Clinical Biomechanics最新文献

{"title":"Degradable poly-lactic-co-glycolic acid and non-degradable polymer implants result in similar fracture healing at early timepoints","authors":"Anna N. Smith ,&nbsp;Kathryn S. Strand ,&nbsp;Trent J. Levy ,&nbsp;Joseph B. Ulsh ,&nbsp;Stephen Ching ,&nbsp;Edgardo J. Arroyo ,&nbsp;Robert L. Mauck ,&nbsp;Michael W. Hast","doi":"10.1016/j.clinbiomech.2025.106545","DOIUrl":"10.1016/j.clinbiomech.2025.106545","url":null,"abstract":"<div><h3>Background</h3><div>Although rigid interfragmentary fixation is required for fracture repair, overly stiff implants are known to cause stress shielding which ultimately inhibits healing. While gradual dynamization of the fracture site both accelerates and improves osteogenesis, this approach requires external fixators or secondary surgeries. This study leverages biodegradable implants as mechanisms of gradual, passive dynamization during fracture healing.</div></div><div><h3>Methods</h3><div>Using a rat femoral osteotomy model, additively manufactured poly-lactic-co-glycolic acid implants were compared to geometrically matched non-degradable biocompatible resin devices. Bone healing was assessed at 3 and 6 weeks via micro-computed tomography, histology, and mechanical testing. Implant degradation kinetics were assessed through testing of plates that were used in the rat model and with an unloaded in vitro degradation model.</div></div><div><h3>Findings</h3><div>Quantitative bone measures made with micro-computed tomography, histology, and mechanical testing of the healing femora revealed no differences between degradable and non-degradable implants at 3 or 6 weeks. Degradable implants caused significant increases in bone volume to total volume mean density (<em>p</em> &lt; 0.0001) and callus to cortical volume (<em>p</em> &lt; 0.05) ratios between 3 and 6 weeks. Poly-lactic-co-glycolic acid devices were significantly stiffer than resin at week 0, but the two groups were equivalent by week 6 due to in vivo degradation. In vivo ambulatory loading caused significant losses of degradable implant stiffness at both 3 (p &lt; 0.05) and 6 (<em>p</em> &lt; 0.01) weeks, but this was not observed in the unloaded in vitro model.</div></div><div><h3>Interpretation</h3><div>The results from this early timepoint study demonstrate the feasibility of passive, internal fracture dynamization driven by implant material mechanics.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"126 ","pages":"Article 106545"},"PeriodicalIF":1.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935362","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":"Biomechanical effects of cement neck and interspinous process device on locking lumbar interbody cementation","authors":"Shang-Chih Lin ,&nbsp;Yu-Kun Xu ,&nbsp;Che-Wei Liu ,&nbsp;Kung Chia Li","doi":"10.1016/j.clinbiomech.2025.106554","DOIUrl":"10.1016/j.clinbiomech.2025.106554","url":null,"abstract":"<div><h3>Background</h3><div>Locking lumbar interbody cementation is a surgical option in patients with osteoporosis and low mobility. It can quickly stabilize the spine construct and prevent cage subsidence. However, establishing a stable bridging neck cement between the vertebrae and disc is a key procedure.</div></div><div><h3>Methods</h3><div>The validated lumbosacral model analyzed the stress cracking risks for five cement neck diameters under flexion, extension, bending, and twisting. The key indices included disc mobility and neck stress. The biomechanical impact of the interspinous process device was evaluated in high-stress fracture-prone necks.</div></div><div><h3>Findings</h3><div>The neck diameter has a significant impact on neck stress, especially extension. The maximum neck stress with a 4-mm diameter was very close to the ultimate tensile strength (25.4 MPa) of cement, inducing a high risk of neck fracture. Generally, neck fractures have little effect on disc mobility during flexion, bending, and twisting. However, after the fracture, neck failure led to a 17.1 % increase in disc mobility during extension. If the neck diameter was less than 5 mm on intraoperative radiography, the interspinous process device effectively reduced neck stress by 51.1 % during extension and 31.7 % during bending.</div></div><div><h3>Interpretation</h3><div>To improve neck strength, the neck diameter should be increased to at least 5 mm during the surgery. If the strength is inadequate, an interspinous process device can be considered to further minimize the risk of fractures, particularly during extension and bending movements.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"126 ","pages":"Article 106554"},"PeriodicalIF":1.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935345","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":"A combined analysis of spinal mobility and gait spatiotemporal parameters in axial spondyloarthritis using wearable sensors","authors":"Gauthier Desmyttere ,&nbsp;Stéphane Ralandison ,&nbsp;Gilles Dusfour ,&nbsp;Lionel Moulis ,&nbsp;Maïlis Amico ,&nbsp;Marc Julia ,&nbsp;Yves-Marie Pers ,&nbsp;Christian Jorgensen","doi":"10.1016/j.clinbiomech.2025.106555","DOIUrl":"10.1016/j.clinbiomech.2025.106555","url":null,"abstract":"<div><h3>Background</h3><div>Axial spondyloarthritis is a chronic rheumatic disease which impacts spinal mobility and physical functions, including gait. However, current clinical assessments mostly rely on composite indices and questionnaires which involve a degree of subjectivity. This study aimed to assess the discriminant validity of wearable sensors for objective monitoring of axial spondyloarthritis in clinical practice.</div></div><div><h3>Methods</h3><div>Twenty participants with axial spondyloarthritis and 20 healthy controls were included. Spinal mobility alongside gait were assessed while data were collected using inertial measurement units. Data were compared between the two groups and classification performance was assessed by performing receiver-operating characteristic curve analysis. Finally, correlations between parameters measured through inertial measurement units and clinical measures were also evaluated.</div></div><div><h3>Findings</h3><div>The axial spondyloarthritis group showed significantly reduced trunk maximum angles in all planes and direction of motion. Gait was characterized by a reduction in cadence (<em>P</em> = 0.004) and speed (<em>P</em> = 0.015). The combination of gait cadence and trunk kinematics enhanced the classification performance (sensitivity = 95 % <em>vs.</em> 55 % with trunk sagittal range of motion alone). Trunk kinematic variables were correlated to mobility items of clinical measures while spatiotemporal gait parameters showed correlations with the disease activity and its functional impact in daily life.</div></div><div><h3>Interpretation</h3><div>The present study demonstrated the ability of inertial measurement units to effectively discriminate axial spondyloarthritis individuals, with an enhanced classification performance while combining trunk kinematics and gait spatiotemporal parameters. These findings highlight the potential of wearable sensors as valuable tools for assessment and follow-up in clinical practice.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"126 ","pages":"Article 106555"},"PeriodicalIF":1.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935344","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":"Females who have undergone anterior cruciate ligament reconstruction exhibit altered patellofemoral joint contact area and alignment","authors":"Thomas Demirjian ,&nbsp;Richard Souza ,&nbsp;George Salem ,&nbsp;John Crues III ,&nbsp;Christopher M. Powers","doi":"10.1016/j.clinbiomech.2025.106543","DOIUrl":"10.1016/j.clinbiomech.2025.106543","url":null,"abstract":"<div><h3>Background</h3><div>Lateral patella tilt and displacement have been reported to be associated with increased risk for early-onset osteoarthritis post ACL reconstruction. It is conceivable that altered patella alignment may expose these individuals to excessive joint stress owing to a reduction in contact area between the patella and trochlear surface of the femur. Therefore, our study objectives were: 1) to compare patellofemoral joint contact area and patellar alignment between females post-ACL reconstruction and healthy controls, and 2) to assess associations between measures of patellar alignment and contact area.</div></div><div><h3>Methods</h3><div>Forty females between the ages of 18–35 (20 post-ACL reconstruction, 20 matched controls) underwent MR imaging of the patellofemoral joint at 0°, 20°, 40°, and 60° of knee flexion under loaded conditions (35 % bodyweight). Patellofemoral joint contact area, lateral patella tilt and lateral patella displacement were compared between groups and knee flexion angles using repeated measures analysis of variance tests. Pearson correlations evaluated associations between patella alignment and contact area at each knee flexion angle.</div></div><div><h3>Findings</h3><div>Compared to the control group, females post ACL reconstruction exhibited significantly reduced contact area (differences ranging from 21.6 % to 29.1 %), and elevated lateral patella tilt (differences ranging from 3.7° to 4.9°). No differences in lateral patellar displacement were observed. Lateral patellar tilt was negatively correlated with contact area across all knee angles (r-values ranging from −0.32 to −0.66).</div></div><div><h3>Interpretation</h3><div>Reduced contact area highlights a potential mechanism by which patellar alignment may be contributory to early cartilage changes post ACL reconstruction.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"126 ","pages":"Article 106543"},"PeriodicalIF":1.4,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143917237","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":"Performance across the isokinetic velocity spectrum: Interpretation for individuals after anterior cruciate ligament reconstruction","authors":"A. Culiver ,&nbsp;B.L. Riemann ,&nbsp;D. Bennion ,&nbsp;E. Schlichting ,&nbsp;J. Perry ,&nbsp;C. Brunst ,&nbsp;L.C. Schmitt","doi":"10.1016/j.clinbiomech.2025.106544","DOIUrl":"10.1016/j.clinbiomech.2025.106544","url":null,"abstract":"<div><h3>Background</h3><div>Quadriceps strength recovery is a focal point of rehabilitation after anterior cruciate ligament reconstruction. Quadriceps function at slow, moderate and faster isokinetic speeds may prove useful to identify individuals with abnormal muscular force-velocity properties. This study's purpose was to investigate changes in quadriceps peak torque and total work across the isokinetic velocity spectrum and assess between the reconstructed limb, uninvolved limb and a control group limb.</div></div><div><h3>Methods</h3><div>20 participants after primary anterior cruciate ligament reconstruction and 20 control participants performed 5 repetitions of maximal effort knee extension and flexion at 20°/s, 60°/s, 120°/s, 240°/s, 400°/s. Data were averaged across the middle 3 repetitions at each isokinetic velocity and two-way repeated measures analysis of variance models were conducted to evaluate differences among the limbs. Post-hoc polynomial trend analyses and limb differences at each velocity were evaluated using Bonferroni adjusted contrasts.</div></div><div><h3>Findings</h3><div>The involved limb demonstrated lower peak torque and total work at all isokinetic velocities compared to the uninvolved and control limbs. There were no differences between the uninvolved limb and control group limb at any velocity. Trend analyses revealed the involved limb decreased at a significantly different rate across the isokinetic velocity spectrum, compared to the uninvolved and control limbs, for peak torque and total work.</div></div><div><h3>Interpretation</h3><div>Individuals 4 months after anterior cruciate ligament reconstruction demonstrate maximal and sustained quadriceps strength deficits compared to their uninvolved limb and control individuals. The convergence of peak torque and total work across the isokinetic velocity spectrum indicates that slower isokinetic velocities are more discriminative than faster isokinetic velocities for quadriceps testing.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"126 ","pages":"Article 106544"},"PeriodicalIF":1.4,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143922172","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":"Finite element analysis of primary stability in cementless tibial components with varying interference fits","authors":"Esther Sánchez ,&nbsp;Miriam R. Boot ,&nbsp;Christoph Schilling ,&nbsp;Thomas M. Grupp ,&nbsp;Alexander Giurea ,&nbsp;Nico Verdonschot ,&nbsp;Dennis Janssen","doi":"10.1016/j.clinbiomech.2025.106539","DOIUrl":"10.1016/j.clinbiomech.2025.106539","url":null,"abstract":"<div><h3>Background</h3><div>Cementless knee implants achieve initial fixation through an interference fit, where the tibial implant is press-fitted into an undersized bone cavity. The dimensions between the implant and bone cuts must be carefully balanced to achieve an optimal interference fit, ensuring good primary stability, which is crucial for long-term fixation and successful osseointegration. However, the ideal interference fit remains uncertain. Excessive interference fit may lead to bone plastic deformation, while insufficient fit can result in large micromotions, small movements at the bone-implant interface, that compromise stability. This study evaluates how interference fit affects bone plasticity and micromotions, and how different loading conditions influence primary stability using finite element analysis.</div></div><div><h3>Methods</h3><div>Finite element models, based on experimentally implanted components, simulated interference fits of 350 μm and 700 μm. Micromotions, gap dynamics, and bone deformation were assessed during gait and squat activities under both simplified and complex loading conditions.</div></div><div><h3>Findings</h3><div>Higher interference fits increased bone plastic deformation, limiting elastic energy accumulation, whereas lower interference fits exhibited a reduced effect. Micromotions and gaps were consistently larger in lower interference fit implants. Furthermore, simplified loading underestimated micromotions and gaps compared to the complex loading.</div></div><div><h3>Interpretation</h3><div>These findings help explain why higher interference fits provided limited improvements in primary stability during experimental tests, despite differing predictions from simulations. This study enhances our understanding of bone-implant interactions and suggests that increasing interference fit does not necessarily improve implant stability. It also highlights the importance of incorporating complex loading conditions for more accurate primary stability assessment.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"126 ","pages":"Article 106539"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143917231","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":"In vitro evaluation of acetabular host bone coverage and cemented cup stability in total hip arthroplasty","authors":"Yu Takeda ,&nbsp;Yuta Osaka ,&nbsp;Cameron P. Brown ,&nbsp;Shigeo Fukunishi ,&nbsp;Ross W. Crawford ,&nbsp;Toshiya Tachibana","doi":"10.1016/j.clinbiomech.2025.106541","DOIUrl":"10.1016/j.clinbiomech.2025.106541","url":null,"abstract":"<div><h3>Background</h3><div>The percentage of coverage by host bone required to achieve adequate initial cement cup fixation has not yet been determined. Therefore, in this study, we evaluated the relationship between the acetabular bone coverage and the initial cup fixation strength.</div></div><div><h3>Methods</h3><div>Three different defect models were used as minimum fixation models in this study along with two reconstructed models (a cup center-edge angles −10°, −5°, 0°, the bulk cement model, and the bulk bone model). Five each of models were prepared for testing. A cyclic loading test was performed to assess the initial stability of the cup based on the vertical displacement of the femoral head. All models were subjected to cyclic load testing for one million cycles.</div></div><div><h3>Findings</h3><div>Under cyclic loading conditions, vertical displacement of the femoral head gradually increased as the cup center-edge angle changed from 0° to −10°, with vertical displacement at the end of the test for each model being greatest at the cup center-edge angle of −10° and least at the cup center-edge angle 0°. A statistical significance was observed in all comparisons among the individual models. (<em>P</em> &lt; 0.05).</div></div><div><h3>Interpretation</h3><div>This study provides valuable insights into the significance of acetabular host bone coverage on the initial stability of cemented cups. It supports the clinical practice of aiming for host bone coverage with a cup center-edge angle &gt;0° to ensure long-term stability in case of primary total hip arthroplasty cases.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"126 ","pages":"Article 106541"},"PeriodicalIF":1.4,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902247","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":"Laser surface texturing for enhanced implant biocompatibility and osseointegration: A critical review of its effects on surface properties","authors":"Sertan Ozan ,&nbsp;Şefika Kasman ,&nbsp;I. Can Uçar ,&nbsp;Cuie Wen","doi":"10.1016/j.clinbiomech.2025.106540","DOIUrl":"10.1016/j.clinbiomech.2025.106540","url":null,"abstract":"<div><div>An implant's biocompatibility is an important factor in the success of the implantation procedure, along with osseointegration, which is crucial for osseointegrated implants (e.g. cementless total hip prosthesis) that require direct adherence of surrounding bone tissue to the implant surface. Osseointegration is affected by several factors, including surface features (e.g. micro-topography, surface chemistry, wettability, and roughness) which collectively influence implant stability, a key element of osseointegration. These factors are directly impacted by surface preparation methods, which play a critical role in enhancing osseointegration. Laser surface texturing is an effective surface-preparation technique that has become common in recent times. Laser surface texturing alters an implant's surface through thermal effects, including changes in micro-topography, chemical composition, roughness, and wettability. These changes in surface characteristics improve the lifetime and performance of the implant. Laser surface texturing can be used to manufacture implant surfaces with improved osteoblast adherence and activity while increasing antibacterial capacity. This paper reviews the process of laser surface texturing and analyzes its impacts on surface properties and biological performance. It appraises past studies and experimental findings on the potential of laser surface texturing in developing implant technology for improvement in clinical outcomes.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"126 ","pages":"Article 106540"},"PeriodicalIF":1.4,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912016","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":"Biomechanical analysis of upper limb of patients with Duchenne muscular dystrophy in chosen functional tasks: A multi-case study","authors":"Agnieszka Sobierajska-Rek ,&nbsp;Wiktoria Wojnicz ,&nbsp;Bartłomiej Zagrodny ,&nbsp;Michał Ludwicki ,&nbsp;Katarzyna Pytka ,&nbsp;Joanna Jabłońska-Brudło","doi":"10.1016/j.clinbiomech.2025.106542","DOIUrl":"10.1016/j.clinbiomech.2025.106542","url":null,"abstract":"<div><h3>Background</h3><div>The main symptom of Duchenne muscular dystrophy is progressive wasting of muscle tissue. Current research on motor measurements for these patients lacks assessments of the whole trajectories of the functional motions over time in clinical conditions. The main goal of this study was to compare the upper limb movement strategy of patients with Duchenne muscular dystrophy and a healthy Control by assessing the contributions of chosen joint angles and contributions of muscles activity in the functional motions of activities of daily living.</div></div><div><h3>Method</h3><div>A novel score of kinematic and electromyographic patterns is proposed, and results are assessed for a whole trajectory of tested upper limb for five patients and a healthy Control. Contributions of four joint angles and four surface muscle activities are assessed for two relations – kinematic control (a relation between muscle activity and displacement of the wrist) and dynamic control (a relation between muscle activity and displacement of the center of mass of the upper limb).</div></div><div><h3>Findings</h3><div>In vertical motions, higher mobility in the shoulder and elbow was observed in patients with lower Brooke scores. In motions involving horizontal movement of a weight, the contribution of the elbow and the trapezius were higher in all patients vs the Control.</div></div><div><h3>Interpretation</h3><div>The proposed method revealed significant differences in muscle activity and upper limb movement patterns in patients with Duchenne muscular dystrophy compared with a healthy Control. Results of the assessment of contributions in kinematic control and dynamic control show individual movement strategies of patients with Duchenne muscular dystrophy.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"126 ","pages":"Article 106542"},"PeriodicalIF":1.4,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143931662","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":"Effect of walking speed on gait parameters in individuals with myotonic dystrophy type 1","authors":"Barthélémy Hoerter ,&nbsp;Laurent Ballaz ,&nbsp;Yosra Cherni","doi":"10.1016/j.clinbiomech.2025.106538","DOIUrl":"10.1016/j.clinbiomech.2025.106538","url":null,"abstract":"<div><h3>Background</h3><div>Myotonic dystrophy type 1 is a prevalent inherited muscular dystrophy in adults, affecting distal muscles. This leads to significant gait deviations and reduced walking speed, impacting overall well-being and increasing fall risk. This study aimed to assess how walking speed affects gait kinematics in individuals with myotonic dystrophy type 1.</div></div><div><h3>Methods</h3><div>Eighteen individuals with myotonic dystrophy type 1 (4 women, age: 41.0 [35.5; 47.8] years, mass: 76.8 [67.1; 94.6] kg, height: 166.0 [156.7; 173.3] cm) participated in this study. Each participant walked barefoot along a 13-m walkway at comfortable and fast speeds. Spatiotemporal parameters and joint kinematics were assessed.</div></div><div><h3>Findings</h3><div>The step length (<em>p</em> &lt; 0.001), cycle speed (p &lt; 0.001), and cadence (p &lt; 0.001) increased significantly, leading to a higher walking speed. Moreover, the vertical excursion of the center of mass increased significantly (<em>p</em> = 0.015), while the mediolateral amplitude decreased (<em>p</em> = 0.001) at fast walking condition. In addition, significant kinematic changes included increased trunk tilt (<em>p</em> &lt; 0.001), greater anterior pelvic tilt (p &lt; 0.001), increased hip flexion at initial contact, and enhanced knee flexion during both stance and swing phases. Ankle dorsiflexion showed a trend towards increase during stance phase (<em>p</em> = 0.055) at fast walking condition.</div></div><div><h3>Interpretation</h3><div>Fast walking speed in individuals with myotonic dystrophy type 1 lead to significant gait changes. These changes reflect mechanisms to manage muscle weakness. The present study revealed significant changes in spatiotemporal parameters related to walking speed and highlighted kinematic changes in trunk, pelvis and lower limb joints. These findings enhance our understanding of gait mechanisms in this population.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"126 ","pages":"Article 106538"},"PeriodicalIF":1.4,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143917238","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}