Gait & posture最新文献_第8页

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 : 2026-02-01 Epub 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

Corrigendum to “Analysis of the characteristics of anticipatory postural adjustments in older adults using smartphones: Association between cognitive and balance functions” [Gait Posture, 112 (2024) 115–119] “使用智能手机的老年人预估姿势调整的特征分析：认知和平衡功能之间的关系”的勘误表[步态姿势，112(2024)115-119]。

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2026-02-01 Epub Date: 2025-09-29 DOI: 10.1016/j.gaitpost.2025.109987

Ryo Onuma , Hiroshi R. Yamasaki , Fumihiko Hoshi , Ryosuke Tozawa , Yuki Soutome , Tomoko Sakai , Tetsuya Jinno

引用次数: 0

Relationship of flatfoot to physical performance and postural stability in children: The Yamanashi adjunct study of the Japan Environment and Children's Study 儿童扁平足与身体表现和姿势稳定性的关系：日本环境与儿童研究的Yamanashi辅助研究。

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2026-02-01 Epub Date: 2025-09-27 DOI: 10.1016/j.gaitpost.2025.109992

Masanori Wako , Taro Fujimaki , Jiro Ichikawa , Ryoji Shinohara , Sanae Otawa , Anna Kobayashi , Megumi Kushima , Hideki Yui , Zentaro Yamagata , Hirotaka Haro , on behalf of The Yamanashi Adjunct Study of the Japan Environment and Children’s Study Group

Objective

This study examined the relationship between flatfoot, physical performance, and postural stability in 8-year-old children.

Methods

This study involved 196 children from the Japan Environment and Children’s Study (JECS) and focused on foot morphology, postural stability, and physical performance using standardized sports tests. The Chippaux-Smirak index was used to evaluate the degree of flatfoot, which correlated with body composition, physical performance, and postural stability. Results: The results showed that 8.6 % of boys and 3.9 % of girls had flatfoot, with boys exhibiting a higher frequency. A significant correlation was found between flatfoot and increased body weight and fat percentage. The study found no significant association between flatfoot and physical performance as measured by sports tests such as sprinting and jumping. However, a significant relationship between flatfoot and postural stability was observed, as children with more severe flatfoot exhibited greater postural instability, particularly girls. These findings suggest that although flatfoot does not correlate with physical performance, it is associated with decreased postural stability, which may reflect broader developmental issues in children with flatfoot.

Conclusion

These findings highlight the need for further research on the underlying causes of flatfoot and its effect on child development, particularly regarding the role of the nervous system in postural stability.

目的：研究8岁儿童平足、运动表现和姿势稳定性之间的关系。方法：本研究涉及196名来自日本环境与儿童研究（JECS）的儿童，并通过标准化运动测试关注足部形态、姿势稳定性和身体表现。使用Chippaux-Smirak指数来评估扁平足的程度，该指数与身体成分、身体表现和姿势稳定性相关。结果：8.6 %的男生和3.9 %的女生有扁平足，其中男生发病率较高。扁足与体重和脂肪百分比增加之间存在显著的相关性。研究发现，在短跑和跳跃等运动测试中，扁平足和身体表现之间没有明显的联系。然而，扁平足和姿势稳定性之间的显著关系被观察到，因为患有更严重扁平足的儿童表现出更大的姿势不稳定性，尤其是女孩。这些发现表明，尽管扁平足与身体表现无关，但它与姿势稳定性下降有关，这可能反映了扁平足儿童更广泛的发育问题。结论：这些发现表明，需要进一步研究扁平足的潜在原因及其对儿童发育的影响，特别是神经系统在姿势稳定性中的作用。

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引用次数: 0

Does transferred medial gastrocnemius flap help with knee extension during gait following proximal tibial endoprosthesis? 转移腓肠肌内侧皮瓣是否有助于胫骨近端假体术后步态中的膝关节伸展？

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2026-02-01 Epub Date: 2025-11-29 DOI: 10.1016/j.gaitpost.2025.110063

Dyuti Deepta Rano , Love Kapoor , Venkatesan Sampath Kumar , Shamim Ahmed Shamim , Shah Alam Khan

Introduction

Patients undergoing proximal tibial endoprosthesis for bone tumors usually have a medial gastrocnemius flap for wound coverage, supposed to help in knee extension instead of normal flexor of the knee.

Objectives

1. Does medial gastrocnemius flap participates in knee extension during normal gait? 2. What are the gait changes following proximal tibial endoprosthesis?

Materials & methods

This cross-sectional observational study included 52 patients who had proximal tibial endoprosthesis between January 2008 to January 2020 for bone tumours and regained maximum function with independent ambulatory capacity. Instrumented gait analysis was done according to Helen-Hayes protocol with a special surface EMG probe placed over the flap. Tc 99 m three-phase bone scan was used to evaluate flap viability.

Results

Mean age was 27.92 ± 12.88 years and mean follow-up duration was 23.1 ± 4.2 months. Patients walked slower with mean velocity of 0.74 ± 0.23 m/s and mean cadence of 87.9 ± 10.3 steps/min. Mean knee flexion on the operated side was significantly decreased(89.42 ± 14.87° vs 125.38 ± 6.01°, p < 0.001). Mean swing time was significantly increased on the operated limb(0.56 ± 0.08 sec vs 0.46 ± 0.07 sec, p < 0.001) with consequent increase in mean single support phase on the normal limb(operated vs normal limb, 33.71 ± 5.05 % vs 40.81 ± 4.03 %, p < 0.001). Peak knee flexion in swing, total sagittal plane excursion, peak flexion loading response, peak knee extensor moment at early stance and peak ankle plantarflexion moment at stance decreased significantly on operated side. Electrical activity in the knee extensors decreased over the operated side. Bone scan confirmed flap viability in all.

Conclusion

The medial gastrocnemius flap primarily provides successful soft tissue coverage but does not consistently adopt a functional role in knee extension during gait. Patients' walking patterns remain slower and asymmetrical but well compensated post-reconstruction, adopting a stiff-knee gait pattern with features of quadriceps avoidance.

导读：接受胫骨近端骨肿瘤内假体手术的患者通常有一个内侧腓肠肌瓣来覆盖伤口，应该有助于膝关节伸展而不是正常的膝关节屈肌。目的:1。内侧腓肠肌瓣是否参与正常步态下的膝关节伸展？2. 胫骨近端人工植入术后步态有什么变化？材料与方法：本横断面观察性研究包括52例2008年1月至2020年1月间因骨肿瘤行胫骨近端内假体手术并恢复最大功能并具有独立行走能力的患者。根据Helen-Hayes方案，在皮瓣上放置一个特殊的表面肌电图探针，进行仪器步态分析。Tc 99 m三相骨扫描评估皮瓣存活能力。结果：平均年龄27.92 ± 12.88岁，平均随访时间23.1 ± 4.2个月。患者步行速度减慢，平均速度为0.74 ± 0.23 m/s，平均步频为87.9 ± 10.3步/min。手术侧平均膝关节屈曲度显著降低（89.42 ± 14.87°vs 125.38 ± 6.01°，p ）。结论：内侧腓骨肌瓣主要提供成功的软组织覆盖，但在步态中不能始终发挥膝关节伸展的功能作用。患者的行走模式仍然较慢且不对称，但重建后补偿良好，采用以股四头肌回避为特征的硬膝步态模式。

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引用次数: 0

Whole-body angular momentum is influenced by bone-anchored limb use and amputation level during walking 行走过程中全身角动量受骨锚定肢体使用和截肢水平的影响。

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2026-02-01 Epub Date: 2025-09-27 DOI: 10.1016/j.gaitpost.2025.109991

Brecca M.M. Gaffney , Peter B. Thomsen-Freitas , Grace M. Georgiou , Danielle H. Melton , Cory L. Christiansen , Jason W. Stoneback

Background

Bone-anchored limbs (BALs) improve mobility, physical activity, multi-joint biomechanics, and static balance measures compared to when using a socket prosthesis. However, evidence surrounding how BAL use influences dynamic balance, and whether this is dependent on amputation level, remains unknown.

Research questions

Does BAL use change dynamic balance as compared to a socket prosthesis? Do changes in dynamic balance with BAL use differ by amputation level?

Methods

Thirty-two participants with prior unilateral amputation (19 transfemoral, 13 transtibial) who underwent BAL implantation were retrospectively enrolled. Whole-body motion capture data during overground level walking was collected before (using socket prosthesis) and 12-months after BAL implantation. The range of whole-body angular momentum (WBAM) and peak external demand moment were compared across timepoints and groups using a two-way mixed model ANOVA.

Results

Frontal and transverse plane WBAM were reduced in individuals with transfemoral amputation when using a BAL as compared to a socket prosthesis (p < 0.001 and p < 0.001, respectively). Furthermore, when using a BAL or socket prosthesis, frontal plane WBAM was larger in individuals with transfemoral amputation compared to transtibial amputation (p = 0.028 and p = 0.018), which coincided with a larger peak external demand moment (p = 0.027 and p = 0.007).

Significance

Smaller ranges of WBAM and a smaller external demand moment during walking indicate improved dynamic stability when using a BAL compared to socket-type prosthesis, and thus likely suggest a reduced fall risk. As walking is most unstable in the mediolateral direction, greater ranges of frontal plane WBAM (worsened regulation) in individuals with transfemoral amputation compared to transtibial amputation may indicate more compromised balance control and greater fall risk.

背景：与使用窝式假体相比，骨锚定肢体（bal）可以改善活动能力、身体活动、多关节生物力学和静态平衡测量。然而，关于BAL使用如何影响动态平衡的证据，以及这是否依赖于截肢水平，仍然未知。研究问题：与套孔假体相比，BAL使用会改变动态平衡吗？使用BAL后动态平衡的变化是否因截肢程度而异？方法：回顾性研究32例既往单侧截肢（19例经股骨，13例经胫骨）行BAL植入术的患者。在BAL植入前（使用套孔假体）和植入后12个月收集地上行走时的全身运动捕捉数据。使用双向混合模型方差分析比较不同时间点和不同组的全身角动量（WBAM）和峰值外需力矩的范围。结果：与套筒式假体相比，使用BAL的经股骨截肢患者的额面和横面WBAM减少（p ）。意义：与套筒式假体相比，使用BAL时WBAM的范围更小，行走时的外需力矩更小，这表明使用BAL时动态稳定性得到改善，因此可能表明跌倒风险降低。由于行走在中外侧方向最不稳定，与经胫骨截肢相比，经股骨截肢患者的额平面WBAM范围更大（调节更差）可能表明平衡控制更差，摔倒风险更大。

{"title":"Whole-body angular momentum is influenced by bone-anchored limb use and amputation level during walking","authors":"Brecca M.M. Gaffney , Peter B. Thomsen-Freitas , Grace M. Georgiou , Danielle H. Melton , Cory L. Christiansen , Jason W. Stoneback","doi":"10.1016/j.gaitpost.2025.109991","DOIUrl":"10.1016/j.gaitpost.2025.109991","url":null,"abstract":"<div><h3>Background</h3><div>Bone-anchored limbs (BALs) improve mobility, physical activity, multi-joint biomechanics, and static balance measures compared to when using a socket prosthesis. However, evidence surrounding how BAL use influences dynamic balance, and whether this is dependent on amputation level, remains unknown.</div></div><div><h3>Research questions</h3><div>Does BAL use change dynamic balance as compared to a socket prosthesis? Do changes in dynamic balance with BAL use differ by amputation level?</div></div><div><h3>Methods</h3><div>Thirty-two participants with prior unilateral amputation (19 transfemoral, 13 transtibial) who underwent BAL implantation were retrospectively enrolled. Whole-body motion capture data during overground level walking was collected before (using socket prosthesis) and 12-months after BAL implantation. The range of whole-body angular momentum (WBAM) and peak external demand moment were compared across timepoints and groups using a two-way mixed model ANOVA.</div></div><div><h3>Results</h3><div>Frontal and transverse plane WBAM were reduced in individuals with transfemoral amputation when using a BAL as compared to a socket prosthesis (<em>p</em> < 0.001 and <em>p</em> < 0.001, res<em>p</em>ectively). Furthermore, when using a BAL or socket prosthesis, frontal plane WBAM was larger in individuals with transfemoral amputation compared to transtibial amputation (<em>p</em> = 0.028 and <em>p</em> = 0.018), which coincided with a larger peak external demand moment (<em>p</em> = 0.027 and <em>p</em> = 0.007).</div></div><div><h3>Significance</h3><div>Smaller ranges of WBAM and a smaller external demand moment during walking indicate improved dynamic stability when using a BAL compared to socket-type prosthesis, and thus likely suggest a reduced fall risk. As walking is most unstable in the mediolateral direction, greater ranges of frontal plane WBAM (worsened regulation) in individuals with transfemoral amputation compared to transtibial amputation may indicate more compromised balance control and greater fall risk.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"124 ","pages":"Article 109991"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226535","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

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 : 2026-02-01 Epub 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

Altered muscle synergies in knee osteoarthritis patients during locomotion tasks persist over six-week valgus brace intervention 膝关节骨性关节炎患者在运动任务中肌肉协同作用的改变持续超过6周外翻支架干预

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2026-02-01 Epub Date: 2025-11-22 DOI: 10.1016/j.gaitpost.2025.110062

Lasse Hansen, Jana Rogoschin, Jonas Ebbecke, Igor Komnik, Wolfgang Potthast

Introduction

Knee osteoarthritis (KOA) can alter gait biomechanics and neuromuscular activity. Valgus brace (VB) treatment aims to reduce medial compartment loading. While the mechanical efficacy of VBs is well-documented, their effect on neuromuscular deviations in KOA patients remains unclear. This study assesses the potential of VB to modulate altered muscle synergy activation patterns in KOA patients.

Methodology

Forty participants (twenty KOA, twenty age-matched controls) performed five locomotion tasks: overground walking, ramp and stair ascent / descent. Trials with and without VB were conducted at baseline and after six weeks of regular brace use. Muscle synergies were calculated based on electromyographic data of eight lower limb muscles per side. Inverse dynamics were calculated using marker-based motion capture data. A statistical parametric mapping three-way ANOVA with the factors group affiliation, brace condition, and measurement time point was conducted for each task.

Results

Four synergies were identified across groups, tasks, brace conditions, and time points. The KOA cohort exhibited increased knee flexor synergy activity during early- to mid-stance, increased sagittal trunk flexion, increased hip flexion angles and moments, and decreased knee flexion angles and moments. Brace condition and time point had no effect on synergy activity or sagittal joint moments.

Discussion and conclusion

Persistently increased hip flexion moments in the KOA group, possibly caused by increased sagittal trunk flexion, appeared to drive elevated activity of the biarticular knee flexor synergy. Increased knee flexor synergy activity can result in elevated knee joint contact forces, potentially aggravating KOA progression. Rather than being caused solely by the need for local stability, increased knee flexor synergy activity may be driven by altered trunk dynamics, which remained unaffected throughout the brace intervention.

膝骨关节炎（KOA）可以改变步态生物力学和神经肌肉活动。外翻支具（VB）治疗的目的是减少内侧筋室的负荷。虽然VBs的机械功效已被充分证明，但它们对KOA患者神经肌肉偏差的影响尚不清楚。本研究评估了VB在KOA患者中调节改变的肌肉协同激活模式的潜力。方法：40名参与者（20名KOA， 20名年龄匹配的对照组）执行5项运动任务：地上行走、坡道和楼梯上下。在基线和常规支具使用六周后，使用和不使用VB进行试验。根据每侧8块下肢肌肉的肌电图数据计算肌肉协同作用。利用基于标记的动作捕捉数据计算逆动力学。对每个任务进行统计参数映射的三向方差分析，因子为群体隶属关系、括号条件和测量时间点。结果在小组、任务、支撑条件和时间点之间确定了四种协同效应。KOA组在站立早期至站立中期表现出膝关节屈肌协同活动增加，矢状躯干屈曲增加，髋关节屈曲角度和力矩增加，膝关节屈曲角度和力矩减少。支具条件和时间点对协同活动和矢状关节力矩无影响。讨论与结论KOA组持续增加的髋关节屈曲力矩可能是由于矢状躯干屈曲增加引起的，这似乎推动了双关节膝关节屈肌协同作用的活动升高。膝关节屈肌协同活动的增加可导致膝关节接触力升高，潜在地加重KOA的进展。而不是仅仅由局部稳定性的需要引起的，增加的膝关节屈肌协同活动可能是由改变的躯干动力学驱动的，在整个支架干预过程中都不受影响。

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引用次数: 0

Effects of eight-week backward walking training on mechanical energy flow pattern and Achilles tendon properties in older adults with dynapenia: An exploratory study 八周后走训练对老年运动障碍患者机械能流模式和跟腱特性的影响：一项探索性研究

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2026-02-01 Epub Date: 2025-11-27 DOI: 10.1016/j.gaitpost.2025.110065

Long-Huei Lin , Nai-Wen Hsu , Yun-Lin Tsai , Yi-Ling Peng , Chih-Hsiu Cheng

Background

Dynapenia, an age-related decline in muscle strength despite preserved muscle mass, is associated with reduced walking speed and increased fall risk. Backward walking training involves eccentric activation of the plantar flexors and has been shown to enhance walking performance. This exploratory study evaluated how an eight-week backward walking training program influences lower-limb mechanical energy flow and tendon properties in older adults with dynapenia.

Method

Forty-four older females (> 65 years) were recruited, comprising 21 individuals with dynapenia and 23 older adults as the control group. The dynapenia group underwent backward walking training (3 sessions/week, 30 min/session). Mechanical energy flow, Achilles tendon stiffness, and gait speed were assessed before and after the training. Nonparametric tests were used for statistical analysis (p < 0.05).

Results

At baseline, the dynapenia group exhibited significantly lower segmental energy change rates in the thigh and shank, reduced tendon stiffness and stress, and an altered knee joint energy pattern compared with controls. Following training, no significant changes were observed in mechanical energy flow or tendon properties. Walking speed significantly improved by 10.2 %-19.6 % after training.

Conclusion

Backward walking training improved walking speed in older adults with dynapenia. However, such improvement may be attributed to factors other than tendon adaptation or enhanced energy efficiency, given that no significant changes were detected. These findings provide preliminary insights into the biomechanical response to backward walking and underscore the need for future studies to validate potential training effects.

动力不足是一种与年龄相关的肌肉力量下降，尽管肌肉质量保持不变，但与步行速度降低和跌倒风险增加有关。向后行走训练包括偏心激活足底屈肌，并已被证明可以提高行走性能。本探索性研究评估了为期八周的后退行走训练计划如何影响老年运动障碍患者下肢机械能流和肌腱特性。方法招募44名老年女性（65岁），其中21名运动障碍患者，23名老年人作为对照组。运动障碍组进行倒退行走训练（3次/周，30 分钟/次）。在训练前后评估机械能流、跟腱刚度和步态速度。采用非参数检验进行统计分析（p <； 0.05）。结果在基线上，与对照组相比，运动障碍组在大腿和小腿的节段能量变化率显著降低，肌腱刚度和应力降低，膝关节能量模式改变。训练后，没有观察到机械能流或肌腱特性的显著变化。训练后步行速度显著提高10.2 %-19.6 %。结论后向步行训练可提高老年运动障碍患者的步行速度。然而，鉴于没有发现明显的变化，这种改善可能归因于肌腱适应或能量效率提高以外的因素。这些发现为向后行走的生物力学反应提供了初步的见解，并强调了未来研究验证潜在训练效果的必要性。

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引用次数: 0

Perspectives on interdisciplinary posture and gait research from the ISPGR 2025 World Congress: Where do we stand and what are the next steps? ISPGR 2025世界大会对跨学科姿势和步态研究的看法：我们的立场是什么，下一步是什么？

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2026-02-01 Epub Date: 2025-11-19 DOI: 10.1016/j.gaitpost.2025.110058

Benjamin Filtjens , Christopher McCrum

引用次数: 0

Using nonlinear dynamic analysis to differentiate fall status in older women 应用非线性动态分析鉴别老年妇女跌倒状况

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2026-02-01 Epub Date: 2025-11-04 DOI: 10.1016/j.gaitpost.2025.110032

A. Amirpourabasi , S.E. Lamb , J.Y. Chow , G.K.R. Williams

Background

Falls are a significant health concern among older adults. Nonlinear dynamic (NLD) analysis of gait offers insight into fall risk by capturing variability and complexity, but variation in methodological approaches has limited translation. This study aimed to identify NLD measures and data sources that best differentiate fallers from non-fallers.

Methods

Thirty-four healthy older women (mean age 69.3 ± 5.7 years; 17 fallers, 17 non-fallers) walked on a treadmill at preferred and at ±20 %. Kinematic data were collected using motion capture and a lower-back inertial measurement unit (IMU). Gait complexity and stability were quantified using Multiscale Entropy and Lyapunov Exponents (LyE). Principal component analysis, logistic regression, multivariate tests, ROC curves, and linear discriminant analysis (LDA) identified discriminative features.

Results

Fallers reported at least one fall in the past year, walked more slowly, and had a greater chronic disease burden. Short-term LyE (SLyE) from trunk acceleration in the anterior–posterior (AP) direction and sagittal-plane ankle angles best discriminated fall status. ROC analyses showed ankle SLyE provided the highest accuracy (AUC up to 0.88), and AP trunk SLyE had moderate accuracy (AUC up to 0.77). The LDA model achieved 85 % cross-validated accuracy with 82 % sensitivity and 88 % specificity.

Conclusions

The short-term Lyapunov exponent from ankle angle sagittal-plane motion and trunk AP acceleration provide robust markers of fall history in older women. Comparable performance of IMU and motion capture supports IMU-based NLD metrics for scalable fall risk screening.

在老年人中，跌倒是一个重要的健康问题。步态的非线性动态（NLD）分析通过捕获变异性和复杂性来洞察跌倒风险，但方法方法的变化限制了翻译。本研究旨在确定NLD措施和数据来源，以最好地区分跌倒者和非跌倒者。方法34名健康老年妇女（平均年龄69.3 ± 5.7岁，其中跌倒者17例，非跌倒者17例）在跑步机上以首选和±20% %的速度行走。运动学数据通过运动捕捉和下背部惯性测量单元（IMU）收集。采用多尺度熵和Lyapunov指数（LyE）对步态复杂度和稳定性进行量化。主成分分析、logistic回归、多元检验、ROC曲线及线性判别分析（LDA）确定了判别特征。结果：在过去的一年中，跌倒者报告至少跌倒一次，走路更慢，并且有更大的慢性疾病负担。躯干前后方向加速度和踝关节矢状面角度的短期LyE （SLyE）最能区分跌倒状态。ROC分析显示踝关节SLyE准确度最高（AUC高达0.88），AP躯干SLyE准确度中等（AUC高达0.77）。LDA模型的交叉验证准确率为85 %，灵敏度为82 %，特异性为88 %。结论踝关节角矢状面运动的短期Lyapunov指数和躯干AP加速度是老年女性跌倒史的可靠指标。IMU和动作捕捉的可比性性能支持基于IMU的NLD指标，用于可扩展的跌倒风险筛查。

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