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Background  Weakness of ankle and knee musculature following injury or disorder results in reduced joint motion associated with metabolically expensive gait compensations to enable limb support and advancement. However, neuromechanical coupling between the ankle and knee make it difficult to discern independent roles of these restrictions in joint motion on compensatory mechanics and metabolic penalties.    Methods  We sought to determine relative impacts of ankle and knee impairment on compensatory gait strategies and energetic outcomes using an unimpaired cohort (N = 15) with imposed unilateral joint range of motion restrictions as a surrogate for reduced motion resulting from gait pathology. Participants walked on a dual-belt instrumented treadmill at 0.8 m s −1  using a 3D printed ankle stay and a knee brace to systematically limit ankle motion ( restricted-ank) , knee motion ( restricted-knee ), and ankle and knee motion ( restricted-a  +  k)  simultaneously. In addition, participants walked without any ankle or knee bracing ( control ) and with knee bracing worn but unrestricted ( braced).Results  When ankle motion was restricted ( restricted-ank, restricted-a  +  k ) we observed decreased peak propulsion relative to the  braced  condition on the restricted limb. Reduced knee motion ( restricted-knee, restricted-a  +  k ) increased restricted limb circumduction relative to the  restricted-ank  condition through ipsilateral hip hiking. Interestingly, restricted limb average positive hip power increased in the  restricted-ank  condition but decreased in the  restricted-a  +  k  and  restricted-knee  conditions, suggesting that locking the knee impeded hip compensation. As expected, reduced ankle motion, either without ( restricted-ank ) or in addition to knee restriction ( restricted-a  +  k ) yielded significant increase in net metabolic rate when compared with the  braced  condition. Furthermore, the relative increase in metabolic cost was significantly larger with  restricted-a  +  k  when compared to  restricted-knee  condition.    Conclusions  Our methods allowed for the reproduction of asymmetric gait characteristics including reduced propulsive symmetry and increased circumduction. The metabolic consequences bolster the potential energetic benefit of targeting ankle function during rehabilitation.    Trial registration  N/A.

Isolating the energetic and mechanical consequences of imposed reductions in ankle and knee flexion during gait