Search Results (110)

To address the complex surface curvature, massive dimensions, and variable pitch angles of wind turbine blades, this paper proposes a climbing robot design based on a variable-cell mechanism. By dynamically adjusting the support span and body posture, the robot adapts to the geometric features of different blade regions, enabling stable and efficient non-destructive inspection operations. Two reconfigurable configurations—a planar quadrilateral and a regular hexagon—are proposed based on the geometric characteristics of different blade regions. The configuration switching conditions and multi-leg cooperative control mechanisms are investigated. Through static stability margin analysis, the stable gait space and maximum stride length for each configuration are determined, optimizing the robot’s motion performance on surfaces with varying curvature. Simulation and experimental results demonstrate that the proposed multi-configuration gait planning strategy exhibits excellent adaptability and climbing stability across segments of varying curvature. This provides a theoretical foundation and methodological support for the engineering application of robots in wind turbine blade maintenance. Full article

Smart assistive technologies such as sensor-based footwear and walking aids offer promising opportunities for gait rehabilitation through real-time feedback and patient-centered monitoring. While biofeedback applications show great potential, current research rarely explores integrated closed-loop systems with device- and modality-specific feedback. In this work, we present a modular sensor-based system combining a smart foot orthosis and an instrumented forearm crutch to deliver real-time vibrotactile biofeedback. The system integrates plantar pressure and motion sensing, vibrotactile feedback, and wireless communication via a smartphone application. We conducted a user study with eight participants to validate the system’s feasibility for mobile gait detection and app usability, and to evaluate different vibrotactile feedback types across the orthosis and forearm crutch. The results indicate that pattern-based vibrotactile feedback was rated as more useful and suitable for regular use than simple vibration alerts. Moreover, participants reported clear perceptual differences between feedback delivered via the orthosis and the forearm crutch, indicating device-dependent feedback perception. The findings highlight the relevance of feedback strategy design beyond hardware implementation and inform the development of user-centered haptic biofeedback systems. Full article

Background/Objectives: Fragile X-associated tremor/ataxia syndrome (FXTAS) is characterized by tremor, gait ataxia, and cerebellar white matter degeneration, along with possible cognitive and cerebral changes. Although diagnostic criteria were originally developed in males, emerging evidence suggests that FXTAS may present differently in females. The present study examined sensorimotor and memory features of aging in female premutation carriers with (FXTAS+) and without FXTAS (FXTAS−). Methods: We studied 51 female premutation carriers (FXTAS+ = 16, FXTAS− = 35) and 24 age-matched female controls. Participants ranged in age from 47–80 years. All participants completed genetic testing, clinical evaluations, T2-weighted MRIs, and quantitative assessments of sensorimotor (precision grip force task) and memory (reading span; visual paired associates task) functions. Results: During precision grip testing, FXTAS+ carriers showed higher sustained force regularity than FXTAS− carriers (p = 0.03, d = 1.0) and controls (p = 0.004, d = 1.1) at low gain levels only. FXTAS+ participants were slower than controls on motor reaction time (p = 0.009, d = 0.82). Initial force output was higher in FXTAS+ than FXTAS− carriers (p = 0.03, d = 1.0) and controls (p = 0.03, d = 1.0) but at low gain only. FXTAS+ carriers exhibited poorer working memory than FXTAS− carriers (p = 0.03, d = 0.91) and controls (p = 0.02, d = 1.0). During a long-term memory task, FXTAS+ participants were less accurate than FXTAS− carriers (p = 0.04, d = 0.86) and controls (p = 0.004, d = 1.1) and showed increased reaction times relative to FXTAS− carriers (p = 0.03, d = −0.82) and controls (p = 0.01, d = −1.2). Conclusions: Together, these findings indicate that FXTAS+ females exhibit distinct motor and cognitive impairments, underscoring the value of quantitative behavioral measures for detecting and tracking neurodegenerative progression in female premutation carriers. Full article

Background and Objectives: This study aimed to compare gait patterns between young adults and physically active older adults. Additionally, the relation between these parameters and age was explored. Materials and Methods: Transversal case and control study, recruiting 81 participants divided into two groups: young adults (18–45 years) and physically active older adults (60+ years). Participants were assessed using the PodoSmart Insole^® system, which recorded spatiotemporal and kinematic gait data. Gait parameters were measured during a self-selected walking test. Data analysis included descriptive statistics, t-tests for group comparisons, and Pearson’s correlation to explore relationships between age and gait parameters. Results: Significant differences in gait parameters were found between young and older adults, particularly in stride length (right foot: p = 0.009, left foot: p = 0.001), cadence (p < 0.001), contact time (p < 0.001), swing time (p < 0.001), and support phase duration (p < 0.001), with moderate to large effect sizes. Sex differences were also observed within each group for several gait variables. Correlation analysis evidenced worsened parameters with increasing age, with moderate to strong associations in terms of cadence (r = −0.590), contact time (r = −0.504, r = −0.462), swing time (r = −0.662), and support phase duration (r = −0.524, r = −0.439). Conclusions: Evident differences in gait parameters are observed between young adults and active older adults. Although these results follow the trend of previous studies that employed more sophisticated lab-based protocols for gait analysis, slight differences between our study and these others could be attributed to the regular physical activity performed by these participants, which should be explored in more detail in future studies. Full article

Congenital agenesis of the tensor fascia lata (TFL) muscle is an extremely rare anomaly, with very few reports in the literature and unclear clinical significance. We report the incidental finding of unilateral TFL agenesis in a 25-year-old male physician who had been enrolled as a healthy control in a muscle MRI study on genetic myopathies. Imaging demonstrated a complete absence of the right TFL with mild compensatory hypertrophy of the ipsilateral rectus femoris, while the contralateral side and all other muscles appeared normal. The subject had no history of neuromuscular disease, exhibited only a subtle waddling gait, and had previously completed the New York Marathon in 4 h and 16 min without symptoms. Laboratory tests, including creatine kinase, were within normal limits. Thirteen years later, he remains in good health, continues regular sports activities, and has not developed pain or functional impairment. This case emphasizes that TFL agenesis may remain clinically silent and compatible with high levels of physical activity. Nevertheless, awareness of such anomalies is important, as compensatory mechanisms might predispose to long-term biomechanical imbalance, and recognition on imaging can prevent misinterpretation or unnecessary investigations Full article

Three-dimensional human pose estimation from monocular video remains challenging for clinical gait analysis due to high computational cost and the need for temporal consistency. We present Pose3DM, a bidirectional Mamba-based state-space framework that models intra-frame joint relations and inter-frame dynamics with linear computational complexity. Replacing transformer self-attention with state-space modeling improves efficiency without sacrificing accuracy. We further incorporate fractional-order total-variation regularization to capture long-range dependencies and memory effects, enhancing temporal and spatial coherence in gait dynamics. On Human3.6M, Pose3DM-L achieves 37.9 mm MPJPE under Protocol 1 (P1) and 32.1 mm P-MPJPE under Protocol 2 (P2), with 127 M MACs per frame and 30.8 G MACs in total. Relative to MotionBERT, P1 and P2 errors decrease by 3.3% and 2.4%, respectively, with 82.5% fewer parameters and 82.3% fewer MACs per frame. Compared with MotionAGFormer-L, Pose3DM-L improves P1 by 0.5 mm and P2 by 0.4 mm while using 60.6% less computation: 30.8 G vs. 78.3 G total MACs and 127 M vs. 322 M per frame. On AUST-VisGait across six gait patterns, Pose3DM consistently yields lower MPJPE, standard error, and maximum error, enabling reliable extraction of key gait parameters from monocular video. These results highlight state-space models as a cost-effective route to real-time gait assessment using a single RGB camera. Full article

Background: Cerebral palsy (CP) is a static, non-progressive brain pathology that affects mobility and musculoskeletal health. Objective: This review aims to describe the pediatric orthopedic management strategy at one specialty center with focus on optimal lifelong mobility function for ambulatory CP. Methods: Beginning in the 1990s, a protocol was developed to proactively monitor children with surgical or conservative interventions. After three decades, we undertook a prospective institutional review, board-approved 25–45-year-old adults callback study. Inclusion criteria were all children treated through childhood who could be located and were willing to return for a full evaluation. Results: Pediatric orthopedic interventions focused on regular surveillance with proactive treatment of progressive deformities. When function was impacted, we utilized multi-level orthopedic surgery guided by instrumented gait analysis. Childhood outcomes of this approach were evaluated through retrospective studies. Results show high correction rates were achieved for planovalgus foot deformity, knee flexion contracture, torsional malalignments, and stiff-knee gait. Our prospective adult callback study evaluated 136 adults with CP, gross motor function classification system levels I (21%), II (51%), III (22%), and IV (7%), with average ages of 16 ± 3 years (adolescent visit) compared with 29 ± 3 years (adult visit). Adults in the study had an average of 2.5 multi-level orthopedic surgery events and 10.4 surgical procedures. Compared with adults without disability, daily walking ability was lower in adults with CP. Adults with CP had limitations in physical function but no increased depression. A higher frequency of chronic pain compared with normal adults was present, but pain interference in daily life was not different. Adults demonstrated similar levels of education but higher rates of unemployment, caregiver needs, and utilization of Social Security disability insurance. Conclusions: The experience from our center suggests that consistent, proactive musculoskeletal management at regular intervals during childhood and adolescence may help maintain in gait and mobility function from adolescence to young adulthood in individuals with CP. Full article

Background/Objectives: Multiple sclerosis (MS) often leads to gait impairments, even in early stages, and can affect autonomy and quality of life. Traditional assessment methods, while widely used, have been criticized because they lack sensitivity to subtle gait changes. This scoping review aims to map the landscape of advanced gait analysis technologies—both wearable and non-wearable—and evaluate their application in detecting, characterizing, and monitoring possible gait dysfunction in individuals with MS. Methods: A systematic search was conducted across PubMed and Scopus databases for peer-reviewed studies published in the last decade. Inclusion criteria focused on original human research using technological tools for gait assessment in individuals with MS. Data from 113 eligible studies were extracted and categorized based on gait parameters, technologies used, study design, and clinical relevance. Results: Findings highlight a growing integration of advanced technologies such as inertial measurement units, 3D motion capture, pressure insoles, and smartphone-based tools. Studies primarily focused on spatiotemporal parameters, joint kinematics, gait variability, and coordination, with many reporting strong correlations to MS subtype, disability level, fatigue, fall risk, and cognitive load. Real-world and dual-task assessments emerged as key methodologies for detecting subtle motor and cognitive-motor impairments. Digital gait biomarkers, such as stride regularity, asymmetry, and dynamic stability demonstrated high potential for early detection and monitoring. Conclusions: Advanced gait analysis technologies can provide a multidimensional, sensitive, and ecologically valid approach to evaluating and detecting motor function in MS. Their clinical integration supports personalized rehabilitation, early diagnosis, and long-term disease monitoring. Future research should focus on standardizing metrics, validating digital biomarkers, and leveraging AI-driven analytics for real-time, patient-centered care. Full article

Background. Parkinson’s Disease (PD) is a neurological condition that can severely impair gait, often through changes to gait parameters including stride length, velocity, and variability. Therapeutic interventions such as Rhythmic Auditory Stimulation (RAS^®) target gait dysfunction in PD by using the regular beat of music or metronome clips to cue normalized walking patterns. Previous research has suggested that auditory cue properties (e.g., familiarity and groove) and individual factors (e.g., beat perception ability and susceptibility to dual-task interference) influence auditory cueing treatment efficacy in healthy young and older adults; however, optimization of rhythmic cueing across individuals with PD remains understudied. Methods. To address this, we explored the effects of familiarity, groove, beat perception ability, and synchronization instructions on gait in patients with PD during accelerated auditory cues. Individuals with idiopathic PD were randomized to walk freely or synchronized to music and metronome cues played 10% faster than their baseline walking cadence. Musical stimuli varied in self-reported familiarity and perceived groove and beat perception ability was assessed to classify participants as good or poor beat perceivers. Results. Overall, high-groove music and synchronized walking elicited faster gait patterns compared to low-groove music and free walking, respectively, as demonstrated by increased gait velocity and cadence. Familiarity and beat perception ability did not significantly affect gait in individuals with PD. Discussion. Altogether, our results indicate that high-groove music and synchronized walking lead to the greatest gait improvements during cueing, regardless of beat perception ability. Conclusion. Future studies and clinical interventions should consider stimulus type and synchronization instructions when implementing cueing therapies for gait dysfunction in PD in order to optimize treatment responses. Full article

(1) Background: Human walking involves adapting to diverse terrains, influencing gait biomechanics. This study examined how seven outdoor surfaces—flat–even, banked-right/-left, cobblestone, grass, sloped-down, and sloped-up—affect nonlinear gait dynamics in 30 healthy adults (14 females and 15 males). (2) Methods: Trunk and shank accelerations were analyzed for movement predictability (sample entropy, SE), smoothness (log dimensionless jerk, LDLJ), symmetry (step/stride regularity), and stability (short-/long-term Lyapunov exponents, LyE_s, LyE_l). (3) Results: Surface type significantly influenced all gait metrics, regardless of sex. Banked-right and sloped-down walking reduced SE, indicating less predictable movements. All surfaces except flat–even increased LDLJ, suggesting reduced smoothness. Cobblestone and sloped-down surfaces impaired step symmetry, while banked surfaces enhanced stride symmetry. LyE_s decreased on cobblestones (lower variability), while sloped-up increased it. LyE_l rose on all surfaces except cobblestones, indicating a more chaotic gait. No significant sex differences were found, though males showed a non-significant trend toward lower LyE_s. Notably, sex–surface interactions emerged for SE and stride symmetry on banked-right surfaces, with females showing decreased SE and increased symmetry. (4) Conclusions: These findings underscore the importance of terrain and sex in gait dynamics research. Full article

Background: Falls are common among individuals with multiple sclerosis (MS), yet standard clinical mobility assessments—such as the Timed Up and Go (TUG)—may not fully capture the complexities of real-world ambulation, leading to suboptimal fall identification. There is a critical need to evaluate the ecological validity of these assessments and identify alternative tests that better reflect real-world mobility and more accurately detect falls. This study examined the ecological validity of the TUG and novel dual-task clinical assessments by comparing laboratory-based gait metrics to community ambulation in individuals with MS and evaluated their ability to identify fallers. Methods: Twenty-seven individuals with MS (age 59.11 ± 10.57) completed the TUG test and three novel dual-task mobility assessments (TUG-extended, 25-foot walk and turn, and Figure 8 walk), each performed concurrently with a phonemic verbal fluency task. After lab assessments, the participants wore accelerometers for three consecutive days. Gait speed and stride regularity data was collected during both the in-lab clinical assessments and identified walking bouts in the community. The participants were stratified as fallers or non-fallers based on self-reported fall history over the previous six months. Findings: Significant differences were observed between the TUG and real-world ambulation for both gait speed (p < 0.01) and stride regularity (p = 0.04). No significant differences were found in gait metrics between real-world ambulation and both the 25-foot walk and turn and TUG-extended. Intraclass correlation coefficient analysis demonstrated good agreement between the 25-foot walk and turn and real-world ambulation for both gait speed (ICC = 0.75) and stride regularity (ICC = 0.81). When comparing the TUG to real-world ambulation, moderate agreement was observed for gait speed (ICC = 0.56) and poor agreement for stride regularity (ICC = 0.41). The 25-foot walk and turn exhibited superior predictive ability of fall status (AUC = 0.76) compared to the TUG (AUC = 0.67). Conclusions: The 25-foot walk and turn demonstrated strong ecological validity. It also exhibited superior predictive ability of fall status compared to the TUG. These findings support the 25-foot walk and turn as a promising tool for assessing mobility and fall risk in MS, warranting further study. Full article

Cognitive–motor integration is the coordination of cognitive and motor processes; it is commonly impaired among people living with dementia (PWD) and may be improved through exercise. This pilot randomized controlled trial (1:1) aimed to determine the effect of 6 months of exercise on cognitive–motor integration compared to usual care in n = 42 PWD at two residential care facilities. Participants completed single- and dual-task standing (30 s of standing while counting backward by 1 s), walking (4 m walk while naming words), and timed-up-and-go (TUG) tests (TUG with a category task), measured using APDM inertial sensors at baseline and 6 months (age = 82 years, 35% female, Montreal Cognitive Assessment = 10.2 ± 5.9, NCT05488951). The adapted Otago Exercise Program involved 60 min of lower-body strength and balance exercises and walking 3x/week for 6 months. Usual care involved regular social activities and healthcare appointments. Exercise provoked increased single-task stride length and increased dual-task TUG turn velocity compared to usual care (p < 0.05). Usual care may reduce the ability to appropriately select cautious gait, as the usual care group exhibited faster dual-task gait speed at 6 months compared to the OEP plus usual care (p < 0.05), which was faster than their single-task gait speed. Our results support implementing the OEP to improve cognitive–motor integration in PWD. Full article

Blocked or narrowed arteries restrict blood flow to the lower limbs, commonly leading to peripheral artery disease (PAD). Patients with PAD have been shown to have increased gait variability, which may contribute to higher rates of falls and worsen functional outcomes. Surgical revascularization seeks to restore blood flow to the legs, but it is unknown if this restoration enhances limb function. This study investigated whether gait variability changes in patients with PAD after revascularization surgery. Thirty-three patients with PAD exhibiting claudication symptoms were recruited for the study. Kinematic data were recorded using a motion capture system while the patients walked on a treadmill following a progressive treadmill protocol, both before and after undergoing revascularization surgery. Angular sagittal movements’ linear and nonlinear variability in the lower limbs were measured and compared before and after surgery across the ankle, knee, and hip joints. Following revascularization surgery, knee joint sample entropy (SampEn) decreased, suggesting improved gait regularity. Furthermore, the hip range of motion (ROM) significantly decreased, whereas the knee ROM significantly increased. The ankle joint showed significantly greater changes in the Lyapunov Exponent (LyE) relative to the pre-exercise condition compared with the hip and knee joints. No significant differences existed in the linear variability (standard deviation) of the ROM between joints. In individuals with PAD, revascularization surgery considerably increased knee ROM and gait regularity, indicating improved limb function and motor control. However, the ankle ROM remained unchanged, indicating the need for targeted strengthening exercises post-surgery. Full article

This block-randomized crossover study investigated how a speed-modulated aquatic treadmill (AT) impacts the walking biomechanics of pediatric gait. Eight cerebral palsy (CP) and fifteen typically developing (TD) children walked at normal, slow, and fast treadmill speeds in AT and dry treadmill (DT) conditions. The joint angles of participants were calculated from inertial measurement units to derive sample entropy (SE) measures that quantified the regularity or complexity of motion. A hierarchical statistical model revealed that the CP group had lower SE values for the hip, knee, and ankle joints in the AT and at slower than faster treadmill speeds. Only the SE values of the knee and ankle joints were impacted for the TD group. The lower SE values suggest improved regularity for participants at slower speeds and in the AT environment. This study highlights the potential of AT to improve the walking biomechanics of children with CP in acute exposure, but further work is needed to investigate the AT condition as a gait rehabilitation environment. Full article

Background/Objectives: Falls are a leading cause of morbidity in older adults, particularly those with multiple comorbidities. A multidisciplinary approach addressing physical, psychological, and environmental factors is essential for reducing fall risk and supporting aging in place. This report evaluates the effectiveness of a multidisciplinary, multifactorial approach in managing high fall risk in an older adult with diabetes, hypertension, and osteoporosis. Methods: A 72-year-old woman with a recurrent history of falls participated in an 8-week intervention as part of the American Physical Therapy Association (APTA) balance and falls prevention credential program. This study was conducted in Virginia Beach, USA, at the participant’s residence. A single-subject design investigation was conducted, measuring outcomes including the Balance Evaluation Systems Test (BESTest), gait speed, Timed Up and Go (TUG), fear of falling, and balance confidence at baseline and post-intervention. Results: The participant had impaired baseline values across various variables and was classified as a recurrent high-risk faller. After 8 weeks of intervention, clinically meaningful improvements with large effect sizes were observed: self-selected gait speed improved by 25%, BESTest scores improved by 50%, Falls Efficacy—International (FES I) scores improved by 26%, and Activity Balance Confidence (ABC) scores improved by 26%. No falls or adverse events occurred during the intervention period, and the patient reported enhanced mobility and safety at home. Conclusions: A tailored multidisciplinary approach effectively addressed the physical, psychological, and environmental factors contributing to high fall risk. This highlights the importance of patient-centered interventions in managing fall risk and promoting safe aging in place. Continued education, environmental adaptations, and regular follow-up are essential for long-term fall prevention. Full article