{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:56:03Z","timestamp":1790751363835,"version":"4.1.0"},"reference-count":78,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Bioeng. Biotechnol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lower-leg wounds and fractures are some of the most common types of traumatic injuries sustained by U.S. Service members during combat operations. Existing guidelines for on-field management of lower-leg injuries recommend stabilizing the injury and preventing weight-bearing on the affected leg. However, adhering to these recommendations could be challenging because the casualty may need to walk independently to obtain medical care. In this exploratory experimental and computational study, we assessed the biomechanical characteristics of a hands-free crutch device to aid in the mobility of healthy individuals with a hypothetical lower-leg injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an experimental study where we collected anthropometric, body-motion, ground reaction force, spatiotemporal, and electromyography data from 10 young, healthy men who walked with and without the Freedom Leg hands-free crutch on an instrumented treadmill. Using these data, we developed individualized musculoskeletal and finite-element models and computed biomechanical parameters, including joint kinematics and kinetics, muscle activity and metabolic power demand, and tibial stress, for each participant under each of the two walking conditions. We evaluated the suitability of the device by comparing the model-predicted biomechanical parameters between the two conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared to walking unassisted, walking with the Freedom Leg reduced the peak knee joint reaction force (JRF) by 47%, peak ankle JRF by 98%, and peak tibial stress by 59% in the crutch-supported leg. However, it also introduced unintended consequences in the contralateral leg, increasing the peak hip JRF by 19%, peak hip flexion moment by 50%, and peak hip extension moment by 89% as well as the mean metabolic power demand in representative hip and knee muscles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The Freedom Leg improved mobility by effectively reducing weight-bearing and stabilizing the crutch-supported leg. However, changes in gait patterns also introduced unintended biomechanical consequences in the contralateral leg. This exploratory study provides insights into the biomechanical effects of walking with the Freedom Leg in healthy, young individuals and may inform the development and assessment of future hands-free crutch devices to improve mobility of Service members with lower-leg injuries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fbioe.2026.1941015","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:05:27Z","timestamp":1790748327000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Characterization of lower-extremity biomechanics when walking with a hands-free crutch: an integrated experimental and computational analysis"],"prefix":"10.3389","volume":"14","author":[{"given":"Md. Arifuzzaman","family":"Arif","sequence":"first","affiliation":[{"name":"Department of Defense Biotechnology High Performance Computing Software Applications Institute, Defense Health Agency Research & Development, Medical Research and Development Command","place":["Fort Detrick, MD, United States"]},{"name":"The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc.","place":["Bethesda, MD, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaques","family":"Reifman","sequence":"additional","affiliation":[{"name":"Department of Defense Biotechnology High Performance Computing Software Applications Institute, Defense Health Agency Research & Development, Medical Research and Development Command","place":["Fort Detrick, MD, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankur","family":"Padhye","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, East Carolina University","place":["Greenville, NC, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey","family":"Meardon","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, East Carolina University","place":["Greenville, NC, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Willson","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, East Carolina University","place":["Greenville, NC, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose E.","family":"Rubio","sequence":"additional","affiliation":[{"name":"Department of Defense Biotechnology High Performance Computing Software Applications Institute, Defense Health Agency Research & Development, Medical Research and Development Command","place":["Fort Detrick, MD, United States"]},{"name":"The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc.","place":["Bethesda, MD, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1177\/0309364613489145","article-title":"Forces and moments in knee\u2013ankle\u2013foot orthoses while walking on irregular surfaces: a case series study","volume":"38","author":"Andrysek","year":"2014","journal-title":"Prosthetics Orthot. Int."},{"key":"B2","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1111\/j.2517-6161.1995.tb02031.x","article-title":"Controlling the false discovery rate: a practical and powerful approach to multiple testing","volume":"57","author":"Benjamini","year":"1995","journal-title":"J. R. Stat. Soc. Ser. B Methodol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1186\/s12984-021-00955-8","article-title":"Optimized hip-knee-ankle exoskeleton assistance reduces the metabolic cost of walking with worn loads","volume":"18","author":"Bryan","year":"2021","journal-title":"J. NeuroEngineering Rehabilitation"},{"key":"B4","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1002\/pmrj.13109","article-title":"A comparison of energy expenditure and perceived exertion between standard axillary crutches, knee scooters, and a hands-free crutch","volume":"16","author":"Canter","year":"2024","journal-title":"PM&R"},{"key":"B5","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1081\/bip-120016229","article-title":"A note on sample size calculation for mean comparisons based on noncentral t-statistics","volume":"12","author":"Chow","year":"2002","journal-title":"J. Biopharm. Statistics"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1555","DOI":"10.1016\/j.apmr.2003.09.011","article-title":"Leg muscle activity during walking with assistive devices at varying levels of weight bearing","volume":"85","author":"Clark","year":"2004","journal-title":"Archives Phys. Med. Rehabilitation"},{"key":"B7","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/1050-6411(92)90017-D","article-title":"Electromechanical delay: an experimental artifact","volume":"2","author":"Corcos","year":"1992","journal-title":"J. Electromyogr. Kinesiol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1016\/j.clinbiomech.2012.12.003","article-title":"In vivo hip joint loads during three methods of walking with forearm crutches","volume":"28","author":"Damm","year":"2013","journal-title":"Clin. Biomech."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1100","DOI":"10.1016\/j.simpat.2006.09.001","article-title":"Analysis of musculoskeletal systems in the AnyBody modeling system","volume":"14","author":"Damsgaard","year":"2006","journal-title":"Simul. Model. Pract. Theory"},{"key":"B10","doi-asserted-by":"publisher","first-page":"e0322247","DOI":"10.1371\/journal.pone.0322247","article-title":"Hip, knee, and ankle joint forces during exoskeletal-assisted walking: comparison of approaches to simulate human-robot interactions","volume":"20","author":"De Carvalho","year":"2025","journal-title":"PLOS ONE"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/2473011420939875","article-title":"Comparison of lower extremity EMG muscle testing with hands-free single crutch vs standard axillary crutches","volume":"5","author":"Dewar","year":"2020","journal-title":"Foot & Ankle Orthop."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/24730114211060054","article-title":"EMG activity with use of a hands-free single crutch vs a knee scooter","volume":"6","author":"Dewar","year":"2021","journal-title":"Foot & Ankle Orthop."},{"key":"B13","doi-asserted-by":"publisher","first-page":"S11","DOI":"10.1016\/j.jbiomech.2007.03.004","article-title":"In vivo knee moments and shear after total knee arthroplasty","volume":"40","author":"D\u2019Lima","year":"2007","journal-title":"J. Biomechanics"},{"key":"B14","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1177\/0954411911433372","article-title":"Knee joint forces: prediction, measurement, and significance","volume":"226","author":"D\u2019Lima","year":"2012","journal-title":"Proc. Institution Mech. Eng. Part H J. Eng. Med."},{"key":"B15","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1016\/j.mporth.2025.08.004","article-title":"The gait cycle and its disorders","volume":"39","author":"Federer","year":"2025","journal-title":"Orthop. Trauma"},{"key":"B16","doi-asserted-by":"publisher","first-page":"010101","DOI":"10.11613\/bm.2026.010101","article-title":"Effect sizes for nonparametric tests","volume":"36","author":"Fiel Peres","year":"2026","journal-title":"Biochem. Medica Zagreb."},{"key":"B17","unstructured":"Freedom leg \u2013 the best, hands-free alternative to crutches\n          \n          \n          2026"},{"key":"B18","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1097\/JSA.0000000000000259","article-title":"Advanced functional bracing in lower extremity trauma: bracing to improve function","volume":"27","author":"Franklin","year":"2019","journal-title":"Sports Med. Arthrosc. Rev."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1777","DOI":"10.1016\/j.injury.2016.06.003","article-title":"Partial weight bearing of the tibia","volume":"47","author":"Ganse","year":"2016","journal-title":"Injury"},{"key":"B20","doi-asserted-by":"publisher","first-page":"e12027","DOI":"10.1002\/jfa2.12027","article-title":"The relationship of peak ankle dorsiflexion angle with lower extremity biomechanics during walking","volume":"17","author":"Gao","year":"2024","journal-title":"J. Foot Ankle Res."},{"key":"B21","doi-asserted-by":"publisher","first-page":"89","DOI":"10.3109\/03093648609164506","article-title":"Biomechanical study on axillary crutches during single-leg swing-through gait","volume":"10","author":"Goh","year":"1986","journal-title":"Prosthetics Orthot. Int."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1176","DOI":"10.1016\/j.jbiomech.2013.01.001","article-title":"Sensitivity of joint moments to changes in walking speed and body-weight-support are interdependent and vary across joints","volume":"46","author":"Goldberg","year":"2013","journal-title":"J. Biomechanics"},{"key":"B23","article-title":"The influence of percentage body weight support and crutch walking technique on the reduction of knee joint contact forces","volume-title":"Proceedings of the World Physiotherapy Congress; June 2-4, 2023; Dubai","author":"Hagen","year":"2023"},{"key":"B24","doi-asserted-by":"publisher","first-page":"e304","DOI":"10.1097\/OI9.0000000000000304","article-title":"Biomechanics of fracture healing: how best to optimize your construct in the OR","volume":"7","author":"Hast","year":"2024","journal-title":"OTA Int."},{"key":"B25","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1177\/10711007231207637","article-title":"Lower extremity assistive devices (LEADs): a contemporary literature review","volume":"45","author":"Hegeman","year":"2024","journal-title":"Foot & Ankle Int."},{"key":"B26","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1016\/S1050-6411(00)00027-4","article-title":"Development of recommendations for SEMG sensors and sensor placement procedures","volume":"10","author":"Hermens","year":"2000","journal-title":"J. Electromyogr. Kinesiol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"e5","DOI":"10.1017\/wtc.2022.26","article-title":"Exoskeletal solutions to enable mobility with a lower leg fracture in austere environments","volume":"4","author":"Johnson","year":"2023","journal-title":"Wearable Technol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"11","DOI":"10.55460\/ETZI-SI9T","article-title":"Tactical combat casualty care (TCCC) guidelines for medical personnel","volume":"22","year":"2022","journal-title":"J. Special Operations Med."},{"key":"B29","doi-asserted-by":"publisher","first-page":"87","DOI":"10.2147\/oajsm.s39512","article-title":"Diagnosis, treatment, and rehabilitation of stress fractures in the lower extremity in runners","volume":"27","author":"Kahanov","year":"2015","journal-title":"Open Access J. Sports Med."},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.2466\/11.IT.3.1","article-title":"The simple difference formula: an approach to teaching nonparametric correlation","volume":"3","author":"Kerby","year":"2014","journal-title":"Compr. Psychol."},{"key":"B31","doi-asserted-by":"publisher","first-page":"56","DOI":"10.3390\/jfmk8020056","article-title":"Biomechanical analysis of the unaffected limb while using a hands-free crutch","volume":"8","author":"Kim","year":"2023","journal-title":"J. Funct. Morphol. Kinesiol."},{"key":"B32","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1016\/j.clinbiomech.2015.06.014","article-title":"The effect of changing plantarflexion resistive moment of an articulated ankle\u2013foot orthosis on ankle and knee joint angles and moments while walking in patients post stroke","volume":"30","author":"Kobayashi","year":"2015","journal-title":"Clin. Biomech."},{"key":"B33","doi-asserted-by":"publisher","first-page":"e70068","DOI":"10.1049\/htl2.70068","article-title":"Finite element analysis of von Mises stress in external fixators for open tibial fractures: a comparative study of ASTM F1541-02 and tibia-based models in Indonesian patients","volume":"13","author":"Kozin","year":"2026","journal-title":"Healthc. Technol. Lett."},{"key":"B34","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1007\/s11999-011-1982-z","article-title":"Incidence of patients with lower extremity injuries presenting to US emergency departments by anatomic region, disease category, and age","volume":"470","author":"Lambers","year":"2012","journal-title":"Clin. Orthop. Relat. Res."},{"key":"B35","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/23335432.2014.993706","article-title":"Scaling of musculoskeletal models from static and dynamic trials","volume":"2","author":"Lund","year":"2015","journal-title":"Int. Biomech."},{"key":"B36","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1186\/s40634-020-00297-9","article-title":"Cortical thickness of the tibial diaphysis reveals age- and sex-related characteristics between non-obese healthy young and elderly subjects depending on the tibial regions","volume":"7","author":"Maeda","year":"2020","journal-title":"J. Exp. Orthop."},{"key":"B37","doi-asserted-by":"publisher","first-page":"1203","DOI":"10.1177\/1071100719862743","article-title":"Patient preference and physical demand for hands-free single crutch vs standard axillary crutches in foot and ankle patients","volume":"40","author":"Martin","year":"2019","journal-title":"Foot & Ankle Int."},{"key":"B38","doi-asserted-by":"publisher","first-page":"490","DOI":"10.3390\/bioengineering11050490","article-title":"Advancing exoskeleton development: validation of a robotic surrogate to measure tibial strain","volume":"11","author":"McGrath","year":"2024","journal-title":"Bioengineering"},{"key":"B39","doi-asserted-by":"publisher","first-page":"1533001","DOI":"10.3389\/fbioe.2025.1533001","article-title":"Effects of an active ankle exoskeleton on the walking biomechanics of healthy men","volume":"13","author":"Nagaraja","year":"2025","journal-title":"Front. Bioeng. Biotechnol."},{"key":"B40","doi-asserted-by":"publisher","first-page":"1387","DOI":"10.1016\/S0021-9290(01)00105-1","article-title":"Contributions of the individual ankle plantar flexors to support, forward progression and swing initiation during walking","volume":"34","author":"Neptune","year":"2001","journal-title":"J. Biomechanics"},{"key":"B41","volume-title":"Biomechanics of the Musculo-skeletal System","author":"Nigg","year":"1999"},{"key":"B42","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1007\/s00415-025-12995-4","article-title":"Gait changes with aging: an early warning sign for underlying pathology","volume":"272","author":"Nonnekes","year":"2025","journal-title":"J. Neurology"},{"key":"B43","doi-asserted-by":"publisher","first-page":"1454","DOI":"10.26603\/001c.29517","article-title":"Comparison of hip and low back loads between normal gait, axillary crutch ambulation and walking with a hands-free crutch in a healthy population","volume":"16","author":"Orishimo","year":"2021","journal-title":"Int. J. Sports Phys. Ther."},{"key":"B44","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1097\/BOT.0b013e31802f78fb","article-title":"Characterization of extremity wounds in operation Iraqi freedom and operation enduring freedom","volume":"21","author":"Owens","year":"2007","journal-title":"J. Orthop. Trauma"},{"key":"B45","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1097\/00005131-199702000-00014","article-title":"Bilateral brachial plexus compressive neuropathy (crutch palsy)","volume":"11","author":"Raikin","year":"1997","journal-title":"J. Orthop. Trauma"},{"key":"B46","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1097\/MRR.0b013e3282f1fecf","article-title":"The use of a hands-free crutch in patients with musculoskeletal injuries: randomized control trial","volume":"30","author":"Rambani","year":"2007","journal-title":"Int. J. Rehabilitation Res."},{"key":"B47","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1016\/S0021-9290(00)00191-3","article-title":"Muscle recruitment by the min\/max criterion \u2014 a comparative numerical study","volume":"34","author":"Rasmussen","year":"2001","journal-title":"J. Biomechanics"},{"key":"B48","doi-asserted-by":"publisher","first-page":"109489","DOI":"10.1016\/j.jbiomech.2019.109489","article-title":"Walking assistance using crutches: a state of the art review","volume":"98","author":"Rasouli","year":"2020","journal-title":"J. Biomechanics"},{"key":"B49","doi-asserted-by":"publisher","first-page":"88","DOI":"10.26659\/pm3.2020.21.2.88","article-title":"Monitoring healing of orthopedic ailments with an original instrumented crutch","volume":"21","author":"Reynders-Frederix","year":"2020","journal-title":"Health, Sports & Rehabilitation Med."},{"key":"B50","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1093\/icb\/icn056","article-title":"Interpreting muscle function from EMG: lessons learned from direct measurements of muscle force","volume":"48","author":"Roberts","year":"2008","journal-title":"Integr. Comp. Biol."},{"key":"B51","unstructured":"XLEG \u2013 the evolution of recovery\n          \n          \n          2026"},{"key":"B52","doi-asserted-by":"publisher","first-page":"1250937","DOI":"10.3389\/fbioe.2023.1250937","article-title":"Differences in running biomechanics between young, healthy men and women carrying external loads","volume":"11","author":"Rubio","year":"2023","journal-title":"Front. Bioeng. Biotechnol."},{"key":"B53","doi-asserted-by":"publisher","first-page":"1654585","DOI":"10.3389\/fbioe.2025.1654585","article-title":"Effect of walking with an active ankle exoskeleton on the biomechanical responses of the lumbar spine","volume":"13","author":"Rubio","year":"2025","journal-title":"Front. Bioeng. Biotechnol."},{"key":"B54","doi-asserted-by":"publisher","first-page":"26163","DOI":"10.1038\/s41598-026-55814-0","article-title":"Effect of exertion on the biomechanics of walking with load carriage and running in young, healthy women","volume":"16","author":"Rubio","year":"2026","journal-title":"Sci. Rep."},{"key":"B55","doi-asserted-by":"publisher","first-page":"031006","DOI":"10.1115\/1.4070710","article-title":"Ergonomically designed crutches decrease ground reaction forces, joint moments, and underarm pressure compared to standard crutches during walking","volume":"148","author":"Saadat","year":"2026","journal-title":"J. Biomechanical Eng."},{"key":"B56","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1186\/s12984-024-01333-w","article-title":"Walking with unilateral ankle-foot unloading: a comparative biomechanical analysis of three assistive devices","volume":"21","author":"Saffuri","year":"2024","journal-title":"J. NeuroEngineering Rehabilitation"},{"key":"B57","doi-asserted-by":"publisher","first-page":"2780","DOI":"10.1016\/j.jbiomech.2010.06.011","article-title":"Individual muscle contributions to the axial knee joint contact force during normal walking","volume":"43","author":"Sasaki","year":"2010","journal-title":"J. Biomechanics"},{"key":"B58","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1093\/biomet\/52.3-4.591","article-title":"An analysis of variance test for normality (complete samples)","volume":"52","author":"Shapiro","year":"1965","journal-title":"Biometrika"},{"key":"B59","doi-asserted-by":"publisher","first-page":"e008430","DOI":"10.1136\/bmjopen-2015-008430","article-title":"Systematic review of the measurement properties of self-report physical activity questionnaires in healthy adult populations","volume":"5","author":"Silsbury","year":"2015","journal-title":"BMJ Open"},{"key":"B60","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1007\/978-3-319-14418-4_32","article-title":"Interpreting joint moments and powers in gait","volume-title":"Handbook of Human Motion","author":"Sloot","year":"2018"},{"key":"B61","doi-asserted-by":"publisher","first-page":"1645","DOI":"10.1002\/ksa.12465","article-title":"Partial weight-bearing and range of motion limitation significantly reduce the loads at medial meniscus posterior root repair sutures in a cadaveric biomechanical model","volume":"33","author":"Sukopp","year":"2025","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"B62","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1002\/ar.24479","article-title":"Cortical and medullary morphology of the tibia","volume":"304","author":"Taylor","year":"2021","journal-title":"Anatomical Rec."},{"key":"B63","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1016\/j.gaitpost.2022.09.075","article-title":"Assessment of the effect of a total contact cast on lower limb kinematics and joint loading","volume":"98","author":"Theodorakos","year":"2022","journal-title":"Gait & Posture"},{"key":"B64","doi-asserted-by":"publisher","first-page":"2445","DOI":"10.1109\/TBME.2023.3248504","article-title":"Effects of stature and load carriage on the running biomechanics of healthy men","volume":"70","author":"Tong","year":"2023","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"B65","doi-asserted-by":"publisher","first-page":"101","DOI":"10.3102\/10769986025002101","article-title":"A critique and improvement of the CL common language effect size statistics of McGraw and Wong","volume":"25","author":"Vargha","year":"2000","journal-title":"J. Educ. Behav. Statistics"},{"key":"B66","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1123\/jab.28.6.665","article-title":"Normalization of ground reaction forces, joint moments, and free moments in human locomotion","volume":"28","author":"Wannop","year":"2012","journal-title":"J. Appl. Biomechanics"},{"key":"B67","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1080\/10400435.2023.2229879","article-title":"Effect of crutch and walking-boot use on whole-body angular momentum during gait","volume":"36","author":"Wiederien","year":"2024","journal-title":"Assist. Technol."},{"key":"B68","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1007\/978-1-4612-4380-9_16","article-title":"Individual comparisons by ranking methods","volume-title":"Breakthroughs in Statistics: Methodology and Distribution","author":"Wilcoxon","year":"1992"},{"key":"B69","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/0167-9457(84)90005-8","article-title":"Kinematic and kinetic patterns in human gait: variability and compensating effects","volume":"3","author":"Winter","year":"1984","journal-title":"Hum. Mov. Sci."},{"key":"B70","first-page":"A4148","article-title":"Finite element analysis of tibial fractures","volume":"57","author":"Wong","year":"2010","journal-title":"Dan. Med. Bull."},{"key":"B71","doi-asserted-by":"publisher","first-page":"282980","DOI":"10.1155\/2014\/282980","article-title":"Incidence and time to return to training for stress fractures during military basic training","volume":"2014","author":"Wood","year":"2014","journal-title":"J. Sports Med."},{"key":"B72","doi-asserted-by":"publisher","first-page":"1377383","DOI":"10.3389\/fbioe.2024.1377383","article-title":"Rethinking running biomechanics: a critical review of ground reaction forces, tibial bone loading, and the role of wearable sensors","volume":"12","author":"Xiang","year":"2024","journal-title":"Front. Bioeng. Biotechnol."},{"key":"B73","doi-asserted-by":"publisher","first-page":"101001","DOI":"10.1115\/1.4034216","article-title":"An integrated musculoskeletal-finite-element model to evaluate effects of load carriage on the tibia during walking","volume":"138","author":"Xu","year":"2016","journal-title":"J. Biomechanical Eng."},{"key":"B74","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1186\/s12891-017-1481-9","article-title":"A cross-sectional study of the effects of load carriage on running characteristics and tibial mechanical stress: implications for stress-fracture injuries in women","volume":"18","author":"Xu","year":"2017","journal-title":"BMC Musculoskelet. Disord."},{"key":"B75","doi-asserted-by":"publisher","first-page":"e15","DOI":"10.1017\/wtc.2022.11","article-title":"Current developments of robotic hip exoskeleton toward sensing, decision, and actuation: a review","volume":"3","author":"Yang","year":"2022","journal-title":"Wearable Technol."},{"key":"B76","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1016\/j.apmr.2004.03.026","article-title":"Partial weight-bearing gait using conventional assistive devices","volume":"86","author":"Youdas","year":"2005","journal-title":"Archives Phys. Med. Rehabilitation"},{"key":"B77","first-page":"359","article-title":"Muscle and tendon: properties, models, scaling, and application to biomechanics and motor control","volume":"17","author":"Zajac","year":"1989","journal-title":"Crit. Rev. Biomed. Eng."},{"key":"B78","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1186\/s12984-021-00893-5","article-title":"Reducing the metabolic energy of walking and running using an unpowered hip exoskeleton","volume":"18","author":"Zhou","year":"2021","journal-title":"J. NeuroEngineering Rehabilitation"}],"container-title":["Frontiers in Bioengineering and Biotechnology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fbioe.2026.1941015\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:05:30Z","timestamp":1790748330000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fbioe.2026.1941015\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,30]]},"references-count":78,"alternative-id":["10.3389\/fbioe.2026.1941015"],"URL":"https:\/\/doi.org\/10.3389\/fbioe.2026.1941015","relation":{},"ISSN":["2296-4185"],"issn-type":[{"value":"2296-4185","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,30]]},"article-number":"1941015"}}