Gait & posture最新文献

{"title":"The impact of 12 weeks combined resistance and balance training on functional Sit-To-Stand muscle power in mobility limited older patients","authors":"Marie West Pedersen ,&nbsp;Frederik Kronvold Nielsen ,&nbsp;Charlotte Suetta ,&nbsp;Morten Tange Kristensen","doi":"10.1016/j.gaitpost.2025.03.025","DOIUrl":"10.1016/j.gaitpost.2025.03.025","url":null,"abstract":"<div><h3>Background</h3><div>Falls become more frequent with ageing. Improving balance and muscle strength has been shown to reduce the risk of falls in older patients, but the importance of muscle power is less investigated.</div></div><div><h3>Objective</h3><div>To evaluate changes in functional Sit-to-Stand muscle power and the association with dynamic balance in older adults following a 12-week exercise program.</div></div><div><h3>Material and methods</h3><div>A retrospective study including 84 (69 women) with a mean age of 79.3 years were included. Based on the 30s-STS performance, relative muscle power (W*kg⁻¹) and allometric muscle power (W*m⁻²) was calculated, and the Dynamic Gait Index was used for dynamic balance.</div></div><div><h3>Results</h3><div>The mean (SD) relative- and allometric power increased significantly (p &lt; 0.001) from 2.3 (0.9) W*kg⁻¹ to 2.9 (0.9) W*kg⁻¹ and 58.4 (22.6) W*m⁻² to 76.3 (22.6) W*m⁻², respectively. Forty-seven out of 70 patients improved their 30s-STS performances by ≥ 2 repetitions, and 44 out of 68 patients showed an improvement of ≥ 3 points in their DGI scores. Relative- and allometric muscle power was significantly correlated with DGI scores before r = 0.398, (0.188–0.573) and r = 0.381 (0.169–0.560) and after r = 0.439 (0.215–0.62) and r = 0.374 (0.215–0.620) the 12-week program for the whole group. Additionally, 45 % of the patients were at reduced risk of falling according to their DGI values.</div></div><div><h3>Conclusion</h3><div>Sit-to-stand performance and DGI scores improved in older adults after participating in a 12-week combined balance and strength training program. Estimates of STS muscle power was associated with DGI scores.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"120 ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gait patterns in hemiplegic cerebral palsy: Is it time for a new classification?","authors":"Mauro César de Morais Filho ,&nbsp;Marcelo H. Fujino ,&nbsp;Cátia M. Kawamura ,&nbsp;José Augusto F. Lopes ,&nbsp;Laís Przysiada ,&nbsp;Maria Eduarda Antunes Silva","doi":"10.1016/j.gaitpost.2025.03.026","DOIUrl":"10.1016/j.gaitpost.2025.03.026","url":null,"abstract":"<div><h3>Background</h3><div>The Winters, Gage and Hicks classification (WGHC) for spastic hemiplegia has been widely used, despite its limitations. The purpose of this study was to evaluate the reliability of WGHC in large series of cerebral palsy (CP).</div></div><div><h3>Research question</h3><div>May all hemiplegic CP patients be classified according to WGHC?</div></div><div><h3>Methods</h3><div>Participants with the diagnosis of spastic hemiplegic CP were identified in gait laboratory database. Only the first gait analysis of each patient was considered, and 983 patients met the inclusion criteria. Individuals with mixed tone (45), other pathologies combined with hemiplegia (11) and previous orthopedic surgeries or botulinum injections within 12 months (395) were excluded. The remaining 532 subjects were classified according to the 4 groups described by WGHC.</div></div><div><h3>Results</h3><div>224 (42.1 %) patients were unclassified by WGHC and 4 additional groups were identified: group V (115/21.6 %)-none of the alterations described in WGHC; group VI (76/14.3 %)- WGHC III or IV, but with normal ankle dorsiflexion in stance and swing; group VII (29/5.5 %)- WGHC II, III or IV, but with normal ankle dorsiflexion in swing phase; group VIII (4/0.7 %)-reduction of ankle dorsiflexion in stance and swing phases with increased hip flexion in stance, but with normal knee range of motion. The age in group VI (14.5 years) was higher than other groups (<em>p</em> &lt; 0.001). The GDI in group V (76.3) was similar (p = 0.979) to group I (73.9) and greater than other groups (<em>p</em> &lt; 0.001). The mean pelvic asymmetry (32.7⁰) and internal hip rotation (18⁰) in group IV were higher than other groups (<em>p</em> &lt; 0.001). The higher <em>p</em>revalence of perinatal anoxia (33.3 %) was observed in group VII.</div></div><div><h3>Significance</h3><div>In the present study, 57.9 % of patients were classified according to WGHC and 4 additional patterns were identified, leading a proposal of update at WGHC.</div></div><div><h3>Level of evidence</h3><div>III.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"120 ","pages":"Pages 40-45"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776529","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}

{"title":"Effects of a 24-week dual-task training on postural control complexity during standing and walking in older adults: Secondary analysis from a randomized controlled trial","authors":"Francis Trombini-Souza ,&nbsp;Iara dos Santos Leal ,&nbsp;Júlia Gomes de Alencar ,&nbsp;Victória Alves de Brito ,&nbsp;Lucas Martins Rodrigues","doi":"10.1016/j.gaitpost.2025.03.031","DOIUrl":"10.1016/j.gaitpost.2025.03.031","url":null,"abstract":"<div><h3>Background</h3><div>Functional decline in gait motor control and the capacity to maintain balance during upright standing posture in older adults is influenced by deterioration in the complexity of various physiological systems involved in these daily activities.</div></div><div><h3>Research question</h3><div>Is a 24-week dual-task protocol training, beginning with alternating cognitive demands and progressing to simultaneous dual-tasking, more effective than a control group training only with alternating dual tasks in improving the physiological complexity of postural control in older adults during upright standing posture under interoceptive and exteroceptive demands and gait under dual tasks?</div></div><div><h3>Methods</h3><div>This randomized controlled trial enrolled 60 community-dwelling older adults of both sexes, aged between 60 and 80. The experimental group (EG; <em>n</em> = 30) underwent training with progression from alternating dual-task (ADT) to simultaneous dual task (SDT) during activities such as gait, and static and dynamic functional balance. The control group (CG; <em>n</em> = 30) only underwent the ADT protocol throughout the six months of training. The primary outcome of this study was the physiological complexity of gait under dual task calculated by the refined composite multiscale fuzzy entropy method for the anteroposterior (AP), mediolateral (ML), and vertical (V) directions. The outcomes were acquired at baseline (T1) and after 24 weeks of intervention (T2). The analyses were based on the intention-to-treat principle, using generalized linear mixed models (GLMM) with a significance level of 5 %.</div></div><div><h3>Results</h3><div>No interaction or group effects were observed. However, both groups significantly improved body sway physiological complexity in the AP direction during gait under ST, ADT, and SDT and in the V direction under ADT and SDT. No change in complexity during upright standing posture under interoceptive and exteroceptive demand was significantly observed, regardless of the group.</div></div><div><h3>Significance</h3><div>Regardless of the training protocol, both groups significantly improved the physiological complexity of gait under dual task.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"120 ","pages":"Pages 88-97"},"PeriodicalIF":2.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143799016","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}

{"title":"Lower limb contracture definitions in children and adults with cerebral palsy: A systematic review","authors":"Andrea Marron ,&nbsp;Jasmine Milnes ,&nbsp;Laura Conry ,&nbsp;Damien Kiernan","doi":"10.1016/j.gaitpost.2025.03.027","DOIUrl":"10.1016/j.gaitpost.2025.03.027","url":null,"abstract":"<div><h3>Aim</h3><div>To examine the quantitative definitions and prevalence rates of fixed lower limb contractures in people with cerebral palsy (CP). Based on findings, to propose standardized values to define lower limb contractures to improve quality in future research.</div></div><div><h3>Method</h3><div>A systematic review was conducted according to PRISMA guidelines using 4 databases from inception to April 2024. Titles, abstracts, and full texts were independently screened. Data were extracted and quality assessed independently by 2 reviewers. Data were synthesized and presented descriptively.</div></div><div><h3>Results</h3><div>Forty-four studies were included. Ankle plantarflexion contracture definitions ranged from &lt; 10° dorsiflexion to ≥ 20° plantarflexion, and prevalence rates ranged from 32 % to 90 %. Knee flexion contracture definitions ranged from &gt; 0° to ≥ 30° flexion, and prevalence rates ranged from 19 % to 44 %. Hip flexion contracture definitions ranged from &gt; 0° to ≥ 30° flexion, and prevalence rates ranged from 7 % to 68 %. Hip extension and abduction contractures were seldom defined.</div></div><div><h3>Interpretation</h3><div>There is considerable variability in reported contracture definitions and prevalence rates. Based on findings, we propose the following cut-offs for defining contractures; ankle plantarflexion contracture &lt; 0° dorsiflexion, knee flexion contracture &lt; 0° knee extension, hip flexion contracture &lt; 0° hip extension, hip abduction contracture &lt; 30° hip abduction, hip extension contracture ≤ 90° hip flexion range of motion.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"120 ","pages":"Pages 1-8"},"PeriodicalIF":2.2,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759225","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}

{"title":"Lower limb deformity and gait deviations of osteogenesis imperfecta","authors":"Yuanhao Liang ,&nbsp;Shichen Qi ,&nbsp;Tinghan Xu ,&nbsp;Lin Feng ,&nbsp;Eric Hiu Kwong Yeung ,&nbsp;Rong He ,&nbsp;Shijie Yin ,&nbsp;Zhou Yapeng ,&nbsp;Peikai Chen ,&nbsp;Michael Kai-Tsun To ,&nbsp;Yong Hu","doi":"10.1016/j.gaitpost.2025.03.023","DOIUrl":"10.1016/j.gaitpost.2025.03.023","url":null,"abstract":"<div><h3>Background</h3><div>Osteogenesis imperfecta is a rare genetic disorder characterized by complex lower limb deformities, resulting in various gait limitations. This study aimed to (1) investigate the incidence and association between radiographic changes and gait impairment; (2) propose a lower limb deformity index to quantify deformity severity as well as gait performance.</div></div><div><h3>Methods</h3><div>Bilateral X-ray images and 3D gait analysis results were assessed retrospectively from 48 patients with osteogenesis imperfecta. Multivariate linear regression was used to investigate the contribution of each deformity to gait performance. Eight scoring approaches of the proposed index, calculated from radiographic changes, were evaluated by their linear relationship to gait deviation.</div></div><div><h3>Results</h3><div>Patients with osteogenesis imperfecta had high incidence of anterolateral bowing of femur, and anteromedial bowing of tibia, along with abducted hip, varus knee, hip flexion and ankle dorsiflexion deformities. Their maximum joint kinematics and kinetics were less than healthy controls, which was consistent with their major deformities. However, multivariate linear regression indicated a limited contribution from each deformity to gait deviation (only mechanical axis deviation out of 14 radiographic measures showed significance). Remarkably, our proposed index presented a significant linear correlation to gait deviation (Correlation coefficient: −0.650; R square: 0.423; F value: 33.719, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>This study preliminary demonstrated the association between lower limb deformities and gait deviations of patients with osteogenesis imperfecta and proposed a lower limb deformity index to quantify the deformity severity that reflects gait performance.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"119 ","pages":"Pages 229-237"},"PeriodicalIF":2.2,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725469","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}

{"title":"Spine kinematics during gait in paediatric Hereditary Spastic Paraparesis","authors":"V. Farinelli ,&nbsp;C. Palmisano ,&nbsp;C. Dosi ,&nbsp;I. Pedrinelli ,&nbsp;E. Pagliano ,&nbsp;R. Esposti ,&nbsp;P. Cavallari","doi":"10.1016/j.gaitpost.2025.03.029","DOIUrl":"10.1016/j.gaitpost.2025.03.029","url":null,"abstract":"<div><h3>Background</h3><div>Many studies already addressed specific gait abnormalities in children affected by Hereditary Spastic Paraparesis (HSP). Some authors investigated the contribution of the upper body to walking pattern, but simplifying trunk and pelvis as two hinged rigid bodies. Recently, we developed a method to detail spinal kinematics in terms of anatomic curvatures and length; we were thus interested in applying such protocol to HSP.</div></div><div><h3>Research question</h3><div>how HSP influences spinal kinematics during gait?</div></div><div><h3>Methods</h3><div>we enrolled ten HSP patients (5–17 years, 8 males) and twelve Healthy Children (HC, 8–16 years, 4 males). Kinematic data were recorded with an optoelectronic system using the LAMB full body marker set, which included three physical markers placed on the spine, supplemented with a virtual one reconstructed on the coccix. Calculations included the spinal length (linear distance from C7 to coccix), the kyphosis and lordosis angles, the trunk tilt and obliquity, the pelvis and the shoulder-pelvis angles, as well as the joint angles of the lower limbs. For each variable, the average value and the range of motion (ROM) were extracted and compared between groups.</div></div><div><h3>Results</h3><div>the ROM of spinal length, the average value and ROM of kyphosis angle and the average value of trunk tilt significantly increased in HSP vs HC. A pathologic \"double bump” pattern characterized the pelvic tilt traces, the lordosis angles and, with opposite sign, the kyphosis. Both the average value and ROM of pelvic tilt significantly increased in HSP, while ROM of lower limb angles was reduced.</div></div><div><h3>Conclusion</h3><div>spine kinematics were altered in HSP, who also showed an anterior trunk tilt. Therefore, the trunk should be considered an articulated system and not simplified to a rigid body, a perspective that could be also used in treating gait abnormalities.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"120 ","pages":"Pages 143-149"},"PeriodicalIF":2.2,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829681","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}

{"title":"Influence of auditory biofeedback of foot angular velocity on propulsive function and gait performance in old healthy adults","authors":"Sam M. Lyons,&nbsp;Tayler M. Vickery,&nbsp;Douglas W. Powell,&nbsp;Max R. Paquette","doi":"10.1016/j.gaitpost.2025.03.030","DOIUrl":"10.1016/j.gaitpost.2025.03.030","url":null,"abstract":"<div><div>A distal-to-proximal redistribution of joint work and reduction in ankle kinetics may contribute to declines in gait performance with advancing age. Interventions to improve ankle function could help maintain gait performance in old adults. Inertial measurement units are practical and inexpensive and may be used to provide biofeedback of foot angular velocity to improve ankle propulsive function during gait.</div></div><div><h3>Purpose</h3><div>This study assessed if real-time biofeedback of foot plantarflexion angular velocity influenced ankle kinetics and hip-to-ankle work ratio in old adults.</div></div><div><h3>Methods</h3><div>Eight healthy old adults walked at their preferred speed (PS), maximal speed (MS), and MS with auditory feedback for a 5% increase in foot plantarflexion velocity (AUD). Kinematic and ground reaction force data were collected, and joint kinetics were calculated.</div></div><div><h3>Results</h3><div>Ankle positive work was larger during MS (p&lt;0.001) and AUD (p&lt;0.001) compared to PS, and 8% larger during AUD compared to MS (p=0.01). Hip-to-ankle work ratio was not different during MS (p=0.053) compared to PS but AUD reduced the ratio by 7% compared to MS (p=0.03) and by 19% compared to PS (p=0.02).</div></div><div><h3>Conclusion</h3><div>The findings suggest that biofeedback of foot plantarflexion velocity may be an effective strategy to acutely increase ankle positive work and reduce hip-to-ankle work ratio during treadmill walking in old adults.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"120 ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776517","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}

{"title":"The effect of posture misalignment and muscles surrounding the lateral femoral cutaneous nerve on meralgia paresthetica","authors":"Bilge Kesikburun ,&nbsp;Ayşe Merve Ata ,&nbsp;Ayşenur Mert ,&nbsp;İpek Poyraz ,&nbsp;Ebru Karaca Umay","doi":"10.1016/j.gaitpost.2025.03.020","DOIUrl":"10.1016/j.gaitpost.2025.03.020","url":null,"abstract":"<div><h3>Aim</h3><div>The associated etiological factors of Meralgia Paresthetica (MP) are various. We hypothesized that posture misalignment and changes in muscle surrounding the Lateral Femoral Cutaneus Nerve (LFCN) can cause compression on the nerve or that patients with MP may have posture disorder due to pain, which can lead to entrapment. The purpose of study was to determine the potentional relationship between posture misalignment, muscles thickness and MP.</div></div><div><h3>Methods</h3><div>A cross sectional study was undertaken. Twenty-six patients patients diagnosed with MP [12 women and 14 men; median age, 48.5 (35.3–65.0) years] participated in the study. The LFCN was evaluated with ultrasound in patients with MP. The thickness of the vastus medialis, lateralis, iliopsoas, sartorius, tensor fascia lata and rectus femoris muscles was measured using ultrasound. LANSS, Visual Analogue Scale (VAS) and the Lower Extremity Functional Scale (LEFS) were assessed. Postural alignment were evaluated using DIERS formetric 4D and New York Posture Rating (NYPR) scale.</div></div><div><h3>Results</h3><div>Tensor facia lata muscle thickness was significantly lower in the symptomatic side (p = 0.034). There was an inversely correlation between LANSS and sartorius and iliopsoas muscle thickness (respectively, p = 0.036, p = 0.047), while the rectus femoris muscle thickness was inversely correlated with LANSS in the asymptomatic side (p = 0.038). There was a significantly relationship between LANSS and postural misalignment variables (coronal imbalance, trunk length, inflection point). Multiple linear regression analysis revealed that coronal imbalance and trunk length in postural variables were statistically significant predictors of LANSS (r ² =0.342).</div></div><div><h3>Conclusion</h3><div>Our findings suggest that changes in muscles surrounding LFCN and posture misalignment may contribute as an etiological factor in patients with MP or vice versa.</div></div><div><h3>Data availability</h3><div>The corresponding author will provide the datasets used and analyzed during the current work upon reasonable request.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"120 ","pages":"Pages 170-176"},"PeriodicalIF":2.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845050","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}

{"title":"Functional roles of stepping-leg joint torques in body deceleration during the post-trip landing phase in gait","authors":"Takahiro Nakajima ,&nbsp;Shinsuke Yoshioka ,&nbsp;Senshi Fukashiro","doi":"10.1016/j.gaitpost.2025.03.010","DOIUrl":"10.1016/j.gaitpost.2025.03.010","url":null,"abstract":"<div><h3>Background</h3><div>Tripping during walking alters the whole-body linear momentum (WBLM) and angular momentum (WBAM). Inadequate regulation of these changes affects normal gait, potentially resulting in falls and injuries. To avoid these incidents, it is necessary to exert joint torques to generate ground reaction forces (GRFs) that will serve to mitigate WBLM and WBAM changes. However, it remains unclear which joint torques and how they contribute to generating the post-trip GRF.</div></div><div><h3>Research question</h3><div>How is the GRF generated to control the WBLMs and WBAM during the post-trip landing phase in gait?</div></div><div><h3>Methods</h3><div>Twelve young adults completed 150 walking trials on a walkway, with tripping induced in 60 of them. They were required to recover to normal walking after tripping. Body landmark coordinates and GRF data were obtained using a motion capture system and a force platform, respectively. Joint torques, WBLM, WBAM, and the contribution of each torque to the GRF were calculated.</div></div><div><h3>Results</h3><div>The upward GRF was primarily generated by the ankle-plantarflexion torque of the stepping leg, supported by the knee- and hip-extension torques (contributions to vertical GRF: ankle-plantarflexion, 64.4 ± 7.8 %; knee flexion–extension, 16.3 ± 6.1 %; hip flexion–extension, 8.8 ± 4.3 %). The posterior GRF was mainly generated by the knee- and hip-extension torques (contributions to anterior–posterior GRF: knee flexion–extension, 40.2 ± 8.2 %; hip flexion–extension, 12.9 ± 5.6 %). Additionally, the ankle-plantarflexion torque contributed to the backward GRF moment immediately after post-trip stepping-foot contact (contribution to forward–backward GRF moment: 41.7 ± 4.1 %).</div></div><div><h3>Significance</h3><div>The findings of this study enhance the understanding of the kinetics of a body's deceleration to prevent falls during the post-trip landing phase and can serve as normative data for fall-prevention programs in rehabilitation settings and the development of powered exoskeletons.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"119 ","pages":"Pages 252-259"},"PeriodicalIF":2.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759748","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}

{"title":"Automated quantification of the anatomic accuracy of muscle paths and its application in an image-based subject-specific modeling workflow for adult spinal deformity","authors":"Birgitt Peeters ,&nbsp;Erica Beaucage-Gauvreau ,&nbsp;Lieven Moke ,&nbsp;Ilse Jonkers ,&nbsp;Friedl De Groote ,&nbsp;Lennart Scheys","doi":"10.1016/j.gaitpost.2025.03.007","DOIUrl":"10.1016/j.gaitpost.2025.03.007","url":null,"abstract":"<div><h3>Background</h3><div>Musculoskeletal models (MSKM) can non-invasively evaluate the effect of altered muscle geometry and physiology on locomotor function. Nevertheless, this requires anatomically accurate muscle paths throughout functional ranges of motion. However, reference data to evaluate such muscle paths is rarely available, including in adult spinal deformity (ASD). Although this degenerative disorder alters muscle geometry and physiology, these parameters are not available to inform clinical decision-making as generic MSKM cannot account for these alterations, and reliable ASD-specific modeling workflows do not currently exist.</div></div><div><h3>Research question</h3><div>Can an efficient workflow be developed for evaluating and optimizing the anatomic accuracy of dynamic muscle paths in personalized MSKM and applied for reliable spinal motion simulations in ASD?</div></div><div><h3>Methods</h3><div>A workflow was developed to automatically analyze anatomic muscle accuracy throughout predefined ranges of motion in terms of muscle-bone penetration, muscle action, moment arm magnitude, and discontinuities. Erector spinae, multifidus, and psoas muscles were semi-automatically segmented in magnetic resonance images of one healthy and two ASD subjects. Next, their muscle representation, insertion sites, and complexity were iteratively refined with the above workflow to generate subject-specific MSKM and compare them against state-of-the-art generic MSKM.</div></div><div><h3>Results</h3><div>All muscles in the subject-specific MSKM were anatomically accurate, except for discontinuities in 3.81 % (psoas) and 0.37 % (multifidus) of moment arm curves across motions and subjects. In contrast, scaled generic MSKM were consistently associated with muscle-bone penetration, decreased moment arm magnitude, and opposite muscle actions.</div></div><div><h3>Significance</h3><div>This novel workflow is the first to allow for an efficient evaluation of the anatomic accuracy of dynamic muscle paths. Its application in MSKM of ASD patients resulted in subject-specific muscle paths, with an anatomically correct muscle geometry, while preventing bone penetration during the representative range of motions. The workflow is promising to enable biomechanical analyses of ASD with an accuracy beyond that of scaled generic models.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"119 ","pages":"Pages 238-245"},"PeriodicalIF":2.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737981","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}