Search Results (19)

Background/Objectives: There is limited information on the interplay between passive joint motion and joint kinematics from three-dimensional gait analysis (3DGA) and its longitudinal evolution in cerebral palsy (CP). We aimed to associate clinical measurements and gait kinematics over time using a longitudinal study design. Methods: Ambulatory individuals with spastic CP, aged 4–18, who performed a minimum of two 3DGA at the Karolinska University Hospital between 2008 and 2025 were recruited. Primary outcomes were sagittal plane kinematics and maximum passive knee extension (pKE). Canonical correlation (R) with statistical parametric mapping was used to associate passive maximum knee extension with sagittal hip, knee, and ankle angles at two timepoints. Results: the 3DGA data of 31 children (age 4–17 years; mean age 10.4 +/− 2.9) with 22 bilateral (bCP, GMFCS I = 6; II = 13; III = 3) and 9 unilateral CP (uCP, GMFCS I = 8; II = 1) was included. For the whole and bCP groups, respectively, knee flexion/extension and pKE were correlated throughout stance (p < 0.001), with R between −0.47 and −0.57/−0.49 and −0.59 at T1 and between −0.46 and −0.72/−0.50 and −0.76 at T2. Hip flexion/extension and knee pKE were correlated from 17 to 62%/46–52% of the gait cycle (p < 0.001/p = 0.045) for the whole and bCP groups, respectively, with R between −0.41 and −0.57/−0.38 and −0.41 at T1 and from 15 to 64%/17 to 61% with R between −0.50 and −0.57/−0.42 and −0.57 at T2. Conclusions: Reported associations between structural knee properties and knee position during gait demonstrated progression over time, implying that a restricted range of motion may be driven by functional constraints. Combining knee contractures and their longitudinal development with 3DGA is a powerful approach for pre-intervention planning. Full article

Attempting to make machines mimic human walking, grasping, balancing, and other behaviors is a deep exploration of cognitive science and biological principles. Due to the existing prediction lag problem, an error compensation mechanism that integrates historical motion data is proposed. By constructing a humanoid autonomous walking control system, this paper aims to use a three-dimensional linear inverted pendulum model to plan the general framework of motion. Firstly, the landing point coordinates of the single foot support period are preset through gait cycle parameters. In addition, it is substituted into dynamic equation to solve the centroid (COM) trajectory curve that conforms to physical constraints. A hierarchical whole-body control architecture is designed, with a task priority based on quadratic programming solver used at the bottom to decompose high-level motion instructions into joint space control variables and fuse sensor data. Furthermore, the numerical iterative algorithm is used to solve the sequence of driving angles for each joint, forming the control input parameters for driving the robot’s motion. This algorithm solves the limitations of traditional inverted pendulum models on vertical motion constraints by optimizing the centroid motion trajectory online. At the same time, it introduces a contact phase sequence prediction mechanism to ensure a smooth transition of the foot trajectory during the switching process. Simulation results demonstrate that the proposed framework improves disturbance rejection capability by over 30% compared to traditional ZMP tracking and achieves a real-time control loop frequency of 1 kHz, confirming its enhanced robustness and computational efficiency. Full article

Background/Objectives: this study describes the development of a novel three-dimensional electrogoniometer for the quantitative assessment of knee mobility and stability during gait. The primary objective is to determine whether real-time measurements obtained during dynamic activity provide more clinically relevant information than traditional static assessments. Methods: the device employs angular position encoders to capture knee joint kinematics—specifically flexion, extension, rotation, and tibial translation—during locomotion. Data are transmitted in real time to an Android-based application, enabling immediate graphical visualization. A descriptive observational study was conducted involving healthy participants and individuals with anterior cruciate ligament (ACL) injuries to evaluate the device’s performance. Results: results showed that the electrogoniometer captured knee flexion-extension with a range of up to 90°, compared to 45° typically recorded using conventional systems. The device also demonstrated enhanced sensitivity in detecting variations in tibial translation during gait cycles. Conclusions: this electrogoniometer provides a practical tool for clinical assessment of knee function, enabling real-time monitoring of joint behavior during gait. By capturing functional mobility and stability more accurately than static methods, it may enhance diagnostic precision and support more effective rehabilitation planning in orthopedic settings. Full article

Background/Objectives: Although considerable progress has been made in understanding lateral ankle sprains (LAS) and chronic ankle instability (CAI), recurrent injury rates remain high. This highlights the need to explore additional contributors such as comprehensive lower-limb gait analysis, including multisegmented foot models and proximal joint kinematics and strength. This study aimed to assess multisegmented foot and lower-limb kinematics throughout the gait cycle in individuals with CAI compared to healthy controls. Additionally, associations between hip abductor strength and frontal plane ankle kinematics were examined. Methods: Fifty males (25 with CAI and 25 healthy controls) participated in this cross-sectional study. Gait analysis was conducted using a BTS SMART 3D motion capture system to assess multisegmented foot and proximal joint kinematics. Isometric hip strength was measured using a Biodex dynamometer. Statistical Parametric Mapping (SPM) was used to assess group differences, and correlations were calculated between hip abductor strength and ankle kinematics. Results: The CAI group demonstrated significantly greater calcaneus abduction relative to the shank in the transverse plane between 88% and 93% of the gait cycle (MD = −3.50°, 95% CI [−5.60, −1.40], d = −0.95, p = 0.037). No other statistically significant between-group differences in hip, knee, or foot segment kinematics were detected. Furthermore, correlations between hip abductor strength and ankle frontal plane kinematics were not significant. Conclusions: Males with CAI demonstrated altered rearfoot kinematics in the transverse plane during the terminal swing phase. The multisegmented foot model was valuable in detecting subtle deviations and emphasized the importance of including the swing phase. Hip abductor strength was not associated with ankle kinematics, suggesting that its potential role in CAI may involve other mechanisms. These findings may support clinical gait assessment and rehabilitation planning by highlighting the importance of evaluating all foot segments and the entire lower limb, rather than focusing solely on the ankle joint. Segment-specific deviations, particularly those emerging during the swing phase, may help guide targeted interventions aimed at improving foot positioning in males with CAI. Full article

Background/Objectives: This study focuses on the motion planning and control of an active ankle–foot orthosis (AFO) that leverages biomechanical insights to mitigate footdrop, a deficit that prevents safe toe clearance during walking. Methods: To adapt the motion of the device to the user’s walking speed, a geometric model was used, together with real-time measurement of the user’s gait cycle. A geometric speed-adaptive model also scales a trapezoidal ankle-velocity profile in real time using the detected gait cycle. The algorithm was tested at three different walking speeds, with a prototype of the AFO worn by a test subject. Results: At walking speeds of 0.44 and 0.61 m/s, reduced tibialis anterior (TA) muscle activity was confirmed by electromyography (EMG) signal measurement during the stance phase of assisted gait. When the AFO was in assistance mode after toe-off (initial and mid-swing phase), it provided an average of 48% of the estimated required power to make up for the deliberate inactivity of the TA muscle. Conclusions: Kinematic analysis of the motion capture data showed that sufficient foot clearance was achieved at all three speeds of the test. No adverse effects or discomfort were reported during the experiment. Future studies should examine the device in populations with footdrop and include a comprehensive evaluation of safety. Full article

This study presents a comprehensive three-dimensional finite element (FE) model inspired by the biomechanics of the human knee, specifically the tibiofemoral joint during the gait cycle. Drawing from natural biological systems, the model integrates bio-inspired elements, including transversely isotropic materials, to replicate the anisotropic properties of ligaments and cartilage, along with anatomically realistic bone and meniscus structures. This dual-material approach ensures a physiologically accurate representation of knee mechanics under varying conditions. The model effectively captures key biomechanical parameters, including a maximum medial tibial cartilage contact pressure of 16.75 MPa at 25% of the stance phase and a maximum femoral cartilage pressure of 10.57 MPa at 75% of the stance phase. Furthermore, its strong correlation with in vivo and in vitro data highlights its potential for clinical applications in orthopedics, such as pre-surgical planning and post-operative assessments. By bridging the gap between biomechanics and bioinspired design, this research contributes significantly to the field of biomimetics and offers a robust simulation tool for enhancing joint protection strategies and optimizing implant designs. Full article

Background/Objectives: This study aims to examine the effects of clinical exercise training on foot plantar pressure, the subtalar joint, and the gait cycle during pregnancy. Methods: The study was planned as a randomized, controlled, and single-blind study. Participants’ demographic information, obstetric evaluation, physical activity level, fall history, and pain evaluation were recorded. Foot plantar pressure, the subtalar joint, and the gait cycle were measured through pedobarography at Gait Laboratory. The control group was recommended walking. Clinical exercise training was given to the study group 2 days a week for eight weeks. Evaluations were made on day 0 and the day corresponding to the end of week 8. Results: The study was completed with 50 people in the study group (age: 29.7 ± 3.8 years) and 51 in the control group (age: 29.1 ± 6.1 years). As a result of the parametric and non-parametric tests performed before and after the exercise, it was observed that there was a statistically significant difference between the two groups in weight, BMI, pain score, static plantar pressure, dynamic plantar pressure, subtalar joint flexibility, duration of the walking period, and multistep walking speed (p < 0.01). The two groups had a significant difference only in the dominant midfoot plantar pressure (p > 0.05). Conclusions: According to our research, weight control and pain relief are observed in women who engage in clinical exercise in the second trimester of pregnancy; plantar pressure and subtalar joint flexibility are preserved, the walking period does not increase, and the multistep walking speed can be maintained after eight weeks. Full article

Legged soccer robots present a significant challenge in robotics owing to the need for seamless integration of perception, manipulation, and dynamic movement. While existing models often depend on external perception or static techniques, our study aims to develop a robot with dynamic and untethered capabilities. We have introduced a motion planner that allows the robot to excel in dynamic shooting and dribbling. Initially, it identifies and predicts the position of the ball using a rolling model. The robot then pursues the ball, using a novel optimization-based cycle planner, continuously adjusting its gait cycle. This enables the robot to kick without stopping its forward motion near the ball. Each leg is assigned a specific role (stance, swing, pre-kick, or kick), as determined by a gait scheduler. Different leg controllers were used for tailored tiptoe trajectory planning and control. We validated our approach using real-world penalty shot experiments (5 out of 12 successful), cycle adjustment tests (11 out of 12 successful), and dynamic dribbling assessments. The results demonstrate that legged robots can overcome onboard capability limitations and achieve dynamic mobility and manipulation. Full article

This study presents an IoT-based gait analysis system employing insole pressure sensors to assess gait kinetics. The system integrates piezoresistive sensors within a left foot insole, with data acquisition managed using an ESP32 board that communicates via Wi-Fi through an MQTT IoT framework. In this initial protocol study, we conducted a comparative analysis using the Zeno system, supported by PKMAS as the gold standard, to explore the correlation and agreement of data obtained from the insole system. Four volunteers (two males and two females, aged 24–28, without gait disorders) participated by walking along a 10 m Zeno system path, equipped with pressure sensors, while wearing the insole system. Vertical ground reaction force (vGRF) data were collected over four gait cycles. The preliminary results indicated a strong positive correlation (r = 0.87) between the insole and the reference system measurements. A Bland–Altman analysis further demonstrated a mean difference of approximately (0.011) between the two systems, suggesting a minimal yet significant bias. These findings suggest that piezoresistive sensors may offer a promising and cost-effective solution for gait disorder assessment and monitoring. However, operational factors such as high temperatures and sensor placement within the footwear can introduce noise or unwanted signal activation. The communication framework proved functional and reliable during this protocol, with plans for future expansion to multi-device applications. It is important to note that additional validation studies with larger sample sizes are required to confirm the system’s reliability and robustness for clinical and research applications. Full article

This study delves into the multifaceted approaches to treating Parkinson’s disease (PD), a neurodegenerative disorder primarily affecting motor function but also manifesting in a variety of symptoms that vary greatly among individuals. The complexity of PD symptoms necessitates a comprehensive treatment strategy that integrates surgical interventions, pharmacotherapy, and physical therapy to tailor to the unique needs of each patient. Surgical options, such as deep brain stimulation (DBS), have been pivotal for patients not responding adequately to medication, offering significant symptom relief. Pharmacotherapy remains a cornerstone of PD management, utilizing drugs like levodopa, dopamine agonists, and others to manage symptoms and, in some cases, slow down disease progression. However, these treatments often lead to complications over time, such as motor fluctuations and dyskinesias, highlighting the need for precise dosage adjustments and sometimes combination therapies to optimize patient outcomes. Physical therapy plays a critical role in addressing the motor symptoms of PD, including bradykinesia, muscle rigidity, tremors, postural instability, and akinesia. PT techniques are tailored to improve mobility, balance, strength, and overall quality of life. Strategies such as gait and balance training, strengthening exercises, stretching, and functional training are employed to mitigate symptoms and enhance functional independence. Specialized approaches like proprioceptive neuromuscular facilitation (PNF), the Bobath concept, and the use of assistive devices are also integral to the rehabilitation process, aimed at improving patients’ ability to perform daily activities and reducing the risk of falls. Innovations in technology have introduced robotic-assisted gait training (RAGT) and other assistive devices, offering new possibilities for patient care. These tools provide targeted support and feedback, allowing for more intensive and personalized rehabilitation sessions. Despite these advancements, high costs and accessibility issues remain challenges that need addressing. The inclusion of exercise and activity beyond structured PT sessions is encouraged, with evidence suggesting that regular physical activity can have neuroprotective effects, potentially slowing disease progression. Activities such as treadmill walking, cycling, and aquatic exercises not only improve physical symptoms but also contribute to emotional well-being and social interactions. In conclusion, treating PD requires a holistic approach that combines medical, surgical, and therapeutic strategies. While there is no cure, the goal is to maximize patients’ functional abilities and quality of life through personalized treatment plans. This integrated approach, along with ongoing research and development of new therapies, offers hope for improving the management of PD and the lives of those affected by this challenging disease. Full article

The dynamic orientation of total hip replacement acetabular cups during walking may vary substantially from their assumed position at surgical implantation and may vary between individuals. The scale of this effect is of interest for both pre-clinical device testing and for pre-operative surgical planning. This work aimed to evaluate (1) patient variation in dynamic cup orientation; (2) whether walking speed was a candidate proxy measure for the dynamic cup orientation; and (3) the relationships between dynamic cup orientation angles and planar pelvic angles. Pelvic movement data for patients with fast (20 patients) and slow (19 patients) self-selected walking speeds were used to calculate acetabular cup inclination and version angles through gait. For aim 1, the range and extremes of acetabular cup orientation angles were analysed for all patients. A large patient-to-patient variation was found in the ranges of both inclination angle (1° to 11°) and version angle (4° to 18°). The version angle was typically retroverted in comparison to the implantation position (greatest deviation 27°). This orientation is substantially different to the static, 0° version, simplifying assumptions in pre-clinical ‘edge loading’ testing. For aim 2, the cup orientation angles were compared between the fast- and slow-walking groups using statistical parametric mapping. The only significant differences observed were for cup version angle, during ~12% of the gait cycle before toe-off (p < 0.05). Therefore, self-selected walking speed, in isolation, is not a sufficient proxy measure for dynamic acetabular orientation. For aim 3, correlations were recorded between the acetabular cup orientation angles and the planar pelvic angles. The cup inclination angle during gait was strongly correlated (Spearman’s coefficient −1) with pelvic obliquity alone, indicating that simple planar assessment could be used to anticipate inclination angle range. The cup version angle was correlated with both pelvic rotation and tilt (Spearman’s coefficient 0.8–1), indicating that cup version cannot be predicted directly from any single pelvic movement. This complexity, along with the interaction between inclination angle and range of version angle, supports the use of computational tools to aid clinical understanding. Full article

Asymmetry of pelvic rotation affects function. However, predicting the post-operative changes in pelvic rotation is difficult as the root causes are complex and likely multifactorial. This retrospective study explored potential predictors of the changes in pelvic rotation after surgery with or without femoral derotational osteotomy (FDRO) in ambulatory children with cerebral palsy (CP). The change in the mean pelvic rotation angle during the gait cycle, pre- to post-operatively, was examined based on the type of surgery (with or without FDRO) and CP distribution (unilateral or bilateral involvement). In unilaterally involved patients, pelvic rotation changed towards normal with FDRO (p = 0.04), whereas patients who did not undergo FDRO showed a significant worsening of pelvic asymmetry (p = 0.02). In bilaterally involved patients, the changes in pelvic rotation did not differ based on FDRO (p = 0.84). Pelvic rotation corrected more with a greater pre-operative asymmetry (β = −0.21, SE = 0.10, p = 0.03). Sex, age at surgery, GMFCS level, and follow-up time did not impact the change in pelvic rotation. For children with hemiplegia, internal hip rotation might cause compensatory deviation in pelvic rotation, which could be improved with surgical correction of the hip. The predicted changes in pelvic rotation should be considered when planning surgery for children with CP. Full article

When brain damage occurs, gait and balance are often impaired. Evaluation of the gait cycle, therefore, has a pivotal role during the rehabilitation path of subjects who suffer from neurological disorders. Gait analysis can be performed through laboratory systems, non-wearable sensors (NWS), and/or wearable sensors (WS). Using these tools, physiotherapists and neurologists have more objective measures of motion function and can plan tailored and specific gait and balance training early to achieve better outcomes and improve patients’ quality of life. However, most of these innovative tools are used for research purposes (especially the laboratory systems and NWS), although they deserve more attention in the rehabilitation field, considering their potential in improving clinical practice. In this narrative review, we aimed to summarize the most used gait analysis systems in neurological patients, shedding some light on their clinical value and implications for neurorehabilitation practice. Full article

In the study of animal behavior, the prevention of sickness, and the gait planning of legged robots, pose estimation, and gait parameter extraction of quadrupeds are of tremendous importance. However, there are several varieties of quadrupeds, and distinct species frequently have radically diverse body types, limb configurations, and gaits. Currently, it is challenging to forecast animal pose estimation with any degree of accuracy. This research developed a quadruped animal pose estimation and gait parameter extraction method to address this problem. A computational framework including three components of target screening, animal pose estimation model, and animal gaits parameter extraction, which can totally and efficiently solve the problem of quadruped animal pose estimation and gait parameter extraction, makes up its core. On the basis of the HRNet network, an improved quadruped animal keypoint extraction network, RFB-HRNet, was proposed to enhance the extraction effect of quadruped pose estimation. The basic concept was to use a DyConv (dynamic convolution) module and an RFB (receptive field block) module to propose a special receptive field module DyC-RFB to optimize the feature extraction capability of the HRNet network at stage 1 and to enhance the feature extraction capability of the entire network model. The public dataset AP10K was then used to validate the model’s performance, and it was discovered that the proposed method was superior to alternative methods. Second, a two-stage cascade network was created by adding an object detection network to the front end of the pose estimation network to filter the animal object in input images, which enhanced the pose estimation effect of small targets and multitargets. The acquired keypoints data of animals were then utilized to extract the gait parameters of the experimental objects. Experiment findings showed that the gait parameter extraction model proposed in this research could effectively extract the gait frequency, gait sequence, gait duty cycle, and gait trajectory parameters of quadruped animals, and obtain real-time and accurate gait trajectory. Full article

Background: Ataxia is a neurological sign characterized by motor coordination during gait/voluntary limb movements impairment. Ataxic gait leads to disability and worsening of quality of life; physiotherapy intervention is recommended to improve motor function. Recent studies showed benefits due to repetitive robotized assisted gait training using a static exoskeleton in patients affected by acquired ataxias. The aim of the study was to perform a preliminary evaluation of the short-term effects of overground UAN.GO^®-assisted gait training in an adult patient with ataxia but with no clear genetic pattern. Methods: This case report study was conducted on a single male adult patient, who presented ataxic spastic gait, posterior chain tightness, pes cavus, and unstable standing position. The patient underwent two preliminary sessions to take part in the study. Treatment protocol planned 10 sessions and each one lasted 80 min, 60 of which were spent in gait training using the mobile overground exoskeleton UAN.GO^®. At T1 (start of the study) and T10 (final evaluation) assessments using the Scale for the Assessment and Rating of Ataxia, Berg Balance Scale, 6-Minute Walking Test, and Likert Scale were administered. Space-time parameters of gait cycle were also evaluated: left and right step length, stance and swing percentages. Results: improvements on the Scale for the Assessment and Rating of Ataxia, Berg Balance Scale, and in the distance travelled at 6-Minute Walking Test emerged. The patient gave a positive opinion towards the treatment, showed by Likert Scale results. Kinematic gait analysis showed more physiological step length, stance and swing percentages, joint angles. The patient completed the training program with an excellent compliance. Discussion: Since these encouraging outcomes were obtained, it is possible to consider robot-assisted gait training performed with UAN.GO^® as a therapeutic option to improve motor and functional performance in patients with ataxic gait. Full article