Energy exchange between subject and belt during treadmill walking

Treadmill walking aims to simulate overground walking, but intra-stride belt speed variations of treadmills result in some interaction between treadmill and subject, possibly obstructing this aim. Especially in self-paced treadmill walking, in which the belt speed constantly adjusts to the subject, these interactions might affect the gait pattern significantly. The aim of this study was to quantify the energy exchange between subject and treadmill, during the fixed speed (FS) and self-paced (SP) modes of treadmill walking. Eighteen subjects walked on a dual-belt instrumented treadmill at both modes. The energy exchange was calculated as the integration of the product of the belt speed deviation and the fore-aft ground reaction force over the stride cycle. The total positive energy exchange was 0.44 J/stride and the negative exchange was 0.11 J/stride, which was both less than 1.6% of the performed work on the center of mass. Energy was mainly exchanged from subject to treadmill during both the braking and propulsive phase of gait. The two treadmill modes showed a similar pattern of energy exchange, with a slightly increased energy exchange during the braking phase of SP walking. It is concluded that treadmill walking is only mildly disturbed by subject-belt interactions when using instrumented treadmills with adequate belt control.     

Gait modification when decreasing double support percentage

Much is still unknown about walking stability, including which aspects of gait contribute to higher stability. Walking stability appears to be related to walking speed, although the exact relationship is unclear. As walking speed decreases, the double support (DS) period of gait increases both in time and as a percentage of the gait cycle. Because humans have more control over their center of mass movement during DS, increasing DS duration may alter stability. This study examined how human gait is affected by changing DS percentage independent of walking speed. Sixteen young, healthy adults walked on a treadmill at a single speed for six one-minute trials. These trials included normal gait as well as longer- and shorter-than-normal DS percentage gaits. Subjects were consistently able to decrease DS percentage but had difficulty increasing DS percentage. In some cases, subjects altered their cadence when changing DS percentage, particularly when attempting to increase DS percentage. The changes to gait when decreasing DS percentage were similar to changes when increasing walking speed but occurred mainly during the swing period. These changes include increased hip and knee flexion during the swing period, increased swing foot height, and larger magnitude peaks in ground reaction forces. The changes in gait when attempting to increase DS percentage trended toward changes when decreasing walking speed. Altering DS percentage induced gait changes that were similar to, yet clearly distinct from, gait changes due to walking speed. Further, the difficulty of increasing DS percentage when walking at a constant speed suggests that people walk more slowly when they want to increase time spent in DS.     

Can treadmill walking be used to assess propulsion generation?

Instrumented treadmills offer significant advantages for analysis of human locomotion, including recording consecutive steady-state gait cycles, precisely controlling walking speed, and avoiding force plate targeting. However, some studies of hemiparetic walking on a treadmill have suggested that the moving treadmill belt may fundamentally alter propulsion mechanics. Any differences in propulsion mechanics during treadmill walking would be problematic since recent studies assessing propulsion have provided fundamental insight into hemiparetic walking. The purpose of this study was to test the hypothesis that there would be no difference in the generation of anterior/posterior (A/P) propulsion by performing a carefully controlled comparison of the A/P ground reaction forces (GRFs) and impulses in healthy adults during treadmill and overground walking. Gait data were collected from eight subjects walking overground and on a treadmill with speed and cadence controlled. Peak negative and positive horizontal GRFs in early and late stance, respectively, were reduced by less than 5% of body weight (p<0.05) during treadmill walking compared to overground walking. The magnitude of the braking impulse was similarly lower (p<0.05) during treadmill walking, but no significant difference was found between propulsion impulses. While there were some subtle differences in A/P GRFs between overground and treadmill walking, these results suggest there is no fundamental difference in propulsion mechanics. We conclude that treadmill walking can be used to investigate propulsion generation in healthy and by implication clinical populations.     

Energy cost of walking and gait instability in healthy 65- and 80-yr-olds.

This study tested whether the lower economy of walking in healthy elderly subjects is due to greater gait instability. We compared the energy cost of walking and gait instability (assessed by stride to stride changes in the stride time) in octogenarians (G80, n = 10), 65-yr-olds (G65, n = 10), and young controls (G25, n = 10) walking on a treadmill at six different speeds. The energy cost of walking was higher for G80 than for G25 across the different walking speeds (P < 0.05). Stride time variability at preferred walking speed was significantly greater in G80 (2.31 +/- 0.68%) and G65 (1.93 +/- 0.39%) compared with G25 (1.40 +/- 0.30%; P < 0.05). There was no significant correlation between gait instability and energy cost of walking at preferred walking speed. These findings demonstrated greater energy expenditure in healthy elderly subjects while walking and increased gait instability. However, no relationship was noted between these two variables. The increase in energy cost is probably multifactorial, and our results suggest that gait instability is probably not the main contributing factor in this population. We thus concluded that other mechanisms, such as the energy expenditure associated with walking movements and related to mechanical work, or neuromuscular factors, are more likely involved in the higher cost of walking in elderly people.     

Walking speed changes in response to novel user-driven treadmill control

Implementing user-driven treadmill control in gait training programs for rehabilitation may be an effective means of enhancing motor learning and improving functional performance. This study aimed to determine the effect of a user-driven treadmill control scheme on walking speeds, anterior ground reaction forces (AGRF), and trailing limb angles (TLA) of healthy adults. Twenty-three participants completed a 10-m overground walking task to measure their overground self-selected (SS) walking speeds. Then, they walked at their SS and fastest comfortable walking speeds on an instrumented split-belt treadmill in its fixed speed and user-driven control modes. The user-driven treadmill controller combined inertial-force, gait parameter, and position based control to adjust the treadmill belt speed in real time. Walking speeds, peak AGRF, and TLA were compared among test conditions using paired t-tests (α = 0.05). Participants chose significantly faster SS and fast walking speeds in the user-driven mode than the fixed speed mode (p > 0.05). There was no significant difference between the overground SS walking speed and the SS speed from the user-driven trials (p < 0.05). Changes in AGRF and TLA were caused primarily by changes in walking speed, not the treadmill controller. Our findings show the user-driven treadmill controller allowed participants to select walking speeds faster than their chosen speeds on the fixed speed treadmill and similar to their overground speeds. Since user-driven treadmill walking increases cognitive activity and natural mobility, these results suggest user-driven treadmill control would be a beneficial addition to current gait training programs for rehabilitation.     

Walk-, run- and gallop-like gait patterns in human sideways locomotion

The purpose of this study is to examine the characteristics of gait patterns in human preferred sideways locomotion at increasing speeds. Fifteen healthy young males were asked to step sideways on a treadmill at various speeds of 1.3–6.1 km/h. The times of foot contact and take-off were analyzed. Three gait patterns were observed. At slow speeds, all of the subjects performed a walk-like pattern. When the treadmill speed exceeded approximately 3.5 km/h, the subjects preferred gait patterns with a flight phase. Most of the subjects performed an asymmetric gait pattern that was similar to a forward gallop, whereas only two out of fifteen subjects performed a run-like gait pattern. Because the left and right legs are positioned along the movement direction, it might be more efficient to divide roles between the leading and trailing limbs at high speeds: the leading limb functions to produces breaking and vertical force, and the trailing limb mainly absorbs the impact of foot contact and generates propulsive forces.     

Varying treadmill speed and inclination affects spontaneous synchronization when two individuals walk side by side

Studying spontaneous synchronization of stepping as two individuals walk on side-by-side treadmills may be useful for understanding the control of bipedal locomotion and may have implications for gait rehabilitation. Existing data suggest that this behavior is related to differences in leg length, walkway slope, and overground speed between partners, and might be promoted by altering these variables. This idea was evaluated here as 24 pairs of subjects stepped on side-by-side treadmills under several conditions of relative speed and slope. Overall, pairings that demonstrated very little spontaneous synchronization with the same treadmill speed and slope exhibited significant increases in this behavior when one treadmill was manipulated. Conversely, pairings that demonstrated a tendency to synchronize under normal conditions exhibited significant decreases in this behavior when either treadmill was altered.     

A simple,reliable method to determine the mean gait speed using heel markers on a treadmill

Gait speed is an essential parameter of gait analysis. Our study proposed a simple and accurate method to extract a mean gait speed during walking on a treadmill using only kinematic data from markers placed on the heels of the participants’ feet. This method provided an attractive, simple method that remains resistant to errors in treadmill calibration. In addition, this method required only two markers, since heel markers are essential to gait analysis, and the proposed method is robust enough to differentiate among various gait speeds (mean error <1%).     

Dynamic gait stability of treadmill versus overground walking in young adults

Treadmill has been broadly used in laboratory and rehabilitation settings for the purpose of facilitating human locomotion analysis and gait training. The objective of this study was to determine whether dynamic gait stability differs or resembles between the two walking conditions (overground vs. treadmill) among young adults. Fifty-four healthy young adults (age: 23.9 ± 4.7 years) participated in this study. Each participant completed five trials of overground walking followed by five trials of treadmill walking at a self-selected speed while their full body kinematics were gathered by a motion capture system. The spatiotemporal gait parameters and dynamic gait stability were compared between the two walking conditions. The results revealed that participants adopted a “cautious gait” on the treadmill compared with over ground in response to the possible inherent challenges to balance imposed by treadmill walking. The cautious gait, which was achieved by walking slower with a shorter step length, less backward leaning trunk, shortened single stance phase, prolonged double stance phase, and more flatfoot landing, ensures the comparable dynamic stability between the two walking conditions. This study could provide insightful information about dynamic gait stability control during treadmill ambulation in young adults.     

Human-Robot Interaction: Does Robotic Guidance Force Affect Gait-Related Brain Dynamics during Robot-Assisted Treadmill Walking?

In order to determine optimal training parameters for robot-assisted treadmill walking, it is essential to understand how a robotic device interacts with its wearer, and thus, how parameter settings of the device affect locomotor control. The aim of this study was to assess the effect of different levels of guidance force during robot-assisted treadmill walking on cortical activity. Eighteen healthy subjects walked at 2 km.h^-1 on a treadmill with and without assistance of the Lokomat robotic gait orthosis. Event-related spectral perturbations and changes in power spectral density were investigated during unassisted treadmill walking as well as during robot-assisted treadmill walking at 30%, 60% and 100% guidance force (with 0% body weight support). Clustering of independent components revealed three clusters of activity in the sensorimotor cortex during treadmill walking and robot-assisted treadmill walking in healthy subjects. These clusters demonstrated gait-related spectral modulations in the mu, beta and low gamma bands over the sensorimotor cortex related to specific phases of the gait cycle. Moreover, mu and beta rhythms were suppressed in the right primary sensory cortex during treadmill walking compared to robot-assisted treadmill walking with 100% guidance force, indicating significantly larger involvement of the sensorimotor area during treadmill walking compared to robot-assisted treadmill walking. Only marginal differences in the spectral power of the mu, beta and low gamma bands could be identified between robot-assisted treadmill walking with different levels of guidance force. From these results it can be concluded that a high level of guidance force (i.e., 100% guidance force) and thus a less active participation during locomotion should be avoided during robot-assisted treadmill walking. This will optimize the involvement of the sensorimotor cortex which is known to be crucial for motor learning.     

Biomechanics of overground vs. treadmill walking in healthy individuals.

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.     

Simultaneous Scalp Electroencephalography (EEG), Electromyography (EMG), and Whole-body Segmental Inertial Recording for Multi-modal Neural Decoding

Recent studies support the involvement of supraspinal networks in control of bipedal human walking. Part of this evidence encompasses studies, including our previous work, demonstrating that gait kinematics and limb coordination during treadmill walking can be inferred from the scalp electroencephalogram (EEG) with reasonably high decoding accuracies. These results provide impetus for development of non-invasive brain-machine-interface (BMI) systems for use in restoration and/or augmentation of gait- a primary goal of rehabilitation research. To date, studies examining EEG decoding of activity during gait have been limited to treadmill walking in a controlled environment. However, to be practically viable a BMI system must be applicable for use in everyday locomotor tasks such as over ground walking and turning. Here, we present a novel protocol for non-invasive collection of brain activity (EEG), muscle activity (electromyography (EMG)), and whole-body kinematic data (head, torso, and limb trajectories) during both treadmill and over ground walking tasks. By collecting these data in the uncontrolled environment insight can be gained regarding the feasibility of decoding unconstrained gait and surface EMG from scalp EEG.     

The Combined Effects of Body Weight Support and Gait Speed on Gait Related Muscle Activity: A Comparison between Walking in the Lokomat Exoskeleton and Regular Treadmill Walking

Background

For the development of specialized training protocols for robot assisted gait training, it is important to understand how the use of exoskeletons alters locomotor task demands, and how the nature and magnitude of these changes depend on training parameters. Therefore, the present study assessed the combined effects of gait speed and body weight support (BWS) on muscle activity, and compared these between treadmill walking and walking in the Lokomat exoskeleton.

Methods

Ten healthy participants walked on a treadmill and in the Lokomat, with varying levels of BWS (0% and 50% of the participants’ body weight) and gait speed (0.8, 1.8, and 2.8 km/h), while temporal step characteristics and muscle activity from Erector Spinae, Gluteus Medius, Vastus Lateralis, Biceps Femoris, Gastrocnemius Medialis, and Tibialis Anterior muscles were recorded.

Results

The temporal structure of the stepping pattern was altered when participants walked in the Lokomat or when BWS was provided (i.e. the relative duration of the double support phase was reduced, and the single support phase prolonged), but these differences normalized as gait speed increased. Alternations in muscle activity were characterized by complex interactions between walking conditions and training parameters: Differences between treadmill walking and walking in the exoskeleton were most prominent at low gait speeds, and speed effects were attenuated when BWS was provided.

Conclusion

Walking in the Lokomat exoskeleton without movement guidance alters the temporal step regulation and the neuromuscular control of walking, although the nature and magnitude of these effects depend on complex interactions with gait speed and BWS. If normative neuromuscular control of gait is targeted during training, it is recommended that very low speeds and high levels of BWS should be avoided when possible.     

Impaired Cerebral Autoregulation Is Associated with Brain Atrophy and Worse Functional Status in Chronic Ischemic Stroke

Dynamic cerebral autoregulation (dCA) is impaired following stroke. However, the relationship between dCA, brain atrophy, and functional outcomes following stroke remains unclear. In this study, we aimed to determine whether impairment of dCA is associated with atrophy in specific regions or globally, thereby affecting daily functions in stroke patients.We performed a retrospective analysis of 33 subjects with chronic infarctions in the middle cerebral artery territory, and 109 age-matched non-stroke subjects. dCA was assessed via the phase relationship between arterial blood pressure and cerebral blood flow velocity. Brain tissue volumes were quantified from MRI. Functional status was assessed by gait speed, instrumental activities of daily living (IADL), modified Rankin Scale, and NIH Stroke Score.Compared to the non-stroke group, stroke subjects showed degraded dCA bilaterally, and showed gray matter atrophy in the frontal, parietal and temporal lobes ipsilateral to infarct. In stroke subjects, better dCA was associated with less temporal lobe gray matter atrophy on the infracted side ( = 0.029), faster gait speed ( = 0.018) and lower IADL score (0.002). Our results indicate that better dynamic cerebral perfusion regulation is associated with less atrophy and better long-term functional status in older adults with chronic ischemic infarctions.     

Comparison of lower extremity kinematic curves during overground and treadmill running

Researchers conduct gait analyses utilizing both overground and treadmill modes of running. Previous studies comparing these modes analyzed discrete variables. Recently, techniques involving quantitative pattern analysis have assessed kinematic curve similarity in gait. Therefore, the purpose of this study was to compare hip, knee and rearfoot 3-D kinematics between overground and treadmill running using quantitative kinematic curve analysis. Twenty runners ran at 3.35 m/s ± 5% during treadmill and overground conditions while right lower extremity kinematics were recorded. Kinematics of the hip, knee and rearfoot at footstrike and peak were compared using intraclass correlation coefficients. Kinematic curves during stance phase were compared using the trend symmetry method within each subject. The overall average trend symmetry was high, 0.94 (1.0 is perfect symmetry) between running modes. The transverse plane and knee frontal plane exhibited lower similarity (0.86-0.90). Other than a 4.5 degree reduction in rearfoot dorsiflexion at footstrike during treadmill running, all differences were ≤1.5 degrees. 17/18 discrete variables exhibited modest correlations (>0.6) and 8/18 exhibited strong correlations (>0.8). In conclusion, overground and treadmill running kinematic curves were generally similar when averaged across subjects. Although some subjects exhibited differences in transverse plane curves, overall, treadmill running was representative of overground running for most subjects.     

The influence of body weight support on ankle mechanics during treadmill walking

The use of body weight support (BWS) systems during locomotor retraining has become routine in clinical settings. BWS alters load receptor feedback, however, and may alter the biomechanical role of the ankle plantarflexors, influencing gait. The purpose of this study was to characterize the biomechanical adaptations that occur as a result of a change in limb load (controlled indirectly through BWS) and gait speed during treadmill locomotion. Fifteen unimpaired participants underwent gait analysis with surface electromyography while walking on an instrumented dual-belt treadmill at seven different speeds (ranging from 0.4 to 1.6 m/s) and three BWS conditions (ranging from 0% to 40% BWS). While walking, spatiotemporal measures, anterior/posterior ground reaction forces, and ankle kinetics and muscle activity were measured and compared between conditions. At slower gait speeds, propulsive forces and ankle kinetics were unaffected by changing BWS; however, at gait speeds ≥approximately 0.8 m/s, an increase in BWS yielded reduced propulsive forces and diminished ankle plantarflexor moments and powers. Muscle activity remained unaltered by changing BWS across all gait speeds. The use of BWS could provide the advantage of faster walking speeds with the same push-off forces as required of a slower speed. While the use of BWS at slower speeds does not appear to detrimentally affect gait, it may be important to reduce BWS as participants progress with training, to encourage maximal push-off forces. The reduction in plantarflexor kinetics at higher speeds suggests that the use of BWS in higher functioning individuals may impair the ability to relearn walking.     

Specific features of the oscillatory brain activity during the final stage of creative problem solving in young and elderly subjects

The neurophysiological mechanisms underlying retention of creative potential during aging are still poorly studied. Previously, we have identified age-related changes in the temporal dynamics of brain activity and the speed of creative problem solving at its initial stage, suggesting that younger and older subjects used different strategies. These differences in strategies may also be observed at the final stage of problem solving. Therefore, we have studied the pattern of temporal changes in the EEG spectral characteristics (event-related spectral perturbation, ERSP) in younger (N = 89, 22.1 ± 3.2 years) and older (N = 90, 64.9 ± 6.7 years) age cohorts during 600 ms before the preparation to motor response, which indicates that solution is found. The general and ageand sex-related features of the oscillatory brain activity at the final stage of problem solving were revealed. All subjects displayed statistically significant EEG temporal dynamics associated with a reduction of power reactivity of rhythms prior to the response. The age-related differences included more pronounced ERSP frontal–parietal gradient in the θ frequency range and lower ERSP values in the β frequency range in elderly subjects as compared with the younger individuals. The most pronounced age-related differences in the β₁ rhythm were observed in the posterior cortex. The age-related differences in the α₃ frequency range were mediated by the sex factor: lateral differences were pronounced only in young men, and the coefficient of hemispheric asymmetry in this group differed significantly from that in older men and younger women. These data reflect the changes in EEG that were associated with the evaluation of creative idea, making a decision about completion of the search, and intention to make a motor response that indicates that solution is found.     

Spatial organization of biopotentials and decision-making time during purposeful mental activity in humans

Features of spatial organization of neocortical potentials were studied in subjects with different decision-making time during performing the task of memorizing and subsequently reproducing, on a monitor screen, a sequence of signals. The subjects with a short decision-making time differed from those with a long decision-making time in a higher level of the intra- and interhemispheric coherence in alpha EEG frequency band different neocortical areas during reproduction of a signal sequence (coherence in the frontal, central and parietal areas; coherence between the right central and the left frontal, central, parietal, occipital and temporal areas; coherence between the left occipital and both the frontal areas).     

Walking with increased ankle pushoff decreases hip muscle moments

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.     

Determination of toe-off event time during treadmill locomotion using kinematic data

Researchers collecting gait kinematic data during treadmill locomotion are often interested in determining the times of toe off and heel strike for each stride. In the absence of additional hardware, only position data collected with motion-capture equipment may be available. Others have published methods for using kinematic data for detecting overground gait events. However, during treadmill locomotion, especially running, overground methods may not possess sufficient accuracy. The purpose of this paper is to describe a method for using kinematic data to determine the time of toe off during treadmill locomotion. Ten subjects walked and ran on a treadmill while a motion-capture system collected positional data from heel and toe markers. The treadmill was equipped with force platforms that allowed an accurate determination of foot-ground contact. The time of toe off was determined using the vertical component of the toe marker, and this method was found to have greater accuracy for event detection than other published methods. Researchers can use the described method to determine times of heel strike and toe off during treadmill locomotion using only kinematic data.