissues under known forces. Ground reaction forces and plantar pressure distributions during normal walking were measured in ten healthy young adults. One instant in the gait cycle, when pressure under the metatarsal heads reached a peak, was extracted for simulation in an MR imager. T1-weighted 3-D gradient echo MRI sets were collected as the simulated walking ground reaction force was incrementally applied to the foot by the novel foot-loading device. The sub-metatarsal head soft-tissue thickness decreased rapidly at first and then reached a plateau. Peak plantar pressure measurements collected within the loading device (161+/-75kPa) were lower in magnitude and less focal than pressures measured during walking (492+/-91kPa). This finding implies that although the device successfully applied full peak walking ground reaction forces to the foot, they were not distributed in the same manner as during walking. Although not representative of gait, the data collected from this in vivo mechanical test are suitable for determination of foot tissue material properties or, when combined with finite element modeling, to examine the relationship between surface loading and internal stress.     

Ankle torque control that shifts the center of pressure from heel to toe contributes non-zero sagittal plane angular momentum during human walking

A principle objective of human walking is controlling angular motion of the body as a whole to remain upright. The force of the ground on each foot (F) reflects that control, and recent studies show that in the sagittal plane F exhibits a specific coordination between F direction and center-of-pressure (CP) that is conducive to remaining upright. Typical walking involves the CP shifting relative to the body due to two factors: posterior motion of the foot with respect to the hip (stepping) and motion of the CP relative to the foot (foot roll-over). Recent research has also shown how adjusting ankle torque alone to shift CP relative to the foot systematically alters the direction of F, and thus, could play a key role in upright posture and the F measured during walking. This study explores how the CP shifts due to stepping and foot roll-over contribute to the observed F and its role in maintaining upright posture. Experimental walking kinetics and kinematics were combined with a mechanical model of the human to show that variation in F that was not attributable to foot roll-over had systematic correlation between direction and CP that could be described by an intersection point located near the center-of-mass. The findings characterize a component of walking motor control, describe how typical foot roll-over contributes to postural control, and provide a rationale for the increased fall risk observed in individuals with atypical ankle muscle function.     

Correction of the inertial effect resulting from a plate moving under low-friction conditions

The purpose of the present study was to develop a set of equations that can be employed to remove the inertial effect introduced by the movable platform upon which a person stands during a slip induced in gait; this allows the real ground reaction force (GRF) and its center of pressure (COP) to be determined. Analyses were also performed to determine how sensitive the COP offsets were to the changes of the parameters in the equation that affected the correction of the inertial effect. In addition, the results were verified empirically using a low friction movable platform together with a stationary object, a pendulum, and human subjects during a slip induced during gait. Our analyses revealed that the amount of correction required for the inertial effect due to the movable component is affected by its mass and its center of mass (COM) position, acceleration, the friction coefficient, and the landing position of the foot relative to the COM. The maximum error in the horizontal component of the GRF was close to 0.09 (body weight) during the recovery from a slip in walking. When uncorrected, the maximum error in the COP measurement could reach as much as 4 cm. Finally, these errors were magnified in the joint-moment computation and propagated proximally, ranging from 0.2 to 1.0 Nm/body mass from the ankle to the hip.     

Stepping in the direction of the fall: the next foot placement can be predicted from current upper body state in steady-state walking

During human walking, perturbations to the upper body can be partly corrected by placing the foot appropriately on the next step. Here, we infer aspects of such foot placement dynamics using step-to-step variability over hundreds of steps of steady-state walking data. In particular, we infer dependence of the ‘next’ foot position on upper body state at different phases during the ‘current’ step. We show that a linear function of the hip position and velocity state (approximating the body center of mass state) during mid-stance explains over 80% of the next lateral foot position variance, consistent with (but not proving) lateral stabilization using foot placement. This linear function implies that a rightward pelvic deviation during a left stance results in a larger step width and smaller step length than average on the next foot placement. The absolute position on the treadmill does not add significant information about the next foot relative to current stance foot over that already available in the pelvis position and velocity. Such walking dynamics inference with steady-state data may allow diagnostics of stability and inform biomimetic exoskeleton or robot design.     

Kinematic analysis of a multi-segment foot model for research and clinical applications: a repeatability analysis

An unbiased understanding of foot kinematics has been difficult to achieve due to the complexity of foot structure and motion. We have developed a protocol for evaluation of foot kinematics during barefoot walking based on a multi-segment foot model. Stereophotogrammetry was used to measure retroreflective markers on three segments of the foot plus the tibia. Repeatability was evaluated between-trial, between-day and between-tester using two subjects and two testers. Subtle patterns and ranges of motion between segments of the foot were consistently detected. We found that repeatability between different days or different testers is primarily subject to variability of marker placement more than inter-tester variability or skin movement. Differences between inter-segment angle curves primarily represent a shift in the absolute value of joint angles from one set of trials to another. In the hallux, variability was greater than desired due to vibration of the marker array used. The method permits objective foot measurement in gait analysis using skin-mounted markers. Quantitative and objective characterisation of the kinematics of the foot during activity is an important area of clinical and research evaluation. With this work we hope to have provided a firm basis for a common protocol for in vivo foot study.     

Ground reaction forces and lower-limb joint kinetics of turning gait in typically developing children

Turning is a common locomotor task essential to daily activity; however, very little is known about the forces and moments responsible for the kinematic adaptations occurring relative to straight-line gait in typically developing children. Thus, the aims of this study were to analyse ground reaction forces (GRFs), ground reaction free vertical torque (T_Z), and the lower-limb joint kinetics of 90° outside (step) and inside (spin) limb turns. Step, spin, and straight walking trials from fifty-four typically developing children were analysed. All children were fit with the Plug-in Gait and Oxford Foot Model marker sets while walking over force plates embedded in the walkway. Net internal joint moments and power were computed via a standard inverse dynamics approach. All dependent variables were statistically analysed over the entire curves using the mean difference 95% bootstrap confidence band approach. GRFs were directed medially for step turns and laterally for spin turns during the turning phase. Directions were reversed and magnitudes decreased during the approach phase. Step turns showed reduced ankle power generation, while spin turns showed large T_Z. Both strategies required large knee and hip coronal and transverse plane moments during swing. These kinetic differences highlight adaptations required to maintain stability and reorient the body towards the new walking direction during turning. From a clinical perspective, turning gait may better reveal weaknesses and motor control deficits than straight walking in pathological populations, such as children with cerebral palsy, and could potentially be implemented in standard gait analysis sessions.     

Mechanics of locomotion of dogs (Canis familiaris) and sheep (Ovis aries)

Records have been made of the forces exerted on the ground by dogs and a sheep, in walking, trotting, cantering and slow galloping. Film has been taken simultaneously. The difference between walking and trotting was much less marked for the sheep than for the dogs.
Step length and stride length increase as speed increases. They are expressed as functions of the Froude number.
The vertical component of the force exerted by a foot on the ground shows two main maxima in walking, except in the case of the fore feet of sheep. In this case and in other gaits there is only one main maximum. The vertical movements of the fore and hind quarters which occurred in examples of each gait have been calculated from the force records.
The force exerted by a foot on the ground changes direction in the course of a step so as to remain more or less in line with a point fixed relative to the animal, but dorsal to its back.
The force records show impact disturbances in the first 003 sec of contact of each foot with the ground.
The point of application of the force on the sole of a foot tends to move posteriorly as the force increases.
The results are discussed in relation to a theoretical account of the mechanics of locomotion on legs.     

Is "circling" behavior in humans related to postural asymmetry?

In attempting to walk rectilinearly in the absence of visual landmarks, persons will gradually turn in a circle to eventually become lost. The aim of the present study was to provide insights into the possible underlying mechanisms of this behavior. For each subject (N?=?15) six trajectories were monitored during blindfolded walking in a large enclosed area to suppress external cues, and ground irregularities that may elicit unexpected changes in direction. There was a substantial variability from trial to trial for a given subject and between subjects who could either veer very early or relatively late. Of the total number of trials, 50% trajectories terminated on the left side, 39% on the right side and 11% were defined as "straight". For each subject, we established a "turning score" that reflected his/her preferential side of veering. The turning score was found to be unrelated to any evident biomechanical asymmetry or functional dominance (eye, hand…). Posturographic analysis, used to assess if there was a relationship between functional postural asymmetry and veering revealed that the mean position of the center of foot pressure during balance tests was correlated with the turning score. Finally, we established that the mean position of the center of pressure was correlated with perceived verticality assessed by a subjective verticality test. Together, our results suggest that veering is related to a "sense of straight ahead" that could be shaped by vestibular inputs.     

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.     

Greater toe grip and gentler heel strike are the strategies to adapt to slippery surface

This study investigated the plantar pressure distribution during gait on wooden surface with different slipperiness in the presence of contaminants. Fifteen Chinese males performed 10 walking trials on a 5-m wooden walkway wearing cloth shoe in four contaminated conditions (dry, sand, water, oil). A pressure insole system was employed to record the plantar pressure data at 50Hz. Peak pressure and time-normalized pressure-time integral were evaluated in nine regions. In comparing walking on slippery to non-slippery surfaces, results showed a 30% increase of peak pressure beneath the hallux (from 195.6 to 254.1kPa), with a dramatic 79% increase in the pressure time integral beneath the hallux (from 63.8 to 114.3kPa) and a 34% increase beneath the lateral toes (from 35.1 to 47.2kPa). In addition, the peak pressure beneath the medial and lateral heel showed significant 20-24% reductions, respectively (from 233.6-253.5 to 204.0-219.0kPa). These findings suggested that greater toe grip and gentler heel strike are the strategies to adapt to slippery surface. Such strategies plantarflexed the ankle and the metatarsals to achieve a flat foot contact with the ground, especially at heel strike, in order to shift the ground reaction force to a more vertical direction. As the vertical ground reaction force component increased, the available ground friction increased and the floor became less slippery. Therefore, human could walk without slip on slippery surfaces with greater toe grip and gentler heel strike as adaptation strategies.     

Reliability of medial-longitudinal-arch measures for skin-markers based kinematic analysis

The medial-longitudinal arch (MLA) is perhaps the most important feature characterizing foot morphology. While current skin-markers based models of the MLA angle used in stereophotogrammetry allow to estimate foot arch shape and deformation, these do not always appear consistent with foot anatomy and with standard clinical definitions. The aim of this study was to propose novel skin-markers based measures of MLA angle and investigate their reliability during common motor tasks.Markers on the calcaneus, navicular tuberosity, first metatarsal head and base, and on the two malleoli were exploited to test eight definitions of MLA angle consistent with foot anatomy, both as angles between two 3-dimensional vectors and as corresponding projections on the sagittal plane of the foot. The inter-trial, inter-session and inter-examiner reliability of each definition was assessed in multiple walking and running trials of two volunteers, tested by four examiners in three sessions.Inter-trial variability in walking was in the range 0.7–1.2 deg, the inter-session 2.8–7.5 deg, and the inter-examiner in the range 3.7–9.3 deg across all MLA definitions. The Rizzoli Foot Model definition showed the lowest inter-session and inter-examiner variability. MLA measures presented similar variability in walking and running.This study provides preliminary information on the reliability of MLA measurements based on skin-markers. According to the present study, angles between 3-dimensional vectors and minimal marker sets should be preferred over sagittal-plane projections. Further studies should be sought to investigate which definition is more accurate with respect to the real MLA deformation in different loading conditions.     

Correcting for deformation in skin-based marker systems

A new technique is described that reduces error due to skin movement artifact in the opto-electronic measurement of in vivo skeletal motion. This work builds on a previously described point cluster technique marker set and estimation algorithm by extending the transformation equations to the general deformation case using a set of activity-dependent deformation models. Skin deformation during activities of daily living are modeled as consisting of a functional form defined over the observation interval (the deformation model) plus additive noise (modeling error). The method is described as an interval deformation technique. The method was tested using simulation trials with systematic and random components of deformation error introduced into marker position vectors. The technique was found to substantially outperform methods that require rigid-body assumptions. The method was tested in vivo on a patient fitted with an external fixation device (Ilizarov). Simultaneous measurements from markers placed on the Ilizarov device (fixed to bone) were compared to measurements derived from skin-based markers. The interval deformation technique reduced the errors in limb segment pose estimate by 33 and 25% compared to the classic rigid-body technique for position and orientation, respectively. This newly developed method has demonstrated that by accounting for the changing shape of the limb segment, a substantial improvement in the estimates of in vivo skeletal movement can be achieved.     

Voluntary bipedal walking of infant chimpanzees

The voluntary bipedal walking of infant chimpanzees was studied by the analysis of foot force and by motion analysis. The infants were trained to locomote on a level platform without any restrictions on the locomotor pattern. The voluntary bipedal walking was compared with the other types of locomotion at the same age and with the trained bipedal walking performed by other chimpanzees, including adult chimpanzees. The characteristics of voluntary bipedal walking in the infant until one year of age were: (1) high-speed walking with short cycle duration; (2) short stance phase duration; (3) small braking component of the preceding leg and large acceleration of the following leg; (4) one downward peak in the vertical component; and (5) a relatively small transverse component. Bipedal walking usually continued for less than one second and ended in quadrupedal locomotion. During walking, the preceding foot touched the floor, heel first, as in the case of older chimpanzees and humans. At this age, bipedal walking was similar to high-speed locomotion. The voluntary bipedal walking of the two-year-old and frour-yearold chimpanzees was characterized as follows: (1) slower speed than during quadrupedal locomotion, (2) relatively long periods and distances; (3) well balanced accelerating and braking components; and (4) a vertical component showing two downward peaks and a trough in between during numerous trials. The last characteristic means that the body center of gravity is higher in the single stance phase, just as in the bipedal walkinbg of the adult chimpanzees and humans. The bipedal walking of infant chimpanzees was discussed in comparison with the walking of humans, including infants.     

Influence of gait speed on free vertical moment during walking

Free vertical moment (FVM) of ground reaction is recognized to be a meaningful indicator of torsional stress on the lower limbs when walking. The purpose of this study was to examine whether and how gait speed influences the FVM when walking. Fourteen young healthy adults performed a series of overground walking trials at three different speeds: low, preferred and fast. FVM was measured during the stance phase of the dominant leg using a force platform embedded in a 10 m-long walkway. Transverse plane kinematic parameters of the foot and pelvis were measured using a motion capture system. Results showed a significant decrease in peak abduction FVM (i.e., resisting internal foot rotation) and an increase in peak adduction FVM (i.e., resisting external foot rotation), together with an increase in gait speed. Concomitantly, we observed a decrease in the foot progression angle and an increase in the peak pelvis rotation velocity in the transverse plane with an increase in gait speed. A significant positive correlation was found between the pelvis rotation velocity and the peak adduction moment, suggesting that pelvis rotation influences the magnitude of adduction FVM. Furthermore, we also found significant correlations between the peak adduction FVM and both the step length and frequency, indicating that the alterations in FVM may be ascribed to changes in these two key variables of gait speed. These speed-related changes in FVM should be considered when this parameter is used in gait assessment, particularly when used as an index for rehabilitation and injury prevention.     

Estimates of muscle function in human gait depend on how foot-ground contact is modelled

Computational analyses of leg-muscle function in human locomotion commonly assume that contact between the foot and the ground occurs at discrete points on the sole of the foot. Kinematic constraints acting at these contact points restrict the motion of the foot and, therefore, alter model calculations of muscle function. The aim of this study was to evaluate how predictions of muscle function obtained from musculoskeletal models are influenced by the model used to simulate ground contact. Both single- and multiple-point contact models were evaluated. Muscle function during walking and running was determined by quantifying the contributions of individual muscles to the vertical, fore-aft and mediolateral components of the ground reaction force (GRF). The results showed that two factors--the number of foot-ground contact points assumed in the model and the type of kinematic constraint enforced at each point--affect the model predictions of muscle coordination. Whereas single- and multiple-point contact models produced similar predictions of muscle function in the sagittal plane, inconsistent results were obtained in the mediolateral direction. Kinematic constraints applied in the sagittal plane altered the model predictions of muscle contributions to the vertical and fore-aft GRFs, while constraints applied in the frontal plane altered the calculations of muscle contributions to the mediolateral GRF. The results illustrate the sensitivity of calculations of muscle coordination to the model used to simulate foot-ground contact.