Gait & posture最新文献

{"title":"Shared roles of motor, sensory, and cognitive functions in challenging functional mobility tasks.","authors":"Ting-Ting Yeh, Yen-Kuang Lin, Hui-Ya Chen, Han-Yin Sun","doi":"10.1016/j.gaitpost.2025.109985","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2025.109985","url":null,"abstract":"<p><p>Age-related declines in motor (MF), cognitive (CF), and sensory functions (SF) can impact functional mobility. Understanding their interactive contributions across mobility tasks may inform effective interventions for older adults.</p><p><strong>Purpose: </strong>This study examined the distinct and shared contributions of MF, CF, and SF to functional mobility performance under basic and challenging conditions in older adults.</p><p><strong>Methods: </strong>A total of 141 community-dwelling older adults (age=76 ± 7 years) completed comprehensive assessments of MF, CF, and SF. Functional mobility was evaluated using single-task and dual-task Timed Up and Go (TUG) tests, and usual and fastest walking tests. Linear mixed-effects models and commonality analysis examined relationships between functions and mobility performance.</p><p><strong>Results: </strong>CF significantly influenced TUG performance, particularly under dual-task conditions (β=-2.21, p = 0.007, η²p = 0.07), while MF primarily affected walking speed, especially during fastest-speed trials (β=0.08, p = 0.009, η²p = 0.06). Shared contributions of CF and MF explained substantially more variance in dual-task TUG (31.22 %) and fastest walking (41.91 %) than their distinct contributions (5.56 % and 4.04 %, respectively). SF showed minimal impact on functional mobility tasks.</p><p><strong>Conclusion: </strong>In community-dwelling older adults, CF predominantly influences dual-task TUG performance, while MF appears to be the primary factor in fastest walking. The substantial shared contributions of CF and MF to challenging mobility tasks suggest that integrated interventions targeting both functions may be more effective for enhancing functional mobility than approaches focusing on individual domains.</p>","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":" ","pages":"109985"},"PeriodicalIF":2.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gait analysis on daily data using IMUs in smart phones, watch and earbuds.","authors":"Zhuoli Wang, Yuta Sugiura","doi":"10.1016/j.gaitpost.2025.09.003","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2025.09.003","url":null,"abstract":"<p><strong>Background: </strong>The use of inertial measurement unit (IMU) sensors for gait analysis has become more prevalent. More options are being offered under the development of wearable smart devices and smartphones. These techniques provide a cost-effective way to collect motion data from everyday activities, addressing the limitations of controlled laboratory environments. Despite the potential of these technologies, there are still many challenges in analyzing gait data from everyday life.</p><p><strong>Method: </strong>Experiments involved 16 participants (7 women, 9 men; mean age: 27.69 years) who performed walking, jogging, and going up and down stairs under three smartphone-carrying conditions: pocket, backpack, and shoulder bag. Data were collected using iPhone 14, Apple Watch Series 10, and AirPods Pro, supplemented with Xsens motion capture for ground truth. IMU data from accelerometers and gyroscopes were preprocessed and standardized before applying Principal Component Analysis (PCA). A novel sliding window-based algorithm was developed for gait segmentation and grouping, featuring a Continuity-Matching Score (CMS) for evaluating both continuity and match quality.</p><p><strong>Result: </strong>The proposed algorithm achieved an overall segmentation accuracy of 89.25%, with the highest performance (90.38%) observed when the smartphone was carried in a pocket. Rand Index values confirmed reliable gait grouping, with minor accuracy reductions under more dynamic carrying conditions, such as backpacks. For walk-only dataset, segmentation accuracy improved to 95.67%, while for run-only dataset, the accuracy reached 96.21%.</p><p><strong>Conclusion: </strong>This study introduced a system for daily-life gait analysis using consumer-grade IMU-equipped devices. The algorithm is capable of handling data containing multiple gait types, achieving reliable segmentation and grouping of synchronous gaits. Future work will focus on enhancing algorithm adaptability to dynamic environments and expanding its applicability to larger and more diverse datasets.</p>","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":" ","pages":"109969"},"PeriodicalIF":2.4,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can predictive and functional methods locate the dysplastic hip joint center?","authors":"Michael D Harris, Emma C Behrman, Keith R Lohse, Molly C Shepherd, Bruce A MacWilliams, Erin M Mannen","doi":"10.1016/j.gaitpost.2025.109982","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2025.109982","url":null,"abstract":"<p><strong>Background: </strong>Properly characterizing biomechanics in populations with known hip deformities, such as developmental dysplasia of the hip (DDH), requires accurately identifying the hip joint center (HJC). Many studies have assessed the accuracy or repeatability of predictive and functional methods to locate the HJC in normally shaped hips, but not for hips with DDH.</p><p><strong>Research question: </strong>For patients with DDH, which of three common functional and four common predictive HJC methods is most accurate compared to a magnetic-resonance-imaging-based anatomic method?</p><p><strong>Methods: </strong>HJC method accuracy was calculated as the resultant vector distance from the anatomic HJCs. Bias was calculated as distance errors along anatomical directions. Accuracy and bias were tested in patients with DDH (N = 30) and controls with normally shaped hips (N = 20) using each HJC method and two separate techniques for aligning the image-based and skin-marker-based pelvis segments.</p><p><strong>Results: </strong>Using each alignment technique, the predictive Harrington (pelvis-only) method was the most accurate (smallest resultant errors) in more patients with DDH than any other method. The Harrington (pelvis-only) method also had the lowest or nearly lowest bias in each direction. For controls, the Harrington (pelvis-only) method also had among the lowest errors but there was not a standout \"most accurate\" method.</p><p><strong>Significance: </strong>Although no method is perfect, in the absence of imaging data and an anatomic HJC, this study supports the predictive Harrington (pelvis-only) HJC as the most appropriate for dysplastic hips.</p>","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":" ","pages":"109982"},"PeriodicalIF":2.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower extremity kinetics and muscle activation patterns during gait in early postpartum women: 42-day and 3-month comparison with nulliparous controls.","authors":"Fengxian Wu, Zhenghong Wu, Wei Chen, Yiqing Yang, Yaming Liu, Yan Qi, Wenxin Niu","doi":"10.1016/j.gaitpost.2025.109981","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2025.109981","url":null,"abstract":"<p><strong>Background: </strong>Musculoskeletal problems are common during and after pregnancy. Biomechanical adaptations in postpartum females, particularly in pelvic stability and lower extremity mechanics, may contribute to long-term health issues. The postnatal period from 42-day to 3-month is a critical recovery window. This study aimed to compare early postpartum gait adaptations and muscle activation patterns between females at 42 days and 3 months postpartum and nulliparous females.</p><p><strong>Methods: </strong>Nine postpartum females were assessed at 42 days (PT1) and 3 months (PT2) postpartum for lower extremity kinematics, kinetics, and muscle activation during walking. A control group of nine nulliparous females was tested at a single time point. Lower extremity kinematics, moments, and work were calculated. Non-negative matrix factorization decomposed the sEMG data into muscle synergy patterns and activation time courses.</p><p><strong>Results: </strong>At PT1, postpartum participants showed increased pelvic obliquity, reduced knee extension moment and power, and increased ankle plantarflexion compared to controls. Muscle activation analysis revealed greater tibialis anterior activation in postpartum compared to controls. Rectus femoris activation was lower at PT1 than at PT2 during the stance phase, but higher at PT1 during the swing phase. By PT2, pelvic stability and muscle synergy patterns were similar to nulliparous controls.</p><p><strong>Conclusion: </strong>Early postpartum gait mechanics show increased pelvic obliquity and altered muscle activation, indicating neuromuscular instability and compensation. Partial neuromuscular recovery was observed by 3 months postpartum, highlighting the need for rehabilitation targeting pelvic stability and muscle coordination to prevent long-term dysfunction.</p>","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":" ","pages":"109981"},"PeriodicalIF":2.4,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of full-body immobilization on center of pressure complexity in open- and closed-eyes conditions.","authors":"Lucas Michaud, Christina Rosa, Léila Turgeon, Stéphane Babineau, Benoit Boudreau, Yves Lajoie","doi":"10.1016/j.gaitpost.2025.109980","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2025.109980","url":null,"abstract":"<p><strong>Background: </strong>Recent research has shown that center of pressure (COP) variability increases during full-body immobilization, suggesting that sway may be exploratory, with the central nervous system attempting to generate movement to gather sensory information. However, most studies have focused on COP magnitude, and its effect on COP complexity remains unclear.</p><p><strong>Research question: </strong>This study aimed to assess the effect of full-body immobilization in both open- and closed-eye conditions on COP behavior, with a certain focus on COP complexity.</p><p><strong>Method: </strong>Nineteen young adults participated in the study, performing four trials per eye condition using an apparatus that allowed for \"locked\" and \"unlocked\" body positioning. The COP variability, regularity, and frequency were analyzed.</p><p><strong>Results: </strong>Full-body immobilization increased COP variability for most participants in both open- and closed-eye conditions. It also increased COP regularity and shifted the signal toward lower frequencies, suggesting the presence of COP drifts. Additionally, intraclass correlation coefficients (ICC(2,k)) revealed fair to excellent reliability across most COP variables, supporting the use of multi-trials in immobilization studies.</p><p><strong>Significance: </strong>As previously observed, full-body immobilization increases COP variability, but it also alters its complexity, leading to what appears to be a \"drifting\" behavior. Since no effect of visual condition was found, the role of sensory input in this exploratory behavior remains unclear.</p>","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":" ","pages":"109980"},"PeriodicalIF":2.4,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical impact of gait analysis and pedography in treatment decision-making for idiopathic toe walking: A Cross-sectional study.","authors":"Tina Udemark Pasgaard, Morten Bøgelund Pedersen, Sidsel Hald Rahlf, Julie Ladeby Erichsen, Christian Faergemann, Bjarke Viberg, Anders Holsgaard-Larsen","doi":"10.1016/j.gaitpost.2025.109979","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2025.109979","url":null,"abstract":"<p><strong>Background: </strong>Diagnosing idiopathic toe walking (ITW) and assessing its severity based solely on clinical examinations can be challenging, underscoring the need for advanced, objective diagnostic tools to guide orthopedic treatment strategies.</p><p><strong>Aim: </strong>To test whether treatment strategies of children diagnosed with ITW based on clinical examination change when objective and quantitative data from three-dimensional gait analysis (3DGA) and pedography are incorporated.</p><p><strong>Methods: </strong>Children diagnosed with ITW and referred for orthopedic treatment based on clinical examination were included. Ankle and knee kinematics and kinetics were recorded in a single session using 3DGA, while heel contact time was assessed with pedography. Based on ankle joint angles and moments, participants were classified as having no-to-mild or moderate-to-severe ITW according to a predefined severity classification. Statistical parametric mapping (SPM) provided detailed analysis of deviations in kinematic and kinetic gait patterns. The area under the receiver operating curve (AUC) assessed heel contact time's discriminative ability.</p><p><strong>Results: </strong>Forty-seven children were included in the study. 3DGA classified 15 participants as having no-to-mild ITW and 32 as moderate-to-severe ITW. SPM analysis identified significant between-group differences in ankle kinematics and kinetics. Pedography demonstrated strong discriminative ability, with an AUC of 0.80.</p><p><strong>Conclusion: </strong>Adding 3DGA and pedography to clinical assessment altered treatment decisions, shifting 15 of 47 children from planned orthopaedic intervention to conservative management, and emphasised that factors other than gastrocnemius‑soleus muscle‑tendon unit tightness should be considered.</p>","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":" ","pages":"109979"},"PeriodicalIF":2.4,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impaired motor control during post-stroke walking: A systematic review and meta-analysis of muscle synergies across different phases of recovery.","authors":"Arne Defour, Nadia Dominici, Eva Swinnen, Dirk Cambier, Gitte Van Cleemput, Anke Van Bladel","doi":"10.1016/j.gaitpost.2025.109978","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2025.109978","url":null,"abstract":"<p><strong>Background: </strong>Stroke often impairs motor control during walking. Muscle synergy analysis provides insights into motor control by evaluating how muscle groups coordinate movement.</p><p><strong>Objective: </strong>This review has a threefold aim: (1) To compare the number of muscle synergies during walking between the paretic and non-paretic leg, as well as in perspective with healthy controls. (2) To examine eventual associations between these synergies and lower extremity motor impairment and self-selected walking speed. (3) To explore how synergy patterns differ between the sub-acute and chronic phase post-stroke.</p><p><strong>Method: </strong>MEDLINE, Embase, and Web of Science were systematically searched (until 11/04/2025) for studies using matrix factorization to extract muscle synergies during post-stroke walking. Meta-analyses were conducted using standardized mean differences (SMD) and associations with clinical measures were analyzed using correlations and Chi-square statistics.</p><p><strong>Results: </strong>Twenty-four studies (624 individuals post-stroke) were included. The paretic leg showed significant fewer synergies than the non-paretic leg (SMD: -0.73; p < 0.00001) and healthy controls (SMD: -1.04; p < 0.00001). Additionally, the non-paretic leg revealed a small but statistically significant reduction in synergies compared to healthy controls (SMD: -0.40; p = 0.02). The number of synergies in the paretic leg strongly correlated with lower extremity motor function (r = 0.827; p < 0.001). Fewer synergies were more prevalent in the sub-acute than chronic phase (χ² = 15.611; p < 0.001). Synergy composition showed increased co-activation and prolonged activation timing.</p><p><strong>Conclusion: </strong>Stroke leads to fewer and less distinct muscle synergies during walking in the paretic leg, especially in the sub-acute phase and in persons with severe lower extremity motor impairments.</p>","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":" ","pages":"109978"},"PeriodicalIF":2.4,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased backpack weight might lead to increased trunk stiffness during walking in primary school aged children: A pilot study.","authors":"Juliane Mueller, Julia Simmer, Stefan Schmid, Christoph Zinnen, Steffen Mueller","doi":"10.1016/j.gaitpost.2025.09.004","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2025.09.004","url":null,"abstract":"<p><strong>Background: </strong>Backpacks are essential in the daily lives of children. Carrying a heavy backpack affects trunk posture during standing. It remains unclear, whether this effect is also observed during gait.</p><p><strong>Research question: </strong>How do different backpack weights affect trunk kinematics during walking in children?</p><p><strong>Methods: </strong>Sixteen children stood and walked on a 5 m walkway with a custom load-carrying-system simulating unloaded and loaded backpacks (10 %;20 %;30 % of body mass (BM). A marker-based 3D motion analysis system captured whole-body kinematics (Rizzoli model). During walking, the primary outcomes were the maximum ranges of motion (RoM;[°]) of thoracic and lumbar trunk segmental angles in three planes. During standing, the average angles over 5 s were measured in three planes. Secondary measures included stride length, stride time, and velocity during walking. The children's own backpacks' weights were measured and expressed as a percentage of body mass. Statistical analysis was performed using repeated-measures ANOVA (α=0.05) and Tukey-Kramer post hoc test.</p><p><strong>Results: </strong>The average weight of the children's own backpack was 15.4 ± 7.4 %BM. For the experimental conditions, the average weights added to the load-carrying system were 3.3 ± 0.8 kg (10 %BM), 6.5 ± 1.7 kg (20 %BM), and 9.8 ± 2.5 kg (30 %BM). During standing, the average trunk flexion angles (sagittal plane) of the lumbar trunk segment significantly increased with increased backpack weight (p = 0.002). During walking, no changes in sagittal plane RoM but significant decreases in lumbar and thoracic transversal and frontal plane RoM (p < 0.001), stride length (p = 0.047) and velocity (p = 0.041) were observed with additional weight. No significant differences were observed for stride time between the conditions.</p><p><strong>Significance: </strong>Added backpack weight led to a more flexed trunk posture during standing and reduced transversal and frontal plane trunk movement, stride length, and gait velocity during walking. These adjustments likely compensate for the dorsally displaced center of mass and minimize energy expenditure by reducing trunk-backpack-angular momentum during walking.</p>","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":" ","pages":"109970"},"PeriodicalIF":2.4,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of somatosensory stimulation foot orthoses on balance and stability in older adults: A systematic review, meta-analysis, and meta-regression.","authors":"Abu Jor, Toshiki Kobayashi, Mohammad Jobair Khan, Shakawath Hosen Opu, Wing-Kai Lam, Stanley J Winser, Fan Gao, Ming Zhang","doi":"10.1016/j.gaitpost.2025.109974","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2025.109974","url":null,"abstract":"<p><strong>Background: </strong>Somatosensory stimulation foot orthoses (SSFO) are recommended to enhance postural balance by stimulating mechanoreceptors. However, the underlying mechanisms by which SSFO with varying protrusion designs influence postural balance remain unclear.</p><p><strong>Research question: </strong>How do SSFO affect postural balance in older adults, and what role do variations in protrusion design play in these effects?</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Web of Science, Scopus, CINAHL, and Cochrane Library from inception to December 2024. Eighteen studies with 27 SSFO conditions examining the effects on static and dynamic balance in older adults were included in the meta-analysis. Balance parameters reported in at least 10 SSFO conditions were further analyzed using meta-regression analysis.</p><p><strong>Results: </strong>Pooled analyses indicated that SSFO use reduced center of pressure (CoP) displacement during standing, particularly in studies evaluating immediate effects and using SSFO with specific design features. Meta-regression analysis revealed significant positive correlations between effect sizes for anteroposterior CoP range and SSFO with arch-support structures [Coeff: 0.45, 95 % CI (0.19, 0.72), p = 0.001] or site-specific protrusions [Coeff: 0.32, 95 % CI (0.09, 0.56), p = 0.008]. SSFO also significantly improved Timed Up and Go scores [MD= -1.15, 95 % CI (-1.82, -0.47), p < 0.001], while no significant changes were observed in gait or other functional mobility measures.</p><p><strong>Significance: </strong>These findings underscore the potential of customized SSFO designs to enhance mechanoreceptor stimulation and improve postural balance in older adults. While design-specific SSFO may support improvements in static balance for clinical applications, evidence of benefits on gait and broader functional mobility is still limited.</p><p><strong>Registration: </strong>(PROSPERO ID: CRD42024592630).</p>","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":" ","pages":"109974"},"PeriodicalIF":2.4,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3D gait analysis in patients treated for high-grade tibial plateau fractures (Schatzker VI) with closed reduction and external fixation with circular frames.","authors":"Apostolos Z Skouras, Georgios Papagiannis, Ioannis Zafeiris, Fotini Soucacos, Athanasios Triantafyllou, Charilaos Tsolakis, Dimitrios Koulalis, Panagiotis Koulouvaris","doi":"10.1016/j.gaitpost.2025.109976","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2025.109976","url":null,"abstract":"<p><strong>Background: </strong>Tibial plateau fractures (TPF) are complex injuries that may lead to long-term functional deficits despite surgical management. This study aims to evaluate gait biomechanics in patients with severe tibial plateau fractures (Schatzker VI) treated with circular external fixation METHODS: Eighteen patients (mean age 46.3 ± 12.9 years; 19.8 months median follow up) underwent a fully instrumented three-dimensional gait analysis (3DGA), isokinetic strength testing of knee extensors and flexors, and completed self-reported outcomes for quality of life (EQ-5D) and knee-specific function (KOOS). An age- and sex-matched control group (n = 36) served as reference.</p><p><strong>Results: </strong>While only subtle kinematic asymmetries were observed between the healthy and affected limbs, knee excursion in the operated limb was significantly reduced during stance (Δ = -2°, p = 0.039). Joints' kinematics showed overall mild deviations, with no major angular deficits except from the hip and ankle joints. In contrast, kinetic impairments were evident. Ankle plantarflexion moment was reduced by 13.6 % in the operated limb compared to controls (p < 0.001, d = 1.08), and forward propulsive ground reaction force (GRF) was 5.5 % body mass lower (p < 0.001, d = 1.30). The second vertical GRF peak was also significantly diminished (-11.4 % body mass, p < 0.001, d = 1.03). The healthy limb exhibited milder but consistent kinetic alterations. Isokinetic testing revealed significant strength asymmetries, especially reduced quadriceps torque in the operated limb. EQ-5D and KOOS scores were significantly below normative values, though only moderately associated with gait metrics.</p><p><strong>Conclusion: </strong>These findings highlight persistent kinetic impairments months after injury, emphasizing the need for comprehensive lower-limb evaluation and targeted rehabilitation programs that extent beyond the injured joint alone.</p>","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":" ","pages":"109976"},"PeriodicalIF":2.4,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}