A comprehensive review on biomechanical modeling applied to device-assisted locomotion

Abstract

According to the World Health Organization, 15% of the world’s population lived with some form of disability in 2011 and, nowadays, more than one billion people worldwide require the use of one or more assistive devices (AD). The raising significance of this problem led several authors to develop biomechanical models capable of analyzing device-assisted locomotion. The scientific knowledge arising from this analysis helps understand how mobility disabilities affect the human movement and provides promising options for the development and improvement of mobility AD tailored to each subject’s needs, as well as type and level of disability. Consequently, a detailed evaluation of this topic is strongly warranted. Therefore, the purpose of this review is to provide a structured and thorough description and critical assessment of the current evidence on biomechanical modeling applied to device-assisted locomotion, focusing specifically on crutches, walkers, canes, and wheelchairs. To this end, PubMed, Scopus, and Web of Science databases were searched on July 31, 2021. A total of 72 studies, dated from 1985 to 2021, were included and subjected to analysis. A great variety of models’ characteristics and modeling premises was found for the reproduction of device-assisted locomotion. Amongst the spatiotemporal parameters studied, canes allowed higher cadence than crutches and walkers. Wheelchair locomotion was faster, and crutches allowed the longest stride length. Overall, the glenohumeral joint experienced the highest forces and moments, followed by the elbow and wrist joints. Forces exerted on crutches were the highest amongst the four AD considered, whilst wheelchairs experienced the highest moments.