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Biomechanics of Human Movement and Its Clinical Applications

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A special issue of Bioengineering (ISSN 2306-5354). This special issue belongs to the section "Biomechanics and Sports Medicine".

Deadline for manuscript submissions: 31 March 2025 | Viewed by 11661

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Special Issue Editors

Dr. Gordon J. Alderink

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Guest Editor

College of Health Professions, Department of Physical Therapy & Athletic Training, Grand Valley State University, Grand Rapids, MI 49503, USA
Interests: normal and pathological gait; static (standing postural control) and dynamic balance (gait); sports biomechanics; kinesiological electromyography

Sylvia Öunpuu

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Guest Editor

1. Center for Motion Analysis, Connecticut Children’s Medical Center, 399 Farmington Ave., Farmington, CT 05032, USA
2. Department of Orthopaedic Surgery, University of Connecticut School of Medicine, Farmington, CT 06030, USA
Interests: pathological gait; treatment of gait pathology; gait-based treatment outcomes

Special Issue Information

Dear Colleagues,

The focus of this Special Issue will be to examine the application of biomechanics to the study of human movement as it relates to gait. Submitted articles should include a review of select systems for measuring three-dimensional human movement that are presently being used to clinically assess normal and pathological gait in children and adults. These systems include optical motion capture, inertial measurement units (IMUs), and biplane fluoroscopy. The advantages, disadvantages, and challenges of biomechanical modeling (inverse dynamics, induced acceleration analysis, and forward dynamics) should be explored as they are applied in clinical and translational research settings.

This Special Issue will include original research papers, narrative critical reviews, and examples of the clinical application of biomechanics, as provided by cohort studies or case reports. Our intention is to provide an overview of the complexity of the application of cutting-edge experimental and clinical research on human gait. Topics of interest include, but are not limited to, the following areas:

Three-dimensional optical motion capture system; synchronization of motion, force, and electromyography (EMG);
Validation and precision of motion capture systems and biomechanical models;
Evolution of the full-body Helen Hayes (or plug-in gait) model and its use in human gait analysis;
Validation and application of simple versus multisegment foot models;
Use of optical motion capture (kinematics, kinetics [inverse dynamics], and EMG) in the diagnosis, evaluation, treatment recommendations, and outcomes research in cerebral palsy, club feet, Charcot–Marie–Tooth, and myelomeningocele;
Musculoskeletal modeling (induced acceleration and forward dynamics) in gait analysis;
Theory, instrumentation, and evolution (validation and precision) of inertial measurement units in the analysis of gait;
Theory, instrumentation, and evolution (validation and precision) of biplane fluoroscopy in the analysis of gait;
Integration of biplane fluoroscopy and optical motion capture in clinical practice;
Clinical applications in the form of cohort research and case report.

Dr. Gordon J. Alderink
Sylvia Öunpuu
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Bioengineering is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

three-dimensional
kinematics
kinetics
electromyography
inertial measurement units
biplane fluoroscopy
biomechanical and musculoskeletal models
instrumented gait analysis
clinical applications

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Published Papers (8 papers)

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Research

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16 pages, 5739 KiB

Open AccessArticle

Comparison of IMU-Based Knee Kinematics with and without Harness Fixation against an Optical Marker-Based System

by Jana G. Weber, Ariana Ortigas-Vásquez, Adrian Sauer, Ingrid Dupraz, Michael Utz, Allan Maas and Thomas M. Grupp

Bioengineering 2024, 11(10), 976; https://doi.org/10.3390/bioengineering11100976 - 28 Sep 2024

Viewed by 472

Abstract

The use of inertial measurement units (IMUs) as an alternative to optical marker-based systems has the potential to make gait analysis part of the clinical standard of care. Previously, an IMU-based system leveraging Rauch–Tung–Striebel smoothing to estimate knee angles was assessed using a six-degrees-of-freedom joint simulator. In a clinical setting, however, accurately measuring abduction/adduction and external/internal rotation of the knee joint is particularly challenging, especially in the presence of soft tissue artefacts. In this study, the in vivo IMU-based joint angles of 40 asymptomatic knees were assessed during level walking, under two distinct sensor placement configurations: (1) IMUs fixed to a rigid harness, and (2) IMUs mounted on the skin using elastic hook-and-loop bands (from here on referred to as “skin-mounted IMUs”). Estimates were compared against values obtained from a harness-mounted optical marker-based system. The comparison of these three sets of kinematic signals (IMUs on harness, IMUs on skin, and optical markers on harness) was performed before and after implementation of a REference FRame Alignment MEthod (REFRAME) to account for the effects of differences in coordinate system orientations. Prior to the implementation of REFRAME, in comparison to optical estimates, skin-mounted IMU-based angles displayed mean root-mean-square errors (RMSEs) up to 6.5°, while mean RMSEs for angles based on harness-mounted IMUs peaked at 5.1°. After REFRAME implementation, peak mean RMSEs were reduced to 4.1°, and 1.5°, respectively. The negligible differences between harness-mounted IMUs and the optical system after REFRAME revealed that the IMU-based system was capable of capturing the same underlying motion pattern as the optical reference. In contrast, obvious differences between the skin-mounted IMUs and the optical reference indicated that the use of a harness led to fundamentally different joint motion being measured, even after accounting for reference frame misalignments. Fluctuations in the kinematic signals associated with harness use suggested the rigid device oscillated upon heel strike, likely due to inertial effects from its additional mass. Our study proposes that optical systems can be successfully replaced by more cost-effective IMUs with similar accuracy, but further investigation (especially in vivo and upon heel strike) against moving videofluoroscopy is recommended. Full article

(This article belongs to the Special Issue Biomechanics of Human Movement and Its Clinical Applications)

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12 pages, 1223 KiB

Open AccessArticle

Influence of Internal and External Foot Rotation on Peak Knee Adduction Moments and Ankle Moments during Gait in Individuals with Knee Osteoarthritis: A Cross-Sectional Study

by Yongwook Kim

Bioengineering 2024, 11(7), 696; https://doi.org/10.3390/bioengineering11070696 - 9 Jul 2024

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Abstract

The aim of the study was to verify the effects of foot progression angle (FPA) modification during walking on the internal moments of the ankle and knee joints in individuals with knee osteoarthritis (OA). Biomechanical changes such as increased knee adduction moment (KAM) during walking are known to be involved in the development and severity of knee OA. Although various FPA modifications during gait have been applied to reduce peak KAM, few studies have investigated the effects of applying toe-in or toe-out walking modifications for knee OA on peak KAM and three-dimensional (3D) moments of the ankle joint. Kinetic moment variables were acquired from 35 individuals with medial knee compartment OA. A 3D motion analysis system and two force platforms were used to acquire KAM and 3D moments of both ankle joints during gait. Visual3D was used to obtain final moment data for statistical processing. Repeated-measures analysis of variance with Bonferroni adjustment was used to compare kinetic and kinematic values for each FPA walking condition. There was a significant decrease (p < 0.01) in first peak KAM when walking with an internal rotation foot position compared to normal foot position walking. Also, there was a significant decrease (p < 0.01) in second peak KAM when walking with an external rotation foot position compared to normal foot position walking. Compared to a normal foot position, peak ankle inversion moment of the external rotation foot position walking showed a significant decrease (p < 0.05). There were no interactive effects between FPA condition and limb sides for any KAM values (p > 0.05). The results showed no significant increase in the ankle joint moment value during gait for FPA modification conditions. Thus, the clinical implications of this study suggest that modification of the FPA in patients with OA to reduce KAM does not negatively impact the 3D ankle moments. Full article

(This article belongs to the Special Issue Biomechanics of Human Movement and Its Clinical Applications)

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13 pages, 4223 KiB

Open AccessArticle

Validation of Pelvis and Trunk Range of Motion as Assessed Using Inertial Measurement Units

by Farwa Ali, Cecilia A. Hogen, Emily J. Miller and Kenton R. Kaufman

Bioengineering 2024, 11(7), 659; https://doi.org/10.3390/bioengineering11070659 - 28 Jun 2024

Viewed by 785

Abstract

Trunk and pelvis range of motion (ROM) is essential to perform activities of daily living. The ROM may become limited with aging or with neuromusculoskeletal disorders. Inertial measurement units (IMU) with out-of-the box software solutions are increasingly being used to assess motion. We hypothesize that the accuracy (validity) and reliability (consistency) of the trunk and pelvis ROM during steady-state gait in normal individuals as measured using the Opal APDM 6 sensor IMU system and calculated using Mobility Lab version 4 software will be comparable to a gold-standard optoelectric motion capture system. Thirteen healthy young adults participated in the study. Trunk ROM, measured using the IMU was within 5–7 degrees of the motion capture system for all three planes and within 10 degrees for pelvis ROM. We also used a triad of markers mounted on the sternum and sacrum IMU for a head-to-head comparison of trunk and pelvis ROM. The IMU measurements were within 5–10 degrees of the triad. A greater variability of ROM measurements was seen for the pelvis in the transverse plane. IMUs and their custom software provide a valid and reliable measurement for trunk and pelvis ROM in normal individuals, and important considerations for future applications are discussed. Full article

(This article belongs to the Special Issue Biomechanics of Human Movement and Its Clinical Applications)

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10 pages, 1864 KiB

Open AccessArticle

An Investigation of Running Kinematics with Recovered Anterior Cruciate Ligament Reconstruction on a Treadmill and In-Field Using Inertial Measurement Units: A Preliminary Study

by Matteo Hill, Pierre Kiesewetter, Thomas L. Milani and Christian Mitschke

Bioengineering 2024, 11(4), 404; https://doi.org/10.3390/bioengineering11040404 - 19 Apr 2024

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Abstract

Anterior cruciate ligament reconstruction (ACLR) may affect movement even years after surgery. The purpose of this study was to determine possible interlimb asymmetries due to ACLR when running on a treadmill and in field conditions, with the aim of contributing to the establishment of objective movement assessment in real-world settings; moreover, we aimed to gain knowledge on recovered ACLR as a biomechanical risk factor. Eight subjects with a history of unilateral ACLR 5.4 ± 2.8 years after surgery and eight healthy subjects ran 1 km on a treadmill and 1 km on a concrete track. The ground contact time and triaxial peak tibial accelerations were recorded using inertial measurement units. Interlimb differences within subjects were tested and compared between conditions. There were no significant differences between limbs in the ACLR subjects or in healthy runners for any of the chosen parameters on both running surfaces. However, peak tibial accelerations were higher during field running (p-values < 0.01; Cohen’s d effect sizes > 0.8), independent of health status. To minimize limb loading due to higher impacts during field running, this should be considered when choosing a running surface, especially in rehabilitation or when running with a minor injury or health issues. Full article

(This article belongs to the Special Issue Biomechanics of Human Movement and Its Clinical Applications)

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18 pages, 2666 KiB

Open AccessArticle

Influence of Backpack Carriage and Walking Speed on Muscle Synergies in Healthy Children

by Giorgia Marino, Alessandro Scano, Giulia Beltrame, Cristina Brambilla, Alessandro Marazzi, Francesco Aparo, Lorenzo Molinari Tosatti, Roberto Gatti and Nicola Portinaro

Bioengineering 2024, 11(2), 173; https://doi.org/10.3390/bioengineering11020173 - 10 Feb 2024

Cited by 1 | Viewed by 1325

Abstract

Four to five muscle synergies account for children’s locomotion and appear to be consistent across alterations in speed and slopes. Backpack carriage induces alterations in gait kinematics in healthy children, raising questions regarding the clinical consequences related to orthopedic and neurological diseases and ergonomics. However, to support clinical decisions and characterize backpack carriage, muscle synergies can help with understanding the alterations induced in this condition at the motor control level. In this study, we investigated how children adjust the recruitment of motor patterns during locomotion, when greater muscular demands are required (backpack carriage). Twenty healthy male children underwent an instrumental gait analysis and muscle synergies extraction during three walking conditions: self-selected, fast and load conditions. In the fast condition, a reduction in the number of synergies (three to four) was needed for reconstructing the EMG signal with the same accuracy as in the other conditions (three to five). Synergies were grouped in only four clusters in the fast condition, while five clusters were needed for the self-selected condition. The right number of clusters was not clearly identified in the load condition. Speed and backpack carriage altered nearly every spatial–temporal parameter of gait, whereas kinematic alterations reflected mainly hip and pelvis adaptations. Although the synergistic patterns were consistent across conditions, indicating a similar motor pattern in different conditions, the fast condition required fewer synergies for reconstructing the EMG signal with the same level of accuracy. Full article

(This article belongs to the Special Issue Biomechanics of Human Movement and Its Clinical Applications)

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18 pages, 3295 KiB

Open AccessArticle

Kinematic Analysis of Human Gait in Healthy Young Adults Using IMU Sensors: Exploring Relevant Machine Learning Features for Clinical Applications

by Xavier Marimon, Itziar Mengual, Carlos López-de-Celis, Alejandro Portela, Jacobo Rodríguez-Sanz, Iria Andrea Herráez and Albert Pérez-Bellmunt

Bioengineering 2024, 11(2), 105; https://doi.org/10.3390/bioengineering11020105 - 23 Jan 2024

Viewed by 2785

Abstract

Background: Gait is the manner or style of walking, involving motor control and coordination to adapt to the surrounding environment. Knowing the kinesthetic markers of normal gait is essential for the diagnosis of certain pathologies or the generation of intelligent ortho-prostheses for the treatment or prevention of gait disorders. The aim of the present study was to identify the key features of normal human gait using inertial unit (IMU) recordings in a walking test. Methods: Gait analysis was conducted on 32 healthy participants (age range 19–29 years) at speeds of 2 km/h and 4 km/h using a treadmill. Dynamic data were obtained using a microcontroller (Arduino Nano 33 BLE Sense Rev2) with IMU sensors (BMI270). The collected data were processed and analyzed using a custom script (MATLAB 2022b), including the labeling of the four relevant gait phases and events (Stance, Toe-Off, Swing, and Heel Strike), computation of statistical features (64 features), and application of machine learning techniques for classification (8 classifiers). Results: Spider plot analysis revealed significant differences in the four events created by the most relevant statistical features. Among the different classifiers tested, the Support Vector Machine (SVM) model using a Cubic kernel achieved an accuracy rate of 92.4% when differentiating between gait events using the computed statistical features. Conclusions: This study identifies the optimal features of acceleration and gyroscope data during normal gait. The findings suggest potential applications for injury prevention and performance optimization in individuals engaged in activities involving normal gait. The creation of spider plots is proposed to obtain a personalised fingerprint of each patient’s gait fingerprint that could be used as a diagnostic tool. A deviation from a normal gait pattern can be used to identify human gait disorders. Moving forward, this information has potential for use in clinical applications in the diagnosis of gait-related disorders and developing novel orthoses and prosthetics to prevent falls and ankle sprains. Full article

(This article belongs to the Special Issue Biomechanics of Human Movement and Its Clinical Applications)

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11 pages, 787 KiB

Open AccessArticle

Predictors of Changes in Pelvic Rotation after Surgery with or without Femoral Derotational Osteotomy in Ambulatory Children with Cerebral Palsy

by Reiko Hara, Susan A. Rethlefsen, Tishya A. L. Wren and Robert M. Kay

Bioengineering 2023, 10(10), 1214; https://doi.org/10.3390/bioengineering10101214 - 18 Oct 2023

Viewed by 1845

Abstract

Asymmetry of pelvic rotation affects function. However, predicting the post-operative changes in pelvic rotation is difficult as the root causes are complex and likely multifactorial. This retrospective study explored potential predictors of the changes in pelvic rotation after surgery with or without femoral derotational osteotomy (FDRO) in ambulatory children with cerebral palsy (CP). The change in the mean pelvic rotation angle during the gait cycle, pre- to post-operatively, was examined based on the type of surgery (with or without FDRO) and CP distribution (unilateral or bilateral involvement). In unilaterally involved patients, pelvic rotation changed towards normal with FDRO (p = 0.04), whereas patients who did not undergo FDRO showed a significant worsening of pelvic asymmetry (p = 0.02). In bilaterally involved patients, the changes in pelvic rotation did not differ based on FDRO (p = 0.84). Pelvic rotation corrected more with a greater pre-operative asymmetry (β = −0.21, SE = 0.10, p = 0.03). Sex, age at surgery, GMFCS level, and follow-up time did not impact the change in pelvic rotation. For children with hemiplegia, internal hip rotation might cause compensatory deviation in pelvic rotation, which could be improved with surgical correction of the hip. The predicted changes in pelvic rotation should be considered when planning surgery for children with CP. Full article

(This article belongs to the Special Issue Biomechanics of Human Movement and Its Clinical Applications)

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14 pages, 1653 KiB

Open AccessReview

Beyond Inverse Dynamics: Methods for Assessment of Individual Muscle Function during Gait

by Stephen J. Piazza

Bioengineering 2024, 11(9), 896; https://doi.org/10.3390/bioengineering11090896 - 6 Sep 2024

Viewed by 689

Abstract

Three-dimensional motion analysis performed in the modern gait analysis laboratory provides a wealth of information about the kinematics and kinetics of human locomotion, but standard gait analysis is largely restricted to joint-level measures. Three-dimensional joint rotations, joint moments, and joint powers tell us a great deal about gait mechanics, but it is often of interest to know about the roles that muscles play. This narrative review surveys work that has been done, largely over the past four decades, to augment standard gait analysis with muscle-level assessments of function. Often, these assessments have incorporated additional technology such as ultrasound imaging, or complex modeling and simulation techniques. The review discusses measurements of muscle moment arm during walking along with assessment of muscle mechanical advantage, muscle–tendon lengths, and the use of induced acceleration analysis to determine muscle roles. In each section of the review, examples are provided of how the auxiliary analyses have been used to gain potentially useful information about normal and pathological human walking. While this work highlights the potential benefits of adding various measures to gait analysis, it is acknowledged that challenges to implementation remain, such as the need for specialized knowledge and the potential for bias introduced by model choices. Full article

(This article belongs to the Special Issue Biomechanics of Human Movement and Its Clinical Applications)

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