Supervised Exercise Training Improves 6 min Walking Distance and Modifies Gait Pattern during Pain-Free Walking Condition in Patients with Symptomatic Lower Extremity Peripheral Artery Disease

This study aimed to investigate the effects of supervised exercise training (SET) on spatiotemporal gait and foot kinematics parameters in patients with symptomatic lower extremity peripheral artery disease (PAD) during a 6 min walk test. Symptomatic patients with chronic PAD (Fontaine stage II) following a 3 month SET program were included. Prior to and following SET, a 6 min walk test was performed to assess the 6 min walking distance (6MWD) of each patient. During this test, spatiotemporal gait and foot kinematics parameters were assessed during pain-free and painful walking conditions. Twenty-nine patients with PAD (65.4 ± 9.9 years.) were included. The 6MWD was significantly increased following SET (+10%; p ≤ 0.001). The walking speed (+8%) and stride frequency (+5%) were significantly increased after SET (p ≤ 0.026). The stride length was only significantly increased during the pain-free walking condition (+4%, p = 0.001), whereas no significant differences were observed during the condition of painful walking. Similarly, following SET, the relative duration of the loading response increased (+12%), the relative duration of the foot-flat phase decreased (−3%), and the toe-off pitch angle significantly increased (+3%) during the pain-free walking condition alone (p ≤ 0.05). A significant positive correlation was found between changes in the stride length (r = 0.497, p = 0.007) and stride frequency (r = 0.786, p ≤ 0.001) during pain-free walking condition and changes in the 6MWD. A significant negative correlation was found between changes in the foot-flat phase during pain-free walking condition and changes in the 6MWD (r = −0.567, p = 0.002). SET was found to modify the gait pattern of patients with symptomatic PAD, and many of these changes were found to occur during pain-free walking. The improvement in individuals’ functional 6 min walk test was related to changes in their gait pattern.

A novel instrumented outsole for real-time foot kinematics measurement: validation across different speeds and simulated foot landing in Cerebral Palsy gait

<pre>Neuromuscular disorders in Cerebral Palsy (CP) patients lead to foot deformities and affect foot biomechanics leading to compromised gait. Thus, measurement of the foot kinematic measurement is of particular interest to understand and characterize the walking pattern among CP patients. The objective of the present work is to develop a wearable instrument to measure foot kinematics such as foot-to-ground angle in three-dimensional planes and to measure the foot clearance i.e., toe and heel clearances. A template-based outsole was developed that incorporated an optical distance sensor located anatomically on the outsole and the magnetometer to measure the foot kinematics. The developed system was validated against the reference marker-based motion capture system (from Noraxon). The data from eight able-bodied participants were acquired simultaneously from both the systems (developed and the reference system) at three different walking speeds. A CoP based feedback was presented to the participants to shift the sagittal CoP anteriorly, posteriorly and normal to simulate the walking pattern of CP patients with three different foot landing strategies. Pearson's correlation coefficient of more than or equal to 0.62, root mean square error of less than or equal to 7.81 degrees and limit of agreement of more than or equal to 95% is found. Furthermore, a wireless wristband is developed and validated for real-time vibrotactile feedback. The measurement accuracy reported with outsole while participants simulated CP gait shows the potential of present work in real-time foot kinematics detection in CP patients. The instrumentation is wearable, low-cost, easy to use and implement.</pre>

A novel instrumented outsole for real-time foot kinematics measurement: validation across different speeds and simulated foot landing in Cerebral Palsy gait

<pre>Neuromuscular disorders in Cerebral Palsy (CP) patients lead to foot deformities and affect foot biomechanics leading to compromised gait. Thus, measurement of the foot kinematic measurement is of particular interest to understand and characterize the walking pattern among CP patients. The objective of the present work is to develop a wearable instrument to measure foot kinematics such as foot-to-ground angle in three-dimensional planes and to measure the foot clearance i.e., toe and heel clearances. A template-based outsole was developed that incorporated an optical distance sensor located anatomically on the outsole and the magnetometer to measure the foot kinematics. The developed system was validated against the reference marker-based motion capture system (from Noraxon). The data from eight able-bodied participants were acquired simultaneously from both the systems (developed and the reference system) at three different walking speeds. A CoP based feedback was presented to the participants to shift the sagittal CoP anteriorly, posteriorly and normal to simulate the walking pattern of CP patients with three different foot landing strategies. Pearson's correlation coefficient of more than or equal to 0.62, root mean square error of less than or equal to 7.81 degrees and limit of agreement of more than or equal to 95% is found. Furthermore, a wireless wristband is developed and validated for real-time vibrotactile feedback. The measurement accuracy reported with outsole while participants simulated CP gait shows the potential of present work in real-time foot kinematics detection in CP patients. The instrumentation is wearable, low-cost, easy to use and implement.</pre>

A novel instrumented outsole for real-time foot kinematics measurement: validation across different speeds and simulated foot landing in Cerebral Palsy gait

Neuromuscular disorders in Cerebral Palsy (CP) patients lead to foot deformities and affect foot biomechanics leading to compromised gait. The objective of the present work is to develop a wearable instrumentation to measure foot kinematics such as foot-to-ground angle in three-dimensional planes and to measure the foot clearance i.e., toe and heel clearances. A template-based outsole was developed that incorporated an optical distance sensor located anatomically on the outsole and the magnetometer to measure the foot kinematics. The developed system was validated against the reference marker-based motion capture system. The data from eight able-bodied participants were acquired simultaneously from both the systems at three different walking speeds. A CoP based feedback was presented to the participants to shift the sagittal CoP anteriorly, posteriorly and normal to simulate the walking pattern of CP patients with three different foot landing strategies. Pearson’s correlation coefficient of more than or equal to 0.62, root mean square error of less than or equal to 7.81 degrees and limit of agreement of more than or equal to 95% is found. The measurement accuracy reported with outsole while participants simulated CP gait shows the potential of present work in real-time foot kinematics detection in CP patients.

The Effect of Neuropathy and Diabetes Type on Multisegment Foot Kinematics: A Cohort Study on 70 Participants with Diabetes

While lower limb biomechanics of people with diabetes are well described, the effects of diabetes type and of peripheral neuropathy on foot joint kinematics have not been addressed in depth. A total of 70 patients with type 1 (n = 25) and type 2 (n = 45) diabetes mellitus, with and without peripheral neuropathy, underwent functional evaluation via gait analysis using an established multisegment foot kinematic model. ANCOVA was performed to assess differences in foot joints’ range of motion (ROM) between groups with diabetes and a control group by accounting for the effects of age, body mass index (BMI) and normalized walking speed. Statistical parametric mapping was used to assess differences in temporal patterns of foot joint motion across normalized gait cycle. Small but significant correlations were found between age, BMI, speed and foot joints' ROM. Regardless of diabetes type and presence of neuropathy, all subgroups with diabetes showed limited ROM at the midtarsal and tarsometatarsal joints. Increased midtarsal joint dorsiflexion and adduction was associated with increased tarsometatarsal joint plantarflexion. After accounting for the effect of covariates, diabetes is associated with reduced ROM and to alterations of the kinematic patterns, especially at the midtarsal and tarsometatarsal joints, irrespective of type and neuropathy.

Integration of biplanar X-ray, three-dimensional animation and particle simulation reveals details of human ‘track ontogeny’

The emergence of bipedalism had profound effects on human evolutionary history, but the evolution of locomotor patterns within the hominin clade remains poorly understood. Fossil tracks record in vivo behaviours of extinct hominins, and they offer great potential to reveal locomotor patterns at various times and places across the human fossil record. However, there is no consensus on how to interpret anatomical or biomechanical patterns from tracks due to limited knowledge of the complex foot–substrate interactions through which they are produced. Here, we implement engineering-based methods to understand human track formation with the ultimate goal of unlocking invaluable information on hominin locomotion from fossil tracks. We first developed biplanar X-ray and three-dimensional animation techniques that permit visualization of subsurface foot motion as tracks are produced, and that allow for direct comparisons of foot kinematics to final track morphology. We then applied the discrete element method to accurately simulate the process of human track formation, allowing for direct study of human track ontogeny. This window lets us observe how specific anatomical and/or kinematic variables shape human track morphology, and it offers a new avenue for robust hypothesis testing in order to infer patterns of foot anatomy and motion from fossil hominin tracks.

Biomechanical Correlation Between Trunk and Foot Kinematics During Golf Swing Movement Before and After Fatigue

BackgroundKinematic chain of whole body is important during golf swing. Moreover, it was suggested that kinematics of golf swing was affected by fatigue. The purpose of the present study was to investigate the golf swing before and after fatigue of trunk muscles, and to assess the effect of the fatigue on kinematics of trunk as well as lower extremity. A total of 11 healthy adults participated in the current study. Golf swing motion in each subject was measured with a 7-iron on a grass plate using motion capture system. Three-dimensional kinematics of trunk and lower extremity on the lead side were evaluated.ResultsSagittal trunk instability was observed after fatigue. Regarding the kinematic chain, range of motion of trunk rotation (r = -0.76, p < 0.01) and knee rotation (r = 0.82, p < 0.01) were significantly correlated with the hindfoot rotation before the fatigue task. However, after the fatigue task, the hindfoot rotation was significantly correlated only with the knee rotation (r = 0.76, p <0.01). ConclusionsAs fatigue of trunk muscles will alter swing movement and kinematic chain, trunk muscle training can be one of key strategies to maintain swing performance. Trial registrationOur study was registered to UMIN (No. 000037037, date; 01/07/2019).