Investigation of the “Pendulum Effect” during Gait

Locomotion under the Novel Body Weight Support

System and Counter Weight System.

Tran Van Thuc1 and Shin-ichiroh Yamamoto1

1
Shibaura Institute of Technology, 3-5-7 Toyosu, Tokyo, Japan
Nb13507@shibaura-it.ac.jp

Abstract. Recent years, the Body Weight Support (BWS) system has been ap-
plied and played an important role in almost gait training system. The conven-
tional BWS systems commonly used the rope-pulley mechanism such that the
“pendulum effect” would appear during gait training and made subject uncom-
fortable. Our hypothesis that the COM parameters in lateral and vertical of sub-
ject during walking under the weight support system would be modified. More-
over, the novel BWS system developed would reduce the “pendulum effect”
during walking and show the better behavior in comparison with the Counter
Weight system. Our findings that the step width, COM amplitude in mediola-
teral and vertical in case of using both the new BWS and Counter Weight sys-
tem significantly were smaller than the normal walking case. The COM ampli-
tudes in case of using the new BWS were significant closer to the normal walk-
ing case and higher than the Counter Weight system.

Keywords: Body Weight Support system, COM amplitude, Step width.

1 Introduction

In recent years, BWS system has played an important role in gait training for patients
who recovering from spinal cord injury or stroke. One could see the BWS system
appeared in most of the therapeutic of gait training system, both treadmill walking
and ground walking. In the early of the therapeutic, the spinal cord injury or stroke
patient with their weakness leg could not carry their whole body weight; the BWS
system was necessary to reduce almost the load on their lower limbs. During the gait
training period, the sensory afferent nerves of lower limbs activated and conducted
inward to the central nervous system; therapist could gradually reduce the unloading
weight force support to the patient. In clinical, the BWS system represented good
effects in comparison with the conventional therapies [1, 3, 4]. Recently, the devel-
opment of the gait training system usually combined the BWS system with the leg
robotic orthosis; this combination would improve the effect of physiotherapy and
reduce the labor cost [5-6].
BWS system commonly consisted of three main parts: the main frame, actuator
and a harness. The actuator was the center core of the development of the BWS sys-
2

tem, because the actuator was the origin of the generated unloading force. Depending
on the type of apparatus, one would consider of three types of BWS system: the static
system, the passive system [7,8] and the active system [2, 9,10]. The development
actuator for the BWS system has focused on maintaining the unloading force as a
constant and easily adjustment the generated force [7-10]. However, some actuators
were difficult to be sure the constant unloading force such as the series of spring [7,
8]; some other systems were cumbersome and complicated such as a pneumatic cyl-
inder with cart [9], mechatronic Lokolift BWS system [10] or partial BWS system
[11]. Moreover, most of current BWS system included a pulley structure which could
make a swing trunk effect during subject walking like a “pendulum effect” [7-11].
In the previous study, the novel BWS system applied four Pneumatic Artificial
Muscles (PAM) for the body weight unloading has been developed for gait training
[12]. The new system had many advantages in comparison with the conventional
system such as simplicity, low cost, flexible adjustment the unloading force. Further-
more, the new BWS system could implement a total new strategy of gait training such
that the generated unloading force could follow the movement of the center of pres-
sure (COP). Currently, Dragunas, A.C. et al quantified the impacts of the BWS sys-
tem to the stability during walking basing on the step width [13]. Aaslund, M.K. et al
considered the effect of the BWS system by assessment the acceleration of the center
of mass (COM) [14]. The “pendulum effect” by the BWS system during walking, as
mentioned above, however has not been fully investigated. In this paper, we investi-
gated the effect of weight systems to gait parameters during subject walking on
treadmill under new BWS system [12] and Counter Weight system. We hypothesized
that the novel BWS system using PAMs could treat the pendulum effect by using the
new unloading force strategy to get the better gait during locomotion.

2 Method

2.1 Experiment Protocol

Nine healthy subjects (all subjects were male with age = 24.2 ± 3.2 (mean ± SD),
height = 172.1 ± 6.1, and weight = 61.5 ± 6.51) with no prehistoric disability took part
in this experiment to validate the system. For each subject, we did experiments with
different unloading forces, mainly 30%, 50%, 70%, using both new BWS system and
Counter Weight system, and normal walking for comparison. The subject walked on
the treadmill at a speed of 1 km/h for 60 seconds. The procedure was iterated for eve-
ry trial as well as for all unloading force levels. The data collected from four force
sensors embedded under the treadmill was used to calculate the COP parameters. The
motion capture system with six cameras also was used to collect data from 12 markers
positioned at the ends of the bones of lower limbs, pelvis, and shoulder of the subject.
The data collected from the motion capture system were used to calculate the COM
moving. COM was considered very carefully for this research project because by
using the new BWS system or Counter Weight System the COM pattern was much
affected. The time series data that collected from the sensors was difficult for analyz-
ing the difference among the data of cases normal walking, BWS system, and Counter
 3

Weight system. Therefore, In order to analyze the difference between the new BWS
system and Counter Weigh system for all nine subjects, the gait parameters such as
COP amplitude in mediolateral (step width), COM amplitude (in both mediolateral
and vertical) were quantified by using two MATLAB programs.

2.2 Data Analysis

Two MATLAB routines have been developed to analyze the gait parameters such as
step width (COP amplitude in mediolateral), COM amplitude in mediolateral and
vertical direction. The first routine was to calculate the COP trajectory in one gait
cycle such that we could calculate the step width. The key point to separate the COP
data to single gait cycles was to determine the event that started a gait cycle (heel
strike was considered). The Fig.1 shows the analyzing of COP moving when right
heel strike during gait. The moment, such that the COP started to switch from the left
to the right side, was defined as the right heel strike (and so called as Heel-strike de-
tection). The step width, which was used as a parameter for quantifying the COP pa-
rameter, was defined as the distance between two edges (left and right) of the COP
trajectory. In the second routines of calculation of COM in one gait cycle, the event to
detect the starting point of a new gait cycle was defined since the marker on the ankle
joint went down. From that event (the coordination of the marker on ankle joint went
to the lowest position), the time series data of COM was partitioned to single gait
cycles. The COM amplitude parameters in mediolateral and vertical were quantified
to represent the effect of the BWS system and Counter Weight system.

Fig. 1. COP in one gait cycle and the definition of step width.
4

The data of COP and COM amplitude parameters were standardized for all nine
subjects. The standardized procedure for the experimental data of each subject was
conducted by using the formula below:
Parameter value( Normal , BWS , andCWS )
Standardized value 
Mean value( Normal )
The standardized data was used to analyze the difference among the BWS system,
Counter Weight system, and the Normal walking case using one-way ANOVA. The
Tukey HSD test was used to investigate the difference between each couple cases.
The procedure of analyzing was conducted based on the R statistical language using R
Studio.

3 Result and Discussion

In order to quantify the COP in the lateral direction, the step width (COP amplitude in
mediolateral) was considered. The data of step width of all nine subjects, which was
standardized to the normal walking case, was used to investigate the effect BWS sys-
tem and the Counter Weight system. The Table 1 represents the data of the standard-
ized step width data in cases of the normal walking, BWS system and the Counter
Weight system in which the unloading forces were equal to 30%, 50%, and 70% sub-
ject weight. The significant differences of step width between the normal walking
case and both the BWS and the Counter Weight system (p < 0.001) were found. The
mean values of the step width in which subject walking under BWS system and
Counter Weight system were smaller than the normal walking case. The significant
difference of the step width between the BWS system and the Counter Weight system
was not found.

Table 1. Comparison of the step width (of all nine subjects) between BWS system, counter
Weight system, and Normal Walking by one way ANOVA. NormalStd, BwsStd, and CwsStd
are data of step width standardized in cases of Normal walking, BWS system and Counter
Weight system respectively. Significance level was set at 0.05. * represent the significant dif-
ference p < 0.001.

Weight Sample
Method Mean SD 95% CI
Support size
NormalStd 139 1.0000* 0.0753 (0.9756, 1.0244)
30% BwsStd 139 0.7971 0.1726 (0.7727, 0.8215)
CwsStd 139 0.8012 0.1698 (0.7768, 0.8256)
NormalStd 132 1.0000* 0.1131 (0.9749, 1.0251)
50% BwsStd 132 0.7806 0.151 (0.7555, 0.8057)
CwsStd 132 0.7567 0.1697 (0.7316, 0.7817)
NormalStd 138 1.0000* 0.0695 (0.9644, 1.0356)
70% BwsStd 138 0.9334 0.2223 (0.8979, 0.9690)
CwsStd 138 0.9109 0.2852 (0.8753, 0.9464)
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The differences of the amplitude of COMy trajectories were considered. The

standardized COMy data that was used for analyzing the difference of the COMy
amplitude for both BWS system and Counter weight system using ANOVA. On the
Fig. 2, the comparison of the mean value of BWS system and Counter weight system
at difference weight support levels were demonstrated. We could see that increasing
weight support level absolutely reduced the amplitude of COMy during walking (p <
0.001). The significant differences were found between the mean value of the normal
walking case and both BWS system and Counter weight system (p < 0.001). These
results strongly confirmed that the COM in mediolateral was modified by using the
unloading systems. However, we could observe that the mean values by using the
BWS system was significantly higher than the case using the Counter Weight system
(p < 0.001 at 30% weight support, and p < 0.05 at 50% weight support). The signifi-
cant difference between the mean values was not found at 70% weight support (p =
0.927). The mean values in case of using BWS system were closer to the normal
walking case was an evidence such that the new system showed the better behavior in
comparison with the Counter Weight system. The higher mean value of COMy in the
case of applying the BWS system than Counter Weight system could be explained by
the way that the unloading force that applied to the subject’s trunk. The Fig. 3 demon-
strates the unloading force that applying on the subject’ trunk for the Counter Weight
system (subfigure A) and the BWS system (subfigure B). In the case of the Counter
Weight system, the lateral part of unloading force tends to prevent the movement of
the COM during walking and to pull the COM in mediolateral to the center axis. This
affection is similar to the “pendulum effect” since in pendulum mechanism there al-
ways exists a lateral force. This “pendulum effect” could make the subject uncomfort-
able during walking and modify subject’s gait parameters. However, in the case of the
BWS system, the lateral part of the unloading force would be small because the un-
loading force in this case always tries to follow the moving of the COP during walk-
ing, and such that reduce the effect of the lateral unloading force.
6

Fig. 2. Demonstrate the comparison of the COMy amplitudes by using the BWS support sys-
tem and Counter weight system at 30%, 50%, and 70% weight support. *** represents the p <
0.001, ** represent p < 0.05.

Fig. 3. Demonstrate the unloading force applying to the subject’s trunk.

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Fig. 4. Demonstrate the comparison of the COMz amplitude by using the BWS support system
and Counter weight system at 30%, 50%, and 70% weight support by using ANOVA. ***
represented the significant value p < 0.001.

The Fig. 4 represents a comparison of the mean values COM in vertical (COMz)
for both BWS system and Counter weight system case. We could see that the mean
values of COMz amplitude of both BWS system and Counter Weight system were
smaller than the normal walking case. Increasing the weight support levels in case of
using BWS system slightly decreased the COMz amplitude. The significant difference
of the mean could be observed only between the 30% and 70% weight support case (p
< 0.001). There was no significant difference in the pair of 30% and 50% weight sup-
port (p = 0.105) and the pair of 50% and 70% weight support (p= 0.169). In the case
of Counter Weight system, the significant difference of the mean could not be found
among cases 30%, 50%, and 70% weight support. However, one would observe that
at the high level of weight support the variance of the amplitude is extremely higher
than the lower weight support level as well as the variance of the BWS system at all
weight support level (around 0.41 compares to 0.18). The higher variance of COMz
amplitude in the case of CWS system at the high level of weight support represented
for the added oscillation of the COM in vertical to the normal COMz. And, this added
oscillation would due to the stronger influence of “the pendulum effect” to the COM
gait parameter. The significant differences of the mean values were found between the
normal walking case and both BWS system and Counter weight system (p < 0.001).
This results confirmed that the COMz amplitude when subject used the unloading
8

system was modified. However, the significant differences were found between the
case of using the BWS system and Counter Weight system at the low and middle
level of unloading force (30% and 50% weight support) (p < 0.001). Once again, this
result confirmed the better behavior of the new BWS system than the Counter Weight
system since the COM amplitude of BWS system was closer to the normal walking.
At the high level of unloading force (70% weight support), the mean value of the
COMz amplitude in the case of using BWS system was slightly higher than the case
using Counter Weight system. However, the significant difference of the COMz am-
plitude at the high level of weight support (70% weight support) was not found (p =
0.164). This result could be explained that, at the strong “pendulum effect” influence
to the locomotion gait, the moving virtual position of the unloading force could not
compensate the strong deformation of the COM movement.

4 Conclusion

In this paper, the “the pendulum effect” of the new BWS system and Counter Weight
system was investigated. The result agreed with the previous study such that the gait
parameters of subject were modified by the weight support system [13] [14]. In clini-
cal, the gait parameters such as step width, COM amplitude in mediolateral and verti-
cal in cases of using BWS system and Counter Weight system were smaller in com-
parison with the normal walking case. The stronger reducing the COM amplitude
could be due to the stronger influence of the “pendulum effect” of the conventional
BWS systems which were applied the rope – pulley mechanism. The better behavior
of the novel BWS system could be observed since the gait parameters were more
similar to the normal walking case.

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