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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
Bilateral blood flow restriction of the legs worsens acute walking balance of older adults – a full factorial randomised experiment 双侧血液流动限制恶化老年人急性行走平衡-一个全因子随机实验
IF 2.4 3区 医学 Q3 NEUROSCIENCES
Gait & posture
Pub Date : 2026-02-01 Epub Date: 2025-11-03 DOI: 10.1016/j.gaitpost.2025.110022
Brook Galna , Kieran J. Marston , Morteza Ghayomzadeh , Paul S.R. Goods , Keith D. Hill , Jeremiah J. Peiffer , Brendan R. Scott

Background

Multiple sessions of walking with blood flow restriction (BFR) of the legs can improve cardiovascular fitness, muscle strength and hypertrophy in older adults. However, it is unclear whether BFR impairs walking balance acutely, potentially increasing falls risk during BFR training for this at-risk population.

Research Question

Does bilateral BFR of the legs acutely worsen walking balance of older adults?

Methods

Ten older adults (mean age: 73, SD: 3 y) walked for 10 min on a treadmill at 50 %, 60 % and 70 % of their fast walking speed, with 10 cm-wide cuffs on the proximal thigh of both legs inflated to 0 % (no cuff), 40 % or 60 % of arterial occlusion pressure. We measured four characteristics of walking balance which were selected a priori and combined into a gait quality index predictive of future falls in older adults: autocorrelation of vertical accelerations; magnitude and harmonicity of sideways accelerations; and magnitude of the dominant period of forwards accelerations.

Results

Walking balance worsened with BFR, independent of walking speed, for all outcomes except the magnitude of the dominant period of forwards accelerations, with worse balance observed with increasing cuff pressure. Compared to no BFR, gait quality declined 12 % when walking with 50 % occlusion and declined 20 % with 60 % occlusion (p < 0.001).

Significance

Our findings suggest that BFR results in poorer acute walking balance, with a dose-response relationship for cuff pressure. Supervised walking trials are warranted to further assess the safety of BFR training in community settings and whether these balance-related changes may stimulate beneficial chronic balance adaptations.
背景：在限制腿部血流（BFR）的情况下进行多次步行可以改善老年人的心血管健康、肌肉力量和肥厚。然而，目前尚不清楚BFR是否会严重损害行走平衡，这可能会增加这一高危人群在BFR训练期间跌倒的风险。研究问题：双侧BFR会严重恶化老年人的行走平衡吗？方法10名老年人（平均年龄：73岁，SD: 3 y）在跑步机上以其快走速度的50% %、60% %和70% %步行10 min，双腿大腿近端10 cm宽的绑带膨胀至0 %（无绑带）、40 %和60 %的动脉闭塞压。我们测量了行走平衡的四个特征，这些特征是先验选择的，并结合成预测老年人未来跌倒的步态质量指数：垂直加速度的自相关；横向加速度的大小和谐度；以及正向加速度的主要周期的大小。结果除了向前加速的主要周期的大小外，行走平衡随BFR而恶化，与行走速度无关，随着袖带压力的增加，行走平衡变差。与没有BFR相比，在50% %的咬合下行走时，步态质量下降了12% %，在60% %的咬合下行走时，步态质量下降了20% % （p <； 0.001）。我们的研究结果表明，BFR导致较差的急性行走平衡，与袖带压力呈剂量-反应关系。有监督的步行试验是必要的，以进一步评估BFR训练在社区环境中的安全性，以及这些与平衡相关的变化是否会刺激有益的慢性平衡适应。
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引用次数: 0
Effects of 30-min of walking on knee total joint moment asymmetry in asymptomatic adults 步行30分钟对无症状成人膝关节总关节力矩不对称的影响。
IF 2.4 3区 医学 Q3 NEUROSCIENCES
Gait & posture
Pub Date : 2026-02-01 Epub Date: 2025-11-15 DOI: 10.1016/j.gaitpost.2025.110056
Carson Halliwell , Meaghan Hannigan , Ryan Matthews , Anne Doan , Rose MacLeod , Rebecca Moyer

Introduction

Gait asymmetry is considered an indicator of healthy gait and used in clinical and research settings to assess movement. While walking is commonly prescribed to promote cardiovascular health and assess gait under controlled conditions, prolonged walking may disrupt gait asymmetry. This study examined changes in knee total joint moment (TJM) asymmetry following a 30-min treadmill walk in asymptomatic adults.

Methods

Participants completed five overground walking trials at a self-selected speed before and after a 30-min treadmill walk. Three-dimensional motion capture and ground reaction forces were used to calculate knee joint moments. The TJM was calculated as a composite measure of the net external knee frontal, sagittal, and transverse moments, and absolute inter-limb asymmetry in the TJM was calculated. Paired samples t-tests and 95 % bootstrapped confidence intervals were used to assess the expected change in TJM asymmetry following the 30-min walk. Statistical parametric mapping assessed differences in knee frontal, sagittal and transverse plane moments before and after the treadmill walk.

Results

Twenty-one asymptomatic adults (age 61 ± 10 years, 14 F/7 M) were recruited for this study. Following the treadmill walk TJM asymmetry increased by 10.1 % (95 %CI: 4.88–16.1, p = 0.005, d=0.73), with 76 % of participants increasing asymmetry post-walk driven primarily by an increase in the peak frontal plane moment (p = 0.013).

Conclusions

This study provides a benchmark for clinicians and researchers to gauge the expected change in TJM asymmetry in healthy adults following a 30-min walking intervention. We observed that asymmetry increases by approximately 5–16 % in this population; however, high inter-individual variability was noted.
步态不对称被认为是健康步态的一个指标，并在临床和研究环境中用于评估运动。虽然步行通常被用于促进心血管健康和在受控条件下评估步态，但长时间步行可能会破坏步态不对称。本研究检查了无症状成人在30分钟的跑步机步行后膝关节总关节力矩（TJM）不对称性的变化。方法：参与者在跑步机行走30分钟之前和之后，以自己选择的速度完成五次地上行走试验。采用三维运动捕捉和地面反作用力计算膝关节力矩。TJM是由膝外净额、矢状和横向力矩的综合测量来计算的，并计算TJM的绝对肢间不对称性。配对样本t检验和95% %自举置信区间用于评估步行30分钟后TJM不对称性的预期变化。统计参数映射评估了跑步机行走前后膝关节额、矢状面和横切面的差异。结果：21名无症状成人（年龄61 ± 10岁，14 F/7 M）被纳入本研究。在跑步机步行后，TJM不对称性增加了10.1 %(95 %CI: 4.88-16.1, p = 0.005,d=0.73)， 76 %的参与者在步行后增加了不对称性，主要是由于额平面峰值矩的增加（p = 0.013）。结论：本研究为临床医生和研究人员提供了一个基准，以衡量健康成人在30分钟步行干预后TJM不对称的预期变化。我们观察到，在这个人群中，不对称性增加了大约5- 16% %；然而，注意到高度的个体间差异。
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引用次数: 0
Reduced cognitive resources induces risky stepping strategies in older adults 认知资源减少导致老年人采取危险的步进策略。
IF 2.4 3区 医学 Q3 NEUROSCIENCES
Gait & posture
Pub Date : 2026-02-01 Epub Date: 2025-09-26 DOI: 10.1016/j.gaitpost.2025.109989
Adam J. Cocks , William R. Young , Toby J. Ellmers

Background

Falls frequently occur during situations that require a transfer or shift of bodyweight (e.g., stepping around an obstacle or turning). One contributor to falls in this scenario is a risky stepping strategy known as ‘cross-stepping’, whereby the feet cross over during the step. However, contributors to this potentially dangerous stepping strategy are not understood. This study examined whether reduced cognitive resources are a contributor to ‘cross-stepping’.

Methods

Fifty-one older adults without neurological, musculoskeletal, or major cognitive impairment participated. Participants completed a modified multitarget stepping task while traversing a GAITRite walkway containing stepping targets forming paths of various colors. Participants walked designated color paths under single-task (normal walking) and a dual-task (serial subtraction) condition designed to reduce cognitive resources available for walking. The number of cross-steps and stepping errors were assessed. Cognitive performance, gait velocity, and double-limb support (% of gait cycle) were also collected.

Results

During single-task conditions, measures of executive function (set-shifting)/attention (Trail Making Test–Part B) independently predicted greater cross-steps (B=0.01, p = .025). Walking under dual-task conditions significantly increased cross-steps (p = .001). Gait velocity also significantly decreased when compared to single-task, whilst global stepping errors and percentage of the gait cycle spent in double-limb support significantly increased.

Significance

These findings suggest that cross-steps can result from reduced cognitive resources being allocated to movement planning and execution. Future research should seek to explore if the relationship between cognition and cross-stepping is causally linked to increased fall risk.
背景：摔倒经常发生在需要转移或转移体重的情况下（例如，绕过障碍物或转弯）。在这种情况下摔倒的一个原因是一种被称为“交叉行走”的冒险的行走策略，即在行走过程中双脚交叉。然而，造成这种潜在危险的步进策略的原因尚不清楚。这项研究调查了认知资源的减少是否与“跨步”有关。方法：51名没有神经、肌肉骨骼或主要认知障碍的老年人参与了这项研究。参与者完成了一项改进的多目标步进任务，同时穿越GAITRite步道，其中包含形成各种颜色路径的步进目标。参与者在单任务（正常行走）和双任务（连续减法）条件下行走指定的颜色路径，旨在减少行走可用的认知资源。评估了交叉步数和步进误差。同时收集认知能力、步态速度和双肢支持度（占步态周期的百分比）。结果：在单任务条件下，执行功能（集合转移）/注意力（轨迹制造测试-部分B）的测量独立地预测了更大的跨步（B=0.01, p = .025）。在双重任务条件下行走显著增加了交叉步数（p = .001）。与单任务相比，步态速度也显着降低，而全局步进误差和用于四肢支持的步态周期百分比显着增加。意义：这些发现表明，跨步可能是由于分配给运动计划和执行的认知资源减少所致。未来的研究应该寻求探索认知和跨步之间的关系是否与跌倒风险增加有因果关系。
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引用次数: 0
Anticipatory postural adjustments during multidirectional gait initiation with body turning among healthy young men 健康青年男性多向步态起始与身体转动时的预估姿势调整。
IF 2.4 3区 医学 Q3 NEUROSCIENCES
Gait & posture
Pub Date : 2026-01-01 Epub Date: 2025-10-04 DOI: 10.1016/j.gaitpost.2025.110003
Hisanobu Hayashi , Hidehito Tomita , Yuta Ogawa , Narumi Kawamata , Seiya Motomura , Akira Kanai

Background

Direction-specific modulation in anticipatory postural adjustments (APAs) is reportedly essential to control the step direction of multidirectional gait initiation. Lateral and/or backward step tasks without turning the body while facing forward were adopted by previous studies, although gait initiation toward various directions with body turning is frequently observed in daily activities.

Research question

Are APAs during multidirectional gait initiation with body turning modulated with gait directions and enhanced in the directions with larger body rotations?

Methods

Healthy young men (n = 15) started to walk toward previously instructed directions (forward, forward-right, right, backward-right, and backward) with the right limb at their own timing. The center of pressure (CoP) and center of mass (CoM) during multidirectional gait initiation with body turning were measured using a three-dimensional motion capture system.

Results

During the APA phase (preceding the onset of the first step), the CoP moved toward the swing limb side and toward the opposite anteroposterior direction to the intended gait direction. As the gait direction became more lateral, the peak CoP displacement during the APA phase decreased. The CoM displacement and velocity at the peak CoP displacement during the APA phase were toward the stance limb side and the anteroposterior gait direction. The peak CoP displacement and the CoM velocity at this peak increased as the turning degree increased.

Significance

The direction-specific APA modulations may direct the body movement toward the intended direction. Additionally, APA modulation enhancement may maintain stability and help reach the intended speed during gait initiation toward the direction with a larger body rotation.
背景：据报道，预期姿势调整（APAs）中的方向特异性调节对于控制多向步态起始的步向至关重要。虽然在日常活动中经常观察到身体转向不同方向的步态，但以前的研究采用的是面朝前而不转动身体的侧向和/或向后的步骤任务。研究问题：身体旋转多向步态起始时的APAs是否随步态方向而调节，并在身体旋转较大的方向上增强？方法：健康的年轻男性（n = 15）开始按照自己的时间用右臂按照预先指示的方向（向前、向前-右、向右、向后-右和向后）行走。采用三维运动捕捉系统测量了人体多向转向步态启动过程中的压力中心和质心。结果：在APA阶段（第一步开始前），CoP向摆动肢侧移动，并向与预期步态方向相反的前后方向移动。随着步态方向偏侧，APA期CoP位移峰值减小。APA期的CoM位移和速度峰值均向站立肢体侧和前后步态方向移动。峰值CoP位移和峰值CoM速度随转弯程度的增加而增大。意义：定向特异性的APA调节可引导机体运动向预定方向运动。此外，APA调节增强可以保持稳定性，并有助于在步态开始时达到预期的速度，朝着身体旋转较大的方向。
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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 : 2026-01-01 Epub 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
Time to normalization of gait following ACL reconstruction compared with healthy controls: A systematic review and meta-analysis 与健康对照组相比，前交叉韧带重建后的步态正常化时间：系统回顾和荟萃分析。
IF 2.4 3区 医学 Q3 NEUROSCIENCES
Gait & posture
Pub Date : 2026-01-01 Epub Date: 2025-09-10 DOI: 10.1016/j.gaitpost.2025.109972
Shiwei Chen , Han Gong , Chennan Lyu , Kehan Li , Shazlin Shaharudin

Background

Gait abnormalities often persist after anterior cruciate ligament reconstruction (ACLR) and may increase the risk of reinjury and joint degeneration. This review aimed to assess differences in key gait parameters between ACLR patients and healthy controls, and to estimate when these parameters normalize postoperatively.

Methods

Studies comparing individuals ≥ 3 months post–ACLR with healthy controls were included. A systematic search across five databases yielded 5251 records, with 20 studies (n = 976) retained. A longitudinal multilevel meta-analysis was performed, with pooled effect sizes calculated using Cohen’s d, representing the standardized mean difference. Postoperative time was modeled as a moderator in meta-regression analyses.

Results

Compared to healthy controls, ACLR patients assessed at 3–107 months postoperatively exhibited significantly lower peak knee flexion angle (d = −0.48, 95 % CI: −0.87 to −0.10) and peak knee flexion moment (d = −1.06, 95 % CI: −2.06 to −0.07), while walking speed was non-significant (d = −0.17, 95 % CI: −0.47–0.13). Logarithmic modeling indicated that group differences became non-significant at 16.2 months for flexion angle and 10.1 months for flexion moment. Walking speed was statistically non-significant at any timepoint.

Significance

At ≥ 3 months post-ACLR, patients exhibited significantly reduced peak knee flexion angle and flexion moment compared to controls. These deficits normalized at approximately 16.2 and 10.1 months, respectively. Walking speed did not significantly differ at any postoperative timepoint. These findings suggest that early-phase rehabilitation should emphasize quadriceps strengthening and knee flexion restoration within the first 10–16 months to address persistent biomechanical deficits.
背景：步态异常通常在前交叉韧带重建（ACLR）后持续存在，并可能增加再损伤和关节退变的风险。本综述旨在评估ACLR患者与健康对照者之间关键步态参数的差异，并估计这些参数在术后何时正常化。方法：将aclr后3个月≥ 的个体与健康对照者进行比较。对5个数据库的系统搜索产生了5251条记录，保留了20项研究（n = 976）。进行纵向多水平荟萃分析，使用Cohen’s d（代表标准化平均差）计算合并效应量。在meta回归分析中，术后时间被建模为调节因子。结果：与健康对照相比，术后3-107个月评估的ACLR患者膝关节屈曲角峰值（d = -0.48, 95 % CI: -0.87至-0.10）和膝关节屈曲力矩峰值（d = -1.06, 95 % CI: -2.06至-0.07）显著降低，而步行速度无显著性差异（d = -0.17, 95 % CI: -0.47-0.13）。对数模型显示，在屈曲角度16.2个月和屈曲力矩10.1个月时，组间差异无统计学意义。步行速度在任何时间点均无统计学意义。意义：aclr后≥ 3个月，患者与对照组相比，膝关节屈曲角和屈曲力矩峰值明显降低。这些赤字分别在大约16.2个月和10.1个月时正常化。行走速度在术后任何时间点均无显著差异。这些研究结果表明，早期康复应在前10-16个月内强调股四头肌强化和膝关节屈曲恢复，以解决持续的生物力学缺陷。
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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 : 2026-01-01 Epub 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
Effects of somatosensory stimulation foot orthoses on balance and stability in older adults: A systematic review, meta-analysis, and meta-regression 体感刺激足部矫形器对老年人平衡和稳定性的影响：系统回顾、荟萃分析和荟萃回归。
IF 2.4 3区 医学 Q3 NEUROSCIENCES
Gait & posture
Pub Date : 2026-01-01 Epub Date: 2025-09-11 DOI: 10.1016/j.gaitpost.2025.109974
Abu Jor , Toshiki Kobayashi , Mohammad Jobair Khan , Shakawath Hosen Opu , Wing-Kai Lam , Stanley J. Winser , Fan Gao , Ming Zhang

Background

Somatosensory stimulation foot orthoses (SSFO) are recommended to enhance postural balance by stimulating mechanoreceptors. However, the underlying mechanisms by which SSFO with varying protrusion designs influence postural balance remain unclear.

Research question

How do SSFO affect postural balance in older adults, and what role do variations in protrusion design play in these effects?

Methods

A systematic search was conducted in PubMed, Web of Science, Scopus, CINAHL, and Cochrane Library from inception to December 2024. Eighteen studies with 27 SSFO conditions examining the effects on static and dynamic balance in older adults were included in the meta-analysis. Balance parameters reported in at least 10 SSFO conditions were further analyzed using meta-regression analysis.

Results

Pooled analyses indicated that SSFO use reduced center of pressure (CoP) displacement during standing, particularly in studies evaluating immediate effects and using SSFO with specific design features. Meta-regression analysis revealed significant positive correlations between effect sizes for anteroposterior CoP range and SSFO with arch-support structures [Coeff: 0.45, 95 % CI (0.19, 0.72), p = 0.001] or site-specific protrusions [Coeff: 0.32, 95 % CI (0.09, 0.56), p = 0.008]. SSFO also significantly improved Timed Up and Go scores [MD= -1.15, 95 % CI (-1.82, −0.47), p < 0.001], while no significant changes were observed in gait or other functional mobility measures.

Significance

These findings underscore the potential of customized SSFO designs to enhance mechanoreceptor stimulation and improve postural balance in older adults. While design-specific SSFO may support improvements in static balance for clinical applications, evidence of benefits on gait and broader functional mobility is still limited.

Registration

(PROSPERO ID: CRD42024592630)
背景：体感刺激足部矫形器（SSFO）被推荐通过刺激机械感受器来增强姿势平衡。然而，具有不同突出设计的SSFO影响体位平衡的潜在机制尚不清楚。研究问题：SSFO如何影响老年人的姿势平衡，以及在这些影响中突出设计的变化起什么作用？方法：系统检索PubMed、Web of Science、Scopus、CINAHL、Cochrane Library自成立至2024年12月的数据库。荟萃分析包括18项研究，27种SSFO条件，检查老年人静态和动态平衡的影响。使用meta-回归分析进一步分析至少10种SSFO条件下报告的平衡参数。结果：综合分析表明，SSFO可以减少站立时的压力中心（CoP）位移，特别是在评估即刻效果和使用具有特定设计特征的SSFO的研究中。meta回归分析显示，前后位CoP范围的效应大小与弓支撑结构的SSFO [Coeff: 0.45, 95 % CI (0.19, 0.72), p = 0.001]或部位特异性突出[Coeff: 0.32, 95 % CI (0.09, 0.56), p = 0.008]呈正相关。SSFO还显著改善了Timed Up和Go评分[MD= -1.15,95 % CI (-1.82, -0.47)， p ]意义：这些发现强调了定制SSFO设计增强老年人机械受体刺激和改善姿势平衡的潜力。虽然特定设计的SSFO可能支持临床应用中静态平衡的改善，但对步态和更广泛的功能活动的益处证据仍然有限。注册：（普洛斯彼罗ID: CRD42024592630）。
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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 : 2026-01-01 Epub 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。
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