The Use of Wearable Sensors and Machine Learning Methods to Estimate Biomechanical Characteristics During Standing Posture or Locomotion: A Systematic Review.

Balance deficits are present in a variety of clinical populations and can negatively impact quality of life. The integration of wearable sensors and machine learning technology (ML) provides unique opportunities to quantify biomechanical characteristics related to balance outside of a laboratory setting. This article provides a general overview of recent developments in using wearable sensors and ML to estimate or predict biomechanical characteristics such as center of pressure (CoP) and center of mass (CoM) motion.

Altered foot placement modulation with somatosensory stimulation in people with chronic stroke.

Many individuals who experience a stroke exhibit reduced modulation of their mediolateral foot placement, an important gait stabilization strategy. One factor that may contribute to this deficit is altered somatosensory processing, which can be probed by applying vibration to the involved muscles (e.g.

Relationships between mediolateral step modulation and clinical balance measures in people with chronic stroke.

Background: Many people with chronic stroke (PwCS) exhibit walking balance deficits linked to increased fall risk and decreased balance confidence. One potential contributor to these balance deficits is a decreased ability to modulate mediolateral stepping behavior based on pelvis motion. This behavior, hereby termed mediolateral step modulation, is thought to be an important balance strategy but can be disrupted in PwCS.

Abduction/Adduction Assistance From Powered Hip Exoskeleton Enables Modulation of User Step Width During Walking.

Unlabelled: Using wearable robotics to modulate step width in normal walking for enhanced mediolateral balance has not been demonstrated in the field. We designed a bilateral hip exoskeleton with admittance control to power hip abduction and adduction to modulate step width.

Objective: As the first step to show its potential, the objective of this study was to investigate how human's step width reacted to hip exoskeleton's admittance control parameter changes during walking.

Augmented Hip Proprioception Influences Mediolateral Foot Placement During Walking.

Hip abductor proprioception contributes to the control of mediolateral foot placement, which varies with step-by-step fluctuations in pelvis dynamics. Prior work has used hip abductor vibration as a sensory probe to investigate the link between vibration within a single step and subsequent foot placement. Here, we extended prior findings by applying time and location varying vibration in every step, seeking to predictably manipulate the continuous, step-by-step relationship between pelvis dynamics and foot placement.

Post-stroke deficits in mediolateral foot placement accuracy depend on the prescribed walking task.

People with chronic stroke (PwCS) are susceptible to mediolateral losses of balance while walking, possibly due in part to inaccurate control of mediolateral paretic foot placement. We hypothesized that mediolateral foot placement errors when stepping to stationary or shifting visual targets would be larger for paretic steps than for steps taken by neurologically-intact individuals, hereby referred to as controls. Secondarily, we hypothesized that paretic foot placement errors would be correlated with previously identified deficits in isolated paretic hip abduction accuracy.

Effects of Targeted Assistance and Perturbations on the Relationship Between Pelvis Motion and Step Width in People With Chronic Stroke.

During walking in neurologically-intact controls, larger mediolateral pelvis displacements or velocities away from the stance foot are accompanied by wider steps. This relationship contributes to gait stabilization, as modulating step width based on pelvis motion (hereby termed a "mechanically-appropriate" step width) reduces the risk of lateral losses of balance. The relationship between pelvis displacement and step width is often weakened among people with chronic stroke (PwCS) for steps with the paretic leg.

Altered active control of step width in response to mediolateral leg perturbations while walking.

During human walking, step width is predicted by mediolateral motion of the pelvis, a relationship that can be attributed to a combination of passive body dynamics and active sensorimotor control. The purpose of the present study was to investigate whether humans modulate the active control of step width in response to a novel mechanical environment. Participants were repeatedly exposed to a force-field that either assisted or perturbed the normal relationship between pelvis motion and step width, separated by washout periods to detect the presence of potential after-effects.

The influence of lateral stabilization on walking performance and balance control in neurologically-intact and post-stroke individuals.

Background: Individuals post-stroke have an increased risk of falling, which can lead to injuries and reduced quality of life. This increased fall risk can be partially attributed to poorer balance control, which has been linked to altered post-stroke gait kinematics (e.g.

Altered post-stroke propulsion is related to paretic swing phase kinematics.

Background: Gait propulsion is often altered following a stroke, with clear effects on anterior progression. Changes in the pattern of propulsion could potentially also influence swing phase mechanics. The purpose of the present study was to investigate whether post-stroke variability in paretic propulsion magnitude or timing influence paretic swing phase kinematics.

Application of a Novel Force-Field to Manipulate the Relationship Between Pelvis Motion and Step Width in Human Walking.

Motion of the pelvis throughout a step predicts step width during human walking. This behavior is often considered an important component of ensuring bipedal stability, but can be disrupted in populations with neurological injuries. The purpose of this study was to determine whether a novel force-field that exerts mediolateral forces on the legs can manipulate the relationship between pelvis motion and step width, providing proof-of-concept for a future clinical intervention.

Post-stroke deficits in the step-by-step control of paretic step width.

Background: Humans partially maintain gait stability by actively controlling step width based on the dynamic state of the pelvis - hereby defined as the "dynamics-dependent control of step width". Following a stroke, deficits in the accurate control of paretic leg motion may prevent use of this stabilization strategy.

Research Question: Do chronic stroke survivors exhibit paretic-side deficits in the dynamics-dependent control of step width?

Methods: Twenty chronic stroke survivors participated in this cross-sectional study, walking on a treadmill at their self-selected (0.

Characterizing the corticomotor connectivity of the bilateral ankle muscles during rest and isometric contraction in healthy adults.

The investigation of the corticomotor connectivity (CMC) to leg muscles is an emerging research area, and establishing reliability of measures is critical. This study examined the measurement reliability and the differences between bilateral soleus (SOL) and tibialis anterior (TA) CMC in 21 neurologically intact adults. Using single pulse transcranial magnetic stimulation (TMS), each muscle's CMC was assessed twice (7 ± 2 days apart) during rest and active conditions.

Effects of walking speed on the step-by-step control of step width.

Young, healthy adults walking at typical preferred speeds use step-by-step adjustments of step width to appropriately redirect their center of mass motion and ensure mediolateral stability. However, it is presently unclear whether this control strategy is retained when walking at the slower speeds preferred by many clinical populations. We investigated whether the typical stabilization strategy is influenced by walking speed.

Effects of White Noise Achilles Tendon Vibration on Quiet Standing and Active Postural Positioning.

Applying white noise vibration to the ankle tendons has previously been used to improve passive movement detection and alter postural control, likely by enhancing proprioceptive feedback. The aim of the present study was to determine if similar methods focused on the ankle plantarflexors affect the performance of both quiet standing and an active postural positioning task, in which participants may be more reliant on proprioceptive feedback from actively contracting muscles. Twenty young, healthy participants performed quiet standing trials and active postural positioning trials designed to encourage reliance on plantarflexor proprioception.

Effect of Single-Use, Laser-Cut, Slow-Flow Nipples on Respiration and Milk Ingestion in Preterm Infants.

Purpose: Single-use, laser-cut, slow-flow nipples were evaluated for their effect on respiration and milk ingestion in 13 healthy preterm infants (32.7-37.1 weeks postmenstrual age) under nonlaboratory, clinical conditions.

Effects of hip abduction and adduction accuracy on post-stroke gait.

Background: Gait instability often limits post-stroke function, although the mechanisms underlying this instability are not entirely clear. Our recent work has suggested that one possible factor contributing to post-stroke gait instability is a reduced ability to accurately control foot placement. The purpose of the present experiments was to investigate whether post-stroke gait function is related to the ability to accurately abduct and adduct the hip, as required for accurate foot placement.

A Novel Elastic Force-Field to Influence Mediolateral Foot Placement During Walking.

Bipedal gait can be stabilized through mechanically-appropriate mediolateral foot placement, although this strategy is disrupted in a subset of neurologically injured individuals with balance deficits. The goal of the present work was to develop a device to influence mediolateral foot placement during treadmill walking. We created a novel force-field using a combination of passive elasticity and active control; wires in series with extension springs run parallel to the treadmill belts and can be rapidly repositioned to exert mediolateral forces on the legs of users.

Foot placement control and gait instability among people with stroke.

Gait instability is a common problem following stroke, as evidenced by increases in fall risk and fear of falling. However, the mechanism underlying gait instability is currently unclear. We recently found that young, healthy humans use a consistent gait stabilization strategy of actively controlling their mediolateral foot placement based on the concurrent mechanical state of the stance limb.

Hip proprioceptive feedback influences the control of mediolateral stability during human walking.

Active control of the mediolateral location of the feet is an important component of a stable bipedal walking pattern, although the roles of sensory feedback in this process are unclear. In the present experiments, we tested whether hip abductor proprioception influenced the control of mediolateral gait motion. Participants performed a series of quiet standing and treadmill walking trials.

Proprioceptive feedback contributes to the adaptation toward an economical gait pattern.

Humans generally prefer gait patterns with a low metabolic cost, but it is unclear how such patterns are chosen. We have previously proposed that humans may use proprioceptive feedback to identify economical movement patterns. The purpose of the present experiments was to investigate the role of plantarflexor proprioception in the adaptation toward an economical gait pattern.

Asynchronous recruitment of low-threshold motor units during repetitive, low-current stimulation of the human tibial nerve.

Motoneurons receive a barrage of inputs from descending and reflex pathways. Much of our understanding about how these inputs are transformed into motor output in humans has come from recordings of single motor units during voluntary contractions. This approach, however, is limited because the input is ill-defined.

Walking with wider steps increases stance phase gluteus medius activity.

Increases in step width have been reported for several clinical populations, including older adults and stroke survivors. These populations often also exhibit decreased hip abductor strength, suggesting that walking with wider steps may be an adaptive response in order to reduce the mechanical demands on the hip abductors. The purpose of this study was to quantify the relationship between step width and gluteus medius (GM) activity during walking.

A neuromechanical strategy for mediolateral foot placement in walking humans.

Stability is an important concern during human walking and can limit mobility in clinical populations. Mediolateral stability can be efficiently controlled through appropriate foot placement, although the underlying neuromechanical strategy is unclear. We hypothesized that humans control mediolateral foot placement through swing leg muscle activity, basing this control on the mechanical state of the contralateral stance leg.