About

Steven Gard is an Associate Professor of Physical Medicine & Rehabilitation at Northwestern University, with courtesy appointments in Biomedical Engineering and Mechanical Engineering. His research focuses on investigating human movement, particularly in the context of rehabilitation. He studies the biomechanics of both able-bodied and pathological gait to better understand normal walking patterns and to evaluate and improve gait in individuals using prosthetic or orthotic devices. His work aims to develop more functional lower-extremity prosthetic and orthotic components, contributing to advancements in rehabilitation technology and gait analysis.

Research topics

• Political Science
• Medicine
• Medical education
• Engineering
• Computer Science
• Physical therapy
• Anatomy
• Engineering ethics
• Surgery
• Economic growth
• Orthodontics
• Management science
• Physics
• Physical medicine and rehabilitation
• Public relations
• Nursing
• Structural engineering

Selected publications

• Effects of ankle-foot prosthesis design on gait and standing performance in transfemoral prosthesis users: A scoping review

  Wearable Technologies · 2026-01-01 · 1 citations

  articleOpen access

  Ankle-foot mechanisms are designed to substitute for missing anatomical behavior of lower-limb prosthesis users. Historically, the majority of ankle-foot mechanism research has been focused on transtibial prosthesis users despite evidence that current knowledge is not directly translated to transfemoral prosthesis users, such as the influence of single-axis knee alignment during gait and the differences in standing balance management. This review attempts to characterize the current state of published knowledge about the effects of ankle-foot prosthesis design on standing and walking performance in transfemoral prosthesis users. The databases of PubMed, Embase, Cochrane Library, CINAHL, and IEEE Xplore were searched on January 6, 2025. Data from the selected articles were extracted and reported following the PRISMA extension for scoping reviews. Thirty-five articles were included that reported on seven different types of feet, ranging from simple designs like a solid ankle-cushioned heel (SACH) foot to more complex ones such as a microprocessor foot. The range of reported study tasks extended from standing and level walking to more complex tasks like incline/decline slopes and parcourse walking. The results suggest some parallels between transfemoral and transtibial prosthesis users, such as improvements with the incorporation of roll-over-shape (ROS) features and adaptation of a hydraulic ankle. The literature also emphasized how ankle-foot components affect ground force vector position and direction, influencing prosthetic knee control, highlighting the importance of considering the interaction between the prosthetic ankle-foot and knee mechanisms. Understanding these interactions will support the development of clinical practice guidelines by identifying the pair of prosthetic components that maximizes performance.

  PublisherOA PDFDOI

• Investigating the Effect of Colditz Orthosis in the Treatment of Basilar Joint Arthrosis: A Review Article

  JPO Journal of Prosthetics and Orthotics · 2025-11-14

  article

  ABSTRACT Introduction Basilar joint arthrosis, commonly known as osteoarthritis (OA) of the thumb, is a degenerative and multifactorial condition. It is prevalent among individuals aged 50–60, with a higher incidence observed in postmenopausal women. Radiographic studies have revealed a significant prevalence of basilar joint arthrosis in individuals over 60, impacting a substantial portion of the population and affecting their ability to perform daily activities. The economic burden of basilar joint arthrosis is considerable, highlighting the need for effective treatment. This review aimed to investigate the effect of Colditz orthosis in individuals with basilar joint arthrosis on the outcomes of pain, hand function, grip, and pinch strength. Methods This review included randomized controlled trials (RCTs) and observational studies (cohort, cross-sectional, and case-control) evaluating Colditz orthosis for treating basilar joint arthrosis. A structured keyword strategy that includes terms such as “osteoarthritis,” “basilar joint osteoarthritis,” and “orthoses” was applied in a thorough search of PubMed, Web of Science, Scopus, and CINAHL up to the end of March 2025. Thirteen relevant articles were selected following accurate inclusion and exclusion criteria. Data synthesis aimed to assess the effectiveness of Colditz orthosis in managing basilar joint arthrosis. Results Pain reduction was consistently observed across studies, with initial pain levels averaging 4.75 on the visual analog scale (VAS) before orthosis use, decreasing to 3.41 posttreatment. Various questionnaires, including SOLERMAN, AUSCAN, Disabilities of the Arm, Shoulder and Hand (DASH), and Michigan Hand Questionnaire (MHQ), assessed performance and hand function, showing improved scores following orthosis use. Grip strength increased from an average of 14.84 kg to 16.93 kg, and pinch strength improved from 4.38 kg to 4.61 kg. These outcomes suggest that orthosis interventions reduce pain, enhance functional performance, and improve strength parameters in patients with basilar joint osteoarthritis. Conclusions The Colditz orthosis is a promising conservative treatment for basilar joint arthrosis. It has the potential to improve pain, functionality, and overall patient outcomes. The article emphasizes the need for further research to establish the orthosis’s long-term effectiveness. Clinical Relevance The review article highlights the effectiveness of the Colditz orthosis in treating basilar joint arthrosis, providing clinicians with valuable insights into managing this prevalent musculoskeletal disorder.

  PublisherDOI

• Randomized crossover trial of hand and hydrostatic casting for custom lower limb prosthetic sockets: Assessing socket comfort and fabrication time

  PLoS ONE · 2025-11-21

  articleOpen accessCorresponding

  The aim of this study was to compare diagnostic sockets made by hand casting and standing hydrostatic pressure casting in persons with lower limb amputation. This multi-site, single-masked, randomized crossover trial (ClinicalTrials.gov NCT04141748) involved a prosthetist at each site taking one cast by hand (H) and another using hydrostatic casting (S). The process of casting, rectifying and modifying a diagnostic socket was timed in minutes. Socket comfort score (SCS) was assessed during static fitting of the diagnostic socket before (initial) and after (final) any modifications were made by the prosthetist. Difference scores for comfort and timing were calculated for each pair of casts within prosthetist. Bootstrapping methods were used to determine if the mean difference scores were significantly different from zero. Eighty participants with unilateral lower limb amputation were enrolled, with 75 completing the study. The initial SCS was significantly better in the transfemoral amputation group (TFA, n = 24) for the socket made from hand casting (H: 7.1 ± 1.9, S: 6.5 ± 2.2; p = 0.043). The final SCS was significantly better in the transtibial amputation group (TTA, n = 51) for the socket made from hydrostatic casting (H: 7.5 ± 2.0, S: 8.1 ± 1.3; p = 0.025). Total fabrication time for hydrostatic casting was significantly greater than hand casting (H: 42.1 ± 15.6, S: 48.0 ± 10.7; p = 0.001). It took significantly more time to cast (H: 10.6 ± 5.5, S: 23.7 ± 6.1; p < 0.0001) and significantly less time to rectify with hydrostatic casting (H: 23.4 ± 11.1, S: 16.6 ± 17.2; p < 0.0001). There was no difference between casting approaches for time to modify the diagnostic socket (H: 8.1 ± 7.5, S: 7.7 ± 6.6; p = 0.641). In individuals with both TTA and TFA results suggest that hydrostatic casting took more total time than hand casting to fabricate a diagnostic socket. While hand casting resulted in a significantly more comfortable socket initially for the TFA group, hydrostatic casting led to a more comfortable final socket for the TTA group.

  PublisherDOI

• The effect of spinal orthoses on pain, kyphosis angle, balance, fall risk, and quality of life in older adults with hyperkyphosis: A systematic review

  Assistive Technology · 2025-10-07 · 1 citations

  article

  Hyperkyphosis, defined as excessive forward thoracic curvature, is associated with pain, impaired balance, increased fall risk, and reduced quality of life in older adults. Spinal orthoses have been proposed as a therapeutic option. This systematic review evaluated their effects on pain, kyphosis angle, balance, fall risk, and quality of life. The protocol was registered in PROSPERO (CRD42024607584) and followed PRISMA 2020 guidelines. Comprehensive searches of PubMed, Web of Science, Scopus, CINAHL, and Cochrane Library up to November 2024 identified 16 eligible studies involving 757 participants and 13 orthosis types. Inclusion criteria covered clinical trials, cohort, cross-sectional, and observational studies in adults ≥60 years with hyperkyphosis, while surgical, pharmacological, and non-hyperkyphotic studies were excluded. Data were synthesized qualitatively, with balance outcomes classified as static or dynamic, and orthoses categorized by design and function. Risk of bias was assessed using PEDro and ROBINS-I. Findings suggest spinal orthoses, particularly semi-rigid devices, may reduce kyphosis angle, alleviate pain, enhance balance, and improve quality of life. Nonetheless, heterogeneity, limited blinding, and non-randomized designs reduce certainty. Further high-quality trials are warranted to strengthen evidence. No funding was received.

  PublisherDOI

• The effects of virtual reality environment simulations on balance and gait rehabilitation in persons with lower extremity amputation

  Prosthetics and Orthotics International · 2025-03-05 · 4 citations

  articleSenior author

  BACKGROUND: Walking rehabilitation for individuals with lower limb amputation plays a crucial role in effectively using prostheses. The development of new technologies, such as virtual environments, will enhance our ability to improve walking in this population. OBJECTIVE: To explore the potential of virtual reality in lower limb amputee rehabilitation by using immersive virtual reality environments to address gait and balance issues and evaluate outcomes in individuals with lower limb amputation. STUDY DESIGN: A systematic review. METHODS: The search strategy, validated by all authors, conducted in five electronic databases (Web of Science, PubMed, Science Direct, CINAHL Complet, EBSCOhost) from inception to September 2023. To be eligible, articles were required to have a virtual reality environment as an intervention in persons with lower limb amputation with the intent of improving or evaluating their gait or balance. There was no restriction for study design or type of outcome measure. RESULTS: We screened 1577 documents that appeared in the search, thirty-three studies after the full-text evaluation met our inclusion criteria. Ten studies used non-immersive, eighteen used semi-immersive and three used fully immersive virtual reality simulations. Virtual reality environments have been used to test and train individuals with lower limb amputation. All RCTs had focused on non-immersive virtual environment like video games, and most participants were transtibial K3-K4 level amputees. CONCLUSION: The effectiveness of non-immersive, semi-immersive, and fully immersive virtual reality simulations for improving balance in individuals with amputation needs more research, especially in combination with biofeedback and newer gaming technologies. This approach has the potential to enhance rehabilitation for lower limb amputees, but need specific outcome measures for evaluation. DATA SOURCES: The search strategy, validated by all authors, conducted in 5 electronic databases (Web of Science, PubMed, Science Direct, CINAHL Complet, EBSCOhost) from inception to September 2023. STUDY SELECTION: To be eligible, articles were required to have a VR environment as an intervention in persons with lower limb amputation with the intent of improving or evaluating their gait or balance. There was no restriction for study design or type of outcome measure. RESULT: We screened 1577 documents that appeared in the search, and 33 studies after the full-text evaluation met our inclusion criteria. Ten studies used nonimmersive, 18 used semiimmersive, and 3 used fully immersive VR simulations. Virtual reality environments have been used to test and train individuals with lower limb amputation. All randomized controlled trials had focused on nonimmersive virtual environment like video games, and most participants were transtibial K3-K4 level amputees. CONCLUSIONS: Non-immersive VR simulations like video games can be effective for improving balance-related clinical test results in persons with amputation and may have superior benefits for older adults. Semi-immersive VR simulations can improve balance and gait symmetry. Fully immersive VR simulations in combination with subjects' biofeedback need more research to engage in walking and dynamic balance rehabilitation.

  PublisherDOI

• The Effects of Hyperkyphosis on Gait Parameters in Older Adults: A Systematic Review

  Health Science Reports · 2025-07-01 · 2 citations

  reviewOpen access

  Background and Aims: Hyperkyphosis, which affects 20%-40% of older adults, is characterized by excessive thoracic curvature and is linked to impaired mobility. Age-related gait changes further complicate this issue, but studies on the relationship between hyperkyphosis and gait parameters have yielded inconsistent results. Focused research is essential to clarify this relationship and develop effective interventions. Methods: This systematic review examined the effects of hyperkyphosis on gait in older adults ( ≥ 60 years), adhering to PRISMA 2020 guidelines (PROSPERO registration: CRD42024597304). Observational studies were included, while interventions and studies involving younger populations were excluded. Databases (PubMed, Web of Science, Scopus, CINAHL, Cochrane) were systematically searched. Two independent reviewers screened articles, extracted data, and assessed the risk of bias using validated JBI tools (cohort and cross-sectional checklists). Studies were categorized as high-, moderate-, or low-quality ( ≥ 75%, 50%-74%, and < 50% scores, respectively). Discrepancies were resolved through consensus. Results were synthesized qualitatively, focusing on methodological strengths and limitations. Results: Nineteen studies focusing on older adults with hyperkyphosis were analyzed, highlighting diverse methods for measuring kyphosis and gait parameters. The findings indicated hyperkyphosis adversely affects gait characteristics, including walking speed, step time, and overall mobility. A strong association was found between increased age, reduced muscle mass, and impaired gait performance. Conclusion: This review underscores the detrimental impact of hyperkyphosis on gait parameters in older adults, emphasizing the need for standardized measurement protocols and early clinical identification. Targeted interventions are essential to enhance gait performance in this population.

  PublisherOA PDFDOI

• Spatiotemporal gait parameters influencing functional mobility of people with lower limb amputation

  Prosthetics and Orthotics International · 2025-01-14 · 1 citations

  article

  BACKGROUND: Walking speed is a measure of functional mobility that is relatively easy to quantify. In people with lower limb amputation, reduced walking speed has been linked with specific atypical spatiotemporal gait parameters. However, the influence of atypical spatiotemporal gait parameters on the walking speed of people with unilateral transtibial amputation (TTA) and transfemoral amputation (TFA) remains unclear. OBJECTIVES: To identify spatiotemporal gait parameters influencing walking speed of people with unilateral TTA or TFA. STUDY DESIGN: Cross-sectional. METHODS: The 10-meter walk test (10mWT) was used to measure walking speed, and an instrumented walkway was used to record spatiotemporal gait parameters. Regression analyses were used to determine the best subset of spatiotemporal gait parameters that influence the walking speed of people with TTA and TFA. RESULTS: The study included 43 people with TTA and 49 with TFA. In the TTA group, spatiotemporal gait parameters accounted for 65.5% of the variance in walking speed, with prosthetic single limb support accounting for 52.2%, prosthetic terminal double limb support accounting for 8.9%, and stride width accounting for 4.4%. In the TFA group, intact swing accounted for 46.7% of the variance in walking speed. There was no significant difference in walking speed between the TTA and the TFA groups ( p > 0.05). CONCLUSIONS: The study's results highlight specific spatiotemporal gait parameters that affect the walking speed of people with unilateral TTA and TFA. In addition, results suggest that walking speed over short distances is not confounded by amputation level (i.e., TTA and TFA).

  PublisherDOI

• The effects of Hyperkyphosis on Balance and Fall Risk in older adults: A Systematic Review

  Gait & Posture · 2025-02-12 · 6 citations

  review
  PublisherDOI

• The development and reliability testing of the Functional Lower-Limb Amputee Gait Assessment

  Clinical Rehabilitation · 2023-07-20 · 1 citations

  article

  OBJECTIVE: The study purpose was three-fold: (a) to describe the development of the Functional Lower-Limb Amputee Gait Assessment, (b) to determine its reliability with two groups of raters, physical therapists, and certified prosthetists, and (c) to determine the agreement on its results between the two groups. DESIGN: A reliability study. SETTING: Institution for higher education. PARTICIPANTS: Five physical therapists and five certified prosthetists. INTERVENTION: Not applicable. MAIN MEASURE: The gait of people with unilateral lower limb amputation was evaluated using the Functional Lower-Limb Amputee Gait Assessment. Kappa statistic was used to analyze reliability. RESULTS: The intra-rater reliability of nine gait deviations in the physical therapists' group and eight in the certified prosthetists' group was between moderate and almost perfect agreement (kappa = .41-1). In the physical therapists' group, the inter-rater reliability of four gait deviations was moderate (kappa = .41-.6). In the certified prosthetists' group, the inter-rater reliability of six gait deviations was moderate to substantial (kappa = .41-.8). Three gait deviations achieved moderate agreement in both groups of clinicians (kappa = .41-.6). CONCLUSIONS: Most gait deviations included in the Functional Lower-Limb Amputee Gait Assessment appear stable over time when used by the same clinician. Six gait deviations in the certified prosthetists' group and four in the physical therapists' group may be used by multiple clinicians, and three gait deviations may be used across both professions to assist in communication and collaboration on the best course of treatment for a patient with a unilateral lower limb amputation.

  PublisherDOI

• Editor’s Comments

  JPO Journal of Prosthetics and Orthotics · 2023-12-18

  article1st authorCorresponding
  PublisherDOI

Recent grants

• A Quantitative Analysis of Transfemoral Prosthetic Alignment

  NIH · 2010–2013

• NIH Grant R01HD042592

  NIH · $700k · 2005

• Fall risk and prosthetic influence on gait biomechanics in upper limb amputees

  NIH · 2014–2018

• Effect of prosthesis stiffness on impact force during in vivo step loads and gait

  NIH · 2014–2016

Frequent coauthors

• Stefano Négrini

  Istituto Ortopedico Galeazzi

  166 shared

• Allen W. Heinemann

  Shirley Ryan AbilityLab

  165 shared

• Walter R. Frontera

  University of Puerto Rico System

  163 shared

• Catherine Vallée

  163 shared

• Lorie Richards

  163 shared

• Leonard A. Kaminsky

  Ball State University

  163 shared

• Michael Feuerstein

  158 shared

• Matthew J. Major

  Jesse Brown VA Medical Center

  82 shared

Education

• Postdoctoral Fellow, Physical Medicine & Rehabilitation

  Northwestern University Feinberg School of Medicine

  1996

• PhD, Biomedical Engineering

  Northwestern University

  1995

• MS, Biomedical Engineering

  Northwestern University

  1990

• BS, Bioengineering

  Texas A&M University

  1988

Awards & honors

• United States Patent 8,597,369