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Sex differences in whole body gait kinematics at preferred speeds

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... When considering the sex-specific walking characteristics, it is thought that males and females walk differently and have distinct kinematic gait characteristics, of which the anthropometric differences between the sexes are accepted as one potential cause of the sex differences in walking characteristics [16,17]. Specifically, males have longer stride lengths and faster gait speeds at a self-selected walking speed due to their larger stature than females [16]. ...
... PCA-based variables were then determined to differentiate the sex differences in walking stability. As previously reported [16,17], males and females have distinct kinematic gait characteristics. Therefore, it was hypothesized that the differences between the sexes in walking stability would manifest in the specific PMs related to the specific gait patterns. ...
... As reported in traditional gait analysis [16], healthy young females have shorter stride lengths and slower gait speeds at a self-selected walking speed than healthy young males, possibly due to their shorter height. In addition, females exhibited more pelvic movement obliquity, arms swinging, torso rigidity, and attenuated accelerations from the pelvis to the head than males [17]. Contrary to conventional analysis, assessing the gait patterns from a whole-body segment movement revealed the main movement strategies linked to the stance and swing phases formed together to move the body forward [12,13]. ...
Article
Full-text available
Stability during walking is considered a crucial aspect of assessing gait ability. The current study aimed to assess walking stability by applying principal component analysis (PCA) to decompose three-dimensional (3D) whole-body kinematic data of 104 healthy young adults (21.9 ± 3.5 years, 54 females) derived from a depth-sensing camera into a set of movement components/synergies called “principal movements” (PMs), forming together to achieve the task goal. The effect of sex as the focus area was tested on three PCA-based variables computed for each PM: the relative explained variance (rVAR) as a measure of the composition of movement structures; the largest Lyapunov exponent (LyE) as a measure of variability; and the number of zero-crossings (N) as a measure of the tightness of neuromuscular control. The results show that the sex effects appear in the specific PMs. Specifically, in PM1, resembling the swing-phase movement, females have greater LyE (p = 0.013) and N (p = 0.017) values than males. Moreover, in PM3, representing the mid-stance-phase movement, females have smaller rVAR (p = 0.020) but greater N (p = 0.008) values than males. These empirical findings suggest that the inherent sex differences in walking stability should be considered in assessing and training locomotion.
... ,m M (q)} the marker positions calculated by means of the forward kinematics of the model according to (2.34). Provided the number of measured positions on the individual segments is sufficient with respect to the degrees of freedom of the connecting joints, the pose of the system can be estimated by solving the unconstrained optimization problem 36) where in this case the optimal configuration q * is found by minimizing the quadratic error between measured and calculated positions. ...
... Nonetheless, it was observed by some authors that women achieve their preferred gait speed with shorter steps and higher cadence even after compensation for body height [88,112,128], although two of these studies investigated older participants. Somewhat in contrast to these findings, younger women showed slightly longer stride lengths than their male counterparts when walking at self-selected speed in some publications [36,50]. In [225] shorter steps for older women compared to older men at both comfortable and fast walking speeds were observed, no matter if the data was normalized with respect to body size or not. ...
... Compared to men, women were reported to show greater pelvis obliquity, i.e. the rotation around the axis pointing forward, which was more significant with increasing age [240]. For women, amongst other things, greater hip range of motion, greater knee extension in stance phase, less knee extension before initial contact, greater knee abduction during stance phase, greater ankle joint range of motion and narrower step width compared to men are reported [36,47,51,52,126,240]. In [52] women produced greater hip internal rotation and adduction, which matches the greater overall pelvis movement in non-sagittal direction and might be partially explained by the greater hip width to femoral length ratio of women [36,83]. ...
Thesis
Full text available at: https://resolver.obvsg.at/urn:nbn:at:at-ubl:1-46055 ------------------------------------------------------------------------------------------------------------------------------------------------------------------- Over the last decades a continuous trend of the worldwide population growing older could be observed. Increasing life expectancy and falling birth rates are identified as the main factors driving this demographic change. The demand for motion assistance and rehabilitation of age-related movement disorders is growing accordingly, which also facilitates interest in robotic solutions. Two of such devices will be addressed in this thesis, a commercial robotic hippotherapy system and an exoskeleton for the human lower body, developed at the JKU Institute of Robotics. In connection with these robotic systems, several methods and approaches in the context of rehabilitation and motion assistance are introduced. A major topic thereby is the generation of artificial motion patterns based on motion capture data. Hippotherapy refers to horse riding in the context of rehabilitation. It is a medical treatment that has been successfully employed in various fields, e.g. for improving locomotion performance of patients with movement disorders. Robotic systems enable the application of hippotherapy in clinical environments. Additional benefits, amongst others, are the continuously adjustable speed and high repeatability. Fundamental for a therapy outcome equivalent to classical hippotherapy is that the horse motion reproduced by the robotic system is as realistic as possible. Based on an analytical and time-continuous motion description a method to reproduce the horseback movement during typical horse gaits is presented in this thesis. This method allows for motion synthesis with any desired time span and time resolution, generating realistic trajectories applicable to robotic systems for riding simulation in general and robotic hippotherapy in particular. An adjustable time scaling parameter enables the adaptation of the generated motion according to the physical abilities of the patient or the capabilities of the robotic system. Serving as testing platform, where novel control strategies and motion assistance approaches can be implemented in a low-level manner, an exoskeleton prototype was developed in the course of this thesis. In addition to the design and construction of the setup and the pre-requisite implementations facilitating communication and operability, robust recognition of the user's motion intention and accurate timing of the provided assistance are focused on. Two approaches addressing these issues, namely gait assistance by learning periodic motions, as well as classification of gait phases based on measured muscle activities, are introduced. Physiologically consistent motion patterns of healthy human gait are intended to serve as a sound scientific basis for the developed methods and simulations. To this end, a holistic approach to simultaneously identify the geometric parameters of a kinematic human lower limb model and the parameters defining a cyclic gait trajectory, based on three-dimensional motion capture marker positions, is introduced. The presented methodology is then utilized to analyze several datasets of measured gait trials. The influence of person-specific factors, like age or physique, onto the motion pattern is analyzed by applying the presented biomechanical model to gait data of different male and female participants walking at various speeds. Modeling the dependency of gait motions on the considered variables enables the generation of artificial joint angle trajectories according to a simulated person with defined body parameters walking at a prescribed speed. . The presented methods show promising experimental results, which are deemed valuable for future research projects focusing on technologies for rehabilitation or movement assistance.
... With respect to kinematic parameters, Bruening et al. (2015) have reported that females demonstrate greater parameter values including pelvic obliquity, transverse plane pelvis, torso rotation, arm swing, hip, and ankle as compared to men. In addition, the range of motion (ROM) of the pelvis in females is greater than that in males, and there is a significant gender difference (Chockalingam et al., 2012;Chumanov, Wall-Scheffler, & Heiderscheit, 2008;Ryu et al., 2006). ...
... Nonetheless, on statistical analysis, it has been shown that there are no significant gender-based differences in walking. Knee joint kinetics have also been studied and females exhibit smaller ROM values at the knee and a smaller knee flexion motion pattern when compared to males (Bruening et al., 2015;Decker et al., 2002;Lephart et al., 2002;Malinzak et al., 2001) during athletic tasks. The evaluation of muscle activation patterns using electromyography (EMG) suggests that females demonstrate higher tibialis anterior muscle activity than males during normal walking (Chiu & Wang, 2007). ...
... Several studies have addressed the gender-based differences in ROM of the knee joint during walking. Bruening et al. (2015) found that the angles in ROM of the knee were 67.2 and 68.1 degrees in females and males, respectively. Furthermore, Cho et al. (2004) found that females have less landing impact on the ground at the heel-strike and less contraction of the knee joint. ...
Article
This study aims to propose a novel approach for gender recognition using best feature subset based on recursive feature elimination (RFE) in normal walking. This study has focused on the analysis of gait characteristics by distinguishing the gait phases as initial contact (IC), Mid-stance (MS), Pre-swing, and swing (SW), and collected the large number of gait to improve the reliability of quantitative assessment of natural variability associated with muscle activity during free walking. The gait system was designed using pressure and a tri-axis accelerometer sensor, and a 9-channel electromyography sensor for measuring the data. Gender recognition method was proposed using support vector machine (SVM) and random forest (RF) based on RFE to determine best feature subset. Statistical results show that effects of gender-based differences on gait characteristic including temporal, kinematics, and muscle activity were investigated. The temporal parameters of stride time and gait cycle (%) in the gait phases of IC, MS, and SW were significantly different between females and males (p<0.01). The females exhibited both a lower angle and a root mean square acceleration of the knee joint as compared to the males, and there was a clear gender-based difference with respect to knee angle movement. In addition, most muscle activation measurements in the females were larger than those of the males with respect to the gait phases. Gender classification result shows that SVM-RFE was 99.11% (SVM classifier) and RF-RFE was 98.89% (SVM and RF classifier), having powerful performance.
... Gait characteristics are also influenced by demographic factors, such as sex (Bailey et al., 2018;Bruening, Frimenko, Goodyear, Bowden, & Fullenkamp, 2015;Di Nardo, Mengarelli, Maranesi, Burattini, & Fioretti, 2015). When walking at a self-selected pace, females demonstrate greater range of motion through the torso, pelvis, hips and ankle with more complex muscle recruitment patterns, indicated by greater electromyographic signal variability and a higher number of times a muscle becomes active during the gait cycle, compared to males (Bailey et al., 2018;Bruening et al., 2015;Di Nardo et al., 2015). ...
... Gait characteristics are also influenced by demographic factors, such as sex (Bailey et al., 2018;Bruening, Frimenko, Goodyear, Bowden, & Fullenkamp, 2015;Di Nardo, Mengarelli, Maranesi, Burattini, & Fioretti, 2015). When walking at a self-selected pace, females demonstrate greater range of motion through the torso, pelvis, hips and ankle with more complex muscle recruitment patterns, indicated by greater electromyographic signal variability and a higher number of times a muscle becomes active during the gait cycle, compared to males (Bailey et al., 2018;Bruening et al., 2015;Di Nardo et al., 2015). These sex-specific differences in joint kinematics and muscle activity contribute to sex differences in gait mechanics, such as shorter stride length and higher cadence in females (Bruening et al., 2015). ...
... When walking at a self-selected pace, females demonstrate greater range of motion through the torso, pelvis, hips and ankle with more complex muscle recruitment patterns, indicated by greater electromyographic signal variability and a higher number of times a muscle becomes active during the gait cycle, compared to males (Bailey et al., 2018;Bruening et al., 2015;Di Nardo et al., 2015). These sex-specific differences in joint kinematics and muscle activity contribute to sex differences in gait mechanics, such as shorter stride length and higher cadence in females (Bruening et al., 2015). However, there is a paucity of data on sex-specific differences in spatiotemporal gait variability in young, healthy adults. ...
Article
Conditions requiring greater attention or cognitive control, such as fatigue, lead to changes in the motor performance of a task. Perceived fatigue refers to subjective feelings of fatigue, can be expressed as a state variable or trait characteristic and is influenced by demographic factors, such as sex. The purpose of this study was to determine how sex interacts with state and trait physical fatigue (PF) and mental fatigue (MF) to influence gait variability. Methods: 123 healthy adults (77 female, 46 male), aged 18-36 years, completed the Mental and Physical State and Trait Energy and Fatigue Scale. Using a median split for each fatigue variable, participants were placed into "low" or "high" fatigue categories. Gait variability was defined as the asymmetry of lateral step variability (ALSV) and coefficient of variation (CV) of gait speed, stride length and double limb (DL) support during overground walking. Results: Males with low state PF had greater ALSV than females with low state PF (p = 0.05, η2p = 0.07) and males with high state PF (p = 0.007, η2p = 0.15). Females with high trait MF had greater CV of gait speed than females with low trait mental fatigue (p = 0.02, η2p = 0.08). Males with low trait MF had greater CV of gait speed (p = 0.01, η2p = 0.10) and stride length (p = 0.002, η2p = 0.17) than females with low trait MF. CV of DL support did not vary based on fatigue level or sex (p ≥ 0.11). Conclusions: There are sex-specific differences in the impact of state PF on asymmetry of lateral step variability and trait MF on the variability of gait speed and stride length.
... Males had longer step lengths and greater knee flexion than females at both walking speeds (Table 3, Fig. 1). Spatiotemporal measures, peak vertical ground reaction forces, and peak joint angles in the current study are similar to previously reported gait measures, although racial demographics of these previous studies are unknown (Dubbeldam et al., 2010;Espy et al., 2010;Giarmatzis et al., 2015;Hak et al., 2013;Kwon et al., 2015;McAndrew Young and Dingwell, 2012;Murray, 1967 (Bruening et al., 2015;Frimenko et al., 2014;D. Casey Kerrigan et al., 1998a). ...
... Casey Kerrigan et al., 1998a). Females walk with faster cadence than males (Bruening et al., 2015;Frimenko et al., 2014;D. Casey Kerrigan et al., 1998a), which explains the shorter step lengths compared to males observed in the current study. ...
... Casey Kerrigan et al., 1998a), which explains the shorter step lengths compared to males observed in the current study. Additionally, larger peak knee flexion and ankle plantarflexion angles have been previously reported in females while walking at self-selected speeds (Bruening et al., 2015;D. Casey Kerrigan et al., 1998a). ...
... There is an increasing recognition of the need to consider sex-specific analyses in biomedical and clinical research, and there is evidence for sex differences in gait kinematics and kinetics [14,[16][17][18][19]. Past investigations of sex differences in gait have focused on a relatively small age range, leaving it unclear if the differences are consistent across the adult lifespan. ...
... As summarized in Fig. 3, our results showed that differences were not isolated to a single plane of motion, or to a single joint, with most differences in stance phase. Some of our results were consistent with previous studies, including the finding that females have increased internal rotation at the hip from initial foot contact through to the loading response [18], as well as smaller ankle flexion moments throughout most of stance [19]. However, discrepancies between our results and those of previous studies were also revealed. ...
... We report that females walk with smaller hip and ankle angles as well as a reduced range of hip and knee moments in the sagittal plane, suggesting more stiffness (in a clinical sense) in female sagittal plane mechanics compared to males. Similar to previous reports [14,[16][17][18], we did not find significant differences in self-selected gait speeds between females and males and thus, these differences in sagittal plane mechanics cannot be attributed to slower walking velocity. However, as reported in previous literature, females trended towards shorter stride lengths (p = 0.02) suggesting they may walk with higher stride frequencies to maintain similar gait speeds to their male counterparts. ...
Article
Background A comprehensive understanding of healthy gait patterns is a critical first step towards understanding age-related pathologies and disorders that are commonly associated with mobility limitations throughout aging. Further, consideration of sex-specific gait patterns throughout the lifespan is important, considering biological differences between males and females that can manifest biomechanically, and epidemiological evidence of female sex being a risk factor for some age-related pathologies such as osteoarthritis. Research question The aim of this study was to characterize the differences in lower extremity joint kinematics and kinetics during gait between asymptomatic adult women and men in different age groups (20-40 years, 41-50 years, 51-59 years, 60+ years). Methods This was a secondary analysis conducted on instrumented gait data from 154 asymptomatic adult participants (94 females, 60 males). Three-dimensional hip, knee and ankle joint angles and net external moments were calculated and waveform principal component analysis (PCA) was applied to extract major patterns of variability from each. PC scores were examined for significant sex, age and interaction effects using a two-factor ANOVA analysis (p = 0.001). Results 13 PC features differed between asymptomatic male and female gait patterns, and were independent of age category. No PC features significantly differed between the age groups, and there were no significant sex by age interactions. Significance There are significant magnitude and pattern differences in hip, knee and ankle kinematics and kinetics between asymptomatic women and men. As study participants were asymptomatic, these differences do not necessarily correlate with any injury or disease mechanisms. However, these results do suggest the importance of considering sex-specific analyses in gait study design, and the use of sex-specific normative data in clinical gait studies. These results further suggest that consideration of strict age-matching for gait analysis studies using adult controls is not as critical as sex considerations.
... Males had longer step lengths and greater knee flexion than females at both walking speeds (Table 3, Fig. 1). Spatiotemporal measures, peak vertical ground reaction forces, and peak joint angles in the current study are similar to previously reported gait measures, although racial demographics of these previous studies are unknown (Dubbeldam et al., 2010;Espy et al., 2010;Giarmatzis et al., 2015;Hak et al., 2013;Kwon et al., 2015;McAndrew Young and Dingwell, 2012;Murray, 1967 (Bruening et al., 2015;Frimenko et al., 2014;D. Casey Kerrigan et al., 1998a). ...
... Casey Kerrigan et al., 1998a). Females walk with faster cadence than males (Bruening et al., 2015;Frimenko et al., 2014;D. Casey Kerrigan et al., 1998a), which explains the shorter step lengths compared to males observed in the current study. ...
... Casey Kerrigan et al., 1998a), which explains the shorter step lengths compared to males observed in the current study. Additionally, larger peak knee flexion and ankle plantarflexion angles have been previously reported in females while walking at self-selected speeds (Bruening et al., 2015;D. Casey Kerrigan et al., 1998a). ...
Article
The effect of race has rarely been investigated in biomechanics studies despite racial health disparities in the incidence of musculoskeletal injuries and disease, hindering both treatment and assessment of rehabilitation. The purpose of this study was to test the hypothesis that racial differences in gait mechanics exist between African Americans (AA) and white Americans (WA). Ninety-two participants (18–30 years old) were recruited with equal numbers in each racial group and sex. Self-selected walking speed was measured for each participant. 3D motion capture and force plate data were recorded during 7 walking trials at regular and fast set speeds. Step length, step width, peak vertical ground reaction force, peak hip extension, peak knee flexion, and peak ankle plantarflexion were computed for all trials at both set speeds. Multivariate and post-hoc univariate ANOVA models were fit to determine main and interaction effects of sex and race (SPSS V26, α = 0.05). Self-selected walking speed was slower in AA (p = 0.004, ƞp² = 0.088). No significant interactions between race and sex were identified. Males took longer steps (regular: p < 0.001, ƞp² = 0.288, fast: p < 0.001, ƞp² = 0.193) and had larger peak knee flexion (regular: p = 0.007, ƞp² = 0.081, fast: p < 0.001, ƞp² = 0.188) and ankle plantarflexion angles (regular: p = 0.050, ƞp² = 0.044, fast: p = 0.049, ƞp² = 0.044). Peak ankle plantarflexion angle (regular: p = 0.012, ƞp² = 0.071, fast: p < 0.001, ƞp² = 0.137) and peak hip extension angle during fast walking (p = 0.007, ƞp² = 0.083) were smaller in AA. Equivalency in gait measures between racial groups should not be assumed. Racially diverse study samples should be prioritized in the development of future research and individualized treatment protocols.
... Regarding general sex differences of the spine results of different measuring approaches and varying angle definitions do not converge to a consistent picture for alignment (Schr€ oder et al. 2011;Endo et al. 2012;Hamm 2016;Kinel et al. 2018), as well as motion in stance (Dvorak et al. 1995;Dreischarf et al. 2014). As for stance measures of healthy individuals, varying marker based approaches focusing on range of motion (ROM) during gait do not lead to a coherent picture either (Kadaba et al. 1990;Crosbie et al. 1997;Chockalingam et al. 2002;Smith et al. 2002;Cho et al. 2004;Chumanov et al. 2008;Goutier et al. 2010;Bruening et al. 2015). Converging results were only seen when using the same methodic approach, i.e. ...
... The use of transversal movement leads to a major reduction of classification performance compared to the use of data of all planes of motion. According to literature, gender effects in transversal plane are likely to be seen for ROM of the lower thoracic spine, and the pelvis (Crosbie et al. 1997;Bruening et al. 2015). Nevertheless, transversal movement does also not occur as a feature in the most stable and most relevant features of the top 50 ensemble rankings. ...
... Males and females show diverging movement for the respective variables. One of few consistent findings across existing studies is an increased ROM of female's pelvic obliquity (Chockalingam et al. 2002;Smith et al. 2002;Cho et al. 2004;Chumanov et al. 2008;Bruening et al. 2015). However, the current study indicates, that the point in gait cycle of the maximal deflection for pelvic obliquity may have higher discriminative power. ...
Article
Full-text available
Modern technologies enable to capture multiple biomechanical parameters often resulting in relational data. The current work proposes a generally applicable method comprising automated feature extraction, ensemble feature selection and classification to best capture the potentials of the data also for generating new biomechanical knowledge. Its benefits are demonstrated in the concrete biomechanically and medically relevant use case of gender classification based on spinal data for stance and gait. Very good results for accuracy were obtained using gait data. Dynamic movements of the lumbar spine in sagittal and frontal plane and of the pelvis in frontal plane best map gender differences.
... Exclusion criteria were: wearing foot orthoses at the time of recruitment; low back pain ≥ 2 on the NRS; lumbar radiculopathy; spinal or lower limb surgery in the past three months; total joint replacement of hip, knee, or ankle; corticosteroid injection at the hip within the last three months; clinical signs and symptoms of intraarticular hip joint pathology [27]; systemic inflammatory conditions; active cancer; or neurological conditions that would affect gait; and being male due to sex differences in gait kinematics [28] and kinetics [29]. ...
... This may be due to several reasons. First, the inclusion of 22 % males by Allison et al. [6] may impact on the differences noted between the two clinical populations, as sex-specific differences exist in both kinematic [28] and kinetic [29] gait measures. Further, our participants had significantly faster walking velocity and less change in pelvic obliquity than their gluteal tendinopathy group, both of which have been proposed to account for variance in HAM during gait [6,38]. ...
Article
Background Greater trochanteric pain syndrome (GTPS), including gluteal tendinopathy and bursitis, is a common, painful and debilitating condition. It is thought to involve overload of the gluteal tendons, which may be amplified through increased hip adduction moment (HAM) seen during gait in these individuals. Reducing the aberrant HAM may improve pain and function in this population. We aimed to determine if medially-posted foot orthoses immediately reduce HAM and pain in females with GTPS during walking gait. Methods A double-blind, repeated-measures trial with randomised intervention order compared three conditions in 53 women with GTPS. Participants acted as their own control during baseline (everyday-shoe insole), medially-posted (active) orthosis, or flat insert (sham orthosis) walking. Data were collected via three-dimensional gait analysis for HAM, hip, pelvic, and thorax kinematics; as well as ground reaction force; and pain via the numerical rating scale. Subgroup analysis was performed based on a pronated foot-posture defined by the Foot Posture Index. Results A small pain reduction was found between the active orthosis and flat insert (mean difference = -0.444, p = 0.017). No difference was detected for pain between other condition comparisons. Thoracic lateral flexion increased at second-peak HAM between the baseline and active conditions (mean difference = -0.917, p = 0.040). No differences were detected for HAM, remaining kinematic or kinetic variables, or ground reaction force data across the three conditions. No significant differences were detected between any of the three conditions for biomechanical or pain data in the pronated-foot subgroup. Significance A medially-posted foot orthosis did not immediately alter gait biomechanics or provide a clinically meaningful pain reduction in women with GTPS. There is uncertainty regarding the clinical benefit of orthoses in the management of GTPS. Longer-term follow-up or the use of customised orthoses may produce different outcomes and should be explored in future research.
... When considering the sex differences, different performance between males and females (i.e., sex gap) is relatively high in recreational runners [5,6], of which biological differences between the sexes (e.g., hormonal factors, skeletal muscle mass, and oxidative capacities) are accepted as the primary cause [7,8]. Moreover, the sex-specific manner in which individuals perform running tasks is reported [9][10][11] and listed as one potential risk factor for musculoskeletal injuries [2,3]. For instance, a more adducted hip in the stance phase found more in females than in males is considered one possible cause of the high incidence of lower-limb injuries in female runners [12,13]. ...
... PCA-based variables were then determined to differentiate sex differences in running stability. As previously reported [9][10][11], males and females have distinct kinematic running characteristics. Therefore, it was hypothesized that the sex difference in gait stability would manifest in the specific PMs relevant to the current task. ...
Article
Full-text available
A sex-specific manner in running tasks is considered a potential internal injury risk factor in runners. The current study aimed to investigate the sex differences in running stability in recreational runners during self-preferred speed treadmill running by focusing on a whole-body movement. To this end, principal component analysis (PCA) was applied to kinematic marker data of 22 runners (25.7 ± 3.3 yrs.; 12 females) for decomposing the whole-body movements of all participants into a set of principal movements (PMs), representing different movement synergies forming together to achieve the task goal. Then, the sex effects were tested on three types of PCA-based variables computed for individual PMs: the largest Lyapunov exponent (LyE) as a measure of running variability; the relative standard deviation (rSTD) as a measure of movement structures; and the root mean square (RMS) as a measure of the magnitude of neuromuscular control. The results show that the sex effects are observed in the specific PMs. Specifically, female runners have lower stability (greater LyE) in the mid-stance-phase movements (PM4−5) and greater contribution and control (greater rSTD and RMS) in the swing-phase movement (PM1) than male runners. Knowledge of an inherent sex difference in running stability may benefit sports-related injury prevention and rehabilitation.
... Lately, the report from the experimental studies on gait kinematics in both sexes has not totally agreed to the historical findings. [27] This study findings showed that no significant difference exists between gait parameters (STPL and STRL) and both sexes; however, significant difference exist in BOG. In the study by Bruening et al., [27] male and female ambulated at nearly the same mean preferred speed, men using mostly lengthier steps, and women ambulating with a greater pace. ...
... [27] This study findings showed that no significant difference exists between gait parameters (STPL and STRL) and both sexes; however, significant difference exist in BOG. In the study by Bruening et al., [27] male and female ambulated at nearly the same mean preferred speed, men using mostly lengthier steps, and women ambulating with a greater pace. ...
... Several studies have compared gait movement between men and women and reported that stride length was significantly longer in men, while cadence was significantly greater in women [15][16][17]. These sex differences in gait are thought to be affected primarily by height and leg length and partially can lead to morphological variations in TA that are involved in ankle dorsiflexion efficiency. ...
... The longer tendon component and smaller pennation angle of the TA are considered more advantageous for efficient ankle dorsiflexion. According to previous studies, males and females walked at nearly the same mean preferred speed, while males had longer strides and females had higher cadences [17]. Since females are generally shorter in height and leg length than males and have a disadvantage in stride length, females need to increase cadence relatively. ...
Article
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Background Tibialis anterior (TA) muscle is the largest dorsiflexor of the ankle joint and plays an important role during gait movement. However, descriptions of the TA attachment site are inconsistent even among major anatomy textbooks, and its origin, especially the attachment site for the tibia, has not been reported in detail. This study is the first experimental attempt to investigate the origin of the TA in detail, paying particular attention to the relationship with the shape of the tibia, including sex differences. Methods Forty legs (20 males, 20 females) from twenty Japanese cadavers were examined. Gross anatomical examination of the TA's attachment site to the tibia and the tibia's shape was performed. Results The location of the distal end of the TA's attachment on tibia was significantly more distal in males than in females ( p < 0.01). The anterior border of the tibia had a gentle S-like curve, with a medially convex curve in the proximal region and a laterally convex curve in the distal region in frontal plane. The most protruding point of the distal curve of the anterior border located significantly more proximal in females than in males ( p = 0.02). Conclusions There were sex differences in the distal end of the attachment site on tibia of the TA and the shape of the tibia. Consequently, the variations in the attachment site of TA were considered to provide for differences in function of TA. In males, the TA may enable advantageous power exertion, whereas in females it may work efficiently for dorsiflexion of ankle, respectively. Sex differences in TA's attachment site and the shape of the tibia may be involved in gait movement as well as frequency of lower leg disorders such as chronic exertional compartment syndrome.
... Human locomotion, with its highly stereotyped patterns, has been an ideal subject of neuroscience and biomechanics studies for more than one century [6]. Some sex-specific characteristics, often too subtle to quantify [7,8], of human walking and running have been unraveled, such as the different hip-, knee-and ankle-joint kinematics or the body height-dependent preferred speed and step frequency [9][10][11]. Females have been shown to walk with greater hip flexion and lower knee extension at touchdown than males, generating greater mechanical joint power from those two joints during the propulsion phase [9]. ...
... In younger participants these findings were reversed [7] and a greater arm swing and pelvic obliquity in the frontal plane was noted in females. In general, it is clear that the quantitative assessment of anecdotal and qualitative observations is difficult to obtain and only few studies endeavored to rigorously quantify the sex specificity of kinematic and kinetic parameters during locomotion [8]. Similarly, only a few studies analyzed the way in which females and males activate muscles to produce locomotion. ...
Article
Full-text available
There is increasing evidence that including sex as a biological variable is of crucial importance to promote rigorous, repeatable and reproducible science. In spite of this, the body of literature that accounts for the sex of participants in human locomotion studies is small and often produces controversial results. Here, we investigated the modular organization of muscle activation patterns for human locomotion using the concept of muscle synergies with a double purpose: i) uncover possible sex-specific characteristics of motor control and ii) assess whether these are maintained in older age. We recorded electromyographic activities from 13 ipsilateral muscles of the lower limb in young and older adults of both sexes walking (young and old) and running (young) on a treadmill. The data set obtained from the 215 participants was elaborated through non-negative matrix factorization to extract the time-independent (i.e., motor modules) and time-dependent (i.e., motor primitives) coefficients of muscle synergies. We found sparse sex-specific modulations of motor control. Motor modules showed a different contribution of hip extensors, knee extensors and foot dorsiflexors in various synergies. Motor primitives were wider (i.e., lasted longer) in males in the propulsion synergy for walking (but only in young and not in older adults) and in the weight acceptance synergy for running. Moreover, the complexity of motor primitives was similar in younger adults of both sexes, but lower in older females as compared to older males. In essence, our results revealed the existence of small but defined sex-specific differences in the way humans control locomotion and that these are not entirely maintained in older age.
... Human locomotion, with its highly stereotyped patterns, has been an ideal subject of neuroscience and biomechanics studies for more than one century [6]. Some sex-specific characteristics, often too subtle to quantify [7,8], of human walking and running have been unraveled, such as the 50 different hip-, knee-and ankle-joint kinematics or the body height-dependent preferred speed and step frequency [9][10][11]. Females have been shown to walk with greater hip flexion and lower knee extension at touchdown than males, generating greater mechanical joint power from those two joints during the propulsion phase [9]. ...
... In younger participants these findings were reversed [7] and a greater arm swing and pelvic obliquity in the frontal plane was noted in females. In general, it is clear that the quantitative assessment of anecdotal and qualitative observations is difficult to obtain and only few studies endeavored to rigorously quantify the sex specificity of kinematic and kinetic parameters during locomotion [8]. Similarly, only a few studies analyzed the way in which females and males activate 60 muscles to produce locomotion. ...
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There is increasing evidence that including sex as a biological variable is of crucial importance to promote rigorous, repeatable and reproducible science. In spite of this, the body of literature that accounts for the sex of participants in human locomotion studies is small and often produces controversial results. Here, we investigated the modular organization of muscle activation patterns for human locomotion using the concept of muscle synergies with a double purpose: i) uncover possible sex-specific characteristics of motor control and ii) assess whether these are maintained in older age. We recorded electromyographic activities from 13 ipsilateral muscles of the lower limb in young and older adults of both sexes walking (young and old) and running (young) on a treadmill. The data set obtained from the 215 participants was elaborated through non-negative matrix factorization to extract the time-independent (i.e., motor modules) and time-dependent (i.e., motor primitives) coefficients of muscle synergies. We found sparse sex-specific modulations of motor control. Motor modules showed a different contribution of hip extensors, knee extensors and foot dorsiflexors in various synergies. Motor primitives were wider (i.e., lasted longer) in males in the propulsion synergy for walking (but only in young and not in older adults) and in the weight acceptance synergy for running. Moreover, the complexity of motor primitives was similar in younger adults of both sexes, but lower in older females as compared to older males. In essence, our results revealed the existence of small but defined sex-specific differences in the way humans control locomotion and that these strategies are not entirely maintained in older age.
... D'autres études ont également observé une interaction entre l'âge et les paramètres cinématiques de la marche (Begg & Sparrow, 2006;Chehab et al., 2017;Gimmon et al., 2015;Kerrigan et al., 1998). Les sujets âgés ont montré une augmentation de l'antéversion du bassin (Kerrigan et al., 1998), une réduction de l'amplitude de mouvement du bassin dans le plan transverse (Gimmon et al., 2015) et de la flexion du genou (Begg & Sparrow, 2006;Chehab et al., 2017) et une réduction de l'amplitude de mouvement de la cheville (Begg & Sparrow, 2006 (Bruening et al., 2015;Chehab et al., 2017;Cho et al., 2004), d'abduction du genou et d'amplitude de mouvement du genou dans le plan frontal (Chehab et al., 2017;Chiu & Wang, 2007;Cho et al., 2004), d'amplitude de mouvement dans le plan frontal de la hanche, d'adduction et de rotation interne de la hanche (Boyer et al., 2008;Chehab et al., 2017;Chiu & Wang, 2007;Cho et al., 2004;Ko et al., 2011;Phinyomark et al., 2016), d'amplitude de mouvement de la cheville dans le plan sagittal (Ko et al., 2011 Ces différences pourraient provenir de différents facteurs biomécaniques entre les genres, tels que les facteurs neuromusculaires ou des facteurs anatomiques (Chehab et al., 2017). Les femmes ont montré, par exemple, davantage d'activité musculaire du tibial antérieur au niveau de la cheville (Chiu & Wang, 2007). ...
... Cette étude a mis en évidence chez les femmes une association entre la pronation et la lombalgie. Ce résultat pourrait être lié à la différence biomécanique de la locomotion entre les femmes et les hommes, les femmes montrant davantage de rotations du membre inférieur dans les plans frontal et transverse (Boyer et al., 2008;Chehab et al., 2017;Chiu & Wang, 2007;Cho et al., 2004;Ko et al., 2011;Phinyomark et al., 2016) (Bruening et al., 2015;Chehab et al., 2017;Cho et al., 2004). Chez les hommes, notre étude a montré un mouvement du bassin plus élevé dans le plan sagittal (et transverse) chez les sujets pronateurs face aux sujets neutres. ...
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La pronation et les pieds plats ont longtemps été considérés conjointement, notamment dans leur relation avec la blessure. Or, cette relation, au regard des résultats divergents de la littérature, a été remise en question. Récemment, la dissociation entre la typologie et la fonctionnalité du pied a permis de mettre en évidence une possible association entre la pronation et la lombalgie. L’étude de la locomotion de sujets pronateurs identifiés par des tests fonctionnels pourrait exposer les facteurs de risques biomécaniques associés à la lombalgie. L’objectif général était d’identifier et d’étudier l’impact cinématique et baropodométrique de la pronation à la marche. Puis d’évaluer l’effet de traitements préventifs visant à limiter la biomécanique à risque dans un but de prévention primaire. Trois études ont été menées. Une étude de concordance entre différents tests d’identification de la pronation a été réalisée, dans des conditions différentes, afin de sélectionner un test approprié à l’étude de la marche. La cinématique et la baropodométrie de la marche de 159 sapeurs-pompiers professionnels, pronateurs vs non-pronateurs, ont été comparées. Deux protocoles d’un mois visant à réduire la pronation (renforcement musculaire du pied ou port de semelles) ont été proposés chez les sujets pronateurs. La concordance des différents tests de fonctionnalité a été jugée faible. Une combinaison de tests fonctionnels a été utilisée pour affiner le diagnostic de pronation. Les sujets pronateurs ont exposé des différences baropodométriques et cinématiques de l’avant et de l’arrière-pied, du genou et du bassin à la marche. Cette cinématique pourrait constituer un facteur de risque de lombalgie. La pronation a été réduite par les deux protocoles préventifs et accompagnée de modifications cinématiques du pied et de la hanche. Bien que nos protocoles préventifs ne témoignent pas d’une incidence sur le bassin, ils exposent une modification cinématique du membre inférieur, qui pourrait modifier la biomécanique du bassin et constituer un moyen de prévention des lombalgies.
... A post-hoc analysis of co-variance (ANCOVA) was used to determine statistically significant differences between the poor sleeper and good sleeper groups for gait features. The ANCOVA accounted for sex [50], age [51,52], height [52], and weight [52,53] as these factors have been shown to influence gait. ...
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Failure to obtain the recommended 7-9 h of sleep has been associated with injuries in youth and adults. However, most research on the influence of prior night's sleep and gait has been conducted on older adults and clinical populations. Therefore, the objective of this study was to identify individuals who experience partial sleep deprivation and/or sleep extension the prior night using single task gait. Participants (n = 123, age 24.3 ± 4.0 years; 65% female) agreed to participate in this study. Self-reported sleep duration of the night prior to testing was collected. Gait data was collected with inertial sensors during a 2 min walk test. Group differences (<7 h and >9 h, poor sleepers; 7-9 h, good sleepers) in gait characteristics were assessed using machine learning and a post-hoc ANCOVA. Results indicated a correlation (r = 0.79) between gait parameters and prior night's sleep. The most accurate machine learning model was a Random Forest Classifier using the top 9 features, which had a mean accuracy of 65.03%. Our findings suggest that good sleepers had more asymmetrical gait patterns and were better at maintaining gait speed than poor sleepers. Further research with larger subject sizes is needed to develop more accurate machine learning models to identify prior night's sleep using single-task gait.
... There was no sex difference in "%step length" (height ratio). These results accord with previous studies of healthy subjects [25,26], which reported that sex differences in gait re ect differences in bodysize parameters, such as height [27]. Muscle strength and balance may affect walking time, gait speed, and acceleration; grip strength, which relates to global muscle strength [28], and balance (assessed by the FRT and TUG test) are poorer in women than men. ...
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Sex differences in the effect of posture and subjective vertical position (SPV) on gait function have not been clarified in Parkinson's disease (PD) patients. Therefore, this study aimed to determine the involvement of posture and vertical perception in the gait function of PD patients according to sex. The study included 59 adult patients with PD (31 men and 28 women) who visited the Rehabilitation Department of Neurology Clinic as outpatients. Relationships between four postural evaluations [forward trunk flexion (FTF), lateral trunk flexion (LTF), SPV], and eight gait assessments [walking time, step length, gait speed, number of steps, step time, coefficient of variation of step time (step CV), cadence, and mean gait acceleration (acceleration)] were analyzed according to sex. None of the postural evaluations showed an association with gait parameters in men. By contrast, in women, relationships were seen between walking time and SPV in the sagittal plane, stride length and FTF angle, the number of steps and FTF and LTF, and step CV and SPV in the coronal plane, indicating that posture was related to gait function. Our results could aid rehabilitative therapies to improve PD patients' gait function.
... In addition, after an SCI is chronic, changes in gait are reduced mostly to those related to rehabilitation outcomes and are covered by the data included in our dataset. Likewise, the small differences in gait kinematics between men and women that are mostly present in the frontal plane of the pelvis and hip (Bruening et al., 2015) are not as conditioning as the gait limitations after an SCI, allowing the application of the SCI-GDI regardless of sex. We intentionally captured a wide variety of gait data of SCI with different severity, neurological level of injury, time since injury onset, sex, and age, to capture the largest variety in gait patterns we had access to, and guarantee that the SCI-GDI could properly represent any of these patterns. ...
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The Gait Deviation Index (GDI) is a dimensionless multivariate measure of overall gait pathology represented as a single score that indicates the gait deviation from a normal gait average. It is calculated using kinematic data recorded during a three-dimensional gait analysis and an orthonormal vectorial basis with 15 gait features that was originally obtained using singular value decomposition and feature analysis on a dataset of children with cerebral palsy. Ever since, it has been used as an outcome measure to study gait in several conditions, including spinal cord injury (SCI). Nevertheless, the validity of implementing the GDI in a population with SCI has not been studied yet. We investigate the application of these mathematical methods to derive a similar metric but with a dataset of adults with SCI (SCI-GDI). The new SCI-GDI is compared with the original GDI to evaluate their differences and assess the need for a specific GDI for SCI and with the WISCI II to evaluate its sensibility. Our findings show that a 21-feature basis is necessary to account for most of the variance in gait patterns in the SCI population and to provide high-quality reconstructions of the gait curves included in the dataset and in foreign data. Furthermore, using only the first 15 features of our SCI basis, the fidelity of the reconstructions obtained in our population is higher than that when using the basis of the original GDI. The results showed that the SCI-GDI discriminates most levels of the WISCI II scale, except for levels 12 and 18. Statistically significant differences were found between both indexes within each WISCI II level except for 12, 20, and the control group (p < 0.05). In all levels, the average GDI value was greater than the average SCI-GDI value, but the difference between both indexes is larger in data with greater impairment and it reduces progressively toward a normal gait pattern. In conclusion, the implementation of the original GDI in SCI may lead to overestimation of gait function, and our new SCI-GDI is more sensitive to larger gait impairment than the GDI. Further validation of the SCI-GDI with other scales validated in SCI is needed.
... It is apparent that the female gait pattern can best be distinguished from the male counterpart by looking at the pelvis. More pronounced pelvic motion of women is consistently reported in the literature and might be partially explained by the greater pelvis width to femoral length ratio of women [3]. It can equally be observed by analyzing the present data (Fig. 2b, 2d and 2f), especially with regard to the rotation around the x-axis (pelvic obliquity). ...
Chapter
In this paper, a methodology to generate realistic gait patterns is presented. Human gait motion capture data is used along with a kinematic model of the human lower extremity to derive a parametric and time-continuous analytical description of the walking motion. This allows for reproduction of individual recorded gait cycles and for generating new artificial gait cycles. A data pool of about 5700 reproduced gait cycles from 120 participants walking at different velocities is used to generate trajectories of human lower limb joints. Walking motions of simulated male or female persons can thus be synthesized with a prescribed gait speed. The method shall serve as scientific basis for research focused on rehabilitation, motion assistance and simulations.
... Next, we quantitatively compared the onset times of deviation from the straight line to either side. Specifically, the onset times were defined as the instant at which the waist is twisted over 13.6° (Bruening et al., 2015) and undergoes an ML displacement of more than 0.25 m (Aravind & Lamontagne, 2014;Souza Silva et al., 2018). Please refer to Motion Analysis in the Results section. ...
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Background As urban development toward smart cities continues in earnest, pedestrians’ chances of encountering autonomous mobile robots (AMRs) on the street increase. Although recent studies have discussed how humans avoid collisions with others when passing them, it is still unclear how they would avoid AMRs, which could be common on the streets soon. Research question We investigated humans’ avoidance strategy against an AMR approaching head-on through an experiment that included recording human-body motions while walking. Method The AMR approached from various starting points, including directly from the participants. The participants were asked to circumvent it by moving rightward or leftward while their walking trajectories were tracked. Result We found no significant bias on either side, suggesting that the avoidance direction is not simply determined by the participants’ attributes, such as the traffic rules followed in their area of living. The probability of rightward avoidance when the AMR approached head-on indicated that the humans had different avoidance strategy when facing other humans and objects. Moreover, the participants’ motion analysis revealed that their waists unconsciously twisted in the direction of avoidance before they circumvented. Significance The results suggest that the human-waist provides an indicator to predict the avoidance direction. Our findings could be adopted in AMRs’ development to fit them more naturally into our lives. Highlights Human avoidance strategies against a robot approaching head-on were examined. The avoidance direction was not simply determined by the participants’ attributes. Humans used different avoidance strategies when facing other humans and objects. The human waist provides an indicator to predict the avoidance direction.
... Non-time varying and subject specific features contain rich contextual information and have shown to improve network accuracy in bio-medical applications [58]. Including non temporal subject-specific data that affect gait kinematics, such as gender [59], body dimensions [60], age [61] etc. could possibly improve performance. ...
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Intuitive control of powered prosthetic lower limbs is still an open-ended research goal. Current controllers employ discrete locomotion modes for well-defined and frequently encountered scenarios such as stair ascent, stair descent, or ramps. Non-standard movements such as side-shuffling into cars and avoiding obstacles are challenging to powered limb users. Human locomotion is a continuous motion comprising rhythmic and non-rhythmic movements, fluidly adapting to the environment. It exhibits strong inter-joint coordination and the movement of a single joint can be largely predicted based on the movement of the rest of the body. We explore a continuous and unified kinematics estimation strategy for a wide variety of movements without the need for labeled examples. Our data-driven approach uses natural body motion from the intact limbs and trunk to generate a kinematic reference trajectory for prosthetic joints. Wearable sensors were worn by 63 subjects without disabilities to record full-body kinematics during typical scenarios (flat ground and stairs), and non-rhythmic and atypical movements (side shuffles, weaving through cones, backward walking). A Recurrent Neural Network (RNN) was trained to predict right ankle and knee kinematics from the kinematics of other joints as inputs. Results were assessed on 3 different test subjects previously unseen by the network. All predictions had a RMSE of less than 7.5 degrees and a high correlation across activities. These offline predictions were robust to subject-specific variations such as walking speed and step length. Additionally, to test the feasibility of using a data-driven reference towards prosthetic control in real-time, a systems test was designed with a single participant. The controller acquired live kinematics, generated predictions using a pre-trained neural network, and demonstrated the capability to actuate the knee joint of a powered prosthesis for the treadmill walking task.
... To investigate symmetry in joint kinematics, and to assess in which periods of the gait cycle significant differences associated with PD occurred, the angle-cycle curves for PD vs. CG were compared on a point-by-point basis using a one-way ANOVA, setting the group as independent variable. This analysis was performed for each of the 3 joints of interest [28]. ...
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Unilaterality of motor symptoms is a distinctive feature of Parkinson’s Disease (PD) and represents an important co-factor involved in motor deficits and limitations of functional abilities including postural instability and asymmetrical gait. In recent times, an increasing number of studies focused on the characterization of such alterations, which have been associated with increased metabolic cost and risk of falls and may severely compromise their quality of life. Although a large number of studies investigated the gait alterations in people with PD (pwPD), few focused on kinematic parameters and even less investigated interlimb asymmetry under a kinematic point of view. This retrospective study aimed to characterize such aspects in a cohort of 61 pwPD (aged 68.9 � 9.3 years) and 47 unaffected individuals age- and sex-matched (66.0 � 8.3 years), by means of computerized 3D gait analysis performed using an optical motion-capture system. The angular trends at hip, knee and ankle joints of pwPD during the gait cycle were extracted and compared with those of unaffected individuals on a point-by-point basis. Interlimb asymmetry was assessed using angle–angle diagrams (cyclograms); in particular, we analyzed area, orientation, trend symmetry and range offset. The results showed that pwPD are characterized by a modified gait pattern particularly at the terminal stance/early swing phase of the gait cycle. Significant alterations of interlimb coordination were detected at the ankle joint (cyclogram orientation and trend symmetry) and at the hip joint (range offset). Such findings might be useful in clinical routine to characterize asymmetry during gait and thus support physicians in the early diagnosis and in the evaluation of the disease progression.
... En cuanto a la relación entre masa magra y ángulo de fase, se ha podido determinar, en primera instancia, que existen diferencias anatómicas y funcionales importantes respecto a la distribución muscular y de tejido adiposo entre hombres y mujeres, lo cual ha sido demostrado en distintas investigaciones que evidencian que la distribución regional del tejido adiposo es el principal factor que expone la correspondencia entre adiposidad y riesgo cardiometabólico 18,19 . Tales diferencias están determinadas genéticamente y son evidentes cuando se evalúan la amplitud pélvica y su relación con la columna lumbosacra, coxofemoral y los miembros inferiores; estas regiones corporales, en el caso de las mujeres, son más amplias y con ciertos grupos musculares, como los estabilizadores del tronco, que no son tan activos comparados con los varones, por lo que se podría inferir que zonas como el tronco, la cadera y las piernas se convierten fácilmente en reservorios de grasa corporal, por lo que el ángulo de fase tendería a reducirse, incrementando potencialmente el riesgo cardiovascular en las mujeres 20,21 . ...
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Introducción El ángulo de fase se utiliza actualmente como indicador del estado nutricional de los adultos y marcador pronóstico de presencia y progresión de enfermedades crónicas, como las cardiovasculares. Objetivo Determinar la asociación entre el ángulo de fase y los indicadores de riesgo cardiovascular en estudiantes universitarios. Método: Estudio correlacional de corte transversal, en el que se evalúo a 30 estudiantes universitarios (edad 22.1 ± 2 años, peso 65.6 ± 10,3 kg) a través de IPAQ (versión corta), glucometría basal, composición corporal mediante bioimpedancia eléctrica con el instrumento Inbody® de referencia 770, fuerza prensil, batería de Bosco (Optogait®) y consumo de oxígeno indirecto (test de Leger). Resultados Se encontró una media de ángulo de fase de 6.4 ± 0.66, y se halló correlación moderada entre masa magra en tronco (0.68; p = 0.05), tasa metabólica basal (0.64; p = 0.009), nivel de fitness (0.71; p = 0.003), Counter Movement Jump (0.56; p = 0.028) y ángulo de fase. Las mujeres presentan correlación entre relación de cintura y cadera (r = 0.74; p = 0.034). Conclusiones El ángulo demostró ser un indicador predictor de riesgo cardiovascular en población adulta joven; además, permitió una visión más exacta de la predisposición y la potencialidad para padecer enfermedad cardiovascular.
... Based on the sensor orientation and location, acceleration along the X-axis indicates the oblique motion of the pelvis. Such oblique motion in the pelvis has been identified to be a unique characteristic of female gait by numerous studies [20] [21]. Furthermore, this observation coincides with greater ROM of the pelvis in the frontal plane of females [22]. ...
... In addition, minor differences exist in gait kinematics between women and men; in particular, for any given speed, women adopt a lower step length (hence, a higher cadence) . Minor kinematic differences have also been repeatedly demonstrated, following the seminal work by Murray in 1970(Bruening, Frimenko, Goodyear, Bowden, & Fullenkamp, 2015Kerrigan, Todd, & Della Croce, 1998;Murray, Kory, & Sepic, 1970). On the other hand, the critical point of the study is the comparison between age groups in children. ...
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The relative displacements of body segments during walking can be reduced to a small number of multi-joint kinematic patterns, pmk, through Principal Component Analysis (PCA). These patterns were extracted from two groups of children (n = 8, aged 6–9 years, 4 males, and n = 8, aged 10–13 years, 4 males) and 7 adults (21–29 years, 1 male), walking on a treadmill at various velocities, normalized to body stature (adimensional Froude number, Fr). The three-dimensional coordinates of body markers were captured by an optoelectronic system. Five components (pm1 to pm5) explained 99.1% of the original dataset variance. The relationship between the variance explained (“size”) of each pmk and the Fr velocity varied across movement components and age groups. Only pm1 and pm2, which described kinematic patterns in the sagittal plane, showed significant differences (at p < 0.05) across pairs of age groups. The time course of the size of all the five components matched various mechanical events of the step cycle at the level of both body system and lower limb joints. Such movement components appeared clinically interpretable and lend themselves as potential markers of neural development of walking.
... However, the control females demonstrated a similar movement pattern as the patients; females walked with more adduction and a larger total range of motion in the frontal plane. In a reference study by Bruening et al. [21] of healthy persons, it was found that females walk with a larger frontal hip range of motion. Hence, the findings in our study could simply be a sex-specific gait variant. ...
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Introduction Patients with femoroacetabular impingement syndrome (FAIS) experience decreased function. Consequently, earlier studies have evaluated gait biomechanics in these patients, but a larger study evaluating gait biomechanics before and after an intervention standardising gait speed is lacking. We aimed at investigating gait kinematics and kinetics in patients with FAIS compared with pain-free controls before and 1 year after hip arthroscopic surgery. Secondary, we aimed at analysing gait pattern separately for the sexes and to investigate associations between peak kinematics and kinetics and the Copenhagen Hip and Groin Outcome Score (HAGOS). Materials and methods Sixty patients with FAIS and 30 pain-free controls were tested at a standardised gait speed (1.40 m/s ± 10%). Patients were tested twice: before and 1 year after surgery. Kinematics and kinetics were recorded using infrared high-speed cameras and a force plate. Participants answered HAGOS. Results The largest difference among groups was that gait differed between males and females. Neither before nor after surgery could we demonstrate large alterations in gait pattern between patients and pain-free controls. Male patients demonstrated associations between peak kinematics and kinetics and HAGOS Sports function. Conclusions Gait pattern was only vaguely altered in patients with FAIS compared with pain-free controls before and after surgery when using at standardised gait speed. Hence, analysing gait in patients with FAIS does not seem of major importance. Nevertheless, there was an association between HAGOS Sports function and peak kinematics and kinetics in male patients, implying that there could be a clinical importance.
... 12 The marker set used was based on previous models but customized to ensure it met the requirements for measurement of ARs. [20][21][22][23][24] All data were modeled using Visual3D, professional version 6.01.15 (C-motion, Inc, Germantown, MD). A description of this custom model has been provided elsewhere. ...
Article
Research Objectives To: 1. Evaluate relationships between stationary and dynamic associated reaction (AR) tests in people with acquired brain injury (ABI) using surface electromyography (sEMG) muscle activity and three-dimensional motion analysis (3DMA) kinematic measures 2. Assess test-retest reliability of sEMG and seated tests of Ars. Design Cross-sectional observational study. Setting A major brain injury rehabilitation centre in Australia. Participants Forty-two participants with an ABI and hemiplegic upper limb AR during walking. Interventions N/A. Main Outcome Measures Participants underwent AR testing with seated contralateral maximal voluntary isometric contraction (MVIC) tests and walking (self-selected and fast speeds). For seated tests, AR measurements included biceps brachii sEMG and elbow goniometry. For walking tests, AR measurement included biceps brachii sEMG and 3DMA kinematics. Pearson's correlations evaluated relationships between seated and dynamic walking AR tests and between muscle activity and kinematic measures. A subgroup of chronic participants (> 1year post injury) were reassessed one-week later for reliability. Results For biceps brachii sEMG during seated and walking tests, there was a strong (r = 0.65) and moderate (r = 0.53) relationship at self-selected and fast walk, respectively. A low-to-moderate relationship existed between biceps brachii sEMG and kinematics during walking, and between seated and walking measures of ARs (r = 0.23 to 0.53). All tests had strong-to-very strong test-retest reliability (intra-class correlation coefficients > 0.78). Conclusions Seated contralateral MVIC tests (measured by goniometry and biceps brachii sEMG) correlate only weak-to-moderately to AR walking kinematics, and moderately-to-strongly with biceps brachii sEMG during walking. Moderate relationships exist between sEMG and kinematics indicating they may provide different information for ARs. Author(s) Disclosures There are no disclosures for this abstract.
... Instead, the differences associated with the presence of obesity in joint kinematic data were assessed by comparing the "angle vs. time" curves of both groups, for each of the 3 joints of interest, on a point-by-point basis using a one-way ANOVA, using an approach previously proposed in the literature to characterize sex-related differences in kinematic patterns among population of unaffected adults (i.e., men vs. women, Bruening et al. [40]) or between healthy individuals and those affected by neurologic and orthopedic conditions [27,41,42]. In this way it was possible to define the time intervals of the gait cycle characterized by significant differences associated with obesity. ...
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The main purpose of this study is to characterize lower limb joint kinematics during gait in obese individuals by analyzing inter-limb symmetry and angular trends of lower limb joints during walking. To this purpose, 26 obese individuals (mean age 28.5 years) and 26 normal-weight age- and sex-matched were tested using 3D gait analysis. Raw kinematic data were processed to derive joint-specific angle trends and angle-angle diagrams (synchronized cyclograms) which were characterized in terms of area, orientation and trend symmetry parameters. The results show that obese individuals exhibit a kinematic pattern which significantly differs from those of normal weight especially in the stance phase. In terms of inter-limb symmetry, higher values were found in obese individuals for all the considered parameters, even though the statistical significance was detected only in the case of trend symmetry index at ankle joint. The described alterations of gait kinematics in the obese individuals and especially the results on gait asymmetry are important, because the cyclic uneven movement repeated for hours daily can involve asymmetrical spine loading and cause lumbar pain and could be dangerous for overweight individuals.
... How confident are we then that our results can be generalised to other participant groups? Although gait kinematics differ across the life span and in the presence of a variety of disease conditions, sex differences in preferred walking speed for young, healthy volunteers are so small as to be statistically and physiologically insignificant even in the presence of significant variation in height and body mass [see for a review [60][61][62]. More importantly, we were interested in relative gait changes within participants for different environments, finding that all our participants slowed their gait when exposed to more cognitively demanding environments irrespective of their individually preferred walking speed. ...
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Exposure to urban environments requires more cognitive processing than exposure to nature; an effect that can even be measured analysing gait kinematics whilst people walk towards photographic images. Here, we investigated whether differences in cognitive load between nature and urban scenes are still present when scenes are matched for their liking scores. Participants were exposed to images of nature and urban scenes that had been matched a priori for their liking scores by an independent participant sample (n = 300). Participants (N = 44) were either asked to memorise each image during walking or to rate each image for its visual discomfort after each walk. Irrespective of experimental task, liking score but not environment type predicted gait velocity. Moreover, subjective visual discomfort was predictive of gait velocity. The positive impact of nature described in the literature thus might, at least in part, be due to people’s aesthetic preferences for nature images.
... In this group of young, healthy adults, sex and PA were significant modifiers of the relationship between fatigue and energy variables and gait. Sex was particularly influential, which may be the product of sex differences in gait characteristics (Bruening, Frimenko, Goodyear, Bowden, & Fullenkamp, 2015) and self-reported fatigue levels (Engberg et al., 2017). PA was a significant predictor for gait variability. ...
Article
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Compromised attentional resources during perceived fatigue has been suggested to alter motor control. The authors determined if measures of postural control and gait are predicted by state and trait physical and mental fatigue and energy, and how these relationships are modified by sex, sleep quality, and physical activity. Young adults ( n = 119) completed the Modified Clinical Test of Sensory Integration, overground walking, and questionnaires to quantify fatigue and energy, sleep quality, and physical activity. Regression models indicated that trait fatigue, trait energy, and sleep quality were predictors of postural control ( p ≤ .02, R ² ≥ .04). State fatigue, state energy, and sex were predictors of gait ( p ≤ .05, R ² ≥ .03). While the variance explained was low (3–13%), the results demonstrate perceptions of fatigue and energy may influence posture and gait.
... For dynamic ROM, GVS, and GPS analysis, two separate MANOVAs were carried out considering the limb (affected, unaffected, and CG) as the independent variable and the three ROM or the 9 GVS and GPS as dependent variables. The possible differences in joint kinematics were assessed by comparing the "angle vs. time" curves of the affected limb, the unaffected limb, and CG on a point by point basis using a one way ANOVA for each of the 3 joints of interest, similarly to what was pro posed by Bruening et al. [24]. It was thus possible to define the periods of the gait cycle in which significant differences associated with participants' limb were present. ...
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Among the functional limitations associated with hip osteoarthritis (OA), the alteration of gait capabilities represents one of the most invalidating as it may seriously compromise the quality of life of the affected individual. The use of quantitative techniques for human movement analysis has been found valuable in providing accurate and objective measures of kinematics and kinetics of gait in individuals with hip OA, but few studies have reported in depth analyses of lower limb joint kinematics during gait and, in particular, there is a scarcity of data on interlimb symmetry. Such aspects were investigated in the present study which tested 11 individuals with hip OA (mean age 68.3 years) and 11 healthy controls age and sex matched, using 3D computerized gait analysis to perform point by point comparisons of the joint angle trends of hip, knee, and ankle. Angle angle diagrams (cyclograms) were also built to compute several parameters (i.e., cyclogram area and orientation and Trend Symmetry) from which to assess the degree of interlimb symmetry. The results show that individuals with hip OA exhibit peculiar gait patterns characterized by severe modifications of the physiologic trend at hip level even in the unaffected limb (especially during the stance phase), as well as minor (although significant) alterations at knee and ankle level. The symmetry analysis also revealed that the effect of the disease in terms of interlimb coordination is present at knee joint as well as hip, while the ankle joint appears relatively preserved from specific negative effects from this point of view. The availability of data on such kinematic adaptations may be useful in supporting the design of specific rehabilitative strategies during both preoperative and postoperative periods.
... In addition, the potential influence of the non-significant difference in age between the studied groups can not be ruled out, since some studies show a true age-effect, independent of gait velocity [26,27], although this true age-effect was not seen in other studies [28]. In addition, several studies showed gender-specific differences in lower-limb kinematics independent of gait velocity, so the difference in gender distribution between groups may have influenced our results [12,24,29]. ...
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Background Previous research showed that hallux rigidus (HR) affects foot and ankle kinematics during gait. It is unclear if HR affects lower limb kinematics as well. Research question Does HR affect lower limb kinematics, and if so, is gait deviation correlated with patient-reported outcome? Methods This was a retrospective case-control study, including 15 HR patients and 15 healthy controls who underwent three-dimensional gait analysis by using the Plug-in Gait lower body model. The Gait Profile Score (GPS), a gait index score describing gait deviation and composed out of nine Gait Variable Scores (GVS), and intersegmental range of motion of lower limb joints were assessed. Patient-reported outcome was assessed with the Foot Function Index (FFI) and Manchester-Oxford Foot Questionnaire (MOXFQ). Data were analysed with Student t-tests and Spearman rank correlations. Results HR significantly affects gait, reflected by a higher GPS in HR subjects as compared to healthy controls. Gait deviation was seen in ankle flexion (GVSankle flexion) and to a lesser extent in pelvic rotation (GVSpelvic rotation). Interestingly, these differences were not detected when lower limb kinematics were evaluated by comparing the intersegmental ranges of motion of these joints. Positive correlations were present between patient-reported outcomes and GPS, especially functional subdomains, were positively correlated with GPS and GVSankle flexion. Significance This study demonstrated that HR, next to foot kinematics, additionally affects lower limb kinematics evaluated with an objective gait index score, i.e. GPS. The positive correlation between the GPS and patient-reported outcome can be seen as the first step in defining whether objectively measured gait indices can be used in considering surgery since most of the benefit of surgery will be expected in the patients with most gait deviation.
... However, there is [16,[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] Curr Osteoporos Rep debate if males and females have different gait characteristics during walking. Some have shown that females have increased hip abduction/adduction range of motion and increased hip rotation during walking [56]. However, when adjusted for body mass, others have shown no differences in gait patterns or muscle use during walking [57]. ...
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Purpose of Review The development of exercise interventions for bone health requires an understanding of normative growth trends. Here, we summarize changes in bone during growth and the effect of participating in sports on structural and compositional measures in different bones in males and females. Recent Findings Growing females and males have similar normalized density and bone area fraction until age 16, after which males continue increasing at a faster rate than females. All metrics for both sexes tend to plateau or decline in the early 20s. Areal BMD measures indicate significant heterogeneity in adaptation to sport between regions of the body. High-resolution CT data indicate changes in structure are more readily apparent than changes in density. Summary While adaptation to sport is spatially heterogeneous, participation in weight-bearing activities that involve dynamic muscle contractions tends to result in increased bone adaptation.
... The second limitation is the unbalanced men/women ratio among participants. Many sex biomechanical differences have been previously observed in previous studies [35,36]. As only four men were recruited in this study, the results may perhaps not be generalizable for the male population. ...
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Background/purpose: The effects of footwear on the walking kinematics, kinetics and electromyography (EMG) of individuals with chronic ankle instability (CAI) at different speeds are still unknown. The objective of this cross-sectional study was to evaluate the kinematic, kinetic and electromyography differences between shod and barefoot walking at comfortable (CW) and fast (FW) speeds in individuals with CAI. Methods: Twenty-one individuals with CAI walked on a 5-meter walkway shod and barefoot at CW and FW speeds. A force plate was used to record the ground reaction forces, a 3-D motion analysis system to record the lower limb kinematics and a surface EMG system to collect the gluteus medius, vastus lateralis, gastrocnemius lateralis, gastrocnemius medialis, peroneus longus and tibialis anterior muscles activity. The dependent variables were ankle and knee angles and moments and normalized muscle activity. The shod and barefoot data during CW and FW were compared using a one-dimensional non-parametric mapping analysis. Results: The main results of this study were that individuals with CAI exhibited more ankle dorsiflexion angle, knee extension and tibialis anterior muscle activation during the beginning of the stance phase during shod compared to barefoot walking. Also, the biomechanical effects of shoes are similar during walking at FW and CW. Conclusion: The biomechanical deficits associated with CAI were partly attenuated during the shod compared to the barefoot condition and these effects were similar at CW and FW. These findings are compatible with the concept that locomotor interventions using suitable shoes may enhance gait abilities in individuals with CAI.
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Research addressing lower limb amputee gait and prosthetic design often focuses on men, despite female lower limb amputees having different risk factors and lower success with their prosthetics overall. It is widely agreed that sex differences exist in able-bodied gait, but research analyzing sex differences in amputee gait is rare. This study compared male and female transtibial amputee gait to ascertain potential sex differences. Forty-five transtibial amputees were asked to walk at their self-selected speed, and spatiotemporal gait data were obtained. Both the mean and variability metric of parameters were analyzed for 10 male and 10 female participants. For all participants, amputated limbs had a shorter stance time, longer swing time, and larger step length. Females had a 10% shorter stance time and 26% larger normalized step and stride length than males. Female participants also walked over 20% faster than male participants. Finally, significant interactions were found in the mean and variability metric of stride velocity, indicating greater variability in women. These findings suggest that sex differences exist in transtibial amputee gait, offering possible explanations for the different comorbidities experienced by female lower limb amputees. These results have major implications for female amputees and for sex-specific research, rehabilitation, and prosthetic design.
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Continuous Auditory Feedback (CAF) can have profound effects when used to guide bodily movements. CAF is defined as auditory feedback that responds dynamically to continuous streams of data. A large number of studies have used CAF to communicate dynamic human efforts in the body. In contrast, this study uses motion sensor data at the knee and hip joints, which were converted to auditory sounds, to communicate the dynamic phases of walking gait through shifts in tonal brightness and loudness of two tones with harmonic relationships. As a proof-of-concept study, our aim was to determine if CAF mapped to hip and knee movements affects a person's gait. A total of 10 participants, five males and five females, participated in a gait analysis in a Biomechanics lab in relation to the various sound conditions. Quantitative results revealed that CAF has a significant effect on cadence. Notably, females had a higher cadence compared with males. Qualitative responses suggested that participants were aware of a relationship between the rotation of the knee and hip as the rise and fall of audio tonal brightness to concentrate or synchronise their gait. We defined this as a brightness-rotation relationship. Based on these findings, we propose future investigations to further understand and extend this brightness-rotation relationship and develop reliable models of CAF to support movement awareness for gait training and rehabilitation program. These investigations will inform future development of wearable systems of on-body sensing and auditory feedback for this awareness and rehabilitation.
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Autologous osteochondral transplantation (AOT) is used in the treatment of osteochondral lesions (OCL) of the talus. The purpose of this study was to compare the differences in the presentation of talar OCLs and outcomes following AOT between male and female patients. Eighty-seven consecutive patients, ages 16-65 years, who underwent AOT were retrospectively reviewed. Patients were divided into two groups based on sex. Demographic data and OCL defect characteristic data were recorded. Functional outcomes were assessed pre- and post-operatively using the Foot and Ankle Outcome Score (FAOS). The Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score was used to assess cartilage incorporation. Fifty-six (64%) males and 31 (36%) females with mean clinical follow-up of 47.2 months were included in this study. OCL defect size was significantly larger in male patients (112.8 mm²) when compared with female patients (88.7 mm2) (p<0.001). Male patients presented with a lesion associated with a recognized trauma (p<0.006) when compared with female patients who typically presented with associated chronic ankle instability. Mean FAOS improved pre- to postoperatively from 50 to 81 (p< 0.001) with a statistically significant increase found in male patients (p<0.001). The mean MOCART score was 82.1 in male and 86.7 female patients (p<0.001). Our study demonstrates potential gender related differences in the presentation and mechanism of injury in the development of OCLs. It is also not unreasonable to suggest that there may also be differences in treatment and rehabilitation strategies to reduce the risk of developing OCLs in men and women.
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Bone marrow stimulation (BMS) is indicated for patients who have symptomatic osteochondral lesions of the talus (OLT). Despite differences in ankle biomechanics and cartilage morphology between men and women, there is scant evidence examining whether these differences affect surgical outcomes. The purpose of this study was to compare the outcomes in men and women following BMS for OLTs. A retrospective analysis comparing female and male patients treated with BMS for OLT between 2007 and 2015 was performed. Clinical outcomes were evaluated using the Foot and Ankle Outcome Scores (FAOS) and Short-Form 12 (SF-12). Magnetic resonance imaging (MRI) at final follow-up was evaluated with the modified magnetic resonance observation of cartilage repair tissue (MOCART) score. Thirty-one females and 38 males were included. In female patients, the mean FAOS pain score improved from 60±16 preoperatively to 84±8.9 at 1-2 year follow-up (p<0.01), and then decreased to 80±13 at final follow-up at 3-4 years. In male patients, the mean FAOS pain score improved from 65±17 preoperatively to 83±9.2 at 1-2 year follow-up (p<0.01), and then decreased to 76±14.6 at final follow-up at 3-4 years. Lateral lesions were more common in male patients. Medial lesions were more common in female patients. The outcomes following BMS in both female and male patients were good with no significant differences at short term follow-up. FAOS scores in male patients were more likely to decrease after 1-2 years post-surgery, implying a possibly faster decline than in female patients.
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Background Three-dimensional (3D) motion measured at the lower back during walking can describe the regularity and symmetry of gait that may be related to osteoarthritis (OA) and functional status. However, gait speed and inherent sex differences, regardless of the presence of OA, may confound these measures. Therefore, there is a need to understand the effect of OA separately among males and females, without the confounding influence of gait speed. Objective To investigate the difference in 3D gait regularity and symmetry measures between gait speed-matched males and females with and without knee OA. Method Gait regularity and symmetry were computed as autocorrelations of pelvic accelerations during treadmill walking in four groups of older adults: healthy asymptomatic females (AsymF; n=44), healthy asymptomatic males (AsymM; n=45), females diagnosed with knee OA (OAF; n=44), and males diagnosed with knee OA (OAM; n=45). Data were obtained from a larger research database, allowing for the matching of gait speed between groups. The main effect of OA, sex, and interaction effect between them was examined for the 3D gait regularity and symmetry measures at an alpha level of 0.05. Results There was no main effect of OA on any variable, but there was a significant main effect of sex on mediolateral and anteroposterior gait regularity measures. Specifically, females demonstrated significantly greater gait regularity, most notably in the mediolateral directions compared to males. Conclusion Older adult females were found to display significantly greater mediolateral gait regularity as compared to males, regardless of the presence of OA. Further, this difference exists among matched gait speeds, suggesting it is not the result of gait speed. Overall, these results highlight the importance of sex-specific analyses and considering gait speed when examining gait acceleration patterns near the centre of mass for both cross sectional and longitudinal gait assessments.
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To ensure stable obstacle crossing when walking, visual information is required two steps before reaching the obstacle. As possible age-related sex differences in visuomotor control have not been investigated, we assessed sex differences in obstacle crossing while walking, as examined by toe clearance (TC) and postural stability. Participants were 14 younger and 14 older adults (equal numbers of men and women) who wore goggles for visual field adjustment while obstacle crossing during gait. We manipulated three visual field occlusion conditions (total, lower, and no visual field occlusions) two steps before the obstacle and analyzed the TC of the lead limb, and the participants’ step width and root mean square of trunk acceleration as indices of postural stability. We found a significant interaction between sex and visual condition in step width, with men showing larger step width values than women in all visual field conditions. Moreover, while women showed no step-width differences across visual field conditions, men had a larger step width with the lower visual field occluded than in the other visual conditions. We found no other significant sex differences. Our results suggest that men may be more dependent than women on the upper visual field for postural stability during obstacle crossing. Sex differences in visuomotor control were not affected by age.
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Background: Tibialis anterior (TA) muscle is the largest dorsiflexor of the ankle joint and plays an important role during gait movement. However, descriptions of the TA attachment site are inconsistent even among major anatomy textbooks, and its origin, especially the attachment site for the tibia, has not been reported in detail. This study is the first experimental attempt to investigate the origin of the TA in detail, paying particular attention to the relationship with the shape of the tibia, including sex differences. Methods: Forty legs (20 males, 20 females) from twenty Japanese cadavers were examined. Gross anatomical examination of the TA's attachment site to the tibia and the tibia's shape was performed. Results: The location of the distal end of the TA's attachment on tibia was more distal in males than in females. The anterior border of the tibia had a gentle S-like curve, with a medially convex curve in the proximal region and a laterally convex curve in the distal region in frontal plane. The most protruding point of the distal curve of the anterior border locates more proximal in females than in males. Conclusions: There were sex differences in relationship between the distal end of the attachment site on tibia of the TA and the shape of the tibia. Consequently, in males, the TA was considered to be advantageous for power exertion, while in females it worked efficiently for ankle movements. Sex differences in TA's attachment site and the shape of the tibia may be involved in gait movement as well as frequency of lower leg disorders such as chronic exertional compartment syndrome.
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Mobility is crucial for healthy aging. Any disruption to mobility can affect mental, physical and social health, and socio-economic independence. Therefore, studies in gait and lower-joint functionality with respect to different demographic features will play a vital role in maintaining good mobility. In this study, we analyzed a gait database from 70 healthy subjects (18-86 years) constructed using our custom-built multi-sensor-based wearable tele-health monitoring system. The purpose was to extract and use the most informative features for classifying knee joint and gait characteristics of the subjects with respect to their age, body mass index - BMI, and sex. Four supervised machine learning algorithms: partial least square-discriminant analysis (PLS-DA), support vector machine (SVM), random forest (RF), and artificial neural network (ANN) were used to classify the subjects. The features that significantly contributed to all classifications are knee angle, quadriceps muscle pressure adjacent to the knee joint, rotational energy (mediolateral and vertical), acceleration energy (mediolateral), cross-sample entropy (anteroposterior-mediolateral), knee angle variability, symmetry of swing and stance phase, and walk ratio. Classification accuracies of all four methods were 89%, 83%, 81%, 86% for age, 90%, 80%, 83%, 86% for BMI, and 97%, 97%, 96%, 97% for sex, respectively. PLS-DA had the best classification performance for all three categories which makes it preferable for these kinds of analyses. Thus, our knee and gait monitoring system coupled with an efficient machine learning tool can be exploited for real-time evaluation and early diagnoses of mobility disabilities, health assessment, and monitoring the need for interventions.
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Background: Dislocation is the most common reason for early revision following total hip arthroplasty (THA). More than 40 years ago, Lewinnek et al. proposed an acetabular "safe zone" to avoid dislocation. While novel at the time, their study was substantially limited according to modern standards. The purpose of this study was to determine optimal acetabular cup positioning during THA as well as the effect of surgical approach on the topography of the acetabular safe zone and the hazard of dislocation. Methods: Primary THAs that had been performed at a single institution from 2000 to 2017 were reviewed. Acetabular inclination and anteversion were measured using an artificial intelligence neural network; they were validated with performance testing and comparison with blinded grading by 2 orthopaedic surgeons. Patient demographics and dislocation were noted during follow-up. Multivariable Cox proportional-hazards regression, including multidimensional analysis, was performed to define the 3D topography of the acetabular safe zone and its association with surgical approach. Results: We followed 9,907 THAs in 8,081 patients (4,166 women and 3,915 men; 64 ± 13 years of age) for a mean of 5 ± 3 years (range: 2 to 16); 316 hips (3%) sustained a dislocation during follow-up. The mean acetabular inclination was 44° ± 7° and the mean anteversion was 32° ± 9°. Patients who did not sustain a dislocation had a mean anteversion of 32° ± 9° (median, 32°), with the historic ideal anteversion of 15° observed to be only in the third percentile among non-dislocating THAs (p < 0.001). Multivariable modeling demonstrated the lowest dislocation hazards at an inclination of 37° and an anteversion of 27°, with an ideal modern safe zone of 27° to 47° of inclination and 18° to 38° of anteversion. Three-dimensional analysis demonstrated a similar safe-zone location but significantly different safe-zone topography among surgical approaches (p = 0.03) and sexes (p = 0.02). Conclusions: Optimal acetabular positioning differs significantly from historic values, with increased anteversion providing decreased dislocation risk. Additionally, surgical approach and patient sex demonstrated clear effects on 3D safe-zone topography. Further study is needed to characterize the 3D interaction between acetabular positioning and spinopelvic as well as femoral-sided parameters. Level of evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Commonly, the monitoring of external workload has been performed using a single device on player's scapulae. The human body is a complex multi-articular system and quantification in a single location is insufficient, being necessary the assessment in multiple body locations simultaneously. Therefore, this study aimed to characterize the multi-location external workload in men’s and women’s players and to analyze the sex-related differences during the most common movements in basketball. Twenty-six semi-professional basketball players (n = 13 men, n = 13 women) were evaluated in five tests: linear and curvilinear movements, changing of speed, jumping and in-game movements. PlayerLoadRT was evaluated at six anatomical locations simultaneously (scapulae, lumbar region, knees, and ankles) with WIMU PROTM inertial devices attached to the athlete using a full-body skinsuit. Statistical analysis was composed of a t-test of independent measures and Coheńs d effect size. The main results indicated: (1) the type of movement modified the external workload supported by the musculoskeletal structures; (2) sex-related differences were found in the vertical absorption of external workload (p < 0.05); (3) no sex-related differences were shown in the horizontal profile (p > 0.16). The multi-location monitoring will allow the identification of musculoskeletal structures with high vertical absorption of external load depending on sex (men > women: scapulae-lumbar and knee-ankle; women > men: lumbar-knee) and type of movement (scapulae-lumbar: decelerations; lumbar-knee: jumping; knee-ankle: in-game), just like horizontal differences in lower limb (outer > inner leg: curvilinear). Equally movements distribution throughout training sessions, strengthening and recovery programmes of high-workload muscle groups according to player’s characteristics could contributed to performance enhancement and reduce injury risk. HIGHLIGHTS • Men’s and women’s basketball players presented different vertical musculoskeletal absorption of external workload. Men presented higher absorption in scapulae – lumbar and knee – ankle segments while women did so in the lumbar – knee segment. • The type of movements had a direct effect in the multi-location external workload profile. • A combined effect of sex and type of movement was found in the vertical musculoskeletal absorption of the external workload profile. • No sex-related differences were found in the horizontal profile regarding the type of movement.
Chapter
The ankle is a complex joint composed of a network of osseous and soft tissue structures that provide an inherent balance between structure and function, allowing transmission of forces through the ankle during weight-bearing activities. Each component works together biomechanically playing a critical role in the gait cycle. Therefore a thorough understanding of ankle anatomy and biomechanics, as well as an appreciation of the differences in these related to gender, is important when evaluating and treating athletic injuries involving the ankle joint. This chapter will review the ankle bony, soft tissue, and neurovascular anatomy; the biomechanics underlying the gait cycle; and gender-related differences within the ankle joint.
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Background and aims Gait speed estimation using wearable inertial sensors during daily activities suffers from high complexity and inaccuracies in distance estimation when integrating acceleration signals. The aim of the study was to investigate the agreement between the methods of gait speed estimation using the persons’ walk ratio (step-length/step-frequency relation) or step-frequency (number of steps per minute) and a “gold standard”. Methods For this cross-sectional validation study, 20 healthy community-dwelling older persons (mean age 72.1 years; 70% women) walked at slow, normal, and fast speed over an instrumented walkway (reference measure). Gait speed was calculated using the person’s pre-assessed walk ratio. Furthermore, the duration of walking and number of steps were used for calculation. Results The agreement between gait speed calculation using the walk ratio or step-frequency (adjusted to body height) and reference was r = 0.98 and r = 0.93, respectively. Absolute and relative mean errors of calculated gait speed using pre-assessed walk ratio ranged between 0.03–0.07 m/s and 1.97–4.17%, respectively. Discussion and conclusions After confirmation in larger cohorts of healthy community-dwelling older adults, the mean gait speed of single walking bouts during activity monitoring can be estimated using the person’s pre-assessed walk ratio. Furthermore, the mean gait speed can be calculated using the step-frequency and body height and can be an additional parameter in stand-alone activity monitoring.
Article
Background Acetabular dysplasia is an important pre-disposing factor for osteoarthritis of the hip. However, it is not completely known how acetabular dysplasia develops during childhood. Objective To study the prevalence of acetabular dysplasia and its association with body mass index (BMI) and physical activity in 9 year old children. Design The population for this cross-sectional study was drawn from the ongoing prospective cohort study: Generation R. 9,778 mothers with a delivery date from March 2002 until January 2006 were enrolled. In a random subgroup of these children Dual-energy X-ray absorptiometry (DXA) scanning was performed at age 9. Exposures BMI, standardized for the Dutch population and categorized in four groups based on extended international Obesity Task Force cut-offs: underweight, normal, overweight and obesity. Physical activity was based on time spent on playing outdoors, playing sports and walking/cycling to school. Main outcomes and measures The degree of acetabular dysplasia was determined with the centre-edge angle (CEA) and acetabular depth-width ratio (ADR) in DXA images of the hip. Results 1,188 DXA images of children's hips were available for analysis. The median age of the children was 9.86 years. Prevalence of dysplasia and mild dysplasia was respectively 6.3%; 25.6% with CEA and 4.8%; 25.0% with ADR. BMI was negatively associated with mild dysplasia (OR 0.80 CI 0.71–0.90). Obese children showed less mild dysplasia compared to normal children (OR 0.48 CI 0.24–0.97) in unadjusted analysis. Physical activity represented by walking to school showed a statistically significant negative association with mild dysplasia (OR 0.87 CI 0.76–0.99). After adjustment for age, ethnicity, sex, first born, breech presentation, birthweight, gestational age and Caesarean section, the patterns of association with dysplasia remained for both BMI and physical activity. Conclusions In this study, being overweight and light physical activity were negatively associated with the development of (mild) acetabular dysplasia at the age of 9 years.
Article
Context: Previous studies have reported that the incidence of patellofemoral pain in women is 2.2 times higher than that in men. Lower hip frontal dynamic joint stiffness in women may be related to the magnitude of hip adduction and internal rotation associated with patellofemoral pain. Objective: To identify sex differences in hip frontal dynamic joint stiffness and examine the relationship between hip frontal dynamic joint stiffness and hip adduction and internal rotation during gait. Design: Cross-sectional study. Setting: University campus. Participants: A total of 80 healthy volunteers (40 women and 40 men) participated in this study. Intervention(s): Kinematic and kinetic data during gait were collected using a motion capture system and force plates. Main outcome measures: Hip frontal dynamic joint stiffness, hip adduction, and hip internal rotation were calculated during gait. Results: Women demonstrated lower hip frontal dynamic joint stiffness than men during gait (P < .01). They also displayed decreased hip frontal dynamic joint stiffness associated with increased hip adduction (r = -.85, P < .001) and internal rotation (r = -.48, P < .001). Conversely, in men, decreased hip frontal dynamic joint stiffness was associated with increased hip adduction (r = -.74, P < .001) but not internal rotation (r = .17, P = .28). Conclusions: Sex differences between hip frontal dynamic joint stiffness and hip internal rotation during gait may contribute to the increased incidence of patellofemoral pain in women.
Article
Background: This double-blinded randomized-controlled-trial aimed to identify the effects of an elastic band resistance training on walking kinetics and muscle activities in young adults with genu valgus. Methods: Forty-two male young adults aged 22.5(2.7) years with genu valgus were randomly allocated to two experimental groups. The intervention group (n=21) conducted a 14-weeks elastic band resistance training. The control group was passive during the intervention period and received the same treatment after the post-tests. Pre and post training, ground reaction forces and lower limb muscle activities were recorded during walking. Findings: Results revealed significant group-by-time interactions for peak medial ground reaction force and time-to-peak for posterior ground reaction force in favor of the intervention group (p<0.012; d=0.83-3.76). Resistance training with elastic bands resulted in significantly larger peak medial ground reaction force (p<0.001; d=1.45) and longer time-to-peak for posterior ground reaction force (p<0.001; d=1.85). Finding showed significant group-by-time interactions for peak positive free moment amplitudes in favor of the intervention group (p<0.001; d=1.18-2.02). Resistance training resulted in a lower peak positive free moment amplitude (p=0.001;d=1.46). With regards to muscle activities, the analysis revealed significant group-by-time interactions for rectus femoris and gluteus medius activities during the push-off phase in favor of the intervention group (p<0.038; d=0.68-0.89). Resistance training induced higher rectus femoris (p=0.038; d=0.84) and gluteus medius (p=0.007; d=0.54) activities. Interpretation: This study proved the effectiveness of resistance training using elastic bands on kinetics and muscle activities during walking in male adults with genu valgus disorder. Given that this training regime is low cost, effective, and easy-to-administer, we suggest that it should be implemented as a rehabilitative or preventive means for young adults with genu valgus.
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Studies of human locomotion have found that male and female walkers differ in terms of lateral body sway, with males tending to swing their shoulders from side to side more than their hips, and females tending to swing their hips more than their shoulders. Experiments reported here demonstrate that naive viewers can identify the gender of the figure in a biological motion display very reliably when the display contains gender-specific lateral body sway. Sensitivity to gender is high even for displays containing only a fraction of a step cycle. This dynamic cue dominates structural cues based on torso shape (`centre-of-moment') when the cues are set in opposition. It is mediated by gender-specific differences in the velocity of shoulder and hip dots, not by positional differences in shoulder and hip dots during the step cycle.
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It is proposed to scale gait data (e.g. steplength, velocity, force, moment, work) by leg length and body mass. It is concluded that temporal parameters are affected by the scaling as well. One correction: dimensionless power P^ = P/(m.g^3/2.l^1/2
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The sex of human walkers can be recognized without familiarity cues from displays of pointlight sources mounted on major joints. Static versions of these abstract displays do not permit accurate recognition of sex. Variation in the degree of armswing or in walking speed generally interferes with recognition, except that faster speeds are associated somewhat with improved recognition of females. Lights on upper-body joints permit more accurate guesses than do Lights on lower-body joints, but identification is possible even from minimal displays, with lights placed only on the ankles. No feedback was given to observers. Confidence judgments of sex relate to the accuracy of responses in a manner that suggests that viewers know what they are doing.
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Objectives: To determine if there are changes in temporal gait parameters with a focus on pelvis when comparing overground and treadmill ambulation, and to assess the effect of sex. Design: An observational study employing motion analysis techniques to evaluate pelvic movement during gait. Setting: University biomechanics laboratory. Participants: Men (n=8; 22.5±3.0 y) and women (n=6; 23.8±4.1 y). Interventions: Not applicable. Main outcome measures: Cadence, stride time, stance phase percent, and pelvic tilt, obliquity, and rotation parameters throughout the gait cycle were assessed during overground and treadmill walking. Kinematic data were recorded using a passive full body marker based motion analysis system. While an independent sample t test was used to determine if differences in walking speed were evident between sexes, a 2-way, repeated-measures analysis of variance was performed to examine the effect of walking mode and sex on each dependent variable. Results: Significant differences (P<.05) between overground and treadmill walking for the temporal parameters analyzed were evident for both sexes. A lower pelvic obliquity motion for treadmill walking when compared with overground walking was evident for both sexes, and the pelvic rotation movement pattern showed the greatest difference between walking modes. The majority of the significant differences between sexes were of a magnitude greater than the differences between overground and treadmill walking. Conclusions: The differences in temporal and angular kinematics identified in the present study should be considered when treadmills are used in a rehabilitation program.
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Walking speed has implications for community functioning and is predictive of important outcomes. Determining whether an individual's walking speed is limited requires normal values for comparison. To use meta-analysis to describe normal gait speed for healthy individuals within age and gender strata. PubMed, the Cumulative Index of Nursing and Allied Health (CINAHL), Scopus, Science Citation Index and articles identified by hand searches. STUDY SELECTION CRITERIA: Inclusion required that the gait speed of apparently healthy adults was documented as they walked at a normal pace over a course of 3 to 30 m. Summary data were excluded unless obtained from at least 10 participants within a gender and decade stratum. The two authors independently reviewed articles and extracted data. Accuracy was confirmed by the other author. Data were grouped within gender and decade strata. A meta-analysis macro was used to consolidate data by strata and to determine homogeneity. Forty-one articles contributed data to the analysis. Combined, they provided data from 23111 subjects. The gait speed was homogeneous within strata and ranged from a mean of 143.4 cm/second for men aged 40 to 49 years to a mean of 94.3 cm/second for women aged 80 to 99 years. The data presented herein may not be useful as a standard of normal if gait is measured over short distances from the command 'go' or if a turn is involved. The consolidation of data from multiple studies reported in this meta-analysis provides normative data that can serve as a standard against which individuals can be compared. Doing so will aid the interpretation of their performance.
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The purpose of this study was to analyze kinematic trunk motion data in normal adults and to investigate gender effect. Kinematic trunk motion data were obtained for 20 healthy subjects (11 men and 9 women; age from 21 to 40 years) during walking a 9 m long lane at a self selected speed, namely, motions in the sagittal (tilt), coronal (obliquity), and transverse (rotation) planes, which were all expressed as motions in global (relative to the ground) and those in pelvic reference frame (relative to pelvis), i.e., tilt (G), obliquity (G), rotation (G), tilt (P), obliquity (P), rotation (P). Range of tilt (G), obliquity (G) and rotation (G) showed smaller motion than that of tilt (P), obliquity (P) and rotation (P), respectively. When genders were compared, female trunks showed a 5 degree more extended posture during gait than male trunks (p = 0.002), which appeared to be caused by different lumbar lordosis. Ranges of coronal and transverse plane motion appeared to be correlated. In gait cycle, the trunk motion appeared to counterbalance the lower extremity during swing phase in sagittal plane, and to reduce the angular velocity toward the contralateral side immediate before the contralateral heel strike in the coronal plane. Men and women showed different lumbar lordosis during normal gait, which might be partly responsible for the different prevalence of lumbar diseases between genders. However, this needs further investigation.
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Unlabelled: Sex-related influences on pain and analgesia have become a topic of tremendous scientific and clinical interest, especially in the last 10 to 15 years. Members of our research group published reviews of this literature more than a decade ago, and the intervening time period has witnessed robust growth in research regarding sex, gender, and pain. Therefore, it seems timely to revisit this literature. Abundant evidence from recent epidemiologic studies clearly demonstrates that women are at substantially greater risk for many clinical pain conditions, and there is some suggestion that postoperative and procedural pain may be more severe among women than men. Consistent with our previous reviews, current human findings regarding sex differences in experimental pain indicate greater pain sensitivity among females compared with males for most pain modalities, including more recently implemented clinically relevant pain models such as temporal summation of pain and intramuscular injection of algesic substances. The evidence regarding sex differences in laboratory measures of endogenous pain modulation is mixed, as are findings from studies using functional brain imaging to ascertain sex differences in pain-related cerebral activation. Also inconsistent are findings regarding sex differences in responses to pharmacologic and non-pharmacologic pain treatments. The article concludes with a discussion of potential biopsychosocial mechanisms that may underlie sex differences in pain, and considerations for future research are discussed. Perspective: This article reviews the recent literature regarding sex, gender, and pain. The growing body of evidence that has accumulated in the past 10 to 15 years continues to indicate substantial sex differences in clinical and experimental pain responses, and some evidence suggests that pain treatment responses may differ for women versus men.
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