Active foot placement control ensures stable gait: Effect of constraints on foot placement and ankle moments

Leeuwen, A.M. van; Dieën, Jaap H. van; Daffertshofer, Andreas; Bruijn, Sjoerd M.

doi:10.1371/journal.pone.0242215

Cited by 53 publications

(108 citation statements)

References 38 publications

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“…In previous work, we found that walking with constrained ankle moments, wearing a customized shoe (LesSchuh), decreased foot placement accuracy (van Leeuwen et al, 2020). The LesSchuh is a shoe on which it is almost impossible to use mediolateral ankle moment control, due to a narrow ridge attached to the shoe’s sole.…”

Section: Introductionmentioning

confidence: 99%

“…Previous work showed that foot placement can be predicted by the full body center of mass kinematic state during the preceding swing phase (Hurt et al, 2010; Mahaki et al, 2019; van Leeuwen et al, 2020; Wang and Srinivasan, 2014). The quality of foot placement control can thus be quantified as the predictability of foot placement based on center of mass kinematic state or proxies thereof.…”

Section: Introductionmentioning

confidence: 99%

“…Finally, we hypothesized that with time the after-effect would decrease (H4). In addition to changes in foot placement accuracy, we explored modulations in step width and stride frequency, as compensatory stabilizing mechanisms (van Leeuwen et al, 2020). In addition, to assess whether gait changes due to LesSchuh training affected gait stability, we calculated local divergence exponents (Bruijn et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

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Can foot placement during gait be trained? Adaptations in stability control when ankle moments are constrained

Hoogstad

Leeuwen

Dieën

et al. 2021

Preprint

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Accurate coordination of mediolateral foot placement, relative to the center of mass kinematic state, is one of the mechanisms which ensures mediolateral stability during human walking. Previously, we found that shoes constraining ankle moments decreased foot placement accuracy, presumably by impairing control over movement of the swing leg. As such, ankle moment constraints can be seen as a perturbation of foot placement. Direct mechanical perturbations of the swing leg trajectory can improve foot placement accuracy as an after-effect. Here, we asked whether constrained ankle moments could have a similar effect. If confirmed, this would offer a simple training tool for individuals with impaired foot placement control. Participants (n=19) walked in three conditions; normal (baseline, 10 minutes), while wearing shoes constraining ankle moments (training, 15 minutes), and normal again (after-effects, 10 minutes). Foot placement accuracy was calculated as the percentage of variance in foot placement that could be predicted based on the center of mass kinematic state in the preceding swing phase. When walking with constrained ankle moments, foot placement accuracy decreased initially compared to baseline, but it gradually improved over time. In the after-effect condition, foot placement accuracy was higher than during baseline, but this difference was not significant. When walking with constrained ankle moments, we observed increased step width, decreased stride time and reduced local dynamic stability. In conclusion, constraining ankle moment control deteriorates foot placement accuracy. A non-significant trend towards improved foot placement accuracy after prolonged exposure to constrained ankle moments, allows for speculation on a training potential.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Can foot placement during gait be trained? Adaptations in stability control when ankle moments are constrained

Hoogstad

Leeuwen

Dieën

et al. 2021

Preprint

Self Cite

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“…Both passive dynamics and active control are thought to be used by central nervous system to control gait stability [1,2]. Different stabilizing strategies such as ankle [3][4][5], foot placement [1,[5][6][7][8][9][10][11][12][13], hip [9,14,15] and push-off [14,16] strategies are used to control gait stability. To better understand the control of gait stability, external lateral stabilization devices have been used to manipulate medio-lateral stability [6,[17][18][19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

How does external lateral stabilization constrain normal gait, apart from improving medio-lateral gait stability?

et al. 2021

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Background: The effect of external lateral stabilization on medio-lateral gait stability has been investigated previously. However, existing lateral stabilization devices not only constrain lateral motions but also transverse and frontal pelvis rotations. This study aimed to investigate the effect of external lateral stabilization with and without constrained transverse pelvis rotation on mechanical and metabolic gait features. Methods: We undertook two experiments with 11 and 10 young adult subjects, respectively. Kinematic, kinetic and breath-by-breath oxygen consumption data were recorded during three walking conditions (normal walking (Normal), lateral stabilization with (Free) and without transverse pelvis rotation (Restricted)) and at three speeds (0.83, 1.25 and 1.66 m s −1 ) for each condition. In the second experiment, we reduced the weight of the frame, and allowed for longer habituation time to the stabilized conditions. Results: External lateral stabilization significantly reduced the amplitudes of the transverse and frontal pelvis rotations, in addition to medio-lateral, anterior–posterior, and vertical pelvis displacements, transverse thorax rotation, arm swing, step length and step width. The amplitudes of free vertical moment, anterior–posterior drift over a trial, and energy cost were not significantly influenced by external lateral stabilization. The removal of pelvic rotation restrictions by our experimental set-ups resulted in normal frontal pelvis rotation in Experiment 1 and significantly higher transverse pelvis rotation in Experiment 2, although transverse pelvis rotation still remained significantly less than in the Normal condition. Step length increased with the increased transverse pelvis rotation. Conclusion: Existing lateral stabilization set-ups not only constrain medio-lateral motions (i.e. medio-lateral pelvis displacement) but also constrain other movements such as transverse and frontal pelvis rotations, which leads to several other gait changes such as reduced transverse thorax rotation, and arm swing. Our new set-ups allowed for normal frontal pelvis rotation and more transverse pelvis rotation (yet less than normal). However, this did not result in more normal thorax rotation and arm swing. Hence, to provide medio-lateral support without constraining other gait variables, more elaborate set-ups are needed.

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“…Moving the base of support, a stepping response, is the only option to stabilize as is demonstrated with increases in walking speed [ 12 , 13 ]. Moreover, MOS variability reveals information about step-to-step variations in the control of foot placement [ 6 , 14 – 16 ]. Increased MOS variability may be reflective of increased frequency of adjustments and corrective responses of foot placements in response to the environment or task demands [ 6 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Margin of Stability May Be Larger and Less Variable during Treadmill Walking Versus Overground

et al. 2021

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Margin of stability (MOS) is considered a measure of mechanical gait stability. Due to broad application of treadmills in gait assessment experiments, we aimed to determine if walking on a treadmill vs. overground would affect MOS during three speed-matched conditions. Eight healthy young participants walked on a treadmill and overground at Slow, Preferred, and Fast speed-matched conditions. The mean and variability (standard deviation) of the MOS in anterior-posterior and mediolateral directions at heel contact were calculated. Anterior-posterior and mediolateral mean MOS values decreased with increased speed for both overground and treadmill; although mediolateral mean MOS was always wider on the treadmill compared to overground. Due to lack of optic flow and different proprioceptive inputs during treadmill walking, subjects may employ strategies to increase their lateral stability on treadmill compared to overground. Anterior-posterior MOS variability increased with speed overground, while it did not change on treadmill, which might be due to the fixed speed of treadmill. Whereas, lateral variability on both treadmill and overground was U-shaped. Walking at preferred speed was less variable (may be interpreted as more stable) laterally, compared to fast and slow speeds. Caution should be given when interpreting MOS between modes and speeds of walking. As sagittal plane walking is functionally unstable, this raises the consideration as to the meaningfulness of using MOS as a global measure of gait stability in this direction.

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Active foot placement control ensures stable gait: Effect of constraints on foot placement and ankle moments

Cited by 53 publications

References 38 publications

Can foot placement during gait be trained? Adaptations in stability control when ankle moments are constrained

Can foot placement during gait be trained? Adaptations in stability control when ankle moments are constrained

How does external lateral stabilization constrain normal gait, apart from improving medio-lateral gait stability?

Margin of Stability May Be Larger and Less Variable during Treadmill Walking Versus Overground

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