Beyond Inverse Dynamics: Methods for Assessment of Individual Muscle Function during Gait.

Three-dimensional motion analysis performed in the modern gait analysis laboratory provides a wealth of information about the kinematics and kinetics of human locomotion, but standard gait analysis is largely restricted to joint-level measures. Three-dimensional joint rotations, joint moments, and joint powers tell us a great deal about gait mechanics, but it is often of interest to know about the roles that muscles play. This narrative review surveys work that has been done, largely over the past four decades, to augment standard gait analysis with muscle-level assessments of function. Often, these assessments have incorporated additional technology such as ultrasound imaging, or complex modeling and simulation techniques. The review discusses measurements of muscle moment arm during walking along with assessment of muscle mechanical advantage, muscle-tendon lengths, and the use of induced acceleration analysis to determine muscle roles. In each section of the review, examples are provided of how the auxiliary analyses have been used to gain potentially useful information about normal and pathological human walking. While this work highlights the potential benefits of adding various measures to gait analysis, it is acknowledged that challenges to implementation remain, such as the need for specialized knowledge and the potential for bias introduced by model choices.