{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T23:45:03Z","timestamp":1791330303343,"version":"4.3.1"},"reference-count":53,"publisher":"ASME International","issue":"12","license":[{"start":{"date-parts":[[2020,9,8]],"date-time":"2020-09-08T00:00:00Z","timestamp":1599523200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.asme.org\/publications-submissions\/publishing-information\/legal-policies"}],"content-domain":{"domain":["asmedigitalcollection.asme.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Dynamic balance is controlled by lower-limb muscles and is more difficult to maintain during stair ascent compared to level walking. As a result, individuals with lower-limb amputations often have difficulty ascending stairs and are more susceptible to falls. The purpose of this study was to identify the biomechanical mechanisms used by individuals with and without amputation to control dynamic balance during stair ascent. Three-dimensional muscle-actuated forward dynamics simulations of amputee and nonamputee stair ascent were developed and contributions of individual muscles, the passive prosthesis, and gravity to the time rate of change of angular momentum were determined. The prosthesis replicated the role of nonamputee plantarflexors in the sagittal plane by contributing to forward angular momentum. The prosthesis largely replicated the role of nonamputee plantarflexors in the transverse plane but resulted in a greater change of angular momentum. In the frontal plane, the prosthesis and nonamputee plantarflexors contributed oppositely during the first half of stance while during the second half of stance, the prosthesis contributed to a much smaller extent. This resulted in altered contributions from the intact leg plantarflexors, vastii and hamstrings, and the intact and residual leg hip abductors. Therefore, prosthetic devices with altered contributions to frontal-plane angular momentum could improve balance control during amputee stair ascent and minimize necessary muscle compensations. In addition, targeted training could improve the force production magnitude and timing of muscles that regulate angular momentum to improve balance control.<\/jats:p>","DOI":"10.1115\/1.4047387","type":"journal-article","created":{"date-parts":[[2020,5,29]],"date-time":"2020-05-29T08:50:56Z","timestamp":1590742256000},"update-policy":"https:\/\/doi.org\/10.1115\/crossmarkpolicy-asme","source":"Crossref","is-referenced-by-count":2,"title":["Muscle Contributions to Balance Control During Amputee and Nonamputee Stair Ascent"],"prefix":"10.1115","volume":"142","author":[{"given":"Nicole G.","family":"Harper","sequence":"first","affiliation":[{"name":"Walker Department of Mechanical Engineering, The University of Texas at Austin, 204 E. Dean Keeton Street, Stop C2200, Austin, TX 78712"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason M.","family":"Wilken","sequence":"additional","affiliation":[{"name":"Extremity Trauma and Amputation Center of Excellence, Center for the Intrepid, Brooke Army Medical Center, Ft. Sam Houston, TX 78234; Department of Physical Therapy and Rehabilitation Science, The University of Iowa, 1-252 Medical Education Building, Iowa City, IA 52240"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard R.","family":"Neptune","sequence":"additional","affiliation":[{"name":"Walker Department of Mechanical Engineering, The University of Texas at Austin, 204 E. Dean Keeton Street, Stop C2200, Austin, TX 78712"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"33","published-online":{"date-parts":[[2020,9,8]]},"reference":[{"issue":"3","key":"2020090804371825600_bib1","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1016\/j.gaitpost.2010.01.003","article-title":"Indicators of Dynamic Stability in Transtibial Prosthesis Users","volume":"31","year":"2010","journal-title":"Gait Posture"},{"issue":"13","key":"2020090804371825600_bib2","doi-asserted-by":"crossref","first-page":"3380","DOI":"10.1016\/j.jbiomech.2014.08.001","article-title":"Whole-Body Angular Momentum During Stair Walking Using Passive and Powered Lower-Limb Prostheses","volume":"47","year":"2014","journal-title":"J. Biomech."},{"issue":"4","key":"2020090804371825600_bib3","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1016\/j.gaitpost.2014.01.025","article-title":"Whole-Body Angular Momentum During Stair Ascent and Descent","volume":"39","year":"2014","journal-title":"Gait Posture"},{"issue":"4","key":"2020090804371825600_bib4","doi-asserted-by":"crossref","first-page":"399","DOI":"10.3109\/03093646.2010.480964","article-title":"Lower Limb Kinematic and Kinetic Differences Between Transtibial Amputee Fallers and Non-Fallers","volume":"34","year":"2010","journal-title":"Prosthet. Orthot. Int."},{"issue":"2","key":"2020090804371825600_bib5","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.gaitpost.2008.01.014","article-title":"Influence of Light Handrail Use on the Biomechanics of Stair Negotiation in Old Age","volume":"28","year":"2008","journal-title":"Gait Posture"},{"issue":"4","key":"2020090804371825600_bib6","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.gaitpost.2011.07.008","article-title":"Relationship Between Stair Ambulation With and Without a Handrail and Centre of Pressure Velocities During Stair Ascent and Descent","volume":"34","year":"2011","journal-title":"Gait Posture"},{"issue":"1","key":"2020090804371825600_bib7","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.gaitpost.2008.06.001","article-title":"Gait and Kinematics of the Trunk and Lower Extremities in Stair Ascent Using Quadricane in Healthy Subjects","volume":"29","year":"2009","journal-title":"Gait Posture"},{"issue":"4","key":"2020090804371825600_bib8","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1016\/j.gaitpost.2010.07.015","article-title":"The Effect of Cane Use Method on Center of Mass Displacement During Stair Ascent","volume":"32","year":"2010","journal-title":"Gait Posture"},{"issue":"7","key":"2020090804371825600_bib9","doi-asserted-by":"crossref","first-page":"070801","DOI":"10.1115\/1.4042170","article-title":"Dynamic Balance During Human Movement: Measurement and Control Mechanisms","volume":"141","year":"2019","journal-title":"ASME J. Biomech. Eng."},{"issue":"4","key":"2020090804371825600_bib10","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1242\/jeb.008573","article-title":"Angular Momentum in Human Walking","volume":"211","year":"2008","journal-title":"J. Exp. Biol."},{"key":"2020090804371825600_bib11","first-page":"3785","article-title":"Rate of Change of Angular Momentum and Balance Maintenance of Biped Robots","volume-title":"IEEE International Conference on Robotics and Automation","year":"2004"},{"key":"2020090804371825600_bib12","first-page":"2483","article-title":"Exploiting Angular Momentum to Enhance Bipedal Center-of-Mass Control","volume-title":"ICRA","year":"2009"},{"key":"2020090804371825600_bib13","first-page":"1644","article-title":"Resolved Momentum Control: Humanoid Motion Planning Based on the Linear and Angular Momentum","volume-title":"IROS","year":"2003"},{"issue":"1","key":"2020090804371825600_bib14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1123\/jab.16.1.1","article-title":"Whole-Body Momentum During Gait: A Preliminary Study of Non-Fallers and Frequent Fallers","volume":"16","year":"2000","journal-title":"J. Appl. Biomech."},{"issue":"12","key":"2020090804371825600_bib15","doi-asserted-by":"crossref","first-page":"1811","DOI":"10.1016\/j.jbiomech.2004.02.038","article-title":"Contribution of the Support Limb in Control of Angular Momentum After Tripping","volume":"37","year":"2004","journal-title":"J. Biomech."},{"issue":"3","key":"2020090804371825600_bib16","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1016\/j.jbiomech.2004.03.029","article-title":"How Early Reactions in the Support Limb Contribute to Balance Recovery After Tripping","volume":"38","year":"2005","journal-title":"J. Biomech."},{"issue":"4","key":"2020090804371825600_bib17","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/j.gaitpost.2004.04.009","article-title":"Push-Off Reactions in Recovery After Tripping Discriminate Young Subjects, Older Non-Fallers and Older Fallers","volume":"21","year":"2005","journal-title":"Gait Posture"},{"issue":"16","key":"2020090804371825600_bib18","doi-asserted-by":"crossref","first-page":"3641","DOI":"10.1016\/j.jbiomech.2007.06.009","article-title":"Balance Control in Stepping Down Expected and Unexpected Level Changes","volume":"40","year":"2007","journal-title":"J. Biomech."},{"issue":"1","key":"2020090804371825600_bib19","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/s12984-019-0497-9","article-title":"Uneven Terrain Exacerbates the Deficits of a Passive Prosthesis in the Regulation of Whole Body Angular Momentum in Individuals With a Unilateral Transtibial Amputation","volume":"16","year":"2019","journal-title":"J. Neuroeng. Rehabil."},{"issue":"13","key":"2020090804371825600_bib20","doi-asserted-by":"crossref","first-page":"2734","DOI":"10.1016\/j.jbiomech.2016.06.014","article-title":"Balance and Recovery on Coronally-Uneven and Unpredictable Terrain","volume":"49","year":"2016","journal-title":"J. Biomech."},{"key":"2020090804371825600_bib21","doi-asserted-by":"crossref","first-page":"110714","DOI":"10.1016\/j.exger.2019.110714","article-title":"Age-Related Changes in the Control of Whole-Body Angular Momentum During Stepping","volume":"127","year":"2019","journal-title":"Exp. Gerontol."},{"issue":"6","key":"2020090804371825600_bib22","doi-asserted-by":"crossref","first-page":"2860","DOI":"10.1016\/j.ridd.2011.05.019","article-title":"Control of Angular Momentum During Walking in Children With Cerebral Palsy","volume":"32","year":"2011","journal-title":"Res. Dev. Disabil."},{"issue":"1","key":"2020090804371825600_bib23","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.gaitpost.2013.06.008","article-title":"Relationships Between Frontal-Plane Angular Momentum and Clinical Balance Measures During Post-Stroke Hemiparetic Walking","volume":"39","year":"2014","journal-title":"Gait Posture"},{"issue":"3","key":"2020090804371825600_bib24","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/j.jbiomech.2010.10.027","article-title":"Differences in Whole-Body Angular Momentum Between Below-Knee Amputees and Non-Amputees Across Walking Speeds","volume":"44","year":"2011","journal-title":"J. Biomech."},{"issue":"8","key":"2020090804371825600_bib25","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1053\/apmr.2001.24295","article-title":"The Prevalence and Risk Factors of Falling and Fear of Falling Among Lower Extremity Amputees","volume":"82","year":"2001","journal-title":"Arch. Phys. Med. Rehabil."},{"issue":"10","key":"2020090804371825600_bib26","doi-asserted-by":"crossref","first-page":"3044","DOI":"10.1007\/s11999-014-3647-1","article-title":"Does Use of a Powered Ankle-Foot Prosthesis Restore Whole-Body Angular Momentum During Walking at Different Speeds?","volume":"472","year":"2014","journal-title":"Clin. Orthop. Relat. Res."},{"issue":"3","key":"2020090804371825600_bib27","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1016\/j.gaitpost.2015.02.008","article-title":"Mediolateral Angular Momentum Changes in Persons With Amputation During Perturbed Walking","volume":"41","year":"2015","journal-title":"Gait Posture"},{"issue":"14","key":"2020090804371825600_bib28","doi-asserted-by":"crossref","first-page":"3397","DOI":"10.1016\/j.jbiomech.2016.09.010","article-title":"Whole-Body Angular Momentum During Sloped Walking Using Passive and Powered Lower-Limb Prostheses","volume":"49","year":"2016","journal-title":"J. Biomech."},{"key":"2020090804371825600_bib29","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.jbiomech.2018.12.016","article-title":"Dynamic Balance During Running Using Running-Specific Prostheses","volume":"84","year":"2019","journal-title":"J. Biomech."},{"key":"2020090804371825600_bib30","first-page":"1609","article-title":"Segmental Contributions to Sagittal-Plane Whole-Body Angular Momentum When Using Powered Compared to Passive Ankle-Foot Prostheses on Ramps","year":"2017","journal-title":"ICORR"},{"key":"2020090804371825600_bib31","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.jelekin.2018.01.002","article-title":"Trunk Movement Compensations and Corresponding Core Muscle Demand During Step Ambulation in People With Unilateral Transtibial Amputation","volume":"39","year":"2018","journal-title":"J. Electromyogr. Kinesiol."},{"issue":"1","key":"2020090804371825600_bib32","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.jbiomech.2010.08.015","article-title":"Muscle Contributions to Whole-Body Sagittal Plane Angular Momentum During Walking","volume":"44","year":"2011","journal-title":"J. Biomech."},{"issue":"13","key":"2020090804371825600_bib33","doi-asserted-by":"crossref","first-page":"2975","DOI":"10.1016\/j.jbiomech.2016.07.016","article-title":"Muscle Contributions to Frontal Plane Angular Momentum During Walking","volume":"49","year":"2016","journal-title":"J. Biomech."},{"issue":"12","key":"2020090804371825600_bib34","article-title":"Muscle Function and Coordination of Amputee Stair Ascent","volume":"140","year":"2018","journal-title":"ASME J. Biomech. Eng."},{"issue":"1","key":"2020090804371825600_bib35","doi-asserted-by":"crossref","first-page":"011001","DOI":"10.1115\/1.4037791","article-title":"Muscle Function and Coordination of Stair Ascent","volume":"140","year":"2018","journal-title":"ASME J. Biomech. Eng."},{"issue":"4","key":"2020090804371825600_bib36","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1080\/10255840008915275","article-title":"A Method for Numerical Simulation of Single Limb Ground Contact Events: Application to Heel-Toe Running","volume":"3","year":"2000","journal-title":"Comput. Methods Biomech. Biomed. Eng."},{"issue":"5","key":"2020090804371825600_bib37","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1016\/S0003-9993(00)90035-2","article-title":"Walking Symmetry and Energy Cost in Persons With Unilateral Transtibial Amputations: Matching Prosthetic and Intact Limb Inertial Properties","volume":"81","year":"2000","journal-title":"Arch. Phys. Med. Rehabil."},{"issue":"1\u20132","key":"2020090804371825600_bib38","first-page":"65","article-title":"Global Optimization of Statistical Functions With Simulated Annealing","volume":"60","year":"1994","journal-title":"J. Econometrics"},{"issue":"2","key":"2020090804371825600_bib39","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/S0966-6362(03)00062-6","article-title":"Muscle Force Redistributes Segmental Power for Body Progression During Walking","volume":"19","year":"2004","journal-title":"Gait Posture"},{"issue":"11","key":"2020090804371825600_bib40","doi-asserted-by":"crossref","first-page":"2530","DOI":"10.1016\/j.jbiomech.2006.11.001","article-title":"Balance Control During Stair Negotiation in Older Adults","volume":"40","year":"2007","journal-title":"J. Biomech."},{"issue":"2","key":"2020090804371825600_bib41","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/j.jbiomech.2014.11.019","article-title":"Muscle Coordination of Support, Progression and Balance During Stair Ambulation","volume":"48","year":"2015","journal-title":"J. Biomech."},{"issue":"5","key":"2020090804371825600_bib42","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1007\/s00421-007-0613-6","article-title":"Identification of Elderly Fallers by Muscle Strength Measures","volume":"102","year":"2008","journal-title":"Eur. J. Appl. Physiol."},{"issue":"3","key":"2020090804371825600_bib43","doi-asserted-by":"crossref","first-page":"M97","DOI":"10.1093\/geronj\/48.3.M97","article-title":"Kinematics of Recovery From a Stumble","volume":"48","year":"1993","journal-title":"J. Gerontol."},{"issue":"2","key":"2020090804371825600_bib44","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.gaitpost.2007.12.002","article-title":"Balance Control on a Moving Platform in Unilateral Lower Limb Amputees","volume":"28","year":"2008","journal-title":"Gait Posture"},{"issue":"1","key":"2020090804371825600_bib45","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.gaitpost.2013.06.004","article-title":"How Gravity and Muscle Action Control Mediolateral Center of Mass Excursion During Slow Walking: A Simulation Study","volume":"39","year":"2014","journal-title":"Gait Posture"},{"issue":"11","key":"2020090804371825600_bib46","doi-asserted-by":"crossref","first-page":"2055","DOI":"10.1016\/j.jbiomech.2010.04.010","article-title":"Muscle Coordination of Mediolateral Balance in Normal Walking","volume":"43","year":"2010","journal-title":"J. Biomech."},{"issue":"13","key":"2020090804371825600_bib47","doi-asserted-by":"crossref","first-page":"2271","DOI":"10.1016\/j.jbiomech.2012.06.008","article-title":"Muscle and Prosthesis Contributions to Amputee Walking Mechanics: A Modeling Study","volume":"45","year":"2012","journal-title":"J. Biomech."},{"issue":"2","key":"2020090804371825600_bib48","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.gaitpost.2012.03.010","article-title":"The Relative Contributions of the Prosthetic and Sound Limb to Balance Control in Unilateral Transtibial Amputees","volume":"36","year":"2012","journal-title":"Gait Posture"},{"issue":"1","key":"2020090804371825600_bib49","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.gaitpost.2010.09.024","article-title":"Sagittal and Frontal Lower Limb Joint Moments During Stair Ascent and Descent in Young and Older Adults","volume":"33","year":"2011","journal-title":"Gait Posture"},{"key":"2020090804371825600_bib50","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.jbiomech.2018.05.023","article-title":"Hip Recovery Strategy Used by Below-Knee Amputees Following Mediolateral Foot Perturbations","volume":"76","year":"2018","journal-title":"J. Biomech."},{"issue":"3","key":"2020090804371825600_bib51","first-page":"215","article-title":"Biomechanics and Muscle Coordination of Human Walking. Part I: Introduction to Concepts, Power Transfer, Dynamics and Simulations","volume":"16","year":"2002","journal-title":"Gait Posture"},{"issue":"1","key":"2020090804371825600_bib52","first-page":"9","article-title":"Stair Ambulation in Persons With Transtibial Amputation: An Analysis of the Seattle LightFoot","volume":"34","year":"1997","journal-title":"J. Rehabil. Res. Dev."},{"issue":"4","key":"2020090804371825600_bib53","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1016\/j.gaitpost.2008.04.005","article-title":"Compensatory Mechanisms in Below-Knee Amputee Gait in Response to Increasing Steady-State Walking Speeds","volume":"28","year":"2008","journal-title":"Gait Posture"}],"container-title":["Journal of Biomechanical Engineering"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/asmedigitalcollection.asme.org\/biomechanical\/article-pdf\/doi\/10.1115\/1.4047387\/6564284\/bio_142_12_121007.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/asmedigitalcollection.asme.org\/biomechanical\/article-pdf\/doi\/10.1115\/1.4047387\/6564284\/bio_142_12_121007.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,8]],"date-time":"2020-09-08T08:37:58Z","timestamp":1599554278000},"score":1,"resource":{"primary":{"URL":"https:\/\/asmedigitalcollection.asme.org\/biomechanical\/article\/doi\/10.1115\/1.4047387\/1084096\/Muscle-Contributions-to-Balance-Control-During"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,8]]},"references-count":53,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2020,12,1]]}},"URL":"https:\/\/doi.org\/10.1115\/1.4047387","relation":{},"ISSN":["0148-0731","1528-8951"],"issn-type":[{"value":"0148-0731","type":"print"},{"value":"1528-8951","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,8]]},"article-number":"121007"}}