Human movement variability, nonlinear dynamics, and pathology: is there a connection?

Comparison of range-of-motion and variability in upper body movements between transradial prosthesis users and able-bodied controls when executing goal-oriented tasks

Background

Current upper limb prostheses do not replace the active degrees-of-freedom distal to the elbow inherent to intact physiology. Limited evidence suggests that transradial prosthesis users demonstrate shoulder and trunk movements to compensate for these missing volitional degrees-of-freedom. The purpose of this study was to enhance understanding of the effects of prosthesis use on motor performance by comparing the movement quality of upper body kinematics between transradial prosthesis users and able-bodied controls when executing goal-oriented tasks that reflect activities of daily living.

Methods

Upper body kinematics were collected on six able-bodied controls and seven myoelectric transradial prosthesis users during execution of goal-oriented tasks. Range-of-motion, absolute kinematic variability (standard deviation), and kinematic repeatability (adjusted coefficient-of-multiple-determination) were quantified for trunk motion in three planes, shoulder flexion/extension, shoulder ab/adduction, and elbow flexion/extension across five trials per task. Linear mixed models analysis assessed between-group differences and correlation analysis evaluated association between prosthesis experience and kinematic repeatability.

Results

Across tasks, prosthesis users demonstrated increased trunk motion in all three planes and shoulder abduction compared to controls (p ≤ 0.004). Absolute kinematic variability was greater for prosthesis users for all degrees-of-freedom irrespective of task, but was significant only for degrees-of-freedom that demonstrated increased range-of-motion (p ≤ 0.003). For degrees-of-freedom that did not display increased absolute variability for prosthesis users, able-bodied kinematics were characterized by significantly greater repeatability (p ≤ 0.015). Prosthesis experience had a strong positive relationship with average kinematic repeatability (r = 0.790, p = 0.034).

Conclusions

The use of shoulder and trunk movements by prosthesis users as compensatory motions to execute goal-oriented tasks demonstrates the flexibility and adaptability of the motor system. Increased variability in movement suggests that prosthesis users do not converge on a defined motor strategy to the same degree as able-bodied individuals. Kinematic repeatability may increase with prosthesis experience, or encourage continued device use, and future work is warranted to explore these relationships. As compensatory dynamics may be necessary to improve functionality of transradial prostheses, users may benefit from dedicated training that encourages optimization of these dynamics to facilitate execution of daily living activity, and fosters adaptable but reliable motor strategies.

Electronic supplementary material

The online version of this article (doi:10.1186/1743-0003-11-132) contains supplementary material, which is available to authorized users.

Visual availability, balance performance and movement complexity in dancers

Research regarding the complex fluctuations of postural sway in an upright standing posture has yielded controversial results about the relationship between complexity and the capacity of the system to generate adaptive responses. The aim of this study is to compare the performance and complexity of two groups with different levels of expertise in postural control during a balance task. We examined the balance ability and time varying (dynamic) characteristics in a group of 18 contemporary dancers and 30 non-dancers in different visual conditions. The task involved maintaining balance for 30s on a stability platform with opened or closed eyes. The results showed that dancers exhibited greater balance ability only in open eyes task than non-dancers. We also observed a lower performance in both groups during the test with closed eyes, but only dancers reduced their complexity in closed eyes task. The main conclusion is that the greater postural control exhibited by dancers depends on the availability of visual information.

Blood lactate response, oxygen consumption, and muscle activity during treadmill running with constraint

The induction of self-organization during running with a special harness may lead to reduced energy requirements. This experiment was designed to investigate the effect of practicing with a rubber tubing constraint attached between the heel and the hip for 7 wk. (18 treadmill running sessions) on oxygen consumption, caloric unit cost, blood lactate concentration, and muscle activity. 18 male recreational runners (M age = 26.3 yr.) were assigned to either an intervention or a control group. The intervention group trained with the constraint and the control group trained without it. Test 1 was conducted before the intervention, Test 2 after the intervention, and Test 3 7 wk. after Test 2 (no training between Tests 2 and 3). At Test 1, lactate and muscle activity were significantly increased during constrained running. For lactate, a significant decrease was found in the intervention group for running with the constraint; at Test 3, lactate returned to Test 1 level. No notable changes occurred in the physiological parameters. Furthermore, there was no observed transfer effect on normal running.

An accelerometry-based methodology for assessment of real-world bilateral upper extremity activity

BACKGROUND

The use of both upper extremities (UE) is necessary for the completion of many everyday tasks. Few clinical assessments measure the abilities of the UEs to work together; rather, they assess unilateral function and compare it between affected and unaffected UEs. Furthermore, clinical assessments are unable to measure function that occurs in the real-world, outside the clinic. This study examines the validity of an innovative approach to assess real-world bilateral UE activity using accelerometry.

METHODS

Seventy-four neurologically intact adults completed ten tasks (donning/doffing shoes, grooming, stacking boxes, cutting playdough, folding towels, writing, unilateral sorting, bilateral sorting, unilateral typing, and bilateral typing) while wearing accelerometers on both wrists. Two variables, the Bilateral Magnitude and Magnitude Ratio, were derived from accelerometry data to distinguish between high- and low-intensity tasks, and between bilateral and unilateral tasks. Estimated energy expenditure and time spent in simultaneous UE activity for each task were also calculated.

RESULTS

The Bilateral Magnitude distinguished between high- and low-intensity tasks, and the Magnitude Ratio distinguished between unilateral and bilateral UE tasks. The Bilateral Magnitude was strongly correlated with estimated energy expenditure (ρ = 0.74, p<0.02), and the Magnitude Ratio was strongly correlated with time spent in simultaneous UE activity (ρ = 0.93, p<0.01) across tasks.

CONCLUSIONS

These results demonstrate face validity and construct validity of this methodology to quantify bilateral UE activity during the performance of everyday tasks performed in a laboratory setting, and can now be used to assess bilateral UE activity in real-world environments.

Characteristics of stride behavior during treadmill walking and stationary stepping

Much has been learned about the characteristics of gait in overground and treadmill walking. However, there are many contexts in which overground or treadmill walking might not be possible, such as in home-based physical therapy. In those cases, a surrogate task to index gait behavior would be a valuable tool. Thus, the purpose of this study was to evaluate the stride behavior characteristics of stationary stepping compared with treadmill walking. Healthy young adults (N = 10) preformed two 15-minute tasks: (1) treadmill walking and (2) stationary stepping. Several stride behavior characteristics were recorded, including the number of strides taken, minimum and maximum knee angle, stride interval mean, stride interval standard deviation, and detrended fluctuation analysis (DFA) alpha of the stride interval time series. The results showed that stride behavior was similar between tasks when examined at the group level. However, when individual level analyses were used to examine the reliability of each metric between tasks, poor reliability was observed in most metrics, indicating that stationary stepping may not be an appropriate surrogate task for overground or treadmill walking. These results are discussed in the context of a gait dynamics framework, with attention to task constraints that may have influenced the findings.

Online kinematic regulation by visual feedback for grasp versus transport during reach-to-pinch

PURPOSE

This study investigated novel kinematic performance parameters to understand regulation by visual feedback (VF) of the reaching hand on the grasp and transport components during the reach-to-pinch maneuver. Conventional metrics often signify discrete movement features to postulate sensory-based control effects (e.g., time for maximum velocity to signify feedback delay). The presented metrics of this study were devised to characterize relative vision-based control of the sub-movements across the entire maneuver.

METHODS

Movement performance was assessed according to reduced variability and increased efficiency of kinematic trajectories. Variability was calculated as the standard deviation about the observed mean trajectory for a given subject and VF condition across kinematic derivatives for sub-movements of inter-pad grasp (distance between thumb and index finger-pads; relative orientation of finger-pads) and transport (distance traversed by wrist). A Markov analysis then examined the probabilistic effect of VF on which movement component exhibited higher variability over phases of the complete maneuver. Jerk-based metrics of smoothness (minimal jerk) and energy (integrated jerk-squared) were applied to indicate total movement efficiency with VF.

RESULTS/DISCUSSION

The reductions in grasp variability metrics with VF were significantly greater (p<.05) compared to transport for velocity, acceleration, and jerk, suggesting separate control pathways for each component. The Markov analysis indicated that VF preferentially regulates grasp over transport when continuous control is modeled probabilistically during the movement. Efficiency measures demonstrated VF to be more integral for early motor planning of grasp than transport in producing greater increases in smoothness and trajectory adjustments (i.e., jerk-energy) early compared to late in the movement cycle.

CONCLUSIONS

These findings demonstrate the greater regulation by VF on kinematic performance of grasp compared to transport and how particular features of this relativistic control occur continually over the maneuver. Utilizing the advanced performance metrics presented in this study facilitated characterization of VF effects continuously across the entire movement in corroborating the notion of separate control pathways for each component.

Adaptation and prosthesis effects on stride-to-stride fluctuations in amputee gait

Twenty-four individuals with transtibial amputation were recruited to a randomized, crossover design study to examine stride-to-stride fluctuations of lower limb joint flexion/extension time series using the largest Lyapunov exponent (λ). Each individual wore a “more appropriate” and a “less appropriate” prosthesis design based on the subject's previous functional classification for a three week adaptation period. Results showed decreased λ for the sound ankle compared to the prosthetic ankle (F_1,23 = 13.897, p = 0.001) and a decreased λ for the “more appropriate” prosthesis (F_1,23 = 4.849, p = 0.038). There was also a significant effect for the time point in the adaptation period (F_2,46 = 3.164, p = 0.050). Through the adaptation period, a freezing and subsequent freeing of dynamic degrees of freedom was seen as the λ at the ankle decreased at the midpoint of the adaptation period compared to the initial prosthesis fitting (p = 0.032), but then increased at the end compared to the midpoint (p = 0.042). No differences were seen between the initial fitting and the end of the adaptation for λ (p = 0.577). It is concluded that the λ may be a feasible clinical tool for measuring prosthesis functionality and adaptation to a new prosthesis is a process through which the motor control develops mastery of redundant degrees of freedom present in the system.

Compensations during Unsteady Locomotion

Locomotion in a complex environment is often not steady, but the mechanisms used by animals to power and control unsteady locomotion (stability and maneuverability) are not well understood. We use behavioral, morphological, and impulsive perturbations to determine the compensations used during unsteady locomotion. At the level both of the whole-body and of joints, quasi-stiffness models are useful for describing adjustments to the functioning of legs and joints during maneuvers. However, alterations to the mechanics of legs and joints often are distinct for different phases of the step cycle or for specific joints. For example, negotiating steps involves independent changes of leg stiffness during compression and thrust phases of stance. Unsteady locomotion also involves parameters that are not part of the simplest reduced-parameter models of locomotion (e.g., the spring-loaded inverted pendulum) such as moments of the hip joint. Extensive coupling among translational and rotational parameters must be taken into account to stabilize locomotion or maneuver. For example, maneuvers with morphological perturbations (increased rotational inertial turns) involve changes to several aspects of movement, including the initial conditions of rotation and ground-reaction forces. Coupled changes to several parameters may be employed to control maneuvers on a trial-by-trial basis. Compensating for increased rotational inertia of the body during turns is facilitated by the opposing effects of several mechanical and behavioral parameters. However, the specific rules used by animals to control translation and rotation of the body to maintain stability or maneuver have not been fully characterized. We initiated direct-perturbation experiments to investigate the strategies used by humans to maintain stability following center-of-mass (COM) perturbations. When walking, humans showed more resistance to medio-lateral perturbations (lower COM displacement). However, when running, humans could recover from the point of maximum COM displacement faster than when walking. Consequently, the total time necessary for recovery was not significantly different between walking and running. Future experiments will determine the mechanisms used for compensations during unsteady locomotion at the behavioral, joint, and muscle levels. Using reduced-parameter models will allow common experimental and analytical frameworks for the study of both stability and maneuverability and the determination of general control strategies for unsteady locomotion.

Tool use ability depends on understanding of functional dynamics and not specific joint contribution profiles

Researchers in cognitive neuroscience have become increasingly interested in how different aspects of tool use are integrated and represented by the brain. Comparatively less attention has been directed toward tool use actions themselves and how effective tool use behaviors are coordinated. In response, we take this opportunity to consider the mechanical principles of tool use actions and their relationship to motor learning. Using kinematic analysis, we examine both functional dynamics and joint contribution profiles of subjects with different levels of experience in a primordial percussive task. Our results show that the ability to successfully produce stone flakes using the Oldowan method did not correspond with any particular joint contribution profile. Rather, expertise in this tool use action was principally associated with the subject's ability to regulate the functional parameters that define the task itself.

Gradual mechanics-dependent adaptation of medial gastrocnemius activity during human walking

While performing a simple bouncing task, humans modify their preferred movement period and pattern of plantarflexor activity in response to changes in system mechanics. Over time, the preferred movement pattern gradually adapts toward the resonant frequency. The purpose of the present experiments was to determine whether humans undergo a similar process of gradually adapting their stride period and plantarflexor activity after a change in mechanical demand while walking. Participants walked on a treadmill while we measured stride period and plantarflexor activity (medial gastrocnemius and soleus). Plantarflexor activity during stance was divided into a storage phase (30-65% stance) and a return phase (65-100% stance) based on when the Achilles tendon has previously been shown to store and return mechanical energy. Participants walked either on constant inclines (0%, 1%, 5%, 9%) or on a variable incline (0-1%) for which they were unaware of the incline changes. For variable-incline trials, participants walked under both single-task and dual-task conditions in order to vary the cognitive load. Both stride period and plantarflexor activity increased at steeper inclines. During single-task walking, small changes in incline were followed by gradual adaptation of storage-phase medial gastrocnemius activity. However, this adaptation was not present during dual-task walking, indicating some level of cognitive involvement. The observed adaptation may be the result of using afferent feedback in order to optimize the contractile conditions of the plantarflexors during the stance phase. Such adaptation could serve to improve metabolic economy but may be limited in clinical populations with disrupted proprioception.

Postural complexity differs between infant born full term and preterm during the development of early behaviors

BACKGROUND AND AIMS

Postural control differs between infants born preterm and full term at 1-3weeks of age. It is unclear if differences persist or alter the development of early behaviors. The aim of this longitudinal study was to compare changes in postural control variability during development of head control and reaching in infants born preterm and full term.

METHODS

Eighteen infants born preterm (mean gestational age 28.3±3.1weeks) were included in this study and compared to existing data from 22 infants born full term. Postural variability was assessed longitudinally using root mean squared displacement and approximate entropy of the center of pressure displacement from birth to 6months as measures of the magnitude of the variability and complexity of postural control. Behavioral coding was used to quantify development of head control and reaching.

RESULTS

Group differences were identified in postural complexity during the development of head control and reaching. Infants born preterm used more repetitive and less adaptive postural control strategies than infants born full term. Both groups changed their postural complexity utilized during the development of head control and reaching.

DISCUSSION

Early postural complexity was decreased in infants born preterm, compared to infants born full term. Commonly used clinical assessments did not identify these early differences in postural control. Altered postural control in infants born preterm influenced ongoing skill development in the first six months of life.

Amputation effects on the underlying complexity within transtibial amputee ankle motion

The presence of chaos in walking is considered to provide a stable, yet adaptable means for locomotion. This study examined whether lower limb amputation and subsequent prosthetic rehabilitation resulted in a loss of complexity in amputee gait. Twenty-eight individuals with transtibial amputation participated in a 6 week, randomized cross-over design study in which they underwent a 3 week adaptation period to two separate prostheses. One prosthesis was deemed "more appropriate" and the other "less appropriate" based on matching/mismatching activity levels of the person and the prosthesis. Subjects performed a treadmill walking trial at self-selected walking speed at multiple points of the adaptation period, while kinematics of the ankle were recorded. Bilateral sagittal plane ankle motion was analyzed for underlying complexity through the pseudoperiodic surrogation analysis technique. Results revealed the presence of underlying deterministic structure in both prostheses and both the prosthetic and sound leg ankle (discriminant measure largest Lyapunov exponent). Results also revealed that the prosthetic ankle may be more likely to suffer loss of complexity than the sound ankle, and a "more appropriate" prosthesis may be better suited to help restore a healthy complexity of movement within the prosthetic ankle motion compared to a "less appropriate" prosthesis (discriminant measure sample entropy). Results from sample entropy results are less likely to be affected by the intracycle periodic dynamics as compared to the largest Lyapunov exponent. Adaptation does not seem to influence complexity in the system for experienced prosthesis users.

'Human paced' walking: followers adopt stride time dynamics of leaders

Isochronous cueing is widely used in gait rehabilitation even though it alters the stride-time dynamics toward anti-persistent rather than the persistent, fractal fluctuations characteristic of human walking. In the present experiment we tested an alternative cueing method: pacing by a human. To this end, we formed sixteen pairs of walkers based on their preferred stride frequency. Each pair consisted of a designated "leader" and a "follower" who was instructed to synchronize his or her steps to those of the leader. Heel strike times were detected with tiny footswitches, and Detrended Fluctuation Analysis (DFA) was applied to estimate fractal exponents of stride-time series. To ensure that the stride-time dynamics of the follower matched those of the leader, the latter was structurally modified by artificial cueing via either an isochronous metronome or a fractal metronome, in contrast to self-paced walking. Mean relative phases between followers and leaders were close to 0°, confirming that followers effectively synchronized their footfalls with those of the leaders. Mean fractal exponents were not statistically different between followers and leaders in any condition and highly correlated, suggesting that followers matched their stride-time structure to that of leaders. Our results open perspectives for alternative, more natural cueing protocols for gait rehabilitation.

Long term consistency of handwriting grip kinetics in adults

While there is growing interest in clinical applications of handwriting grip kinetics, the consistency of these forces over time is not well-understood at present. In this study, we investigated the short- and long-term intra-participant consistency and inter-participant differences in grip kinetics associated with adult signature writing. Grip data were collected from 20 adult participants using a digitizing tablet and an instrumented pen. The first phase of data collection occurred over 10 separate days within a three week period. To ascertain long-term consistency, a second phase of data collection followed, one day per month over several months. In both phases, data were collected three times a day. After pre-processing and feature extraction, nonparametric statistical tests were used to compare the within-participant grip force variation between the two phases. Participant classification based on grip force features was used to determine the relative magnitude of inter-participant versus intra-participant differences. The misclassification rate for the longitudinal data were used as an indication of long term kinetic consistency. Intra-participant analysis revealed significant changes in grip kinetic features between the two phases for many participants. However, the misclassification rate, on average, remained stable, despite different demarcations of training, and testing data. This finding suggests that while signature writing grip forces may evolve over time, inter-participant kinetic differences consistently exceeds within-participant force changes in the long-term. These results bear implications on the collection, modeling and interpretation of grip kinetics in clinical applications.

A Review of Theoretical Perspectives in Cognitive Science on the Presence of 1/f Scaling in Coordinated Physiological and Cognitive Processes

Time series of human performances present fluctuations around a mean value. These fluctuations are typically considered as insignificant, and attributable to random noise. Over recent decades, it became clear that temporal fluctuations possess interesting properties, however, one of which the property of fractal 1/f scaling. 1/f scaling indicates that a measured process extends over a wide range of timescales, suggesting an assembly over multiple scales simultaneously. This paper reviews neurological, physiological, and cognitive studies that corroborate the claim that 1/f scaling is most clearly present in healthy, well-coordinated activities. Prominent hypotheses about the origins of 1/f scaling are confronted with these reviewed studies. It is concluded that 1/f scaling in living systems appears to reflect their genuine complex nature, rather than constituting a coincidental side-effect. The consequences of fractal dynamics extending from the small spatial and temporal scales (e.g., neurons) to the larger scales of human behavior and cognition, are vast, and impact the way in which relevant research questions may be approached. Rather than focusing on specialized isolable subsystems, using additive linear methodologies, nonlinear dynamics, more elegantly so, imply a complex systems methodology, thereby exploiting, rather than rejecting, mathematical concepts that enable describing large sets of natural phenomena.

Visual conflict and cognitive load modify postural responses to vibrotactile noise

BACKGROUND

Underlying the increased incidence of falls during multitasking is a reduced ability to detect or attend to the sensory information signaling postural instability. Adding noise to a biological system has been shown to enhance the detection and transmission of weakened or sub-threshold cutaneous signals. If stochastic resonance is to become an effective adjunct to rehabilitation, we need to determine whether vibrotactile noise can be effective when added to an environment presenting with other sensory noise.

METHODS

Sub-threshold vibration noise was applied for 30 sec at the soles of the feet in 21 healthy adults (20-29 yrs) between two 30-sec periods of no vibration. During the trials, subjects stood quietly with eyes closed or while viewing a visual scene that rotated in continuous upward pitch at 30 deg/sec. Subjects were also tested with these two visual conditions while performing a mental calculation task. It was hypothesized that sub-threshold vibration would increase regularity of postural sway, thereby improving postural stabilization during an attention demanding task but exerting less effect with multiple sensory demands. An ellipse fit to the covariance matrix revealed excursion of center of pressure (COP) and center of mass (COM) responses in the anterior-posterior and lateral planes. RMS values and approximate entropy of the COP and COM were calculated and statistically compared.

RESULTS

The addition of vibrotactile noise to the plantar surface during quiet stance with eyes closed reduced the area of the COM and COP responses, which then returned to pre-vibration levels after vibration was removed. Postural sway was generally increased with both visual field rotations and mental calculation compared to the eyes closed condition. The effect of sub-threshold vibratory noise on postural behavior was modified when visual field rotations and mental calculation was combined. It was shown that the measure of approximate entropy reflected increased task complexity.

CONCLUSIONS

Our results suggest that the impact of destabilizing signals is modulated when combined with vibrotactile stimulation. The strong aftereffects of the vibration stimulus suggest that the system has adapted to the sensory array even in the short time period tested here. The results imply that application of vibrotactile stimulation has the potential for diminishing sway magnitudes while increasing the potential for response variability, thereby presenting a non-invasive method of reducing the potential for falls.

Decision support for stroke rehabilitation therapy via describable attribute-based decision trees

This paper proposes a computational framework for movement quality assessment using a decision tree model that can potentially assist a physical therapist in a telerehabilitation context. Using a dataset of key kinematic attributes collected from eight stroke survivors, we demonstrate that the framework can be reliably used for movement quality assessment of a reach-to-grasp cone task, an activity commonly used in upper extremity stroke rehabilitation therapy. The proposed framework is capable of providing movement quality scores that are highly correlated to the ratings provided by therapists, who used a custom rating rubric created by rehabilitation experts. Our hypothesis is that a decision tree model could be easily utilized by therapists as a potential assistive tool, especially in evaluating movement quality on a large-scale dataset collected during unsupervised rehabilitation (e.g., training at the home), thereby reducing the time and cost of rehabilitation treatment.

Characterization of information-based learning benefits with submovement dynamics and muscular rhythmicity

For skill advancement, motor variability must be optimized based on target information during practice sessions. This study investigated structural changes in kinematic variability by characterizing submovement dynamics and muscular oscillations after practice with visuomotor tracking under different target conditions. Thirty-six participants were randomly assigned to one of three groups (simple, complex, and random). Each group practiced tracking visual targets with trajectories of varying complexity. The velocity trajectory of tracking was decomposed into 1) a primary contraction spectrally identical to the target rate and 2) an intermittent submovement profile. The learning benefits and submovement dynamics were conditional upon experimental manipulation of the target information. Only the simple and complex groups improved their skills with practice. The size of the submovements was most greatly reduced by practice with the least target information (simple > complex > random). Submovement complexity changed in parallel with learning benefits, with the most remarkable increase in practice under a moderate amount of target information (complex > simple > random). In the simple and complex protocols, skill improvements were associated with a significant decline in alpha (8–12 Hz) muscular oscillation but a potentiation of gamma (35–50 Hz) muscular oscillation. However, the random group showed no significant change in tracking skill or submovement dynamics, except that alpha muscular oscillation was reduced. In conclusion, submovement and gamma muscular oscillation are biological markers of learning benefits. Effective learning with an appropriate amount of target information reduces the size of submovements. In accordance with the challenge point hypothesis, changes in submovement complexity in response to target information had an inverted-U function, pertaining to an abundant trajectory-tuning strategy with target exactness.

Test-retest consistency of a postural sway assessment protocol for adolescent athletes measured with a force plate

PURPOSE/BACKGROUND

Postural control assessments can provide a powerful means of detecting concussion-related neurophysiological abnormalities and are considered an important part of the concussion management processes. Studies with college athletes indicate that postural sway analyzed using complexity metrics may provide a sensitive and novel way to detect post-concussion postural control impairments. The purpose of this study was to determine if a postural sway assessment protocol (PSAP) measured using a force plate system can serve as a reliable assessment tool for adolescent athletes.

METHODS

The short-term and long-term test-retest reliability of the PSAP was examined in a group of adolescent female athletes under eyes open and eyes closed conditions. Detrended fluctuation analysis was used to evaluate the complexity of the times series data (i.e., degree of self-similarity across time scales). Conventional measures of standard deviation and total path length (distance traveled by the center-of-pressure) were also assessed.

RESULTS

The complexity and conventional measures generally demonstrated good reliability coefficients for short-term and long-term test-retest reliability with both eyes open and eyes closed conditions. Intra-class Correlation Coefficient (ICC) values ranged from .38-.90 The highest ICC values corresponded with the short-term reliability for the eyes open condition, while the lower ICC values corresponded with the long-term reliability for the eyes closed condition.

CONCLUSIONS

The results of this study indicate that the PSAP demonstrated good short-term and long-term test-retest reliability. In addition, no evidence of learning effects was elicited through this study. Future studies should further explore the validity and feasibility of the use of this protocol for different age groups, different types of athletes, and longitudinal evaluations of post-concussion impairments.

CLINICAL RELEVANCE

This study provides preliminary support for the utility of a postural sway assessment protocol measured using a force plate for use with adolescent athletes.

LEVEL OF EVIDENCE

Level III.

Gait performance is not influenced by working memory when walking at a self-selected pace

Gait performance exhibits patterns within the stride-to-stride variability that can be indexed using detrended fluctuation analysis (DFA). Previous work employing DFA has shown that gait patterns can be influenced by constraints, such as natural aging or disease, and they are informative regarding a person's functional ability. Many activities of daily living require concurrent performance in the cognitive and gait domains; specifically working memory is commonly engaged while walking, which is considered dual-tasking. It is unknown if taxing working memory while walking influences gait performance as assessed by DFA. This study used a dual-tasking paradigm to determine if performance decrements are observed in gait or working memory when performed concurrently. Healthy young participants (N = 16) performed a working memory task (automated operation span task) and a gait task (walking at a self-selected speed on a treadmill) in single- and dual-task conditions. A second dual-task condition (reading while walking) was included to control for visual attention, but also introduced a task that taxed working memory over the long term. All trials involving gait lasted at least 10 min. Performance in the working memory task was indexed using five dependent variables (absolute score, partial score, speed error, accuracy error, and math error), while gait performance was indexed by quantifying the mean, standard deviation, and DFA α of the stride interval time series. Two multivariate analyses of variance (one for gait and one for working memory) were used to examine performance in the single- and dual-task conditions. No differences were observed in any of the gait or working memory dependent variables as a function of task condition. The results suggest the locomotor system is adaptive enough to complete a working memory task without compromising gait performance when walking at a self-selected pace.

Intra-limb coordination in karate kicking: Effect of impacting or not impacting a target

This study aimed to investigate the kicking limb coordinative patterns adopted by karate practitioners (karateka) when impacting (IRK), or not impacting (NIRK) a target during a roundhouse kick. Six karateka performed three repetitions of both kicks while kicking limb kinematics were recorded using a stereophotogrammetric system. Intra-limb coordination was quantified for hip and knee flexion-extension from toe-off to kick completion, using the Continuous relative phase (CRP). Across the same time interval, thigh and shank angular momentum about the vertical axis of the body was calculated. For all trials, across all participants, CRP curve peaks and maximum and minimum angular momentum were determined. A RM-ANOVA was performed to test for differences between kicking conditions. The CRP analysis highlighted, during the central portion of both kicks, a delayed flexion of the hip with respect to the knee. Conversely, during the terminal portion of the CRP curves, the NIRK is performed with a more in-phase action, caused by a higher hip angular displacement. The NIRK is characterized by a lower angular momentum which may enhance control of the striking limb. It would seem that the issue of no impact appears to be solved through the control of all segments of the kicking limb, in contrast to the primary control of the lower leg only observed during the IRK.

Effect of altered surfaces on postural sway characteristics in elderly subjects

Mobility is essentially based on successful balance control. The evaluation of functional strategies for postural stability is requisite for effective balance rehabilitation and fall prevention in elderly subjects. Our objective was to clarify control mechanisms of different standing positions reflecting challenges of typical everyday life situations. For this purpose, elderly subjects stood on different surfaces resulting in a change of the biomechanical constraints. Sway parameters out of time and frequency domain were calculated from center-of-pressure (COP) excursions. Besides the classic quantification of the amount of sway variability, we investigated the temporal organization of postural sway by means of nonlinear time series analysis. Limb load symmetry was quantified via foot pressure insoles. We found task dependent motor outputs: (1) asymmetrical loading in all conditions; (2) altered amount and structure of COP movements with dissimilar changes in medio-lateral and anterior-posterior direction; (3) changes of the motor output affect several time scales especially when standing on a balance board or with one foot on a step. Our results indicate that elderly subjects preferred forcefully one limb which supports a step-initiation strategy. Modifications of the postural sway structure refer to the interaction of multiple control mechanisms to cope with the altered demands. The identification of postural strategies employed in daily activities augments the ecological validity of postural control studies.

Non-linear dynamics of human locomotion: effects of rhythmic auditory cueing on local dynamic stability

It has been observed that times series of gait parameters [stride length (SL), stride time (ST), and stride speed (SS)], exhibit long-term persistence and fractal-like properties. Synchronizing steps with rhythmic auditory stimuli modifies the persistent fluctuation pattern to anti-persistence. Another non-linear method estimates the degree of resilience of gait control to small perturbations, i.e., the local dynamic stability (LDS). The method makes use of the maximal Lyapunov exponent, which estimates how fast a non-linear system embedded in a reconstructed state space (attractor) diverges after an infinitesimal perturbation. We propose to use an instrumented treadmill to simultaneously measure basic gait parameters (time series of SL, ST, and SS from which the statistical persistence among consecutive strides can be assessed), and the trajectory of the center of pressure (from which the LDS can be estimated). In 20 healthy participants, the response to rhythmic auditory cueing (RAC) of LDS and of statistical persistence [assessed with detrended fluctuation analysis (DFA)] was compared. By analyzing the divergence curves, we observed that long-term LDS (computed as the reverse of the average logarithmic rate of divergence between the 4th and the 10th strides downstream from nearest neighbors in the reconstructed attractor) was strongly enhanced (relative change +73%). That is likely the indication of a more dampened dynamics. The change in short-term LDS (divergence over one step) was smaller (+3%). DFA results (scaling exponents) confirmed an anti-persistent pattern in ST, SL, and SS. Long-term LDS (but not short-term LDS) and scaling exponents exhibited a significant correlation between them (r = 0.7). Both phenomena probably result from the more conscious/voluntary gait control that is required by RAC. We suggest that LDS and statistical persistence should be used to evaluate the efficiency of cueing therapy in patients with neurological gait disorders.

Lower limb kinematic variability in dancers performing drop landings onto floor surfaces with varied mechanical properties

Elite dancers perform highly skilled and consistent movements. These movements require effective regulation of the intrinsic and extrinsic forces acting within and on the body. Customized, compliant floors typically used in dance are assumed to enhance dance performance and reduce injury risk by dampening ground reaction forces during tasks such as landings. As floor compliance can affect the extrinsic forces applied to the body, secondary effects of floor properties may be observed in the movement consistency or kinematic variability exhibited during dance performance. The aim of this study was to investigate the effects of floor mechanical properties on lower extremity kinematic variability in dancers performing landing tasks. A vector coding technique was used to analyze sagittal plane knee and ankle joint kinematic variability, in a cohort of 12 pre-professional dancers, through discrete phases of drop landings from a height of 0.2m. No effect on kinematic variability was observed between floors, indicating that dancers could accommodate the changing extrinsic floor conditions. Future research may consider repeat analysis under more dynamic task constraints with a less experienced cohort. However, knee/ankle joint kinematic variability was observed to increase late in the landing phase which was predominantly comprised of knee flexion coupled with the terminal range of ankle dorsiflexion. These findings may be the result of greater neural input late in the landing phase as opposed to the suggested passive mechanical interaction of the foot and ankle complex at initial contact with a floor. Analysis of joint coordination in discrete movement phases may be of benefit in identifying intrinsic sources of variability in dynamic tasks that involve multiple movement phases.

Quality and structure of variability in children during motor development: a systematic review

Variability has been perceived to be beneficial to movement organization and execution, being essential to selection of movement patterns during motor development, to obtain flexible patterns and adaptability to different task demands. Human movement variability can be measured by linear and nonlinear tools. Recently, nonlinear techniques have been used successfully to give insight into motor skills control in children, and be able to discriminate pathologic and non-pathologic children. For that, this paper is the first to review systematically studies that used nonlinear measures in children. We intend to describe which mathematical tools are utilized to analyze quality and structure of variability, the factors that influence this variability and methodological procedures which are considered for its analysis, and how they are interpreted in child motor development field. A search was performed by one reviewer in relevant databases and the quality appraisal was conducted independently by two reviewers. In all, 27 articles were identified and 20 were selected for the present review. It was detected a large variation in sample characteristics and methodological issues among studies. In fact, the main importance of this review was due to the attempt to define some parameters and standardize some values for typical children and children with disabilities. It is noted that the results from nonlinear techniques depend on the task being analyzed, the age and the type of mathematical technique chosen. The presence of disability is associated to decreases in complexity and nonlinear tools were considered sensible to investigate the effectiveness of practice and intervention in typical children and children with cerebral palsy. Furthermore, future studies should be more careful in standardizing selection, recruitment and explaining missing data. Future reports also should present details of their results and limitations to favor comparisons and helping in formulating new research questions.

Intra-individual movement variability during skill transitions: a useful marker?

Applied research suggests that athletes and coaches need to be challenged in knowing when and how much a movement should be consciously attended to. This is exacerbated when the skill is in transition between two more stable states, such as when an already well-learnt skill is being refined. Using existing theory and research, this paper highlights the potential application of movement variability as a tool to inform a coach's decision-making process when implementing a systematic approach to technical refinement. Of particular interest is the structure of co-variability between mechanical degrees-of-freedom (e.g., joints) within the movement system's entirety when undergoing a skill transition. Exemplar data from golf are presented, demonstrating the link between movement variability and mental effort as an important feature of automaticity, and thus intervention design throughout the different stages of refinement. Movement variability was shown to reduce when mental effort directed towards an individual aspect of the skill was high (target variable). The opposite pattern was apparent for variables unrelated to the technical refinement. Therefore, two related indicators, movement variability and mental effort, are offered as a basis through which the evaluation of automaticity during technical refinements may be made.

Getting Your Sea Legs

Sea travel mandates changes in the control of the body. The process by which we adapt bodily control to life at sea is known as getting one's sea legs. We conducted the first experimental study of bodily control as maritime novices adapted to motion of a ship at sea. We evaluated postural activity (stance width, stance angle, and the kinematics of body sway) before and during a sea voyage. In addition, we evaluated the role of the visible horizon in the control of body sway. Finally, we related data on postural activity to two subjective experiences that are associated with sea travel; seasickness, and mal de debarquement. Our results revealed rapid changes in postural activity among novices at sea. Before the beginning of the voyage, the temporal dynamics of body sway differed among participants as a function of their (subsequent) severity of seasickness. Body sway measured at sea differed among participants as a function of their (subsequent) experience of mal de debarquement. We discuss implications of these results for general theories of the perception and control of bodily orientation, for the etiology of motion sickness, and for general phenomena of perceptual-motor adaptation and learning.

Dynamics of revolution time variability in cycling pattern: voluntary intent can alter the long-range autocorrelations

Long-range dependency has been found in most rhythmic motor signals. The origin of this property is unknown and largely debated. There is a controversy on the influence of voluntary control induced by requiring a pre-determined pace such as asking subjects to step to a metronome. We studied the cycle duration variability of 15 men pedaling on an ergometer at free pace and at an imposed pace (60 rpm). Revolution time was determined based on accelerometer signals (sample frequency 512 Hz). Revolution time variability was assessed by coefficient of variation (CV). The presence of long-range autocorrelations was based on scaling properties of the series variability (Hurst exponent) and the shape of the power spectral density (α exponent). Mean revolution time was significantly lower at freely chosen cadence, while values of CV were similar between both sessions. Long-range autocorrelations were highlighted in all series of cycling patterns. However, Hurst and α exponents were significantly lower at imposed cadence. This study demonstrates the presence of long-range autocorrelations during cycling and that voluntary intent can modulate the interdependency between consecutive cycles. Therefore, cycling may constitute a powerful paradigm to investigate the influence of central control mechanisms on the long-range interdependency characterizing rhythmic motor tasks.

Assessing the stability of human locomotion: a review of current measures

Falling poses a major threat to the steadily growing population of the elderly in modern-day society. A major challenge in the prevention of falls is the identification of individuals who are at risk of falling owing to an unstable gait. At present, several methods are available for estimating gait stability, each with its own advantages and disadvantages. In this paper, we review the currently available measures: the maximum Lyapunov exponent (λS and λL), the maximum Floquet multiplier, variability measures, long-range correlations, extrapolated centre of mass, stabilizing and destabilizing forces, foot placement estimator, gait sensitivity norm and maximum allowable perturbation. We explain what these measures represent and how they are calculated, and we assess their validity, divided up into construct validity, predictive validity in simple models, convergent validity in experimental studies, and predictive validity in observational studies. We conclude that (i) the validity of variability measures and λS is best supported across all levels, (ii) the maximum Floquet multiplier and λL have good construct validity, but negative predictive validity in models, negative convergent validity and (for λL) negative predictive validity in observational studies, (iii) long-range correlations lack construct validity and predictive validity in models and have negative convergent validity, and (iv) measures derived from perturbation experiments have good construct validity, but data are lacking on convergent validity in experimental studies and predictive validity in observational studies. In closing, directions for future research on dynamic gait stability are discussed.

Do orthopaedic shoes improve local dynamic stability of gait? An observational study in patients with chronic foot and ankle injuries

Background

Complex foot and ankle fractures, such as calcaneum fractures or Lisfranc dislocations, are often associated with a poor outcome, especially in terms of gait capacity. Indeed, degenerative changes often lead to chronic pain and chronic functional limitations. Prescription footwear represents an important therapeutic tool during the rehabilitation process. Local Dynamic Stability (LDS) is the ability of locomotor system to maintain continuous walking by accommodating small perturbations that occur naturally during walking. Because it reflects the degree of control over the gait, LDS has been advocated as a relevant indicator for evaluating different conditions and pathologies. The aim of this study was to analyze changes in LDS induced by orthopaedic shoes in patients with persistent foot and ankle injuries. We hypothesised that footwear adaptation might help patients to improve gait control, which could lead to higher LDS:

Methods

Twenty-five middle-aged inpatients (5 females, 20 males) participated in the study. They were treated for chronic post-traumatic disabilities following ankle and/or foot fractures in a Swiss rehabilitation clinic. During their stay, included inpatients received orthopaedic shoes with custom-made orthoses (insoles). They performed two 30s walking trials with standard shoes and two 30s trials with orthopaedic shoes. A triaxial motion sensor recorded 3D accelerations at the lower back level. LDS was assessed by computing divergence exponents in the acceleration signals (maximal Lyapunov exponents). Pain was evaluated with Visual Analogue Scale (VAS). LDS and pain differences between the trials with standard shoes and the trials with orthopaedic shoes were assessed.

Results

Orthopaedic shoes significantly improved LDS in the three axes (medio-lateral: 10% relative change, paired t-test p < 0.001; vertical: 9%, p = 0.03; antero-posterior: 7%, p = 0.04). A significant decrease in pain level (VAS score -29%) was observed.

Conclusions

Footwear adaptation led to pain relief and to improved foot & ankle proprioception. It is likely that that enhancement allows patients to better control foot placement. As a result, higher dynamic stability has been observed. LDS seems therefore a valuable index that could be used in early evaluation of footwear outcome in clinical settings.

Interaction of support surface stability and Achilles tendon vibration during a postural adaptation task

Orchestration of sensory-motor information and adaptation to internal or external, acute or chronic changes is one of the fundamental features of human postural control. The postural control system is challenged on a daily basis, and displays a remarkable ability to adapt to both long and short term challenges. To explore the interaction between support surface stability and Achilles tendon vibration during a period of adaptation we used both a linear measure and a non-linear measure derived from center-of-pressure (COP) data. An equilibrium score (ES), based upon peak amplitude of anterior-posterior sway towards theoretical limits of stability was the linear measure used to assess postural performance. We observed early effects of vibration on postural stability, depending on support characteristics. Participants were able to decrease sway with extended practice over days, independent of support surface stability. Approximate entropy analysis of COP data provided additional information about control adaptation processes.

Gait variability and multiple sclerosis

Gait variability, that is, fluctuations in movement during walking, is an indicator of walking function and has been associated with various adverse outcomes such as falls. In this paper, current research concerning gait variability in persons with multiple sclerosis (MS) is discussed. It is well established that persons with MS have greater gait variability compared to age and gender matched controls without MS. The reasons for the increase in gait variability are not completely understood. Evidence indicates that disability level, assistive device use, attentional requirement, and fatigue are related to gait variability in persons with MS. Future research should address the time-evolving structure (i.e., temporal characteristics) of gait variability, the clinical importance of gait variability, and underlying mechanisms that drive gait variability in individuals with MS.

The biomechanical mechanism of how strength and power training improves walking speed in old adults remains unknown

Maintaining and increasing walking speed in old age is clinically important because this activity of daily living predicts functional and clinical state. We reviewed evidence for the biomechanical mechanisms of how strength and power training increase gait speed in old adults. A systematic search yielded only four studies that reported changes in selected gait biomechanical variables after an intervention. A secondary analysis of 20 studies revealed an association of r(2)=0.21 between the 22% and 12% increase, respectively, in quadriceps strength and gait velocity in 815 individuals age 72. In 6 studies, there was a correlation of r(2)=0.16 between the 19% and 9% gains in plantarflexion strength and gait speed in 240 old volunteers age 75. In 8 studies, there was zero association between the 35% and 13% gains in leg mechanical power and gait speed in 150 old adults age 73. To increase the efficacy of intervention studies designed to improve gait speed and other critical mobility functions in old adults, there is a need for a paradigm shift from conventional (clinical) outcome assessments to more sophisticated biomechanical analyses that examine joint kinematics, kinetics, energetics, muscle-tendon function, and musculoskeletal modeling before and after interventions.

A Perspective on Human Movement Variability With Applications in Infancy Motor Development

Movement variability is considered essential to typical motor development. However, multiple theoretical perspectives and measurement tools have limited interpretation of the importance of movement variability in biological systems. The complementary use of linear and nonlinear measures have recently allowed for the evaluation of not only the magnitude of variability but also the temporal structure of variability. As a result, the theoretical model of optimal movement variability was introduced. The model suggests that the development of healthy and highly adaptable systems relies on the achievement of an optimal state of variability. Alternatively, abnormal development may be characterized by a narrow range of behaviors, some of which may be rigid, inflexible, and highly predictable or, on the contrary, random, unfocused, and unpredictable. In the present review, this theoretical model is described as it relates to motor development in infancy and specifically the development of sitting posture.

Variability in bimanual wheelchair propulsion: consistency of two instrumented wheels during handrim wheelchair propulsion on a motor driven treadmill

Background

Handrim wheelchair propulsion is a complex bimanual motor task. The bimanually applied forces on the rims determine the speed and direction of locomotion. Measurements of forces and torques on the handrim are important to study status and change of propulsion technique (and consequently mechanical strain) due to processes of learning, training or the wheelchair configuration. The purpose of this study was to compare the simultaneous outcomes of two different measurement-wheels attached to the different sides of the wheelchair, to determine measurement consistency within and between these wheels given the expected inter- and intra-limb variability as a consequence of motor control.

Methods

Nine able-bodied subjects received a three-week low-intensity handrim wheelchair practice intervention. They then performed three four-minute trials of wheelchair propulsion in an instrumented hand rim wheelchair on a motor-driven treadmill at a fixed belt speed. The two measurement-wheels on each side of the wheelchair measured forces and torques of one of the two upper limbs, which simultaneously perform the push action over time. The resulting data were compared as direct output using cross-correlation on the torque around the wheel-axle. Calculated push characteristics such as power production and speed were compared using an intra-class correlation.

Results

Measured torque around the wheel axle of the two measurement-wheels had a high average cross-correlation of 0.98 (std=0.01). Unilateral mean power output over a minute was found to have an intra-class correlation of 0.89 between the wheels. Although the difference over the pushes between left and right power output had a high variability, the mean difference between the measurement-wheels was low at 0.03 W (std=1.60). Other push characteristics showed even higher ICC’s (>0.9).

Conclusions

A good agreement between both measurement-wheels was found at the level of the power output. This indicates a high comparability of the measurement-wheels for the different propulsion parameters. Data from both wheels seem suitable to be used together or interchangeably in experiments on motor control and wheelchair propulsion performance. A high variability in forces and timing between the left and right side were found during the execution of this bimanual task, reflecting the human motor control process.

Transtibial amputee joint motion has increased attractor divergence during walking compared to non-amputee gait

The amputation and subsequent prosthetic rehabilitation of a lower leg affects gait. Dynamical systems theory would predict the use of a prosthetic device should alter the functional attractor dynamics to which the system self-organizes. Therefore, the purpose of this study was to compare the largest Lyapunov exponent (a nonlinear tool for assessing attractor dynamics) for amputee gait compared to healthy non-amputee individuals. Fourteen unilateral, transtibial amputees and fourteen healthy, non-amputee individuals ambulated on a treadmill at preferred, self-selected walking speed. Our results showed that the sound hip (p = 0.013), sound knee (p = 0.05), and prosthetic ankle (p = 0.023) have significantly greater largest Lyapunov exponents than healthy non-amputees. Furthermore, the prosthetic ankle has a significantly greater (p = 0.0.17) largest Lyapunov exponent than the sound leg ankle. These findings indicate attractor states for amputee gait with increased divergence. The increased attractor divergence seems to coincide with decreased ability for motor control between the natural rhythms of the individual and those of the prosthetic device. Future work should consider the impact of different prostheses and rehabilitation on the attractor dynamics.

Footfall placement variability and falls in multiple sclerosis

Gait variability (i.e., fluctuations in walking) provides unique information about the control of movement and is associated with falls. This investigation examined the association between gait variability and falls in persons with multiple sclerosis (MS) and healthy controls. Traditional distributional metrics of gait variability (i.e., coefficient of variation (CV)) and a novel metric based on Fourier series analysis of footfall placement variability were determined for 41 individuals with MS and 20 age- and sex-matched controls. Spatiotemporal parameters of gait were collected using a 7.9 m electronic walkway that recorded individual footfalls during steady state comfortable walking. Persons with MS were divided into two groups based on fall history (non-fallers and recurrent fallers). Overall, persons with MS had greater gait variability than controls as indexed by CV and Fourier-based variability (p's < 0.05). Moreover, recurrent fallers with MS had greater Fourier-based variability than non-fallers with MS (p = 0.025), whereas there was no difference in MS groups in traditional gait variability metrics (p > 0.05). These observations highlight that footfall placement variability is related to fall status in MS. Future work determining the sensitivity of footfall placement variability to dysfunction is warranted.

Extreme levels of noise constitute a key neuromuscular deficit in the elderly

Fluctuations during isometric force production tasks occur due to the inability of musculature to generate purely constant submaximal forces and are considered to be an estimation of neuromuscular noise. The human sensori-motor system regulates complex interactions between multiple afferent and efferent systems, which results in variability during functional task performance. Since muscles are the only active component of the motor system, it therefore seems reasonable that neuromuscular noise plays a key role in governing variability during both standing and walking. Seventy elderly women (including 34 fallers) performed multiple repetitions of isometric force production, quiet standing and walking tasks. No relationship between neuromuscular noise and functional task performance was observed in either the faller or the non-faller cohorts. When classified into groups with either nominal (group NOM, 25^th –75^th percentile) or extreme (either too high or too low, group EXT) levels of neuromuscular noise, group NOM demonstrated a clear association (r²>0.23, p<0.05) between neuromuscular noise and variability during task performance. On the other hand, group EXT demonstrated no such relationship, but also tended to walk slower, and had lower stride lengths, as well as lower isometric strength. These results suggest that neuromuscular noise is related to the quality of both static and dynamic functional task performance, but also that extreme levels of neuromuscular noise constitute a key neuromuscular deficit in the elderly.

Children with ADHD show no deficits in plantar foot sensitivity and static balance compared to healthy controls

The goal of this study was to investigate plantar foot sensitivity and balance control of ADHD (n=21) impaired children compared to age-matched healthy controls (n=25). Thresholds were measured at 200 Hz at three anatomical locations of the plantar foot area of both feet (hallux, first metatarsal head (METI) and heel). Body balance was quantified using the length, area and velocity described by the center of pressure (COP) during two-legged as well as one-legged stand (right and left legs). The comparison of vibration thresholds showed no differences between ADHD and healthy children at all anatomical locations of both feet. Whereas COP excursion and area were significantly lower in ADHD subjects compared to the healthy controls during two-legged stand, no differences were found in those variables when balancing on one leg. No differences in COP velocity between ADHD and healthy children were found in any analyzed conditions. The results indicate that the unusual and simple test situation may have increased the perception of vibration stimuli by the ADHD children. Furthermore, ADHD subjects seem to be less variable when performing simple tasks than healthy controls.

Variability in cadence during forced cycling predicts motor improvement in individuals with Parkinson's disease

Variability in severity and progression of Parkinson's disease symptoms makes it challenging to design therapy interventions that provide maximal benefit. Previous studies showed that forced cycling, at greater pedaling rates, results in greater improvements in motor function than voluntary cycling. The precise mechanism for differences in function following exercise is unknown. We examined the complexity of biomechanical and physiological features of forced and voluntary cycling and correlated these features to improvements in motor function as measured by the Unified Parkinson's Disease Rating Scale (UPDRS). Heart rate, cadence, and power were analyzed using entropy signal processing techniques. Pattern variability in heart rate and power were greater in the voluntary group when compared to forced group. In contrast, variability in cadence was higher during forced cycling. UPDRS Motor III scores predicted from the pattern variability data were highly correlated to measured scores in the forced group. This study shows how time series analysis methods of biomechanical and physiological parameters of exercise can be used to predict improvements in motor function. This knowledge will be important in the development of optimal exercise-based rehabilitation programs for Parkinson's disease.

A long-memory model of motor learning in the saccadic system: a regime-switching approach

Maintenance of movement accuracy relies on motor learning, by which prior errors guide future behavior. One aspect of this learning process involves the accurate generation of predictions of movement outcome. These predictions can, for example, drive anticipatory movements during a predictive-saccade task. Predictive saccades are rapid eye movements made to anticipated future targets based on error information from prior movements. This predictive process exhibits long-memory (fractal) behavior, as suggested by inter-trial fluctuations. Here, we model this learning process using a regime-switching approach, which avoids the computational complexities associated with true long-memory processes. The resulting model demonstrates two fundamental characteristics. First, long-memory behavior can be mimicked by a system possessing no true long-term memory, producing model outputs consistent with human-subjects performance. In contrast, the popular two-state model, which is frequently used in motor learning, cannot replicate these findings. Second, our model suggests that apparent long-term memory arises from the trade-off between correcting for the most recent movement error and maintaining consistent long-term behavior. Thus, the model surprisingly predicts that stronger long-memory behavior correlates to faster learning during adaptation (in which systematic errors drive large behavioral changes); greater apparent long-term memory indicates more effective incorporation of error from the cumulative history across trials.

Vascular occlusion affects gait variability patterns of healthy younger and older individuals

Insufficient blood flow is one possible mechanism contributing to altered gait patterns in lower extremity peripheral arterial disease (PAD). Previously, our laboratory found that induced occlusion alters gait variability patterns in healthy young individuals. However the effect of age was not explored. The purpose of this study was to account for age by investigating gait variability following induced vascular occlusion in healthy older individuals and to identify amount of change from baseline to post vascular occlusion between younger and older individuals. Thirty healthy younger individuals and 30 healthy older individuals walked on a treadmill during baseline and post vascular occlusion conditions while lower extremity joint kinematics were captured. Vascular occlusion was induced by thigh cuffs inflated bilaterally on the upper thighs. Amount and temporal structure of gait variability was assessed. Older individuals exhibited significantly increased values of temporal structure of variability post vascular occlusion. Post vascular occlusion values were similar between younger and older individuals after adjusting for baseline measurements. Results show blood flow contributes to altered gait variability. However alterations were less severe than previously documented in symptomatic PAD patients, suggesting that neuromuscular problems in the lower extremities of PAD patients also contribute to gait alterations in these patients.