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Total ankle arthroplasty (TAA) is a common surgical solution for patients with debilitating arthritis of the ankle. Prior to surgery patients experience high levels of pain and fatigue and low mechanical energy recovery. It is not known if TAA restores healthy levels of mechanical energy recovery in this patient population. This study was designed to determine whether mechanical energy recovery was restored following TAA. Ground reaction forces during self-selected speed walking were collected from patients with symptomatic, unilateral ankle arthritis (N = 29) before and one and two years after primary, unilateral TAA. The exchange of potential (PE) and kinetic (KE) energy was examined, and direction of change (%congruity) and energy exchange (%recovery) between the two curves was calculated, with those subjects with low congruity experiencing high energy recovery. Linear regressions were used to examine the impact of walking speed, congruity, and amplitude of the center of mass (COM) displacement on %recovery, while ANOVA and ANCOVA models were used to compare energy recovery and congruity across the three time points. Gender, BMI, and age at surgery had no effect in this study. TAA improved walking speed (p = 0.001), increased energy recovery (p = 0.020), and decreased congruity (p = 0.002), and these levels were maintained over at least two years. Differences in congruity were independent of walking speed. In some patients, especially those who are severely debilitated by ankle arthritis, TAA is effective in restoring mechanical energy recovery to levels similar to an asymptomatic population of a similar age recorded by other studies., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Maintaining forward walking during human locomotion requires mechanical joint work, mainly provided by the ankle-foot in non-amputees. In lower-limb amputees, their metabolic overconsumption is generally attributed to reduced propulsion. However, it remains unclear how altered walking patterns resulting from amputation affect energy exchange. The purpose of this retrospective study was to investigate the impact of self-selected walking speed (SSWS) on mechanical works generated by the ankle-foot and by the entire lower limbs depending on the level of amputation. 155 participants, including 47 non-amputees (NAs), 40 unilateral transtibial amputees (TTs) and 68 unilateral transfemoral amputees (TFs), walked at their SSWS. Positive push-off work done by the trailing limb (W StS + ) and its associated ankle-foot (W ankle-foot + ), as well as negative collision work done by the leading limb (W StS - ) were analysed during the transition from prosthetic limb to contralateral limb. An ANCOVA was performed to assess the effect of amputation level on mechanical works, while controlling for SSWS effect. After adjusting for SSWS, NAs produce more push-off work with both their biological ankle-foot and trailing limb than amputees do on prosthetic side. Using the same type of prosthetic feet, TTs and TFs can generate the same amount of prosthetic W ankle-foot + , while prosthetic W StS + is significantly higher for TTs and remains constant with SSWS for TFs. Surprisingly and contrary to theoretical expectations, the lack of propulsion at TFs' prosthetic limb did not affect their contralateral W StS - , for which a difference is significant only between NAs and TTs. Further studies should investigate the relationship between the TFs' inability to increase prosthetic limb push-off work and metabolic expenditure., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

During human locomotion, each limb performs step-to-step work on the body center of mass to maintain forward walking. This energy exchange relies on physiological mechanisms which are altered or impaired in transfemoral prosthesis users (TFPUs). Exploring step-to-step energy exchange modifications displayed by TFPUs at greater walking speeds may provide insight into their means for improving gait efficiency. The primary aim of this study was to characterize the effects of walking speed on mechanical work in unilateral TFPUs. The secondary aim assessed the effect of prosthetic knee (microprocessor, mechanical passive) on limb collision work. Twenty-five TFPUs walked with their customary prosthesis on a split-belt instrumented treadmill at eight speeds (0.55-1.53 m/s range), and collision, midstance, and push-off work were calculated for each limb. TFPUs displayed a significant (p < 0.001) bilateral increase in collision work with increased walking speed, but midstance and push-off work increased only for the sound limb and remained nearly constant for the prosthetic limb. TFPUs displayed significantly (p < 0.001) less push-off work generated by the prosthetic limb across all speeds. A microprocessor knee was associated with reduced sound limb collision work across speeds with the peak (negative) power being significantly greater for mechanical knees (p = 0.032). Results suggest that TFPU gait inefficiency may be related to a near complete loss of energy transfer on the prosthetic limb, relying on the sound limb to drive energy changes. Such reliance emphasizes need for attention to the long-term effects on sound limb health and possible benefit of microprocessor knees to offset that impact., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Cardiac mechanics is primarily described by the pressure-volume relationship. The ventricular pressure-volume loop displays the instantaneous relationship between intraventricular pressure and volume throughout the cardiac cycle; however, it does not consider the shape of the ventricles, their spatiotemporal deformation patterns, and how these balance with the flowing blood. Our study demonstrates that the pressure-volume relationship represents a first level of approximation for the mechanical power of the ventricles, while, at a further level of approximation, the importance of hemodynamic power emerges through the balance between deformation patterns and fluid dynamics. The analysis is preliminarily tested in a healthy subject's right ventricle and two patients. Moreover, patients' geometry was then rescaled to present a normal volumetric profile to verify whether results were affected by volume size or by the spatiotemporal pattern of how that volume profile was achieved. Results show that alterations of hemodynamic power were found in the abnormal ventricles and that they were not directly caused by the ventricular size but by changes in the ability of intraventricular pressure gradient to generate blood flow. Therefore, hemodynamic power represents a physics-based measure that takes into account the dynamics of the space-time shape changes in combination with blood flow. Hemodynamic power is assessed non-invasively using cardiac imaging techniques and can be an early indicator of cardiac dysfunction before changes occur in volumetric measurements. These preliminary results provide a physical ground to evaluate its diagnostic or prognostic significance in future clinical studies., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

The present study aimed to compare the effects of chair height and anterior seat inclination on sit-to-stand (STS) performance in children with spastic diplegic cerebral palsy (SDCP). Twelve children with SDCP were tested with three conditions of STS task: low chair with horizontal seat (control), low chair with anterior seat inclination (AiC), and high chair with horizontal seat (HiC) conditions. A 3D motion analysis system and two force plates were used to collect and analyze the movement time, mechanical work, kinematics, and kinetics. The results showed that in the AiC and HiC conditions, movement time and mechanical work during STS were significantly reduced when compared with the control condition. In addition, in the AiC condition, trunk alignment at the beginning of the STS task improved and the range of pelvis movement reduced, whereas in the HiC condition, the range of movement of hip, knee, and ankle joint and maximum hip and knee extension moment were reduced in children with SDCP when compared with the control condition. These results suggest that chair height and anterior seat inclination may have a positive effect on STS ability in children with SDCP. Trial register No. TCTR20170619003., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

The subtalar joint (STJ) contributes to the absorption and generation of mechanical energy (and power) during walking to maintain frontal plane stability. Previous observational studies have suggested that there may be a relationship between step width and STJ supination moment. This study directly tests the hypothesis that walking with a step width greater than preferred would reduce STJ moments, energy absorption, and power generation requirements, while increasing energy absorption at the hip during initial contact. Participants (n = 12, 7 females) were asked to walk on an instrumented treadmill at a constant velocity and cadence at a range of fixed step widths ranging from 0.1 to 0.4 times leg length (L). Walking at step widths greater than preferred (0.149 ± 0.04 L) reduced peak STJ moments at initial contact and propulsion which subsequently reduced the negative and positive work performed at the STJ. There was a 43% reduction in energy absorption (negative work) and approximately 30% decrease in positive work at the STJ as step width increased from 0.1 L to 0.4 L. An increase in energy absorption at the knee and hip was evident with an increase in step width during initial contact, although minimal mechanical changes were observed at the proximal joints during propulsion. These results suggest an increase in step width reduces the forces generated by muscles at the STJ across stance and is therefore likely to be beneficial in the prevention and treatment of their injuries. In terms of rehabilitation, the increase in mechanical costs occurring due to an increase in energy absorption by the hip and knee is of minimal concern., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

The mechanical output of a muscle may be characterised by having distinct functional behaviours, which can shift to satisfy the varying demands of movement, and may vary relative to a proximo-distal gradient in the muscle-tendon architecture (MTU) among lower-limb muscles in humans and other terrestrial vertebrates. We adapted a previous joint-level approach to develop a muscle-specific index-based approach to characterise the functional behaviours of human lower-limb muscles during movement tasks. Using muscle mechanical power and work outputs derived from experimental data and computational simulations of human walking and running, our index-based approach differentiated known distinct functional behaviours with varying mechanical demands, such as greater spring-like function during running compared with walking; with anatomical location, such as greater motor-like function in proximal compared with the distal lower-limb muscles; and with MTU architecture, such as greater strut-like muscles fibre function compared with the MTU in the ankle plantarflexors. The functional indices developed in this study provide distinct quantitative measures of muscle function in the human lower-limb muscles during dynamic movement tasks, which may be beneficial towards tuning the design and control strategies of physiologically-inspired robotic and assistive devices., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Changes of direction (CoDs) have a high metabolic and mechanical impact in field and court team sports, but the estimation of the associated workload is still inaccurate. This study aims at validating an algorithm based on kinematic data to estimate the energy cost of running with frequent 180°-CoDs. Twenty-six physically active male subjects (22.4 ± 3.2 years) participated in two sessions: (1) maximum oxygen uptake (V̇O 2,max ) and maximal aerobic speed (MAS) test; (2) 5-m continuous shuttle run (two 5-min trials at 50% and 75% MAS, 6-min recovery). In (2), full-body 3D-kinematics and V̇O 2 were simultaneously recorded. Actual cost of shuttle running (C meas ) was obtained from the aerobic, anaerobic alactic and lactic components. The proposed algorithm detects "braking phases", periods of mostly negative (eccentric) work occurring at concurrent knee flexion and ground contact, and estimates energy cost (C est ) considering negative mechanical work in braking phases, and positive elsewhere. At the speed of, respectively, 1.54 ± 0.17 and 1.90 ± 0.15 m s -1 (rate of perceived exertion: 9.1 ± 1.8 and 15.8 ± 1.9), C meas was 8.06 ± 0.49 and 9.04 ± 0.73 J kg -1  m -1 . C est was more accurate than regression models found in literature (p < 0.01), and not significantly different from C meas (p > 0.05; average error: 8.3%, root-mean-square error: 0.86 J kg -1  m -1 ). The proposed algorithm improved existing techniques based on CoM kinematics, integrating data of ground contacts and joint angles that allowed to separate propulsive from braking phases. This work constitutes the basis to extend the model from the laboratory to the field, providing a reliable measure of training and matches workload., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: Chronic heart failure patients present higher cost of transport and some changes in pattern of walking, but the same aspects have not yet been investigated in heart transplant patients., Methods: The aim of this study was to investigate both metabolic and mechanicals parameters, at five different walking speeds on treadmill, in chronic heart failure and heart transplant patients. Twelve chronic heart failure patients, twelve healthy controls and five heart transplant patients participated in the study. Tridimensional kinematics data and oxygen uptake were collected simultaneously., Findings: In both experimental groups the self-selected walking speed was lower than in controls, and lower than the expected optimal walking speed. At that speed all groups showed the best ventilatory efficiency. On contrary, chronic heart failure and heart transplant patients reached the minimum cost of transport and the maximum recovery at greater speeds than the self-selected walking speed. Their mechanical efficiency was lower than in controls, while their metabolic cost and mechanical work were on average larger., Interpretation: We conclude that actions, like a physical training, that could increase the self-selected walking speed in these patients, could also increase their economy and optimize the mechanical parameters of walking. We propose a rehabilitation index, based on the theoretical optimal walking speed, to measure the improvements during a physical rehabilitation therapy. These results have an important clinical relevance and can help to improve the quality of life of heart failure and transplant patients., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Force depression (FD), the reduction of isometric force following active shortening, is a phenomenon of skeletal muscle that has received significant attention in biomechanical and physiological literature, yet the mechanisms underlying FD remain unknown. Recent experiments identified a slower rate of force redevelopment with increasing amounts of steady-state FD, suggesting that FD may be caused, at least in part, by a decrease in cross-bridge binding rate (Corr and Herzog, 2005; Koppes et al., 2014). Herein, we develop a cross-bridge based model of FD in which the binding rate function, f, decreases with the mechanical work performed during shortening. This modification incorporates a direct relationship between steady-state FD and muscle mechanical work (Corr and Herzog, 2005; Herzog et al., 2000; Kosterina et al., 2008), and is consistent with a proposed mechanism attributing FD to stress-induced inhibition of cross-bridge attachments (Herzog, 1998; Maréchal and Plaghki, 1979). Thus, for an increase in mechanical work, the model should predict a slower force redevelopment (decreased attachment rate) to a more depressed steady-state force (fewer attached cross-bridges), and a reduction in contractile element stiffness (Ford et al., 1981). We hypothesized that since this modification affects the cross-bridge kinetics, a corresponding model would be able to account for both transient and steady-state FD behaviors. Comparisons to prior experiments (Corr and Herzog, 2005; Herzog et al., 2000; Kosterina et al., 2008) show that both steady-state and transient aspects of FD, as well as the relationship of FD with respect to speed and amplitude of shortening, are well captured by this model. Thus, this relatively simple cross-bridge based model of FD lends support to a mechanism involving the inhibition of cross-bridge binding, and indicates that cross-bridge kinetics may play a critical role in FD., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Locomotion on an accelerating treadmill belt is not dynamically similar to overground acceleration. The purpose of this study was to test if providing an external force to compensate for inertial forces during locomotion on an accelerating treadmill belt could induce locomotor dynamics similar to real accelerations. Nine males (mean±sd age=26±4 years, mass=81±9kg, height=1.8±0.05m) began walking and transitioned to running on an accelerating instrumented treadmill belt at three accelerations (0.27ms(-2), 0.42ms(-2), 0.76ms(-2)). Half the trials were typical treadmill locomotion (TT) and half were emulated acceleration (EA), where elastic tubing harnessed to the participant provided a horizontal force equal to mass multiplied by acceleration. Net mechanical work (WCOM) and ground reaction force impulses (IGRF) were calculated for individual steps and a linear regression was performed with these experimental measures as independent variables and theoretically derived values of work and impulse as predictor variables. For EA, linear fits were significant for WCOM (y=1.19x+10.5, P<0.001, R(2)=0.41) and IGRF (y=0.95x+8.1, P<0.001, R(2)=0.3). For TT, linear fits were not significant and explained virtually no variance for WCOM (y=0.06x+1.6, P=0.29, R(2)<0.01) and IGRF (y=0.10x+0.4, P=0.06, R(2)=0.01). This suggested that the EA condition was a better representation of real acceleration dynamics than TT. Running steps from EA where work and impulse closely matched theoretical values showed similar adaptations to increasing acceleration as have been previously observed overground (forward reorientation of GRF vector without an increase in magnitude or change in spatio-temporal metrics)., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

The mechanisms underlying the metabolic cost of running, and legged locomotion in general, remain to be well understood. Prior experimental studies show that the metabolic cost of human running correlates well with the vertical force generated to support body weight, the mechanical work done, and changes in the effective leg stiffness. Further, previous work shows that the metabolic cost of running decreases with decreasing body weight, increases with increasing body weight and mass, and does not significantly change with changing body mass alone. In the present study, we seek to uncover the basic mechanism underlying this existing experimental data. We find that an actuated spring-mass mechanism representing the effective mechanics of human running provides a mechanistic explanation for the previously reported changes in the metabolic cost of human running if the dimensionless relative leg stiffness (effective stiffness normalized by body weight and leg length) is regulated to be constant. The model presented in this paper provides a mechanical explanation for the changes in metabolic cost due to changing body weight and mass which have been previously measured experimentally and highlights the importance of active leg stiffness regulation during human running., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

During human running, softer parts of the body may deform under load and dissipate mechanical energy. Although tissues such as the heel pad have been characterized individually, the aggregate work performed by all soft tissues during running is unknown. We therefore estimated the work performed by soft tissues (N=8 healthy adults) at running speeds ranging 2-5 m s(-1), computed as the difference between joint work performed on rigid segments, and whole-body estimates of work performed on the (non-rigid) body center of mass (COM) and peripheral to the COM. Soft tissues performed aggregate negative work, with magnitude increasing linearly with speed. The amount was about -19 J per stance phase at a nominal 3 m s(-1), accounting for more than 25% of stance phase negative work performed by the entire body. Fluctuations in soft tissue mechanical power over time resembled a damped oscillation starting at ground contact, with peak negative power comparable to that for the knee joint (about -500 W). Even the positive work from soft tissue rebound was significant, about 13 J per stance phase (about 17% of the positive work of the entire body). Assuming that the net dissipative work is offset by an equal amount of active, positive muscle work performed at 25% efficiency, soft tissue dissipation could account for about 29% of the net metabolic expenditure for running at 5 m s(-1). During running, soft tissue deformations dissipate mechanical energy that must be offset by active muscle work at non-negligible metabolic cost., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Background: The Intrepid Dynamic Exoskeletal Orthosis (IDEO) is an ankle-foot orthosis developed to address the high rates of delayed amputation in the military. Its use has enabled many wounded Service Members to run again. During running, stiffness is thought to influence an orthosis' energy storage and return mechanical properties. This study examined the effect of orthosis stiffness on running biomechanics in patients with lower limb impairments who had undergone unilateral limb salvage., Methods: Ten patients with lower limb impairments underwent gait analysis at a self-selected running velocity. 1. Nominal (clinically-prescribed), 2. Stiff (20% stiffer than nominal), and 3. Compliant (20% less stiff than nominal) ankle-foot orthosis stiffnesses were tested., Findings: Ankle joint stiffness was greatest in the stiffest strut and lowest in the compliant strut, however ankle mechanical work remained unchanged. Speed, stride length, cycle time, joint angles, moments, powers, and ground reaction forces were not significantly different among stiffness conditions. Ankle joint kinematics and ankle, knee and hip kinetics were different between limbs. Ankle power, in particular, was lower in the injured limb., Interpretation: Ankle-foot orthosis stiffness affected ankle joint stiffness but did not influence other biomechanical parameters of running in individuals with unilateral limb salvage. Foot strike asymmetries may have influenced the kinetics of running. Therefore, a range of stiffness may be clinically appropriate when prescribing ankle-foot orthoses for active individuals with limb salvage., (Published by Elsevier Ltd.)

Humans can perform motor tasks in a variety of ways, yet often favor a particular strategy. Some factors governing the preferred strategy may be objective and quantifiable, (e.g. metabolic energy or mechanical work) while others may be more subjective and less measurable, (e.g. discomfort, pain, or mental effort). Subjectivity can make it challenging to explain or predict preferred movement strategies. We propose that subjective factors might nevertheless be characterized indirectly by their trade-offs against more objective measures such as work. Here we investigated whether subjective costs that influence human movement during drop landings could be indirectly assessed by quantifying mechanical work performed. When landing on rigid ground, humans typically absorb much of the collision actively by bending their knees, perhaps to avoid the discomfort of stiff-legged landings. We measured how work performed by healthy adults (N=8) changed as a function of surface cushioning for drop landings (fixed at about 0.4m) onto varying amounts of foam. Landing on more foam dissipated more energy passively in the surface, thus reducing the net dissipation required of subjects, due to relatively fixed landing energy. However, subjects actually performed even less work in the dissipative collision, as well as in the subsequent active, positive work to return to upright stance (approximately linear decrease of about 1.52 J per 1 cm of foam thickness). As foam thickness increased, there was also a corresponding reduction in center-of-mass vertical displacement after initial impact by up to 43%. Humans appear to subjectively value cushioning, revealed by the extra work they perform landing without it. Cushioning is thus worth more than the energy it dissipates, in an amount that indicates the subjective discomfort of stiff landings., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

The aim of this study was to investigate force depression in Type I and Type II muscle fibers. Experiments were performed using skinned fibers from rabbit soleus and psoas muscles. Force depression was quantified after active fiber shortening from an average sarcomere length (SL) of 3.2µ m to an average SL of 2.6 µm at an absolute speed of 0.115f iber length/s and at a relative speed corresponding to 17% of the unloaded shortening velocity (V0) in each type of fibers. Force decay and mechanical work during shortening were also compared between fiber types. After mechanical testing, each fiber was subjected to myosin heavy chain (MHC) analysis in order to confirm its type (Type I expressing MHC I, and Type II expressing MHC IId). Type II fibers showed greater steady-state force depression after active shortening at a speed of 0.115 fiber length/s than Type I fibers (14.5±1.5% versus 7.8±1.7%). Moreover, at this absolute shortening speed, Type I fibers showed a significantly greater rate of force decay during shortening and produced less mechanical work than Type II fibers. When active shortening was performed at the same relative speed (17% V0), the difference in force depression between fiber types was abolished. These results suggest that no intrinsic differences were at the origin of the disparate force depressions observed in Type I and Type II fibers when actively shortened at the same absolute speed, but rather their distinct force-velocity relationships., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Elastically-suspended loads have been shown to reduce the peak forces acting on the body while walking with a load when the suspension stiffness and damping are minimized. However, it is not well understood how elastically-suspended loads can affect the energetic cost of walking. Prior work shows that elastically suspending a load can yield either an increase or decrease in the energetic cost of human walking, depending primarily on the suspension stiffness, load, and walking speed. It would be useful to have a simple explanation that reconciles apparent differences in existing data. The objective of this paper is to help explain different energetic outcomes found with experimental load suspension backpacks and to systematically investigate the effect of load suspension parameters on the energetic cost of human walking. A simple two-degree-of-freedom model is used to approximate the energetic cost of human walking with a suspended load. The energetic predictions of the model are consistent with existing experimental data and show how the suspension parameters, load mass, and walking speed can affect the energetic cost of walking. In general, the energetic cost of walking with a load is decreased compared to that of a stiffly-attached load when the natural frequency of a load suspension is tuned significantly below the resonant walking frequency. The model also shows that a compliant load suspension is more effective in reducing the energetic cost of walking with low suspension damping, high load mass, and fast walking speed. This simple model could improve our understanding of how elastic load-carrying devices affect the energetic cost of walking with a load., (Copyright © 2014 Elsevier Ltd. All rights reserved.)