Gait & posture最新文献_第7页

The effect of inaccurate initial contact events on kinematics in healthy and pathological gait 不准确的初始接触事件对健康和病理步态运动学的影响。

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-10-16 DOI: 10.1016/j.gaitpost.2025.110012

Bernhard Dumphart , Djordje Slijepcevic , Fabian Unglaube , Andreas Kranzl , Arnold Baca , Brian Horsak

Background:

Clinical gait analysis (CGA) is the established gold standard for clinical decision-making. While previous research has identified error sources that affect the quality of CGA (e.g., marker placement and soft tissue artifacts), the impact of inaccurately identified initial contact (IC) events has not been systematically investigated. As IC events define the beginning and end of the stance phase, they directly impact spatiotemporal, kinematic, and kinetic parameters.

Research question:

To what extent do inaccurately detected IC events affect sagittal hip, knee, and ankle kinematics at IC across different cohorts?

Methods:

The impact of inaccurately detected IC events on sagittal hip, knee, and ankle kinematics at IC was investigated in healthy individuals (n=28) and two patient populations, patients with cerebral palsy (CP, n=208) and patients with malrotation deformities and/or frontal malalignments of the lower extremities (MD, n=1122). IC events were incrementally shifted by

\pm

1 to

\pm

6 frames to systematically simulate inaccuracies. The mean absolute error (MAE) was calculated for the hip, knee, and ankle kinematics between the waveforms based on the original IC and each shifted IC.

Results:

Kinematics of the sagittal knee and ankle are highly sensitive to inaccurate ICs, with a median MAE exceeding

2 °

within two frames for MD and healthy participants and three frames for patients with CP. The hip kinematics showed a lower sensitivity to IC inaccuracies.

Significance:

These results highlight the importance of accurately identified IC events in CGA to ensure reliable data. Based on our results, we recommend adopting stricter error tolerance thresholds of 13.3 ms to 20.0 ms (i.e., two to three frames at 150 Hz) for gait event detection algorithms to reduce potential errors in clinical assessments.

背景：临床步态分析（CGA）是临床决策的金标准。虽然以前的研究已经确定了影响CGA质量的误差来源（例如，标记放置和软组织伪影），但尚未系统地研究不准确识别的初始接触（IC）事件的影响。由于IC事件定义了姿态阶段的开始和结束，它们直接影响时空、运动学和动力学参数。研究问题：在不同的队列中，不准确检测到的IC事件在多大程度上影响IC的髋、膝关节和踝关节矢状位运动学？方法：在健康个体（n=28）和脑瘫患者（n= 208）和下肢旋转畸形和/或额位畸形患者（MD, n=1122）中，研究了不准确检测的IC事件对IC时髋、膝关节和踝关节矢状位运动学的影响。IC事件增量移动±1到±6帧，系统地模拟不准确性。结果：矢状位膝关节和踝关节的运动学对不准确的IC高度敏感，MD和健康参与者的中位MAE在两帧内超过2°，CP患者的中位MAE在三帧内超过2°。髋关节运动学对IC不准确的敏感性较低。意义：这些结果强调了准确识别CGA中IC事件对于确保数据可靠的重要性。基于我们的研究结果，我们建议在步态事件检测算法中采用更严格的容错阈值，即13.3 ms至20.0 ms（即150 Hz下的2至3帧），以减少临床评估中的潜在错误。

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引用次数: 0

A data-driven modeling approach to prediction of persistent foot drop after gastroc-soleus lengthening surgery in children with cerebral palsy 预测脑瘫患儿胃-比目鱼肌延长手术后持续性足下垂的数据驱动建模方法。

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-10-14 DOI: 10.1016/j.gaitpost.2025.110010

Mohammad Yavari , Elyse Passmore , Erich Rutz , Pam Thomason , David C. Ackland

Background

Gastrocsoleus lengthening (GSL) is an established surgical intervention for equinus deformity in children with cerebral palsy (CP). While GSL typically improves ankle function during stance, some children experience persistent ankle plantar flexion during swing, known as foot drop. The etiology and key indicators for post-GSL foot drop are not fully understood. This study aimed to (1) predict foot drop following GSL using pre-operative gait and clinical data and (2) identify associated risk factors of foot drop.

Methods

One-hundred and ten children with CP (36 with hemiplegia, 74 with diplegia) were recruited. Physical examinations and three-dimensional gait analysis of barefoot walking were conducted pre- and post-operatively. A deep learning model, incorporating convolutional and feed-forward neural networks, was developed to predict post-operative ankle dorsiflexion using both pre-operative clinical and gait data. Shapley Additive exPlanations (SHAP) and logistic regression were used to assess associations between pre-operative gait and clinical variables and post-operative foot drop.

Results

Ankle dorsiflexion during a full gait cycle was predicted with an RMS difference of 5.1° relative to measured joint angles, and post-operative foot drop classified with 87% accuracy. Soleus muscle length, maximum dorsiflexion during mid-swing, CP topography, and ankle gait variable score (GVS) were the greatest determinants of foot drop, exhibiting the highest SHAP values (0.40, 0.32, 0.17, and 0.15 respectively) and strongest correlation with post-operative foot drop (β: −0.74, −0.87, 0.37, and 0.59, respectively) (p < 0.05).

Significance

Accurate predictions of post-GSL dorsiflexion and foot drop risk can be achieved using pre-operative gait and clinical assessment. Several features, including pre-operative dorsiflexion during mid-swing, soleus muscle length, and ankle GVS, were identified as significant contributors to persistent foot drop. The findings may be useful in surgical planning for equinus deformities.

背景：腓肠肌延长术（GSL）是治疗脑瘫（CP）患儿马蹄肌畸形的一种成熟的手术干预方法。虽然GSL通常在站立时改善踝关节功能，但有些孩子在摇摆时经历持续的踝关节足底弯曲，称为足下垂。gsl后足下垂的病因和关键指标尚不完全清楚。本研究旨在(1)利用术前步态和临床数据预测GSL术后足下垂；(2)确定足下垂的相关危险因素。方法：选取110例CP患儿，其中偏瘫36例，双瘫74例。术前、术后分别进行体格检查和赤脚行走三维步态分析。研究人员开发了一种深度学习模型，结合卷积和前馈神经网络，利用术前临床和步态数据预测术后踝关节背屈。采用Shapley加性解释（SHAP）和logistic回归评估术前步态和临床变量与术后足下垂之间的关系。结果：在整个步态周期中，踝关节背屈与测量关节角度的RMS差为5.1°，术后足下垂分类准确率为87%。比目鱼肌长度、摆动中最大背屈度、CP地形和踝关节步态变量评分（GVS）是足下垂的最大决定因素，其SHAP值最高（分别为0.40、0.32、0.17和0.15），与术后足下垂的相关性最强（β值分别为-0.74、-0.87、0.37和0.59）（p值 ）意义：通过术前步态和临床评估，可以准确预测gsl术后背屈度和足下垂风险。有几个特征，包括术前摆动中背屈、比目鱼肌长度和踝关节GVS，被认为是导致持续足下垂的重要因素。研究结果可为马蹄形畸形的手术规划提供参考。

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引用次数: 0

Relationships between disease severity and walking kinematics in relapsing-remitting multiple sclerosis 复发缓解型多发性硬化症患者疾病严重程度与行走运动学的关系

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-10-12 DOI: 10.1016/j.gaitpost.2025.110011

Sumire D. Sato , Sutton B. Richmond , Clayton W. Swanson , Kristin A. Johnson , Brett W. Fling , Rachael D. Seidler

Background

Declines in walking function commonly occur in people with multiple sclerosis (MS). Walking is a continuous movement and a complex motor task that requires precise timing and scaling of activation across many muscles.

Research question

Identifying kinematic gait characteristics during a 2-min walk test that are associated with disease severity in individuals with relapsing-remitting MS.

Methods

Participants (n = 45) were instrumented with inertial measurement units from APDM (APDM Inc, Portland, OR, USA) and performed the 2-min walk test twice: once at their self-selected speed and another at their fastest, safe speed.

Results

Gait speed was not associated with MS disease duration (Self-selected: p = 0.180; Fast: p = 0.167). Canonical correlation analysis showed that disease severity characteristics was strongly associated with lateral step width variability and ankle pitch at toe-off, which was also reflected in the multiple linear regression models. Both self-selected and fast-speed kinematics were associated with disease duration (Self-selected: p = 0.007; Fast: p = 0.004).

Significance

Our study highlights the importance of considering individual differences in specific gait kinematics (such as lateral step width variability and ankle pitch at toe-off) when assessing disease severity in MS. This approach may provide more personalized insights into the impact of MS on mobility and help tailor interventions to improve gait and overall function in affected individuals. Future research should continue exploring these kinematic parameters to better understand their role in MS severity and progression and develop targeted therapeutic strategies.

背景：行走功能下降常见于多发性硬化症（MS）患者。步行是一项持续的运动，也是一项复杂的运动任务，需要精确的时间和许多肌肉的激活比例。研究问题：确定与复发缓解型多发性硬化患者疾病严重程度相关的2分钟步行测试中的运动学步态特征方法：参与者（n = 45）使用APDM （APDM Inc ., Portland， OR， USA）的惯性测量装置进行2分钟步行测试两次：一次以他们自己选择的速度，另一次以他们最快的安全速度。结果：步态速度与MS病程无相关性（自我选择：p = 0.180；快速：p = 0.167）。典型相关分析显示，疾病严重程度特征与侧步宽变异性和踝关节离趾距密切相关，这也反映在多元线性回归模型中。自选运动和快速运动均与病程相关（自选运动：p = 0.007；快速运动：p = 0.004）。意义：我们的研究强调了在评估MS疾病严重程度时考虑特定步态运动学个体差异的重要性（如侧步宽度变异性和脚趾着地时的踝关节间距）。这种方法可能为MS对活动能力的影响提供更个性化的见解，并有助于定制干预措施，以改善患者的步态和整体功能。未来的研究应继续探索这些运动学参数，以更好地了解它们在MS严重程度和进展中的作用，并制定有针对性的治疗策略。

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引用次数: 0

Effects of step rate based gait training on running biomechanics: A systematic review and meta-analysis 基于步速的步态训练对跑步生物力学的影响：一项系统综述和荟萃分析。

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-10-11 DOI: 10.1016/j.gaitpost.2025.110009

Dante D. Goss, Jennifer Xu, Jay Hertel

Background

Step rate based gait training is a useful method of dealing with running related injuries, though many methods exist to increase step rate. No systematic review has been performed to evaluate the effectiveness of the different intervention strategies.

Research question

The primary aim of this systematic review and meta-analysis was to evaluate the effectiveness of different step rate based gait retraining intervention magnitudes, durations, and modalities on step rate during running.

Methods

A systematic electronic search was performed using PubMed and Web of Science databases to identify studies meeting inclusion criteria published before September 2024. Included studies sought to change running step rate in adult runners and measured this change. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. Pre-post comparisons of step rate were made for each intervention condition and meta-analyses were performed to calculate pooled mean differences when possible. For the meta-analyses, a random effects model was used at a 95 % confidence level.

Results

Twenty original studies were included with a total of 483 individuals enrolled. Meta-analysis found both acute and multisession step rate based gait training protocols to be effective at increasing running step rate with acute interventions causing an increase of 16.15 (95 % CI: 11.28, 21.01) steps/minute. Multisession interventions caused significant increases in running step rate when categorized by modality 12.02 (10.20, 13.84), magnitude 12.04 (10.22, 13.87), and duration 12.61 (11.09, 14.13). Additionally, there were no subgroup differences for comparison between modalities (p = 0.14, p = 0.81, p = 0.76 respectively).

Significance

Step rate based gait training is effective at increasing running step rate during both acute and multisession interventions. These changes are resistant to different modalities, magnitudes, and durations, potentially pointing to increased ability to customize training specifications. The protocol registration number is CRD42022354275 (PROSPERO International Prospective Register of Systematic Reviews).

背景：基于步频的步态训练是处理跑步相关损伤的有效方法，尽管有许多方法可以提高步频。没有进行系统评价来评估不同干预策略的有效性。研究问题：本系统综述和荟萃分析的主要目的是评估基于不同步速的步态再训练干预的强度、持续时间和方式对跑步时步速的影响。方法：使用PubMed和Web of Science数据库进行系统的电子检索，以确定2024年9月之前发表的符合纳入标准的研究。纳入的研究试图改变成年跑步者的跑步步数，并测量这种变化。采用物理治疗证据数据库（PEDro）量表评估方法学质量。对每个干预条件的步速进行前后比较，并在可能的情况下进行荟萃分析以计算合并平均差异。meta分析采用随机效应模型，置信水平为95% %。结果：纳入了20项原始研究，共纳入了483名受试者。荟萃分析发现，急性期和多期基于步频的步态训练方案都能有效地提高跑步步频，急性干预导致16.15步/分钟（95 % CI: 11.28, 21.01）步/分钟。当按模态12.02（10.20,13.84）、幅度12.04（10.22,13.87）和持续时间12.61（11.09,14.13）分类时，多时段干预导致跑步步数显著增加。此外，两种方式的比较没有亚组差异（p = 0.14,p = 0.81,p = 0.76）。意义：基于步速的步态训练在急性期和多期干预中都能有效地提高跑步步速。这些变化可以抵抗不同的模式、幅度和持续时间，潜在地指向定制培训规范的能力增加。方案注册号为CRD42022354275 （PROSPERO国际前瞻性系统评价注册）。

{"title":"Effects of step rate based gait training on running biomechanics: A systematic review and meta-analysis","authors":"Dante D. Goss, Jennifer Xu, Jay Hertel","doi":"10.1016/j.gaitpost.2025.110009","DOIUrl":"10.1016/j.gaitpost.2025.110009","url":null,"abstract":"<div><h3>Background</h3><div>Step rate based gait training is a useful method of dealing with running related injuries, though many methods exist to increase step rate. No systematic review has been performed to evaluate the effectiveness of the different intervention strategies.</div></div><div><h3>Research question</h3><div>The primary aim of this systematic review and meta-analysis was to evaluate the effectiveness of different step rate based gait retraining intervention magnitudes, durations, and modalities on step rate during running.</div></div><div><h3>Methods</h3><div>A systematic electronic search was performed using PubMed and Web of Science databases to identify studies meeting inclusion criteria published before September 2024. Included studies sought to change running step rate in adult runners and measured this change. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. Pre-post comparisons of step rate were made for each intervention condition and meta-analyses were performed to calculate pooled mean differences when possible. For the meta-analyses, a random effects model was used at a 95 % confidence level.</div></div><div><h3>Results</h3><div>Twenty original studies were included with a total of 483 individuals enrolled. Meta-analysis found both acute and multisession step rate based gait training protocols to be effective at increasing running step rate with acute interventions causing an increase of 16.15 (95 % CI: 11.28, 21.01) steps/minute. Multisession interventions caused significant increases in running step rate when categorized by modality 12.02 (10.20, 13.84), magnitude 12.04 (10.22, 13.87), and duration 12.61 (11.09, 14.13). Additionally, there were no subgroup differences for comparison between modalities (p = 0.14, p = 0.81, p = 0.76 respectively).</div></div><div><h3>Significance</h3><div>Step rate based gait training is effective at increasing running step rate during both acute and multisession interventions. These changes are resistant to different modalities, magnitudes, and durations, potentially pointing to increased ability to customize training specifications. The protocol registration number is CRD42022354275 (PROSPERO International Prospective Register of Systematic Reviews).</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"123 ","pages":"Article 110009"},"PeriodicalIF":2.4,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145305115","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

Uphill walking unveils hidden instability and biomechanical adaptations in anterior cruciate ligament-deficient copers 上坡行走揭示了前交叉韧带缺陷患者隐藏的不稳定性和生物力学适应性。

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-10-10 DOI: 10.1016/j.gaitpost.2025.110008

Jr-Yi Wang , Shiuan-Huei Lu , Chia-Han Hu , Kuan-Wen Wu , Ting-Ming Wang , Tung-Wu Lu

Objective

Using computerised motion analysis, the study investigated possible joint instability and biomechanical adaptations during uphill walking in participants with anterior cruciate ligament deficiency (ACLD) classified as copers based on level walking performance.

Methods

Thirteen participants with ACLD and thirteen healthy adults each walked and ascended a 3-meter slope with inclines of 3°, 6°, and 9°. Trunk angular motions, lower-limb joint angles, forces and moments, and tibial inclination angles were calculated. Two-way analyses of variance were used to study between-subject (group) and within-subject (slope angle) effects on the variables, using a significant level of α = 0.05 for all tests.

Results

The ACLD group displayed a compensatory trunk anterior tilt strategy over the stance phase of uphill walking to reduce knee extensor moments and posterior knee forces to accommodate knee instability during uphill walking. Compared to Control, the ACLD group showed increased anterior forces during single-limb support (SLS) and decreased posterior forces at the affected knee during the double-limb support (DLS) of uphill walking. They also demonstrated an increased anterior tibial angle of the affected limb with a decreased extensor moment at the affected knee around the contralateral heel-strike. The trunk anterior tilt was also accompanied by increased extensor moments at both hips and ankle dorsiflexion during terminal DLS.

Conclusions

This study demonstrates that uphill walking uncovers hidden functional instability at the ACL-deficient knee that remains undetected during level walking. This suggests that assessments based solely on level walking may overestimate the functional stability of the ACLD knee during more demanding uphill walking. Incorporating uphill walking into clinical evaluations may help identify compromised movement patterns that could necessitate surgical intervention in ACLD.

目的：利用计算机运动分析，研究了前交叉韧带缺陷（ACLD）患者在上坡行走时可能出现的关节不稳定和生物力学适应。方法：13名ACLD患者和13名健康成人分别步行和攀登3米坡度为3°，6°和9°的斜坡。计算躯干角运动、下肢关节角、力和力矩以及胫骨倾角。采用双向方差分析研究受试者之间（组）和受试者内部（斜率角）对变量的影响，所有检验均采用显著水平α = 0.05。结果：ACLD组在上坡行走的站立阶段表现出代偿性躯干前倾策略，以减少膝关节伸肌力矩和膝关节后侧力，以适应上坡行走时膝关节不稳定。与对照组相比，ACLD组在单肢支持（SLS）时表现出增加的前侧力，在上坡行走的双肢支持（DLS）时表现出患膝后侧力的减少。他们还显示患肢胫骨前角增加，患膝在对侧脚跟撞击周围的伸肌力矩减少。末梢DLS时，躯干前倾还伴有双髋伸肌力矩增加和踝关节背屈。结论：本研究表明，上坡行走揭示了在水平行走中未被发现的acl缺陷膝关节隐藏的功能不稳定。这表明，仅基于水平行走的评估可能高估了ACLD膝关节在更高要求的上坡行走时的功能稳定性。将上坡行走纳入临床评估可能有助于识别受损的运动模式，可能需要对ACLD进行手术干预。

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引用次数: 0

Comparisons of hip-worn and ankle-worn accelerometers on measuring physical activity and their correlations with perceived activity level in community-dwelling older adults 髋部和踝关节加速度计测量社区老年人身体活动的比较及其与感知活动水平的相关性

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-10-10 DOI: 10.1016/j.gaitpost.2025.110007

Chih-Hsiu Cheng , Asghar Rezaei , Kenton R. Kaufman

Background

Aging leads to declines in muscle strength, balance, and cardiopulmonary function, reducing mobility and increasing health risks. Accurate monitoring of physical activity is essential to understand its impact on health outcomes in older adults. This study aimed to evaluate the effectiveness of hip-worn and ankle-worn accelerometers in capturing physical activities in older adults, comparing their performance to self-reported activity across weekdays and weekends.

Methods

Forty healthy participants aged 51–82 years completed the International Physical Activity Questionnaire (IPAQ) and wore an ActiGraph GT3X+ accelerometer on both their right hip and ankle for four consecutive days, covering two weekdays and two weekends. Data from the accelerometers were analyzed to compare step counts and the ability to detect sedentary, light, moderate, and vigorous activities between the two sensor placements.

Results

The ankle-worn accelerometer recorded higher step counts and more light physical activities. In contrast, the hip-worn accelerometer detected more moderate to vigorous physical activities. Self-reported physical activity was well correlated with step counts and sedentary/light activities on weekdays, but failed to reflect moderate to vigorous activity and all activities on weekends.

Significance

Ankle-worn accelerometers are more effective in estimating light activities, which dominate the daily activity patterns of older adults. Hip-worn accelerometers better capture intensive activities. Self-reports demonstrated limited reliability in assessing physical activity on weekends. These findings enhance the understanding of physical activity patterns in older adults and inform interventions aimed at promoting healthy aging, especially regarding activity monitoring and the choice of accelerometer placement.

衰老会导致肌肉力量、平衡能力和心肺功能的下降，降低活动能力，增加健康风险。准确监测身体活动对于了解其对老年人健康结果的影响至关重要。这项研究旨在评估穿戴在臀部和脚踝上的加速计在捕捉老年人身体活动方面的有效性，并将他们的表现与工作日和周末的自我报告活动进行比较。方法40名年龄51 ~ 82岁的健康参与者完成国际体育活动问卷（IPAQ），并在右髋关节和脚踝连续佩戴ActiGraph GT3X+加速度计4天，包括2个工作日和2个周末。分析来自加速度计的数据，比较两种传感器位置之间的步数和检测久坐、轻度、中度和剧烈活动的能力。结果穿戴在脚踝上的加速度计记录了更高的步数和更多的轻体力活动。相比之下，佩戴在臀部的加速度计检测到的是中度到剧烈的体育活动。自我报告的身体活动与工作日的步数和久坐/轻度活动密切相关，但未能反映中度至剧烈活动和周末的所有活动。佩戴在脚踝上的加速度计在估计轻度活动方面更有效，而轻度活动是老年人日常活动模式的主导。穿戴在臀部的加速度计能更好地捕捉密集活动。自我报告在评估周末身体活动时显示出有限的可靠性。这些发现增强了对老年人身体活动模式的理解，并为旨在促进健康老龄化的干预措施提供了信息，特别是在活动监测和加速度计放置的选择方面。

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引用次数: 0

Does kinematic coupling in the lower extremities and trunk during a chair transfer task change between younger and older adulthood? 在椅子转移任务中下肢和躯干的运动学耦合在年轻人和老年人之间发生变化吗？

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-10-09 DOI: 10.1016/j.gaitpost.2025.110001

Emma McArthur, Trevor Kirk, Taylor Matson, Alison Schinkel-Ivy

Background

Past work examining relationships across biomechanical domains during gait has observed that age-related effects may be dependent on the joint of interest. This work has not been extended to other functional tasks, nor to relationships within the kinematic domain.

Research question

How does kinematic coupling between the lower extremity and trunk segments during a functional task (sit-stand-sit) differ between younger and older adults?

Methods

Younger (n = 21) and older (n = 28) adults performed a sit-stand-sit task while whole-body motion was tracked. Sagittal foot, shank, thigh, and trunk segment angles were calculated and cross-correlated between pairings of adjacent segments (foot-shank, shank-thigh, and thigh-trunk). Maximum cross-correlation coefficients and their temporal lags quantified the strength and timing of coupling, respectively, and were compared between age groups.

Results

Where significant differences were identified, foot-shank and thigh-trunk cross-correlation coefficients were generally stronger, and temporal lags were generally shorter, for older and younger adults, respectively. The thigh-trunk pairing exhibited the opposite trend during the sit-down phase, with stronger cross-correlation coefficients observed for older adults.

Significance

These joint-dependent trends may be an indicator of the use of compensatory strategies during sit-stand-sit, which may aid in identifying older adults who could benefit from interventions to prevent functional declines in the ability to perform chair transfer tasks.

背景：过去研究步态中生物力学领域的关系的工作已经观察到，年龄相关的影响可能取决于感兴趣的关节。这项工作尚未扩展到其他功能任务，也没有扩展到运动学域中的关系。研究问题：在功能性任务（坐-立-坐）中，下肢和躯干节段之间的运动学耦合在年轻人和老年人之间有何不同？方法：年轻（n = 21）和年长（n = 28）的成年人在跟踪全身运动的同时进行坐-立-坐任务。计算足、小腿、大腿和躯干的矢状角，并在相邻节段（脚-小腿、小腿-大腿和大腿-躯干）的配对之间交叉相关。最大相互相关系数及其时间滞后分别量化了耦合的强度和时间，并在年龄组之间进行了比较。结果：在发现显著差异的地方，对于老年人和年轻人来说，脚胫和大腿躯干的相互关联系数通常更强，时间滞后通常更短。在坐着的阶段，大腿和躯干的配对表现出相反的趋势，在老年人中观察到更强的交叉相关系数。意义：这些依赖关节的趋势可能是坐-立-坐过程中代偿策略使用的一个指标，这可能有助于识别老年人，他们可以从干预中受益，以防止执行椅子转移任务的能力下降。

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引用次数: 0

Trailing limb angle as a clinically feasible measure of propulsion: A state-of-the-art review 作为临床可行的推进措施的后肢角度：最新的回顾。

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-10-08 DOI: 10.1016/j.gaitpost.2025.110002

Sally A. Kenworthy , Stacey L. Gorniak

Background

Trailing limb angle (TLA) has emerged as A potentially clinically feasible measure of propulsion during gait rehabilitation.

Research Question

The aim of this state-of-the-art review was to: (1) determine how propulsion is typically defined in studies using TLA, (2) map the varying definitions of TLA in the literature, and (3) identify what timing indicators are provided in TLA definitions.

Methods

A six-stage approach to the state-of-the-art review is conducted to finalize the research questions, determine the timeline of the review, develop the search strategy, and analyze the results. The literature search was performed using PubMed, EMBASE, CINAHL, Medline, and Web of Science databases.

Results

Seven articles published between 2006 and 2011 were identified as studies key to the development of TLA as a key contributor to propulsion function. Thirty-two articles published between 2011 and 2024 were included in the primary analysis.

Significance

Studies conducted prior to the emergence of TLA in the literature utilized the impulse of the anterior ground reaction force (AGRF) to quantify a propulsion during walking. However, recent studies investigating TLA more frequently use the peak GRF to characterize propulsion. Both propulsion and TLA definitions have evolved in small yet critical ways that may limit TLA use in clinical settings. There is a need to report clinically accessible timing indicators of TLA measurement to ensure reliable and accurate use of this measurement both within and beyond the research setting.

背景：在步态康复过程中，后肢角度（TLA）已成为一种潜在的临床可行的推进力测量方法。研究问题：这篇最新综述的目的是：(1)确定在使用TLA的研究中通常如何定义推进，(2)绘制文献中TLA的不同定义，(3)确定TLA定义中提供了哪些定时指标。方法：采用六个阶段的方法对最新的综述进行最终的研究问题，确定综述的时间表，制定检索策略和分析结果。文献检索使用PubMed、EMBASE、CINAHL、Medline和Web of Science数据库。结果：2006年至2011年间发表的7篇论文被确定为TLA作为推进功能关键贡献者发展的关键研究。2011年至2024年间发表的32篇文章被纳入初步分析。意义：文献中在TLA出现之前进行的研究利用了前地面反作用力（AGRF）的脉冲来量化行走过程中的推进力。然而，最近关于TLA的研究更多地使用峰值GRF来表征推进。推进力和TLA的定义都在小而关键的方面发生了变化，这可能会限制TLA在临床环境中的应用。有必要报告临床可获得的TLA测量的定时指标，以确保在研究环境内外可靠和准确地使用该测量。

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引用次数: 0

Somatosensory augmentation has sustained effects on mediolateral foot placement modulation while walking in people with chronic stroke 体感增强对慢性中风患者行走时中外侧足位调节有持续的影响

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-10-08 DOI: 10.1016/j.gaitpost.2025.110005

Keith E. Howard , Ethan B. Schonhaut , Heather L. Knight , Camden J. Jacobs , Jesse C. Dean

Background

Many people with chronic stroke (PwCS) exhibit reduced mediolateral foot placement modulation while walking, a deficit linked with poorer walking balance. Applying hip abductor vibration to augment the available somatosensory feedback can elicit immediate increases in foot placement modulation.

Aim

The purpose of this study was to test whether such somatosensory augmentation can also cause sustained increases in foot placement modulation among PwCS after the vibration ceases, a beneficial characteristic for rehabilitation applications.

Methods

44 PwCS performed a series of treadmill walking trials, with some trials including hip vibration designed either to augment sensory feedback (Augmentation group; n = 22), or to follow a random distribution (Noise group; n = 22). We quantified foot placement modulation using the partial correlation between foot placement and mediolateral pelvis displacement (ρ_FP), accounting for pelvis velocity. ρ_FP was compared between a baseline walking period without vibration, periods when vibration was applied, and interspersed minute-long catch periods in which the vibration ceased.

Results

In the Augmentation group, foot placement modulation increased significantly both while the vibration was applied (p < 0.0001) and during the subsequent catch periods (p = 0.007), providing evidence for short-term sustained effects of somatosensory augmentation. In contrast, no changes in foot placement were observed in the Noise group, either while the vibration was applied (p = 0.21) or during the catch periods (p = 0.36).

Conclusion

These results provide initial evidence that somatosensory augmentation via hip vibration has effects on foot placement modulation that persist after the augmentation ceases, possibly due to sensory reweighting.

背景：许多慢性中风（PwCS）患者在行走时表现出内侧脚位置调节减少，这一缺陷与较差的行走平衡有关。应用髋外展肌振动来增强可用的体感反馈可以引起足部位置调节的立即增加。本研究的目的是测试这种体感增强是否也能在振动停止后引起PwCS中足部位置调节的持续增加，这对康复应用是有益的。方法44 PwCS进行了一系列跑步机行走试验，其中一些试验包括臀部振动，这些试验要么是为了增强感觉反馈（增强组，n = 22），要么是为了遵循随机分布（噪音组，n = 22）。我们使用足部位置和骨盆中外侧位移（ρFP）之间的部分相关性来量化足部位置调制，并考虑骨盆速度。在没有振动的基线行走周期，施加振动的周期，以及振动停止的间隔一分钟的捕获周期之间比较ρFP。结果在增强组中，在施加振动时（p <； 0.0001）和随后的捕获期（p = 0.007），足部位置调制显著增加，为体感增强的短期持续效果提供了证据。相比之下，在噪音组中，无论是在施加振动时（p = 0.21）还是在捕捉期间（p = 0.36），都没有观察到足部位置的变化。结论这些结果提供了初步证据，表明通过髋关节振动进行的体感增强对足部位置调节有影响，这种影响在增强停止后仍持续存在，可能是由于感觉权重的重新调整。

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引用次数: 0

Effects of transcranial direct current stimulation on foot sensorimotor function and postural control in healthy young adults: A systematic review and meta-analysis based on randomized controlled trials 经颅直流电刺激对健康年轻人足部感觉运动功能和体位控制的影响：基于随机对照试验的系统回顾和meta分析

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2025-10-08 DOI: 10.1016/j.gaitpost.2025.110006

Yaru Wei, Peng Chen, Lulu Yin, Zhongqi Yu, Jianglong Zhan, Lin Wang

Objective

To evaluate systematically the effects of transcranial direct current stimulation （tDCS）on foot sensorimotor function and postural control in healthy young adults using meta-analysis and thus provide evidence-based medical data for its clinical application.

Methods

A systematic search was conducted across six databases—PubMed, Web of Science, Embase, Cochrane Library, Scopus, and China National Knowledge Infrastructure—to identify eligible studies examining the effects of tDCS on foot sensorimotor function and postural control in healthy young adults, up to July 27, 2025. The methodological quality of the included studies was assessed using the Cochrane risk of bias tool. Meta-analysis was conducted using RevMan 5.3, and meta-regression was performed in Stata 14.0 under a random-effects model. Subgroup analyses and meta-regression were used to explore potential moderating factors.

Results

A total of 22 RCTs involving 813 healthy young adults were included in the analysis. The meta-analysis revealed that tDCS significantly reduced the passive kinesthesia threshold of ankle joint in healthy young adults compared with the control (SMD = −0.83, 95 % CI: −1.07–−0.60, P < 0.001). However, no significant difference was observed in foot muscle strength, static balance and dynamic balance (all p > 0.05). In addition, meta-regression did not identify any significant moderators affecting the impact of tDCS on COP area and COP displacement velocity, including stimulation parameters, task type, and sample characteristics (all p > 0.05).

Conclusion

In conclusion, the current evidence suggested that tDCS may enhance ankle joint proprioception in healthy young adults, while no significant improvements were observed in foot muscle strength or static and dynamic postural control. Further research is warranted to determine the optimal stimulation parameters and to evaluate the efficacy of tDCS in clinical populations.

目的采用meta分析方法系统评价经颅直流电刺激（tDCS）对健康青壮年足部感觉运动功能和体位控制的影响，为其临床应用提供循证医学数据。方法系统检索pubmed、Web of Science、Embase、Cochrane Library、Scopus和中国国家知识基础设施等6个数据库，以确定截至2025年7月27日tDCS对健康年轻人足部感觉运动功能和姿势控制影响的合格研究。采用Cochrane偏倚风险工具评估纳入研究的方法学质量。meta分析采用RevMan 5.3软件，meta回归采用Stata 14.0软件，采用随机效应模型。采用亚组分析和元回归探讨潜在的调节因素。结果共纳入22项随机对照试验，涉及813名健康青年。荟萃分析显示，与对照组相比，tDCS显著降低了健康年轻人踝关节被动动觉阈值（SMD = - 0.83, 95 % CI: - 1.07 - - 0.60, P <； 0.001）。但两组足部肌力、静平衡和动平衡无显著差异（p均为 >； 0.05）。此外，meta回归没有发现任何显著的调节因子影响tDCS对COP面积和COP位移速度的影响，包括刺激参数、任务类型和样本特征（均p >； 0.05）。结论tDCS可增强健康青壮年踝关节本体感觉，但对足部肌力、静态和动态姿势控制无明显改善。需要进一步的研究来确定最佳的刺激参数，并评估tDCS在临床人群中的疗效。

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引用次数: 0