{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T08:26:37Z","timestamp":1787214397004,"version":"build-2736575974"},"reference-count":44,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Delaware Bioscience Center for Advanced Technology"},{"DOI":"10.13039\/100000968","name":"American Heart Association\/American Stroke Association","doi-asserted-by":"publisher","award":["20A01135"],"award-info":[{"award-number":["20A01135"]}],"id":[{"id":"10.13039\/100000968","id-type":"DOI","asserted-by":"publisher"}]},{"award":["20A01135"],"award-info":[{"award-number":["20A01135"]}],"id":[{"id":"https:\/\/ror.org\/013kjyp64","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Portable electromyography biofeedback (EMG-BFB) may support gait rehabilitation, but whole-gait responses across increasing portable auditory feedback goals are unclear. Twenty-four adults completed baseline treadmill walking and four counterbalanced right medial gastrocnemius activation-goal conditions set at 20%, 40%, 60%, and 80% above baseline; 23 contributed primary biomechanical data. Treadmill speed was adjusted within each condition to support achievement of the activation goal. Outcomes included walking speed, ground-reaction forces, force-time metrics, step length, temporal measures, and asymmetry. Repeated-measures MANOVA, outcome-specific repeated-measures ANOVAs, dose-response coefficients, bootstrap intervals, and leave-one-participant-out analyses were used. The combined gait-biomechanics outcomes differed significantly across activation-goal conditions (p &lt; 0.001), with large condition effects for walking speed, propulsion, braking magnitude, and step length. From baseline to the highest goal, treadmill speed increased from 1.07 to 1.44 m\/s, mean propulsion by 0.086 N\/BW, braking magnitude by 0.109 N\/BW, and mean step length by 0.150 m. Exploratory speed-adjusted models retained anterior\u2013posterior and vertical loading-response associations but not peak propulsion; activation goal and achieved speed were strongly collinear. Unilateral feedback was not associated with systematic step-length or step-time asymmetry. Portable auditory EMG-BFB at increasing activation goals was accompanied by coordinated changes across gait mechanics.<\/jats:p>","DOI":"10.3390\/s26165266","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T08:10:20Z","timestamp":1787213420000},"page":"5266","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Gait Biomechanics with Portable EMG Biofeedback at Increasing Muscle-Activation Goals: Walking Speed, Propulsion, Braking, and Step Length"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3823-6348","authenticated-orcid":false,"given":"Reza","family":"Koiler","sequence":"first","affiliation":[{"name":"Biomechanics and Movement Science Interdisciplinary Program, University of Delaware, Newark, DE 19716, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9230-9838","authenticated-orcid":false,"given":"Nancy","family":"Getchell","sequence":"additional","affiliation":[{"name":"Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE 19716, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1161\/01.STR.26.6.982","article-title":"Classification of walking handicap in the stroke population","volume":"26","author":"Perry","year":"1995","journal-title":"Stroke"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2096","DOI":"10.1161\/STROKEAHA.106.475921","article-title":"Improvements in speed-based gait classifications are meaningful","volume":"38","author":"Schmid","year":"2007","journal-title":"Stroke"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1093\/gerona\/63.8.841","article-title":"Mobility limitation in self-described well-functioning older adults: Importance of endurance walk testing","volume":"63","author":"Simonsick","year":"2008","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1111\/j.1532-5415.2005.00580.x","article-title":"Epidemiology of gait disorders in community-residing older adults","volume":"54","author":"Verghese","year":"2006","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1007\/s00508-016-1096-4","article-title":"Gait disorders in adults and the elderly: A clinical guide","volume":"129","author":"Pirker","year":"2017","journal-title":"Wien. Klin. Wochenschr."},{"key":"ref_6","unstructured":"Winter, D.A. (1991). The Biomechanics and Motor Control of Human Gait: Normal, Elderly and Pathological, University of Waterloo Press. [2nd ed.]."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1016\/j.gaitpost.2011.01.010","article-title":"Braking and propulsive impulses increase with speed during accelerated and decelerated walking","volume":"33","author":"Peterson","year":"2011","journal-title":"Gait Posture"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1016\/j.humov.2014.11.008","article-title":"The relative contribution of ankle moment and trailing limb angle to propulsive force during gait","volume":"39","author":"Hsiao","year":"2015","journal-title":"Hum. Mov. Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.gaitpost.2018.10.027","article-title":"Paretic propulsion as a measure of walking performance and functional motor recovery post-stroke: A review","volume":"68","author":"Roelker","year":"2019","journal-title":"Gait Posture"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1161\/01.STR.0000204063.75779.8d","article-title":"Anterior-posterior ground reaction forces as a measure of paretic leg contribution in hemiparetic walking","volume":"37","author":"Bowden","year":"2006","journal-title":"Stroke"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2348","DOI":"10.1016\/j.jbiomech.2010.04.027","article-title":"Pre-swing deficits in forward propulsion, swing initiation and power generation by individual muscles during hemiparetic walking","volume":"43","author":"Peterson","year":"2010","journal-title":"J. Biomech."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1177\/1545968315624780","article-title":"Contribution of paretic and nonparetic limb peak propulsive forces to changes in walking speed in individuals poststroke","volume":"30","author":"Hsiao","year":"2016","journal-title":"Neurorehabil. Neural Repair"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/j.gaitpost.2011.01.004","article-title":"Step length asymmetry is representative of compensatory mechanisms used in post-stroke hemiparetic walking","volume":"33","author":"Allen","year":"2011","journal-title":"Gait Posture"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.apmr.2006.10.004","article-title":"Relationship between step length asymmetry and walking performance in subjects with chronic hemiparesis","volume":"88","author":"Balasubramanian","year":"2007","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_15","first-page":"217","article-title":"Electromyographic feedback in the remobilization of stroke patients: A controlled trial","volume":"63","author":"Burnside","year":"1982","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1016\/0003-9993(93)90069-M","article-title":"Feedback of ankle joint angle and soleus electromyography in the rehabilitation of hemiplegic gait","volume":"74","author":"Colborne","year":"1993","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1093\/ptj\/69.10.863","article-title":"Joint angle feedback and biomechanical gait analysis in stroke patients: A case report","volume":"69","author":"Olney","year":"1989","journal-title":"Phys. Ther."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1177\/1545968309355986","article-title":"Task-oriented biofeedback to improve gait in individuals with chronic stroke: Motor learning approach","volume":"24","author":"Jonsdottir","year":"2010","journal-title":"Neurorehabil. Neural Repair"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.jphys.2016.11.006","article-title":"Biofeedback improves activities of the lower limb after stroke: A systematic review","volume":"63","author":"Stanton","year":"2017","journal-title":"J. Physiother."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.clinbiomech.2013.10.018","article-title":"Real-time feedback enhances forward propulsion during walking in old adults","volume":"29","author":"Franz","year":"2014","journal-title":"Clin. Biomech."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/s12984-017-0252-z","article-title":"Effects of unilateral real-time biofeedback on propulsive forces during gait","volume":"14","author":"Schenck","year":"2017","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1080\/10749357.2018.1436384","article-title":"Effects of real-time gait biofeedback on paretic propulsion and gait biomechanics in individuals post-stroke","volume":"25","author":"Genthe","year":"2018","journal-title":"Top. Stroke Rehabil."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Spencer, J., Wolf, S.L., and Kesar, T.M. (2021). Biofeedback for post-stroke gait retraining: A review of current evidence and future research directions in the context of emerging technologies. Front. Neurol., 12.","DOI":"10.3389\/fneur.2021.637199"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Bowman, T., Gervasoni, E., Arienti, C., Lazzarini, S.G., Negrini, S., Crea, S., Cattaneo, D., and Carrozza, M.C. (2021). Wearable devices for biofeedback rehabilitation: A systematic review and meta-analysis to design application rules and estimate the effectiveness on balance and gait outcomes in neurological diseases. Sensors, 21.","DOI":"10.3390\/s21103444"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e40680","DOI":"10.2196\/40680","article-title":"Evidence for the efficacy of commercially available wearable biofeedback gait devices: Consumer-centered review","volume":"10","author":"Mate","year":"2023","journal-title":"JMIR Rehabil. Assist. Technol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1186\/s12984-025-01863-x","article-title":"Can wearable real-time biofeedback gait training devices improve gait speed, balance, functional mobility and activities of daily living in individuals post-stroke? A systematic review and meta-analysis of randomized controlled trials","volume":"23","author":"Wang","year":"2025","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Koiler, R., Bakhshipour, E., Glutting, J., Lalime, A., Kofa, D., and Getchell, N. (2021). Repurposing an EMG biofeedback device for gait rehabilitation: Development, validity and reliability. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18126460"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/S0966-6362(96)01109-5","article-title":"Understanding the roles of vision in the control of human locomotion","volume":"5","author":"Patla","year":"1997","journal-title":"Gait Posture"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Higuchi, T. (2013). Visuomotor control of human adaptive locomotion: Understanding the anticipatory nature. Front. Psychol., 4.","DOI":"10.3389\/fpsyg.2013.00277"},{"key":"ref_30","doi-asserted-by":"crossref","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":"ref_31","unstructured":"mTrigger (2022). mTrigger Biofeedback System User Manual, V2-d7, mTrigger LLC. Available online: https:\/\/www.fab-ent.com\/MEDIA\/41_INSTRUCTIONS\/12-0061_MANUAL.PDF."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.gaitpost.2009.10.014","article-title":"Evaluation of gait symmetry after stroke: A comparison of current methods and recommendations for standardization","volume":"31","author":"Patterson","year":"2010","journal-title":"Gait Posture"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.bspc.2018.01.013","article-title":"Gait symmetry measures: A review of current and prospective methods","volume":"42","author":"Viteckova","year":"2018","journal-title":"Biomed. Signal Process. Control"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1016\/j.gaitpost.2007.08.006","article-title":"The symmetry angle: A novel, robust method of quantifying asymmetry","volume":"27","author":"Zifchock","year":"2008","journal-title":"Gait Posture"},{"key":"ref_35","unstructured":"Perry, J., and Burnfield, J.M. (2010). Gait Analysis: Normal and Pathological Function, SLACK Incorporated. [2nd ed.]."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.gaitpost.2024.01.018","article-title":"One-dimension statistical parametric mapping in lower limb biomechanical analysis: A systematic scoping review","volume":"109","author":"Yona","year":"2024","journal-title":"Gait Posture"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/0268-0033(95)00068-2","article-title":"Relationship between vertical ground reaction force and speed during walking, slow jogging, and running","volume":"11","author":"Keller","year":"1996","journal-title":"Clin. Biomech."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Foroughi, F., Sadeh, S., and Hsiao, H.Y. (2025). Effect of vertical ground reaction force biofeedback on knee and hip neuromechanical characteristics during walking in older adults. Appl. Sci., 15.","DOI":"10.3390\/app15062945"},{"key":"ref_39","unstructured":"Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences, Lawrence Erlbaum Associates. [2nd ed.]."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Lakens, D. (2013). Calculating and reporting effect sizes to facilitate cumulative science: A practical primer for t-tests and ANOVAs. Front. Psychol., 4.","DOI":"10.3389\/fpsyg.2013.00863"},{"key":"ref_41","doi-asserted-by":"crossref","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 Stat. Methodol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1152\/jn.00391.2011","article-title":"How does the motor system correct for errors in time and space during locomotor adaptation?","volume":"108","author":"Malone","year":"2012","journal-title":"J. Neurophysiol."},{"key":"ref_43","first-page":"1919","article-title":"Contextual interference during adaptation to asymmetric split-belt treadmill walking results in transfer of unique gait mechanics","volume":"6","author":"Hahn","year":"2017","journal-title":"Biol. Open"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"212","DOI":"10.3200\/JMBR.36.2.212-224","article-title":"Challenge point: A framework for conceptualizing the effects of various practice conditions in motor learning","volume":"36","author":"Guadagnoli","year":"2004","journal-title":"J. Mot. Behav."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/26\/16\/5266\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T08:22:34Z","timestamp":1787214154000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/26\/16\/5266"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,20]]},"references-count":44,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["s26165266"],"URL":"https:\/\/doi.org\/10.3390\/s26165266","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,20]]}}}