Upper body and ankle strategies compensate for reduced lateral stability at very slow walking speeds.
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SUBMITTER: Best AN
PROVIDER: S-EPMC7657866 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundElastic ankle exoskeletons with intermediate stiffness springs in parallel with the human plantarflexors can reduce the metabolic cost of walking by ~?7% at 1.25?m?s-?1. In a move toward 'real-world' application, we examined whether the unpowered approach has metabolic benefit across a range of walking speeds, and if so, whether the optimal exoskeleton stiffness was speed dependent. We hypothesized that, for any walking speed, there would be an optimal ankle exoskeleton stiffness - not too compliant and not too stiff - that minimizes the user's metabolic cost. In addition, we expected the optimal stiffness to increase with walking speed.MethodsEleven participants walked on a level treadmill at 1.25, 1.50, and 1.75?m?s-?1 while we used a state-of-the-art exoskeleton emulator to apply bilateral ankle exoskeleton assistance at five controlled rotational stiffnesses (kexo?=?0, 50, 100, 150, 250?Nm?rad-?1). We measured metabolic cost, lower-limb joint mechanics, and EMG of muscles crossing the ankle, knee, and hip.ResultsMetabolic cost was significantly reduced at the lowest exoskeleton stiffness (50?Nm?rad-?1) for assisted walking at both 1.25 (4.2%; p?=?0.0162) and 1.75?m?s-?1 (4.7%; p?=?0.0045). At these speeds, the metabolically optimal exoskeleton stiffness provided peak assistive torques of ~?0.20?Nm?kg-?1 that resulted in reduced biological ankle moment of ~?12% and reduced soleus muscle activity of ~?10%. We found no stiffness that could reduce the metabolic cost of walking at 1.5?m?s-?1. Across all speeds, the non-weighted sum of soleus and tibialis anterior activation rate explained the change in metabolic rate due to exoskeleton assistance (p?<?0.05; R2?>?0.56).ConclusionsElastic ankle exoskeletons with low rotational stiffness reduce users' metabolic cost of walking at slow and fast but not intermediate walking speed. The relationship between the non-weighted sum of soleus and tibialis activation rate and metabolic cost (R2?>?0.56) indicates that muscle activation may drive metabolic demand. Future work using simulations and ultrasound imaging will get 'under the skin' and examine the interaction between exoskeleton stiffness and plantarflexor muscle dynamics to better inform stiffness selection in human-machine systems.
| S-EPMC7294672 | biostudies-literature
Project description:This paper presents the experimental validation of a novel control strategy that unifies the entire gait cycle of a powered knee-ankle prosthetic leg without the need to switch between controllers for different periods of gait. Current control methods divide the gait cycle into several sequential periods each with independent controllers, resulting in many patient-specific control parameters and switching rules that must be tuned for a specific walking speed. The single controller presented is speed-invariant with a minimal number of control parameters to be tuned. A single, periodic virtual constraint is derived that exactly characterizes the desired actuated joint motion as a function of a mechanical phase variable across walking cycles. A single sensor was used to compute a phase variable related to the residual thigh angle's phase plane, which was recently shown to robustly represent the phase of non-steady human gait. This phase variable allows the prosthesis to synchronize naturally with the human user for intuitive, biomimetic behavior. A custom powered knee-ankle prosthesis was designed and built to implement the control strategy and validate its performance. A human subject experiment was conducted across multiple walking speeds (1 to 3 miles/hour) in a continuous sequence with the single phase-based controller, demonstrating its adaptability to the user's intended speed.
| S-EPMC5381823 | biostudies-literature
Project description:Lower extremity powered exoskeletons (LEPE) are an emerging technology that assists people with lower-limb paralysis. LEPE for people with complete spinal cord injury walk at very slow speeds, below 0.5m/s. For the able-bodied population, very slow walking uses different neuromuscular, locomotor, postural, and dynamic balance control. Speed dependent kinetic and kinematic regression equations in the literature could be used for very slow walking LEPE trajectory scaling; however, kinematic and kinetic information at walking speeds below 0.5 m/s is lacking. Scaling LEPE trajectories using current reference equations may be inaccurate because these equations were produced from faster than real-world LEPE walking speeds. An improved understanding of how able-bodied people biomechanically adapt to very slow walking will provide LEPE developers with more accurate models to predict and scale LEPE gait trajectories. Full body motion capture data were collected from 30 healthy adults while walking on an instrumented self-paced treadmill, within a CAREN-Extended virtual reality environment. Kinematic and kinetic data were collected for 0.2 m/s-0.8 m/s, and self-selected walking speed. Thirty-three common sagittal kinematic and kinetic gait parameters were identified from motion capture data and inverse dynamics. Gait parameter relationships to walking speed, cadence, and stride length were determined with linear and quadratic (second and third order) regression. For parameters with a non-linear relationship with speed, cadence, or stride-length, linear regressions were used to determine if a consistent inflection occurred for faster and slower walking speeds. Group mean equations were applied to each participant's data to determine the best performing equations for calculating important peak sagittal kinematic and kinetic gait parameters. Quadratic models based on walking speed had the strongest correlations with sagittal kinematic and kinetic gait parameters, with kinetic parameters having the better results. The lack of a consistent inflection point indicated that the kinematic and kinetic gait strategies did not change at very slow gait speeds. This research showed stronger associations with speed and gait parameters then previous studies, and provided more accurate regression equations for gait parameters at very slow walking speeds that can be used for LEPE joint trajectory development.
| S-EPMC6141077 | biostudies-literature
Project description:Lateral premalleolar bursitis of the ankle is a rarely reported disorder in the English literature although it is not uncommon in Asian countries where people commonly sit on their feet. Here, we present the case of a 66-year-old woman with recalcitrant lateral premalleolar bursitis associated with lateral ankle instability which was successfully treated with surgical resection of the bursa and repair of the anterior talofibular ligament. Operative findings revealed a communication between the bursa and articular cavity of the ankle joint via the sheath of the extensor digitorum longus tendon, which was considered to act as a check valve leading to a large and recalcitrant bursitis. This report provides a novel concept about the etiology of recalcitrant lateral premalleolar bursitis of the ankle.
| S-EPMC5559932 | biostudies-other
Project description:A select 10-30% of patients with recurrent lateral ankle sprains develop chronic ankle instability (CAI). Patients with chronic ankle instability describe a history of the ankle "giving way" with or without pathological laxity on examination. Evaluation includes history, identification of predisposing risk factors for recurrent sprains, and the combination of clinical tests (eg, laxity tests) with imaging to establish the diagnosis. There are a variety of nonoperative strategies to address chronic ankle instability, which include rehabilitation and taping or bracing to prevent future sprains. Patients who fail conservative treatment are candidates for surgery. The anatomic approaches (eg, modified Broström) are preferred to nonanatomic procedures since they recreate the ankle's biomechanics and natural course of the attenuated ligaments. There is a growing interest in minimally invasive procedures via ankle arthroscopy that also address the associated intra-articular disorders. This article provides a review of chronic lateral ankle instability consisting of relevant anatomy, associated disorders, evaluation, treatment methods, and complications.Level of evidenceLevel V, expert opinion.
| S-EPMC8696766 | biostudies-literature
Project description:Ankle joint quasi-stiffness is an aggregate measure of the interaction between triceps surae muscle stiffness and Achilles tendon stiffness. This interaction may be altered due to age-related changes in the structural properties and functional behavior of the Achilles tendon and triceps surae muscles. The authors hypothesized that, due to a more compliant of Achilles' tendon, older adults would exhibit lower ankle joint quasi-stiffness than young adults during walking and during isolated contractions at matched triceps surae muscle activations. The authors also hypothesized that, independent of age, triceps surae muscle stiffness and ankle joint quasi-stiffness would increase with triceps surae muscle activation. The authors used conventional gait analysis in one experiment and, in another, electromyographic biofeedback and in vivo ultrasound imaging applied during isolated contractions. The authors found no difference in ankle joint quasi-stiffness between young and older adults during walking. Conversely, this study found that (1) young and older adults modulated ankle joint quasi-stiffness via activation-dependent changes in triceps surae muscle length-tension behavior and (2) at matched activation, older adults exhibited lower ankle joint quasi-stiffness than young adults. Despite age-related reductions during isolated contractions, ankle joint quasi-stiffness was maintained in older adults during walking, which may be governed via activation-mediated increases in muscle stiffness.
| S-EPMC8020011 | biostudies-literature
Project description:The muscles surrounding the ankle, knee and hip joints provide 42, 16 and 42%, respectively, of the total leg positive power required to walk on level ground at various speeds. However, each joint's contribution to leg work when walking up/downhill at a range of speeds is not known. Determining each biological joint's contribution to leg work over a range of speeds and slopes can inform the design of biomimetic assistive devices (i.e. prostheses). Twenty healthy adults walked 1.00, 1.25 and 1.50 m s-1 on 0°, ±3°, ±6° and ±9° while we collected kinematic and kinetic data. We calculated sagittal plane joint work and individual leg work over the entire stance phase. The ratio of ankle joint to total individual leg positive work (summed ankle, knee and hip joint work) did not change (0.42) with speed or slope, but the ratio of ankle joint to individual leg negative work was 0.38 at -9°, 0.42 at 0° and 0.27 at +9° across all speeds. The ratio of ankle joint to total individual leg negative work was 0.41 at 1.00 m s-1 and 0.32 at 1.50 m s-1 across all slopes. The ratio of knee joint to total individual positive leg work (0.22) did not change with speed or slope. The ratio of knee joint to total individual leg negative work was 0.39 at 1.00 m s-1 and 0.45 at 1.50 m s-1 across all slopes. The ratio of hip joint to total individual leg positive work did not change with speed but was 0.34 at -9°, 0.33 at 0° and 0.37 at +9° across all speeds. The ratio of hip joint to total individual leg negative work was 0.21 at 1.00 m s-1, and 0.24 at 1.50 m s-1 across all slopes and 0.17 at -9°, 0.19 at 0° and 0.29 at +9° across all speeds. The ankle significantly contributes to walking on slopes and this contribution changes during sloped compared with level-ground walking, thus assistive devices that provide biomimetic ankle function must adapt to accommodate walking at different speeds and slopes; whereas assistive biomimetic devices for the knee only need to adapt at different speeds.
| S-EPMC6124028 | biostudies-literature
Project description:Reducing the mechanical load on the human body through simulated reduced gravity can reveal important insight into locomotion biomechanics. The purpose of this study was to quantify the effects of simulated reduced gravity on muscle activation levels and lower limb biomechanics across a range of overground walking speeds. Our overall hypothesis was that muscle activation amplitudes would not decrease proportionally to gravity level. We recruited 12 participants (6 female, 6 male) to walk overground at 1.0, 0.76, 0.55, and 0.31 G for four speeds: 0.4, 0.8, 1.2, and 1.6 ms-1. We found that peak ground reaction forces, peak knee extension moment in early stance, peak hip flexion moment, and peak ankle extension moment all decreased substantially with reduced gravity. The peak knee extension moment at late stance/early swing did not change with gravity. The effect of gravity on muscle activity amplitude varied considerably with muscle and speed, often varying nonlinearly with gravity level. Quadriceps (rectus femoris, vastus lateralis, & vastus medialis) and medial gastrocnemius activity decreased in stance phase with reduced gravity. Soleus and lateral gastrocnemius activity had no statistical differences with gravity level. Tibialis anterior and biceps femoris increased with simulated reduced gravity in swing and stance phase, respectively. The uncoupled relationship between simulated gravity level and muscle activity have important implications for understanding biomechanical muscle functions during human walking and for the use of bodyweight support for gait rehabilitation after injury.
| S-EPMC8279339 | biostudies-literature
Project description:Ankle instability is a condition that often requires surgery to stabilize the ankle joint that will improve pain and function if nonoperative treatments fail. Ankle stabilization surgery may be performed as a repair in which the native existing anterior talofibular ligament or calcaneofibular ligament (or both) is imbricated or reattached. Alternatively, when native ankle ligaments are insufficient for repair, a reconstruction of the ligaments may be performed in which an autologous or allograft tendon is used to reconstruct the anterior talofibular ligament or calcaneofibular ligament (or both). Currently, ankle stabilization surgery is most commonly performed through an open incision, but arthroscopic ankle stabilization using repair techniques has been described and is being used more often. We present our technique for anatomic ankle arthroscopic reconstruction of the lateral ligaments (anti-ROLL) performed in an all-inside-out manner that is likely safe for patients and minimally invasive.
| S-EPMC4722511 | biostudies-literature
Project description:Very long-chain acyl-CoA dehydrogenase (VLCAD)-deficiency is the most common long-chain fatty acid oxidation disorder presenting with heterogeneous phenotypes. Similar to many patients with VLCADD, VLCAD-deficient mice (VLCAD(-/-)) remain asymptomatic over a long period of time. In order to identify the involved compensatory mechanisms, wild-type and VLCAD(-/-) mice were fed one year either with a normal diet or with a diet in which medium-chain triglycerides (MCT) replaced long-chain triglycerides, as approved intervention in VLCADD. The expression of the mitochondrial long-chain acyl-CoA dehydrogenase (LCAD) and medium-chain acyl-CoA dehydrogenase (MCAD) was quantified at mRNA and protein level in heart, liver and skeletal muscle. The oxidation capacity of the different tissues was measured by LC-MS/MS using acyl-CoA substrates with a chain length of 8 to 20 carbons. Moreover, in white skeletal muscle the role of glycolysis and concomitant muscle fibre adaptation was investigated. In one year old VLCAD(-/-) mice MCAD and LCAD play an important role in order to compensate deficiency of VLCAD especially in the heart and in the liver. However, the white gastrocnemius muscle develops alternative compensatory mechanism based on a different substrate selection and increased glucose oxidation. Finally, the application of an MCT diet over one year has no effects on LCAD or MCAD expression. MCT results in the VLCAD(-/-) mice only in a very modest improvement of medium-chain acyl-CoA oxidation capacity restricted to cardiac tissue. In conclusion, VLCAD(-/-) mice develop tissue-specific strategies to compensate deficiency of VLCAD either by induction of other mitochondrial acyl-CoA dehydrogenases or by enhancement of glucose oxidation. In the muscle, there is evidence of a muscle fibre type adaptation with a predominance of glycolytic muscle fibres. Dietary modification as represented by an MCT-diet does not improve these strategies long-term.
| S-EPMC3443214 | biostudies-literature