Gait & posture最新文献_第7页

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-10-31 DOI: 10.1016/j.gaitpost.2025.110024

Seok-Hyun Song

Objective

This study aimed to examine the interaction between visual search and postural control in young and older adults during a standing posture task while performing a Multiple Object Tracking (MOT) task.

Methods

The study participants consisted of 30 individuals, divided into two groups: the young adult group (n = 15) and the older adult group (n = 15). Participants performed the MOT task while maintaining a single-leg stance, during which gaze entropy and Center of Pressure (COP) displacement were measured to analyze differences in visual search strategies and postural control.

Results

The results indicated that gaze entropy was modulated by the number of targets in the MOT task. Young adults reduced gaze entropy when tracking two targets by utilizing a visual pivot to simultaneously track both targets but exhibited increased gaze entropy when tracking three targets. In contrast, the older group demonstrated a tendency for reduced gaze entropy as task difficulty increased, suggesting a strategic shift toward maintaining postural stability over active visual search. COP analysis revealed that the older group exhibited greater COP displacement compared to young adults, reflecting age-related differences in postural control. Additionally, under increased cognitive load, the older group experienced greater difficulty in maintaining postural stability, supporting the notion of limited attentional resource allocation.

Conclusion

These findings suggest that as task demands increase, older individuals prioritize postural stability over visual search. Future research should further explore the relationship between visual search and postural control across diverse contexts.

目的：本研究旨在探讨年轻人和老年人在执行多目标跟踪（MOT）任务时站立姿势任务中视觉搜索和姿势控制之间的相互作用。方法：研究对象共30人，分为两组：青壮年组（n = 15）和老年人组（n = 15）。参与者在保持单腿站立的情况下完成MOT任务，在此期间测量凝视熵和压力中心（COP）位移，以分析视觉搜索策略和姿势控制的差异。结果：注视熵受MOT任务中目标数量的调节。年轻人利用视觉枢轴同时跟踪两个目标时，注视熵降低，而同时跟踪三个目标时，注视熵增加。相比之下，随着任务难度的增加，老年人的注视熵有减少的趋势，这表明他们的策略转向了保持姿势的稳定性，而不是主动的视觉搜索。COP分析显示，与年轻人相比，老年组表现出更大的COP位移，反映了与年龄相关的姿势控制差异。此外，在认知负荷增加的情况下，老年人在保持姿势稳定性方面经历了更大的困难，这支持了注意力资源分配有限的概念。结论：这些发现表明，随着任务要求的增加，老年人优先考虑姿势稳定性而不是视觉搜索。未来的研究应进一步探讨不同情境下视觉搜索与姿势控制之间的关系。

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引用次数: 0

Effects of running technique characteristics on the patellofemoral joint load: A systematic review and meta-analysis 跑步技术特征对髌股关节负荷的影响：系统回顾和荟萃分析

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-10-31 DOI: 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.

最近的研究表明，步态再训练可以显著影响髌股关节的生物力学负荷。了解这些跑步技术特点对髌股关节负荷的影响，对于制定有效的损伤预防和康复策略具有重要意义。方法对PubMed、Web of Science、EBSCO、中国知网（CNKI）、万方数据库的相关研究进行系统综述，并对数据进行综合分析。提取髌骨股骨关节接触力（PFCF）和髌骨股骨关节应力（PFJS）数据进行汇总分析。结果共检索到2102篇研究，应用纳入和排除标准，最终纳入32篇研究。亚组分析结果显示，一些跑步技术特征显著降低了PFCF (SMD =−0.60;95 % CI:−0.71,−0.49;z = 10.98,p = 0.000)，包括前掌着地（FFS）、步长减少、步速增加、速度降低、躯干前倾、后跑、跑软；而一些特征显著增加了PFCF (SMD = 0.46; 95 % CI: 0.29, 0.62; z = 5.47,p = 0.000)，包括步长增加，步速降低，速度增加，躯干向后倾斜。此外，一些特征显著降低了PFJS (SMD = - 0.59; 95 % CI: - 0.72, - 0.47; z = 9.02,p = 0.000)，包括FFS、步长减少、步率增加、速度降低和躯干前倾；而一些特征显著增加了PFJS (SMD = 0.43; 95 % CI: 0.24, 0.62; z = 4.39,p = 0.000)，如步长增加，步速减少，躯干向后倾斜。结论某些特定的跑步技术特点对髌股关节负荷有显著影响。FFS、缩短步长、提高步速、降低速度、躯干前倾、后跑、跑软等技术特点，可以有效减轻负荷。相反，增加步长、降低步速、增加速度和躯干向后倾斜倾向于增加负荷。

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引用次数: 0

Five-times sit-to-stand test: Exploring movement synergies and anthropometric influences 五次坐立测试：探索运动协同效应和人体测量学影响

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-10-30 DOI: 10.1016/j.gaitpost.2025.110028

Arunee Promsri , Peter Federolf

Background

The five-times sit-to-stand test (5TSTS) is widely used to assess functional mobility, measuring the time required for an individual to complete five consecutive sit-to-stand movements as quickly as possible.

Objective

This study aimed to investigate movement components or synergies—termed principal movements (PMs)—underlying 5TSTS performance and to examine how anthropometric characteristics and 5TSTS completion time relate to the composition and neuromuscular control of these PMs.

Methods

Principal component analysis (PCA) was applied to three-dimensional position data from 50 young adults (median age 24 [21–26] years) performing the 5TSTS. PM composition was quantified from principal positions, while the neuromuscular control was assessed from principal accelerations.

Results

Anthropometric characteristics significantly influenced the composition of specific PMs. Greater body weight (p = 0.005) and height (p = 0.002) were positively correlated with PM₁ (sit-to-stand transition) but negatively correlated with PM₂ (trunk extension, p = 0.006 for weight, p = 0.001 for height) and PM₄ (anterior body sliding on the chair, p = 0.024 for weight, p = 0.007 for height). Shorter 5TSTS times were associated with higher acceleration magnitudes across PM₁–PM₄ (all p < 0.001), reflecting greater neuromuscular output and more dynamic postural control.

Conclusion

Body size strongly shapes the composition of movement synergies during 5TSTS, underscoring the importance of anthropometric factors in functional mobility assessments. Furthermore, 5TSTS time reflects the neuromuscular control of movement synergies and may serve as a clinically meaningful indicator of neuromuscular control, dynamic stability, and functional performance.

五次坐立测试（5TSTS）被广泛用于评估功能活动能力，测量个体尽可能快地完成连续五次坐立动作所需的时间。本研究旨在探讨5TSTS表现背后的运动成分或协同作用，即主要运动（PMs），并研究人体测量特征和5TSTS完成时间与这些运动成分和神经肌肉控制的关系。方法采用主成分分析（PCA）对50例进行5TSTS的年轻成人（中位年龄24岁[21-26]岁）的三维位置数据进行分析。PM成分从主位置量化，而神经肌肉控制从主加速度评估。结果人体计量学特征显著影响特异性pmms的组成。更大的体重(p = 0.005)和高度(0.002 p = )呈正相关,与PM1 (sit-to-stand产品化)但与PM2负相关(树干扩展,p = 0.006 体重,0.001 p = 高度)和PM4(前身体在椅子上滑动,p = 0.024 体重,0.007 p = 高度)。更短的5TSTS时间与更高的PM1-PM4加速度大小相关（均p <； 0.001），反映出更大的神经肌肉输出和更动态的姿势控制。结论在5TSTS中，身体尺寸对运动协同作用的组成有很大影响，强调了人体测量因素在功能活动能力评估中的重要性。此外，5TSTS时间反映了神经肌肉对运动协同的控制，可以作为神经肌肉控制、动态稳定性和功能表现的临床有意义的指标。

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引用次数: 0

Spinal compensation patterns in dropped head syndrome according to prone-position cervical extension performance 俯卧位颈椎伸展表现对落头综合征脊柱代偿模式的影响。

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-10-30 DOI: 10.1016/j.gaitpost.2025.110023

Hiroki Sano , Kenji Endo , Tsukasa Ooka , Ryutaro Deguchi , Tomoyasu Yamauchi , Masahiro Ishiyama , Takuya Osada , Ryuuichi Ueno , Kengo Yamamoto

Background

Dropped Head Syndrome (DHS) is caused by muscle weakness of the cervical extensor muscles (CEM), resulting in global imbalance. However, the relationship between CEM weakness and sagittal spinal alignment remains unclear. The purpose of this study was to investigate the correlation between CEM weakness and global spinal posture in patients with DHS.

Methods

The subjects were 159 patients diagnosed with DHS. CEM was evaluated by cervical extension performance in the prone position, and the subjects were classified into Mild DHS (MMT≥3; 33 subjects) and Severe DHS (MMT<3; 126 subjects). Sagittal spinal alignment was measured by standing whole-body radiography, and correlations between the parameters were analyzed individually.

Results

Both DHS groups had a positive correlation between CBVA (chin- brow vertical angle), C-SVA (cervical sagittal vertical axis) and TK (Thoracic kyphosis angle). In Mild DHS, T1S (T1 slope angle) showed a positive correlation with TK (thoracic kyphotic angle) but not with PT (pelvic tilt angle), while T1S of Severe DHS showed a positive correlation with TK as well as with PT.

Conclusions

CEM weakness affected the global sagittal spinal posture in patients with DHS. In CEM with MMT< 3, the compensation of head drop was lost to thoraco-lumbar segments, and the head imbalance was compensated for by the pelvic posterior tilt.

背景：低垂头综合征（DHS）是由颈伸肌（CEM）肌肉无力引起的，导致全身失衡。然而，CEM无力与矢状面脊柱对齐之间的关系尚不清楚。本研究的目的是探讨DHS患者的CEM无力与整体脊柱姿势之间的相关性。方法：选取159例诊断为DHS的患者作为研究对象。采用俯卧位颈椎伸展表现评价CEM，将受试者分为轻度DHS （MMT≥3,33例）和重度DHS （MMT≥3,33例）。结果：DHS组CBVA（颏眉垂直角）、C-SVA（颈椎矢状垂直轴）和TK（胸后凸角）均呈正相关。轻度DHS患者T1S （T1倾斜角）与TK（胸后凸角）呈正相关，与PT（骨盆倾斜角）无关；重度DHS患者T1S与TK和PT呈正相关。结论：CEM无力影响DHS患者整体矢状位。在CEM和MMT中

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引用次数: 0

The effect of emotional stimuli on static postural stability in adults: A systematic review 情绪刺激对成人静态姿势稳定性的影响：一项系统综述。

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-10-24 DOI: 10.1016/j.gaitpost.2025.110017

Daniela Benesova , Ladislav Cepicka , Lucie Kovarova , Chipo Malambo , Martin Musalek , Karel Svatora

Background

Postural stability is fundamental to motor control, daily activities, and motor learning. Emerging research suggests that emotional stimuli may modulate postural responses through neural pathways linking the limbic, vestibular, and motor systems. However, findings on this relationship remain inconsistent, particularly concerning the effects of emotional valence and arousal on static postural stability.

Research question

Does exposure to emotional stimuli influence postural stability, and how do factors such as stimulus valence, arousal, and individual differences contribute to these effects?

Methods

A systematic review was conducted following PRISMA guidelines. Literature searches were performed using predefined keywords on the Web of Science, Scopus, and PsycInfo. Studies published between 2004 and 2024 that investigated the influence of emotional stimuli on postural stability were included. A total of 19 studies met the eligibility criteria.

Results

Several studies suggested an effect of emotional stimuli on postural control; however, statistical support was inconsistently reported. Unpleasant stimuli often increased center of pressure (COP) displacements, particularly in the anterior-posterior direction, while pleasant stimuli had a less pronounced effect. Individual differences, including age, gender, and anxiety levels, modulated postural responses. Contradictory findings regarding the "freezing" response suggest that methodological and cultural factors may influence outcomes.

Significance

This review highlights the impact of emotional stimuli on postural stability but also underscores the variability in research methodologies. Standardized protocols, integration of dynamic balance assessments, and objective physiological measures, such as electrodermal activity and heart rate monitoring, are needed to refine our understanding of this relationship. These findings affect clinical assessments, sports performance, and rehabilitation strategies.

背景：体位稳定性是运动控制、日常活动和运动学习的基础。新兴研究表明，情绪刺激可能通过连接边缘、前庭和运动系统的神经通路调节姿势反应。然而，关于这种关系的研究结果仍然不一致，特别是关于情绪效价和唤醒对静态姿势稳定性的影响。研究问题：暴露于情绪刺激是否会影响姿势稳定性？刺激效价、唤醒和个体差异等因素如何影响这些影响？方法：按照PRISMA指南进行系统评价。在Web of Science、Scopus和PsycInfo上使用预定义的关键词进行文献搜索。2004年至2024年间发表的研究调查了情绪刺激对姿势稳定性的影响。共有19项研究符合入选标准。结果：多项研究表明情绪刺激对体位控制有影响；然而，统计支持的报告并不一致。不愉快的刺激通常会增加压力中心（COP）移位，特别是在前后方向，而愉快的刺激则没有那么明显的影响。个体差异，包括年龄、性别和焦虑水平，调节姿势反应。关于“冻结”反应的矛盾发现表明，方法和文化因素可能影响结果。意义：本综述强调了情绪刺激对体位稳定性的影响，但也强调了研究方法的可变性。标准化的方案，动态平衡评估的整合，以及客观的生理测量，如皮电活动和心率监测，需要完善我们对这种关系的理解。这些发现影响临床评估、运动表现和康复策略。

{"title":"The effect of emotional stimuli on static postural stability in adults: A systematic review","authors":"Daniela Benesova , Ladislav Cepicka , Lucie Kovarova , Chipo Malambo , Martin Musalek , Karel Svatora","doi":"10.1016/j.gaitpost.2025.110017","DOIUrl":"10.1016/j.gaitpost.2025.110017","url":null,"abstract":"<div><h3>Background</h3><div>Postural stability is fundamental to motor control, daily activities, and motor learning. Emerging research suggests that emotional stimuli may modulate postural responses through neural pathways linking the limbic, vestibular, and motor systems. However, findings on this relationship remain inconsistent, particularly concerning the effects of emotional valence and arousal on static postural stability.</div></div><div><h3>Research question</h3><div>Does exposure to emotional stimuli influence postural stability, and how do factors such as stimulus valence, arousal, and individual differences contribute to these effects?</div></div><div><h3>Methods</h3><div>A systematic review was conducted following PRISMA guidelines. Literature searches were performed using predefined keywords on the Web of Science, Scopus, and PsycInfo. Studies published between 2004 and 2024 that investigated the influence of emotional stimuli on postural stability were included. A total of 19 studies met the eligibility criteria.</div></div><div><h3>Results</h3><div>Several studies suggested an effect of emotional stimuli on postural control; however, statistical support was inconsistently reported. Unpleasant stimuli often increased center of pressure (COP) displacements, particularly in the anterior-posterior direction, while pleasant stimuli had a less pronounced effect. Individual differences, including age, gender, and anxiety levels, modulated postural responses. Contradictory findings regarding the \"freezing\" response suggest that methodological and cultural factors may influence outcomes.</div></div><div><h3>Significance</h3><div>This review highlights the impact of emotional stimuli on postural stability but also underscores the variability in research methodologies. Standardized protocols, integration of dynamic balance assessments, and objective physiological measures, such as electrodermal activity and heart rate monitoring, are needed to refine our understanding of this relationship. These findings affect clinical assessments, sports performance, and rehabilitation strategies.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"123 ","pages":"Article 110017"},"PeriodicalIF":2.4,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145403227","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

Multidimensional abnormal gait analysis and biomarker identification for patients with spinocerebellar ataxia type 3 using an Azure Kinect-based motion capture system 基于Azure kinect的运动捕捉系统对3型脊髓小脑性共济失调患者的多维异常步态分析和生物标志物识别

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-10-24 DOI: 10.1016/j.gaitpost.2025.110019

Mao-Lin Cui , Li-Ying Pan , Wei Lin , Zhuo-Ying Huang , Bei-Ning Ye , Chu-Yi Li , Ying-Xin Ye , Han Lin , Ming-Ting Lin , Ning Wang , Shi-Rui Gan , Yun-Ru Ma , on behalf of the OSCCAR Investigators

Background

Spinocerebellar Ataxia Type 3 (SCA3), the most common hereditary ataxia in China, is characterized by progressive gait dysfunction. While quantitative gait analysis provides critical insights into movement disorder management, conventional motion capture systems are often cost-prohibitive and impractical for clinical use.

Objectives

We propose using the markerless Azure Kinect, a cost-effective and portable tool for gait analysis, to detect SCA3-specific gait patterns and identify gait parameters associated with disease severity and duration.

Methods

We enrolled 38 patients with SCA3 patients and 42 healthy controls (HCs). Gait was recorded using an Azure Kinect. Multiple gait parameters were computed and compared with t-tests/Mann-Whitney U tests. The receiver operating characteristic (ROC) analysis identified discriminatory biomarkers, while Pearson’s test assessed gait-clinical characteristic associations.

Results

Patients with SCA3 exhibited increased mediolateral margins of stability (MOS, p < 0.01), wider step width (p < 0.001), shorter stride length (p = 0.003), slower gait speed (p = 0.007), and reduced hip/knee/ankle joint angles (p < 0.05) compared to HCs. Step width demonstrated the highest diagnostic accuracy (AUC = 0.878, cutoff = 0.197). Increased medial-lateral MOS was negatively correlated with step length (r = -0.52∼-0.45, P < 0.005). Minimal hip frontal angles negatively correlated with SARA scores (r = -0.46, p = 0.004) and disease duration (r = -0.35, p = 0.028), reflecting a progressive cerebellar degeneration.

Conclusion

In SCA3, gait abnormalities such as increased step width and shortened stride length indicate compensatory adaptations exist to enhance dynamic stability. Step width is identified as a sensitive biomarker for SCA3 screening.

脊髓小脑性共济失调3型（SCA3）是中国最常见的遗传性共济失调，以进行性步态功能障碍为特征。虽然定量步态分析为运动障碍管理提供了关键的见解，但传统的运动捕捉系统通常成本过高，不适合临床使用。我们建议使用无标记Azure Kinect，这是一种成本效益高的便携式步态分析工具，用于检测sca3特异性步态模式，并识别与疾病严重程度和持续时间相关的步态参数。方法纳入38例SCA3患者和42例健康对照（hc）。使用Azure Kinect记录步态。计算多个步态参数，并与t检验/Mann-Whitney U检验进行比较。受试者工作特征（ROC）分析确定了歧视性生物标志物，而Pearson检验评估了步态与临床特征的关联。ResultsPatients SCA3表现出增加稳定的中间外侧的利润率(金属氧化物半导体,p & lt; 0.01),更广泛的一步宽度(p & lt; 0.001),短步幅(p = 0.003),步速慢(p = 0.007),并降低髋部/膝盖/踝关节角度(p & lt; 0.05)相比,高碳钢。步宽显示出最高的诊断准确度（AUC = 0.878，截止值= 0.197）。中外侧MOS增加与步长呈负相关（r = -0.52 ~ -0.45,P <； 0.005）。最小髋前角与SARA评分（r = -0.46,p = 0.004）和病程（r = -0.35,p = 0.028）呈负相关，反映小脑退行性变。结论在SCA3中，步宽增加、步长缩短等步态异常提示存在代偿性适应以增强动态稳定性。步宽被确定为SCA3筛选的敏感生物标志物。

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引用次数: 0

Three-dimensional in vivo kinematics of the subtalar joint during weight-bearing standing on coronal-wedge surfaces using upright computed tomography 站立在冠状楔面上负重时距下关节的三维体内运动学研究

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-10-22 DOI: 10.1016/j.gaitpost.2025.110021

Naomichi Ogihara , Hiroyuki Seki , Asahi Sujino , Akimasa Ito , Yuka Matsumoto , Gen Suwa , Takeo Nagura , Yoichi Yokoyama , Minoru Yamada , Yoshitake Yamada , Masahiro Jinzaki

Background

The human subtalar joint is crucial for bipedal posture and locomotion, providing stability, adaptability, and force dissipation. While its kinematics have been studied, most research has been under non-weight-bearing conditions, leaving its function under physiological loading unclear.

Research question

What is the three-dimensional kinematics of the human subtalar joint during weight-bearing postures, as quantified by the helical axis?

Methods

This study analyzed three-dimensional in vivo subtalar joint kinematics during weight-bearing using upright CT. Fifteen healthy elderly adults (11 females, 4 males; mean age: 64.9 ± 5.0 years) underwent CT scans in neutral, inverted, and everted postures using 10° coronal wedges. Kinematics were quantified via helical axis representation relative to two talar coordinate systems: the foot longitudinal axis and the talus principal axis.

Results

The helical axis ran obliquely from anterior-medial-dorsal to posterior-lateral-plantar, with inclination and deviation angles of 22.4° ± 9.6° and 35.2° ± 5.6° in the former system, and 36.5° ± 10.7° and 12.0° ± 7.1° in the latter. Rotation along the axis was 9.9° ± 3.8°, with minimal translation (0.5 ± 0.5 mm).

Significance

These findings suggest subtalar joint movement is more constrained under weight-bearing conditions than in non-weight-bearing studies. This study underscores the importance of weight-bearing analyses for clinical applications and understanding human foot adaptations for bipedalism.

人类距下关节对两足姿势和运动至关重要，提供稳定性、适应性和力量消散。虽然对其运动学进行了研究，但大多数研究都是在非负重条件下进行的，因此对其在生理负荷下的功能还不清楚。研究问题：人体距下关节在负重姿势时的三维运动学是怎样用螺旋轴来量化的？方法采用直立CT对人体负重过程中距下关节的三维运动学进行分析。15名健康老年人（11名女性，4名男性，平均年龄：64.9 ± 5.0岁）采用10°冠状楔采用中位、倒位和仰卧位进行CT扫描。运动学通过相对于两个距骨坐标系的螺旋轴表示来量化：足纵轴和距骨主轴。结果螺旋轴由前中背侧斜向足底后外侧倾斜，前者倾斜角度为22.4°±9.6°，后者倾斜角度为35.2°±5.6°，偏离角度为36.5°±10.7°，偏离角度为12.0°±7.1°。沿轴旋转9.9°±3.8°，最小平移（0.5 ± 0.5 mm）。这些研究结果表明，距下关节运动在负重条件下比在非负重条件下更受限制。这项研究强调了负重分析对临床应用和理解人类足部适应两足动物的重要性。

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引用次数: 0

How many strides are needed for reliable markerless gait analysis? 可靠的无标记步态分析需要多少步？

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-10-22 DOI: 10.1016/j.gaitpost.2025.110020

Andreia Carvalho , Jos Vanrenterghem , Todd C. Pataky , Mark A. Robinson , António P. Veloso , Vera Moniz-Pereira

Background/Aim

Markerless motion capture is an emerging tool for gait analysis. In some populations, e.g., older adults, traditional gait analysis poses practical challenges, such as reduced assessment tolerance, and the number of strides collected can be limited. This study aimed to investigate the influence of the number of strides on test-retest reliability and measurement error of markerless gait biomechanics in older adults.

Methods

Twenty strides were extracted from 29 healthy older adults for each of two sessions. Lower-limb kinematics and kinetics were computed. Subsequently, non-consecutive random subsets of k = 2–19 strides were averaged within-subjects and within-sessions, including scenarios with unequal k between sessions. Integrated Intraclass Correlation Coefficients (iICC_A,k) and Standard Errors of Measurement (SEM) were calculated for trajectory data. ICC_A,k [Confidence Intervals] were computed for the range of motion and peaks. Two arbitrary thresholds for the minimally acceptable number of strides were combined: (1) the smallest k that yielded an ICC within 10 % of the maximum ICC across all k, and (2) an absolute ICC threshold of 0.75. SEM≤ 2º was deemed suitable for kinematics, and SEM%≤ 5 % for kinetics.

Results

For joint angles and moments, iICC dropped less than 10 % from the highest iICC when using ≥ 7 strides with an equal number of strides across sessions, attaining iICCs≥ 0.75. Reducing the number of strides in one session had less impact than reducing both equally. Lower Confidence intervals were generally ≥ 0.75 for discrete parameters. Kinematic SEM rarely exceeds 2º. Globally, 4 strides are needed to have a kinetics SEM%≤ 5 %.

Conclusion

A minimum of 7 strides contributing to the average observation is generally sufficient to achieve reliable markerless kinematics and kinetics in older adults. These results have particular relevance to populations who may experience limited tolerance for lengthy assessments. Allowing flexibility in stride number collected across sessions, while maintaining reliability, contributes to optimizing data collection strategies.

背景/无AimMarkerless运动捕捉是一种新兴的步态分析工具。在某些人群中，例如老年人，传统的步态分析存在实际挑战，例如评估容忍度降低，并且收集的步幅数量可能有限。本研究旨在探讨步数对老年人无标记步态生物力学重测信度和测量误差的影响。方法选取29名健康老年人，每组20步。计算下肢运动学和动力学。随后，对k = 2-19步的非连续随机子集在受试者和会话内进行平均，包括会话之间k不相等的场景。计算了弹道数据的类内相关系数（iICCA,k）和测量标准误差（SEM）。计算运动范围和峰值的ICCA，k[置信区间]。对于最小可接受步幅数的两个任意阈值进行了组合：(1)产生ICC的最小k在所有k的最大ICC的10 %内，以及(2)绝对ICC阈值为0.75。SEM≤ 2º被认为适合运动学，SEM%≤ 5 %被认为适合动力学。结果对于关节角度和力矩，当使用≥ 7步幅和相同步幅时，iICC比最高iICC下降了不到10 %，达到iICC≥ 0.75。减少一次训练中步幅的数量比同等减少两者的效果要小。对于离散参数，较低置信区间一般≥ 0.75。运动扫描电镜很少超过2º。在全球范围内，需要4步才能达到动力学SEM%≤ 5 %。结论：在老年人中，至少7步的平均观察通常足以获得可靠的无标记运动学和动力学。这些结果与那些可能对长时间评估耐受性有限的人群特别相关。允许跨会话收集步数的灵活性，同时保持可靠性，有助于优化数据收集策略。

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引用次数: 0

Effects of a 12-week intrinsic foot muscle strengthening program (STIFF) on gait, balance and concerns about falling in physically active older adults: An assessor-blinded randomized-controlled trial 12周内在足部肌肉强化计划（STIFF）对运动老年人步态、平衡和跌倒担忧的影响：一项评估盲随机对照试验

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-10-20 DOI: 10.1016/j.gaitpost.2025.110018

Lydia Willemse , Eveline J.M. Wouters , Martijn F. Pisters , Benedicte Vanwanseele

Background

Falling is a major concern in the ageing population. Strengthening the plantar intrinsic foot muscles (PIFM) may improve gait and balance in older adults and, therefore, may have potential for fall prevention.

Research question

The aim of the present study is to examine the effect of a PIFM strengthening program on gait, balance and functional outcomes in older adults.

Methods

For this assessor-blinded RCT, older adults (> 65 years) with potentially increased fall risk were recruited at functional exercise classes and randomly assigned to an intervention (12-week supervised and progressive PIFM strengthening program) and a control group. The trial outcomes were between-group differences in mean change from baseline in maximum gait speed (primary outcome), balance during gait, foot and ankle biomechanics during gait and concerns about falling and within-group differences in capacity and strength of foot muscles.

Results

Thirty-three participants were included. No between group differences were found for change in maximum gait speed. However, the intervention group showed a larger reduction in concerns about falling. In addition, the intervention group showed increased capacity and strength of foot muscles, but this was not related to other findings.

Significance

This study did not show an effect of PIFM strengthening training on maximum gait speed in older adults who are involved in a functional exercise program. However, it seems to reduce concerns about falling. This advocates further research on the benefits of integrating PIFM strengthening exercises in functional exercise programs. In addition, future studies are needed to unravel the mechanism behind the reduction in concerns about falling.

背景：跌倒是人口老龄化的一个主要问题。加强足底内在足肌（PIFM）可以改善老年人的步态和平衡，因此可能有预防跌倒的潜力。研究问题：本研究的目的是检查PIFM强化计划对老年人步态、平衡和功能结果的影响。方法：在这项评估盲随机对照试验中，在功能锻炼课程中招募了可能增加跌倒风险的老年人（bb0 ~ 65岁），并随机分配到干预组（12周监督和进行性PIFM强化计划）和对照组。试验结果是组间最大步态速度（主要结果）、步态平衡、步态时足部和踝关节生物力学、对跌倒的担忧以及足部肌肉容量和力量的组内差异的平均变化。结果：共纳入33例受试者。两组之间在最大步态速度方面没有发现差异。然而，干预组对摔倒的担忧明显减少。此外，干预组显示足部肌肉的容量和力量增加，但这与其他发现无关。意义：本研究并未显示PIFM强化训练对参与功能性锻炼项目的老年人最大步态速度的影响。然而，它似乎减少了人们对摔倒的担忧。这就需要进一步研究将PIFM强化训练整合到功能性锻炼项目中的益处。此外，未来的研究需要揭示减少对跌倒的担忧背后的机制。

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引用次数: 0

Balance control during obstacle-crossing in older adults after a fatiguing protocol 老年人疲劳训练后过障时的平衡控制。

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-10-20 DOI: 10.1016/j.gaitpost.2025.110015

Szu-Hua Chen , Li-Shan Chou

Background

Obstacle-crossing (OC) requires dynamic balance and cognitive attention, which may decline with age and fatigue. While age-related gait changes are known, the combined effects of fatigue and cognitive demand on OC remain unclear.

Research Question

How does performance fatigability affect balance and crossing performance during single- and dual-task OC in older versus younger adults?

Methods

Seventeen older and 17 young adults (9 females in each group) with post-fatigue Rating of Perceived Exertion (RPE) > 15/20 were included. In Visit 1, participants were familiarized with OC and a working memory task. In Visit 2, they performed single- and dual-task OC trials before and after a fatiguing sit-to-stand protocol. Motion capture and force plates recorded toe-obstacle clearance, foot placement, crossing velocity, and balance (measured as center of mass-center of pressure inclination angle, IA). Fatigue was assessed via RPE and knee extension torque. Cognitive performance was evaluated by accuracy and reaction time. Data were analyzed using repeated measures ANOVAs and mixed-effects models (α =.05).

Results

Both age groups experienced similar exertion and strength loss post-fatigue. Increased mediolateral IA indicated reduced balance control, though crossing velocity and foot placement remained stable. Post-fatigue, the typical increase in toe-obstacle clearance during dual-tasking was reduced. Surprisingly, cognitive performance improved post-fatigue, with higher accuracy and faster reaction times.

Significance

Fatigue impaired gait balance control in both age groups, shown by increased IA. The reduced toe-clearance during dual-tasking post-fatigue suggests decreased emphasis on safe obstacle navigation. Improved cognitive performance without slowing suggests a shift in attentional priorities.

背景：障碍穿越（OC）需要动态平衡和认知注意力，可能随着年龄和疲劳而下降。虽然已知与年龄相关的步态变化，但疲劳和认知需求对OC的综合影响尚不清楚。研究问题：表现疲劳如何影响老年人和年轻人在单任务和双任务OC中的平衡和交叉表现？方法：选取疲劳后感觉劳累评分(RPE) > 15/20的老年人17名，青壮年17名，每组9名女性。在访问1中，参与者熟悉OC和工作记忆任务。在第2次访问中，他们在疲劳坐姿-站立方案之前和之后进行了单任务和双任务OC试验。动作捕捉和力板记录了脚趾与障碍物的间隙、脚的位置、穿越速度和平衡（以质心压力中心倾角IA测量）。通过RPE和膝关节伸展扭矩评估疲劳程度。通过准确性和反应时间来评估认知表现。数据分析采用重复测量方差分析和混合效应模型（α = 0.05）。结果：两个年龄组在疲劳后的用力和力量损失相似。增加的中外侧内陷表明平衡控制能力下降，尽管穿越速度和足部位置保持稳定。疲劳后，双任务中典型的增加的脚趾障碍清除减少了。令人惊讶的是，疲劳后的认知表现得到了改善，准确性更高，反应速度更快。意义：两个年龄组的步态平衡控制均因疲劳受损，表现为IA增加。双任务疲劳后的脚趾间隙减少表明对安全障碍导航的重视程度降低。认知能力的提高而不减慢表明注意力优先级的转移。

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引用次数: 0