The effect of constraining mediolateral ankle moments and foot placement on the use of the counter-rotation mechanism during walking

Bogaart, Maud van den; Bruijn, Sjoerd M.; Spildooren, Joke; Dieën, Jaap H. van; Meyns, Pieter

doi:10.1016/j.jbiomech.2022.111073

Cited by 13 publications

(15 citation statements)

References 23 publications

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“…Another training-effect was found for gait stability. We defined gait stability as a local divergence exponent, which has previously been shown to be able to distinguish fall-prone from healthy older adults (31). During the normal walking condition, gait stability consistently improved between sessions, and from week 3 onwards participants walked more stable as compared to the control week.…”

Section: Training Effectsmentioning

confidence: 99%

“…For example, increasing foot placement contribution allows for more CoM kinematic state variability during swing, and perhaps less use of an energetically costly ankle mechanism (31). And, for instance, an increased step-by-step foot placement contribution may also allow for less wider steps (32), again potentially decreasing energy cost (33). On the other hand, one could argue that stability training should be aimed at reducing CoM kinematic state variance, and this may be reflected by a lower absolute foot placement contribution instead (see Figure 13 panel C).…”

Section: Foot Placement Controlmentioning

confidence: 99%

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Mediolateral foot placement control can be trained: Older adults learn to walk more stable, when ankle moments are constrained

Mahaki

Leeuwen

Velde

et al. 2023

Preprint

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Falls are a problem, especially for older adults. Placing our feet accurately relative to the center-of-mass helps us to prevent falling during gait. The degree of foot placement control with respect to the center-of mass kinematic state is decreased in older as compared to young adults. Here, we attempted to train foot placement control in healthy older adults. Ten older adults trained by walking on shoes with a narrow ridge underneath (LesSchuh), restricting mediolateral center-of-pressure shifts. As a training effect, we expected improved foot placement control during normal walking. A training session consisted of a normal walking condition, followed by a training condition on LesSchuh and finally an after-effect condition. Participants performed six of such training sessions, spread across three weeks. As a control, before the first training session, we included two similar sessions, but on normal shoes only. We evaluated whether a training effect was observed across sessions and weeks in a repeated-measures design. Whilst walking with LesSchuh, the magnitude of foot placement error reduced half-a-millimeter between sessions within a week (cohen's d=0.394). As a training effect in normal walking, the magnitude of foot placement errors was significantly lower compared to the control week, by one millimeter in weeks 2 (cohen's d=0.686) and 3 (cohens'd=0.780) and by two millimeters in week 4 (cohen's d=0.875). Local dynamic stability of normal walking also improved significantly. More precise foot placement may thus have led to improved stability. It remains to be determined whether the training effects were the result of walking on LesSchuh or from repeated treadmill walking itself. Moreover, enhancement of mechanisms beyond the scope of our outcome measures may have improved stability. At the retention test, gait stability returned to similar levels as in the control week. Yet, a reduction in foot placement error persisted.

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Section: Training Effectsmentioning

confidence: 99%

Section: Foot Placement Controlmentioning

confidence: 99%

Mediolateral foot placement control can be trained: Older adults learn to walk more stable, when ankle moments are constrained

Mahaki

Leeuwen

Velde

et al. 2023

Preprint

View full text Add to dashboard Cite

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“…On the other hand, when standing on balance boards which could rotate in the mediolateral 43 , or antero-posterior direction 44 , the CoP mechanism was dominant, with contributions of angular momentum changes often in the opposite direction of the CoP mechanism. In a recent experiment, we tested whether subjects use angular momentum control in walking, when their other possibilities to stabilize gait are diminished 45 . Subjects walked on a treadmill in a control condition, a condition wearing shoes which restrict the use of the ankle mechanism, and in a condition in which they both wore these shoes and were instructed to walk with narrow steps.…”

Section: Angular Momentum Changesmentioning

confidence: 99%

Mechanisms that stabilize human walking

Leeuwen

Bruijn

Dieën

2022

BJMB

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In this paper we review what mechanisms are used to stabilize human bipedal gait. Based on mechanical reasoning, potential mechanisms to control the body center of mass trajectory are modulation of foot placement, stance leg control consisting of modulation of ankle moments and push-off forces, and modulations of the body’s angular momentum. The first two mechanisms and especially the first are dominant in controlling center of mass accelerations during gait, while angular momentum control plays a lesser role, but may be important to control body alignment and orientation. The same control mechanisms stabilize both steady-state and perturbed gait in both the mediolateral and antero-posterior directions. Control is at least in part active and is affected by proprioceptive, visual and vestibular information. Results support that this reflects a feedback process in which sensory information is used to obtain an estimate of the center of mass state based on which foot placement and ankle moments are modulated. These active feedback mechanisms suggest training approaches for populations at risk of falling, such as augmenting their effective use by means of augmented feedback, or using their complementary nature to train one mechanism by constraining the other mechanisms.

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“…We consider that the regression analysis will be most useful in providing insight into dynamic balance control variations among people, between different subject groups, and as a function of environmental conditions. For example, constraining changes in step width or the ability to generate ankle torque would be expected to result in increased contributions from mechanisms that were not constrained ( 33 , 73 ). The increased contributions would be represented by larger regression coefficient values that relate CoM motion to asymmetry measures for those measures that substituted for the constrained mechanisms.…”

Section: Discussionmentioning

confidence: 99%

Asymmetry measures for quantification of mechanisms contributing to dynamic stability during stepping-in-place gait

2023

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The goal of this study is to introduce and to motivate the use of new quantitative methods to improve our understanding of mechanisms that contribute to the control of dynamic balance during gait. Dynamic balance refers to the ability to maintain a continuous, oscillating center-of-mass (CoM) motion of the body during gait even though the CoM frequently moves outside of the base of support. We focus on dynamic balance control in the frontal plane or medial–lateral (ML) direction because it is known that active, neurally-mediated control mechanisms are necessary to maintain ML stability. Mechanisms that regulate foot placement on each step and that generate corrective ankle torque during the stance phase of gait are both known to contribute to the generation of corrective actions that contribute to ML stability. Less appreciated is the potential role played by adjustments in step timing when the duration of the stance and/or swing phases of gait can be shortened or lengthened to allow torque due to gravity to act on the body CoM over a shorter or longer time to generate corrective actions. We introduce and define four asymmetry measures that provide normalized indications of the contribution of these different mechanisms to gait stability. These measures are ‘step width asymmetry’, ‘ankle torque asymmetry’, ‘stance duration asymmetry’, and ‘swing duration asymmetry’. Asymmetry values are calculated by comparing corresponding biomechanical or temporal gait parameters from adjacent steps. A time of occurrence is assigned to each asymmetry value. An indication that a mechanism is contributing to ML control is obtained by comparing asymmetry values to the ML body motion (CoM angular position and velocity) at the time points associated with the asymmetry measures. Example results are demonstrated with measures obtained during a stepping-in-place (SiP) gait performed on a stance surface that either remained fixed and level or was pseudorandomly tilted to disturb balance in the ML direction. We also demonstrate that the variability of asymmetry measures obtained from 40 individuals during unperturbed, self-paced SiP were highly correlated with corresponding coefficient of variation measures that have previously been shown to be associated with poor balance and fall risk.

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The effect of constraining mediolateral ankle moments and foot placement on the use of the counter-rotation mechanism during walking

Cited by 13 publications

References 23 publications

Mediolateral foot placement control can be trained: Older adults learn to walk more stable, when ankle moments are constrained

Mediolateral foot placement control can be trained: Older adults learn to walk more stable, when ankle moments are constrained

Mechanisms that stabilize human walking

Asymmetry measures for quantification of mechanisms contributing to dynamic stability during stepping-in-place gait

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