I’m working on a variety of learning materials to teach clinical gait analysis at the moment. Our masters programme in clinical gait analysis should start in 8 months time. One thing I find really depressing is how little of our clinical reasoning for individual patients is based on biomechanics. Most of the interpretation we do is essentially learned and largely subjective pattern recognition. We don’t really understand the data in a way that approaches science.
There are numerous reasons for this but one of the issues is that the biomechanics of walking is not being developed at the right level. On the one hand we have a group of researchers, coalescing under the Dynamic Walking Group, who are developing extremely simple and often non-physiological models to explore very basic principles. On the other hand are researchers typified by (but not restricted to) the OpenSim project who are developing really complex computer models. Neither group, as far as I can see is having a significant impact on the clinical understanding of gait or affecting how we manage our patient’s conditions.
To my mind the simple models are just too simple – how do you use a model without muscles to understand the consequences of a spastic gasttrocnemius? Equally the complex models are too complex- it’s impractical to perform a full CMC analysis for every patient. Even if we did we wouldn’t know which results are robust indications of the biomechanics of the patient and which are consequences of modelling assumptions and parameters.
What we really need is models that are neither too simple nor too complex – borrowing from modern astrophysics we need them to inhabit the Goldilocks zone – Goldilocks biomechanics.
“Inverted pendulum” is one of those terms that seems to have crept up on me over my time in biomechanics. I don’t remember it being commonly used or taught when I was a student but now it seems to be everywhere. I suspect it is one of those terms that is not understood anywhere nearly as well as it should be. I’m not aware, for instance, of any biomechanics text book that properly explains what an inverted pendulum is or what its mechanical characteristics are. This is particularly important because in mechanics the “inverted pendulum” is more often studied as a classic example of dynamics and control theory (see the Wikipedia article for example). Anyone looking at these descriptions but wanting insight into the biomechanics of walking is going to end up very confused.
An ordinary pendulum is one with the pivot at the top and the mass at the bottom. An inverted pendulum is the opposite way round. The pivot is at the bottom and the mass is on top. Fierljeppen (canal vaulting) is the best example I’ve got of an inverted pendulum (see video below). The pole rotates about its foot (at the bottom of the canal) and transports the vaulter from one side of the canal to the other. “Transports” is the key word here. The inverted pendulum is a mechanism for carrying an object form one place to another and this is how it functions during walking. The “passenger unit” as Perry would call it is carried forward by the outstretched leg as it pivots over the foot.
It should be noted that there are important differences between the two types of pendulum. The inverted pendulum only carries an object in one direction, it doesn’t swing backward and forward like the ordinary pendulum. Another difference is that the inverted pendulum does not have a characteristic frequency like an ordinary pendulum – it would be absolutely useless inside a grandfather clock.
The earliest use of the term as a model of the stance phase of walking that I am aware of was by Cavagna et al. (1976). Earlier workers have used different terms for essentially the same concept. The “compass gait” of the much aligned Saunders, Inman and Eberhart (1953) is essentially a description of the inverted pendulum. A decade later Elftman (1966) suggested that “the body moves forwards as if vaulting on a pole” and a further decade on Alexander used the term “stiff-legged gait” (1976). It is probably the more recent work of the dynamic walking group (best summarised by Kuo, 2007) that has really popularised the use of the term.
Some papers refer to Cavagna as having tested the hypothesis that the leg behaves like an inverted pendulum (e.g. Kuo, 2007, page 619). I’ve never found any evidence of this in Cavagna’s writing or anywhere else. He certainly commented that changes in kinetic and potential energy of the centre of mass correlate so that the total energy remains approximately constant throughout the gait cycle but there are an infinite number of ways this can occur without requiring an inverted pendulum mechanism (I might write more about this in a later post).
“Proving” that walking is based on the inverted pendulum is problematic in that at a very broad level it is obvious that walking involves a similar mechanism. The foot is clearly planted and the passenger unit is carried over it by the outstretched leg. On the other hand it is equally clear that the mechanism is not a simple inverted pendulum. The trunk remains upright, there is stance phase knee flexion and the pivot with the floor changes position and anatomical location through stance (Perry’s rockers). Any study attempting to establish whether stance is like an inverted pendulum will inevitably conclude that it is a bit like one but not exactly. Forming a sensible research question to “prove” the importance of this mechanism is quite a challenge.
Anderson and Pandy (2003) reported briefly on the dynamics of the inverted pendulum as a model of stance phase and Buczek and his team in more detail (2006). Both these papers are worth reading and held a couple of surprises for me but I’ll keep those for a later post.
Alexander, M. (1976). Mechanics of bipedal locomotion. In P. Davis (Ed.), Perspectives in experimental biology (pp. 493-504). Oxford: Pergamon.
Anderson, F. C., & Pandy, M. G. (2003). Individual muscle contributions to support in normal walking. Gait Posture, 17(2), 159-169.
Buczek, F. L., Cooney, K. M., Walker, M. R., Rainbow, M. J., Concha, M. C., & Sanders, J. O. (2006). Performance of an inverted pendulum model directly applied to normal human gait. Clin Biomech (Bristol, Avon), 21(3), 288-296.
Cavagna, G. A., Thys, H., & Zamboni, A. (1976). The sources of external work in level walking and running. J Physiol, 262(3), 639-657.
Elftman, H. (1966). Biomechanics of muscle with particular application to studies of gait. J Bone Joint Surg Am, 48(2), 363-377.
Kuo, A. D. (2007). The six determinants of gait and the inverted pendulum analogy: A dynamic walking perspective. Hum Mov Sci, 26(4), 617-656.
Saunders, J. D. M., Inman, V. T., & Eberhart, H. D. (1953). The major determinants in normal and pathological gait. Journal of Bone and Joint Surgery, 35A(3), 543-728.
Walking with Richard 