Clinical Biomechanics最新文献

{"title":"Explainable machine learning for Montreal Cognitive Assessment score estimation from gait in community-dwelling older adults: An exploratory evaluation.","authors":"Yuta Totoki, Tetsuya Hasegawa, Kohei Kaminishi, Arito Yozu, Jun Ota","doi":"10.1016/j.clinbiomech.2026.106996","DOIUrl":"https://doi.org/10.1016/j.clinbiomech.2026.106996","url":null,"abstract":"<p><strong>Background: </strong>Machine learning for gait-based cognitive assessment is rarely benchmarked against a mean-prediction null or checked for explanation stability. We evaluated an explainable multimodal model against this null to estimate Montreal Cognitive Assessment (MoCA) score from gait. We assessed explanation stability and the contribution of joint-angle trajectories.</p><p><strong>Methods: </strong>Fifty community-dwelling older adults walked overground with markerless motion capture, yielding 713 gait cycles. Gait-MoCA associations were assessed with Pearson and partial correlations. Under participant-level five-fold cross-validation, a multimodal long short-term memory (LSTM) model was compared with summary-statistics models, reduced input sets omitting the trajectories, and a null model returning the training-fold mean. Scaling and epoch selection were limited to training data. Shapley additive explanations (SHAP) were computed per fold.</p><p><strong>Findings: </strong>Four gait parameters were associated with MoCA after false-discovery-rate correction in unadjusted analyses. All five variability-coefficient correlations with MoCA were positive. Stance-time and double-support-time variability had the strongest covariate-adjusted correlations (partial r=0.38 and 0.34), although no covariate-adjusted correlation survived correction. After correction, no model tested against the null improved significantly. The null-model participant-level root mean square error was 3.03, versus 2.83 for the best model, 2.96 for the multimodal LSTM and 2.92 for the selected demographics-only model. SHAP attributions concentrated at the end of the cycle, 24% in the final frame, but varied between folds.</p><p><strong>Interpretation: </strong>The variability measures capture between-cycle differences that the single-cycle models did not encode and may guide future model development. Benchmarking against a mean-prediction null and quantifying explanation stability may help identify which inputs merit further evaluation.</p>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"141 ","pages":"106996"},"PeriodicalIF":1.8,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225431","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":"Corrigendum to \"Effects of Nordic walking after total hip arthroplasty: A scoping review\" [Clinical Biomechanics 137 (2026) 106833].","authors":"Philippe Henry, Mathias Blandeau, Philippe Pudlo, Laura Wallard","doi":"10.1016/j.clinbiomech.2026.106914","DOIUrl":"https://doi.org/10.1016/j.clinbiomech.2026.106914","url":null,"abstract":"","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":" ","pages":"106914"},"PeriodicalIF":1.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118061","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":"Wound care technologies: from multidisciplinary mechanobiological science to clinical practice.","authors":"Qiyao Peng, Fred Vermolen, Amit Gefen, Paul P M van Zuijlen, H Ibrahim Korkmaz","doi":"10.1016/j.clinbiomech.2026.106976","DOIUrl":"https://doi.org/10.1016/j.clinbiomech.2026.106976","url":null,"abstract":"","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":" ","pages":"106976"},"PeriodicalIF":1.8,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118070","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":"Load sharing and stability of deltoid ligament during ankle motion loading—A cadaveric biomechanical study","authors":"Yuta Mori ,&nbsp;Yasutaka Murahashi ,&nbsp;Katsunori Takahashi ,&nbsp;Kazushi Horita ,&nbsp;Tomoaki Kamiya ,&nbsp;Makoto Emori ,&nbsp;Kota Watanabe ,&nbsp;Hiromichi Fujie ,&nbsp;Atsushi Teramoto","doi":"10.1016/j.clinbiomech.2026.106875","DOIUrl":"10.1016/j.clinbiomech.2026.106875","url":null,"abstract":"<div><h3>Background</h3><div>The deltoid ligament stabilizes the medial ankle through multiple fiber bundles that resist eversion and external rotation. Although its overall biomechanical function is well established, the specific contributions of individual bundles dur<!--> <!-->ing complex motions such as pronation remain unclear. This study aimed to replicate previous findings using a modified ligament transection sequence and investigate load-sharing among deltoid ligament bundles.</div></div><div><h3>Methods</h3><div>Eight fresh-frozen cadaveric lower limbs (mean age, 85.1 ± 5.8 years) were examined using a six-degree-of-freedom robotic system. Talocrural joint motion was measured under eversion (1.7 Nm) and external rotation (1.7 Nm) at various flexion angles. Pronation was defined as a combination of eversion and external rotation at 15-degree dorsiflexion. Tests were performed in the intact ankle and after deep to superficial sequential transection. In situ forces of individual ligament bundles were calculated using a robotic replay method based on the principle of superposition.</div></div><div><h3>Findings</h3><div>The tibiocalcaneonavicular ligament exhibited the highest in situ force during eversion in plantarflexion and during external rotation from neutral to plantarflexion. Under pronation, it also exhibited significantly greater force than the deep bundles. These findings remained consistent despite reversal of the transection sequence.</div></div><div><h3>Interpretation</h3><div>Load-sharing distribution among deltoid ligament bundles remained consistent despite reversal of the transection sequence, supporting the robustness of the findings. The tibiocalcaneonavicular ligament plays a major role in resisting eversion, external rotation in plantarflexion, and pronation under non-weight-bearing conditions.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"137 ","pages":"Article 106875"},"PeriodicalIF":1.4,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147996059","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":"Decoupling speed matters: Optimizing gait mechanics after anterior cruciate ligament reconstruction with Split-belt adaptation training of the healthy leg","authors":"Alfred J. Crone ,&nbsp;Alexa K. Johnson ,&nbsp;Reagan Recchia ,&nbsp;Abdulhamit Tayfur ,&nbsp;Edward M. Wojtys ,&nbsp;Chandramouli Krishnan ,&nbsp;Riann M. Palmieri-Smith ,&nbsp;ATC","doi":"10.1016/j.clinbiomech.2026.106872","DOIUrl":"10.1016/j.clinbiomech.2026.106872","url":null,"abstract":"<div><h3>Background</h3><div>Knee and limb underloading are common problems after anterior cruciate ligament (ACL) reconstruction associated with early-onset osteoarthritis. Split-belt treadmill training is a promising method to address knee/limb underloading, but the dose-response relationship and its efficacy to target underloading after reconstruction remain unknown. Here, we examined if split-belt treadmill training of the healthy limb (i.e., modifying belt speed under this limb) affects ACL knee/limb loading.</div></div><div><h3>Methods</h3><div>Twenty-five participants with ACL reconstruction (Age: 23.24 ± 6.48 yr, Height: 1.73 ± 0.08 m, Mass: 76.08 ± 13.72 kg, Postoperative Time: 8.04 ± 1.78 months) were evaluated utilizing an instrumented treadmill synced with a 12-camera motion capture system. Participants completed 5 min of baseline walking with belts tied at 1.1 m/s. Belt speed under the healthy limb was then manipulated with eight, randomized 5-min decoupled speed configurations (30–170% of 1.1 m/s in 20% increments) with 2 min of tied-belt walking after each speed. Sagittal plane knee moments, angles, and vertical ground reaction forces were measured, and one-dimensional statistical parametric mapping was used to compare dependent variables between legs and decoupling speeds during stance.</div></div><div><h3>Findings</h3><div>A dose-response relationship was found where faster speeds increased ACL knee/limb loads throughout stance and slower speeds decreased them. In the healthy limb, faster speeds led to increased early stance and decreased midstance loading, with the opposite effect at slower speeds.</div></div><div><h3>Interpretation</h3><div>Our findings suggest that split-belt treadmill training the healthy limb at faster speeds may improve ACL knee/limb loading, but further research is needed to obtain a clear understanding of how this transfers to overground walking.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"137 ","pages":"Article 106872"},"PeriodicalIF":1.4,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147995996","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":"Six-week biofeedback gait retraining programme for people with knee osteoarthritis: A randomised controlled trial","authors":"Yi Wan ,&nbsp;Polly McGuigan ,&nbsp;James Bilzon ,&nbsp;Logan Wade","doi":"10.1016/j.clinbiomech.2026.106776","DOIUrl":"10.1016/j.clinbiomech.2026.106776","url":null,"abstract":"<div><h3>Background</h3><div>Knee osteoarthritis causes pain, can limits mobility and is linked to excessive knee loading. Gait retraining with biofeedback shows promise in reducing knee loading and improving pain and function, but optimal feedback strategies remain unclear. This study compared the effects of different biofeedback-based gait retraining approaches on knee joint loading, pain and functional outcomes.</div></div><div><h3>Methods</h3><div>Fifty individuals with knee osteoarthritis were randomised to gait pattern feedback group, knee moment feedback group, or control group. Participants underwent a six-week programme, with activity knee pain, functional ability and biomechanical assessments conducted at baseline, post-intervention, and one-month follow-up. Data were analysed using linear mixed models under an intention-to-treat approach.</div></div><div><h3>Findings</h3><div>All groups improved in functional ability and activity knee pain post-intervention (<em>p</em> &lt; 0.001), with sustained benefits in the intervention groups (p &lt; 0.001). Only the gait pattern group showed a lasting reduction in the 1st peak knee adduction moment during (−7.6%, <em>p</em> = 0.003; maintained at follow-up). No significant change in foot progression angle was observed in any group. Step width increased during stair ascent and sit-to-stand (<em>p</em> ≤ 0.010) and step length decreased during walking (<em>p</em> = 0.021) for all groups, but both changes were transient.</div></div><div><h3>Interpretation</h3><div>Gait retraining improves pain and function in individuals with knee OA, but gait pattern feedback uniquely reduces joint loading during walking, supporting the importance of target-specific personalised gait modifications for long-term biomechanical benefit.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"134 ","pages":"Article 106776"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167913","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":"Soft tissue injuries induce lumbar instability and intervertebral disc degeneration: A mechanobiological study based on a rabbit model","authors":"Pengren Luo ,&nbsp;Jiawen Zhan ,&nbsp;Boyu Zhang ,&nbsp;Pingjin Xie ,&nbsp;Pengchao Zhen ,&nbsp;Zhefeng Jin ,&nbsp;Tao Han ,&nbsp;Liguo Zhu","doi":"10.1016/j.clinbiomech.2026.106773","DOIUrl":"10.1016/j.clinbiomech.2026.106773","url":null,"abstract":"<div><h3>Background</h3><div>Lumbar instability, often associated with intervertebral disc degeneration, is a key contributor to chronic low back pain. However, the mechanobiological interplay between soft tissue injury and the onset of spinal instability remains poorly elucidated.This study aimed to develop and characterize a rabbit model of lumbar instability based on endogenous (ligamentous) and exogenous (muscular) soft tissue injuries, and to investigate the biomechanical and biological progression of intervertebral disc degeneration over time.</div></div><div><h3>Methods</h3><div>Fifty-four New Zealand white rabbits were randomly assigned to three groups: endogenous ligament injury, exogenous muscle injury, and control. Multiple evaluation methods—including X-ray imaging, finite element analysis, creep and fatigue testing, histological staining, TUNEL apoptosis detection, and Western blotting for Aggrecan, Collagen II, and Caspase-3—were conducted at 0, 4, 8, 16, and 24 weeks post-modeling.</div></div><div><h3>Findings</h3><div>Both injury models led to progressive lumbar instability and intervertebral disc degeneration, evidenced by decreased disc elasticity, increased displacement under load, and structural deterioration in imaging and histology. FEA revealed altered stress distribution and increased mechanical burden over time. Aggrecan and Collagen II expression significantly declined, while Caspase-3 levels and TUNEL-positive apoptotic cells increased, especially in the exogenous group.</div></div><div><h3>Interpretation</h3><div>Muscle and ligament injuries are sufficient to induce lumbar instability and promote progressive disc degeneration through biomechanical failure and apoptosis. These findings underscore the importance of early mechanical and biological interventions targeting soft tissue integrity to prevent intervertebral disc degeneration and lumbar instability.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"134 ","pages":"Article 106773"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167928","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":"Restraining effect of the newly developed elastomeric knee brace for anterior cruciate ligament-deficient knees using anterior displacement model","authors":"Junpil Song ,&nbsp;Maki Koyanagi ,&nbsp;Satoshi Morishita ,&nbsp;Kouichi Mukai ,&nbsp;Yoshiatsu Ikegami ,&nbsp;Kai Hirata ,&nbsp;Kazuhiko Nakano","doi":"10.1016/j.clinbiomech.2026.106781","DOIUrl":"10.1016/j.clinbiomech.2026.106781","url":null,"abstract":"<div><h3>Background</h3><div>Knee braces are often prescribed for individuals with anterior cruciate ligament-deficient knees. Although rigid functional knee braces are limited to certain contact sports, soft knee braces can be used in almost all sports. However, few studies have investigated the restraining effect of soft knee braces. We developed an elastomeric knee brace with anatomical straps and no rigid hinges to improve its suitability for athletic use. This study aimed to investigate the restraining force of the elastomeric brace and compare it with that of functional and soft braces.</div></div><div><h3>Methods</h3><div>A custom-made anterior displacement knee model was used. The restraining force of the elastomeric, functional, and soft braces against 20 mm of anterior tibial displacement was measured in five sets of five repetitions using a tensile testing machine directly connected to the knee model.</div></div><div><h3>Findings</h3><div>The elastomeric knee brace demonstrated a higher restraining force at all displacements than the functional and soft knee braces, particularly in the initial phase (0–10 mm). The decrease in the restraining force over repeated trials was less pronounced at 5- and 10-mm displacements, indicating that the elastomeric knee brace maintained a more stable restraining force.</div></div><div><h3>Interpretation</h3><div>The developed elastomeric knee brace exerted a higher restraining force against anterior tibial displacement than the functional and soft knee braces, and this restraining effect was maintained even after repeated use.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"134 ","pages":"Article 106781"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146159120","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":"Predicting gait kinetics using 3-degrees of freedom acceleration data and artificial neural networks","authors":"Carina Gempfer ,&nbsp;Gilmar F. Santos ,&nbsp;Alexander Hobein ,&nbsp;Timo Kuhlgatz ,&nbsp;Christof Hurschler ,&nbsp;Eike Jakubowitz","doi":"10.1016/j.clinbiomech.2026.106775","DOIUrl":"10.1016/j.clinbiomech.2026.106775","url":null,"abstract":"<div><h3>Background</h3><div>Motion analysis plays an important role in clinical decision-making and biomechanical research. Conventional assessments rely on laboratory-based motion capture and force plates, which are accurate but resource-intensive. Wearable sensors combined with artificial neural networks offer a promising alternative for use outside the laboratory, but they must be validated against established systems. The aim of this study was to predict important kinetic gait parameters, such as ground reaction forces, knee joint moments and knee power, using wearable sensors and neural networks. Such an approach may support gait assessment in orthopaedic conditions and enable more responsive adjustment of exoprostheses.</div></div><div><h3>Methods</h3><div>Thirty-two healthy adults provided informed consent and were instrumented. Standard kinematic and kinetic data were captured using a conventional motion analysis setup, while linear accelerations were recorded synchronously using wearable sensors. These acceleration signals were used as inputs for two neural network models (long short-term memory and multilayer perceptron) to predict kinetic parameters.</div></div><div><h3>Findings</h3><div>Both models achieved good to very good agreement with the reference system. Pearson correlation coefficients ranged from 0.79 for the knee joint power to 0.99 for anteroposterior ground reaction force. The normalised root mean square errors between 3.1% and 10.3% further demonstrated promising predictive accuracy.</div></div><div><h3>Interpretation</h3><div>The findings indicate that wearable sensors combined with neural networks can estimate clinically relevant kinetic gait parameters with high accuracy outside a laboratory setting. In the future, such predictions may help standardize dynamic adjustments of exoprostheses, support the diagnosis of orthopaedic conditions and evaluate treatment outcomes.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"134 ","pages":"Article 106775"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146122563","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":"Upper and lower trunk accelerometer-based metrics during gait as predictors of physical function in older adults","authors":"Takahiro Oki ,&nbsp;Keiko Yamada ,&nbsp;Shigeru Nada ,&nbsp;Ryoki Nishimoto ,&nbsp;Sayaka Fujiwara ,&nbsp;Toru Ogata","doi":"10.1016/j.clinbiomech.2026.106774","DOIUrl":"10.1016/j.clinbiomech.2026.106774","url":null,"abstract":"<div><h3>Background</h3><div>Physical function and activities of daily living (ADLs) are key determinants of independence in older adults, with walking being an essential component of ADLs. Gait assessment using multiple sensors may enable early detection of functional decline and cause-specific intervention. We hypothesized that specific accelerometer-based gait metrics from both the upper and lower trunk sensors are associated with declining mobility in older adults.</div></div><div><h3>Methods</h3><div>Gait analysis was conducted in community-dwelling older adults with declining mobility using accelerometers attached to the upper and lower trunk. Physical function was evaluated using the five-repetition sit-to-stand test, single-leg standing time, three-meter Timed Up and Go test, preferred gait speed, and the locomotive syndrome risk test. Associations between physical performance and accelerometer-based metrics were examined using correlation, regression, and principal component analyses.</div></div><div><h3>Findings</h3><div>Gait speed correlated strongly with Root Mean Square (RMS)-vertical (VT) and with several performance metrics. Upper RMS-VT, upper improved Harmonic Ratio in the anteroposterior direction (iHR-AP), upper iHR-VT, lower iHR-AP, and the upper/lower trunk RMS ratio in the mediolateral direction ([U/L] RMS ratio-ML) associated with performance metrics. After adjustment for age, sex, and gait speed, upper and lower iHR-AP and upper iHR-VT remained associated (<em>p</em> &lt; 0.05). Principal component analysis indicated that principal component 1, which was correlated with gait speed, included RMS-VT, whereas iHRs belonged to a different component.</div></div><div><h3>Interpretation</h3><div>Accelerometer-based metrics obtained from both the upper and lower trunk reflect physical function and may serve as indicators of early gait impairment, as well as for future interventional studies.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"134 ","pages":"Article 106774"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183421","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}