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Background: The effect of external lateral stabilization on medio-lateral gait stability has been investigated previously. However, existing lateral stabilization devices not only constrain lateral motions but also transverse and frontal pelvis rotations. This study aimed to investigate the effect of external lateral stabilization with and without constrained transverse pelvis rotation on mechanical and metabolic gait features., Methods: We undertook two experiments with 11 and 10 young adult subjects, respectively. Kinematic, kinetic and breath-by-breath oxygen consumption data were recorded during three walking conditions (normal walking (Normal), lateral stabilization with (Free) and without transverse pelvis rotation (Restricted)) and at three speeds (0.83, 1.25 and 1.66 m s -1 ) for each condition. In the second experiment, we reduced the weight of the frame, and allowed for longer habituation time to the stabilized conditions., Results: External lateral stabilization significantly reduced the amplitudes of the transverse and frontal pelvis rotations, in addition to medio-lateral, anterior-posterior, and vertical pelvis displacements, transverse thorax rotation, arm swing, step length and step width. The amplitudes of free vertical moment, anterior-posterior drift over a trial, and energy cost were not significantly influenced by external lateral stabilization. The removal of pelvic rotation restrictions by our experimental set-ups resulted in normal frontal pelvis rotation in Experiment 1 and significantly higher transverse pelvis rotation in Experiment 2, although transverse pelvis rotation still remained significantly less than in the Normal condition. Step length increased with the increased transverse pelvis rotation., Conclusion: Existing lateral stabilization set-ups not only constrain medio-lateral motions (i.e. medio-lateral pelvis displacement) but also constrain other movements such as transverse and frontal pelvis rotations, which leads to several other gait changes such as reduced transverse thorax rotation, and arm swing. Our new set-ups allowed for normal frontal pelvis rotation and more transverse pelvis rotation (yet less than normal). However, this did not result in more normal thorax rotation and arm swing. Hence, to provide medio-lateral support without constraining other gait variables, more elaborate set-ups are needed., (© 2021 The Authors.)

Identification of individuals at risk of falling is important when designing fall prevention methods. Current measures that estimate gait stability and robustness appear limited in predicting falls in older adults. Inspired by recent findings on changes in phase-dependent local stability within a gait cycle, we devised several phase-dependent stability measures and tested for their usefulness to predict gait robustness in compass walker models. These measures are closely related to the often-employed maximum finite-time Lyapunov exponent and maximum Floquet multiplier that both assess a system's response to infinitesimal perturbations. As such, they entail linearizing the system, but this is realized in a rotating hypersurface orthogonal to the period-one solution followed by estimating the trajectory-normal divergence rate of the swing phases and the foot strikes. We correlated the measures with gait robustness, i.e. the largest perturbation a walker can handle, in two compass walker models with either point or circular feet to estimate their prediction accuracy. To also test for the dependence of the measures under state space transform, we represented the point feet walker in both Euler-Lagrange and Hamiltonian canonical form. Our simulations revealed that for most of the measures their correlation with gait robustness differs between models and between different state space forms. In particular, the latter may jeopardize many stability measures' predictive capacity for gait robustness. The only exception that consistently displayed strong correlations is the divergence of foot strike. Our results admit challenges of using phase-dependent stability measures as objective means to estimate the risk of falling., (© 2021 The Authors.)

During human walking, the centre of mass (COM) laterally oscillates, regularly transitioning its position above the two alternating support limbs. To maintain upright forward-directed walking, lateral COM excursion should remain within the base of support, on average. As necessary, humans can modify COM motion through various methods, including foot placement. How the nervous system controls these oscillations and the costs associated with control are not fully understood. To examine how lateral COM motions are controlled, healthy participants walked in a 'Movement Amplification' force field that increased lateral COM momentum in a manner dependent on the participant's own motion (forces were applied to the pelvis proportional to and in the same direction as lateral COM velocity). We hypothesized that metabolic cost to control lateral COM motion would increase with the gain of the field. In the Movement Amplification field, participants were significantly less stable than during baseline walking. Stability significantly decreased as the field gain increased. Participants also modified gait patterns, including increasing step width, which increased the metabolic cost of transport as the field gain increased. These results support previous research suggesting that humans modulate foot placement to control lateral COM motion, incurring a metabolic cost., Competing Interests: We declare we have no competing interests., (© 2020 The Authors.)

Although measures of actual and perceived physical ability appear to predict falls in older adults, a disparity between these two, also known as misjudgement, may even better explain why some older adults fall, while their peers with similar abilities do not. Therefore, we investigated whether adding a misjudgement term improved prediction of future falls. Besides conventional measures of actual (physical measures) and perceived abilities (questionnaires), we used a stepping down paradigm to quantify behavioural misjudgement. In a sample of 55 older adults (mean age 74.5 (s.d. = 6.6) years, 33 females and 20 fallers over a 10-month follow-up period), we tested the added value of a misjudgement term and of a stepping-down task by comparing experimental Bayesian logistic-regression models to a default null model, which was composed of the conventional measures: Falls Efficacy Scale international and QuickScreen. Our results showed that the default null model fitted the data most accurately; however, the accuracy of all models was low (area under the receiver operating characteristic curve (ROC) ≤ 0.65). This indicates that neither a misjudgement term based on conventional measures, nor on behavioural measures improved the prediction of future falls in older adults (Bayes Factor 10 ≤ 0.5)., Competing Interests: No conflicts of interest are declared by the authors., (© 2019 The Authors.)