@article{mccain_dalman_berno_libera_lewek_sawicki_saul_2023, title={The influence of induced gait asymmetry on joint reaction forces}, volume={153}, ISSN={["1873-2380"]}, DOI={10.1016/j.jbiomech.2023.111581}, abstractNote={Chronic injury- or disease-induced joint impairments result in asymmetric gait deviations that may precipitate changes in joint loading associated with pain and osteoarthritis. Understanding the impact of gait deviations on joint reaction forces (JRFs) is challenging because of concurrent neurological and/or anatomical changes and because measuring JRFs requires medically invasive instrumented implants. Instead, we investigated the impact of joint motion limitations and induced asymmetry on JRFs by simulating data recorded as 8 unimpaired participants walked with bracing to unilaterally and bilaterally restrict ankle, knee, and simultaneous ankle + knee motion. Personalized models, calculated kinematics, and ground reaction forces (GRFs) were input into a computed muscle control tool to determine lower limb JRFs and simulated muscle activations guided by electromyography-driven timing constraints. Unilateral knee restriction increased GRF peak and loading rate ipsilaterally but peak values decreased contralaterally when compared to walking without joint restriction. GRF peak and loading rate increased with bilateral restriction compared to the contralateral limb of unilaterally restricted conditions. Despite changes in GRFs, JRFs were relatively unchanged due to reduced muscle forces during loading response. Thus, while joint restriction results in increased limb loading, reductions in muscle forces counteract changes in limb loading such that JRFs were relatively unchanged.}, journal={JOURNAL OF BIOMECHANICS}, author={McCain, Emily M. and Dalman, Morgan J. and Berno, Matthew E. and Libera, Theresa L. and Lewek, Michael D. and Sawicki, Gregory S. and Saul, Katherine R.}, year={2023}, month={May} }
 @article{mccain_libera_berno_sawicki_saul_lewek_2021, title={Isolating the energetic and mechanical consequences of imposed reductions in ankle and knee flexion during gait}, volume={18}, ISSN={["1743-0003"]}, DOI={10.1186/s12984-021-00812-8}, abstractNote={Abstract}, number={1}, journal={JOURNAL OF NEUROENGINEERING AND REHABILITATION}, author={McCain, Emily M. and Libera, Theresa L. and Berno, Matthew E. and Sawicki, Gregory S. and Saul, Katherine R. and Lewek, Michael D.}, year={2021}, month={Feb} }
 @article{mccain_berno_libera_lewek_sawicki_saul_2021, title={Reduced joint motion supersedes asymmetry in explaining increased metabolic demand during walking with mechanical restriction}, volume={126}, ISSN={["1873-2380"]}, DOI={10.1016/j.jbiomech.2021.110621}, abstractNote={Recent research has highlighted the complex interactions among chronic injury- or disease-induced joint limitations, walking asymmetry, and increased metabolic cost. Determining the specific metabolic impacts of asymmetry or joint impairment in clinical populations is difficult because of concurrent neurological and physiological changes. This work investigates the metabolic impact of gait asymmetry and joint restriction by unilaterally (asymmetric) and bilaterally (symmetric) restricting ankle, knee, and combined ankle and knee ranges of motion in unimpaired individuals. We calculated propulsive asymmetry, temporal asymmetry, and step-length asymmetry for an average gait cycle; metabolic rate; average positive center of mass power using the individual limbs method; and muscle effort using lower limb electromyography measurements weighted by corresponding physiological cross-sectional areas. Unilateral restriction caused propulsive and temporal asymmetry but less metabolically expensive gait than bilateral restriction. Changes in asymmetry did not correlate with changes in metabolic cost. Interestingly, bilateral restriction increased average positive center of mass power compared to unilateral restriction. Further, increased average positive center of mass power correlated with increased energy costs, suggesting asymmetric step-to-step transitions did not drive metabolic changes. The number of restricted joints reduces available degrees of freedom and may have a larger metabolic impact than gait asymmetry, as this correlated significantly with increases in metabolic rate for 7/9 participants. These results emphasize symmetry is not by definition metabolically optimal, indicate that the mechanics underlying symmetry are meaningful, and suggest that available degrees of freedom should be considered in designing future interventions.}, journal={JOURNAL OF BIOMECHANICS}, author={McCain, Emily M. and Berno, Matthew E. and Libera, Theresa L. and Lewek, Michael D. and Sawicki, Gregory S. and Saul, Katherine R.}, year={2021}, month={Sep} }