Gait & posture最新文献

The effects of vision and multiple cognitive tasks on pre-landing and early landing mechanics associated with ACL loading 视觉和多重认知任务对与ACL负荷相关的着陆前和早期着陆机制的影响

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2026-05-01 Epub Date: 2026-01-28 DOI: 10.1016/j.gaitpost.2026.110106

Ling Li , Yu Song , Peyton Hatcher , Raychl Fairbanks , Jefferson Danso , Gerwyn Hughes , Boyi Dai

Background

Anterior cruciate ligament (ACL) injuries often occur during landing tasks when visual information is limited and attentional resources are divided.

Purpose

This study examined how the absence of vision and multiple cognitive tasks influenced pre-landing and early landing mechanics associated with ACL loading.

Methods

Thirty-four recreationally active college students with jump-landing sports experience performed single-leg drop landings under eight conditions: vision or no vision combined with no cognitive task, backward counting, tone counting, or both cognitive tasks simultaneously.

Results

The absence of vision delayed the timing of minimal knee flexion during the pre-landing phase. It also increased peak vertical ground reaction forces during early landing, reflecting altered preparation and impact mechanics compared with vision. Cognitive tasks generally reduced maximal knee flexion angles, and backward counting in particular lowered knee flexion at initial contact. Tone counting reduced average knee flexion angular velocity and knee flexion range of motion during the early landing phase compared with the no-task and backward-counting conditions and increased the internal knee extension moment compared with the backward-counting task. The two cognitive task condition did not exacerbate ACL loading variables and instead lowered peak vertical ground reaction forces relative to no-task trials, suggesting a conservative landing strategy under high attentional demands.

Conclusion

Overall, the absence of vision had a stronger influence on ACL loading–related mechanics than cognitive load. Cognitive tasks altered both sagittal and transverse plane strategies, but their effects were non-linear. These findings highlight the importance of incorporating visual constraints and secondary tasks into screening and prevention protocols to better simulate sport environments.

背景前交叉韧带（ACL）损伤常发生在着陆任务中视觉信息有限、注意力资源分散的情况下。目的：本研究探讨了视觉缺失和多重认知任务如何影响与ACL负荷相关的着陆前和早期着陆机制。方法对34名具有娱乐活动经验的大学生进行单腿起落实验，实验条件为：有视觉或无视觉合并无认知任务、向后计数、声调计数、两种认知任务同时进行。结果失视延迟了着陆前膝关节屈曲的时间。在早期着陆时，它还增加了垂直地面反作用力的峰值，这反映了与视觉相比，准备和撞击力学发生了变化。认知任务通常降低最大膝关节屈曲角度，特别是在初次接触时降低膝关节屈曲。与无任务和向后计数相比，音调计数降低了着陆前期的平均膝关节屈曲角速度和膝关节屈曲运动幅度，与向后计数相比，音调计数增加了膝关节内伸力矩。与无任务试验相比，两种认知任务条件均没有加重ACL负荷变量，反而降低了垂直地面反力峰值，提示高注意力要求下的保守着陆策略。结论总体而言，视力缺失对前交叉韧带负荷相关机制的影响大于认知负荷。认知任务改变了矢状面和横向策略，但其影响是非线性的。这些发现强调了将视觉限制和次要任务纳入筛查和预防方案以更好地模拟运动环境的重要性。

{"title":"The effects of vision and multiple cognitive tasks on pre-landing and early landing mechanics associated with ACL loading","authors":"Ling Li , Yu Song , Peyton Hatcher , Raychl Fairbanks , Jefferson Danso , Gerwyn Hughes , Boyi Dai","doi":"10.1016/j.gaitpost.2026.110106","DOIUrl":"10.1016/j.gaitpost.2026.110106","url":null,"abstract":"<div><h3>Background</h3><div>Anterior cruciate ligament (ACL) injuries often occur during landing tasks when visual information is limited and attentional resources are divided.</div></div><div><h3>Purpose</h3><div>This study examined how the absence of vision and multiple cognitive tasks influenced pre-landing and early landing mechanics associated with ACL loading.</div></div><div><h3>Methods</h3><div>Thirty-four recreationally active college students with jump-landing sports experience performed single-leg drop landings under eight conditions: vision or no vision combined with no cognitive task, backward counting, tone counting, or both cognitive tasks simultaneously.</div></div><div><h3>Results</h3><div>The absence of vision delayed the timing of minimal knee flexion during the pre-landing phase. It also increased peak vertical ground reaction forces during early landing, reflecting altered preparation and impact mechanics compared with vision. Cognitive tasks generally reduced maximal knee flexion angles, and backward counting in particular lowered knee flexion at initial contact. Tone counting reduced average knee flexion angular velocity and knee flexion range of motion during the early landing phase compared with the no-task and backward-counting conditions and increased the internal knee extension moment compared with the backward-counting task. The two cognitive task condition did not exacerbate ACL loading variables and instead lowered peak vertical ground reaction forces relative to no-task trials, suggesting a conservative landing strategy under high attentional demands.</div></div><div><h3>Conclusion</h3><div>Overall, the absence of vision had a stronger influence on ACL loading–related mechanics than cognitive load. Cognitive tasks altered both sagittal and transverse plane strategies, but their effects were non-linear. These findings highlight the importance of incorporating visual constraints and secondary tasks into screening and prevention protocols to better simulate sport environments.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"126 ","pages":"Article 110106"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Osseointegrated prostheses reduce reactive stability demands during walking in Service members with unilateral transfemoral amputation 骨整合假体减少单侧经股截肢军人行走时的反应性稳定性需求

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2026-03-01 Epub Date: 2025-12-24 DOI: 10.1016/j.gaitpost.2025.110090

Julian C. Acasio , Pawel R. Golyski , Benjamin K. Potter , Jonathan A. Forsberg , Brad D. Hendershot

Background

Heightened fall risk following lower limb amputation can lead to adaptations during walking that increase proactive stability (e.g., a wider base of support). However, such compensations also reduce maneuverability, increasing reactive stability demands (e.g., corrective steps) as more lateral foot placement necessitates greater lateral impulses. By improving prosthetic control, osseointegration (OI) may mitigate fall risk and reduce the need for proactive stability compensations. Thus, this work aims to characterize proactive stability compensations, via mediolateral margins of stability (MOS_ML) as well as reactive stability demands, via absolute and net integrated whole-body angular momentum (iWBAM), and variability in net iWBAM.

Methods

Eight Service members (SMs) with unilateral transfemoral amputation completed biomechanical gait evaluations before, and 12- and 24-months after OI. We hypothesized minimum MOS_ML would decrease as would absolute tri-planar integrated WBAM (iWBAM) and net iWBAM variability following OI, indicative of decreased reliance on proactive stability compensations and reduced reactive stability demands, respectively.

Results

Relative to pre-OI, minimum MOS_ML did not decrease at either post-OI evaluation, sagittal absolute iWBAM were 8.8 % and 7.0 % less at 12-months and 24-months post-OI, respectively. Additionally, sagittal net iWBAM variability decreased by 32.1 % at 24-months post-OI versus pre-OI. No other differences were observed in pre- versus post-OI measures.

Significance

These findings suggest that, unlike civilian populations, OI does not decrease passive stability compensations among SMs; however, OI may reduce reactive stability demands relative to socket-suspended prostheses among SMs. Future work should evaluate whether these differences extend to decreased fall risk in daily life.

背景：下肢截肢后跌倒风险的增加可能导致行走时的适应性，从而增加主动稳定性（例如，更宽的支撑基础）。然而，这样的补偿也降低了机动性，增加了反应稳定性要求（例如，纠正步骤），因为更多的侧向脚放置需要更大的侧向脉冲。通过改善假肢控制，骨整合（OI）可以减轻跌倒风险，减少对主动稳定性补偿的需求。因此，本研究旨在通过中外侧稳定性边缘（MOSML）和反应性稳定性需求，通过绝对和净综合全身角动量（iWBAM）以及净iWBAM的变异性来表征主动稳定性补偿。方法8例单侧经股截肢患者分别在成骨不全术前、术后12个月和24个月完成生物力学步态评估。我们假设最小MOSML和绝对三平面集成WBAM （iWBAM）以及净iWBAM变异性在OI后会降低，分别表明对主动稳定性补偿的依赖减少，反应性稳定性需求减少。结果：相对于成骨不全术前，最小MOSML在成骨不全后评估均未降低，矢状面绝对iWBAM在成骨不全后12个月和24个月分别降低8.8 %和7.0 %。此外，在成骨不全后24个月与成骨不全前相比，矢状面净iWBAM变异性降低了32.1% %。在成骨不全前后的测量中未观察到其他差异。这些发现表明，与平民人群不同，成骨不全不会降低SMs之间的被动稳定性补偿；然而，相对于套筒悬浮假体，成骨不全可能降低对反应性稳定性的要求。未来的工作应该评估这些差异是否延伸到日常生活中跌倒风险的降低。

{"title":"Osseointegrated prostheses reduce reactive stability demands during walking in Service members with unilateral transfemoral amputation","authors":"Julian C. Acasio , Pawel R. Golyski , Benjamin K. Potter , Jonathan A. Forsberg , Brad D. Hendershot","doi":"10.1016/j.gaitpost.2025.110090","DOIUrl":"10.1016/j.gaitpost.2025.110090","url":null,"abstract":"<div><h3>Background</h3><div>Heightened fall risk following lower limb amputation can lead to adaptations during walking that increase proactive stability (e.g., a wider base of support). However, such compensations also reduce maneuverability, increasing reactive stability demands (e.g., corrective steps) as more lateral foot placement necessitates greater lateral impulses. By improving prosthetic control, osseointegration (OI) may mitigate fall risk and reduce the need for proactive stability compensations. Thus, this work aims to characterize proactive stability compensations, via mediolateral margins of stability (MOS<sub>ML</sub>) as well as reactive stability demands, via absolute and net integrated whole-body angular momentum (iWBAM), and variability in net iWBAM.</div></div><div><h3>Methods</h3><div>Eight Service members (SMs) with unilateral transfemoral amputation completed biomechanical gait evaluations before, and 12- and 24-months after OI. We hypothesized minimum MOS<sub>ML</sub> would decrease as would absolute tri-planar integrated WBAM (iWBAM) and net iWBAM variability following OI, indicative of decreased reliance on proactive stability compensations and reduced reactive stability demands, respectively.</div></div><div><h3>Results</h3><div>Relative to pre-OI, minimum MOS<sub>ML</sub> did not decrease at either post-OI evaluation, sagittal absolute iWBAM were 8.8 % and 7.0 % less at 12-months and 24-months post-OI, respectively. Additionally, sagittal net iWBAM variability decreased by 32.1 % at 24-months post-OI versus pre-OI. No other differences were observed in pre- versus post-OI measures.</div></div><div><h3>Significance</h3><div>These findings suggest that, unlike civilian populations, OI does not decrease passive stability compensations among SMs; however, OI may reduce reactive stability demands relative to socket-suspended prostheses among SMs. Future work should evaluate whether these differences extend to decreased fall risk in daily life.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"125 ","pages":"Article 110090"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145880981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The single-leg sit-to-stand test is valid and reliable for assessing lower limb performance and asymmetry in international cross-country skiers 单腿坐立测试是评估国际越野滑雪运动员下肢表现和不对称的有效和可靠的方法。

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2026-03-01 Epub Date: 2026-01-17 DOI: 10.1016/j.gaitpost.2026.110100

Mürşit Ceyhun Birinci , Yücel Makaracı , Buket Sevindik Aktaş , Gökhan Atasever , Juan D. Ruiz-Cárdenas

Objective

To evaluate the validity and test–retest reliability of single-leg sit-to-stand (SLSTS) performance metrics derived from a mobile application in elite cross-country skiing (XCS) athletes.

Design

Cross-sectional, repeated-measures.

Setting

Laboratory, field.

Participants

22 international-level XCS athletes (13 females, 9 males; median age: 18 yrs).

Main outcome measures

SLSTS rising time, velocity, power, and inter-limb asymmetry were collected across two sessions separated by three days. Isokinetic knee extension peak torque and countermovement jump (CMJ) height were assessed to establish convergent and construct validity, respectively. Reliability was determined using intraclass correlation coefficients (ICC_2,1) and coefficient of variation (CV). Validity was assessed using Pearson correlations.

Results

SLSTS metrics demonstrated good inter-day reliability (ICC_2,1 = 0.81–0.89; CV = 6.1–9.9 %) for both limbs, with no differences in inter-limb asymmetry between sessions. These metrics showed moderate convergent validity (|r| = 0.34–0.54) with isokinetic peak torque, and moderate–strong construct validity (|r| = 0.46–0.75) with CMJ height. Notably, the strength of the associations with CMJ height was comparable to those observed between isokinetic torque and CMJ height (Steiger’s Z-test, p > 0.05).

Conclusion

The app-based SLSTS is a reliable and valid alternative for assessing lower-limb performance and asymmetry in elite XCS athletes when laboratory-based assessments are not feasible.

目的：评估基于移动应用程序的单腿坐立（SLSTS）成绩指标在优秀越野滑雪（XCS）运动员中的效度和重测信度。设计：横断面，重复测量。设置：实验室、野外。参与者：22名国际水平的XCS运动员（女13名，男9名，中位年龄：18 岁）。主要结果测量：SLSTS上升时间、速度、力量和肢间不对称性在间隔三天的两个疗程中收集。评估等速膝关节伸展峰值扭矩和反运动跳跃高度，分别建立收敛效度和构建效度。采用类内相关系数（ICC2,1）和变异系数（CV）确定信度。使用Pearson相关性评估效度。结果：SLSTS指标对四肢表现出良好的日间信度（ICC2,1 = 0.81-0.89; CV = 6.1-9.9 %），两组间肢体间不对称无差异。这些指标具有中等趋同效度（|r| = 0.34-0.54），具有等速峰值扭矩；具有中强建构效度（|r| = 0.46-0.75），具有CMJ高度。值得注意的是，与CMJ高度相关的强度与等速扭矩和CMJ高度之间的相关性相当（Steiger's z检验，p > 0.05）。结论：在实验室评估不可行的情况下，基于应用程序的SLSTS是评估优秀XCS运动员下肢运动和不对称性的可靠有效的替代方法。

{"title":"The single-leg sit-to-stand test is valid and reliable for assessing lower limb performance and asymmetry in international cross-country skiers","authors":"Mürşit Ceyhun Birinci , Yücel Makaracı , Buket Sevindik Aktaş , Gökhan Atasever , Juan D. Ruiz-Cárdenas","doi":"10.1016/j.gaitpost.2026.110100","DOIUrl":"10.1016/j.gaitpost.2026.110100","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the validity and test–retest reliability of single-leg sit-to-stand (SLSTS) performance metrics derived from a mobile application in elite cross-country skiing (XCS) athletes.</div></div><div><h3>Design</h3><div>Cross-sectional, repeated-measures.</div></div><div><h3>Setting</h3><div>Laboratory, field.</div></div><div><h3>Participants</h3><div>22 international-level XCS athletes (13 females, 9 males; median age: 18 yrs).</div></div><div><h3>Main outcome measures</h3><div>SLSTS rising time, velocity, power, and inter-limb asymmetry were collected across two sessions separated by three days. Isokinetic knee extension peak torque and countermovement jump (CMJ) height were assessed to establish convergent and construct validity, respectively. Reliability was determined using intraclass correlation coefficients (ICC<sub>2,1</sub>) and coefficient of variation (CV). Validity was assessed using Pearson correlations.</div></div><div><h3>Results</h3><div>SLSTS metrics demonstrated good inter-day reliability (ICC<sub>2,1</sub> = 0.81–0.89; CV = 6.1–9.9 %) for both limbs, with no differences in inter-limb asymmetry between sessions. These metrics showed moderate convergent validity (|r| = 0.34–0.54) with isokinetic peak torque, and moderate–strong construct validity (|r| = 0.46–0.75) with CMJ height. Notably, the strength of the associations with CMJ height was comparable to those observed between isokinetic torque and CMJ height (Steiger’s Z-test, <em>p</em> > 0.05).</div></div><div><h3>Conclusion</h3><div>The app-based SLSTS is a reliable and valid alternative for assessing lower-limb performance and asymmetry in elite XCS athletes when laboratory-based assessments are not feasible.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"125 ","pages":"Article 110100"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Markerless motion capture affects talocrural joint frontal plane interpretation 无标记动作捕捉影响距肢关节前缘平面解释

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2026-03-01 Epub Date: 2026-01-28 DOI: 10.1016/j.gaitpost.2026.110107

Hui Tang , Barry Munkasy , Li Li

Background

Motion analysis is critical for understanding injury mechanisms and enhancing prevention and rehabilitation strategies in sports medicine. Although conventional marker-based motion capture is effective for detailed biomechanical assessment, it is time-consuming, restricted to controlled environments, and susceptible to human error. Markerless motion capture offers greater convenience, enabling efficient data collection and on-site analysis. Nevertheless, its reliability for clinical applications requires validation.

Research question

This study investigates whether using the Theia3D markerless motion capture system yields different interpretations of subtalar joint kinematics during running compared to a marker-based system.

Methods

Fifteen recreational runners free of neuromuscular or musculoskeletal impairments were recruited. Previously collected treadmill running data were reprocessed using the updated Theia3D software, and the resulting subtalar joint kinematics were compared to those from the marker-based system. Statistical parametric mapping analysis and two-way within-subject repeated measures analysis of variance were used to determine differences between the two systems.

Results

Statistical parametric mapping revealed that Theia3D had systematic biases during different running speeds: overestimated subtalar frontal plane joint range of motion, maximal angular velocity, and maximal acceleration in the frontal plane compared to the marker-based system.

Significance

Given the association between subtalar joint kinematics and running-related injuries, we conclude that Theia3D provides convenience for clinical biomechanical studies but requires cautious interpretation for injury prediction and rehabilitation practices.

在运动医学中，运动分析对于理解损伤机制和加强预防和康复策略至关重要。尽管传统的基于标记的动作捕捉对于详细的生物力学评估是有效的，但它耗时，受控制环境的限制，并且容易受到人为错误的影响。无标记动作捕捉提供了更大的便利，实现了高效的数据收集和现场分析。然而，其临床应用的可靠性需要验证。研究问题：本研究调查了在跑步过程中，与基于标记的系统相比，使用Theia3D无标记运动捕捉系统是否会产生不同的距下关节运动学解释。方法招募15名无神经肌肉或肌肉骨骼损伤的休闲跑步者。先前收集的跑步机运行数据使用更新的Theia3D软件进行重新处理，并将所得的距下关节运动学与基于标记系统的结果进行比较。采用统计参数映射分析和双向受试者重复测量方差分析来确定两个系统之间的差异。结果统计参数映射显示，与基于标记的系统相比，Theia3D在不同跑步速度下存在系统性偏差：高估距下额平面关节运动范围、最大角速度和额平面最大加速度。考虑到距下关节运动学与跑步相关损伤之间的联系，我们得出结论，Theia3D为临床生物力学研究提供了便利，但在损伤预测和康复实践中需要谨慎的解释。

{"title":"Markerless motion capture affects talocrural joint frontal plane interpretation","authors":"Hui Tang , Barry Munkasy , Li Li","doi":"10.1016/j.gaitpost.2026.110107","DOIUrl":"10.1016/j.gaitpost.2026.110107","url":null,"abstract":"<div><h3>Background</h3><div>Motion analysis is critical for understanding injury mechanisms and enhancing prevention and rehabilitation strategies in sports medicine. Although conventional marker-based motion capture is effective for detailed biomechanical assessment, it is time-consuming, restricted to controlled environments, and susceptible to human error. Markerless motion capture offers greater convenience, enabling efficient data collection and on-site analysis. Nevertheless, its reliability for clinical applications requires validation.</div></div><div><h3>Research question</h3><div>This study investigates whether using the Theia3D markerless motion capture system yields different interpretations of subtalar joint kinematics during running compared to a marker-based system.</div></div><div><h3>Methods</h3><div>Fifteen recreational runners free of neuromuscular or musculoskeletal impairments were recruited. Previously collected treadmill running data were reprocessed using the updated Theia3D software, and the resulting subtalar joint kinematics were compared to those from the marker-based system. Statistical parametric mapping analysis and two-way within-subject repeated measures analysis of variance were used to determine differences between the two systems.</div></div><div><h3>Results</h3><div>Statistical parametric mapping revealed that Theia3D had systematic biases during different running speeds: overestimated subtalar frontal plane joint range of motion, maximal angular velocity, and maximal acceleration in the frontal plane compared to the marker-based system.</div></div><div><h3>Significance</h3><div>Given the association between subtalar joint kinematics and running-related injuries, we conclude that Theia3D provides convenience for clinical biomechanical studies but requires cautious interpretation for injury prediction and rehabilitation practices.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"125 ","pages":"Article 110107"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Development and validity of composite scores for the instrumented-modified Clinical Test of Sensory Interaction in Balance in inpatients with subacute stroke 亚急性脑卒中住院患者平衡感觉相互作用仪器改良临床测试综合评分的研制与有效性。

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2026-03-01 Epub Date: 2025-12-04 DOI: 10.1016/j.gaitpost.2025.110067

Tatsuya Igarashi , Shota Hayashi , Shingo Hirano , Kazusa Saisu , Hironobu Kakima , Yuta Tani , Hiroyuki Inooka

Background

The instrumented modified Clinical Test of Sensory Interaction on Balance (i-mCTSIB) assesses sensory contributions to postural control using Center of Pressure (CoP) data. Existing composite scores do not reflect task difficulty or sensory weighting across conditions.

Objectives

This study developed a regression-based new composite score and examined its ability to discriminate walking independence and its correlation with standard balance measures in subacute stroke.

Methods

This study included 54 patients with first-ever stroke. Postural control was evaluated under four i-mCTSIB conditions combining visual input and surface type. Total CoP path length was recorded, and a composite score was derived using regression analysis. Discriminative ability for walking independence was assessed via receiver operating characteristic analysis, and area under the curve (AUC) values were compared. Measures with AUC > 0.80 were further tested for construct validity using the Mini-Balance Evaluation Systems Test (Mini-BESTest).

Results

The i-mCTSIB composite score demonstrated an AUC of 0.84 (95 % CI: 0.69–0.98), exceeding the threshold of 0.80 and outperforming all individual test conditions, which showed AUCs below 0.80. The composite score also showed a moderate correlation with the Mini-BESTest (r̄ = 0.48, 95 % CI: 0.24–0.67, p < 0.001).

Conclusions

This study developed a novel composite score for the i-mCTSIB that quantitatively reflects sensory integration in postural control and demonstrated its superior ability to discriminate walking independence in patients with subacute stroke. Further investigations are required to evaluate whether these findings generalize to additional CoP parameters.

背景：仪器改良的感觉相互作用平衡临床测试（i-mCTSIB）通过压力中心（CoP）数据评估感觉对姿势控制的贡献。现有的综合分数不能反映任务难度或感觉权重。目的：本研究开发了一种基于回归的新综合评分，并检验了其区分亚急性卒中患者行走独立性的能力及其与标准平衡测量的相关性。方法：本研究纳入54例首次脑卒中患者。在结合视觉输入和表面类型的四种i-mCTSIB条件下评估姿势控制。记录总CoP路径长度，采用回归分析得出综合评分。通过受试者工作特征分析评估行走独立的判别能力，并比较曲线下面积（AUC）值。AUC为> 0.80的测量方法使用Mini-Balance评估系统测试（mini - best）进一步检验结构效度。结果：i-mCTSIB综合评分的AUC为0.84(95 % CI: 0.69-0.98)，超过了0.80的阈值，优于所有单项测试条件的AUC均低于0.80。该综合评分与Mini-BESTest也显示出中度相关性（r = 0.48, 95 % CI: 0.24-0.67, p ）。结论：本研究为i-mCTSIB开发了一种新的综合评分，定量反映了姿势控制中的感觉统合，并证明了其在区分亚急性卒中患者行走独立性方面的卓越能力。需要进一步的调查来评估这些发现是否可以推广到其他CoP参数。

{"title":"Development and validity of composite scores for the instrumented-modified Clinical Test of Sensory Interaction in Balance in inpatients with subacute stroke","authors":"Tatsuya Igarashi , Shota Hayashi , Shingo Hirano , Kazusa Saisu , Hironobu Kakima , Yuta Tani , Hiroyuki Inooka","doi":"10.1016/j.gaitpost.2025.110067","DOIUrl":"10.1016/j.gaitpost.2025.110067","url":null,"abstract":"<div><h3>Background</h3><div>The instrumented modified Clinical Test of Sensory Interaction on Balance (i-mCTSIB) assesses sensory contributions to postural control using Center of Pressure (CoP) data. Existing composite scores do not reflect task difficulty or sensory weighting across conditions.</div></div><div><h3>Objectives</h3><div>This study developed a regression-based new composite score and examined its ability to discriminate walking independence and its correlation with standard balance measures in subacute stroke.</div></div><div><h3>Methods</h3><div>This study included 54 patients with first-ever stroke. Postural control was evaluated under four i-mCTSIB conditions combining visual input and surface type. Total CoP path length was recorded, and a composite score was derived using regression analysis. Discriminative ability for walking independence was assessed via receiver operating characteristic analysis, and area under the curve (AUC) values were compared. Measures with AUC > 0.80 were further tested for construct validity using the Mini-Balance Evaluation Systems Test (Mini-BESTest).</div></div><div><h3>Results</h3><div>The i-mCTSIB composite score demonstrated an AUC of 0.84 (95 % CI: 0.69–0.98), exceeding the threshold of 0.80 and outperforming all individual test conditions, which showed AUCs below 0.80. The composite score also showed a moderate correlation with the Mini-BESTest (r̄ = 0.48, 95 % CI: 0.24–0.67, p < 0.001).</div></div><div><h3>Conclusions</h3><div>This study developed a novel composite score for the i-mCTSIB that quantitatively reflects sensory integration in postural control and demonstrated its superior ability to discriminate walking independence in patients with subacute stroke. Further investigations are required to evaluate whether these findings generalize to additional CoP parameters.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"125 ","pages":"Article 110067"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145703629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Immediate effects of ankle–foot orthosis on gait coordination and kinematics in subacute stroke 踝足矫形器对亚急性中风患者步态协调和运动学的直接影响

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2026-03-01 Epub Date: 2025-11-28 DOI: 10.1016/j.gaitpost.2025.110064

Yeo Joon Yun , Jae Hyeon Park , Min Kyu Jang , Ji Woong Choi , Seong Ho Jang

Background

Ankle–foot orthoses (AFOs) are commonly prescribed after stroke, yet their immediate effects on bilateral hip–knee coordination and joint-specific contributors to functional gains are unclear.

Research question

What are the immediate effects of AFO use on bilateral coordination and joint-level kinematics, and which changes relate to performance gains?

Methods

Forty-eight individuals with subacute stroke (mean age 57.9 ± 13.9 years; 28 men/20 women; FAC median 3.0) performed overground 10-m trials under pre-AFO and immediate post-AFO conditions (no acclimatization); eight had two measurements (56 pre–post sets). A prefabricated semi-rigid AFO (UD-Flex, anterior shell) was fitted on the paretic limb. Seven inertial-measurement units recorded spatiotemporal metrics, phase-specific (stance/swing) peak angles, and hip–knee cyclogram metrics. Condition differences were expressed as Δ = post − pre. Elastic-net selection followed by ordinary least squares identified predictors of Δ velocity, Δ cadence, and Δ hip/knee ROM.

Results

AFO use was associated with a small increase in walking speed (+0.01 m/s; p = 0.01), below MCID, whereas cadence and stride time were unchanged On the paretic limb, swing-phase peak hip flexion (−3.1°), knee flexion (−4.4°), and ankle dorsiflexion (−2.3°) decreased; contralateral peaks showed no significant change. Cyclogram geometry was largely preserved. Predictive models linked faster walking to greater non-paretic hip/knee excursions and paretic-ankle change (adjusted R²=0.36). Cadence related positively to non-paretic knee and paretic hip excursions and negatively to paretic-ankle change.

Significance

AFO use was associated with reduced paretic swing-phase peak flexion and ankle stabilization, coinciding with a modest, sub-MCID speed gain. Findings support training that pairs paretic-ankle stability with non-paretic propulsion, while recognizing the limited clinical magnitude of the immediate effect.

踝关节足矫形器（AFOs）通常在中风后使用，但其对双侧髋关节-膝关节协调和关节特异性功能增强的直接影响尚不清楚。研究问题：使用AFO对双侧协调和关节水平运动学的直接影响是什么？哪些变化与性能提高有关？方法48例亚急性脑卒中患者（平均年龄57.9 ± 13.9岁，男性28人/女性20人，FAC中位数3.0）在afo前和afo后（未适应）条件下进行10米地上试验；8例有2次测量（56组前后测量）。将预制的半刚性AFO （UD-Flex，前壳）安装在患瘫肢体上。七个惯性测量单元记录了时空度量、相位特定（站立/摆动）峰值角度和髋-膝循环度量。条件差异表示为Δ = post−pre。结果使用safo与步行速度的小幅增加相关（+0.01 m/s; p = 0.01），低于MCID，而节奏和步幅时间不变。在麻痹的四肢上，摆动相峰值髋关节屈曲（- 3.1°）、膝关节屈曲（- 4.4°）和踝关节背屈（- 2.3°）下降；对侧峰无明显变化。环形几何在很大程度上被保留了下来。预测模型将更快的步行与更大的非麻痹性髋关节/膝关节运动和麻痹性踝关节变化联系起来（调整后的R²=0.36）。节奏与非麻痹性膝关节和麻痹性髋关节漂移呈正相关，与麻痹性踝关节变化负相关。意义：使用afo可减少家长挥摆阶段的峰值屈曲和踝关节稳定，并伴有适度的、低于mcid的速度增加。研究结果支持将paretic-ankle stability与非paretic- propulsion相结合的训练，同时认识到临床效果有限。

{"title":"Immediate effects of ankle–foot orthosis on gait coordination and kinematics in subacute stroke","authors":"Yeo Joon Yun , Jae Hyeon Park , Min Kyu Jang , Ji Woong Choi , Seong Ho Jang","doi":"10.1016/j.gaitpost.2025.110064","DOIUrl":"10.1016/j.gaitpost.2025.110064","url":null,"abstract":"<div><h3>Background</h3><div>Ankle–foot orthoses (AFOs) are commonly prescribed after stroke, yet their immediate effects on bilateral hip–knee coordination and joint-specific contributors to functional gains are unclear.</div></div><div><h3>Research question</h3><div>What are the immediate effects of AFO use on bilateral coordination and joint-level kinematics, and which changes relate to performance gains?</div></div><div><h3>Methods</h3><div>Forty-eight individuals with subacute stroke (mean age 57.9 ± 13.9 years; 28 men/20 women; FAC median 3.0) performed overground 10-m trials under pre-AFO and immediate post-AFO conditions (no acclimatization); eight had two measurements (56 pre–post sets). A prefabricated semi-rigid AFO (UD-Flex, anterior shell) was fitted on the paretic limb. Seven inertial-measurement units recorded spatiotemporal metrics, phase-specific (stance/swing) peak angles, and hip–knee cyclogram metrics. Condition differences were expressed as Δ = post − pre. Elastic-net selection followed by ordinary least squares identified predictors of Δ velocity, Δ cadence, and Δ hip/knee ROM.</div></div><div><h3>Results</h3><div>AFO use was associated with a small increase in walking speed (+0.01 m/s; p = 0.01), below MCID, whereas cadence and stride time were unchanged On the paretic limb, swing-phase peak hip flexion (−3.1°), knee flexion (−4.4°), and ankle dorsiflexion (−2.3°) decreased; contralateral peaks showed no significant change. Cyclogram geometry was largely preserved. Predictive models linked faster walking to greater non-paretic hip/knee excursions and paretic-ankle change (adjusted R²=0.36). Cadence related positively to non-paretic knee and paretic hip excursions and negatively to paretic-ankle change.</div></div><div><h3>Significance</h3><div>AFO use was associated with reduced paretic swing-phase peak flexion and ankle stabilization, coinciding with a modest, sub-MCID speed gain. Findings support training that pairs paretic-ankle stability with non-paretic propulsion, while recognizing the limited clinical magnitude of the immediate effect.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"125 ","pages":"Article 110064"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Identification potential of cognitive-motor dual-task gait in frailty via machine learning model 基于机器学习模型的衰弱认知-运动双任务步态识别潜力

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2026-03-01 Epub Date: 2026-01-08 DOI: 10.1016/j.gaitpost.2026.110096

Jiani Wu , Yurou He , Xiaoqin Wang , Haodong Huang , Zhangjing Deng , Yingxi Chen , Jiaqi Song , Zehu Sheng , Qi Tian , Yang Lü

Background

The early diagnosis and intervention of frailty play a crucial role in enhancing the quality of life for elderly individuals in their later years. Currently, the identification of frailty relies on various manual assessment scales, which are time-consuming and pose significant challenges to clinical practice.

Methods

A total of 220 participants were recruited to collect Timed Up-and-Go Test (TUGT) data, as well as single-task (ST) and cognitive-motor dual-task gait parameters. The modified Frailty Index-11 (mFI-11) scale and cognitive function assessments were completed. Machine learning (ML) methods were employed to screen gait parameters and construct a frailty diagnostic model. The receiver operating characteristic (ROC) curve was utilized to evaluate the correlation between significant gait indicators identified in the optimal model and cognitive frailty.

Results

Among the 220 participants, the numbers of individuals classified as non-frailty, pre-frailty, and frailty were 83, 88, and 49, respectively. Within these groups, 43 were cognitively normal, and 53 exhibited cognitive frailty. In the model utilizing gait features, the SVM - Linear Kernel model exhibited the best classification performance, with an accuracy of 64.09 % and an F1 score of 64.38 %. Among the gait parameters, TUGT contributed significantly to the model while also demonstrating high predictive value for cognitive frailty (AUC = 0.8293, P < 0.0001).

Conclusions

The integration of cognitive-motor dual-task gait parameters with ML methods demonstrates satisfactory overall accuracy for the tri-classification diagnosis of frailty, indicating potential for community screening and auxiliary clinical diagnosis. Cognitive frailty shows significant correlations with gait parameters, particularly those assessed by TUGT.

背景虚弱的早期诊断和干预对提高老年人晚年生活质量起着至关重要的作用。目前，虚弱的识别依赖于各种人工评估量表，这既耗时又对临床实践构成重大挑战。方法共招募220名受试者，收集时间起身测试（TUGT）数据、单任务（ST）和认知-运动双任务步态参数。完成修改后的衰弱指数-11 （mFI-11）量表和认知功能评估。采用机器学习（ML）方法筛选步态参数，构建虚弱诊断模型。利用受试者工作特征（ROC）曲线评估最优模型中识别的重要步态指标与认知衰弱之间的相关性。结果220名参与者中，非体弱、预体弱和体弱的人数分别为83人、88人和49人。在这些组中，43人认知正常，53人表现出认知脆弱。在利用步态特征的模型中，SVM - Linear Kernel模型的分类性能最好，准确率为64.09 %，F1得分为64.38 %。在步态参数中，TUGT对模型的贡献显著，同时对认知衰弱也有很高的预测价值（AUC = 0.8293, P <； 0.0001）。结论将认知-运动双任务步态参数与ML方法相结合，对虚弱三分类诊断具有满意的总体准确性，具有社区筛查和辅助临床诊断的潜力。认知衰弱显示出与步态参数的显著相关性，特别是那些由TUGT评估的。

{"title":"Identification potential of cognitive-motor dual-task gait in frailty via machine learning model","authors":"Jiani Wu , Yurou He , Xiaoqin Wang , Haodong Huang , Zhangjing Deng , Yingxi Chen , Jiaqi Song , Zehu Sheng , Qi Tian , Yang Lü","doi":"10.1016/j.gaitpost.2026.110096","DOIUrl":"10.1016/j.gaitpost.2026.110096","url":null,"abstract":"<div><h3>Background</h3><div>The early diagnosis and intervention of frailty play a crucial role in enhancing the quality of life for elderly individuals in their later years. Currently, the identification of frailty relies on various manual assessment scales, which are time-consuming and pose significant challenges to clinical practice.</div></div><div><h3>Methods</h3><div>A total of 220 participants were recruited to collect Timed Up-and-Go Test (TUGT) data, as well as single-task (ST) and cognitive-motor dual-task gait parameters. The modified Frailty Index-11 (mFI-11) scale and cognitive function assessments were completed. Machine learning (ML) methods were employed to screen gait parameters and construct a frailty diagnostic model. The receiver operating characteristic (ROC) curve was utilized to evaluate the correlation between significant gait indicators identified in the optimal model and cognitive frailty.</div></div><div><h3>Results</h3><div>Among the 220 participants, the numbers of individuals classified as non-frailty, pre-frailty, and frailty were 83, 88, and 49, respectively. Within these groups, 43 were cognitively normal, and 53 exhibited cognitive frailty. In the model utilizing gait features, the SVM - Linear Kernel model exhibited the best classification performance, with an accuracy of 64.09 % and an F1 score of 64.38 %. Among the gait parameters, TUGT contributed significantly to the model while also demonstrating high predictive value for cognitive frailty (AUC = 0.8293, P < 0.0001).</div></div><div><h3>Conclusions</h3><div>The integration of cognitive-motor dual-task gait parameters with ML methods demonstrates satisfactory overall accuracy for the tri-classification diagnosis of frailty, indicating potential for community screening and auxiliary clinical diagnosis. Cognitive frailty shows significant correlations with gait parameters, particularly those assessed by TUGT.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"125 ","pages":"Article 110096"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145972774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From resting-state to movement: The role of cortical networks in parkinsonian gait 从静息状态到运动：皮质网络在帕金森步态中的作用。

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2026-03-01 Epub Date: 2025-08-28 DOI: 10.1016/j.gaitpost.2025.08.079

Layla Cupertino , Ellen Lirani-Silva , Diego Orcioli-Silva , Victor S. Beretta , Lucas G.S. França , Daniel Boari Coelho , Rodrigo Vitorio

Background

Gait impairments in Parkinson’s disease (PD) arise from disruptions in automatic motor control, requiring compensatory engagement of cortical networks. This study compared resting-state functional connectivity in specific cortical regions (frontal, central, parietal, occipital, and temporal) between people with PD and healthy individuals and explored its potential association with multidimensional gait domains. Methods: Twenty individuals with PD and 19 healthy controls participated. Resting-state electroencephalography was recorded, and functional connectivity was analyzed using local efficiency measures. Spatiotemporal gait parameters were assessed to calculate scores for five gait domains. Spearman correlations were used to evaluate the association between regional connectivity and gait domains. Results: Individuals with PD exhibited reduced functional connectivity in frontal and central regions compared to healthy controls. Connectivity in the frontal region significantly correlated with the pace domain in PD, highlighting its role in compensatory mechanisms for maintaining gait speed. In healthy controls, broader correlations were observed: parietal and occipital connectivity were associated with pace and rhythm, suggesting more integrated and adaptive network functionality. Conclusion: Current findings highlight the distinct roles of cortical regions in regulating gait domains and the compensatory mechanisms employed in PD. The findings underscore the potential role of connectivity-based biomarkers in improving our understanding of gait impairments and informing targeted interventions, such as neuromodulation and rehabilitation. However, their clinical utility remains limited by methodological and feasibility challenges, and future research should focus on validating their applicability in larger, longitudinal, and task-based studies.

背景：帕金森病（PD）的步态障碍源于自动运动控制的中断，需要皮质网络的代偿性参与。本研究比较了PD患者和健康个体在特定皮质区域（额叶、中央、顶叶、枕叶和颞叶）的静息状态功能连通性，并探讨了其与多维步态域的潜在关联。方法：20例PD患者和19例健康对照。静息状态脑电图记录，用局部效率测量分析功能连通性。评估时空步态参数以计算五个步态域的得分。Spearman相关性用于评估区域连通性和步态域之间的关联。结果：与健康对照相比，PD患者表现出额叶和中央区域功能连接减少。额叶区域的连通性与PD患者的速度域显著相关，突出了其在维持步态速度的代偿机制中的作用。在健康对照中，观察到更广泛的相关性：顶叶和枕叶连接与速度和节奏相关，表明更综合和适应性的网络功能。结论：目前的研究结果强调了皮质区域在PD中调节步态域和代偿机制的独特作用。这些发现强调了基于连接的生物标志物在提高我们对步态障碍的理解和告知有针对性的干预措施（如神经调节和康复）方面的潜在作用。然而，它们的临床应用仍然受到方法学和可行性挑战的限制，未来的研究应侧重于验证它们在更大规模、纵向和基于任务的研究中的适用性。

{"title":"From resting-state to movement: The role of cortical networks in parkinsonian gait","authors":"Layla Cupertino , Ellen Lirani-Silva , Diego Orcioli-Silva , Victor S. Beretta , Lucas G.S. França , Daniel Boari Coelho , Rodrigo Vitorio","doi":"10.1016/j.gaitpost.2025.08.079","DOIUrl":"10.1016/j.gaitpost.2025.08.079","url":null,"abstract":"<div><h3>Background</h3><div>Gait impairments in Parkinson’s disease (PD) arise from disruptions in automatic motor control, requiring compensatory engagement of cortical networks. This study compared resting-state functional connectivity in specific cortical regions (frontal, central, parietal, occipital, and temporal) between people with PD and healthy individuals and explored its potential association with multidimensional gait domains. Methods: Twenty individuals with PD and 19 healthy controls participated. Resting-state electroencephalography was recorded, and functional connectivity was analyzed using local efficiency measures. Spatiotemporal gait parameters were assessed to calculate scores for five gait domains. Spearman correlations were used to evaluate the association between regional connectivity and gait domains. Results: Individuals with PD exhibited reduced functional connectivity in frontal and central regions compared to healthy controls. Connectivity in the frontal region significantly correlated with the pace domain in PD, highlighting its role in compensatory mechanisms for maintaining gait speed. In healthy controls, broader correlations were observed: parietal and occipital connectivity were associated with pace and rhythm, suggesting more integrated and adaptive network functionality. Conclusion: Current findings highlight the distinct roles of cortical regions in regulating gait domains and the compensatory mechanisms employed in PD. The findings underscore the potential role of connectivity-based biomarkers in improving our understanding of gait impairments and informing targeted interventions, such as neuromodulation and rehabilitation. However, their clinical utility remains limited by methodological and feasibility challenges, and future research should focus on validating their applicability in larger, longitudinal, and task-based studies.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"125 ","pages":"Article 109961"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Design, mechanical evaluation, and wear trial of 3D printed insole for plantar off-loading in older adults with diabetes 老年糖尿病患者足底卸荷3D打印鞋垫的设计、机械评估和磨损试验

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2026-03-01 Epub Date: 2026-01-21 DOI: 10.1016/j.gaitpost.2026.110102

Karolyn Ning , Mei-Ying Kwan , Kit-Lun Yick

Background

Up to 15 % of people with diabetes are at risk of developing a foot ulcer. Diabetic insoles are crucial for preventing foot ulcers by redistributing plantar pressure and increasing contact area. This study investigated the effects of novel insoles made with three-dimensional (3D) printed auxetic structure in older adults with diabetes.

Research question

What are the effects of insoles on plantar off-loading, pressure distribution and mechanical properties in older adults with diabetes, as evaluated using a novel 3D printed auxetic-structured insole and compared to conventional insoles?

Methods

Twenty-three elderly patients with diabetes were recruited as research subjects to evaluate the plantar off-loading effect of the insole prototype while walking. A total of seven 3D printed reentrant structures with varying internal angles and beam sizes were fabricated and evaluated. The differences in foot contact area and plantar pressure distribution were compared with conventional insoles. The mechanical properties of the heel pad material, especially its force absorption and compression properties were also evaluated.

Results

The mean peak pressure (MPP) has been reduced by using diabetic insoles during walking. Compared to the commercial diabetic insole, the 3D printed insole shows a reduction of MPP up to 30.7 % which is also able to maintain the most evenly distributed plantar pressure by a 19.7 % increase of contact area with the midfoot.

Significance

The capability of 3D printing on making insoles with 3D geometries that fit the human plantar surface was confirmed. The proposed 3D printed insole reliably alleviates peak plantar pressure based on laboratory findings and future long-term follow-up studies are necessary to confirm these benefits in daily life activities. The output of the study could also extend to the development of customized insole orthosis to prevent the development of diabetic foot ulcers.

高达15% %的糖尿病患者有患足部溃疡的风险。糖尿病鞋垫通过重新分配足底压力和增加接触面积，对预防足溃疡至关重要。本研究探讨了三维（3D）打印的新型鞋垫对老年糖尿病患者的影响。研究问题：与传统鞋垫相比，使用新型3D打印塑形结构鞋垫评估鞋垫对老年糖尿病患者足底卸荷、压力分布和机械性能有何影响？方法以23例老年糖尿病患者为研究对象，评价步行时鞋垫原型的卸足效果。共制作和评估了七个具有不同内角和梁尺寸的3D打印可入式结构。比较了与常规鞋垫在足部接触面积和足底压力分布上的差异。对鞋垫材料的力学性能，特别是吸力性能和压缩性能进行了评价。结果使用糖尿病足垫可降低步行时的平均峰值压（MPP）。与商业糖尿病鞋垫相比，3D打印鞋垫显示MPP降低高达30.7% %，并且能够通过与中足的接触面积增加19.7% %来保持最均匀分布的足底压力。意义：验证了3D打印制作符合人体足底表面三维几何形状的鞋垫的能力。根据实验结果，3D打印鞋垫可以可靠地缓解足底压力峰值，未来的长期随访研究需要在日常生活活动中证实这些益处。本研究的成果也可以扩展到定制鞋垫矫形器的开发，以防止糖尿病足溃疡的发展。

{"title":"Design, mechanical evaluation, and wear trial of 3D printed insole for plantar off-loading in older adults with diabetes","authors":"Karolyn Ning , Mei-Ying Kwan , Kit-Lun Yick","doi":"10.1016/j.gaitpost.2026.110102","DOIUrl":"10.1016/j.gaitpost.2026.110102","url":null,"abstract":"<div><h3>Background</h3><div>Up to 15 % of people with diabetes are at risk of developing a foot ulcer. Diabetic insoles are crucial for preventing foot ulcers by redistributing plantar pressure and increasing contact area. This study investigated the effects of novel insoles made with three-dimensional (3D) printed auxetic structure in older adults with diabetes.</div></div><div><h3>Research question</h3><div>What are the effects of insoles on plantar off-loading, pressure distribution and mechanical properties in older adults with diabetes, as evaluated using a novel 3D printed auxetic-structured insole and compared to conventional insoles?</div></div><div><h3>Methods</h3><div>Twenty-three elderly patients with diabetes were recruited as research subjects to evaluate the plantar off-loading effect of the insole prototype while walking. A total of seven 3D printed reentrant structures with varying internal angles and beam sizes were fabricated and evaluated. The differences in foot contact area and plantar pressure distribution were compared with conventional insoles. The mechanical properties of the heel pad material, especially its force absorption and compression properties were also evaluated.</div></div><div><h3>Results</h3><div>The mean peak pressure (MPP) has been reduced by using diabetic insoles during walking. Compared to the commercial diabetic insole, the 3D printed insole shows a reduction of MPP up to 30.7 % which is also able to maintain the most evenly distributed plantar pressure by a 19.7 % increase of contact area with the midfoot.</div></div><div><h3>Significance</h3><div>The capability of 3D printing on making insoles with 3D geometries that fit the human plantar surface was confirmed. The proposed 3D printed insole reliably alleviates peak plantar pressure based on laboratory findings and future long-term follow-up studies are necessary to confirm these benefits in daily life activities. The output of the study could also extend to the development of customized insole orthosis to prevent the development of diabetic foot ulcers.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"125 ","pages":"Article 110102"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Assessment of forward head posture in individuals with and without chronic neck pain: A cross-sectional study 有或无慢性颈部疼痛的个体前倾头部姿势的评估：一项横断面研究

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2026-03-01 Epub Date: 2026-01-07 DOI: 10.1016/j.gaitpost.2026.110093

Isabel Tunas-Maceiras , Fernando Ramos-Gómez , Beatriz Rodríguez-Romero

Background

Chronic neck pain (CNP) is a leading cause of disability worldwide. Forward head posture (FHP) is a prevalent craniocervical posture, with controversy regarding its relationship with CNP. The craniovertebral angle (CVA) is commonly used to assess FHP.

Objectives

To determine whether significant differences in head posture, assessed through the CVA, exist between adults with and without CNP. Secondary objectives include conducting an exploratory analysis of variables, evaluating intra- and interobserver reliability of CVA by novice evaluators and analyzing CVA correlations between sitting and standing.

Design

Two-group cross-sectional study.

Methods

92 participants were evaluated (50 with CNP, 42 asymptomatic). CVA was measured in sitting and standing using photogrammetry. Sociodemographic data, musculoskeletal pain prevalence, pain intensity, general health, physical activity, and neck disability were collected. CVA intra- and interobserver reliability was assessed using Kinovea. Factors associated with CVA were identified using multiple linear regression analysis.

Results

No association was found between FHP and CNP. Gender and BMI were associated with CVA. Women had significantly lower CVA than men seated (B= −2.5, p = 0.024) and standing (B= −2.0, p = 0.031). Overweight individuals had significantly lower CVA than normal-weight individuals seated and standing (B= −0.6, p < 0.001 for both). Inter- and intra-reliability in both positions was excellent (all ICC > 0.90). A correlation was observed between sitting and standing measurements.

Conclusion

No significant association was found between CNP and FHP based on CVA. Sex, age and BMI demonstrated a substantial influence on head posture. CVA photogrammetry is reliable for novice evaluators.

背景：慢性颈部疼痛（CNP）是世界范围内致残的主要原因。头部前倾姿势（FHP）是一种常见的颅颈姿势，关于其与CNP的关系存在争议。颅椎角（CVA）通常用于评估FHP。目的通过CVA评估，确定有和没有CNP的成年人在头部姿势上是否存在显著差异。次要目标包括进行变量的探索性分析，评估新手评估者CVA的内部和观察者之间的可靠性，以及分析坐姿和站立之间的CVA相关性。设计两组横断面研究。方法对92例受试者进行评估（伴有CNP者50例，无症状者42例）。采用摄影测量法分别在坐姿和站立状态下测量CVA。收集社会人口统计数据、肌肉骨骼疼痛患病率、疼痛强度、一般健康状况、身体活动和颈部残疾。使用Kinovea评估CVA在观察者内部和观察者之间的信度。使用多元线性回归分析确定与CVA相关的因素。结果FHP与CNP无相关性。性别和BMI与CVA相关。女性的CVA明显低于男性坐着（B= - 2.5, p = 0.024）和站立（B= - 2.0, p = 0.031）。超重个体的CVA显著低于坐着和站立的正常体重个体（B= - 0.6, p <； 0.001）。两个位置之间和内部的可靠性都很好（所有ICC >； 0.90）。坐着和站着的测量结果之间存在相关性。结论CNP与基于CVA的FHP无显著相关性。性别、年龄和身体质量指数对头部姿势有重大影响。CVA摄影测量对新手评价者是可靠的。

{"title":"Assessment of forward head posture in individuals with and without chronic neck pain: A cross-sectional study","authors":"Isabel Tunas-Maceiras , Fernando Ramos-Gómez , Beatriz Rodríguez-Romero","doi":"10.1016/j.gaitpost.2026.110093","DOIUrl":"10.1016/j.gaitpost.2026.110093","url":null,"abstract":"<div><h3>Background</h3><div>Chronic neck pain (CNP) is a leading cause of disability worldwide. Forward head posture (FHP) is a prevalent craniocervical posture, with controversy regarding its relationship with CNP. The craniovertebral angle (CVA) is commonly used to assess FHP.</div></div><div><h3>Objectives</h3><div>To determine whether significant differences in head posture, assessed through the CVA, exist between adults with and without CNP. Secondary objectives include conducting an exploratory analysis of variables, evaluating intra- and interobserver reliability of CVA by novice evaluators and analyzing CVA correlations between sitting and standing.</div></div><div><h3>Design</h3><div>Two-group cross-sectional study.</div></div><div><h3>Methods</h3><div>92 participants were evaluated (50 with CNP, 42 asymptomatic). CVA was measured in sitting and standing using photogrammetry. Sociodemographic data, musculoskeletal pain prevalence, pain intensity, general health, physical activity, and neck disability were collected. CVA intra- and interobserver reliability was assessed using Kinovea. Factors associated with CVA were identified using multiple linear regression analysis.</div></div><div><h3>Results</h3><div>No association was found between FHP and CNP. Gender and BMI were associated with CVA. Women had significantly lower CVA than men seated (B= −2.5, p = 0.024) and standing (B= −2.0, p = 0.031). Overweight individuals had significantly lower CVA than normal-weight individuals seated and standing (B= −0.6, p < 0.001 for both). Inter- and intra-reliability in both positions was excellent (all ICC > 0.90). A correlation was observed between sitting and standing measurements.</div></div><div><h3>Conclusion</h3><div>No significant association was found between CNP and FHP based on CVA. Sex, age and BMI demonstrated a substantial influence on head posture. CVA photogrammetry is reliable for novice evaluators.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"125 ","pages":"Article 110093"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0