Dynamic Balance During Walking in Transfemoral Prosthesis Users: Step-to-Step Changes in Whole-Body and Segment Angular Momenta.

Transfemoral prosthesis users (TFPUs) typically have a high risk of balance loss and falling. Whole-body angular momentum ( [Formula: see text] is a common measure for assessing dynamic balance during human walking. However, little is known about how unilateral TFPUs maintain this dynamic balance through segment-to-segment cancellation strategies. Better understanding of the underlying mechanisms of dynamic balance control in TFPUs is required to improve gait safety. Thus, this study aimed to evaluate dynamic balance in unilateral TFPUs during walking at a self-selected constant speed. Fourteen unilateral TFPUs and fourteen matched controls performed level-ground walking at a comfortable speed on a straight, 10-m-long walkway. In the sagittal plane, the TFPUs had a greater and smaller range of [Formula: see text] compared to controls during intact and prosthetic steps, respectively. Further, the TFPUs generated greater average positive and negative [Formula: see text] than did the controls during intact and prosthetic steps, respectively, which may necessitate larger step-to-step postural changes in the forward and backward rotation about the body center of mass (COM). In the transverse plane, no significant difference was observed in the range of [Formula: see text] between groups. However, the TFPUs displayed smaller negative average [Formula: see text] in the transverse plane than did the controls. In the frontal plane, the TFPUs and controls demonstrated similar range of [Formula: see text] and step-to-step whole-body dynamic balance owing to the employment of different segment-to-segment cancellation strategies. Our findings should be interpreted and generalized with caution for the demographic features in our participants.

How do swimmers control their front crawl swimming velocity? Current knowledge and gaps from hydrodynamic perspectives.

The aim of this study was to review the literature on front crawl swimming biomechanics, focusing on propulsive and resistive forces at different swimming velocities. Recent studies show that the resistive force increases in proportion to the cube of the velocity, which implies that a proficient technique to miminise the resistive (and maximise the propulsive) force is particularly important in sprinters. To increase the velocity in races, swimmers increase their stroke frequency. However, experimental and simulation studies have revealed that there is a maximum frequency beyond which swimmers cannot further increase swimming velocity due to a change in the angle of attack of the hand that reduces its propulsive force. While the results of experimental and simulation studies are consistent regarding the effect of the arm actions on propulsion, the findings of investigations into the effect of the kicking motion are conflicting. Some studies have indicated a positive effect of kicking on propulsion at high swimming velocities while the others have yielded the opposite result. Therefore, this review contributes to knowledge of how the upper-limb propulsion can be optimised and indicates a need for further investigation to understand how the kicking action can be optimised in front crawl swimming.Abbreviations: C: Energy cost [kJ/m]; E: Metabolic power [W, kJ/s]; Fhand: Fluid resultant force exerted by the hand [N]; Ftotal: Total resultant force [N] (See Appendix A); Fnormal: The sum of the fluid forces acting on body segments toward directions perpendicular to the segmental long axis, which is proportional to the square of the segmental velocity. [N] (See Appendix A); Ftangent: The sum of the fluid forces acting on body segments along the direction parallel to the segmental long axis, which is proportional to the square of the segmental velocity. [N] (See Appendix A); Faddmass: The sum of the inertial force acting on the body segments due to the acceleration of a mass of water [N] (See Appendix A); Fbuoyant: The sum of the buoyant forces acting on the body segments [N] (See Appendix A); D: Fluid resistive force acting on a swimmer's body (active drag) [N]; T: Thrust (propulsive) force acting in the swimming direction in reaction to the swimmer's actions [N]; Thand: Thrust force produced in reaction to the actions of the hand [N]; Tupper_limb: Thrust force produced in reaction to the actions of the upper limbs [N]; Tlower_limb: Thrust force produced in reaction to the actions of the lower limbs [N]; Mbody: Whole-body mass of the swimmer [kg]; SF: Stroke frequency (stroke number per second) [Hz]; SL: Stroke length (distance travelled per stroke) [m]; v: Instantaneous centre of mass velocity of the swimmer [m/s]; V-: Mean of the instantaneous centre of mass velocities in the swimming direction over the period of the stroke cycle [m/s]; a: Centre of mass acceleration of the swimmer [m/s2]; V-hand: Mean of the instantaneous magnitudes of hand velocity over a period of time [m/s]; Wtot: Total mechanical power [W]; Wext: External mechanical power [W]; Wd: Drag power (mechanical power needed to overcome drag) [W, Nm/s]; α: Angle of attack of the palm plane with respect to the velocity vector of the hand [deg]; ηo: Overall efficiency [%]; ηp: Propelling efficiency [%]; MAD-system: Measuring Active Drag system; MRT method: Measuring Residual Thrust method.

Unilateral above-knee amputees achieve symmetric mediolateral ground reaction impulse in walking using an asymmetric gait strategy.

The ability to sustain steady straight-ahead walking is one goal of gait rehabilitation for individuals with unilateral above-knee (UAK) amputation. Despite the morphological and musculoskeletal asymmetry resulting from unilateral limb loss, the mediolateral ground-reaction-impulse (GRI) should be counterbalanced between the affected and unaffected limbs during straight-ahead walking. Therefore, we investigated the strategies of mediolateral ground-reaction-force (GRF) generation adopted by UAK prosthesis users walking along a straight path. GRFs of 15 participants with UAK amputation were measured during straight-ahead walking. Then, the mediolateral GRI, stance time, and mean mediolateral GRF during the stance phase of the affected and unaffected limbs were compared. To better understand the GRF generation strategy, statistical-parametric-mapping (SPM) was applied to assess the phase-dependent difference of the mediolateral GRFs between two limbs. The results showed that UAK prosthesis users can achieve symmetric mediolateral GRI during straight-ahead walking by adopting an asymmetric gait strategy: shorter stance time and higher mean mediolateral GRF over the stance phase for the affected than for the unaffected limb. In addition, the analysis using SPM revealed that the affected limb generates a higher mean medial GRF component than the unaffected limb, especially during the single-support phase. Thus, a higher medial GRF during the single-support phase of the affected limb may allow UAK prosthesis users to achieve mediolateral GRI that are similar to those of the unaffected limb. Further insights on these mechanics may serve as guidelines on the improved design of prosthetic devices and the rehabilitation needs of UAK prosthesis users.

Factors associated with a risk of prosthetic knee buckling during walking in unilateral transfemoral amputees.

BACKGROUND: Walking and mobility are essential for a satisfactory quality of life. However, individuals with transfemoral amputations have difficulties in preventing falls due to prosthetic knee buckling, defined as the sudden loss of postural support during weight-bearing activities. The risk of prosthetic knee buckling can be evaluated by determining the prosthetic knee angular impulse (PKAI) during the early stance phase. However, little is known about the factors associated with PKAI in individuals with unilateral transfemoral amputations. RESEARCH QUESTION: What are the demographic factors that can be associated with the risk of prosthetic knee buckling, quantified by PKAI, during walking in individuals with unilateral transfemoral amputations? METHODS: Thirteen individuals with unilateral transfemoral amputations were instructed to perform level walking at a comfortable, self-selected speed on a straight, 10-m walkway. PKAI was calculated as the time integral of the prosthetic knee external flexion-extension moment during the initial 40 % of the prosthetic gait cycle. We used Pearson's correlation coefficients to examine the relationship of PKAI with the following variables: the subject's body height, body mass, and age; the time since amputation; and the current prosthesis use history. Furthermore, an independentt-test was used to compare PKAI according to the sex (male vs. female) and etiology (trauma vs. nontrauma). RESULTS: PKAI exhibited a significant negative linear relationship with the subject's body height and body mass. However, it showed no significant correlation with age, the time since amputation, and the current prosthesis use history. It was also significantly greater in women than in men and was not significantly influenced by the etiology. SIGNIFICANCE: Awareness about demographic factors associated with PKAI during walking can contribute to fall assessments in gait rehabilitation programs for individuals with unilateral transfemoral amputations.

Effect of leg kick on active drag in front-crawl swimming: Comparison of whole stroke and arms-only stroke during front-crawl and the streamlined position.

The purpose of this study was to examine the effect of leg kick on the resistance force in front-crawl swimming. The active drag in front-crawl swimming with and without leg motion was evaluated using measured values of residual thrust (MRT method) and compared with the passive drag of the streamlined position (SP) for the same swimmers. Seven male competitive swimmers participated in this study, and the testing was conducted in a swimming flume. Each swimmer performed front-crawl under two conditions: using arms and legs (whole stroke: WS) and using arms only (arms-only stroke: AS). Active drag and passive drag were measured at swimming velocities of 1.1 and 1.3 m s-1 using load cells connected to the swimmer via wires. We calculated a drag coefficient to compare the resistances of the WS, AS and SP at each velocity. For both the WS and AS at both swimming velocities, active drag coefficient was found to be about 1.6-1.9 times larger than that in passive conditions. In contrast, although leg movement did not cause a difference in drag coefficient for front-crawl swimming, there was a large effect size (d = 1.43) at 1.3 m s-1. Therefore, although upper and lower limb movements increase resistance compared to the passive condition, the effect of leg kick on drag may depend on swimming velocity.

Developing a methodology for estimating the drag in front-crawl swimming at various velocities.

We aimed to develop a new method for evaluating the drag in front-crawl swimming at various velocities and at full stroke. In this study, we introduce the basic principle and apparatus for the new method, which estimates the drag in swimming using measured values of residual thrust (MRT). Furthermore, we applied the MRT to evaluate the active drag (Da) and compared it with the passive drag (Dp) measured for the same swimmers. Da was estimated in five-stages for velocities ranging from 1.0 to 1.4ms-1; Dp was measured at flow velocities ranging from 0.9 to 1.5ms-1 at intervals of 0.1ms-1. The variability in the values of Da at MRT was also investigated for two swimmers. According to the results, Da (Da=32.3 v3.3, N=30, R2=0.90) was larger than Dp (Dp=23.5 v2.0, N=42, R2=0.89) and the variability in Da for the two swimmers was 6.5% and 3.0%. MRT can be used to evaluate Da at various velocities and is special in that it can be applied to various swimming styles. Therefore, the evaluation of drag in swimming using MRT is expected to play a role in establishing the fundamental data for swimming.

Numerical and experimental investigations of human swimming motions.

This paper reviews unsteady flow conditions in human swimming and identifies the limitations and future potential of the current methods of analysing unsteady flow. The capability of computational fluid dynamics (CFD) has been extended from approaches assuming steady-state conditions to consideration of unsteady/transient conditions associated with the body motion of a swimmer. However, to predict hydrodynamic forces and the swimmer's potential speeds accurately, more robust and efficient numerical methods are necessary, coupled with validation procedures, requiring detailed experimental data reflecting local flow. Experimental data obtained by particle image velocimetry (PIV) in this area are limited, because at present observations are restricted to a two-dimensional 1.0 m(2) area, though this could be improved if the output range of the associated laser sheet increased. Simulations of human swimming are expected to improve competitive swimming, and our review has identified two important advances relating to understanding the flow conditions affecting performance in front crawl swimming: one is a mechanism for generating unsteady fluid forces, and the other is a theory relating to increased speed and efficiency.

Unsteady hydrodynamic forces acting on a robotic arm and its flow field: application to the crawl stroke.

This study aims to clarify the mechanisms by which unsteady hydrodynamic forces act on the hand of a swimmer during a crawl stroke. Measurements were performed for a hand attached to a robotic arm with five degrees of freedom independently controlled by a computer. The computer was programmed so the hand and arm mimicked a human performing the stroke. We directly measured forces on the hand and pressure distributions around it at 200 Hz; flow fields underwater near the hand were obtained via 2D particle image velocimetry (PIV). The data revealed two mechanisms that generate unsteady forces during a crawl stroke. One is the unsteady lift force generated when hand movement changes direction during the stroke, leading to vortex shedding and bound vortex created around it. This bound vortex circulation results in a lift that contributes to the thrust. The other occurs when the hand moves linearly with a large angle of attack, creating a Kármán vortex street. This street alternatively sheds clockwise and counterclockwise vortices, resulting in a quasi-steady drag contributing to the thrust. We presume that professional swimmers benefit from both mechanisms. Further studies are necessary in which 3D flow fields are measured using a 3D PIV system and a human swimmer.

A new measure for upright stability.

The control of balance is a primary objective in most human movements. In many cases, research or practice, it is essential to quantitatively know how good the balance is at a body posture or at every moment during a task. In this paper we suggest a new measure for postural upright stability which assigns a value to a body state based on the probability of avoiding a fall initiation from that state. The balance recovery problem is solved for a population sample using a strength database, and the probability of successfully maintaining the balance is found over the population and called the probability of recovery (PoR). It, therefore, describes an attribute of a body state: how possible the control of balance is, or how safe being at that state is. We also show the PoR calculated for a 3-link body model for all states on a plane, compare it to that found using a 2-link model, and compare it to a conventional metric: the margin of stability (MoS). It is shown, for example, that MoS may be very low at a state from which most of the people will be able to easily control their balance.

Unsteady hydrodynamic forces acting on a robotic hand and its flow field.

This study aims to clarify the mechanism of generating unsteady hydrodynamic forces acting on a hand during swimming in order to directly measure the forces, pressure distribution, and flow field around the hand by using a robotic arm and particle image velocimetry (PIV). The robotic arm consisted of the trunk, shoulder, upper arm, forearm, and hand, and it was independently computer controllable in five degrees of freedom. The elbow-joint angle of the robotic arm was fixed at 90°, and the arm was moved in semicircles around the shoulder joint in a plane perpendicular to the water surface. Two-component PIV was used for flow visualization around the hand. The data of the forces and pressure acting on the hand were sampled at 200Hz and stored on a PC. When the maximum resultant force acting on the hand was observed, a pair of counter-rotating vortices appeared on the dorsal surface of the hand. A vortex attached to the hand increased the flow velocity, which led to decreased surface pressure, increasing the hydrodynamic forces. This phenomenon is known as the unsteady mechanism of force generation. We found that the drag force was 72% greater and the lift force was 4.8 times greater than the values estimated under steady flow conditions. Therefore, it is presumable that swimmers receive the benefits of this unsteady hydrodynamic force.

Prediction of postural risk of fall initiation based on a two-variable description of body dynamics: position and velocity of center of mass.

This research addresses the question: what is the risk of fall initiation at a certain human posture? There are postures from which no one is able to keep their balance and a fall will surely initiate (risk=1), and others from which everyone may regain their stability (risk=0). In other postures, only a portion of people can control their stability. One may interpret risk to chance of a fall to be initiated, and based on the portion of fallers assign a risk value to a given human posture (postural risk). Human posture can be mapped to a point in a 2-dimensional space: the x-v plane, the axes of which are horizontal components of the position and velocity of the center of mass of the body. For every pair of (x, v), the outcome of the balance recovery problem defines whether a person with a given strength level is able to regain their stability when released from a posture corresponding to that point. Using strength distribution data, we estimated the portion of the population who will initiate a fall if starting at a certain posture. A fast calculation approach is also introduced to replace the time-consuming method of solving the recovery problem many times. Postural risk of fall initiation for situations expressed by (x, v) pairs for the entire x-v plane is calculated and shown in a color-map.