Background: Minimum Toe Clearance (MTC) is defined as the minimum vertical distance between the lowest point under the front part of the foot and the ground, during mid-swing. Low values of MTC and walking on inclines are both related to higher probability of tripping and falling in lower limb amputees. New prosthetic designs aim at improving MTC, especially on ramps, however the real effect on MTC still needs investigation. The objective of this study was then to evaluate the effect of different prosthetic designs on MTC in inclined walking. Methods: Thirteen transtibial amputees walked on a ramp using three different prostheses: non articulating ankle (NAA), articulating hydraulic ankle (AHA), and articulating hydraulic ankle with microprocessor (AHA-MP). Median MTC, coefficient of variation (CV), and tripping probability (TP) for obstacles of 10 and 15 mm were compared across ankle type in ascent and descent. Findings: When using AHA-MP, larger MTC median values for ascending (P ≤ 0.001, W = 0.58) and descending the ramp (P = 0.003, W = 0.47) were found in the prosthetic limb. Also significantly lower CV was found on the prosthetic limb for both types of AHA feet when compared to NAA for descending the ramp (P = 0.014, W = 0.45). AHA-MP showed the lowest TP for the prosthetic leg in three conditions evaluated. On the sound limb results showed the median MTC was significantly larger (P = 0.009, W = 0.43) and CV significantly lower (P = 0.005, W = 0.41) when using an AHA in ascent. Interpretation: Both AHA prosthetic designs help reduce the risk of tripping of the prosthetic limb by increasing the median MTC, lowering its variability and reducing TP for both legs when ascending and descending the ramp. For most of the conditions, AHA-MP showed the lowest TP values. Findings suggest that AHA prostheses, especially AHA-MP could reduce the risk of tripping on ramps in amputees. [11][12][13], type of terrain [14,15] and type of shoes [15]. The changes are reflected on MTC distribution, including median, interquartile

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Analysis of the human locomotor system using rigid-body musculoskeletal models has increased in the biomechanical community with the objective of studying muscle activations of different movements. Simultaneously, the finite element method has emerged as a complementary approach for analyzing the mechanical behavior of tissues. This study presents an integrative biomechanical framework for gait analysis by linking a musculoskeletal model and a subject-specific finite element model of the pelvis. To investigate its performance, a convergence study was performed and its sensitivity to the use of non-subject-specific material properties was studied. The total hip joint force estimated by the rigid musculoskeletal model and by the finite element model showed good agreement, suggesting that the integrative approach estimates adequately (in shape and magnitude) the hip total contact force. Previous studies found movements of up to 1.4 mm in the anterior-posterior direction, for single leg stance. These results are comparable with the displacement values found in this study: 0-0.5 mm in the sagittal axis. Maximum von Mises stress values of approximately 17 MPa were found in the pelvic bone. Comparing this results with a previous study of our group, the new findings show that the introduction of muscular boundary conditions and the flexion-extension movement of the hip reduce the regions of high stress and distributes more uniformly the stress across the pelvic bone. Thus, it is thought that muscle force has a relevant impact in reducing stresses in pelvic bone during walking of the finite element model proposed in this study. Future work will focus on including other deformable structures, such as the femur and the tibia, and subject-specific material properties.

This study measured spatio temporal parameters (STP) and their symmetry index (SI) in order to evaluate the differential effect on the gait pattern of individuals with unilateral transtibial amputations when using two different prostheses. Twelve individuals with transtibial amputations walked on level ground using an Energy Storage and Return (ESAR) prosthesis with fixed ankle and a prosthetic foot with adaptive ankle (PFAA). The STP were measured in the prosthetic and sound limbs and the symmetry index for each parameter was calculated afterwards. The results showed no statistically significant differences between the prostheses for the STP measured, and this was the case both for the prosthetic and sound limbs. Similarly, the SI did not reflect statistically significant differences when the different prostheses were used. Thus, the results suggest that the STP studied and their SI may not reflect differences when evaluating ESAR versus PFAA prostheses in the conditions proposed in this study.

Clinical gait analysis provides great contributions to the understanding of gait patterns. However, a complete distribution of muscle forces throughout the gait cycle is a current challenge for many researchers. Two techniques are often used to estimate muscle forces: inverse dynamics with static optimization and computer muscle control that uses forward dynamics to minimize tracking. The first method often involves limitations due to changing muscle dynamics and possible signal artefacts that depend on day-to-day variation in the position of electromyographic (EMG) electrodes. Nevertheless, in clinical gait analysis, the method of inverse dynamics is a fundamental and commonly used computational procedure to calculate the force and torque reactions at various body joints. Our aim was to develop a generic musculoskeletal model that could be able to be applied in the clinical setting. The musculoskeletal model of the lower limb presents a simulation for the EMG data to address the common limitations of these techniques. This model presents a new point of view from the inverse dynamics used on clinical gait analysis, including the EMG information, and shows a similar performance to another model available in the OpenSim software. The main problem of these methods to achieve a correct muscle coordination is the lack of complete EMG data for all muscles modelled. We present a technique that simulates the EMG activity and presents a good correlation with the muscle forces throughout the gait cycle. Also, this method showed great similarities whit the real EMG data recorded from the subjects doing the same movement.

Crouch gait is the most common motion abnormality in children with cerebral palsy (CP). This paper presents a new biomechanical model based on a simple rescaling and adjustment to CP patients who develop crouch gait by subject-specific anthropometric data. The model estimates the length of hamstrings, as the distance between the origin and insertion of the muscle, and the velocity of shortening of hamstrings by the first derivative of the length with respect to time. This model has the potential to increase the benefits of three-dimensional biomechanical models as it can discriminate between short, spastic or normal hamstrings. The main advantage of this model in clinical use is that it does not require costly magnetic resonance imaging.

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This paper describes an action-research experience carried out with second year students at the School of Engineering of the National University of Entre Ríos, Argentina. Vector calculus students played an active role in their own learning process. They were required to present weekly reports, in both oral and written forms, on the topics studied, instead of merely sitting and watching as the teacher solved problems on the blackboard. The students were also asked to perform computer assignments, and their learning process was continuously monitored. Among many benefits, this methodology has allowed students and teachers to identify errors and misconceptions that might have gone unnoticed under a more passive approach.