Computer Methods in Biomechanics and Biomedical Engineering

Acute subdural hematoma (ASDH) is a prevalent injury with high mortality and morbidity, often resulting from bridging vein (BV) disruption secondary to cortical relative motion. As a thin membrane enveloping the brain surface and anchoring BVs, the pia mater is hypothesized to play a critical mechanical role in cortical response and hence ASDH pathogenesis. Finite element (FE) head models are valuable tools to predict ASDH occurrence during impacts. However, the pia mater is often represented as an elastic material in existing FE head models, despite experimental evidence reporting its nonlinear mechanical behavior. In this study, both linear (Young's modulus of 11.5 MPa) and nonlinear (the stress-strain curve derived from pial tension tests) material models of the pia mater were implemented in one FE head model. The models were subjected to three experimental impact loadings, one of which was known to cause ASDH and two of which were not. Results demonstrated that, across all simulated impacts, the model with nonlinear pia mater properties predicted larger cortical displacements and BV responses than the linear model. For the impact with known ASDH occurrence, the predicted BV strain was 0.17 for the nonlinear model and 0.094 for the linear model, with only the former approaching the reported rupture strain range of the BV-superior sagittal sinus complex (0.29 {+/-} 0.13). These findings verified the mechanical importance of the pia mater in cortical responses and hence the prediction of ASDH, suggesting that conventional linear pia modeling might over-constrain cortical motion, leading to underestimation of BV strain and ASDH risk. The current study supported the adoption of experimentally derived nonlinear pia mater properties in FE head models to improve the reliability of ASDH prediction.

Cetaceans reduce the net cost of sustained swimming through intermittent locomotion, alternating active fluking with unpowered gliding. The energy balance of this strategy is central to understanding survival rates, population sustainability, and the effects of anthropogenic and environmental pressures. While active-phase energetics have been characterized extensively, the glide phase remains largely unexplored. Here we derive the optimal glide duration (Topt) and the maximum glide duration beyond which energy savings vanish (Tzero) for three odontocetes spanning a 20-fold range in body mass, using high-fidelity CAD models and wall-modeled large eddy simulations. We show analytically that speed retention at Topt and mass-specific peak energy savings are both fully determined by the active-to-passive drag ratio, propulsive efficiency, and swimming speed, independently of body morphometry and drag coefficient, and are therefore invariant across species at any given speed. These passive-phase optima extend the known size-independent active-phase invariants to the glide phase, towards a scale-independent energetic framework for burst-and-glide locomotion in small cetaceans.

Finite element (FE) head models are virtual tools to study brain biomechanics and their predictions must be numerically convergent. Previous convergence studies focused on the influence of mesh size, but the potential effect of element formulation on model convergence was often ignored. To address this, one original model with brain mesh size as 6.4 {+/-} 1.9 mm was modified to generate three derivatives with the same mesh topology but different element sizes, i.e., a coarse model (mesh size: 12.2 {+/-} 3.9 mm), a medium model (mesh size: 3.2 {+/-} 1.0 mm), and a fine model (mesh size: 1.6 {+/-} 0.5 mm). Three commonly used element formulations, i.e., reduced integration, selectively reduced (S/R) integration, and full integration, were implemented to the brain elements. These models were subjected to rotational loadings along the axial, coronal, and sagittal axes, respectively. The maximum relative displacement at representative sites and 95th percentile maximum principal strain at the whole brain level were used to evaluate mesh convergency. The results showed that the S/R integration yielded a 5% difference between the original and medium meshes, while the reduced and full integration revealed a difference over 5% even between the medium and fine meshes. This study verified that the mesh convergence of FE brain models is affected by the choice of element formulation and the S/R integration contributes to the fastest convergence behavior than the reduced and full integrations. It provided practical information on how to develop numerically convergent and computationally efficient FE brain models. HighlightsO_LIThis study verifies that the choice of element formulation affects the mesh convergence behavior of finite element brain models C_LIO_LIThis study finds the selectively reduced integration yields the fastest convergence behavior than the reduced and full integration C_LIO_LIThis study provides practical guidance on the choice of mesh density and element formulation on how to develop numerically convergent and computationally efficient finite element brain models. C_LI

Repetitive low-intensity blast (LIB) exposure has been identified as a probable cause of mild blast-induced traumatic brain injury (mbTBI) and a chronic injury risk to U.S. military personnel. However, the human brains biomechanical response to this loading regime remains poorly characterized. Using blast-exposure-validated 3D models of human anatomy, we simulated the intracranial tissue response to blast pressure typically experienced by Warfighters during weapons training. Two scenarios were evaluated, a single-dose exposure and a repetitive-dose exposure, to study intracranial pressure (ICP), shear strains, and spectral content. Ansys LS-DYNA was used to generate planar blast waves with peak overpressures of 4-90 kPa and positive phase durations of 2.2-10 ms. Single exposures produced ICP ranging from 4.7-112.7 kPa, dependent on dose and positive phase duration. Under repetitive LIB exposure, peak ICP increased by 8-26% relative to single exposures, with an increase of high-frequency components (>2 kHz). These results demonstrate that LIB can produce measurable intracranial responses that are amplified through repetition, producing pronounced spectral content and elevated pressures despite low strain levels. This study underscores the need to further investigate cumulative dose effects and the value of computational approaches to clarify hypothesized mbTBI mechanisms in operationally relevant conditions.

The relationship between external forces and bone strain in running is often complex and nonintuitive. We used Groucho running (i.e., running with exaggerated knee flexion) as a model to dramatically reduce the vertical ground reaction force (VGRF) and examined the relationship between peak VGRF and finite element (FE)-predicted tibia-fibula bone strain. Nine physically active males ran on an instrumented treadmill at 2.8 m/s with their preferred running technique, increased knee flexion (Groucho), and exaggerated knee flexion (Ex Groucho) in a randomized order. Strains at the tibia-fibula midshaft were calculated using computed-tomography-based FE modeling with loads and boundary conditions calculated from an inverse-dynamics based musculoskeletal model. Pressure-modified von Mises strain was used to quantify the peak strain (90th percentile strain) and strained volume (volume of bone experiencing strains above 3000 {micro}{varepsilon}). We further explored the relationship between peak VGRF, lower leg angle, and FE-predicted strain variables. The results showed that a 15.8% and 22.9% reduction in VGRF during Groucho and Ex Groucho, respectively, had no significant effect on FE-predicted peak strain (p > 0.304) and strained volume (p>0.053). Changes in peak VGRF did not correlate with FE-predicted strain variables (p>0.54) while changes in lower leg angle in the sagittal plane were moderately correlated (r>0.65; p<0.047). Our findings suggest that reductions in peak external forces do not always coincide with reductions in bone strain, especially in cases where running kinematics are dramatically altered. This work has important implications for designing gait retraining interventions based on reductions in external force measures.

Humans tend to walk at speeds that minimize energy expenditure and time duration. While most walking experiments examine individuals in relative isolation, everyday locomotion frequently occurs in social contexts. We investigated whether walking speed is modulated in response to a social interaction during a cooperative task. Participants completed 96 randomized walking trials where they approached and retrieved boxes varying in distance (2.5-10 m) and mass (0-6.8 kg). Boxes either rested on the ground or were handed off by an experimenter, signaling prosocial effort benefitting the participant. Approach speed was measured with inertial measurement units placed at the feet and fit to a saturating exponential function of walking distance using a nonlinear mixed-effects regression model. Based on the energy-time optimization framework, we hypothesized that participants would approach more quickly when larger boxes were held at farther distances, to reduce energy and time costs of the experimenter, despite exerting more effort themselves. Participants walked 8.5% faster (1.29 m s-1 versus 1.19 m s-1; p = 3.85 x 10-6) when the largest box was held out by the experimenter versus left on the ground. However, the manner in which the box was held had no influence on approach speeds (p = 0.31). Exploratory analyses identified modest trends between experiment responses and individual characteristics, but none reached statistical significance. The findings suggest that locomotor decisions reflect not only an individuals own energy and time costs but also the perceived costs borne by others. This study demonstrates that social context can meaningfully influence walking behavior. Summary StatementHumans walk more quickly in response to the perceived energy and time others spend helping them, even at the cost of exerting more energy themselves.

ObjectiveThis study investigates knee joint biomechanics during lunges under varying tibial angles and external loads using musculoskeletal modeling and finite element analysis. The goal is to provide a biomechanical basis for understanding knee loading patterns and optimizing sports training and rehabilitation. MethodsTwenty-six healthy young men performed lunges under tibial inclination angles relative to the ground (60{degrees} and 90{degrees}) and two external load conditions (bodyweight and an additional 98 N external load). Kinematic and kinetic data were captured using motion capture and force plates. Musculoskeletal models were used to estimate joint moments, range of motion, and stiffness, with data analyzed using two-way repeated-measures ANOVA. Finite element analysis was performed at 90{degrees} tibial angle to evaluate tissue stress and displacement. ResultsThe joint moment at a 60{degrees} tibial angle was much higher than at a 90{degrees}. External load showed significant effects on knee stiffness, with lower rotational stiffness in the horizontal plane (P < 0.001) and lower coronal plane stiffness at 90{degrees} (P = 0.012) under the 98 N external-load condition, indicating reduced resistance to angular displacement in these planes. Under the 90{degrees} tibial-angle condition with external load, peak stress and displacement were concentrated in the posterior horn of the meniscus, with a maximum displacement of 3.12 mm. ConclusionThe anterior tilt of the tibia increased sagittal-plane knee loading, while external load mainly reduced joint stiffness in the coronal and horizontal planes. Under the 90{degrees} loaded condition, the concentration of stress and displacement in the posterior horn of the meniscus suggests a mechanically unfavorable loading pattern rather than direct evidence of injury risk. These findings may provide useful biomechanical information for load management during lunge-based training and rehabilitation.

Pitch control models quantify spatial dominance in football by estimating which player can arrive first at each pitch location, but they treat all players as equivalently capable regardless of preceding effort. We introduce physiology-aware pitch control (Phys-PC), a model-agnostic time-to-arrive correction that imposes two physiological capacity channels calibrated from tracking data: a transient recoverable burden capturing incomplete recovery from recent high-intensity efforts, and a cumulative non-recoverable drain accumulating across match play. Both channels reduce a bounded access scale that modulates kinematic TTA before any downstream pitch-control computation. All parameters are anchored to exercise-physiology benchmarks; no laboratory measurements are assumed. Applied to a 64-match international tournament, Phys-PC reveals structure that kinematic models cannot detect. In head-to-head races, the dominant burden channel shifts from transient to cumulative over the course of a match, with a transient resurgence in the final 15 minutes. These physiological asymmetries predict match outcomes: relative reserve advantage is associated with higher odds of winning ground challenges (OR = 1.20, p = 0.006; +4.2 pp), completing over-the-top passes past recovering defenders (OR = 1.45, p = 0.034; +8.3 pp), and progressing possession sequences into the final third (OR = 1.31, p = 0.013; +5.1 pp). At the player-profile level, an acute-cumulative decomposition of contested space access separates roles and individuals whose territorial reach is maintained through sustained positioning from those whose access is rebuilt through repeated high-intensity actions, providing a physiological lens on team tactical structure.

Trees are routinely pruned to mitigate the risk of wind damage, but there are few studies examining changes in wind loads after pruning, especially for large conifers. In this study, ten Colorado spruces (Picea pungens) were monitored before and after a series of pruning treatments. Trees were pruned to raise or thin crowns over a range of severities between 0% and 40%. Wind-induced bending moments were measured using two calibrated displacement probes installed orthogonally on the lower stem of each tree. Using a hierarchical Bayesian model, the relationship between maximum wind speeds and bending moments was quantified, consistent with theoretical and empirical expectations, as a non-linear power law. Random intercepts for model coefficients were used to account for individual variability in aerodynamic behavior among experimental trees, and predictions were made using the median response marginalized over the observed trees. The modeled relationship between wind speeds and bending moments was physically reasonable and like existing measurements with scaling exponents below two. Despite considerable variation among experimental trees, the aerodynamic behavior of trees, as indicated by model coefficients, was not clearly altered by pruning treatments, and, correspondingly, model predictions of bending moments over the range of observed wind speeds remained similar for all pruning treatments. Ultimately, the study yielded weak evidence for a change in bending moments following conventional pruning treatments for Colorado spruce, and the practical value of pruning to mitigate risk appeared limited for the studied conditions. Highlights- Wind loads were monitored on large Colorado spruce after crown raising and thinning - A hierarchical Bayesian model quantified wind speed and bending moment power laws - Negligible change in bending moments was found for all pruning types and severities - Conventional pruning methods may not mitigate risk for Colorado spruce

Muscle force sharing during locomotion is influenced by the mechanical demands of movement and the contractile properties of synergistic muscles. In cats, plantarflexor muscles exhibit distinct functional specialization, with the slow-fibred soleus maintaining relatively constant force across conditions while faster muscles such as the plantaris and gastrocnemius increase force production with increasing locomotor demand. However, it remains unclear whether similar force-sharing patterns occur in larger animals with different musculoskeletal designs. Therefore, the purpose of this study was to examine force sharing between the superficial digital flexor (SDF) and medial gastrocnemius (MG) muscles during treadmill locomotion in sheep. Tendon buckle force transducers were surgically implanted on the SDF and MG tendons of seven sheep, and in vivo muscle forces were recorded during walking and trotting across different speeds and inclines. Both muscles increased force with increasing speed and incline; however, speed had a substantially greater effect than incline. The SDF consistently produced greater absolute force than the MG across all conditions, whereas the MG exhibited slightly larger relative increases in force with increasing speed. Time to peak force decreased with increasing speed in both muscles, although the SDF reached peak force later in stance than the MG across conditions. In contrast to the distinct specialization observed in cats, neither muscle displayed a relatively condition-independent, soleus-like force contribution. These findings suggest that force sharing in sheep is more distributed across synergistic muscles and may reflect the influence of musculoskeletal design, tendon compliance, and mixed fibre-type composition on muscle function in larger species.

This study examined how tempo, dynamics, and string influence upper-extremity physical exposure in professional violinists and how exposure variability is distributed among musical characteristics, between-subject differences, and residual variability. Twelve violinists performed seven standardized scales while bilateral upper-arm and wrist kinematics and shoulder and forearm muscle activity were recorded. Linear mixed-effects models showed that faster tempo increased right upper-arm velocity and bilateral forearm activity while reducing right upper-arm and wrist ranges of motion. Louder dynamics increased bilateral forearm and right trapezius activity and right-wrist ranges of motion. Higher-posture strings increased right upper-arm elevation and right shoulder muscle activity. Variance analysis identified exposures predominantly related to musical characteristics, jointly related to musical characteristics and between-subject differences, predominantly related to between-subject differences, or mainly unexplained. These findings support future exposure prediction from musical characteristics and targeted prevention through repertoire-based workload management, structured recovery, and individualized technique-focused strategies.

The metabolic cost of walking is widely used to evaluate human performance and effectiveness of clinical interventions. Decades of laboratory research, largely based on treadmill experiments, have established a canonical relationship between walking speed and metabolic cost, and suggested that ageing shifts this relationship upward, implying reduced efficiency in older adults. However, this relationship has not been well tested during overground walking across matched speeds. We compared healthy younger (n=16; 26{+/-}2yr) and older (n=11; 74{+/-}3yr) adults across eight outdoor overground walking trials at different speeds: preferred walking speed (PWS), three fixed speeds (0.8, 1.2, 1.6 m{middle dot}s-{superscript 1}), and four speeds at {+/-}5% and {+/-}10% of PWS. Contrary to our hypothesis, older adults did not show higher gross or net metabolic cost of walking (GCOW and NCOW) than younger adults at any speed; rather, both trended consistently lower in older adults, reaching significance for GCOW at 0.8 m{middle dot}s-{superscript 1} only. Comparisons of resting metabolic rate and respiratory exchange ratio to prior reference groups did not indicate that our older cohort was unusually fit. Independent of age, GCOW was significantly higher at 0.8 m{middle dot}s-{superscript 1} than at the remaining speeds (1.2-1.6 m{middle dot}s-{superscript 1}), confirming that walking at slower speeds increases GCOW. These findings challenge the view that ageing intrinsically increases the energetic cost of walking, suggesting instead that previously reported upward shifts in cost may reflect treadmill-specific constraints or speed effects. Future work is needed to explore direct comparisons of outdoor, overground walking with treadmill walking at fixed speeds in both younger and older adults.

Classical neuronal cable theory relies on quasi-static electric field approximations and neglects magnetic induction, Lorentz force coupling, and transient electromagnetic currents, limiting its ability to fully characterize action potential propagation within geometrically branched axons and dendrites. This work develops a coupled Maxwell-electromagnetic cable framework by integrating finite-difference time-domain (FDTD) solutions of Maxwells equations with extended Hodgkin-Huxley and Fitzhugh-Nagumo membrane dynamics, incorporating magnetic gating perturbations, electromagnetic trans-membrane currents IEM, and nanoscale quantum corrections for thin neural segments. Controlled propagation experiments are designed to quantify deviations from standard cable predictions across asymmetric and symmetric axonal bifurcation geometries. Numerical results demonstrate that inductive magnetic effects lower the critical branch radius for junction conduction failure and break symmetric action potential invasion in geometrically identical child branches under external transverse magnetic fields. An electromagnetic corrected geometric ratio GREM is proposed to revise impedance-matching conditions at branch points, accounting for size-dependent axial current imbalance induced by magnetic and displacement currents. Parent axon conduction velocity deviates substantially from the canonical [Formula] scaling law when electromagnetic feedback and quantum charge distributions are included, triggering early signal blockage at large cable diameters. Collectively, this study establishes that quasi-static cable models underestimate electromagnetic corrections to propagation speed, waveform shape, and bifurcation transmission fidelity; the coupled Maxwell-cable framework provides a comprehensive multi-physics tool for modeling electrodynamic signal behavior in complex neuronal architectures.

Background: Venous thromboembolism (VTE), including deep vein thrombosis (DVT), remains a major global health burden. Diagnostic pathways rely on ultrasound but are limited by availability and prolonged time-to-imaging. Novel artificial intelligence (AI) guidance systems have been designed to enable non-ultrasound-trained operators to acquire proximal lower extremity compression ultrasounds for remote clinician interpretation. Methods: This multicenter, double-blinded, prospective, nonrandomized study evaluated the performance of an AI guidance system (ThinkSono Guidance, ThinkSono, GmbH). Patients underwent AI-guided ultrasound(s) and standard of care ultrasound(s). Primary and secondary endpoints were image quality, sensitivity and specificity for proximal DVT, and prioritization specificity, a measure of specificity in identifying patients requiring standard of care ultrasound after AI-guided scan. Results: Of 634 recruited subjects, 594 were analyzed, with 67 DVTs across 700 scans. 86.83% of AI-guided scans achieved diagnostic image quality. Triage sensitivity was 92.86%, triage specificity 39.12%, prioritization specificity 97.96%. Standard of care ultrasounds could be avoided in 35.32% of patients. Total median AI-guided scan and review time was 7.57 minutes. Conclusions: Clinician-reviewed AI-guided scans were rapid, sensitive for DVT, and specific for prioritizing patients requiring standard of care ultrasounds. These findings suggest AI-guided ultrasound may be a scalable triage strategy to expand DVT evaluation access, particularly in resource-constrained and after-hours settings

Most widely used lower-limb musculoskeletal models are derived from male anatomy and adapted to female participants solely by linear scaling, which may not capture sex-specific differences in pelvic and hip geometry. We developed a population-averaged, female lower-limb musculoskeletal model, built from MRI-based models of a cohort of 25 adult women using thin-plate-spline muscle-path mapping, bilateral symmetrisation, and wrapping-surface optimisation. We hypothesised that this average model, adapted to a new individual by standard linear scaling alone, would reproduce that individual's MRI-based model's walking biomechanics more closely than a linearly scaled generic male-based model. We also expected that this advantage would be concentrated in pelvis- and hip-dependent outputs rather than distributed evenly across all joints. Using 5-fold cross-validation, the scaled average-female model and the scaled male model were each compared against the held-out individual's MRI-based model across gait kinematics, joint moments, muscle moment arms, muscle forces/activations, and joint reaction forces. The average-female model outperformed the male model in every output category (Holm-corrected p [&le;] *10-5), supporting our primary hypothesis. Consistent with our secondary hypothesis, differences were largest and most sustained for pelvis tilt, hip flexion, and gluteal/adductor moment arms and forces, and smaller for knee and ankle kinematics. Some divergence remained localised to early-stance knee kinematics and patellofemoral loading. The population-averaged female musculoskeletal model is freely available on SimTK https://simtk.org/projects/aver_fem and is recommended for studies involving female participants, particularly when pelvic and hip biomechanics are the primary outcomes.

Background: Tuberculosis remains a persistent infectious disease whose control is complicated by latent infection, delayed treatment, incomplete recovery, reinfection, and continuing transmission from infectious individuals. Although treatment is central to tuberculosis management, it is frequently represented only as a transition parameter in mathematical models rather than as a separate epidemiological state. In this study, treatment was therefore incorporated explicitly as an independent compartment so that its influence on transmission, recovery, disease-induced mortality, and long-term disease persistence could be evaluated. Methods: A deterministic nonlinear compartmental model was formulated by dividing the total population into susceptible, exposed, actively infected, treated, and recovered classes. Reinfection of recovered individuals, progression from latent infection to active disease, movement of infectious individuals into treatment, treatment-associated recovery, natural mortality, and disease-induced mortality were included. Positivity and boundedness of the solutions were examined to establish biological validity. The basic reproduction number, R0, was derived through the next-generation matrix approach. Disease-free and endemic equilibria were determined, and their local and conditional global stability properties were investigated using Jacobian analysis, the Routh-Hurwitz criterion, center manifold theory, Lyapunov functions, and LaSalles invariance principle. Normalized sensitivity indices, Latin hypercube sampling, partial rank correlation coefficients, and numerical simulations were also applied. Results: The disease-free equilibrium was shown to be locally asymptotically stable when ,R0<1 whereas sustained transmission and a unique endemic equilibrium were associated with R0>1. Under the stated reduced-model assumptions, stability of the endemic equilibrium was established. Transmission-related parameters were identified as the strongest positive contributors to disease persistence. In contrast, treatment and recovery parameters were found to reduce the reproduction number and infectious burden. Numerical simulations indicated that stronger treatment implementation and reduced transmission opportunities produced substantial reductions in active tuberculosis cases. Conclusion: Treatment was shown to function as both a clinical pathway and an epidemiological control mechanism. The proposed framework may support the design of treatment-centered strategies for reducing tuberculosis prevalence and preventing long-term endemic persistence.

Many people which are affected by drop foot syndrome, have to face difficulty while walking which leads to pathological gait. This type of syndrome is treated by means of an external artificial stimulation known as functional electric stimulator (FES). In this paper we are designing an online feedback control system which optimize the strength of a FES given to paretic muscle which results in correction of pathological gait of the patient in a tolerable domain. Different phases of gait are identified using inertial measurement unit (IMU) as a feedback sensor mounted on the foot. Data is collected form 8 different healthy subjects and average of collected data is used as a reference template. Different trajectories of drop foot patients are simulated (due to unavailability of patients) and corrected according to the reference template.

The temporal resolution of medical imaging sequences used to drive patient-specific computational fluid dynamics (CFD) simulations remains limited, typically providing 10-20 frames per cardiac cycle. Therefore, temporal interpolation to reconstruct left atrial (LA) wall motion and boundary conditions is required, but its impact on hemodynamic predictions has not been systematically characterized. To investigate this, we constructed high-temporal-resolution reference wall-motion data using electromechanical (EM) simulations on five patient-specific atrial geometries with a history of atrial fibrillation. We then generated temporally downsampled datasets to emulate clinical frame rates (5, 10, 20, and 40 frames per cycle) and performed CFD simulations to isolate the effects of temporal undersampling on hemodynamic metrics. The focus was placed on kinetic energy, KE, and residence time, TR, particularly in the left atrial appendage (LAA), where thrombosis is most likely to occur. We employed an immersed boundary method to prescribe the wall motion and computed blood TR through a passive scalar transport equation. Results indicate that while global LA hemodynamic indices were marginally affected by the frame rate (errors < 9%), LAA metrics were more sensitive with errors up to 31% compared to reference values. The results based on 20 and 40 frames per cycle yielded favorable agreement with reference results, while 5-and 10-frame reconstructions showed larger, though not systematically biased, deviations from the reference. Importantly, patient ranking by blood-stasis indices was largely preserved. The analysis suggests that patientspecific LA reconstructions derived from dynamic CT imaging provide a reliable basis for estimating LAA blood-stasis indices. Higher frame rates ([&ge;] 20 per cycle) offer improved quantitative accuracy, while lower temporal resolutions may remain informative for patient stratification purposes, where relative ranking is more relevant than absolute accuracy.

Older adults face an increased risk of falls that may have severe consequences for their well-being. Routine, accessible clinical screening may help mitigate fall risk through early detection of balance impairments. Portable force plates offer a convenient and practical solution for balance assessment in clinical settings. A new force-plate-based balance measure, the intersection-point-height, has shown particularly promising results in its ability to distinguish between healthy and impaired balance behaviors. However, the intersection-point-height measure requires measurement of shear force during standing, which exhibits magnitudes of less than 0.2% of normal forces (body weight), taxing the dynamic range of most sensor technologies. The ability of existing force plates to measure such low-magnitude shear forces observed during quiet standing is currently unknown. This study presents a force-plate performance assessment method to evaluate shear-force measurement errors and quantify the uncertainty of the intersection-point-height measure. The method was applied to test a commonly used laboratory-grade portable force plate. While the device successfully captured sagittal-plane intersection-point-height at the lowest frequencies, low signal strength prevented precise readings in the frontal plane. Thus, the tested device only marginally met the precision required for quiet-standing analysis, underscoring the critical need for systematic performance validation of portable force plates prior to clinical use. Future efforts should focus on evaluating alternative portable force plates and exploring economical design improvements to enhance shear-force measurement precision.

BackgroundThe use of specialized perturbation systems has become an increasingly popular approach for investigating walking stability. By accelerating or decelerating one belt, researchers can induce slip- and trip-like perturbations in a controlled laboratory setting. However, many existing studies rely on specialized perturbation systems that require expertise in device-specific software and handling of the equipment, limiting the accessibility of perturbation-based gait research to laboratories with access to such equipment. To address this limitation, we developed an open-source method capable of inducing slip- and trip-like perturbations using a standard split-belt treadmill. Here, we 1) describe the hardware and software components of the system, 2) validate the applications accuracy and precision, and 3) characterize the stability demands imparted by the perturbations with spatial stability measurements. Measured perturbation onset delay and duration were compared to the desired onset timing and programmed duration in addition to step length, step width, minimum mediolateral margin of stability, and sagittal-plane whole-body angular momentum range during the perturbed and recovery steps. ResultsFive participants with traumatic unilateral transtibial limb loss experienced perturbations consisting of brief, rapid increases or decreases in unilateral treadmill velocity, eliciting a "slip" or "trip". The mean (standard deviation) onset delay was 183.3 (9.7) ms, or 24.18% (1.91%) of stance duration. Mean perturbation duration was 239.90 (7.5) ms, 18.14% longer than the intended duration. The perturbations produced measurable changes in gait stability, such as increased step length during the perturbed step and step width during the subsequent recovery step in addition to increased minimum mediolateral margin of stability and sagittal whole body angular momentum. ConclusionThis open-source method successfully induced instability in individuals with impaired balance, demonstrating its feasibility as an accessible alternative to specialized perturbation systems. Future work will focus on refining both the software and hardware components to further improve timing, accuracy, and consistency.