Sex differences in dynamic joint stiffness during walking in older adults.

BACKGROUND: Knee osteoarthritis (OA) often occurs in older women. Walking assistance such as knee brace is used to reduce mechanical stress on the knee, preventing OA onset. Dynamic joint stiffness (DJS) quantifies the resistance of an assistive device, providing a foundation for an objective bending stiffness prescription model. DJS may show sex differences among older adults. RESEARCH QUESTION: This study aimed to investigate sex differences in lower limb DJS in the sagittal plane during walking in older adults. METHODS: A total of 132 healthy older adults, aged 65 years or older (71 men and 61 women), were extracted from a public dataset. DJS of the hip, knee, and ankle joints in the sagittal plane was determined during the power absorption phase of the stance. DJS, joint angular excursion, and Δ joint moment were compared between older men and women using the Mann-Whitney U test. In addition, the r-value was calculated to represent the effect size of the differences in amplitude. RESULTS: Ankle DJS in older women was significantly lower with a reduced Δ ankle plantar flexion moment compared with that into men (p < 0.001 and p = 0.001; r = 0.35 and 0.42, respectively). Additionally, knee DJS was lower in older women (p = 0.007). However, since the joint angular excursion and ΔMoment showed no differences (p = 0.624 and 0.222, respectively), the effect size was small (r = 0.24). Hip DJS showed no significant sex differences (p = 0.703). SIGNIFICANCE: These results suggest that the decrease in ankle DJS in older women was caused by the reduced ankle plantarflexion moment. Thus, support for ankle DJS is necessary for healthy older women. Nonetheless, knee DJS does not elucidate the cause of knee OA in the older women.

Acquisition of bipedal locomotion in a neuromusculoskeletal model with unilateral transtibial amputation.

Adaptive locomotion is an essential behavior for animals to survive. The central pattern generator in the spinal cord is responsible for the basic rhythm of locomotion through sensory feedback coordination, resulting in energy-efficient locomotor patterns. Individuals with symmetrical body proportions exhibit an energy-efficient symmetrical gait on flat ground. In contrast, individuals with lower limb amputation, who have morphologically asymmetrical body proportions, exhibit asymmetrical gait patterns. However, it remains unclear how the nervous system adjusts the control of the lower limbs. Thus, in this study, we investigated how individuals with unilateral transtibial amputation control their left and right lower limbs during locomotion using a two-dimensional neuromusculoskeletal model. The model included a musculoskeletal model with 7 segments and 18 muscles, as well as a neural model with a central pattern generator and sensory feedback systems. Specifically, we examined whether individuals with unilateral transtibial amputation acquire prosthetic gait through a symmetric or asymmetric feedback control for the left and right lower limbs. After acquiring locomotion, the metabolic costs of transport and the symmetry of the spatiotemporal gait factors were evaluated. Regarding the metabolic costs of transportation, the symmetric control model showed values approximately twice those of the asymmetric control model, whereas both scenarios showed asymmetry of spatiotemporal gait patterns. Our results suggest that individuals with unilateral transtibial amputation can reacquire locomotion by modifying sensory feedback parameters. In particular, the model reacquired reasonable locomotion for activities of daily living by re-searching asymmetric feedback parameters for each lower limb. These results could provide insight into effective gait assessment and rehabilitation methods to reacquire locomotion in individuals with unilateral transtibial amputation.

Prediction of anatomically and biomechanically feasible precision grip posture of the human hand based on minimization of muscle effort.

We developed a method to estimate a biomechanically feasible precision grip posture of the human hand for a given object based on a minimization of the muscle effort. The hand musculoskeletal model was constructed as a chain of 21 rigid links with 37 intrinsic and extrinsic muscles. To grasp an object, the static force and moment equilibrium condition of the object, force balance between the muscle and fingertip forces, and static frictional conditions must be satisfied. We calculated the hand posture, fingertip forces, and muscle activation signals for a given object to minimize the square sum of the muscle activations while satisfying the above kinetic constraints using an evolutionary optimization technique. To evaluate the estimated hand posture and fingertip forces, a wireless fingertip force-sensing device with two six-axis load cells was developed. When grasping the object, the fingertip forces and hand posture were experimentally measured to compare with the corresponding estimated values. The estimated hand postures and fingertip forces were in reasonable agreement to the corresponding measured data, indicating that the proposed hand posture estimation method based on the minimization of muscle effort is effective for the virtual ergonomic assessment of a handheld product.

Effect of vibrotactile stimulation of the hallux nail on segmental coordination: A secondary analysis using uncontrolled manifold analysis.

Controlling center of mass (CoM) movement in the mediolateral direction is imperative for stable walking. During walking, CoM movement is adjusted by the coordination of each body segment, which can be evaluated using uncontrolled manifold (UCM) analysis. UCM analysis evaluates segmental coordination by analyzing variablity in motor movement among the different segments of the body. The vibrotactile stimulation of the hallux nail can augment the sensory information of the plantar surface for necessary motor control. This study aims to investigate the effect of the vibrotactile stimulation of the hallux nail on segmental coordination to control CoM movement in the mediolateral direction during walking. Thirteen healthy men participated in the study. A vibrator was attached to each hallux nail, and pressure sensors were placed under the hallux balls. When the hallux ball was in contact with the floor, vibration stimulation was applied. A three-dimensional motion analysis system was used to measure the segment angles during walking, and UCM analysis was used to evaluate kinematic synergy for controlling CoM movement in the mediolateral direction. Subsequently, segment angles were used as an elemental variable. The synergy index and bad variability as motor noise were negatively related to the status without the stimulation. Vibrotactile stimulation in young people was more effective for people with large motor noise and a small synergy index during the single-stance phase. Thus, kinematic synergy can be immediately changed by sensory input using vibrotactile stimulation of the hallux nail, although applying vibration stimulation should be considered in advance.

Digital Twin-Driven Human Robot Collaboration Using a Digital Human.

Advances are being made in applying digital twin (DT) and human-robot collaboration (HRC) to industrial fields for safe, effective, and flexible manufacturing. Using a DT for human modeling and simulation enables ergonomic assessment during working. In this study, a DT-driven HRC system was developed that measures the motions of a worker and simulates the working progress and physical load based on digital human (DH) technology. The proposed system contains virtual robot, DH, and production management modules that are integrated seamlessly via wireless communication. The virtual robot module contains the robot operating system and enables real-time control of the robot based on simulations in a virtual environment. The DH module measures and simulates the worker's motion, behavior, and physical load. The production management module performs dynamic scheduling based on the predicted working progress under ergonomic constraints. The proposed system was applied to a parts-picking scenario, and its effectiveness was evaluated in terms of work monitoring, progress prediction, dynamic scheduling, and ergonomic assessment. This study demonstrates a proof-of-concept for introducing DH technology into DT-driven HRC for human-centered production systems.

Self-Reported Walking Difficulty Associated with Stiff-Knee Gait in Japanese Patients with Knee Osteoarthritis: A Preliminary Cross-Sectional Study.

BACKGROUND: Individuals with knee osteoarthritis are restricted in their daily activity because of walking difficulty. The purpose of this investigation was to examine the association between self-reported walking difficulty and knee flexion excursion during gait in Japanese patients with knee osteoarthritis. METHODS: Twenty-eight patients with knee osteoarthritis participated in this study. Knee flexion excursions in loading response and swing during gait were measured through an inertial measurement unit-based motion capture system. The walking difficulty was assessed by a subitem in the Japanese Knee Osteoarthritis Measure. Pain intensity was assessed by a visual analog scale. Characteristics and gait variables were compared between groups that were determined a priori using the results of the walking difficulty assessment. The relationship between knee flexion excursion during gait and walking difficulty were analyzed using logistic regression. RESULTS: The participants with walking difficulty had significantly small knee flexion excursion in both loading response and swing with large pain. After controlling the effect of pain, only knee flexion excursion in the swing was significantly related to the walking difficulty. CONCLUSIONS: This study suggested that the knee flexion excursion in swing during gait is helpful for understanding the walking difficulty experienced in Japanese patients with knee osteoarthritis.

Self-Perception of the Knee Is Associated with Joint Motion during the Loading Response in Individuals with Knee Osteoarthritis: A Pilot Cross-Sectional Study.

Small knee flexion motion is a characteristic of gait in individuals with knee osteoarthritis. This study examined the relationship between knee flexion excursion in loading response and knee self-perception in individuals with knee osteoarthritis. Twenty-one individuals with knee osteoarthritis participated in this study. Knee flexion excursions in loading response while walking at a comfortable and a fast-walking speed were measured using an inertial measurement unit-based motion capture system. The degree of knee perceptual impairment was evaluated using the Fremantle Knee Awareness Questionnaire (FreKAQ). The relationships between the FreKAQ score and gait variables and knee function were evaluated by calculating the correlation coefficient. The unique contributions of knee self-perception and muscle strength to knee flexion excursion in loading response were analyzed using hierarchical linear regression. Knee self-perception was significantly correlated with pain during walking, muscle strength and knee flexion excursion at fast speed. In the fast speed condition only, impaired knee self-perception was inversely proportional to knee flexion excursion and accounted for 21.8% of the variance in knee flexion excursion. This result suggests that impaired self-perception of the knee may help to explain the decrease in the knee flexion excursion in the loading response in individuals with knee osteoarthritis.

Influence of Patella thickness on Patellofemoral pressure in total knee Arthroplasty.

BACKGROUND: Patellofemoral complications are one of the major issues after total knee arthroplasty (TKA). Excessive patellofemoral joint pressure is associated with complications after TKA surgery, and the amount of patellar osteotomy has a direct effect on patellofemoral joint pressure. The purpose of this study was to evaluate the influence of patella thickness on patellofemoral pressure in TKA. METHODS: Five freshly frozen cadavers were operated with a custom-made Stryker posterior stabilizing type knee joint prosthesis. Patellofemoral joint pressure was measured using a pressure sensor, with the knee joint flexed from 90 to 110 degrees, and with patellar thickness of - 2 mm to + 4 mm. RESULTS: Increasing or decreasing patellar thickness significantly increased or decreased patellofemoral pressure. Regarding knee flexion angle, patellofemoral pressure increased with increasing patellar thickness at all flexion angles, but the pressure increase was greatest at 90 degrees of knee flexion and smallest at 110 degrees. CONCLUSIONS: The amount of patellar osteotomy influences the patellofemoral pressure. Surgeons should avoid increasing patella thickness, since the resulting increased patellofemoral pressure may reduce knee joint function.

Indoor vs. Outdoor Walking: Does It Make Any Difference in Joint Angle Depending on Road Surface?

Measurement of the joint angle during walking in real-world environments facilitates comprehension of the adaptation strategy corresponding to road surfaces. This study investigated the differences between the joint angles in the lower limb when walking on flat road surfaces in indoor and outdoor environments. Ten healthy young males who walked on a carpet-lined corridor in the indoor environment and on an interlocking block pavement surface in the outdoor environment participated in the study. The joint angles of their lower limbs were measured using seven inertial measurement units, and the average and coefficient of variation (%CV) of the joint angular excursion in the two environments were evaluated. The %CVs of the ankle plantar flexion excursion in the early stance was 45% higher in the outdoor environment compared with that in the indoor, although the spatiotemporal parameters and joint angular excursion of the proximal joints showed no difference between the environments. Though the road surfaces were flat from a macroscopic point of view, the interlocking block pavement had stiffer and more irregular characteristics. The variability in the ankle plantar flexion motion in the early stance may be most likely affected by these surface characteristics in the real-world outdoor environment.

Resolving Position Ambiguity of IMU-Based Human Pose with a Single RGB Camera.

Human motion capture (MoCap) plays a key role in healthcare and human-robot collaboration. Some researchers have combined orientation measurements from inertial measurement units (IMUs) and positional inference from cameras to reconstruct the 3D human motion. Their works utilize multiple cameras or depth sensors to localize the human in three dimensions. Such multiple cameras are not always available in our daily life, but just a single camera attached in a smart IP devices has recently been popular. Therefore, we present a 3D pose estimation approach from IMUs and a single camera. In order to resolve the depth ambiguity of the single camera configuration and localize the global position of the subject, we present a constraint which optimizes the foot-ground contact points. The timing and 3D positions of the ground contact are calculated from the acceleration of IMUs on foot and geometric transformation of foot position detected on image, respectively. Since the results of pose estimation is greatly affected by the failure of the detection, we design the image-based constraints to handle the outliers of positional estimates. We evaluated the performance of our approach on public 3D human pose dataset. The experiments demonstrated that the proposed constraints contributed to improve the accuracy of pose estimation in single and multiple camera setting.

Robustness analysis of decoding SSVEPs in humans with head movements using a moving visual flicker.

OBJECTIVE: The emergence of mobile electroencephalogram (EEG) platforms have expanded the use cases of brain-computer interfaces (BCIs) from laboratory-oriented experiments to our daily life. In challenging situations where humans' natural behaviors such as head movements are unrestrained, various artifacts could deteriorate the performance of BCI applications. This paper explored the effect of muscular artifacts generated by participants' head movements on the signal characteristics and classification performance of steady-state visual evoked potentials (SSVEPs). APPROACH: A moving visual flicker was employed to induce not only SSVEPs but also horizontal and vertical head movements at controlled speeds, leading to acquiring EEG signals with intensity-manipulated muscular artifacts. To properly induce neck muscular activities, a laser light was attached to participants' heads to give visual feedback; the laser light indicates the direction of the head independently from eye movements. The visual stimulus was also modulated by four distinct frequencies (10, 11, 12, and 13 Hz). The amplitude and signal-to-noise ratio (SNR) were estimated to quantify the effects of head movements on the signal characteristics of the elicited SSVEPs. The frequency identification accuracy was also estimated by using well-established decoding algorithms including calibration-free and fully-calibrated approaches. MAIN RESULTS: The amplitude and SNR of SSVEPs tended to deteriorate when the participants moved their heads, and this tendency was significantly stronger in the vertical head movements than in the horizontal movements. The frequency identification accuracy also deteriorated in proportion to the speed of head movements. Importantly, the accuracy was significantly higher than its chance-level regardless of the level of artifact contamination and algorithms. SIGNIFICANCE: The results suggested the feasibility of decoding SSVEPs in humans freely moving their head directions, facilitating the real-world applications of mobile BCIs.

Inter-Individual Variability in The Joint Negative Work During Running.

The inter-individual variability of running technique is an important factor affecting the negative work of lower extremity joints that leads to muscle damage. Our study examines the relationships between the negative work of the lower extremity joints and the associated mechanical parameters that account for inter-individual variability in the negative work. Twenty-four young male adults were asked to run on a runway at a speed of 3.0 m·s -1 . Multiple linear regression analysis was conducted to examine the relationships between the negative work and the associated mechanical parameters for each lower extremity joint. With regards to the results, 76.3% of inter-individual variability in the negative work of the hip joint was accounted for by inter-individual variabilities in the corresponding moment (25.4%) and duration (50.9%). For the knee joint, the inter-individual variabilities in the moment (40.6%), angular velocity (24.5%), and duration (23.8%) accounted for 88.9% of inter-individual variability in the negative work. The inter-individual variability in the moment of the ankle joint alone accounted for 89.3% of the inter-individual variability in the corresponding negative work. These results suggest that runners can change the negative work by adapting their running techniques to influence the relevant mechanical parameter values; however, major parameters corresponding to the change in the negative work are not the same among the lower extremity joints.

Semi-simulation Experiments for Quantifying the Performance of SSVEP-based BCI after Reducing Artifacts from Trapezius Muscles.

Muscular artifacts often contaminate electroencephalograms (EEGs) and deteriorate the performance of brain-computer interfaces (BCIs). Although many artifact reduction techniques are available, most of the studies have focused on their reduction ability (i.e. reconstruction errors), and it has been missing to evaluate their effect on the performance of BCIs. This study aims at evaluating the performance of a state-of-the-art muscular artifact reduction technique on a scenario of a steady-state visual evoked potentials (SSVEPs)based BCI. The performance was evaluated based on a semisimulation setting using a benchmark dataset of SSVEPs artificially contaminated by muscular artifacts acquired from the trapezius. Our results showed that combining the artifact reduction method and the classification algorithm based on the task-related component analysis gained improved classification accuracy. Interestingly, the artifact reduction setting minimizing the reconstruction errors, i.e. elaborately recovering the true EEG waveforms, was inconsistent to the one maximizing the classification performance. The results suggest that artifact reduction methods should be tuned so as to tomaximize performance of BCIs.

Evaluation of plantar pressures in people with hallux valgus using principal component analysis.

BACKGROUND: Foot deformities are serious problems in the elderly as they increase the risk of falling. OBJECTIVE: This study aimed to examine the relationship between foot plantar pressure during gait and hallux valgus (HV). METHODS: Foot-pressure data were recorded using an F-scan II system. We analyzed the entire waveform of plantar pressure during gait from 37 healthy adults using principle component analysis (PCA), conducted using a 370 × 357 matrix of time-normalized plantar data of 7 areas during gait (5 gait trials × 2 (both feet) of 37 participants × 51 data points × 7 plantar areas). Two-way (plantar pressure × presence or absence of HV) analyses of variance were conducted on the principal component scores (PCSs) of principal component vectors (PCVs) 1 through 5, each of which exhibited more than 5% variance. RESULTS: The PCA clarified that the 2nd, 3rd, and 5th PCVs (PCV 2, 3, and 5) were related to HV (p< 0.01). These PCVs exhibit a significant interaction between plantar pressure area and HV presence. CONCLUSIONS: The larger plantar pressure of the HV group around the hallux area during walking compared with the non-HV group is a dominant difference in plantar pressure features due to HV.

Evaluation of the Translation Distance of the Glenohumeral Joint and the Function of the Rotator Cuff on Its Translation: A Cadaveric Study.

PURPOSE: To evaluate the distance and position of humeral head translation during glenohumeral motion and to investigate the function of the rotator cuff in glenohumeral translation. METHODS: Using 9 cadavers, glenohumeral translation during passive pendulum motion was tracked by an optical motion capture system. Tension was applied to 5 compartments of the rotator cuff muscles, and 7 different conditions of rotator cuff dysfunction were sequentially simulated. Three-dimensional glenohumeral structure was reconstructed from the computed tomography images of the specimens, and the distance and position of glenohumeral translation were compared among the conditions. RESULTS: The average radius of glenohumeral translation was 10.6 ± 4.3 mm when static loading was applied to all rotator cuff muscles. The radius increased significantly in the models without traction force on the supraspinatus and total subscapularis tendons (P = .030). The position of the translation center did not change in the mediolateral direction (P = .587) and in the anteroposterior direction (P = .138), but it moved significantly superiorly in the models without supraspinatus and infraspinatus loading (P = .011) and in those without supraspinatus, infraspinatus, and teres minor loading (P < .001). CONCLUSIONS: The distance and position of humeral head translation during glenohumeral motion changed with rotator cuff deficiency. The present study indicated that the subscapularis plays an important role in maintaining the central position of the humeral head, and that the infraspinatus acts as a major depressor of the humeral head during shoulder motion. CLINICAL RELEVANCE: The results of this study suggest that extension of a tear into the subscapularis should be avoided to maintain the centering function of the glenohumeral joint in cases with rotator cuff tear.

Modeling and analysis of individual with lower extremity amputation locomotion using prosthetic feet and running-specific prostheses.

Prostheses have enabled individuals with lower extremity amputation (ILEAs) to accomplish many daily activities. Prosthetic feet allow ILEA to locomote and improves their quality of life. Carbon-fiber running-specific prostheses (RSPs) with energy storing capabilities support ILEAs to perform sprinting by partly providing spring-like properties in their amputated legs. Previous studies declare the spring-like RSP behavior and stiffness regulation during ILEA sprinting using RSP, though little is known about the behavior of the whole system that is a complex combination of human body and prostheses. This paper models this combined system with human and prosthetic foot and RSP using the digital human technology, then, analyzes the ILEA walking using the prosthetic foot and sprinting using RSP. We develop models that are combinations of human and prostheses by individualizing a linkage structure and inertial parameters of the digital human model. Then, locomotion of ILEA is analyzed based on measurements with optical motion capture system and force plates, and kinematics and dynamics computation. This modeling and computational technique can be applied to the locomotion of ILEA as well as a human motion using tools, and expanded to an analysis and improvement of system involving human.

Exploring optimal myoelectric feature indices for forearm control strategy using robust principal component analysis.

Forearm movements realize various functions needed in daily life. For reproduction of the motion sequences, active myoelectric devices have been developed. Usually, feature indices are extracted from observed signals in control strategy; however, the optimal combination of indices is still unclear. This paper introduces sparsity-inducing penalty term in principal component analysis (PCA) to explore optimal myoelectric feature indices. An electromyographic database including seven forearm movements from 30 subjects was used for performance comparison. Linear classifier with sparse features showed best performance (7.86±3.82% error rate) that was significantly better than linear classifier with all features because of recovering low rank matrix in original data. Furthermore, the sparse features had a large contribution of underlying data structure with less number of principal components than PCA. Root-mean-square, time-domain features, autoregressive coefficients, and Histogram purported to be important in projected feature space; therefore, the feature indices are important to myoelectric strategies.

Training Shoes do not Decrease the Negative Work of the Lower Extremity Joints.

Different types of running shoes may have different influence on the negative work of each lower extremity joint. Clarifying this influence can reduce the potential risk of muscle injury. The present study examined the difference in the negative work and associated kinetic and kinematic parameters of the lower extremity joints between training shoes and racing flats during the contact phase of running. Participants were asked to run on a runway at a speed of 3.0 m·s-1 for both training shoes and racing flats. The negative work and associated kinetic and kinematic parameters of each lower extremity joint were calculated. No difference was found in the negative work of the hip and ankle joints between the two types of running shoes. Meanwhile, the negative work of the knee joint was significantly greater for training shoes than for racing flats. This aspect was related to a longer duration of the negative power of the knee joint with the invariant amplitude of the negative power, moment, and angular velocity. These results suggest a higher potential risk of muscle injury around the knee joint for training shoes than for racing flats.

Influence of Total Knee Arthroplasty on Patellar Kinematics and Patellofemoral Pressure.

BACKGROUND: Patellofemoral complications are one of the main problems after total knee arthroplasty (TKA). The design of the TKA component may affect the patellar biomechanics, which may be associated with this postoperative complication. The purpose of this study was to assess the influence of TKA and prosthesis designs on the patellar kinematics and patellofemoral pressure. METHODS: Using fresh-frozen cadavers, we measured the patellofemoral pressure, patella offset, and patella tilt in the following 4 conditions: normal knee (patella replacement only), cruciate-retaining TKA, condylar-stabilizing TKA, and posterior-stabilized TKA. RESULTS: The patellofemoral pressure increased significantly after the cruciate-retaining TKA and condylar-stabilizing TKA compared with the normal knee. The patella offset in the normal knee decreased with increasing knee flexion angles, while the patella offset in the TKA knees did not change significantly through the full range of motion. The amount of lateral patella tilt in the normal knee was significantly larger than the TKA knees in the full range of motion. CONCLUSION: Although the femoral components are designed to reproduce an anatomical patellar tracking, the physiological patellar kinematics were not observed. Relatively high patellofemoral pressure and kinematic change after TKA may be associated with postoperative complications such as the anterior knee pain.

Justification for a 2D versus 3D fingertip finite element model during static contact simulations.

The biomechanical response of a human hand during contact with various products has not been investigated in details yet. It has been shown that excessive contact pressure on the soft tissue can result in discomfort, pain and also cumulative traumatic disorders. This manuscript explores the benefits and limitations of a simplified two-dimensional vs. an anatomically correct three-dimensional finite element model of a human fingertip. Most authors still use 2D FE fingertip models due to their simplicity and reduced computational costs. However we show that an anatomically correct 3D FE fingertip model can provide additional insight into the biomechanical behaviour. The use of 2D fingertip FE models is justified when observing peak contact pressure values as well as displacement during the contact for the given studied cross-section. On the other hand, an anatomically correct 3D FE fingertip model provides a contact pressure distribution, which reflects the fingertip's anatomy.