Gait & posture · 2025
Influence of wide-stance gait, foot progression modification and lateral trunk lean on knee contact forces in healthy adults: A musculoskeletal modelling-based study.
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Atia Imaan, Subasinghe Arachchige Ransi S S, Sreenivasa Manish, Cheung Roy T H
Аннотация
OBJECTIVE: To evaluate the effects of wide-stance, toe-in, and lateral trunk lean gait modifications on knee joint contact forces (KCF) in healthy participants through motion capture and musculoskeletal modelling.
METHODS: Twenty healthy participants completed walking trials under four gait conditions: natural walking, wide stance, toe-in, and lateral trunk lean. Walking biomechanics were recorded using an 8-camera motion capture system, synchronised with four ground reaction force plates. Kinematic and kinetic data were used to calculate right-limb KCF during early and late stance using an OpenSim-based musculoskeletal model. Within-subject differences in KCF across the four walking conditions were evaluated using a linear mixed model, accounting for speed as a covariate.
RESULTS: Only medial-lateral forces were affected by condition during early stance, with wide-stance (p < 0.001, Cohen's d=-0.91) and toe-in (p < 0.001, Cohen's d=-1.28) gaits reducing medial KCF compared to natural gait, and toe-in exhibiting lower medial forces than lateral trunk lean (p < 0.001, Cohen's d=-0.91). In late stance, both medial-lateral and vertical forces were condition dependent, with wide-stance (p < 0.001, Cohen's d=-0.79) and toe-in (p < 0.001, Cohen's d=-1.68) gaits continuing to reduce medial forces compared to natural gait. Toe-in gait further decreased medial forces relative to both wide-stance (p < 0.001, Cohen's d=-0.90) and lateral trunk lean (p < 0.001, Cohen's d=-1.39), while also lowering vertical forces in comparison to natural walking (p < 0.001, Cohen's d=-0.90) and lateral trunk lean (p < 0.001, Cohen's d=-0.77).
CONCLUSION: Gait retraining is an achievable intervention to immediately modify KCF in healthy adults, with toe-in gait demonstrating the most lateralisation of force amongst the walking conditions observed.
METHODS: Twenty healthy participants completed walking trials under four gait conditions: natural walking, wide stance, toe-in, and lateral trunk lean. Walking biomechanics were recorded using an 8-camera motion capture system, synchronised with four ground reaction force plates. Kinematic and kinetic data were used to calculate right-limb KCF during early and late stance using an OpenSim-based musculoskeletal model. Within-subject differences in KCF across the four walking conditions were evaluated using a linear mixed model, accounting for speed as a covariate.
RESULTS: Only medial-lateral forces were affected by condition during early stance, with wide-stance (p < 0.001, Cohen's d=-0.91) and toe-in (p < 0.001, Cohen's d=-1.28) gaits reducing medial KCF compared to natural gait, and toe-in exhibiting lower medial forces than lateral trunk lean (p < 0.001, Cohen's d=-0.91). In late stance, both medial-lateral and vertical forces were condition dependent, with wide-stance (p < 0.001, Cohen's d=-0.79) and toe-in (p < 0.001, Cohen's d=-1.68) gaits continuing to reduce medial forces compared to natural gait. Toe-in gait further decreased medial forces relative to both wide-stance (p < 0.001, Cohen's d=-0.90) and lateral trunk lean (p < 0.001, Cohen's d=-1.39), while also lowering vertical forces in comparison to natural walking (p < 0.001, Cohen's d=-0.90) and lateral trunk lean (p < 0.001, Cohen's d=-0.77).
CONCLUSION: Gait retraining is an achievable intervention to immediately modify KCF in healthy adults, with toe-in gait demonstrating the most lateralisation of force amongst the walking conditions observed.