Backward slope walking was considered as a practical rehabilitation and training skill. However, its gait stability has been hardly studied, resulting in its limited application as a rehabilitation tool. In this study, the effect of walking direction and slope grade were investigated on the local dynamic stability of the motion of lower extremity joints and trunk segment during backward and forward upslope walking (BUW/FUW). The local divergence exponents (λS) of 16 adults were calculated during their BUW and FUW at grades of 0%, 5%, 10%, and 15%. Mean standard deviation over strides (MeanSD) was analyzed as their gait variability. Backward walking showed larger λS for the abduction-adduction and rotational angles of knee and ankle on inclined surface than forward walking, while λS for hip flexion-extension angle at steeper grades was opposite. No grade effect for any joint existed during BUW, while λS increased with the increasing grade during FUW. As to the trunk, walking direction did little impact on λS. Still, significant larger λS for its medial-lateral and vertical motion were found at the steeper grades during both FUW and BUW. Results indicate that during BUW, the backward direction may influence the stability of joint motions, while the trunk stability was challenged by the increasing grades. Therefore, BUW may be a training tool for the stability of both upper and lower body motion during gait.

Arm swing is an essential component in regulating dynamic stability of the whole body during walking, while the contribution of active arm swing to local dynamic stability of different motion segments remains unclear. This study investigated the effects of arm swing under natural arm swing condition and active arm swing condition on local dynamic stability and gait variability of the trunk segments (C7 and T10 joint) and lower extremity joints (hip, knee and ankle joint). The local divergence exponents (λs) and mean standard deviation over strides (MeanSD) of 24 young healthy adults were calculated while they were walking on treadmill with two arm swing conditions at their preferred walking speed (PWS). We found that in medial-lateral direction, both λs and MeanSD values of the trunk segments (C7 and T10 joint) in active arm swing condition were significantly lower than those in natural arm swing condition (p<0.05), while no significant difference of λs or MeanSD in lower extremity joints (hip, knee and ankle joint) was found between two arm swing conditions (p>0.05, respectively). In anterior-posterior and vertical direction, neither λs nor MeanSD values of all body segments showed significant difference between two arm swing conditions (p>0.05, respectively). These findings indicate that active arm swing may help to improve the local dynamic stability of the trunk segments in medial-lateral direction.

Gait stability is the ability to deal with small perturbations that naturally occur during walking. Changes in motor control caused by pain could affect this ability. This study investigated whether nociceptive stimulation (hypertonic saline injection) in a low back (LBP) or calf (CalfP) muscle affects gait stability. Sixteen participants walked on a treadmill at 0.94ms(-1) and 1.67ms(-1), while thorax kinematics were recorded using 3D-motion capture. From 110 strides, stability (local divergence exponent, LDE), stride-to-stride variability and root mean squares (RMS) of thorax linear velocities were calculated along the three movement axes. At 0.94ms(-1), independent of movement axes, gait stability was lower (higher LDE) and stride-to-stride variability was higher, during LBP and CalfP than no pain. This was more pronounced during CalfP, likely explained by the biomechanical function of calf muscles in gait, as supported by greater mediolateral RMS and stance time asymmetry than in LBP and no pain. At 1.67ms(-1), independent of movement axes, gait stability was greater and stride-to-stride variability was smaller with LBP than no pain and CalfP, whereas CalfP was not different from no pain. Opposite effects of LBP on gait stability between speeds suggests a more protective strategy at the faster speed. Although mediolateral RMS was greater and participants had more asymmetric stance times with CalfP than LBP and no pain, limited effect of CalfP at the faster speed could relate to greater kinematic constraints and smaller effects of calf muscle activity on propulsion at this speed. In conclusion, pain effects on gait stability depend on pain location and walking speed.

Local dynamic stability has been assessed by the short-term local divergence exponent (λS), which quantifies the average rate of logarithmic divergence of infinitesimally close trajectories in state space. Both increased and decreased local dynamic stability at faster walking speeds have been reported. This might pertain to methodological differences in calculating λS. Therefore, the aim was to test if different calculation methods would induce different effects of walking speed on local dynamic stability. Ten young healthy participants walked on a treadmill at five speeds (60%, 80%, 100%, 120% and 140% of preferred walking speed) for 3min each, while upper body accelerations in three directions were sampled. From these time-series, λS was calculated by three different methods using: (a) a fixed time interval and expressed as logarithmic divergence per stride-time (λS-a), (b) a fixed number of strides and expressed as logarithmic divergence per time (λS-b) and (c) a fixed number of strides and expressed as logarithmic divergence per stride-time (λS-c). Mean preferred walking speed was 1.16±0.09m/s. There was only a minor effect of walking speed on λS-a. λS-b increased with increasing walking speed indicating decreased local dynamic stability at faster walking speeds, whereas λS-c decreased with increasing walking speed indicating increased local dynamic stability at faster walking speeds. Thus, the effect of walking speed on calculated local dynamic stability was significantly different between methods used to calculate local dynamic stability. Therefore, inferences and comparisons of studies employing λS should be made with careful consideration of the calculation method.