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15 pages, 2729 KiB

Open AccessArticle

Asymmetric Knee Joint Loading in Post-Stroke Gait: A Musculoskeletal Modeling Analysis of Medial and Lateral Compartment Forces

by Georgios Giarmatzis, Nikolaos Aggelousis, Marinos Marinidis, Styliani Fotiadou, Erasmia Giannakou, Evangelia Makri, Junshi Liu and Konstantinos Vadikolias

Biomechanics 2025, 5(2), 39; https://doi.org/10.3390/biomechanics5020039 - 11 Jun 2025

Abstract

Background/Objectives: Stroke survivors often develop asymmetric gait patterns that may lead to abnormal knee joint loading and potentially increased risk of osteoarthritis. This study aimed to investigate differences in knee joint loading between paretic and non-paretic limbs during walking in individuals post-stroke. Methods [...] Read more.

Background/Objectives: Stroke survivors often develop asymmetric gait patterns that may lead to abnormal knee joint loading and potentially increased risk of osteoarthritis. This study aimed to investigate differences in knee joint loading between paretic and non-paretic limbs during walking in individuals post-stroke. Methods: Twenty-one chronic stroke survivors underwent three-dimensional gait analysis. A modified musculoskeletal model with a specialized knee mechanism was used to estimate medial and lateral tibiofemoral contact forces during the stance phase. Statistical parametric mapping was used to identify significant differences in joint kinematics, kinetics, and contact forces between limbs. Stepwise regression analyses examined relationships between knee moments and compartmental contact forces. Results: Significant differences in knee loading were observed between limbs, with the non-paretic limb experiencing higher medial compartment forces during early stance (6.7–15.1%, p = 0.001; 21.9–30.7%, p = 0.001) and late stance (72.3–93.7%, p < 0.001), and higher lateral compartment forces were recorded during pre-swing (86.2–99.0%, p < 0.001). In the non-paretic limb, knee extensor moment was the primary predictor of first peak medial contact force (R² = 0.573), while knee abductor moment was the primary predictor in the paretic limb (R² = 0.559). Conclusions: Musculoskeletal modeling revealed distinct asymmetries in knee joint loading between paretic and non-paretic limbs post-stroke, with the non-paretic limb experiencing consistently higher loads, particularly during late stance. These findings suggest that rehabilitation strategies should address not only paretic limb function but also potentially harmful compensatory mechanisms in the non-paretic limb to prevent long-term joint degeneration. Full article

(This article belongs to the Special Issue Gait and Balance Control in Typical and Special Individuals)

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9 pages, 889 KiB

Open AccessArticle

Curve Analysis of Foot Coupling Kinematics in Runners with Plantar Heel Pain During Running Gait

by Hanieh Pazhooman, Robin L. Pomeroy, Mohammed S. Alamri, Zahra Mollaei and Stephen C. Cobb

Biomechanics 2025, 5(2), 34; https://doi.org/10.3390/biomechanics5020034 - 30 May 2025

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Abstract

(1) Background: Plantar heel pain (PHP), a common overuse foot injury, significantly impacts runners. While the mechanical role of the plantar fascia during gait is established, its effect on foot function during running, particularly foot joint coupling, remains unclear. This study investigated foot [...] Read more.

(1) Background: Plantar heel pain (PHP), a common overuse foot injury, significantly impacts runners. While the mechanical role of the plantar fascia during gait is established, its effect on foot function during running, particularly foot joint coupling, remains unclear. This study investigated foot joint coupling during running in runners with and without PHP using statistical parametric mapping (SPM). (2) Methods: Thirteen uninjured runners (seven m, six f; age = 30.5 ± 5.9 years; BMI = 23.5 ± 3.0 kg/m²) and thirteen runners with PHP (six m, seven f; age = 29.0 ± 8.0 years; BMI = 23.1 ± 2.0 kg/m²) performed running trials at 4.0 m/s. A seven-segment foot model that defined six functional articulations (rearfoot, medial and lateral midfoot, medial and lateral forefoot, first metatarsophalangeal) was used to quantify foot kinematics, vector coding was used to calculate joint coupling between adjacent foot segments, and SPM was used to analyze joint stance phase coupling angles. (3) Results: There were statistically significant differences in rearfoot frontal plane–medial midfoot frontal plane joint coupling between runners with and without PHP from 69 to 70% stance phase (mean difference = 39.41°) and at 76% stance (mean difference = 47.89°). The differences were indicative of greater medial midfoot eversion rotation relative to rearfoot complex inversion in the PHP group. (4) Conclusions: The difference in the rearfoot complex and medial midfoot frontal plane coupling occurred during the propulsion phase of the running stance when the foot should be transitioning to a more supinated position, which may reflect compromised supination due to plantar fascia degeneration. Full article

(This article belongs to the Special Issue Gait and Balance Control in Typical and Special Individuals)

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14 pages, 3010 KiB

Open AccessArticle

Effects of Simulated Hyper-Gravity on Lower Limb Kinematics and Electromyography During Walking

by Christopher A. Malaya, Pranav J. Parikh, Dean L. Smith and Charles S. Layne

Biomechanics 2025, 5(2), 31; https://doi.org/10.3390/biomechanics5020031 - 4 May 2025

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Abstract

Background: Gravity profoundly influences human locomotion. Studies examining the effects of hyper-gravity on gait have largely relied on added external mass, potentially confounding results with changes in inertia and center of mass. This study attempted to isolate the effects of increased gravitational load [...] Read more.

Background: Gravity profoundly influences human locomotion. Studies examining the effects of hyper-gravity on gait have largely relied on added external mass, potentially confounding results with changes in inertia and center of mass. This study attempted to isolate the effects of increased gravitational load on kinematics and electromyography during walking at several different levels of load. Methods: Fifteen healthy adults were exposed to simulated gravitational loads ranging from 100% to 130% of body weight using a novel harness and spring-based system that increased weight without the addition of external mass and without altering limb inertia. Participants walked on a treadmill at a self-selected speed through incremental loading and unloading. Lower limb kinematics and electromyography data were recorded. Traditional measures of gait, as well as more dynamical measures, including angle–angle analysis and phase portraits, were examined. Results: Data demonstrated that a 130% load is sufficient to induce kinematic changes at the hip and knee; however, these changes become significant only during the transition from 130% to lower load levels. Ankle kinematics and electromyography appeared to be unaffected. Conclusions: These findings suggest that the presence of external mass and alterations in limb inertias should be considered seriously as independent variables in future loading studies, and that weight and mass may need to be considered as separate effectors during locomotion. This study also found that the act of loading and unloading elicit distinct responses in the joints of the lower extremities, as well as that it may induce an adaptative after-effect. Full article

(This article belongs to the Special Issue Gait and Balance Control in Typical and Special Individuals)

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10 pages, 458 KiB

Open AccessArticle

Exploring the Effect of Prolonged Ankle Plantar-Flexed Standing on Postural Control, Balance Confidence, Falls Efficacy, and Perceived Balance in Older Adults

by Daniel Craig Low

Biomechanics 2025, 5(2), 19; https://doi.org/10.3390/biomechanics5020019 - 24 Mar 2025

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Abstract

Background/Objectives: Postural control describes our ability to maintain an upright position. This study explored the impact of prolonged ankle plantar-flexed standing on postural control variability and strategy in an older adult population. The ability to perceive balance change was also assessed via subjective [...] Read more.

Background/Objectives: Postural control describes our ability to maintain an upright position. This study explored the impact of prolonged ankle plantar-flexed standing on postural control variability and strategy in an older adult population. The ability to perceive balance change was also assessed via subjective balance-related variables. Methods: Twenty-four community-dwelling older adults were recruited via convenience sampling. Each participant completed a balance confidence and falls efficacy questionnaire at baseline. Five barefoot quiet standing trials on a force plate then followed (Timepoint 1). After this, the participants stood with their ankles in a plantar-flexed position for up to 7.5 min before completing another quiet standing trial on the force plate. Four further ankle plantar-flexed standing trials of 2 min were then completed, interspersed with quiet standing trials on a force plate (Timepoint 2). The balance confidence and falls efficacy questionnaires were then completed again. For measures of postural control variability (sway path length, root mean square [RMS], sway area) and strategy (fractal dimension), mean values for the five trials were calculated for Timepoints 1 and 2 separately. Results: The sway path length and RMS measures were significantly increased (p < 0.05) at Timepoint 2. However, the fractal dimension did not change. There was also no change in balance confidence or falls efficacy. Conclusions: The findings suggest that prolonged standing can impact measures of postural variability without a change in postural control strategy. Postural control change also occurred without a change in subjective balance measures, suggesting that the altered balance may not be practically significant or perceptible to the individual. Full article

(This article belongs to the Special Issue Gait and Balance Control in Typical and Special Individuals)

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11 pages, 7766 KiB

Open AccessArticle

Nonlinear Gait Variability Increases with Age in Children from 2–10 Years Old

by Bryon C. Applequist, Zachary L. Motz and Anastasia Kyvelidou

Biomechanics 2025, 5(1), 10; https://doi.org/10.3390/biomechanics5010010 - 3 Feb 2025

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Abstract

Background: Linear methods of analysis of variability are concerned with the magnitude of variability and often consider deviations from a central mean as errors. The utilization of nonlinear tools to examine variability allows for the exploration and measurement of the patterns of variability [...] Read more.

Background: Linear methods of analysis of variability are concerned with the magnitude of variability and often consider deviations from a central mean as errors. The utilization of nonlinear tools to examine variability allows for the exploration and measurement of the patterns of variability displayed by the system. This methodology explores the deterministic properties of biological signals, in this case, gait, or how previous iterations within the gait cycle influence subsequent and future iterations. The nonlinear analysis of gait variability of the joint angle time series has not been investigated in developing children. Methods: We collected 3 min of treadmill walking data for 28 children between the ages of 2 and 10 years old and analyzed their joint angle time series using nonlinear methods of analysis (sample entropy, largest Lyapunov exponent, and recurrence quantification analysis). Results: Our results indicate that the nonlinear variability of children’s gait increases as children age. Interestingly, this contrasts with the findings from our previous work that showed a decrease in linear variability as children age. The combination of a decrease in linear variability, or a refined and improved stability of gait, as well as an increase in nonlinear variability, or an increase in the sophistication and quality of movement patterns, suggest an overall maturation of the neuromuscular system. Conclusions: Our study indicate that there is a refining of gait with age and motor maturation. This refining speaks to the overall multifaceted organization of systems that defines the maturation of gait. Full article

(This article belongs to the Special Issue Gait and Balance Control in Typical and Special Individuals)

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13 pages, 1379 KiB

Open AccessArticle

People with Parkinson’s Disease Are Able to Couple Eye Movements and Postural Sway to Improve Stability

by Fabio Augusto Barbieri, Paula Favaro Polastri, José Angelo Barela, Cédrick T. Bonnet, Matheus Belizario Brito and Sergio Tosi Rodrigues

Biomechanics 2024, 4(3), 460-472; https://doi.org/10.3390/biomechanics4030032 - 1 Aug 2024

Cited by 1 | Viewed by 2976

Abstract

Considering that people with Parkinson’s disease (PD) experience challenges in the control of both balance and eye movements, this study investigated the effects of saccadic eye movements on body sway in people with PD in two bases of support positions (side-by-side and tandem [...] Read more.

Considering that people with Parkinson’s disease (PD) experience challenges in the control of both balance and eye movements, this study investigated the effects of saccadic eye movements on body sway in people with PD in two bases of support positions (side-by-side and tandem stances). Ten people with PD and 11 healthy individuals performed (a) fixation; (b) horizontal saccadic eye movements to the right and left; and (c) vertical saccadic eye movements up and down. The protocol for each postural task consisted of one block of six trials, making a total of 12 trials. Body sway and gaze parameters were measured during the trials. In both people with PD and healthy individuals, anterior–posterior body sway was significantly reduced in horizontal saccadic eye movements in contrast to fixation, regardless of the body position (side-by-side and tandem stances). Furthermore, vertical saccadic eye movements increased the area of sway in contrast to horizontal ones (and not to fixation) in people with PD. In addition, people with PD showed a higher number of fixations in all experimental conditions, without changes in the mean duration of fixations in both body positions. In conclusion, individuals with PD can improve body sway by coupling eye movements and postural sway when performing horizontal saccadic eye movements but not when performing vertical saccadic eye movements. Full article

(This article belongs to the Special Issue Gait and Balance Control in Typical and Special Individuals)

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13 pages, 1229 KiB

Open AccessArticle

Evaluation of Voluntary Dynamic Balance through Standardized Squat-Lift Movements: A Comparison between Gymnasts and Athletes from Other Sports

by Jair Wesley Ferreira Bueno, Daniel Boari Coelho and Luis Augusto Teixeira

Biomechanics 2024, 4(3), 439-451; https://doi.org/10.3390/biomechanics4030030 - 21 Jul 2024

Cited by 1 | Viewed by 1326

Abstract

In the quotidian, people perform voluntary whole-body movements requiring dynamic body balance. However, the literature is scarce of dynamic balance evaluations employing standardized voluntary movements. In this investigation, we aimed to analyze the sensitivity of balance evaluation between gymnasts and athletes from other [...] Read more.

In the quotidian, people perform voluntary whole-body movements requiring dynamic body balance. However, the literature is scarce of dynamic balance evaluations employing standardized voluntary movements. In this investigation, we aimed to analyze the sensitivity of balance evaluation between gymnasts and athletes from other sports in the performance of balance tasks. Participants were evaluated in upright quiet standing and the performance of cyclic dynamic tasks of hip flexion-extension and squat-lift movements. Movements were individually standardized in amplitude, while the rhythm was externally paced at the frequency of 0.5 Hz. Tasks were performed on a force plate, with dynamic balance measured through the center of pressure displacement. Results showed that in quiet standing and the dynamic hip flexion-extension task, no significant differences were found between the groups. Conversely, results for the squat-lift task revealed a better balance of the gymnasts over controls, as indicated by the reduced amplitude and velocity of the center of pressure displacement during the task execution. The superior balance performance of gymnasts in the squat-lift task was also observed when vision was suppressed. These findings suggest the employed squat-lift task protocol is a potentially sensitive procedure for the evaluation of voluntary dynamic balance. Full article

(This article belongs to the Special Issue Gait and Balance Control in Typical and Special Individuals)

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54 pages, 1086 KiB

Open AccessSystematic Review

Gait Biomechanical Parameters Related to Falls in the Elderly: A Systematic Review

by Jullyanne Silva, Tiago Atalaia, João Abrantes and Pedro Aleixo

Biomechanics 2024, 4(1), 165-218; https://doi.org/10.3390/biomechanics4010011 - 5 Mar 2024

Cited by 5 | Viewed by 4389

Abstract

According to the World Health Organization, one-third of elderly people aged 65 or over fall annually, and this number increases after 70. Several gait biomechanical parameters were associated with a history of falls. This study aimed to conduct a systematic review to identify [...] Read more.

According to the World Health Organization, one-third of elderly people aged 65 or over fall annually, and this number increases after 70. Several gait biomechanical parameters were associated with a history of falls. This study aimed to conduct a systematic review to identify and describe the gait biomechanical parameters related to falls in the elderly. MEDLINE Complete, Cochrane, Web of Science, and CINAHL Complete were searched for articles on 22 November 2023, using the following search sentence: (gait) AND (fall*) AND ((elder*) OR (old*) OR (senior*)) AND ((kinematic*) OR (kinetic*) OR (biomechanic*) OR (electromyogram*) OR (emg) OR (motion analysis*) OR (plantar pressure)). This search identified 13,988 studies. From these, 96 were selected. Gait speed, stride/step length, and double support phase are gait biomechanical parameters that differentiate fallers from non-fallers. Fallers also tended to exhibit higher variability in gait biomechanical parameters, namely the minimum foot/toe clearance variability. Although the studies were scarce, differences between fallers and non-fallers were found regarding lower limb muscular activity and joint biomechanics. Due to the scarce literature and contradictory results among studies, it is complex to draw clear conclusions for parameters related to postural stability. Minimum foot/toe clearance, step width, and knee kinematics did not differentiate fallers from non-fallers. Full article

(This article belongs to the Special Issue Gait and Balance Control in Typical and Special Individuals)

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