Pub Date : 2026-02-01Epub Date: 2025-09-25DOI: 10.1016/j.gaitpost.2025.109986
Jonas Armbruster , Lea Viola Fuchs , Ursula Trinler , Gregor Reiter , Paul Alfred Grützner , Holger Freischmidt
Objective
This study aims to quantify residual functional limitations and to identify rehabilitation needs in adults with healed tibial nonunions using comprehensive motion analysis.
Design
Clinical-experimental cohort study.
Methods
Subjective status was captured with the Lower Extremity Functional Scale, Short-Form 36, and a Numeric Rating Scale for pain. Objective performance was profiled via marker-based gait analysis and two functional tasks - single-leg stance and squat. Key read-outs comprised temporal-spatial gait metrics, the Gait Profile Score, and individual Gait Variable Scores.
Results
Thirty-one adults were analysed (twelve with healed tibial nonunions and nineteen with uncomplicated fracture healing). Compared with controls, the nonunion group showed markedly lower functional scores and higher pain. Leg length inequality was greater and strongly related to pain intensity. Motion analysis documented wider step width, higher stride-length variability, and other indicators of gait instability. Functional tests confirmed reduced single-leg balance and limited joint range during squatting.
Conclusion
Bone union does not guarantee functional recovery. Patients who overcome tibial nonunion continue to display substantial gait and performance deficits that warrant structured, individually targeted rehabilitation programmes guided by motion-analysis findings to restore efficient locomotion and quality of life.
{"title":"Does bony consolidation guarantee functional recovery after tibial nonunion? Impairments and rehabilitation needs assessed by motion analysis","authors":"Jonas Armbruster , Lea Viola Fuchs , Ursula Trinler , Gregor Reiter , Paul Alfred Grützner , Holger Freischmidt","doi":"10.1016/j.gaitpost.2025.109986","DOIUrl":"10.1016/j.gaitpost.2025.109986","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to quantify residual functional limitations and to identify rehabilitation needs in adults with healed tibial nonunions using comprehensive motion analysis.</div></div><div><h3>Design</h3><div>Clinical-experimental cohort study.</div></div><div><h3>Methods</h3><div>Subjective status was captured with the Lower Extremity Functional Scale, Short-Form 36, and a Numeric Rating Scale for pain. Objective performance was profiled via marker-based gait analysis and two functional tasks - single-leg stance and squat. Key read-outs comprised temporal-spatial gait metrics, the Gait Profile Score, and individual Gait Variable Scores.</div></div><div><h3>Results</h3><div>Thirty-one adults were analysed (twelve with healed tibial nonunions and nineteen with uncomplicated fracture healing). Compared with controls, the nonunion group showed markedly lower functional scores and higher pain. Leg length inequality was greater and strongly related to pain intensity. Motion analysis documented wider step width, higher stride-length variability, and other indicators of gait instability. Functional tests confirmed reduced single-leg balance and limited joint range during squatting.</div></div><div><h3>Conclusion</h3><div>Bone union does not guarantee functional recovery. Patients who overcome tibial nonunion continue to display substantial gait and performance deficits that warrant structured, individually targeted rehabilitation programmes guided by motion-analysis findings to restore efficient locomotion and quality of life.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"124 ","pages":"Article 109986"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187925","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}
Pub Date : 2026-02-01Epub Date: 2025-09-13DOI: 10.1016/j.gaitpost.2025.109979
Tina Udemark Pasgaard , Morten Bøgelund Pedersen , Sidsel Hald Rahlf , Julie Ladeby Erichsen , Christian Faergemann , Bjarke Viberg , Anders Holsgaard-Larsen
Background
Diagnosing idiopathic toe walking (ITW) and assessing its severity based solely on clinical examinations can be challenging, underscoring the need for advanced, objective diagnostic tools to guide orthopedic treatment strategies.
Aim
To test whether treatment strategies of children diagnosed with ITW based on clinical examination change when objective and quantitative data from three-dimensional gait analysis (3DGA) and pedography are incorporated.
Methods
Children diagnosed with ITW and referred for orthopedic treatment based on clinical examination were included. Ankle and knee kinematics and kinetics were recorded in a single session using 3DGA, while heel contact time was assessed with pedography. Based on ankle joint angles and moments, participants were classified as having no-to-mild or moderate-to-severe ITW according to a predefined severity classification. Statistical parametric mapping (SPM) provided detailed analysis of deviations in kinematic and kinetic gait patterns. The area under the receiver operating curve (AUC) assessed heel contact time’s discriminative ability.
Results
Forty-seven children were included in the study. 3DGA classified 15 participants as having no-to-mild ITW and 32 as moderate-to-severe ITW. SPM analysis identified significant between-group differences in ankle kinematics and kinetics. Pedography demonstrated strong discriminative ability, with an AUC of 0.80.
Conclusion
Adding 3DGA and pedography to clinical assessment altered treatment decisions, shifting 15 of 47 children from planned orthopaedic intervention to conservative management, and emphasised that factors other than gastrocnemius‑soleus muscle‑tendon unit tightness should be considered.
{"title":"Clinical impact of gait analysis and pedography in treatment decision-making for idiopathic toe walking: A Cross-sectional study","authors":"Tina Udemark Pasgaard , Morten Bøgelund Pedersen , Sidsel Hald Rahlf , Julie Ladeby Erichsen , Christian Faergemann , Bjarke Viberg , Anders Holsgaard-Larsen","doi":"10.1016/j.gaitpost.2025.109979","DOIUrl":"10.1016/j.gaitpost.2025.109979","url":null,"abstract":"<div><h3>Background</h3><div>Diagnosing idiopathic toe walking (ITW) and assessing its severity based solely on clinical examinations can be challenging, underscoring the need for advanced, objective diagnostic tools to guide orthopedic treatment strategies.</div></div><div><h3>Aim</h3><div>To test whether treatment strategies of children diagnosed with ITW based on clinical examination change when objective and quantitative data from three-dimensional gait analysis (3DGA) and pedography are incorporated.</div></div><div><h3>Methods</h3><div>Children diagnosed with ITW and referred for orthopedic treatment based on clinical examination were included. Ankle and knee kinematics and kinetics were recorded in a single session using 3DGA, while heel contact time was assessed with pedography. Based on ankle joint angles and moments, participants were classified as having <em>no-to-mild</em> or <em>moderate-to-severe</em> ITW according to a predefined severity classification. Statistical parametric mapping (SPM) provided detailed analysis of deviations in kinematic and kinetic gait patterns. The area under the receiver operating curve (AUC) assessed heel contact time’s discriminative ability.</div></div><div><h3>Results</h3><div>Forty-seven children were included in the study. 3DGA classified 15 participants as having no-to-mild ITW and 32 as moderate-to-severe ITW. SPM analysis identified significant between-group differences in ankle kinematics and kinetics. Pedography demonstrated strong discriminative ability, with an AUC of 0.80.</div></div><div><h3>Conclusion</h3><div>Adding 3DGA and pedography to clinical assessment altered treatment decisions, shifting 15 of 47 children from planned orthopaedic intervention to conservative management, and emphasised that factors other than gastrocnemius‑soleus muscle‑tendon unit tightness should be considered.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"124 ","pages":"Article 109979"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088624","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}
Pub Date : 2026-02-01Epub Date: 2025-09-19DOI: 10.1016/j.gaitpost.2025.109982
Michael D. Harris , Emma C. Behrman , Keith R. Lohse , Molly C. Shepherd , Bruce A. MacWilliams , Erin M. Mannen
Background
Properly characterizing biomechanics in populations with known hip deformities, such as developmental dysplasia of the hip (DDH), requires accurately identifying the hip joint center (HJC). Many studies have assessed the accuracy or repeatability of predictive and functional methods to locate the HJC in normally shaped hips, but not for hips with DDH.
Research question
For patients with DDH, which of three common functional and four common predictive HJC methods is most accurate compared to a magnetic-resonance-imaging-based anatomic method?
Methods
HJC method accuracy was calculated as the resultant vector distance from the anatomic HJCs. Bias was calculated as distance errors along anatomical directions. Accuracy and bias were tested in patients with DDH (N = 30) and controls with normally shaped hips (N = 20) using each HJC method and two separate techniques for aligning the image-based and skin-marker-based pelvis segments.
Results
Using each alignment technique, the predictive Harrington (pelvis-only) method was the most accurate (smallest resultant errors) in more patients with DDH than any other method. The Harrington (pelvis-only) method also had the lowest or nearly lowest bias in each direction. For controls, the Harrington (pelvis-only) method also had among the lowest errors but there was not a standout “most accurate” method.
Significance
Although no method is perfect, in the absence of imaging data and an anatomic HJC, this study supports the predictive Harrington (pelvis-only) HJC as the most appropriate for dysplastic hips.
{"title":"Can predictive and functional methods locate the dysplastic hip joint center?","authors":"Michael D. Harris , Emma C. Behrman , Keith R. Lohse , Molly C. Shepherd , Bruce A. MacWilliams , Erin M. Mannen","doi":"10.1016/j.gaitpost.2025.109982","DOIUrl":"10.1016/j.gaitpost.2025.109982","url":null,"abstract":"<div><h3>Background</h3><div>Properly characterizing biomechanics in populations with known hip deformities, such as developmental dysplasia of the hip (DDH), requires accurately identifying the hip joint center (HJC). Many studies have assessed the accuracy or repeatability of predictive and functional methods to locate the HJC in normally shaped hips, but not for hips with DDH.</div></div><div><h3>Research question</h3><div>For patients with DDH, which of three common functional and four common predictive HJC methods is most accurate compared to a magnetic-resonance-imaging-based anatomic method?</div></div><div><h3>Methods</h3><div>HJC method accuracy was calculated as the resultant vector distance from the anatomic HJCs. Bias was calculated as distance errors along anatomical directions. Accuracy and bias were tested in patients with DDH (N = 30) and controls with normally shaped hips (N = 20) using each HJC method and two separate techniques for aligning the image-based and skin-marker-based pelvis segments.</div></div><div><h3>Results</h3><div>Using each alignment technique, the predictive Harrington (pelvis-only) method was the most accurate (smallest resultant errors) in more patients with DDH than any other method. The Harrington (pelvis-only) method also had the lowest or nearly lowest bias in each direction. For controls, the Harrington (pelvis-only) method also had among the lowest errors but there was not a standout “most accurate” method.</div></div><div><h3>Significance</h3><div>Although no method is perfect, in the absence of imaging data and an anatomic HJC, this study supports the predictive Harrington (pelvis-only) HJC as the most appropriate for dysplastic hips.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"124 ","pages":"Article 109982"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139846","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}
Pub Date : 2026-02-01Epub Date: 2025-09-12DOI: 10.1016/j.gaitpost.2025.109978
Arne Defour , Nadia Dominici , Eva Swinnen , Dirk Cambier , Gitte Van Cleemput , Anke Van Bladel
Background
Stroke often impairs motor control during walking. Muscle synergy analysis provides insights into motor control by evaluating how muscle groups coordinate movement.
Objective
This review has a threefold aim: (1) To compare the number of muscle synergies during walking between the paretic and non-paretic leg, as well as in perspective with healthy controls. (2) To examine eventual associations between these synergies and lower extremity motor impairment and self-selected walking speed. (3) To explore how synergy patterns differ between the sub-acute and chronic phase post-stroke.
Method
MEDLINE, Embase, and Web of Science were systematically searched (until 11/04/2025) for studies using matrix factorization to extract muscle synergies during post-stroke walking. Meta-analyses were conducted using standardized mean differences (SMD) and associations with clinical measures were analyzed using correlations and Chi-square statistics.
Results
Twenty-four studies (624 individuals post-stroke) were included. The paretic leg showed significant fewer synergies than the non-paretic leg (SMD: −0.73; p < 0.00001) and healthy controls (SMD: −1.04; p < 0.00001). Additionally, the non-paretic leg revealed a small but statistically significant reduction in synergies compared to healthy controls (SMD: −0.40; p = 0.02). The number of synergies in the paretic leg strongly correlated with lower extremity motor function (r = 0.827; p < 0.001). Fewer synergies were more prevalent in the sub-acute than chronic phase (χ² = 15.611; p < 0.001). Synergy composition showed increased co-activation and prolonged activation timing.
Conclusion
Stroke leads to fewer and less distinct muscle synergies during walking in the paretic leg, especially in the sub-acute phase and in persons with severe lower extremity motor impairments.
背景：中风常损害行走时的运动控制。肌肉协同分析通过评估肌肉群如何协调运动提供了对运动控制的见解。目的：本综述有三个目的：(1)比较瘫腿和非瘫腿行走时肌肉协同作用的数量，并与健康对照进行比较。(2)研究这些协同作用与下肢运动障碍和自我选择步行速度之间的最终关联。(3)探讨脑卒中后亚急性期和慢性期协同模式的差异。方法：系统地检索MEDLINE、Embase和Web of Science（截止到2025年4月11日），查找使用矩阵分解提取中风后步行时肌肉协同作用的研究。采用标准化平均差异（SMD）进行meta分析，并采用相关性和卡方统计分析与临床措施的关联。结果：纳入24项研究（624例卒中后个体）。与非瘫腿相比，瘫腿的协同作用明显减少（SMD: -0.73; p ）。结论：卒中导致瘫腿行走时肌肉协同作用减少且不明显，特别是在亚急性期和下肢运动障碍严重的患者。
{"title":"Impaired motor control during post-stroke walking: A systematic review and meta-analysis of muscle synergies across different phases of recovery.","authors":"Arne Defour , Nadia Dominici , Eva Swinnen , Dirk Cambier , Gitte Van Cleemput , Anke Van Bladel","doi":"10.1016/j.gaitpost.2025.109978","DOIUrl":"10.1016/j.gaitpost.2025.109978","url":null,"abstract":"<div><h3>Background</h3><div>Stroke often impairs motor control during walking. Muscle synergy analysis provides insights into motor control by evaluating how muscle groups coordinate movement.</div></div><div><h3>Objective</h3><div>This review has a threefold aim: (1) To compare the number of muscle synergies during walking between the paretic and non-paretic leg, as well as in perspective with healthy controls. (2) To examine eventual associations between these synergies and lower extremity motor impairment and self-selected walking speed. (3) To explore how synergy patterns differ between the sub-acute and chronic phase post-stroke.</div></div><div><h3>Method</h3><div>MEDLINE, Embase, and Web of Science were systematically searched (until 11/04/2025) for studies using matrix factorization to extract muscle synergies during post-stroke walking. Meta-analyses were conducted using standardized mean differences (SMD) and associations with clinical measures were analyzed using correlations and Chi-square statistics.</div></div><div><h3>Results</h3><div>Twenty-four studies (624 individuals post-stroke) were included. The paretic leg showed significant fewer synergies than the non-paretic leg (SMD: −0.73; p < 0.00001) and healthy controls (SMD: −1.04; p < 0.00001). Additionally, the non-paretic leg revealed a small but statistically significant reduction in synergies compared to healthy controls (SMD: −0.40; p = 0.02). The number of synergies in the paretic leg strongly correlated with lower extremity motor function (r = 0.827; p < 0.001). Fewer synergies were more prevalent in the sub-acute than chronic phase (χ² = 15.611; p < 0.001). Synergy composition showed increased co-activation and prolonged activation timing.</div></div><div><h3>Conclusion</h3><div>Stroke leads to fewer and less distinct muscle synergies during walking in the paretic leg, especially in the sub-acute phase and in persons with severe lower extremity motor impairments.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"124 ","pages":"Article 109978"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139873","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}
Pub Date : 2026-02-01Epub Date: 2025-11-10DOI: 10.1016/j.gaitpost.2025.110048
Michael VanNostrand , Patrick G. Monaghan , Wendy Wu , Nora E. Fritz
Objective
Backward walking (BW) has gained increasing attention as a clinically relevant assessment and intervention for individuals with neurological conditions. Given the heterogeneity in how BW has been applied and studied across neurological populations, the objectives of this scoping review were to synthesize the literature related to: 1) the reliability and validity of BW mobility assessments, 2) the utility of BW as a clinical assessment tool, and 3) the efficacy of BW as an exercise intervention.
Data sources
A literature search of six electronic databases and citation searching were conducted through June 9th, 2025. Articles were included in this review if they were peer-reviewed studies involving adults with a central nervous system neurological disorder and met at least one of the following criteria: assessed the reliability or validity of BW, used BW as a clinical assessment tool, or implemented BW as part of an exercise intervention.
Results
Fifty-nine studies were included, examining BW’s reliability/validity (n = 14), use as a clinical assessment (n = 17), and role in interventions (n = 28). BW showed high reliability and moderate-to-strong correlations with established measures, outperformed other assessments in discriminating fall risk and mobility status, and improved gait speed, balance, and postural control when used in interventions.
Conclusion
BW is a reliable, valid marker of mobility and balance that better distinguishes fall risk and mobility status than common assessments and shows promise as an intervention to improve gait, balance, and postural control. However, methodological inconsistencies and limited longitudinal data warrant further research to standardize assessment protocols and optimize intervention strategies.
{"title":"Backward walking as a mobility assessment and exercise intervention for persons with neurologic disorders: A scoping review","authors":"Michael VanNostrand , Patrick G. Monaghan , Wendy Wu , Nora E. Fritz","doi":"10.1016/j.gaitpost.2025.110048","DOIUrl":"10.1016/j.gaitpost.2025.110048","url":null,"abstract":"<div><h3>Objective</h3><div>Backward walking (BW) has gained increasing attention as a clinically relevant assessment and intervention for individuals with neurological conditions. Given the heterogeneity in how BW has been applied and studied across neurological populations, the objectives of this scoping review were to synthesize the literature related to: 1) the reliability and validity of BW mobility assessments, 2) the utility of BW as a clinical assessment tool, and 3) the efficacy of BW as an exercise intervention.</div></div><div><h3>Data sources</h3><div>A literature search of six electronic databases and citation searching were conducted through June 9th, 2025. Articles were included in this review if they were peer-reviewed studies involving adults with a central nervous system neurological disorder and met at least one of the following criteria: assessed the reliability or validity of BW, used BW as a clinical assessment tool, or implemented BW as part of an exercise intervention.</div></div><div><h3>Results</h3><div>Fifty-nine studies were included, examining BW’s reliability/validity (n = 14), use as a clinical assessment (n = 17), and role in interventions (n = 28). BW showed high reliability and moderate-to-strong correlations with established measures, outperformed other assessments in discriminating fall risk and mobility status, and improved gait speed, balance, and postural control when used in interventions.</div></div><div><h3>Conclusion</h3><div>BW is a reliable, valid marker of mobility and balance that better distinguishes fall risk and mobility status than common assessments and shows promise as an intervention to improve gait, balance, and postural control. However, methodological inconsistencies and limited longitudinal data warrant further research to standardize assessment protocols and optimize intervention strategies.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"124 ","pages":"Article 110048"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145535032","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}
Pub Date : 2026-02-01Epub Date: 2025-09-23DOI: 10.1016/j.gaitpost.2025.109984
Sutton B. Richmond , Clayton W. Swanson , Steven P. Winesett , Jungyun Hwang , Brianne Borgia , David J. Clark
Objective
Synchronized left-right stepping (bilateral coordination) is essential for safe movement and independent mobility function. The phase coordination index (PCI) quantifies this coordination. This study aimed to assess the reliability of PCI when measured multiple times within a study.
Methods
Forty-three neurotypical older adults completed a single 2-min walk test, three weeks apart, to assess the reliability and consistency of the PCI. During the 2-min walk test, participants walked along a 15-m hallway at their preferred natural speed while wearing seven inertial monitoring units. PCI was first calculated for each trial using the standard method and then normalized to gait speed using two approaches. The normalization methods included dividing each PCI value by: (1) the mean gait speed of the individual trial, and (2) the mean gait speed averaged across both trials.
Results
The reliability (ICC) values were 0.566 for PCI alone, 0.771 when adjusted for gait speed at each trial, and 0.784 when adjusted for gait speed over both trials. Bland-Altman analysis showed no significant bias between trials across analyses.
Conclusion
These findings suggest that PCI offers acceptable test-retest reliability. However, the results of this investigation advocate for normalizing PCI to gait speed for enhanced reliability.
{"title":"Test-retest reliability of the phase coordination index – A measure of bilateral coordination","authors":"Sutton B. Richmond , Clayton W. Swanson , Steven P. Winesett , Jungyun Hwang , Brianne Borgia , David J. Clark","doi":"10.1016/j.gaitpost.2025.109984","DOIUrl":"10.1016/j.gaitpost.2025.109984","url":null,"abstract":"<div><h3>Objective</h3><div>Synchronized left-right stepping (bilateral coordination) is essential for safe movement and independent mobility function. The phase coordination index (PCI) quantifies this coordination. This study aimed to assess the reliability of PCI when measured multiple times within a study.</div></div><div><h3>Methods</h3><div>Forty-three neurotypical older adults completed a single 2-min walk test, three weeks apart, to assess the reliability and consistency of the PCI. During the 2-min walk test, participants walked along a 15-m hallway at their preferred natural speed while wearing seven inertial monitoring units. PCI was first calculated for each trial using the standard method and then normalized to gait speed using two approaches. The normalization methods included dividing each PCI value by: (1) the mean gait speed of the individual trial, and (2) the mean gait speed averaged across both trials.</div></div><div><h3>Results</h3><div>The reliability (ICC) values were 0.566 for PCI alone, 0.771 when adjusted for gait speed at each trial, and 0.784 when adjusted for gait speed over both trials. Bland-Altman analysis showed no significant bias between trials across analyses.</div></div><div><h3>Conclusion</h3><div>These findings suggest that PCI offers acceptable test-retest reliability. However, the results of this investigation advocate for normalizing PCI to gait speed for enhanced reliability.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"124 ","pages":"Article 109984"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208780","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}
Pub Date : 2026-02-01Epub Date: 2025-11-01DOI: 10.1016/j.gaitpost.2025.110027
Zilong Wang , Xiangdong Wang , Mengya Lu , Hedi Yang , Lingyu Kong , Tao Liu , Qiuxia Zhang
Objective
This study examined mental fatigue (MF)’s biomechanical effects on stable/unstable lower extremities in unilateral functional ankle instability (FAI) during single-leg landings.
Methods
Eighteen unilateral FAI individuals (9 males/9 females) met International Ankle Consortium criteria (CAIT ≤24, anterior drawer test). Kinematic/kinetic data were collected via Vicon motion capture and Kistler force plates during pre-/post-MF single-leg landings (stable/unstable sides). A 2 × 2 repeated-measures analysis of variance (ANOVA) was employed for data analysis.
Results
1) At the time of initial contact, a main effect of side was observed for hip flexion angle, with significantly smaller values on the unstable side compared to the stable side (p = 0.002). At the time of peak vertical ground reaction force (vGRF), a main effect of MF was identified for hip flexion angle, showing a significant reduction post-MF intervention (p = 0.012). 2) At the time of initial contact, a main effect of MF was detected for ankle plantarflexion angle, which significantly decreased after MF induction (p < 0.001). At the time of peak vGRF, a main effect of MF was observed for ankle inversion angle, with a significant reduction following MF intervention (p = 0.041). 3) The time to stabilization (TTS) was significantly prolonged after MF exposure (p = 0.036). 4) No interaction effects between MF and side were observed (p > 0.05).
Conclusion
MF impaired FAI individuals’ hip/ankle biomechanics (reduced flexion/plantarflexion/inversion, prolonged stabilization), suggesting compromised motor control and elevated reinjury risks via biomechanical overload. Absent MF-side interactions imply MF’s effects are limb-independent. Rehabilitation should address bilateral cognitive load impacts to enhance stability and injury prevention.
{"title":"Investigation on the effects of mental fatigue on drop landing motion control in individuals with functional Ankle instability: A biomechanical perspective","authors":"Zilong Wang , Xiangdong Wang , Mengya Lu , Hedi Yang , Lingyu Kong , Tao Liu , Qiuxia Zhang","doi":"10.1016/j.gaitpost.2025.110027","DOIUrl":"10.1016/j.gaitpost.2025.110027","url":null,"abstract":"<div><h3>Objective</h3><div>This study examined mental fatigue (MF)’s biomechanical effects on stable/unstable lower extremities in unilateral functional ankle instability (FAI) during single-leg landings.</div></div><div><h3>Methods</h3><div>Eighteen unilateral FAI individuals (9 males/9 females) met International Ankle Consortium criteria (CAIT ≤24, anterior drawer test). Kinematic/kinetic data were collected via Vicon motion capture and Kistler force plates during pre-/post-MF single-leg landings (stable/unstable sides). A 2 × 2 repeated-measures analysis of variance (ANOVA) was employed for data analysis.</div></div><div><h3>Results</h3><div>1) At the time of initial contact, a main effect of side was observed for hip flexion angle, with significantly smaller values on the unstable side compared to the stable side (p = 0.002). At the time of peak vertical ground reaction force (vGRF), a main effect of MF was identified for hip flexion angle, showing a significant reduction post-MF intervention (<em>p</em> = 0.012). 2) At the time of initial contact, a main effect of MF was detected for ankle plantarflexion angle, which significantly decreased after MF induction (<em>p</em> < 0.001). At the time of peak vGRF, a main effect of MF was observed for ankle inversion angle, with a significant reduction following MF intervention (<em>p</em> = 0.041). 3) The time to stabilization (TTS) was significantly prolonged after MF exposure (<em>p</em> = 0.036). 4) No interaction effects between MF and side were observed (<em>p</em> > 0.05).</div></div><div><h3>Conclusion</h3><div>MF impaired FAI individuals’ hip/ankle biomechanics (reduced flexion/plantarflexion/inversion, prolonged stabilization), suggesting compromised motor control and elevated reinjury risks via biomechanical overload. Absent MF-side interactions imply MF’s effects are limb-independent. Rehabilitation should address bilateral cognitive load impacts to enhance stability and injury prevention.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"124 ","pages":"Article 110027"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454082","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}
A recovery step is a crucial balance reaction that prevents falls in individuals with stroke. However, the characteristics of this response after tripping remain unclear, particularly regarding which limb is used for stepping and the factors associated with whether a step is taken.
Research question
This study aimed to identify the factors associated with whether a recovery step was taken following a trip to support the development of effective fall prevention strategies for individuals with stroke.
Methods
A large-scale motion capture database comprising 41,943 gait trials was analyzed to identify near-falls caused by paretic toe tripping in 42 patients with subacute stroke. Logistic regression analysis was conducted to examine the influence of physical function, walking-aid use, and near-fall velocity during tripping on step execution.
Results
Recovery steps were observed in 48 % of the participants, and 95 % of these steps were initiated with the non-paretic limb. The key factors associated with the occurrence of recovery steps included right-sided hemiparesis (p = 0.085), nonuse of a cane (p = 0.028), and higher fall velocity (p = 0.007). The full logistic regression model demonstrated good predictive ability, with an area under the curve of 0.850.
Conclusions
Individuals with stroke predominantly rely on the non-paretic limb for recovery stepping. The side of hemiparesis, cane use, and near-fall velocity were identified as key factors associated with step occurrence. These findings support the facilitation of recovery stepping through individualized training with rapid disturbances during independent walking in individuals with stroke.
{"title":"Who takes a recovery step? Predictors of step execution after tripping in individuals with stroke","authors":"Yuji Osada , Yosuke Kobayashi , Tomo Osuka , Sumiko Yamamoto","doi":"10.1016/j.gaitpost.2025.110031","DOIUrl":"10.1016/j.gaitpost.2025.110031","url":null,"abstract":"<div><h3>Background</h3><div>A recovery step is a crucial balance reaction that prevents falls in individuals with stroke. However, the characteristics of this response after tripping remain unclear, particularly regarding which limb is used for stepping and the factors associated with whether a step is taken.</div></div><div><h3>Research question</h3><div>This study aimed to identify the factors associated with whether a recovery step was taken following a trip to support the development of effective fall prevention strategies for individuals with stroke.</div></div><div><h3>Methods</h3><div>A large-scale motion capture database comprising 41,943 gait trials was analyzed to identify near-falls caused by paretic toe tripping in 42 patients with subacute stroke. Logistic regression analysis was conducted to examine the influence of physical function, walking-aid use, and near-fall velocity during tripping on step execution.</div></div><div><h3>Results</h3><div>Recovery steps were observed in 48 % of the participants, and 95 % of these steps were initiated with the non-paretic limb. The key factors associated with the occurrence of recovery steps included right-sided hemiparesis (p = 0.085), nonuse of a cane (p = 0.028), and higher fall velocity (p = 0.007). The full logistic regression model demonstrated good predictive ability, with an area under the curve of 0.850.</div></div><div><h3>Conclusions</h3><div>Individuals with stroke predominantly rely on the non-paretic limb for recovery stepping. The side of hemiparesis, cane use, and near-fall velocity were identified as key factors associated with step occurrence. These findings support the facilitation of recovery stepping through individualized training with rapid disturbances during independent walking in individuals with stroke.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"124 ","pages":"Article 110031"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454159","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}
Pub Date : 2026-02-01Epub Date: 2025-10-31DOI: 10.1016/j.gaitpost.2025.110025
Shiqi Yu , Peng Yuan , Yilin Xu , Yuwen Shangguan , Xuefeng Wang , Zhongmei Wang , Mingze Zhuang , Yawei Song
Background
Recent studies have shown that gait retraining can significantly affect the biomechanical load on the patellofemoral joint. It is of great significance to understand the effects of these running technique characteristics on patellofemoral joint load for developing effective prevention and rehabilitation strategies for injury.
Methods
A systematic review was conducted on the relevant studies from PubMed, Web of Science, EBSCO, CNKI, and Wanfang database, and the data were synthesized. Data including patellofemoral joint contact force (PFCF) and patellofemoral joint stress (PFJS) were extracted and pooled for analysis.
Results
A total of 2102 studies were retrieved, and 32 studies were finally included after applying the inclusion and exclusion criteria. According to subgroup analysis results, some running technique characteristics notably decreased PFCF (SMD = − 0.60; 95 % CI: − 0.71, − 0.49; z = 10.98, p = 0.000), including forefoot strike (FFS), decreased step length, increased step rate, decreased speed, trunk forward lean, backward running, and running softer; whereas some characteristics significantly increased PFCF (SMD = 0.46; 95 % CI: 0.29, 0.62; z = 5.47, p = 0.000), including increased step length, decreased step rate, increased speed, and trunk backward lean. Additionally, some characteristics remarkably decreased PFJS (SMD = − 0.59; 95 % CI: − 0.72, − 0.47; z = 9.02, p = 0.000), including FFS, decreased step length, increased step rate, decreased speed, and trunk forward lean; whereas some characteristics significantly increased PFJS (SMD = 0.43; 95 % CI: 0.24, 0.62; z = 4.39, p = 0.000), such as increased step length, decreased step rate, and trunk backward lean.
Conclusion
Some specific running technique characteristics can significantly influence patellofemoral joint load. Technique characteristics, such as FFS, decreased step length, increased step rate, decreased speed, trunk forward lean, backward running, and running softer, can effectively decrease the load. Conversely, increased step length, decreased step rate, increased speed, and trunk backward lean tended to increase the load.
{"title":"Effects of running technique characteristics on the patellofemoral joint load: A systematic review and meta-analysis","authors":"Shiqi Yu , Peng Yuan , Yilin Xu , Yuwen Shangguan , Xuefeng Wang , Zhongmei Wang , Mingze Zhuang , Yawei Song","doi":"10.1016/j.gaitpost.2025.110025","DOIUrl":"10.1016/j.gaitpost.2025.110025","url":null,"abstract":"<div><h3>Background</h3><div>Recent studies have shown that gait retraining can significantly affect the biomechanical load on the patellofemoral joint. It is of great significance to understand the effects of these running technique characteristics on patellofemoral joint load for developing effective prevention and rehabilitation strategies for injury.</div></div><div><h3>Methods</h3><div>A systematic review was conducted on the relevant studies from PubMed, Web of Science, EBSCO, CNKI, and Wanfang database, and the data were synthesized. Data including patellofemoral joint contact force (PFCF) and patellofemoral joint stress (PFJS) were extracted and pooled for analysis.</div></div><div><h3>Results</h3><div>A total of 2102 studies were retrieved, and 32 studies were finally included after applying the inclusion and exclusion criteria. According to subgroup analysis results, some running technique characteristics notably decreased PFCF (SMD = − 0.60; 95 % CI: − 0.71, − 0.49; z = 10.98, <em>p</em> = 0.000), including forefoot strike (FFS), decreased step length, increased step rate, decreased speed, trunk forward lean, backward running, and running softer; whereas some characteristics significantly increased PFCF (SMD = 0.46; 95 % CI: 0.29, 0.62; z = 5.47, <em>p</em> = 0.000), including increased step length, decreased step rate, increased speed, and trunk backward lean. Additionally, some characteristics remarkably decreased PFJS (SMD = − 0.59; 95 % CI: − 0.72, − 0.47; z = 9.02, <em>p</em> = 0.000), including FFS, decreased step length, increased step rate, decreased speed, and trunk forward lean; whereas some characteristics significantly increased PFJS (SMD = 0.43; 95 % CI: 0.24, 0.62; z = 4.39, <em>p</em> = 0.000), such as increased step length, decreased step rate, and trunk backward lean.</div></div><div><h3>Conclusion</h3><div>Some specific running technique characteristics can significantly influence patellofemoral joint load. Technique characteristics, such as FFS, decreased step length, increased step rate, decreased speed, trunk forward lean, backward running, and running softer, can effectively decrease the load. Conversely, increased step length, decreased step rate, increased speed, and trunk backward lean tended to increase the load.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"124 ","pages":"Article 110025"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145518146","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}
Musculoskeletal problems are common during and after pregnancy. Biomechanical adaptations in postpartum females, particularly in pelvic stability and lower extremity mechanics, may contribute to long-term health issues. The postnatal period from 42-day to 3-month is a critical recovery window. This study aimed to compare early postpartum gait adaptations and muscle activation patterns between females at 42 days and 3 months postpartum and nulliparous females.
Methods
Nine postpartum females were assessed at 42 days (PT1) and 3 months (PT2) postpartum for lower extremity kinematics, kinetics, and muscle activation during walking. A control group of nine nulliparous females was tested at a single time point. Lower extremity kinematics, moments, and work were calculated. Non-negative matrix factorization decomposed the sEMG data into muscle synergy patterns and activation time courses.
Results
At PT1, postpartum participants showed increased pelvic obliquity, reduced knee extension moment and power, and increased ankle plantarflexion compared to controls. Muscle activation analysis revealed greater tibialis anterior activation in postpartum compared to controls. Rectus femoris activation was lower at PT1 than at PT2 during the stance phase, but higher at PT1 during the swing phase. By PT2, pelvic stability and muscle synergy patterns were similar to nulliparous controls.
Conclusion
Early postpartum gait mechanics show increased pelvic obliquity and altered muscle activation, indicating neuromuscular instability and compensation. Partial neuromuscular recovery was observed by 3 months postpartum, highlighting the need for rehabilitation targeting pelvic stability and muscle coordination to prevent long-term dysfunction.
{"title":"Lower extremity kinetics and muscle activation patterns during gait in early postpartum women: 42-day and 3-month comparison with nulliparous controls","authors":"Fengxian Wu , Zhenghong Wu , Wei Chen, Yiqing Yang, Yaming Liu, Yan Qi, Wenxin Niu","doi":"10.1016/j.gaitpost.2025.109981","DOIUrl":"10.1016/j.gaitpost.2025.109981","url":null,"abstract":"<div><h3>Background</h3><div>Musculoskeletal problems are common during and after pregnancy. Biomechanical adaptations in postpartum females, particularly in pelvic stability and lower extremity mechanics, may contribute to long-term health issues. The postnatal period from 42-day to 3-month is a critical recovery window. This study aimed to compare early postpartum gait adaptations and muscle activation patterns between females at 42 days and 3 months postpartum and nulliparous females.</div></div><div><h3>Methods</h3><div>Nine postpartum females were assessed at 42 days (PT1) and 3 months (PT2) postpartum for lower extremity kinematics, kinetics, and muscle activation during walking. A control group of nine nulliparous females was tested at a single time point. Lower extremity kinematics, moments, and work were calculated. Non-negative matrix factorization decomposed the sEMG data into muscle synergy patterns and activation time courses.</div></div><div><h3>Results</h3><div>At PT1, postpartum participants showed increased pelvic obliquity, reduced knee extension moment and power, and increased ankle plantarflexion compared to controls. Muscle activation analysis revealed greater tibialis anterior activation in postpartum compared to controls. Rectus femoris activation was lower at PT1 than at PT2 during the stance phase, but higher at PT1 during the swing phase. By PT2, pelvic stability and muscle synergy patterns were similar to nulliparous controls.</div></div><div><h3>Conclusion</h3><div>Early postpartum gait mechanics show increased pelvic obliquity and altered muscle activation, indicating neuromuscular instability and compensation. Partial neuromuscular recovery was observed by 3 months postpartum, highlighting the need for rehabilitation targeting pelvic stability and muscle coordination to prevent long-term dysfunction.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"124 ","pages":"Article 109981"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152358","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}
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