A patient-centered 'test-drive' strategy for ankle-foot orthosis prescription: Protocol for a randomized participant-blinded trial.

Background: Ankle-foot orthoses (AFOs) are commonly used to overcome mobility limitations related to lower limb musculoskeletal injury. Despite a multitude of AFOs to choose from, there is scant evidence to guide AFO prescription and limited opportunities for AFO users to provide experiential input during the process. To address these limitations in the current prescription process, this study evaluates a novel, user-centered and personalized 'test-drive' strategy using a robotic exoskeleton ('AFO emulator') to emulate commercial AFO mechanical properties (i.

Compromised neuromuscular function of walking in people with diabetes: A narrative review.

Aim: This review summarizes recent studies that have investigated the neuromuscular dysfunction of walking in people with diabetes and its relationship to ulcer formation.

Methods: A comprehensive electronic search in the database (Scopus, Web of Science, PsycINFO, ProQuest, and PubMed) was performed for articles pertaining to diabetes and gait biomechanics.

Results: The Achilles tendon is thicker and stiffer in those with diabetes.

Comparison of five different methodologies for evaluating ankle-foot orthosis stiffness.

Background: The mechanical properties of an ankle-foot orthosis (AFO) play an important role in the gait mechanics of the end user. However, testing methodologies for evaluating these mechanical properties are not standardized. The purpose of this study was to compare five different evaluation frameworks to assess AFO stiffness.

Uneven Treadmill Training for Rehabilitation of Lateral Ankle Sprains and Chronic Ankle Instability: Protocol for a Pragmatic Randomized Controlled Trial.

Background: Lateral ankle sprains (LASs) are common injuries among military service members. Approximately 40% of individuals with an LAS progress to develop chronic ankle instability (CAI), a condition that results in substantial mechanical and neurophysiological impairment and activity limitation. Since proprioceptive and balance training improve functional outcomes and prevent secondary injury following LAS, they are recommended in clinical practice.

Muscle synergy structure and gait patterns in children with spastic cerebral palsy.

Aim: To determine if muscle synergy structure (activations and weights) differs between gait patterns in children with spastic cerebral palsy (CP).

Method: In this cross-sectional study, we classified 188 children with unilateral (n=82) or bilateral (n=106) spastic CP (mean age: 9y 5mo, SD: 4y 3mo, range: 3y 9mo-17y 7mo; 75 females; Gross Motor Function Classification System [GMFCS] level I: 106, GMFCS level II: 55, GMFCS level III: 27) into a minor deviations (n=34), drop foot (n=16), genu recurvatum (n=26), apparent equinus (n=53), crouch (n=39), and jump gait pattern (n=20). Surface electromyography recordings from eight lower limb muscles of the most affected side were used to calculate synergies with weighted non-negative matrix factorization.

Multiplanar Stiffness of Commercial Carbon Composite Ankle-Foot Orthoses.

The mechanical properties of an ankle-foot orthosis (AFO) can impact how a user's movement is either restricted or augmented by the device. However, standardized methods for assessing stiffness properties of AFOs are lacking, posing a challenge for comparing between devices and across vendors. Therefore, the purpose of this study was to quantify the rotational stiffness of thirteen commercial, nonarticulated, carbon composite ankle-foot orthoses.

Muscle weakness has a limited effect on motor control of gait in Duchenne muscular dystrophy.

Aim: Our aim was to determine if synergy weights and activations are altered in Duchenne muscular dystrophy (DMD) and if these alterations could be linked to muscle weakness.

Methods: In 22 children with DMD and 22 typical developing (TD) children of a similar age, surface electromyography (sEMG) of the gluteus medius, rectus femoris (REF), medial hamstrings, tibialis anterior, and medial gastrocnemius (GAS) were recorded during gait. Muscle weakness was assessed with maximal voluntary isometric contractions (MVIC).

Muscle Synergy Constraints Do Not Improve Estimates of Muscle Activity From Static Optimization During Gait for Unimpaired Children or Children With Cerebral Palsy.

Neuromusculoskeletal simulation provides a promising platform to inform the design of assistive devices or inform rehabilitation. For these applications, a simulation must be able to accurately represent the person of interest, such as an individual with a neurologic injury. If a simulation fails to predict how an individual recruits and coordinates their muscles during movement, it will have limited utility for informing design or rehabilitation.

Muscle synergies demonstrate only minimal changes after treatment in cerebral palsy.

Background: Children with cerebral palsy (CP) have altered synergies compared to typically-developing peers, reflecting different neuromuscular control strategies used to move. While these children receive a variety of treatments to improve gait, whether synergies change after treatment, or are associated with treatment outcomes, remains unknown.

Methods: We evaluated synergies for 147 children with CP before and after three common treatments: botulinum toxin type-A injection (n = 52), selective dorsal rhizotomy (n = 38), and multi-level orthopaedic surgery (n = 57).

Repeatability of electromyography recordings and muscle synergies during gait among children with cerebral palsy.

Background: Clinical gait analysis is commonly used in the evaluation and treatment of children with cerebral palsy (CP). While the repeatability of kinematic and kinetic measures of gait has previously been evaluated, the repeatability of electromyography (EMG) recordings or measures calculated from EMG data, such as muscle synergies, remains unclear for this population.

Research Question: Are EMG recordings and muscle synergies from clinical gait analysis repeatable between visits for children with CP?

Methods: We recruited 20 children with bilateral CP who had been referred for clinical gait analysis.

Associations Between Muscle Synergies and Treatment Outcomes in Cerebral Palsy Are Robust Across Clinical Centers.

Objective: To determine whether patient-specific differences in motor control quantified using muscle synergy analysis were associated with changes in gait after treatment of cerebral palsy (CP) across 2 clinical centers with different treatments and clinical protocols.

Design: Retrospective cohort study.

Setting: Clinical medical center.

Crouch severity is a poor predictor of elevated oxygen consumption in cerebral palsy.

Children with cerebral palsy (CP) expend more energy to walk compared to typically-developing peers. One of the most prevalent gait patterns among children with CP, crouch gait, is often singled out as especially exhausting. The dynamics of crouch gait increase external flexion moments and the demand on extensor muscles.

Electromyography Data Processing Impacts Muscle Synergies during Gait for Unimpaired Children and Children with Cerebral Palsy.

Muscle synergies calculated from electromyography (EMG) data identify weighted groups of muscles activated together during functional tasks. Research has shown that fewer synergies are required to describe EMG data of individuals with neurologic impairments. When considering potential clinical applications of synergies, understanding how EMG data processing impacts results and clinical interpretation is important.

Muscle recruitment and coordination with an ankle exoskeleton.

Exoskeletons have the potential to assist and augment human performance. Understanding how users adapt their movement and neuromuscular control in response to external assistance is important to inform the design of these devices. The aim of this research was to evaluate changes in muscle recruitment and coordination for ten unimpaired individuals walking with an ankle exoskeleton.

Multistep model for predicting upper-limb 3D isometric force application from pre-movement electrocorticographic features.

Neural correlates of movement planning onset and direction may be present in human electrocorticography in the signal dynamics of both motor and non-motor cortical regions. We use a three-stage model of jPCA reduced-rank hidden Markov model (jPCA-RR-HMM), regularized shrunken-centroid discriminant analysis (RDA), and LASSO regression to extract direction-sensitive planning information and movement onset in an upper-limb 3D isometric force task in a human subject. This mode achieves a relatively high true positive force-onset prediction rate of 60% within 250ms, and an above-chance 36% accuracy (17% chance) in predicting one of six planned 3D directions of isometric force using pre-movement signals.

Flow mechanotransduction regulates traction forces, intercellular forces, and adherens junctions.

Endothelial cells respond to fluid shear stress through mechanotransduction responses that affect their cytoskeleton and cell-cell contacts. Here, endothelial cells were grown as monolayers on arrays of microposts and exposed to laminar or disturbed flow to examine the relationship among traction forces, intercellular forces, and cell-cell junctions. Cells under laminar flow had traction forces that were higher than those under static conditions, whereas cells under disturbed flow had lower traction forces.