Clinical Biomechanics最新文献

{"title":"Comparing participant recruitment methods in knee osteoarthritis: Implications for community recruitment and its effects on clinical and biomechanical outcomes","authors":"Carson Halliwell ,&nbsp;Aleksandra Budarick ,&nbsp;Janie Astephen Wilson ,&nbsp;Derek Rutherford ,&nbsp;Meaghan Hannigan ,&nbsp;Rebecca Moyer","doi":"10.1016/j.clinbiomech.2025.106740","DOIUrl":"10.1016/j.clinbiomech.2025.106740","url":null,"abstract":"<div><h3>Background</h3><div>Community-based recruitment may relieve clinician-dependant strategies for participant recruitment in gait analyses for clinical populations. However, it is unknown whether individuals recruited through community-based self-report methods exhibit similar patient-reported outcomes and gait biomechanics to those clinically diagnosed by a healthcare provider. This study aims to explore the differences between self-reported and clinically diagnosed knee osteoarthritis in terms of pain, function, quality of life, and gait biomechanics.</div></div><div><h3>Methods</h3><div>Participants with self-reported knee osteoarthritis (<em>n</em> = 16) were recruited based on activity-related knee pain, while those with clinically diagnosed knee osteoarthritis (n = 16) diagnosed based on the American College of Rheumatology guidelines by an orthopaedic surgeon. Both groups completed the Knee Injury and Osteoarthritis Outcome Score and Intermittent and Constant Osteoarthritis Pain questionnaires. Gait analysis was performed using three-dimensional motion capture, with sagittal plane knee angles, and knee flexion and adduction moments. Independent <em>t</em>-tests and statistical parametric mapping were used for group comparisons.</div></div><div><h3>Findings</h3><div>No differences were found between groups for patient-reported outcomes. Compared to individuals with clinically diagnosed knee osteoarthritis, individuals with self-reported knee osteoarthritis walked with reduced knee flexion angles and reduced peak knee flexion and adduction moments.</div></div><div><h3>Interpretation</h3><div>While patient-reported outcomes were not different, the biomechanical characteristics indicate that individuals recruited using community-based self-reported methodology may walk with gait patterns more closely resembling severe knee osteoarthritis. Although neither recruitment strategy is superior, these data support that employing a community-based self-report recruitment criterion may yield individuals who walk with gait patterns more closely resembling severe knee osteoarthritis compared to those clinically diagnosed.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106740"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145822017","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":"Postural adjustments during activities of daily living with an upper limb prosthesis","authors":"Mira E. Mutnick ,&nbsp;Susannah M. Engdahl ,&nbsp;Alec McKheen ,&nbsp;Christina Lee ,&nbsp;Deanna H. Gates","doi":"10.1016/j.clinbiomech.2025.106745","DOIUrl":"10.1016/j.clinbiomech.2025.106745","url":null,"abstract":"<div><h3>Background</h3><div>People with upper limb difference (ULD) using prostheses often use compensatory trunk movements to perform activities of daily living (ADL). Compensatory movements may provide additional challenges for the postural control system to maintain balance. However, no prior studies have quantified postural adjustments during ADLs in this population. The purpose of this study was to determine if upper limb prosthesis users make larger postural adjustments during ADLs compared to people without ULD.</div></div><div><h3>Methods</h3><div>Nine individuals with ULD and nine without ULD performed unimanual and bimanual ADLs. Participants with ULD wore their prescribed body-powered or myoelectric prostheses. For each ADL, postural adjustments derived from center of pressure (CoP) position were compared across limbs (control, prosthetic, and intact). The impact of additional factors including prosthetic type, etiology, and duration of prosthetic use was also explored.</div></div><div><h3>Findings</h3><div>When using only the prosthesis or using it asymmetrically to the intact limb, people with ULD had larger CoP motion than people without ULD (<em>p</em> &lt; 0.012). Exploratory comparisons found that during tasks that required grasping larger objects, body-powered prosthesis users and people with acquired amputation had larger CoP motion than myoelectric prosthesis users and people with congenital limb difference, respectively (g &gt; 0.642). When performing a bimanual symmetric task, people who had owned their prosthesis longer had less CoP motion (<em>p</em> = 0.032).</div></div><div><h3>Interpretation</h3><div>Overall, the study demonstrates that individuals with ULD make larger postural adjustments when performing ADLs that incorporate their prosthesis. The extent of these differences is affected by prosthesis type, limb difference etiology, and duration of prosthesis ownership.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106745"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884584","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":"Relationship between hip flexor tightness and low back pain in non-care-seeking individuals","authors":"Kira Eimiller ,&nbsp;Matthew Vraa ,&nbsp;Kemery Sigmund ,&nbsp;Matthew Zellmer","doi":"10.1016/j.clinbiomech.2025.106739","DOIUrl":"10.1016/j.clinbiomech.2025.106739","url":null,"abstract":"<div><h3>Background</h3><div>Low back pain (LBP) is a prevalent musculoskeletal condition with significant economic consequences (Wu et al., 2020). Despite evidence of functional limitations, non-care-seeking individuals with LBP remain an under-researched population (Vraa et al., 2022). Hip flexor tightness has been proposed as a potential contributor to LBP due to its role in altered biomechanics and compensatory lumbar movements (Kim &amp; Shin, 2020). Tight hip flexors are frequently assumed to contribute to LBP, yet the nature of the relationship is unclear. The objective of this study was to examine the relationship between hip flexor tightness and LBP severity in individuals with and without LBP who have not sought medical care.</div></div><div><h3>Methods</h3><div>A cross-sectional study of 118 adults (aged 20–61) assessed hip flexor range of motion (ROM) using the Modified Thomas Test and low back pain severity using the Modified Oswestry Disability Index. Between-group comparisons and generalized linear models examined the relationship between ROM, LBP presence, and disability.</div></div><div><h3>Findings</h3><div>LBP participants had significantly reduced ROM (4 ± 9° vs. 8 ± 9°, <em>p</em> = 0.003). However, in the adjusted generalized linear model, only BMI remained a significant predictor of hip flexor ROM (<em>p</em> = 0.011), while LBP status was not independently associated with hip flexor ROM (<em>p</em> = 0.180).</div></div><div><h3>Interpretation</h3><div>Reduced hip flexor ROM was observed in non-care-seeking individuals with LBP but was not independently predictive after adjustment. BMI was the only significant factor associated with hip flexor ROM, underscoring the multifactorial nature of LBP.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106739"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770006","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":"Detecting the pterygomaxillary disjunction using an instrumented hammer: A cadaveric study","authors":"Manon Bas dit Nugues ,&nbsp;Giuseppe Rosi ,&nbsp;Charles Henri Flouzat-Lachaniette ,&nbsp;Gaoussou Toure ,&nbsp;Guillaume Haiat","doi":"10.1016/j.clinbiomech.2025.106736","DOIUrl":"10.1016/j.clinbiomech.2025.106736","url":null,"abstract":"<div><h3>Background</h3><div>In many maxillofacial surgeries, the surgeon must perform a pterygomaxillary disjunction in order to separate the jaw from the skull. The disjunction is performed using an osteotome which is impacted with a hammer until its tip crosses through the pterygoid plates. To determine whether the disjunction has occurred and avoid complications, surgeons still rely on their proprioception.</div></div><div><h3>Methods</h3><div>The aim of this study is to validate a vibroacoustic set-up constituted by an instrumented hammer equipped with a force sensor, aiming at detecting if the disjunction has occurred. To do so, fourteen osteotomies were performed in anatomical subject jaws. For each impact, the force signal was recorded and analyzed. A classification algorithm (Support Vector Machine method coupled with a cost matrix) was developed based on indicators extracted from the signal to determine whether the disjunction had occurred. Impacts were classified into two classes, one before and the other after the osteotome had crossed the pterygoid plates. To avoid undetected disjunctions a cost matrix was added to the algorithm. The coefficients from the matrix were chosen using by minimizing the Negative Likelihood Ratio.</div></div><div><h3>Findings</h3><div>The algorithm was able to distinguish impacts before and after the disjunction with an accuracy of 96 %. Moreover, the instrumented hammer was able to detect the disjunction with a maximum delay of two impacts.</div></div><div><h3>Interpretation</h3><div>These results pave the way for the development of a per-operative decision support system for the pterygomaxillary disjunction.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106736"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783586","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":"Relation of vertical ground reaction forces while walking to contralateral structural worsening in adults with unilateral knee osteoarthritis: the Multicenter Osteoarthritis Study","authors":"Patrick Corrigan ,&nbsp;Cara L. Lewis ,&nbsp;Kerry E. Costello ,&nbsp;Deepak Kumar ,&nbsp;David T. Felson ,&nbsp;Tuhina Neogi ,&nbsp;Kathryn L. Bacon ,&nbsp;Michael P. LaValley ,&nbsp;Ali Guermazi ,&nbsp;Frank Roemer ,&nbsp;Michael C. Nevitt ,&nbsp;Cora E. Lewis ,&nbsp;James C. Torner ,&nbsp;Joshua J. Stefanik","doi":"10.1016/j.clinbiomech.2025.106718","DOIUrl":"10.1016/j.clinbiomech.2025.106718","url":null,"abstract":"<div><h3>Background</h3><div>It is unclear why knee osteoarthritis (KOA) progresses from a unilateral to bilateral joint disease. This study aimed to evaluate relations between vertical ground reaction forces (VGRFs) while walking and structural worsening in the unaffected limb of adults with unilateral KOA.</div></div><div><h3>Methods</h3><div>Discrete metrics were extracted from the unaffected limb VGRF signal while walking at a self-selected speed. Structural worsening of the unaffected knee was evaluated over 2 years with radiographs (primary) and MRIs (secondary). Logistic regression models evaluated associations between VGRF metrics and structural worsening outcomes, while adjusting for relevant covariates. Similar relations were evaluated in adults without OA in either knee to determine if VGRF metrics uniquely relate to contralateral structural worsening in adults with unilateral KOA.</div></div><div><h3>Findings</h3><div>In adults with unilateral KOA (<em>n</em> = 262), VGRFs were not associated with radiographic joint space narrowing within the tibiofemoral compartments of the unaffected knee. Additionally, VGRFs were not associated with MRI-detected cartilage loss in the medial tibiofemoral compartment. However, for the lateral tibiofemoral compartment, higher vertical loading and unloading rates were protective against cartilage loss (Odd ratios (OR) = 0.31–0.47), while larger vertical impulses and valley magnitudes were associated with increased odds of cartilage loss (OR = 2.50 and 2.26, respectively). No relations were found in adults without OA in either knee (<em>n</em> = 985).</div></div><div><h3>Interpretation</h3><div>VGRF metrics lack the ability to predict medial tibiofemoral structural worsening in knees without OA. However, vertical impulse and valley magnitude can assist with identifying contralateral knees at risk for lateral tibiofemoral cartilage loss in those with unilateral KOA.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106718"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685688","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 disc cement for lumbar locking interbody cementation: Finite-element mobility analysis and debris-removing reamer design","authors":"Kung-Chia Li ,&nbsp;Che-Wei Liu ,&nbsp;Yu-Kun Xu ,&nbsp;Chun-Ming Chen ,&nbsp;Shang-Chih Lin","doi":"10.1016/j.clinbiomech.2025.106708","DOIUrl":"10.1016/j.clinbiomech.2025.106708","url":null,"abstract":"<div><h3>Background</h3><div>Before locking interbody cementation, debris from the reamed disc should be thoroughly cleared to increase the cement volume and decrease its flow resistance to the vertebrae.</div></div><div><h3>Methods</h3><div>A finite element lumbosacral model was used to assess the biomechanical effects of five different disc cement sizes on disc mobility. A new reamer featuring staggered, barbed, and multilayered cutting edges, along with spiral and conical profiles, was designed and 3D-printed to enhance debris removal. Biomechanical and clinical tests were performed using synthetic and patient discs to compare the debris weights removed by the standard drill bit and the 3D-printed reamer.</div></div><div><h3>Findings</h3><div>Cement size significantly affected disc mobility beyond the impact of torsional factors alone. Larger cement volumes produced a more stable cage-cement foundation and reduced sagittal and coronal motions by approximately 23.8 % compared to the standard 5 mm-thick cement coverage. The average weight of synthetic disc debris removed was 926.28 ± 49.71 mg with the 3D-printed reamer versus only 63.04 ± 4.86 mg with the standard drill bit (p &lt; 0.01). When the drill bit was withdrawn, debris easily slipped from the spiral cutting edge. In contrast, drill bits failed to retain debris effectively, whereas the reamer’s staggered and barbed features consistently hooked and removed disc material.</div></div><div><h3>Interpretation</h3><div>Implanting a 5 mm cage requires removing approximately 6 ml of disc material. A larger cement fill provides a more stable cage-cement interface. The 3D-printed reamer’s staggered barbs removed debris more efficiently than traditional drill bits.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106708"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716672","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":"Importance of analyzing spasticity and co-activation as complementary biomarkers of gait in children with cerebral palsy","authors":"Gabriel Graffagnino ,&nbsp;Benoît Sijobert ,&nbsp;Karine Patte ,&nbsp;Christine Azevedo-Coste ,&nbsp;David Gasq","doi":"10.1016/j.clinbiomech.2025.106743","DOIUrl":"10.1016/j.clinbiomech.2025.106743","url":null,"abstract":"<div><h3>Background</h3><div>Cerebral palsy (CP) is a neurological disorder characterized by motor impairments, including muscle spasticity, weakness, and abnormal co-activation leading to gait abnormalities. Understanding the relationship between these factors is essential for optimizing rehabilitation strategies but remains unclear, particularly in terms of phase-specific neuromuscular adaptations during gait. This study investigated the correlations between muscle spasticity, strength, co-activation, and gait variable scores (GVS) in children with CP during clinical gait analysis. Two muscle pairs were analyzed: Gastrocnemius Medialis-Tibialis Anterior (GM-TA) and Rectus Femoris-Semitendinosus (RF-ST).</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 55 children with CP using surface electromyography and clinical scales (Modified Ashworth Scale for spasticity, Medical Research Council scale for strength). Co-activation was computed for stance and swing phases and compared to reference values from literature data about typically developing children. Correlations between variables were assessed using Spearman's coefficient and Chi-square tests evaluated categorical relationships between spasticity and abnormal co-activation.</div></div><div><h3>Findings</h3><div>No clear correlations between spasticity and co-activation were demonstrated, except for RF during swing (moderate correlation). GVS for ankle and hip flexion was moderately correlated with co-activation. Muscle strength negatively correlated with co-activation and deviations of joint angles relative to healthy gait.</div></div><div><h3>Interpretation</h3><div>These findings highlight partial correlations between clinical examination (i.e., spasticity and strength) and gait data (i.e., muscle co-activation and kinematic alterations), reinforcing the importance of assessing multiple biomarkers to better characterize gait abnormalities. Future rehabilitation protocols should comprehensively evaluate spasticity, muscle strength, co-activation, and GVS to better adapt interventions and optimize motor function in children with CP.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106743"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840883","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":"Ultrasound for the assessment of muscle architecture in Parkinson's disease: A scoping review","authors":"Mahyar Behraznia ,&nbsp;Massimiliano Ditroilo ,&nbsp;Tina Smith","doi":"10.1016/j.clinbiomech.2025.106733","DOIUrl":"10.1016/j.clinbiomech.2025.106733","url":null,"abstract":"<div><h3>Background</h3><div>Parkinson's disease (PD) affects motor function and muscle performance, which are closely linked to muscle architecture (MA). Ultrasound (US) provides a non-invasive method to assess MA, yet its application in PD remains underexplored. This review aimed to map and synthesise existing research on US assessment of MA in individuals with PD to clarify how US imaging methodologies contribute to understanding muscle structure and function in this population.</div></div><div><h3>Methods</h3><div>This scoping review was conducted following established guidelines and searching these databases: Scopus, PubMed, Web of Science Core Collection, MEDLINE and CINAHL Ultimate.</div></div><div><h3>Findings</h3><div>Of the 913 records identified, 20 studies met the inclusion criteria. Research varied in design, US measurement methodology, and measurement and reporting approaches. The synthesis revealed that while MA at rest was largely preserved in PD with notable exceptions, muscle fascicle responsiveness during contraction was significantly impaired, potentially due to rigidity. MA differences were associated with PD clinical manifestations (i.e., bradykinesia and rigidity) and reduced functional performance. PD-related comorbidities including sarcopenia, camptocormia, and dysphagia were found to further affect MA, exacerbating muscle degradation and remodelling. Exercise was found to alter the structural characteristics of MA, suggesting beneficial adaptive potential.</div></div><div><h3>Significance and interpretation</h3><div>Despite consistent evidence of altered MA and muscle responsiveness in PD, methodological heterogeneity and small samples limit firm conclusions. Standardised US protocols and longitudinal studies are needed to clarify the relationship between MA, functional performance, and PD clinical features, and to evaluate the effects of exercise and rehabilitation on muscle structure and strength.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106733"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840907","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":"Patellofemoral pain is associated with complex gait deviations captured by an artificial intelligence-derived gait index","authors":"Gabriel Jacob Navarro ,&nbsp;Tadeu Aldrovando Bryhy de Albuquerque ,&nbsp;Cid André Fidelis-de-Paula-Gomes ,&nbsp;Cintia Lopes Ferreira ,&nbsp;João Carlos Ferreira Correa ,&nbsp;Gabor Jószef Barton ,&nbsp;Paulo Roberto Garcia Lucareli","doi":"10.1016/j.clinbiomech.2025.106735","DOIUrl":"10.1016/j.clinbiomech.2025.106735","url":null,"abstract":"<div><h3>Background</h3><div>Patellofemoral pain (PFP) in active women is associated with gait adaptations. The Movement Deviation Profile (MDP) summarises deviations in multi-segment kinematic deviation, but it is unclear how the magnitude of deviation relates to pain. We investigated the relationship between MDP and pain intensity during walking.</div></div><div><h3>Methods</h3><div>In a retrospective, laboratory-based study, we analysed three-dimensional gait data from women with PFP (<em>n</em> = 571) alongside matched asymptomatic controls for reference modelling. Pain intensity was rated on a 0–10 visual analogue scale (VAS). Typical gait was defined from controls; Euclidean distances across 13 kinematic curves yielded the mean MDP (MDP_mean). We used linear regression, and the results remained consistent after controlling for the year of data collection and addressing heteroskedasticity in the standard errors.</div></div><div><h3>Findings</h3><div>In women with PFP, the mean MDP was 13.17° (95 % CI: 12.93°–13.41°), and the mean VAS was 6.03 (95 % CI: 5.91–6.15). Each 1-point increase in VAS corresponded to an approximately 1.99° increase in MDP_mean (R² = 0.92). This relationship remained consistent even after adjusting for the year (β = 1.98°; 95 % CI: 1.93–2.04; <em>p</em> &lt; 0.001), suggesting that changes over time did not influence the observed association.</div></div><div><h3>Interpretation</h3><div>In women with PFP, higher pain intensity is closely linked to more significant gait deviations, underlining the clinical importance of MDP as a quick measure of movement change. Although the retrospective nature prevents causal conclusions, the strength and consistency of the link indicate that pain level can serve as a useful marker for kinematic deviations during gait analysis.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106735"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758298","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":"Limitations of standard gait models for the precise and accurate evaluation of prosthetic knee joints regarding their functional quality, reliability, reproducibility and safety","authors":"Eva Pröbsting ,&nbsp;Michael Ernst ,&nbsp;Harald Böhm ,&nbsp;Thomas Schmalz ,&nbsp;Veit Schopper ,&nbsp;Barbara Pobatschnig ,&nbsp;Malte Bellmann","doi":"10.1016/j.clinbiomech.2025.106715","DOIUrl":"10.1016/j.clinbiomech.2025.106715","url":null,"abstract":"<div><h3>Background</h3><div>Accurate motion analysis of prosthetic knee joints is essential for optimizing component design, improving gait restoration, and evaluating clinical performance. Sagittal knee angles and moments are key biomechanical parameters for assessing joint function. This study determined these parameters using various gait models and validated the results against sensor data from the prosthetic knee, supporting more reliable gait analysis and potential improvements in patient outcomes.</div></div><div><h3>Methods</h3><div>Nineteen above-knee amputees walked at three self-selected speeds while gait was analyzed using optoelectronic cameras and force plates. Sagittal prosthetic knee moment and angle were calculated with four different models: Plug-in Gait, adapted Clinical Cleveland, 2D-model and a new 3D-model developed for analysis of transfemoral amputees. Simultaneously, prosthetic knee sensor angle and moment data were recorded.</div></div><div><h3>Findings</h3><div>The mean sagittal knee angle and moment waveforms from all models closely match the sensor data, reflected by low root mean square errors, with the new developed model showing the smallest values. The most precise (most often lowest reproducibility coefficient) sagittal knee angle and moment is shown with the new model. For the sagittal knee angle the highest accuracy (most often lowest mean deviation) is also determined with this model. For the knee moment, the new model, the 2D-model and Plug-in Gait equally frequently show the smallest mean deviation.</div></div><div><h3>Interpretation</h3><div>Relevant parameters of prosthetic knee joints can be determined using gait analysis, but not all models have the level of accuracy and precision required for evaluating prosthetic knee joints. The new model shows the most reliable data.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106715"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145665408","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}