Article

In clinical gait analysis, we strive to understand contributions to body support and propulsion as this forms a basis for treatment selection, yet the relative importance of gravitational forces and joint powers can be controversial even for normal gait. We hypothesized that an inverted pendulum model, propelled only by gravity, would be inadequate to predict velocities and ground reaction forces during gait. Methods. Unlike previous ballistic and passive dynamic walking studies, we directly compared model predictions to gait data for 24 normal children. We defined an inverted pendulum from the average center-of-pressure to the instantaneous center-of-mass, and derived equations of motion during single support that allowed a telescoping action. Forward and inverse dynamics predicted pendulum velocities and ground reaction forces, and these were statistically and graphically compared to actual gait data for identical strides. Findings. Results of forward dynamics replicated those in the literature, with reasonable predictions for velocities and anterior ground reaction forces, but poor predictions for vertical ground reaction forces. Deviations from actual values were explained by joint powers calculated for these subjects. With a telescoping action during inverse dynamics, predicted vertical forces improved dramatically and gained a dual-peak pattern previously missing in the literature, yet expected for normal gait. These improvements vanished when telescoping terms were set to zero. Interpretation. Because this telescoping action is difficult to explain without muscle activity, we believe these results support the need for both gravitational forces and joint powers in normal gait. Our approach also begins to quantify the relative contributions of each. (C) 2005 Elsevier Ltd. All rights reserved.

Langue : ANGLAIS