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The effective procedure for activating muscles and improving movements in individuals who have a central nervous system injury is Functional electrical stimulation (FES). To have accurate movements of the limbs, appropriate stimulation patterns should be generated and exerted on the muscles. The challenging problem is the redundancy in the musculoskeletal system that makes it necessary to use optimal control to derive muscle activations. For doing this, the redundant musculoskeletal model of the ankle joint is derived in this paper, then an optimal control method for estimating muscle activation during the gait cycle is designed. The aim of optimal control theory is to minimize the cost function, including muscle activation as the control input and joint angle tracking error as the output of the model. Two optimal control algorithms are implemented in this research. These approaches present direct and indirect control methods to solve the optimization problem of ankle movement achieved by experimental research on two healthy males during the gait cycle. Based on the results, the direct method is smoother for nonlinear systems and estimates desired muscle activation more precisely and the cost function coefficients are chosen with logical and less values in comparison to the indirect method.

Total ankle arthroplasty (TAA) is a motion-preserving treatment for end-stage ankle arthritis. An effective tool for analyzing these implants’ mechanical performance and longevity in silico is finite element analysis (FEA). An FEA in ABAQUS was used to statically analyze the mechanical behavior of the ultra-high-molecular-weight polyethylene (UHMWPE) bearing component at varying dorsiflexion/plantarflexion ankle angles and axial loading conditions during the stance phase of the gait cycle for a single cycle. The von Mises stress and contact pressure were examined on the articulating surface of the bearing component in two newly installed fixed-bearing TAA implants (Wright Medical INBONE II and Exactech Vantage). Six different FEA models of variable ankle compressive load levels and ankle angle positions, for the varying subphases of the stance phase of the gait cycle, were created. The components in these models were constrained to be conducive to the bone–implant interface, where implant loosening occurs. Our results showed that the von Mises stress and contact pressure distributions increased as the compressive load increased. The highest stress was noted at dorsiflexion angles > 15°, in areas where the UHMWPE liner was thinnest, at the edges of the talar and UHMWPE components, and during the terminal stance phase of the gait cycle. This static structural analysis highlighted these failure regions are susceptible to yielding and wear and indicated stress magnitudes that are in agreement (within 25%) with those in previous static structural TAA FEAs. The mechanical wear of the UHMWPE bearing component in TAA can lead to aseptic loosening and peri-implant cyst formation over time, requiring surgical revision. This study provides ankle replacement manufacturers and orthopedic surgeons with a better understanding of the stress response and contact pressure sustained by TAA implants, which is critical to optimizing implant longevity and improving patient care.

Abstract Gait cycle variability during steady walking, described by the stride interval time series, has been used as a gait-stability-related measure. In particular, the positive persistency in the stride intervals with 1/f-like fluctuation and reduction of the persistency are the well-documented metrics that can characterize gait patterns of healthy young adults and elderly including patients with neurological diseases, respectively. Here, we examined effects of a dual task on gait cycle variability in healthy young adults, based on the mean and standard deviation statistics as well as the positive persistency of the stride intervals during steady walking on a treadmill. Specifically, three gait conditions were examined: control condition, non-cognitive task with holding a smartphone in front of the chest using their dominant hand and looking fixedly at a blank screen of the smartphone, and cognitive motor task with holding a smartphone as in the non-cognitive task and playing a puzzle game displayed on the smartphone by one-thumb operation. We showed that only the positive persistency, not the mean and standard deviation statistics, was affected by the cognitive and motor load of smartphone usage in the cognitive condition. More specifically, the positive persistency exhibited in the control and the non-cognitive conditions was significantly reduced in the cognitive condition. Our results suggest that the decrease in the positive persistency during the cognitive task, which might represent the deterioration of healthy gait pattern, is caused endogenously by the cognitive and motor load, not necessarily by the reduction of visual field as often hypothesized.

Total ankle arthroplasty (TAA) is a motion-preserving treatment for end-stage ankle arthritis. An effective tool for analyzing these implants' mechanical performance and longevity in silico is finite element analysis (FEA). An FEA in ABAQUS was used to statically analyze the mechanical behavior of the ultra-high-molecular-weight polyethylene (UHMWPE) bearing component at varying dorsiflexion/plantarflexion ankle angles and axial loading conditions during the stance phase of the gait cycle for a single cycle. The von Mises stress and contact pressure were examined on the articulating surface of the bearing component in two newly installed fixed-bearing TAA implants (Wright Medical INBONE II and Exactech Vantage). Six different FEA models of variable ankle compressive load levels and ankle angle positions, for the varying subphases of the stance phase of the gait cycle, were created. The components in these models were constrained to be conducive to the bone–implant interface, where implant loosening occurs. Our results showed that the von Mises stress and contact pressure distributions increased as the compressive load increased. The highest stress was noted at dorsiflexion angles > 15°, in areas where the UHMWPE liner was thinnest, at the edges of the talar and UHMWPE components, and during the terminal stance phase of the gait cycle. This static structural analysis highlighted these failure regions are susceptible to yielding and wear and indicated stress magnitudes that are in agreement (within 25%) with those in previous static structural TAA FEAs. The mechanical wear of the UHMWPE bearing component in TAA can lead to aseptic loosening and peri-implant cyst formation over time, requiring surgical revision. This study provides ankle replacement manufacturers and orthopedic surgeons with a better understanding of the stress response and contact pressure sustained by TAA implants, which is critical to optimizing implant longevity and improving patient care. [ABSTRACT FROM AUTHOR]

Among older people, walking difficulty results from actual and perceived declines in physical capacities and environmental requirements for walking. We investigated whether the physiological complexity of the gait cycle covaries with experience of walking difficulty. Walking difficulty, gait speed, and gait cycle complexity were evaluated among 702 community-dwelling older people aged 75, 80, and 85 years who took part in the six-minute walking test in the research laboratory. Walking difficulty for 500 m was self-reported. Complexity was quantified as trunk acceleration multiscale entropy during the gait cycle. Complexity was then compared between those with no reported walking difficulty, walking with modifications but no difficulty, and those reporting walking difficulty. Higher entropy differentiated those reporting no difficulty walking from those reporting walking difficulties, while those reporting having modified their walking, but no difficulty formed an intermediate group that could not be clearly distinguished from the other categories. The higher complexity of the gait cycle is associated with slower gait speed and the presence of self-reported walking difficulty. Among older people, gait cycle complexity which primarily reflects the biomechanical dimensions of gait quality, could be a clinically meaningful measure reflecting specific features of the progression of walking decline. This encourages further investigation of the sensitivity of gait cycle complexity to detect early signs of gait deterioration and to support targeted interventions among older people.

Abstract Background Anterior femoral notching (AFN) is a severe complication of total knee replacement (TKR), which in a percentage of patients may lead to fractures after surgery. The purpose of this study was to investigate the stress distribution in patients with AFN and the safety depth of AFN during the gait cycle. Methods We performed a finite element (FE) analysis to analyse the mechanics around the femur during the gait cycle in patients with AFN. An adult volunteer was selected as the basis of the model. The TKR models were established in the 3D reconstruction software to simulate the AFN model during the TKR process, and the 1 mm, 2 mm, 3 mm, 4 mm, and 5 mm AFN models were established, after which the prosthesis was assembled. Three key points of the gait cycle (0°, 22°, and 48°) were selected for the analysis. Results The stress on each osteotomy surface was stable in the 0° phase. In the 22° phase, the maximum equivalent stress at 3 mm was observed. In the 48° phase, with the increase in notch depth, each osteotomy surface showed an overall increasing trend, the stress range was more extended, and the stress was more concentrated. Moreover, the maximum equivalent force value (158.3 MPa) exceeded the yield strength (115.1 MPa) of the femur when the depth of the notch was ≥ 3 mm. Conclusions During the gait cycle, if there is an anterior femoral cortical notch ≥ 3 mm, the stress will be significantly increased, especially at 22° and 48°. The maximum equivalent stress exceeded the femoral yield strength and may increase the risk of periprosthetic fractures.

Background: The prevalence of falls among the older population underscores the imperative of comprehending human adaptations to gait perturbations. Dual-belt treadmills offer a controlled setting for such investigations. The purpose of this study was to examine the effect of the acceleration of one belt of the treadmill during three different phases of the gait cycle on kinematic and kinetic parameters and relate these changes to unperturbed gait. Methods: Twenty-one healthy young females walked on a treadmill in a virtual environment, in which five unexpected perturbations were applied to the left belt at the Initial Contact (IC), Mid Stance (MS), and Pre-Swing (PS) phase of the gait cycle. Data from the undisturbed gait and the first disturbance of each trial were extracted for analysis. Results: All perturbations significantly affected the gait pattern, mainly by decreasing the knee extension angle. The perturbation in the IC phase had the most significant effect, resulting in a 248.48% increase in knee flexion torque. The perturbation in the MS phase mainly affected plantar flexion torque, increasing it by 118.18%, while perturbation in the PS phase primarily increased the hip extension torque by 73.02%. Conclusions: The presence of perturbations in the IC and PS phases caused the most aggressive and significant changes in gait parameters.

Objectives: The ankle kinematic characteristics of chronic ankle instability (CAI) at different gait phases and dimensions were not directly and overall explained. These characteristics have yet to be established. This study aimed to observe ankle kinematic changes of CAI, and explore their mechanisms, at different gait phases and dimensions in full gait cycle. Methods: A three-dimensional (3D) motion capture system measured the 3D ankle movements of 53 individuals with CAI (meanage = 25.11 ± 6.01years, meanheight = 170.77 ± 7.80 cm, meanmass = 64.28 ± 9.28 kg) and 53 healthy controls (meanage = 24.66 ± 6.32 years, meanheight = 169.98 ± 9.00 cm, meanmass = 63.11 ± 9.62 kg) during barefoot walking overground at a self-selected speed. Once the acquisition results were processed with visual 3D software, the kinematics data were exported, and the eight phases of the gait cycle were identified. Results: As compared with the control group, individuals with CAI displayed a significantly smaller plantarflexion in toe off (P = 0.049, Cohen's d = 0.387), a significantly increased inversion in heel strike (P = 0.007, Cohen's d = 0.271) and initial swing (P = 0.035, Cohen's d = 0.233), mid-swing (P = 0.019, Cohen's d = 0.232) and end-swing (P = 0.021, Cohen's d = 0.214), and significantly smaller eversion in mid stance（P = 0.010, Cohen's d = 0.288）and heel off (P = 0.033, Cohen's d = 0.089). Significant between-group differences in ankle kinematics were observed in the sagittal and frontal planes, but not in the horizontal plane, during walking. Conclusion: When walking, patients with CAI have altered sagittal- and frontal-plane kinematics during different stance and swing phases. These kinematic changes require multi-dimensional, dynamic, continuous functional assessment and specialized rehabilitation intervention.

Context: This work presents the development of a dynamic model for human lower limb motion in the sagittal plane during the gait cycle. The primary objective of this model is to serve as a powerful tool for the design of rehabilitation and assistive devices, such as exoskeletons, prostheses, and orthoses. It achieves this by facilitating the estimation of joint torques, the detailed analysis of kinematic variables, optimal actuator selection, and the exploration of advanced control techniques. Method: The dynamic model consists of two primary components: (1) the plant model and (2) a closed-loop controller. The plant model represents the forward dynamics of human gait and is based on a multi-mass pendulum composed of three segments of the lower limb (thigh, lower leg, and foot) and three joints (hip, knee, and ankle). It is analyzed using the Euler-Lagrange formulation and the nonlinear second-order differential equations are implemented in MATLAB’s Simulink. To reproduce reference human gait trajectories and simulate the functioning of the neuromusculoskeletal system and the central nervous system, a closed-loop PID controller is incorporated into the plant model. It is noteworthy that the scope of this dynamic model is specifically confined to the sagittal plane. Results: The dynamic model is evaluated in terms of angular displacement tracking using the relative maximum error (RME) and the root mean square error (RMSE) for reference trajectories of healthy adult male human gait as reported in the literature. The model demonstrates tracking with errors below 2.2 [°] in magnitude and 3,5% for all three considered segments (thigh, lower leg, and foot). Conclusions: The quantitative results show that the dynamic model developed in this work is reliable and allows for a precise reproduction of human gait trajectories.

Abstract Hip joint prostheses are used to replace hip joint function in the human body. The latest dual-mobility hip joint prosthesis has an additional component of an outer liner that acts as a cover for the liner component. Research on the contact pressure generated on the latest model of a dual-mobility hip joint prosthesis under a gait cycle has never been done before. The model is made of ultrahigh molecular weight polyethylene (UHMWPE) on the inner liner and 316L stainless steel (SS 316L) on the outer liner and acetabular cup. Simulation modeling using the finite element method is considered static loading with an implicit solver for studying the geometric parameter design of dual-mobility hip joint prostheses. In this study, simulation modeling was carried out by applying varying inclination angles of 30°, 40°, 45°, 50°, 60°, and 70° to the acetabular cup component. Three-dimensional loads were placed on femoral head reference points with variations of femoral head diameter used at 22 mm, 28 mm, and 32 mm. The results in the inner surface of the inner liner, the outer surface of the outer liner, and the inner surface of the acetabular cup showed that the variations in inclination angle do not have a major effect on the maximum contact pressure value on the liner component, where the acetabular cup with an inclination angle of 45° can reduce contact pressure more than the other studied inclination angle variations. In addition, it was found that the 22 mm diameter of the femoral head increases the contact pressure. The use of a larger diameter femoral head with an acetabular cup configuration at a 45° inclination can minimize the risk of implant failure due to wear.

Cognitive Fatigue (CF) is the decline in cognitive abilities due to prolonged exposure to mentally demanding tasks. In this paper, we used gait cycle analysis, a biometric method related to human locomotion to identify cognitive fatigue in individuals. The proposed system in this paper takes two asynchronous videos of the gait of individuals to classify if they are cognitively fatigued or not. We leverage the pose estimation library OpenPose, to extract the body keypoints from the frames in the videos. To capture the spatial and temporal information of the gait cycle, a CNN-based model is used in the system to extract the embedded features which are then used to classify the cognitive fatigue level of individuals. To train and test the model, a gait dataset is built from 21 participants by collecting walking data before and after inducing cognitive fatigue using clinically used games. The proposed model can classify cognitive fatigue from the gait data of an individual with an accuracy of 81%.

With its low birthrate, Japan currently faces an aging issue. As the senior population gradually increases, applying moderate daily exercise has been widely accepted as a key to ease the incidence of life-related diseases, such as cerebrovascular disease that leads to severe aftermath by causing unhealthy gait posture. An already productized active assistive device named RE-Gait® uses a motor and pressure sensors to detect the force varying from forefoot to heel in walking, thereby aiding both plantarflexion and dorsiflexion for people who are unable to freely control their lower limbs. Corresponding torque output depending on individual physical conditions can be customized from physiotherapist’s site. By contrast, considering a larger torque production with short delay time and less weight, replacing the motor with springs is appropriate. Furthermore, given that the target user includes senior and able-bodied people who possess muscle functionalities, the proposed device reduces the amount of time spent on learning to maneuver the battery-powered type and allows them to walk freely with less concerns on adjusting parameters and battery level. Therefore, the full mechanical types appear to be appropriate. By implementing the ratchet–pawl combination, the necessary energy source used for driving the assistance can be obtained from the body weight. With the pair of mechanical pressure sensors that can store and release the body weight energy, assistance on the foot can be enhanced at each anticipated stage. Four sets of experiments, including Motion Capture to verify the ankle angle variation and electromyography (EMG) to muscle activities, are used to verify the effectiveness of the mechanical walking assistive device. Results show that the device effectively offers assistance to both plantarflexion and dorsiflexion. Comparison with and without attaching the device and trajectories from Motion Capture are all increased. Furthermore, compared with the percentage of maximum voluntary contraction (%MVC) for muscle acquired by EMG, the muscle activities clearly decline. The device effectively provide assistance to foot flexions.

This article introduces a data‐driven locomotion style controller for full‐body human characters using gait cycle features. Based on gait analysis, we define a set of gait features that can represent various locomotion styles as spatio‐temporal patterns within a single gait cycle. We compute the gait features for every single gait cycle in motion capture data and use them to search for the desired motion. Our real‐time style controller provides users with visual feedback for the changing inputs, exploiting the Motion Matching algorithm. We also provide a graphical controller interface that visualizes our style representation to enable intuitive control for users. We show that the proposed method is capable of retrieving appropriate locomotions for various gait cycle features, from simple walking motions to single‐foot motions such as hopping and dragging. To validate the effectiveness of our method, we conducted a user study that compares the usability and performance of our system with those of an existing footstep animation tool. The results show that our method is preferred over the baseline method for intuitive control and fast visual feedback. [ABSTRACT FROM AUTHOR]

Powered prosthesis actuation is a field where energy efficiency and mass are important characteristics. The motion requirements of high torque at low speed and low torque at high speed are difficult to effectively combine in a single electric motor. A possibility is to use an oversized direct–drive motor that can deliver the peak torque. However, this results in a heavy actuation system and low overall efficiency. A common practice is combining a smaller electric motor with a gear reduction system. In the literature, novel redundant electric actuation systems have been presented with or without locking mechanisms to mitigate this problem. In this work, we provide a comparison of multiple electrical actuation systems composed of electric motors, gear reduction systems and locking mechanisms. This is done using the gait cycle of a human ankle as a case study. An electric motor with a double stator and a single rotor combined with a gearbox shows the most promising overall results when taking energy loss, total mass and complexity of the system into account.

Background: The prevalence of falls among the older population underscores the imperative of comprehending human adaptations to gait perturbations. Dual-belt treadmills offer a controlled setting for such investigations. The purpose of this study was to examine the effect of the acceleration of one belt of the treadmill during three different phases of the gait cycle on kinematic and kinetic parameters and relate these changes to unperturbed gait. Methods: Twenty-one healthy young females walked on a treadmill in a virtual environment, in which five unexpected perturbations were applied to the left belt at the Initial Contact (IC), Mid Stance (MS), and Pre-Swing (PS) phase of the gait cycle. Data from the undisturbed gait and the first disturbance of each trial were extracted for analysis. Results: All perturbations significantly affected the gait pattern, mainly by decreasing the knee extension angle. The perturbation in the IC phase had the most significant effect, resulting in a 248.48% increase in knee flexion torque. The perturbation in the MS phase mainly affected plantar flexion torque, increasing it by 118.18%, while perturbation in the PS phase primarily increased the hip extension torque by 73.02%. Conclusions: The presence of perturbations in the IC and PS phases caused the most aggressive and significant changes in gait parameters. [ABSTRACT FROM AUTHOR]

Abstract Objective To construct a comprehensive simulation method of “gait-musculoskeletal system (MS)-finite element (FE)” for analysis of hip joint dynamics characteristics and the changes in the contact stress in the hip throughout a gait cycle. Methods Two healthy volunteers (male and female) were recruited. The 3D gait trajectories during normal walking and the CT images including the hip and femur of the volunteers were obtained. CT imaging data in the DICOM format were extracted for subjected 3D hip joint reconstruction. The reconstructed 3D model files were used to realize the subject-specific registration of the pelvis and thigh segment of general musculoskeletal model. The captured marker trajectory data were used to drive subject-specific musculoskeletal model to complete inverse dynamic analysis. Results of inverse dynamic analysis were exported and applied as boundary and load settings of the hip joint finite element in ABAQUS. Finally, the finite element analysis (FEA) was performed to analyze contact stress of hip joint during a gait cycle of left foot. Results In the inverse dynamic analysis, the dynamic changes of the main hip-femoral muscle force with respect to each phase of a single gait cycle were plotted. The hip joint reaction force reached a maximum value of 2.9%BW (body weight) and appeared at the end of the terminal stance phase. Twin peaks appeared at the initial contact phase and the end of the terminal stance phase, respectively. FEA showed the temporal changes in contact stress in the acetabulum. In the visual stress cloud chart, the acetabular contact stress was mainly distributed in the dome of the acetabulum and in the anterolateral area at the top of the femoral head during a single gait cycle. The acetabular contact area was between 293.8 and 998.4 mm2, and the maximum contact area appear at the mid-stance phase or the loading response phase of gait. The maximum contact stress of the acetabulum reached 6.91 MPa for the model 1 and 6.92 MPa for the model 2 at the terminal stance phase. Conclusions The “Gait-MS-FE” technology is integrated to construct a comprehensive simulation framework. Based on human gait trajectories and their CT images, individualized simulation modeling can be achieved. Subject-specific gait in combination with an inverse dynamic analysis of the MS provides pre-processing parameters for FE simulation for more accurate biomechanical analysis of hip joint. Graphical abstract

A common approach in the biomechanical analysis of running technique is to average data from several gait cycles to compute a ‘representative mean.’ However, the impact of the quantity and selection of gait cycles on biomechanical measures is not well understood. We examined the effects of gait cycle selection on kinematic data by: (i) comparing representative means calculated from varying numbers of gait cycles to ‘global’ means from the entire capture period; and (ii) comparing representative means from varying numbers of gait cycles sampled from different parts of the capture period. We used a public dataset (n = 28) of lower limb kinematics captured during a 30-second period of treadmill running at three speeds (2.5 m s−1, 3.5 m s−1 and 4.5 m s−1). ‘Ground truth’ values were determined by averaging data across all collected strides and compared to representative means calculated from random samples (1,000 samples) of n (range = 5–30) consecutive gait cycles. We also compared representative means calculated from n (range = 5–15) consecutive gait cycles randomly sampled (1,000 samples) from within the same data capture period. The mean, variance and range of the absolute error of the representative mean compared to the ‘ground truth’ mean progressively reduced across all speeds as the number of gait cycles used increased. Similar magnitudes of ‘error’ were observed between the 2.5 m s−1 and 3.5 m s−1 speeds at comparable gait cycle numbers —where the maximum errors were < 1.5 degrees even with a small number of gait cycles (i.e., 5–10). At the 4.5 m s−1 speed, maximum errors typically exceeded 2–4 degrees when a lower number of gait cycles were used. Subsequently, a higher number of gait cycles (i.e., 25–30) was required to achieve low errors (i.e., 1–2 degrees) at the 4.5 m s−1 speed. The mean, variance and range of absolute error of representative means calculated from different parts of the capture period was consistent irrespective of the number of gait cycles used. The error between representative means was low (i.e., < 1.5 degrees) and consistent across the different number of gait cycles at the 2.5 m s−1 and 3.5 m s−1 speeds, and consistent but larger (i.e., up to 2–4 degrees) at the 4.5 m s−1 speed. Our findings suggest that selecting as many gait cycles as possible from a treadmill running bout will minimise potential ‘error.’ Analysing a small sample (i.e., 5–10 cycles) will typically result in minimal ‘error’ (i.e., < 2 degrees), particularly at lower speeds (i.e., 2.5 m s−1 and 3.5 m s−1). Researchers and clinicians should consider the balance between practicalities of collecting and analysing a smaller number of gait cycles against the potential ‘error’ when determining their methodological approach. Irrespective of the number of gait cycles used, we recommend that the potential ‘error’ introduced by the choice of gait cycle number be considered when interpreting the magnitude of effects in treadmill-based running studies.

The analysis of gait patterns and plantar pressure distributions via insoles is increasingly used to monitor patients and treatment progress, such as recovery after surgeries. Despite the popularity of pedography, also known as baropodography, characteristic effects of anthropometric and other individual parameters on the trajectory of the stance phase curve of the gait cycle have not been previously reported. We hypothesized characteristic changes of age, body height, body weight, body mass index and handgrip strength on the plantar pressure curve trajectory during gait in healthy participants. Thirty-seven healthy women and men with an average age of 43.65 ± 17.59 years were fitted with Moticon OpenGO insoles equipped with 16 pressure sensors each. Data were recorded at a frequency of 100 Hz during walking at 4 km/h on a level treadmill for 1 minute. Data were processed via a custom-made step detection algorithm. The loading and unloading slopes as well as force extrema-based parameters were computed and characteristic correlations with the targeted parameters were identified via multiple linear regression analysis. Age showed a negative correlation with the mean loading slope. Body height correlated with Fmeanload and the loading slope. Body weight and the body mass index correlated with all analyzed parameters, except the loading slope. In addition, handgrip strength correlated with changes in the second half of the stance phase and did not affect the first half, which is likely due to stronger kick-off. However, only up to 46% of the variability can be explained by age, body weight, height, body mass index and hand grip strength. Thus, further factors must affect the trajectory of the gait cycle curve that were not considered in the present analysis. In conclusion, all analyzed measures affect the trajectory of the stance phase curve. When analyzing insole data, it might be useful to correct for the factors that were identified by using the regression coefficients presented in this paper.

This work involved two major parts: the first one is the experimental part which included treatment of scoliosis deformity by manufacturing thoracolumbosacral orthosis, measuring the cobb angle of deformity, measuring the gait cycle data and walk path for both legs and suggesting a composite material to improve the mechanical properties of the orthosis and finally the interface pressure between trunk and orthosis is measured for twelve points covering of the total TLSO surface area by using f-socket devise. The second part of this study is the numerical simulation part during which the stresses are calculated using Ansys software for calculating stresses due to interface pressure loading boundary condition. The result shows no deference in gait cycle phases but the clear difference noted in walking path due to deviate center of mass, maximum pressure recorded left thoracic region with 900KPa due to correct spinal deformity while the minimum pressure recorded at right chest with l40KPa because of it is tissue region and Maximum value of stress was recorded at the left thoracic region with 2.81MPa due to Maximum interface pressure at this point.

Abstract Background This study evaluated the influence of meniscal allograft transplantation (MAT) on knee joint mechanics during normal walking using finite element (FE) analysis and biomechanical data. Methods The study included 20 patients in a transpatellar group and 25 patients in a parapatellar group. Patients underwent magnetic resonance imaging (MRI) evaluation after lateral MAT as a baseline input for three-dimensional (3D) and FE analyses. Three different models were compared for lateral MAT: intact, transpatellar approach, and parapatellar approach. Analysis was performed using high kinematic displacement and rotation inputs based on the kinematics of natural knees. ISO standards were used for axial load and flexion. Maximum contact stress on the grafted menisci and maximum shear stress on the articular surface of the knee joint were evaluated with FE analysis. Results Relatively high maximum contact stresses and maximum shear stresses were predicted in the medial meniscus and cartilage of the knee joint during the loading response for all three knee joint models. Maximum contact stress and maximum shear stress in the meniscus and cartilage increased on the lateral side after lateral MAT, especially during the first 20% of the stance phase of the gait cycle. The transpatellar approach was most similar to the intact knee model in terms of contact stresses of the lateral grafted and medial meniscus, as well as maximum shear stresses during the gait cycle. In addition, the transpatellar model had lower maximum contact stress on the menisci than did the parapatellar model, and it also had lower maximum shear stress on the tibial cartilage. Conclusions Therefore, the transpatellar approach may reduce the overall risk of degenerative osteoarthritis (OA) after lateral MAT.