title: Adjusting kinematics and kinetics in a feedback-controlled toe walking model.
abstract: BACKGROUND
  In clinical gait assessment, the correct interpretation of gait kinematics and kinetics has a decisive impact on the success of the therapeutic programme. Due to the vast amount of information from which primary anomalies should be identified and separated from secondary compensatory changes, as well as the biomechanical complexity and redundancy of the human locomotion system, this task is considerably challenging and requires the attention of an experienced interdisciplinary team of experts. The ongoing research in the field of biomechanics suggests that mathematical modeling may facilitate this task. This paper explores the possibility of generating a family of toe walking gait patterns by systematically changing selected parameters of a feedback-controlled model.
  
  
  METHODS
  From the selected clinical case of toe walking we identified typical toe walking characteristics and encoded them as a set of gait-oriented control objectives to be achieved in a feedback-controlled walking model. They were defined as fourth order polynomials and imposed via feedback control at the within-step control level. At the between-step control level, stance leg lengthening velocity at the end of the single support phase was adaptively adjusted after each step so as to facilitate gait velocity control. Each time the gait velocity settled at the desired value, selected intra-step gait characteristics were modified by adjusting the polynomials so as to mimic the effect of a typical therapeutical intervention - inhibitory casting.
  
  
  RESULTS
  By systematically adjusting the set of control parameters we were able to generate a family of gait kinematic and kinetic patterns that exhibit similar principal toe walking characteristics, as they were recorded by means of an instrumented gait analysis system in the selected clinical case of toe walking. We further acknowledge that they to some extent follow similar improvement tendencies as those which one can identify in gait kinematics and kinetics in the selected clinical case after inhibitory casting.
  
  
  CONCLUSIONS
  The proposed walking model that is based on a two-level control strategy has the ability to generate different gait kinematics and kinetics when the set of control parameters that define walking premises change. Such a framework does not have only educational value, but may also prove to have practical implications in pathological gait diagnostics and treatment.
authors.affiliation: University Rehabilitation Institute, Republic of Slovenia, Ljubljana, Slovenia. andrej.olensek@mail.ir-rs.si
authors.forename: Andrej
authors.initials: A
authors.lastname: Olenšek
authors.forename: Zlatko
authors.initials: Z
authors.lastname: Matjačić
mesh_terms: D000465:Algorithms; D001676:Biofeedback, Psychology / Q000379:methods*; D001696:Biomechanical Phenomena; D004558:Electric Stimulation; D005684:Gait / Q000502:physiology; D006801:Humans; D007596:Joints / Q000502:physiology; D007700:Kinetics; D007866:Leg / Q000033:anatomy & histology; D008959:Models, Neurological; D010388:Pelvis / Q000502:physiology; D014034:Toes / Q000502:physiology*; D016896:Treatment Outcome; D014584:User-Computer Interface; D016138:Walking / Q000502:physiology*