Modular control of human walking: A simulation study

Recent evidence suggests that performance of complex locomotor tasks such as walking may be accomplished using a simple underlying organization of co-active muscles, or “modules”, which have been assumed to be structured to perform task-specific biomechanical functions. However, no study has explicitly tested whether the modules would actually produce the biomechanical functions associated with them or even produce a well-coordinated movement. In this study, we generated muscle-actuated forward dynamics simulations of normal walking using muscle activation modules (identified using non-negative matrix factorization) as the muscle control inputs to identify the contributions of each module to the biomechanical sub-tasks of walking (i.e., body support, forward propulsion, and leg swing). The simulation analysis showed that a simple neural control strategy involving five muscle activation modules was sufficient to perform the basic sub-tasks of walking. Module 1 (gluteus medius, vasti, and rectus femoris) primarily contributed to body support in early stance while Module 2 (soleus and gastrocnemius) contributed to both body support and propulsion in late stance. Module 3 (rectus femoris and tibialis anterior) acted to decelerate the leg in early and late swing while generating energy to the trunk throughout swing. Module 4 (hamstrings) acted to absorb leg energy (i.e., decelerate it) in late swing while increasing the leg energy in early stance. Post-hoc analysis revealed an additional module (Module 5: iliopsoas) acted to accelerate the leg forward in pre- and early swing. These results provide evidence that the identified modules can act as basic neural control elements that generate task-specific biomechanical functions to produce well-coordinated walking.     

Mechanical energetic contributions from individual muscles and elastic prosthetic feet during symmetric unilateral transtibial amputee walking: a theoretical study

Energy storage and return (ESAR) foot-ankle prostheses have been developed in an effort to improve gait performance in lower-limb amputees. However, little is known about their effectiveness in providing the body segment mechanical energetics normally provided by the ankle muscles. The objective of this theoretical study was to use muscle-actuated forward dynamics simulations of unilateral transtibial amputee and non-amputee walking to identify the contributions of ESAR prostheses to trunk support, forward propulsion and leg swing initiation and how individual muscles must compensate in order to produce a normal, symmetric gait pattern. The simulation analysis revealed the ESAR prosthesis provided the necessary trunk support, but it could not provide the net trunk forward propulsion normally provided by the plantar flexors and leg swing initiation normally provided by the biarticular gastrocnemius. To compensate, the residual leg gluteus maximus and rectus femoris delivered increased energy to the trunk for forward propulsion in early stance and late stance into pre-swing, respectively, while the residual iliopsoas delivered increased energy to the leg in pre- and early swing to help initiate swing. In the intact leg, the soleus, gluteus maximus and rectus femoris delivered increased energy to the trunk for forward propulsion in the first half of stance, while the iliopsoas increased the leg energy it delivered in pre- and early swing. Thus, the energy stored and released by the ESAR prosthesis combined with these muscle compensations was able to produce a normal, symmetric gait pattern, although various neuromuscular and musculoskeletal constraints may make such a pattern non-optimal.     

Differences in muscle function during walking and running at the same speed

Individual muscle contributions to body segment mechanical energetics and the functional tasks of body support and forward propulsion in walking and running at the same speed were quantified using forward dynamical simulations to elucidate differences in muscle function between the two different gait modes. Simulations that emulated experimentally measured kinesiological data of young adults walking and running at the preferred walk-to-run transition speed revealed that muscles use similar biomechanical mechanisms to provide support and forward propulsion during the two tasks. The primary exception was a decreased contribution of the soleus to forward propulsion in running, which was previously found to be significant in walking. In addition, the soleus distributed its mechanical power differently to individual body segments between the two gait modes from mid- to late stance. In walking, the soleus transferred mechanical energy from the leg to the trunk to provide support, but in running it delivered energy to both the leg and trunk. In running, earlier soleus excitation resulted in it working in synergy with the hip and knee extensors near mid-stance to provide the vertical acceleration for the subsequent flight phase in running. In addition, greater power output was produced by the soleus and hip and knee extensors in running. All other muscle groups distributed mechanical power among the body segments and provided support and forward propulsion in a qualitatively similar manner in both walking and running.     

Muscle and prosthesis contributions to amputee walking mechanics: A modeling study

Unilateral, below-knee amputees have altered gait mechanics, which can significantly affect their mobility. Below-knee amputees lose the functional use of the ankle muscles, which are critical during walking to provide body support, forward propulsion, leg-swing initiation and mediolateral balance. Thus, either muscles must compensate or the prosthesis must provide the functional tasks normally provided by the ankle muscles. Three-dimensional (3D) forward dynamics simulations of amputee and non-amputee walking were generated to identify muscle and prosthesis contributions to amputee walking mechanics, including the subtasks of body support, forward propulsion, leg-swing initiation and mediolateral balance. Results showed that the prosthesis provided body support in the absence of the ankle muscles. The prosthesis contributed to braking from early to mid-stance and propulsion in late stance. The prosthesis also functioned like the uniarticular soleus muscle by transferring energy from the residual leg to the trunk to provide trunk propulsion. The residual-leg vasti and rectus femoris reduced their contributions to braking in early stance, which mitigated braking from the prosthesis during this period. The prosthesis did not replace the function of the gastrocnemius, which normally generates energy to the leg to initiate swing. As a result, lower overall energy was delivered to the residual leg. The prosthesis also acted to accelerate the body laterally in the absence of the ankle muscles. These results provide further insight into muscle and prosthesis function in below-knee amputee walking and can help guide rehabilitation methods and device designs to improve amputee mobility.     

Effects of load inversion in cockroach walking

To examine how walking patterns are adapted to changes in load, we recorded leg movements and muscle activities when cockroaches (Periplaneta americana) walked upright and on an inverted surface. Animals were videotaped to measure the hindleg femoro-tibial joint angle while myograms were taken from the tibial extensor and flexor muscles. The joint is rapidly flexed during swing and extended in stance in upright and inverted walking. When inverted, however, swing is shorter in duration and the joint traverses a range of angles further in extension. In slow upright walking, slow flexor motoneurons fire during swing and the slow extensor in stance, although a period of co-contraction occurs early in stance. In inverted walking, patterns of muscle activities are altered. Fast flexor motoneurons fire both in the swing phase and early in stance to support the body by pulling the animal toward the substrate. Extensor firing occurs late in stance to propel the animal forward. These findings are discussed within the context of a model in which stance is divided into an early support and subsequent propulsion phase. We also discuss how these changes in use of the hindleg may represent adaptations to the reversal of the effects of gravity.     

Pre-swing deficits in forward propulsion,swing initiation and power generation by individual muscles during hemiparetic walking

Clinical studies of hemiparetic walking have shown pre-swing abnormalities in the paretic leg suggesting that paretic muscle contributions to important biomechanical walking subtasks are different than those of non-disabled individuals. Three-dimensional forward dynamics simulations of two representative hemiparetic subjects with different levels of walking function classified by self-selected walking speed (i.e., limited community=0.4–0.8 m/s and community walkers=>0.8 m/s) and a speed-matched control were generated to quantify individual muscle contributions to forward propulsion, swing initiation and power generation during the pre-swing phase (i.e., double support phase proceeding toe-off). Simulation analyses identified decreased paretic soleus and gastrocnemius contributions to forward propulsion and power generation as the primary impairment in the limited community walker compared to the control subject. The non-paretic leg did not compensate for decreased forward propulsion by paretic muscles during pre-swing in the limited community walker. Paretic muscles had the net effect to absorb energy from the paretic leg during pre-swing in the community walker suggesting that deficits in swing initiation are a primary impairment. Specifically, the paretic gastrocnemius and hip flexors (i.e., iliacus, psoas and sartorius) contributed less to swing initiation and the paretic soleus and gluteus medius absorbed more power from the paretic leg in the community walker compared to the control subject. Rehabilitation strategies aimed at diminishing these deficits have much potential to improve walking function in these hemiparetic subjects and those with similar deficits.     

Modular control of human walking: Adaptations to altered mechanical demands

Studies have suggested that the nervous system may adopt a control scheme in which synergistic muscle groups are controlled by common excitation patters, or modules, to simplify the coordination of movement tasks such as walking. A recent computer modeling and simulation study of human walking using experimentally derived modules as the control inputs provided evidence that individual modules are associated with specific biomechanical subtasks, such as generating body support and forward propulsion. The present study tests whether the modules identified during normal walking could produce simulations of walking when the mechanical demands were substantially altered. Walking simulations were generated that emulated human subjects who had their body weight and/or body mass increased and decreased by 25%. By scaling the magnitude of five module patterns, the simulations could emulate the subjects’ response to each condition by simply scaling the mechanical output from modules associated with specific biomechanical subtasks. Specifically, the modules associated with providing body support increased (decreased) their contribution to the vertical ground reaction force when body weight was increased (decreased) and the module associated with providing forward propulsion increased its contribution to the positive anterior–posterior ground reaction force and positive trunk power when the body mass was increased. The modules that contribute to controlling leg swing were unaffected by the perturbations. These results support the idea that the nervous system may use a modular control strategy and that flexible modulation of module recruitment intensity may be sufficient to meet large changes in mechanical demand.     

Phase-Dependent Effects of Transcutaneous Spinal Cord Stimulation on Regulation of Kinematics of Human Stepping Motions

The effect of transcutaneous electrical spinal cord stimulation on the kinematic parameters of movement of the ipsilateral and contralateral legs in healthy subjects during treadmill walking at speeds of 1.5 to 1.7 km/h has been studied. The stimulation electrodes were placed 2.5 cm lateral from the right and left sides of the spinal midline at L1 and T11 levels. During the stance phase, stimulation was administered at L1 level at a frequency of 15 Hz; during the swing phase the stimuli was delivered to T11 at a frequency of 30 Hz, followed by alternating stimulation at L1 and T11. The stimulation during the swing phase (T11) was more effective than that during the stance phase (L1); the most impressive changes in kinematic parameters were observed when combined delivery of stimulations to L1 and T11 was performed. With unilateral spinal stimulation, the amplitude of the angles in the hip, knee and/or ankle joints, the length of the transfer, and the height of the leg elevation increased in the ipsilateral leg. Similar but less pronounced changes were observed in the contralateral leg. A 10% increase in the duration of stimulation in the swing phase caused a change in the kinematic stepping parameters both in ipsilateral and contralateral legs. The maximum effect was observed when bilateral alternating stimulation was used. These data show that phasic transcutaneous electrical spinal cord stimulation, using a wide range of natural walking speeds, can be applied to control kinematic movement parameters.

     

Contributions of the individual ankle plantar flexors to support, forward progression and swing initiation during walking.

Walking is a motor task requiring coordination of many muscles. Previous biomechanical studies, based primarily on analyses of the net ankle moment during stance, have concluded different functional roles for the plantar flexors. We hypothesize that some of the disparities in interpretation arise because of the effects of the uniarticular and biarticular muscles that comprise the plantar flexor group have not been separated. Furthermore, we believe that an accurate determination of muscle function requires quantification of the contributions of individual plantar flexor muscles to the energetics of individual body segments. In this study, we examined the individual contributions of the ankle plantar flexors (gastrocnemius (GAS); soleus (SOL)) to the body segment energetics using a musculoskeletal model and optimization framework to generate a forward dynamics simulation of normal walking at 1.5 m/s. At any instant in the gait cycle, the contribution of a muscle to support and forward progression was defined by its contribution to trunk vertical and horizontal acceleration, respectively, and its contribution to swing initiation by the mechanical energy it delivers to the leg in pre-swing (i.e., double-leg stance prior to toe-off). GAS and SOL were both found to provide trunk support during single-leg stance and pre-swing. In early single-leg stance, undergoing eccentric and isometric activity, they accelerate the trunk vertically but decelerate forward trunk progression. In mid single-leg stance, while isometric, GAS delivers energy to the leg while SOL decelerates it, and SOL delivers energy to the trunk while GAS decelerates it. In late single-leg stance through pre-swing, though GAS and SOL both undergo concentric activity and accelerate the trunk forward while decelerating the downward motion of the trunk (i.e., providing forward progression and support), they execute different energetic functions. The energy produced from SOL accelerates the trunk forward, whereas GAS delivers almost all its energy to accelerate the leg to initiate swing. Although GAS and SOL maintain or accelerate forward motion in mid single-leg stance through pre-swing, other muscles acting at the beginning of stance contribute comparably to forward progression. In summary, throughout single-leg stance both SOL and GAS provide vertical support, in mid single-leg stance SOL and GAS have opposite energetic effects on the leg and trunk to ensure support and forward progression of both the leg and trunk, and in pre-swing only GAS contributes to swing initiation.     

Muscle contributions to whole-body sagittal plane angular momentum during walking

Walking is a complex dynamic task that requires the regulation of whole-body angular momentum to maintain dynamic balance while performing walking subtasks such as propelling the body forward and accelerating the leg into swing. In human walking, the primary mechanism to regulate angular momentum is muscle force generation. Muscles accelerate body segments and generate ground reaction forces that alter angular momentum about the body’s center-of-mass to restore and maintain dynamic stability. In addition, gravity contributes to whole-body angular momentum through its contribution to the ground reaction forces. The purpose of this study was to generate a muscle-actuated forward dynamics simulation of normal walking to quantify how individual muscles and gravity contribute to whole-body angular momentum in the sagittal plane. In early stance, the uniarticular hip and knee extensors (GMAX and VAS), biarticular hamstrings (HAM) and ankle dorsiflexors (TA) generated backward angular momentum while the ankle plantar flexors (SOL and GAS) generated forward momentum. In late stance, SOL and GAS were the primary contributors and generated angular momentum in opposite directions. SOL generated primarily forward angular momentum while GAS generated backward angular momentum. The difference between muscles was due to their relative contributions to the horizontal and vertical ground reaction forces. Gravity contributed to the body’s angular momentum in early stance and to a lesser extent in late stance, which was counteracted primarily by the plantar flexors. These results may provide insight into balance and movement disorders and provide a basis for developing locomotor therapies that target specific muscle groups.     

Energy cost and muscular activity required for leg swing during walking.

To investigate the metabolic cost and muscular actions required for the initiation and propagation of leg swing, we applied a novel combination of external forces to subjects walking on a treadmill. We applied a forward pulling force at each foot to assist leg swing, a constant forward pulling force at the waist to provide center of mass propulsion, and a combination of these foot and waist forces to evaluate leg swing. When the metabolic cost and muscle actions were at a minimum, the condition was considered optimal. We reasoned that the difference in energy consumption between the optimal combined waist and foot force trial and the optimal waist force-only trial would reflect the metabolic cost of initiating and propagating leg swing during normal walking. We also reasoned that a lower muscle activity with these assisting forces would indicate which muscles are normally responsible for initiating and propagating leg swing. With a propulsive force at the waist of 10% body weight (BW), the net metabolic cost of walking decreased to 58% of normal walking. With the optimal combination, a propulsive force at the waist of 10% BW plus a pulling force at the feet of 3% BW the net metabolic cost of walking further decreased to 48% of normal walking. With the same combination, the muscle activity of the iliopsoas and rectus femoris muscles during the swing phase was 27 and 60% lower, respectively, but the activity of the medial gastrocnemius and soleus before swing did not change. Thus our data indicate that approximately 10% of the net metabolic cost of walking is required to initiate and propagate leg swing. Additionally, the hip flexor muscles contribute to the initiation and propagation leg swing.     

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.     

Muscle activity patterns of the tensor fascia latae and adductor longus for ramp and stair walking

Walking on both outdoor and indoor surfaces requires the ability to negotiate connections between vertical distances, simply known as hills and stairs. Therefore, the purpose of the present study was to evaluate the muscle activity patterns of the TFL and ADL during both hill and stair walking. We hypothesized that TFL and ADL activity during initial swing, initial stance, and late stance of up-ramp and up-stair walking would be greater than level walking. In contrast, we hypothesized that both TFL and ADL activity during initial swing of down-ramp and down-stair walking would be less. We utilized a 15° ramp, a 35° stair set, and for comparison of this steep angle, we also collected data on a 33° ramp. During up-ramp and up-stair walking, TFL and ADL activity during both initial swing and late stance of the up conditions were greater than level walking. For the down conditions, ADL activity during the swing phase of the steep down-ramp was less. Practically, our muscle activity results demonstrate that the hip abductors and hip adductors may provide additional pelvic stability and supplementary thigh acceleration during ramp and stair walking.     

Biomechanical strategies for successful obstacle crossing with the trailing limb in older adults with medial compartment knee osteoarthritis

To investigate the biomechanical strategy adopted by older adults with medial compartment knee osteoarthritis (OA) for successful obstacle crossing with the trailing limb, and to discuss its implications for fall-prevention, 15 older adults with bilateral medial compartment knee OA and 15 healthy controls were recruited to walk and cross obstacles of heights of 10%, 20%, and 30% of their leg lengths. Kinematic and kinetic data were obtained using a three-dimensional (3D) motion analysis system and forceplates. The OA group had higher trailing toe clearance than the controls. When the trailing toe was above the obstacle, the OA group showed greater swing hip abduction, yet smaller stance hip adduction, knee flexion, and ankle eversion. They showed greater pelvic anterior tilt and toe-out angle. They also exhibited greater peak knee abductor moments during early stance and at the instant when the swing toe was above the obstacle, while a greater peak hip abductor moment was found during late stance. Smaller knee extensor, yet greater hip extensor moments, were found in the OA group throughout the stance phase. In order to achieve higher toe clearance with knee OA, particular joint kinematic and kinetic strategies have been adopted by the OA group. Weakness in the hip abductors and extensors in individuals with OA may be risk factors for tripping owing to the greater demands on these muscle groups during obstacle crossing by these individuals.     

Propulsive adaptation to changing gait speed

Understanding propulsion and adaptation to speed requirements is important in determining appropriate therapies for gait disorders. We hypothesize that adaptations for changing speed requirements occur primarily at the hip. The slow, normal and fast gait of 24 healthy young subjects was analyzed. The linear power was analyzed at the hip joint. The anterior-posterior and vertical induced accelerations of the hip were also determined. Linear power and anterior-posterior-induced acceleration (IA) analyses of the hip reveal that the lower limb joint's moments contribute to body forward propulsion primarily during late swing and early stance. Propulsive adaptations to speed changes occur primarily at the hip and secondarily at the ankle. These analyses show that hip muscles, particularly the hip extensors, are critical to propulsion. They also show that ankle function is primarily for support, but is important to propulsion, especially at slow speeds.     

An electromyographic analysis of hindlimb function in Alligator during terrestrial locomotion

The neuromuscular control of the hindlimb of American alligators (Alligator mississippiensis) walking on a treadmill was analyzed using simultaneous electromyography (EMG) and cineradiography. EMG and kinematic data were integrated with myological information to discern the interplay of muscles mediating hip and knee movement during the high walk. Twelve muscles, subdivided into 23 individual heads, cross the hip joint of Alligator. Activity patterns of 12 heads of 11 hip muscles and one knee muscle were recorded and quantified. An additional five heads from four muscles were recorded in single individuals. During the stance phase, the caudofemoralis longus prevents hip flexion and actively shortens to retract the femur through an arc of 60–80°. At the same time, the adductor femoris 1 and pubo-ischio-tibialis control femoral abduction. The knee is extended 30–40° during stance by contraction of the femoro-tibialis internus. These stance phase muscles often produce discontinuous, periodic EMG signals within their normal burst profile. In late stance and early swing, the ilio-fibularis and the pubo-ischio-tibialis are responsible for flexing the knee. The limb is protracted by the pubo-ischio-femoralis internus 2 and pubo-ischio-femoralis externus 2, which flex the hip. The ilio-femoralis abducts the limb during swing to suspend it above the tread. The role of the ambiens 1, which is active in midswing, is unclear. The ilio-tibialis 2, flexor-tibialis externus and flexor-tibialis internus 2 yield sporadic, low amplitude EMGs; these muscles are recruited at a very low level, if at all, during the slow high walk. Although EMGs do not conclusively delineate muscle function, activity patterns are particularly helpful in elucidating the complex interaction of muscular heads in this system. J. Morphol. 234:197–212, 1997. © 1997 Wiley-Liss, Inc.     

A bipedal compliant walking model generates periodic gait cycles with realistic swing dynamics

A simple spring mechanics model can capture the dynamics of the center of mass (CoM) during human walking, which is coordinated by multiple joints. This simple spring model, however, only describes the CoM during the stance phase, and the mechanics involved in the bipedality of the human gait are limited. In this study, a bipedal spring walking model was proposed to demonstrate the dynamics of bipedal walking, including swing dynamics followed by the step-to-step transition. The model consists of two springs with different stiffnesses and rest lengths representing the stance leg and swing leg. One end of each spring has a foot mass, and the other end is attached to the body mass. To induce a forward swing that matches the gait phase, a torsional hip joint spring was introduced at each leg. To reflect the active knee flexion for foot clearance, the rest length of the swing leg was set shorter than that of the stance leg, generating a discrete elastic restoring force. The number of model parameters was reduced by introducing dependencies among stiffness parameters. The proposed model generates periodic gaits with dynamics-driven step-to-step transitions and realistic swing dynamics. While preserving the mimicry of the CoM and ground reaction force (GRF) data at various gait speeds, the proposed model emulated the kinematics of the swing leg. This result implies that the dynamics of human walking generated by the actuations of multiple body segments is describable by a simple spring mechanics.     

Pattern of reflex responses in lower limb muscles to a resistance in walking man

Reflex responses in the lower limbs were investigated using electromyographic and kinematic techniques in man walking on a treadmill. A momentary resistance was applied to one leg at three selected points in the step cycle. The responses to such stimuli, as well as the locomotor activity, were picked up electromyographically and displayed on a four channel oscilloscope. Four superficial muscles viz: gluteus medius, vastus lateralis, rectus femoris and tibialis anterior were studied in both ipsilateral and contralateral legs. In general it was found that the ipsilateral leg muscles produced a response throughout the step cycle regardless of whether the muscle was active or silent at the time the reflex occurred. In contrast, contralateral leg muscles showed a different pattern of response which depended on where the resistance was applied in the step cycle. The long reflex latency, of the order of 80 ms, was a consistent feature of the responses and suggests the possible involvement of supra-spinal pathways. The latencies for a particular muscle were identical on the ipsi- and contralateral sides. The durations of the swing and stance phases of the step cycle were also recorded but showed no change due to application of the resistance. In general, the results indicate that the body has the inherent ability to reinforce the ongoing locomotor muscle activity in response to external stimuli in order to maintain upright balanced walking.     

Muscle contributions to support and progression over a range of walking speeds

Muscles actuate walking by providing vertical support and forward progression of the mass center. To quantify muscle contributions to vertical support and forward progression (i.e., vertical and fore-aft accelerations of the mass center) over a range of walking speeds, three-dimensional muscle-actuated simulations of gait were generated and analyzed for eight subjects walking overground at very slow, slow, free, and fast speeds. We found that gluteus maximus, gluteus medius, vasti, hamstrings, gastrocnemius, and soleus were the primary contributors to support and progression at all speeds. With the exception of gluteus medius, contributions from these muscles generally increased with walking speed. During very slow and slow walking speeds, vertical support in early stance was primarily provided by a straighter limb, such that skeletal alignment, rather than muscles, provided resistance to gravity. When walking speed increased from slow to free, contributions to support from vasti and soleus increased dramatically. Greater stance-phase knee flexion during free and fast walking speeds caused increased vasti force, which provided support but also slowed progression, while contralateral soleus simultaneously provided increased propulsion. This study provides reference data for muscle contributions to support and progression over a wide range of walking speeds and highlights the importance of walking speed when evaluating muscle function.     

Combining muscle synergies and biomechanical analysis to assess gait in stroke patients

The understanding of biomechanical deficits and impaired neural control of gait after stroke is crucial to prescribe effective customized treatments aimed at improving walking function. Instrumented gait analysis has been increasingly integrated into the clinical practice to enhance precision and inter-rater reliability for the assessment of pathological gait. On the other hand, the analysis of muscle synergies has gained relevance as a novel tool to describe the neural control of walking. Since muscle synergies and gait analysis capture different but equally important aspects of walking, we hypothesized that their combination can improve the current clinical tools for the assessment of walking performance.To test this hypothesis, we performed a complete bilateral, lower limb biomechanical and muscle synergies analysis on nine poststroke hemiparetic patients during overground walking. Using stepwise multiple regression, we identified a number of kinematic, kinetic, spatiotemporal and synergy-related features from the paretic and non-paretic side that, combined together, allow to predict impaired walking function better than the Fugl-Meyer Assessment score. These variables were time of peak knee flexion, VAF_total values, duration of stance phase, peak of paretic propulsion and range of hip flexion. Since these five variables describe important biomechanical and neural control features underlying walking deficits poststroke, they may be feasible to drive customized rehabilitation therapies aimed to improve walking function.This paper demonstrates the feasibility of combining biomechanical and neural-related measures to assess locomotion performance in neurologically injured individuals.