Effect of age and speed on the step-to-step transition strategies in children.

The development and acquisition of mature walking in children is multifactorial, depending among others on foot interaction with the ground, body dynamics and the knowledge of the 'rules' stemming from the gravity field. Indeed, each step the velocity of the centre of mass must be redirected upwards. This redirection may be initiated by the trailing leg, propulsing forward and upward the body before foot contact, or later by the loading limb after the contact with the ground. While it has been suggested that mature walking develops slowly from first independent steps to about 7 years of age, it is still unknown how children acquire the appropriate loading and propulsion forces during the step-to-step transition. To answer that question, twenty-four children (from 3 to 12 years old) and twelve young adults (from 20 to 27 years old) walked on force platforms at different walking speed. The ground reaction forces under each foot were recorded and the vertical velocity of the centre of mass of the body was computed. With decreasing age and increasing velocity (or Froude number), the occurrence of unanticipated transition is higher, related to a different ratio between the vertical support of the front and back leg. The different transition strategy observed in children indicates that body weight transfer from one limb to the other is not fully mature at 12 years old.

A robust machine learning enabled decomposition of shear ground reaction forces during the double contact phase of walking.

BACKGROUND: Dynamic analyses of walking rely on the 3D ground reaction forces (GRF) under each foot, while only the resultant force of both limbs may be recorded on a single-belt instrumented treadmill or when both feet touch the same force platform. RESEARCH QUESTION: This study aims to develop a robust decomposition of the shear GRF to complete the most accurate decomposition of the vertical GRF [8]. METHODS: A retrospective study of 374 healthy adults records (age: 22.8 ±â€¯2.6 years, speed: 1.34 ±â€¯0.28 m/s) and of 434 patient records (age: 21.3 ±â€¯17.8 years, speed: 0.64 ±â€¯0.19 m/s) were used in a machine learning process to develop a robust predictive model to decompose the fore-aft GRF. The lateral GRF was decomposed by resolving the equilibrium of transverse moments around the center of pressure. RESULTS: A predictive linear model of the fore-aft GRF under the back foot every 5% of the double contact phase was obtained from 2 predictors: the total fore-aft GRF and the vertical GRF under the back foot. Each predictor uses a time series of 31 samples before and during the double contact. The model performs accurately in healthy (median[IQR] error of 3.0[2.2-4.1]%) and in clinical gaits (7.7[4.7-13.4]%). The error in lateral GRF decomposition is of 5.7[3.9-10.2]% in healthy gaits and of 12.0[7.2-19.2]% in patients under the back foot and about half of that under the front foot. SIGNIFICANCE: The decomposition of shear GRFs achieved in this study supports the mechanics of walking. It provides outstanding accuracy in healthy gait and also applies to neurologic and orthopedic disorders. Together with the vertical GRF decomposition [8], this approach for the shear components paves the way for robust single limb GRF determination on a single-belt instrumented treadmill or when both feet touch the same force platform in normal and clinical gait analysis.

Effect of age and speed on the step-to-step transition phase during walking.

Gait is a powerful measurement tool to evaluate the functional decline throughout ageing. Falls in elderly adults happen mainly during the redirection of the center of mass of the body (CoM) in the transition between steps. In young adults, this step-to-step transition begins before the double contact phase (DC) with a simultaneous forward and upward acceleration of the CoM. We hypothesize that, compared to young adults, elderly adults would exhibit unbalanced contribution of the back leg and the front leg during the transition. We calculated the mean vertical push-off done by the back leg (FBACK) and the mean impact force on the front leg (FFRONT) during the transition. Eight young (mean ±â€¯SD; age: 24 ±â€¯2 y) and 19 elderly (age: 74 ±â€¯6 y) healthy adults walked on a force-measuring treadmill at five selected speeds ranging from 0.56 to 1.67 m·s-1. Results show that, at mid and high speeds, elderly adults exhibit a smaller FBACK compared to young adults, possibly linked to the decreased plantar flexion of the back foot. As a consequence, FFRONT is significantly increased and the transition begins lately in the step, at the beginning of DC. Also, elderly adults show an inability to accelerate the CoM upward and forward simultaneously. Our findings show a different adaptation of the step-to-step transition with speed in elderly adults and identify two potential indicators of gait impairment with age: the FFRONT/FBACK contribution and the synchronization between the upward and forward acceleration of the CoM during the transition.

Determination of the vertical ground reaction forces acting upon individual limbs during healthy and clinical gait.

In gait lab, the quantification of the ground reaction forces (GRFs) acting upon individual limbs is required for dynamic analysis. However, using a single force plate, only the resultant GRF acting on both limbs is available. The aims of this study are (a) to develop an algorithm allowing a reliable detection of the front foot contact (FC) and the back foot off (FO) time events when walking on a single plate, (b) to reconstruct the vertical GRFs acting upon each limb during the double contact phase (DC) and (c) to evaluate this reconstruction on healthy and clinical gait trials. For the purpose of the study, 811 force measurements during DC were analyzed based on walking trials from 27 healthy subjects and 88 patients. FC and FO are reliably detected using a novel method based on the distance covered by the centre of pressure. The algorithm for the force reconstruction is a revised version of the approach of Davis and Cavanagh [24]. In order to assess the robustness of the algorithm, we compare the resulting GRFs with the real forces measured with individual force plates. The median of the relative error on force reconstruction is 1.8% for the healthy gait and 2.5% for the clinical gait. The reconstructed and the real GRFs during DC are strongly correlated for both healthy and clinical gait data (R(2)=0.998 and 0.991, respectively).

Impact of ankle osteoarthritis on the energetics and mechanics of gait: the case of hemophilic arthropathy.

BACKGROUND: Osteoarthritis may affect joints in any part of the body, including the ankle. The purpose of this study was to assess the impact of ankle osteoarthritis on the energetics and mechanics of gait, while taking into account the effect of slower speed generally adopted by patients with osteoarthritis. METHODS: Using a motion analysis system, synchronous kinematic, kinetics, spatiotemporal, mechanics and metabolic gait parameters were measured in 10 patients diagnosed with ankle osteoarthritis consecutive to hemophilia. The subjects walked at a self-selected speed and their performance was compared to speed-matched normal values obtained in healthy control subjects. FINDINGS: Speed-normalization using a Z-score transformation showed a significant increase in metabolic cost (Z=1.78; P=0.006) and decrease in mechanical work (Z=-0.97; P=0.009). As a consequence, muscular efficiency also decreased (Z=-0.97; P=0.001). These changes were associated with a surprising efficacy of the pendular mechanism, i.e., an improved recovery index (Z=0.97; P=0.004). INTERPRETATION: Our findings suggest that patients with ankle osteoarthritis adopt a walking strategy which improves recovery through the pendular mechanism. This may be a compensatory mechanism in order to economize energy which would counterbalance the energy waste due to low muscle efficiency. These modifications are proportional to the impaired ankle function. Our data provides a quantitative baseline to better understand the dynamics of ankle osteoarthritis and determine the individual role that lower limb joints play in the multiple chronic joint affections.

Effect of speed on the energy cost of walking in unilateral traumatic lower limb amputees.

In this work, the effect of walking speed on the energy expenditure in traumatic lower-limb amputees was studied. The oxygen consumption was measured in 10 transfemoral amputees, 9 transtibial amputees and 13 control subjects, while they stood and walked at different speeds from 0.3 m s(-1) to near their maximum sustainable speed. Standing energy expenditure rate was the same in lower-limb amputees and in control subjects (approximately 1.85 W kg(-1)). On the contrary, during walking, the net energy expenditure rate was 30-60% greater in transfemoral amputees and 0-15% greater in transtibial amputees than in control subjects. The maximal sustainable speed was about 1.2 m s(-1) in transfemoral amputees and 1.6 m s(-1) in transtibial amputees, whereas it was above 2 m s(-1) in control subjects. Among these three groups, the cost of transport versus speed presented a U-shaped curve; the minimum cost increased with the level of amputation, and the speed at which this minimum occurred decreased.

Energetics of load carrying in Nepalese porters.

Nepalese porters routinely carry head-supported loads equal to 100 to 200% of their body weight (Mb) for many days up and down steep mountain footpaths at high altitudes. Previous studies have shown that African women carry head-supported loads of up to 60% of their Mb far more economically than army recruits carrying equivalent loads in backpacks. Here we show that Nepalese porters carry heavier loads even more economically than African women. Female Nepalese porters, for example, carry on average loads that are 10% of their Mb heavier than the maximum loads carried by the African women, yet do so at a 25% smaller metabolic cost.