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Kang P, Jiang S, Shull PB, Lo B. Feasibility Validation on Healthy Adults of a Novel Active Vibrational Sensing Based Ankle Band for Ankle Flexion Angle Estimation. IEEE OPEN JOURNAL OF ENGINEERING IN MEDICINE AND BIOLOGY 2021; 2:314-319. [PMID: 35402967 PMCID: PMC8940205 DOI: 10.1109/ojemb.2021.3130206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/25/2021] [Accepted: 11/17/2021] [Indexed: 11/12/2022] Open
Abstract
Goal: In this paper, we introduced a novel ankle band with a vibrational sensor that can achieve low-cost ankle flexion angle estimation, which can be potentially used for automated ankle flexion angle estimation in home-based foot drop rehabilitation scenarios. Methods: Previous ankle flexion angle estimation methods require either professional knowledge or specific equipment and lab environment, which is not feasible for foot drop patients to achieve accurate measurement by themselves in a home-based scenario. To solve the above problems, a prototype was developed based on the assumption that the echo of a vibration signal on the tibialis anterior had different acoustic impedance distribution. By analyzing the frequency spectrum of the echo, the ankle flexion angle can be estimated. Therefore, a surface transducer was utilized to generate frequency-varying active vibration, and a contact microphone was utilized to capture the echo. A portable analog signal processing hub drove the transducer, and was used for echo signal collection from the microphone. Finally, a Random Forest regression model was applied to estimate the ankle flexion angle based on the spectrum amplitude of the echo. Results: Five healthy subjects were recruited in the experiment. The regression estimation error is 4.16 degrees, and the R2 is 0.81. Conclusions: These results demonstrate the feasibility of the proposed ankle band for accurate ankle flexion angle estimation.
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Affiliation(s)
- Peiqi Kang
- State Key Laboratory of Mechanical System and Vibration, School of Mechanical EngineeringShanghai Jiao Tong University Shanghai 200240 China
| | - Shuo Jiang
- College of Electronics and Information EngineeringTongji University Shanghai 201804 China
| | - Peter B Shull
- State Key Laboratory of Mechanical System and Vibration, School of Mechanical EngineeringShanghai Jiao Tong University Shanghai 200240 China
| | - Benny Lo
- Hamlyn CentreImperial College London London SW7 2BX U.K
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Zarkou A, Lee SCK, Prosser L, Hwang S, Franklin C, Jeka J. Foot and ankle somatosensory deficits in children with cerebral palsy: A pilot study. J Pediatr Rehabil Med 2021; 14:247-255. [PMID: 33896853 DOI: 10.3233/prm-190643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE To investigate foot and ankle somatosensory function in children with cerebral palsy (CP). METHODS Ten children with spastic diplegia (age 15 ± 5 y; GMFCS I-III) and 11 typically developing (TD) peers (age 15 ± 10 y) participated in the study. Light touch pressure and two-point discrimination were assessed on the plantar side of the foot by using a monofilament kit and an aesthesiometer, respectively. The duration of vibration sensation at the first metatarsal head and medial malleolus was tested by a 128 Hz tuning fork. Joint position sense and kinesthesia in the ankle joint were also assessed. RESULTS Children with CP demonstrated significantly higher light touch pressure and two-point discrimination thresholds compared to their TD peers. Individuals with CP perceived the vibration stimulus for a longer period compared to the TD participants. Finally, the CP group demonstrated significant impairments in joint position sense but not in kinesthesia of the ankle joints. CONCLUSIONS These findings suggest that children with CP have foot and ankle tactile and proprioceptive deficits. Assessment of lower extremity somatosensory function should be included in clinical practice as it can guide clinicians in designing more effective treatment protocols to improve functional performance in CP.
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Affiliation(s)
- Anastasia Zarkou
- Spinal Cord Injury Research Laboratory, Crawford Research Institute, Shepherd Center, Atlanta, GA, USA
| | - Samuel C K Lee
- Program in Biomechanics and Movement Science, University of Delaware, Newark, DE, USA.,Department of Physical Therapy, University of Delaware, Newark, DE, USA.,Research Department, Shriners Hospital for Children, Philadelphia, PA, USA
| | - Laura Prosser
- Division of Rehabilitation Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sungjae Hwang
- Department of Kinesiology, University of Maryland Eastern Shore, Princess Anne, MD, USA
| | - Corinna Franklin
- Research Department, Shriners Hospital for Children, Philadelphia, PA, USA
| | - John Jeka
- Department of Kinesiology, University of Delaware, Newark, DE, USA
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Hill MW, Hosseini EA, McLellan A, Price MJ, Lord SR, Kay AD. Delayed Impairment of Postural, Physical, and Muscular Functions Following Downhill Compared to Level Walking in Older People. Front Physiol 2020; 11:544559. [PMID: 33192547 PMCID: PMC7609421 DOI: 10.3389/fphys.2020.544559] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 09/18/2020] [Indexed: 11/15/2022] Open
Abstract
Transient symptoms of muscle damage emanating from unaccustomed eccentric exercise can adversely affect muscle function and potentially increase the risk of falling for several days. Therefore, the aims of the present study were to investigate the shorter- and longer-lasting temporal characteristics of muscle fatigue and damage induced by level (i.e., concentrically biased contractions) or downhill (i.e., eccentrically biased contractions) walking on postural, physical, and muscular functions in older people. Nineteen participants were matched in pairs for sex, age and self-selected walking speed and allocated to a level (n = 10, age = 72.3 ± 2.9 years) or downhill (n = 9, age = 72.1 ± 2.2 years) walking group. Postural sway, muscle torque and power, physical function (5× and 60 s sit-to-stand; STS), and mobility (Timed-Up-and-Go; TUG) were evaluated at baseline (pre-exercise), 1 min, 15 min, 30 min, 24 h, and 48 h after 30 min of level (0% gradient) or downhill (−10% gradient) walking on a treadmill. Following downhill walking, postural sway (+66 to 256%), TUG (+29%), 60 s STS (+29%), five times STS (−25%) and concentric power (−33%) did not change at 1–30 min post exercise, but were significantly different (p < 0.05) at 24 and48 h post-exercise when compared to baseline (p < 0.05). Muscle torque decreased immediately after downhill walking and remained impaired at 48 h post-exercise (−27 to −38%). Immediately following level walking there was an increase in postural sway (+52 to +98%), slower TUG performance (+29%), fewer STS cycles in 60 s (−23%), slower time to reach five STS cycles (+20%) and impaired muscle torque (−23%) and power (−19%) which returned to baseline 30-min after exercise cessation (p > 0.05). These findings have established for the first time distinct impairment profiles between concentric and eccentric exercise. Muscle damage emanating from eccentrically biased exercise can lead to muscle weakness, postural instability and impaired physical function persisting for several days, possibly endangering older adult’s safety during activities of daily living by increasing the risk of falls.
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Affiliation(s)
- Mathew William Hill
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, United Kingdom
| | - Edyah-Ariella Hosseini
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, United Kingdom
| | - Abbie McLellan
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, United Kingdom
| | - Michael James Price
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, United Kingdom
| | - Stephen Ronald Lord
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Sydney, NSW, Australia
| | - Anthony David Kay
- Centre for Physical Activity and Life Sciences, University of Northampton, Northampton, United Kingdom
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Oddsson LIE, Bisson T, Cohen HS, Jacobs L, Khoshnoodi M, Kung D, Lipsitz LA, Manor B, McCracken P, Rumsey Y, Wrisley DM, Koehler-McNicholas SR. The Effects of a Wearable Sensory Prosthesis on Gait and Balance Function After 10 Weeks of Use in Persons With Peripheral Neuropathy and High Fall Risk - The walk2Wellness Trial. Front Aging Neurosci 2020; 12:592751. [PMID: 33240077 PMCID: PMC7680959 DOI: 10.3389/fnagi.2020.592751] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 10/22/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Sensory peripheral neuropathy (PN) is associated with gait, balance problems and high fall risk. The walk2Wellness trial investigates effects of long-term, home-based daily use of a wearable sensory prosthesis on gait function, balance, quality of life and fall rates in PN patients. The device (Walkasins®, RxFunction Inc., MN, United States) partially substitutes lost nerve function related to plantar sensation providing directional tactile cues reflecting plantar pressure measurements during standing and walking. We tested the null hypothesis that the Functional Gait Assessment (FGA) score would remain unchanged after 10 weeks of use. METHODS Participants had PN with lost plantar sensation, gait and balance problems, an FGA score < 23 (high fall risk), and ability to sense tactile stimuli above the ankle. Clinical outcomes included FGA, Gait Speed, Timed Up&Go (TUG) and 4-Stage Balance Test. Patient-reported outcomes included Activities-Specific Balance Confidence (ABC) scale, Vestibular Disorders Activities of Daily Living Scale, PROMIS participation and satisfaction scores, pain rating, and falls. Evaluations were performed at baseline and after 2, 6, and 10 weeks. Subjects were not made aware of changes in outcomes. No additional balance interventions were allowed. RESULTS Forty-five participants of 52 enrolled across four sites completed in-clinic assessments. FGA scores improved from 15.0 to 19.1 (p < 0.0001), normal and fast gait speed from 0.86 m/s to 0.95 m/s (p < 0.0001) and 1.24 m/s to 1.33 m/s (p = 0.002), respectively, and TUG from 13.8 s to 12.5 s (p = 0.012). Four-Stage Balance Test did not improve. Several patient-reported outcomes were normal at baseline and remained largely unchanged. Interestingly, subjects with baseline ABC scores lower than 67% (high fall risk cut-off) increased their ABC scores (49.9% to 59.3%, p = 0.01), whereas subjects with ABC scores above 67% showed a decrease (76.6% to 71.8%, p = 0.019). Subjects who reported falls in the prior 6 months (n = 25) showed a decrease in the number of fall-risk factors (5.1 to 4.3, p = 0.023) and a decrease in fall rate (13.8 to 7.4 falls/1000 days, p = 0.014). Four pre-study non-fallers (n = 20) fell during the 10 weeks. CONCLUSION A wearable sensory prosthesis presents a new way to treat gait and balance problems and manage falls in high fall-risk patients with PN. TRIAL REGISTRATION ClinicalTrials.gov (#NCT03538756).
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Affiliation(s)
- Lars I. E. Oddsson
- RxFunction Inc., Eden Prairie, MN, United States
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, United States
- Recaniti School for Community Health Professions, Ben Gurion University of the Negev, Beersheba, Israel
| | - Teresa Bisson
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, United States
- M Health Fairview, Minneapolis, MN, United States
| | | | - Laura Jacobs
- RxFunction Inc., Eden Prairie, MN, United States
| | - Mohammad Khoshnoodi
- The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Doris Kung
- Baylor College of Medicine, Houston, TX, United States
| | - Lewis A. Lipsitz
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Roslindale, MA, United States
- Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Brad Manor
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Roslindale, MA, United States
- Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | | | | | | | - Sara R. Koehler-McNicholas
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, United States
- Minneapolis VA Health Care System, Minneapolis, MN, United States
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Comparison of Postural Sway, Plantar Cutaneous Sensation According to Saccadic Eye Movement Frequency in Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197067. [PMID: 32992570 PMCID: PMC7579430 DOI: 10.3390/ijerph17197067] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/24/2020] [Accepted: 09/25/2020] [Indexed: 11/17/2022]
Abstract
The crossover trial study aimed to identify the saccadic eye movement (SEM) frequency to improve postural sway (PS) and plantar cutaneous sensation (PUS) in young adults. The 17 participants randomly performed 0.5-, 2-, and 3-Hz SEM. The SEM frequency was determined to allow the target to appear once per 2 s (0.5 Hz), twice per second (2 Hz), or thrice per second (3 Hz). SEM performance time was 3 min with a washout period of 5 min. PS and PUS were measured at baseline and during 0.5-Hz, 2-Hz, and 3-Hz SEMs using a Zebris FDM 1.5 force plate. PS was determined by measuring the sway area, path length, and speed of center of pressure (COP) displacement, and PUS was determined via the plantar surface area (PSA). In PS parameters, there was a significant difference among the SEM frequencies in the COPsway area PSAleft foot and PSAright foot. Compared to that at baseline, COPsway area decreased at 0.5 Hz and 2 Hz, while PSAleft foot and PSAright foot increased at 2 Hz. These results suggest that 2 Hz SEM may improve PS and PSA.
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56
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Bueno JWF, Coelho DB, Souza CRD, Teixeira LA. Associations Between Women's Obesity Status and Diminished Cutaneous Sensibility Across Foot Sole Regions. Percept Mot Skills 2020; 128:243-257. [PMID: 32962537 DOI: 10.1177/0031512520958511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
People who are obese sustain very high foot pressures when standing, with potential consequences to their feet soles' cutaneous sensibility. In the current investigation, we performed a detailed assessment of foot sole sensibility in women with morbid obesity (n = 13; age = 38.85, SD = 8.09 years) status in comparison with leaner women (n = 13; age = 37.62, SD = 7.10 years). We estimated tactile feet sole sensibility through graduated monofilament light touch applied at several hotspots of both feet soles, covering the toes, metatarsal heads, midfoot internal and lateral arches, and heel. Intergroup comparisons per foot sole region indicated significantly lower sensibility for the group with morbid obesity under the fifth and third metatarsal heads, midfoot lateral and internal arches and heel. We found a large variation across the sole regions, with the lowest difference between the obese and lean groups observed under the hallux (18%) and the largest difference observed under the lateral arch of the midfoot (76%). Correlation analyses between body weight and sensibility scores revealed a significant positive correlation among participants who were leaner (rs = 0.56, p = 0.05) but not among participants who were obese (rs = -0.06, p = 0.83). Mainly, our results showed that morbid obesity was associated with significantly higher cutaneous sensibility thresholds, with large variability of the sensibility deficit across different regions of both feet soles. Due to its functional relevance for body balance control, reduced sensibility thresholds among women who are morbidly obese may have implications for stance stability.
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Affiliation(s)
- Jair Wesley Ferreira Bueno
- Human Motor Systems Laboratory, School of Physical Education and Sport, University of São Paulo, SP, Brazil
| | - Daniel Boari Coelho
- Human Motor Systems Laboratory, School of Physical Education and Sport, University of São Paulo, SP, Brazil.,Biomedical Engineering, Federal University of ABC, São Bernardo do Campo, SP, Brazil
| | - Caroline Ribeiro de Souza
- Human Motor Systems Laboratory, School of Physical Education and Sport, University of São Paulo, SP, Brazil
| | - Luis Augusto Teixeira
- Human Motor Systems Laboratory, School of Physical Education and Sport, University of São Paulo, SP, Brazil
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Peters RM, Mildren RL, Hill AJ, Carpenter MG, Blouin J, Timothy Inglis J. Lower-limb muscle responses evoked with noisy vibrotactile foot sole stimulation. Physiol Rep 2020; 8:e14530. [PMID: 32776496 PMCID: PMC7415907 DOI: 10.14814/phy2.14530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 07/10/2020] [Indexed: 12/14/2022] Open
Abstract
AIM Cutaneous feedback from the foot sole contributes to the control of standing balance in two ways: it provides perceptual awareness of tactile perturbations at the interface with the ground (e.g., shifts in the pressure distribution, slips, etc.) and it reflexively activates lower-motor neurons to trigger stabilizing postural responses. Here we focus on the latter, cutaneous (or cutaneomotor) reflex coupling in the lower limb. These reflexes have been studied most-frequently with electrical pulse trains that bypass natural cutaneous mechanotransduction, stimulating cutaneous afferents in a largely non-physiological manner. Harnessing the mechanical filtering properties of cutaneous afferents, we take a novel mechanical approach by applying supra-threshold continuous noisy vibrotactile stimulation (NVS) to the medial forefoot. METHODS Using NVS, we characterized the time and frequency domain properties of cutaneomotor reflexes in the Tibialis Anterior. We additionally measured stimulus-triggered average muscle responses to repeated discrete sinusoidal pulses for comparison. To investigate cutaneomotor reflex gain scaling, stimuli were delivered at 3- or 10-times perceptual threshold (PT), while participants held 12.5% or 25% of maximum voluntary contraction (MVC). RESULTS Peak responses in the time domain were observed at lags reflecting transmission delay through a polysynaptic reflex pathway (~90-100 ms). Increasing the stimulus amplitude enhanced cutaneomotor coupling, likely by increasing afferent firing rates. Although greater background muscle contraction increased the overall amplitude of the evoked responses, it did not increase the proportion of the muscle response attributable to cutaneous input. CONCLUSION Taken together, our findings support the use of NVS as a novel tool for probing the physiological properties of cutaneomotor reflex pathways.
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Affiliation(s)
- Ryan M. Peters
- Faculty of KinesiologyUniversity of CalgaryCalgaryABCanada
- School of KinesiologyUniversity of British ColumbiaVancouverBCCanada
| | - Robyn L. Mildren
- School of KinesiologyUniversity of British ColumbiaVancouverBCCanada
| | - Aimee J. Hill
- School of KinesiologyUniversity of British ColumbiaVancouverBCCanada
| | - Mark G. Carpenter
- School of KinesiologyUniversity of British ColumbiaVancouverBCCanada
- Djavad Mowafaghian Centre for Brain HealthUniversity of British ColumbiaVancouverBCCanada
- International Collaboration on Repair DiscoveriesUniversity of British ColumbiaVancouverBCCanada
| | - Jean‐Sébastien Blouin
- School of KinesiologyUniversity of British ColumbiaVancouverBCCanada
- International Collaboration on Repair DiscoveriesUniversity of British ColumbiaVancouverBCCanada
- Institute for Computing, Information, and Cognitive SystemsUniversity of British ColumbiaVancouverBCCanada
| | - J. Timothy Inglis
- School of KinesiologyUniversity of British ColumbiaVancouverBCCanada
- Djavad Mowafaghian Centre for Brain HealthUniversity of British ColumbiaVancouverBCCanada
- International Collaboration on Repair DiscoveriesUniversity of British ColumbiaVancouverBCCanada
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Oku K, Kawahara I, Sugioka T, Tanaka Y, Hoshiba T, Hirose N, Kumai T. Immediate effects of plantar vibration stimuli during static upright posture following total hip arthroplasty in females. Somatosens Mot Res 2020; 37:238-244. [PMID: 32597287 DOI: 10.1080/08990220.2020.1784129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE Proprioceptive function of the lower limbs deteriorates in patients following total hip arthroplasty. Patients show poor balance and rely more on visual information than proprioceptive information. Plantar vibration stimuli can mechanically enhance somatosensory input from the plantar cutaneous mechanoreceptors, thereby improving static balance. Plantar vibration stimuli may improve static balance in patients after total hip arthroplasty. This is the first study to investigate whether plantar vibration stimuli affects static balance during the early phase following total hip arthroplasty. MATERIALS AND METHODS In this cross-over design study, 16 female patients (aged 65.1 ± 11.0 years) received plantar vibration stimuli for 2 minutes or the sham interventions after total hip arthroplasty in a randomized order on different days. The foot centre of pressure was measured for the total path length, mediolateral path length, and anteroposterior path length directions before and immediately after the interventions in the static standing position both with eyes open and closed. Patients were instructed to minimize body sway when standing. RESULTS A significant increase was observed in the centre of pressure parameters in the eyes closed condition than in the eyes open condition. The centre of pressure parameters for the eyes closed condition was significantly decreased after vibration interventions than that before intervention. CONCLUSIONS This study supports the view that plantar vibration stimuli can change static balance in patients in the early phase after total hip arthroplasty temporarily by up-weighting sensory information. These stimuli may serve as a treatment option for influencing balance following total hip arthroplasty.
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Affiliation(s)
- Kosuke Oku
- Nara Medical University Graduate School, Kashihara, Nara, Japan.,Faculty of Rehabilitation, Kawasaki University of Medical Welfare, Kurashiki, Okayama, Japan
| | - Isao Kawahara
- Division of Rehabilitation, Hanna Central Hospital, Ikoma, Nara, Japan.,Department of Molecular Pathology, Nara Medical University, Kashihara, Nara, Japan
| | - Tatsuya Sugioka
- Division of Rehabilitation, Hanna Central Hospital, Ikoma, Nara, Japan
| | - Yasuhito Tanaka
- Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Nara, Japan
| | - Takuma Hoshiba
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | - Norikazu Hirose
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan.,Department of Sports Medicine, Nara Medical University, Kashihara, Nara, Japan
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Erdoğanoğlu Y, Sayaca Ç, Çalık M, Noyan CO, Çetin A, Yertutanol DK, Taşcılar LN, Kaya D. Evaluation of Plantar Foot Sensation, Balance, Physical Performance, and Fear of Movement in Substance Use Disorders. J Am Podiatr Med Assoc 2020; 110:436239. [PMID: 31566442 DOI: 10.7547/18-194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Neuropathologic changes may occur in the nervous system due to long-term substance use, leading to functional disability with altering of balance. We know little about substance-related mechanisms that can cause movement disorders. This study investigated the effects of plantar foot sensation and balance on physical performance as an effect of substance use in detoxified patients. METHODS Twenty-three users of cannabis, volatile agents, or narcotic/stimulant agents alone or in combination for at least 1 year (mean age, 27.6 years) and 20 healthy volunteers (mean age, 24.6 years) were included. Participant evaluations were implemented immediately after the detoxification process with psychiatrist approval. Depression, state-trait anxiety, and fear of movement levels were evaluated with the Beck Depression Inventory, State-Trait Anxiety Inventory, and Tampa Scale for Kinesiophobia, respectively. Plantar foot sensations were evaluated with light touch, two-point discrimination, and vibration examinations. Balance was assessed with balance software and a balance board and force platform. Balance path, balance path distance, and center of pressure were recorded. Physical performance was evaluated with the Timed Up and Go (TUG) test in the final step. RESULTS There was a significant difference in two-point discrimination of patients versus controls (P < .05). Significant differences were also found in balance values, particularly in the sagittal direction (P < .05). TUG test results of patients compared with controls showed a negative influence on physical function (P < .05). CONCLUSIONS Detailed examination should be performed to understand movement disorders in substance users. Herein, substance users had impaired two-point discrimination and sagittal balance reciprocally. Thus, customized physiotherapy approaches to substance users should be considered to improve their movement disorders.
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60
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Charkhkar H, Christie BP, Triolo RJ. Sensory neuroprosthesis improves postural stability during Sensory Organization Test in lower-limb amputees. Sci Rep 2020; 10:6984. [PMID: 32332861 PMCID: PMC7181811 DOI: 10.1038/s41598-020-63936-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 04/08/2020] [Indexed: 12/26/2022] Open
Abstract
To maintain postural stability, unilateral lower-limb amputees (LLAs) heavily rely on visual and vestibular inputs, and somatosensory cues from their intact leg to compensate for missing somatosensory information from the amputated limb. When any of these resources are compromised, LLAs exhibit poor balance control compared to able-bodied individuals. We hypothesized that restoring somatosensation related to the missing limb via direct activation of the sensory nerves in the residuum would improve the standing stability of LLAs. We developed a closed-loop sensory neuroprosthesis utilizing non-penetrating multi-contact cuff electrodes implanted around the residual nerves to elicit perceptions of the location and intensity of plantar pressures under the prosthetic feet of two transtibial amputees. Effects of the sensory neuroprosthesis on balance were quantified with the Sensory Organization Test and other posturographic measures of sway. In both participants, the sensory neuroprosthesis improved equilibrium and sway when somatosensation from the intact leg and visual inputs were perturbed simultaneously. One participant also showed improvement with the sensory neuroprosthesis whenever somatosensation in the intact leg was compromised via perturbations of the platform. These observations suggest the sensory feedback elicited by neural stimulation can significantly improve the standing stability of LLAs, particularly when other sensory inputs are depleted or otherwise compromised.
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Affiliation(s)
- Hamid Charkhkar
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, 44106, USA. .,Louis Stokes Cleveland Veterans Affairs Medical Center, 10701 East Boulevard, Cleveland, OH, 44106, USA.
| | - Breanne P Christie
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, 44106, USA.,Louis Stokes Cleveland Veterans Affairs Medical Center, 10701 East Boulevard, Cleveland, OH, 44106, USA
| | - Ronald J Triolo
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, 44106, USA.,Louis Stokes Cleveland Veterans Affairs Medical Center, 10701 East Boulevard, Cleveland, OH, 44106, USA
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61
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Bagherzadeh Cham M, Mohseni-Bandpei MA, Bahramizadeh M, Forogh B, Kalbasi S, Biglarian A. Effects of vibro-medical insoles with and without vibrations on balance control in diabetic patients with mild-to-moderate peripheral neuropathy. J Biomech 2020; 103:109656. [PMID: 32005550 DOI: 10.1016/j.jbiomech.2020.109656] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 01/18/2020] [Accepted: 01/22/2020] [Indexed: 10/25/2022]
Abstract
The purpose of this study was to investigate the effects of a total-contact insole with and without subthreshold mechanical random noise on the balance control in diabetic patients with mild-to-moderate peripheral neuropathy. Twenty diabetic patients with mild-to-moderate neuropathy was recruited to this study. A total-contact insole was prototyped and vibratory motors were embedded into it. The parameters of the center of pressure (amplitude, velocity, and phase plane portrait) were analyzed after 30-minute walks with the shoe only, the shoe with vibro-medical insole with and without vibrations in eyes open and closed condition. The center of pressure amplitude, velocity, and phase plane portrait in the anterior-posterior and medio-lateral directions were significantly decreased using a vibro-medical insole without vibration in the eyes open condition (p < 0.05), as compared to the shoe, and with vibro- medical insole with vibration in both eyes open and closed conditions (p < 0.05) compared to the shoe. A significant drop was observed in the center of pressure amplitude, velocity and phase plane portrait parameters when the vibro-medical insole with vibration was used compared to vibro- medical insole without vibration in eyes closed condition (p < 0.05). The use of vibro-medical insoles was found to improve the patient's balance control, as compared to the shoe. In the eyes closed condition, an improvement in the balance control was observed only with vibro-medical insole with vibration rather than vibro-medical insole without vibration or the shoe. Current finding suggest that a combination of the total-contact insole with vibration may improve the balance control remarkably in diabetic patients with mild-to-moderate neuropathy.
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Affiliation(s)
- Masumeh Bagherzadeh Cham
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, Iran University of Medical Sciences, Tehran, Iran; Department of Orthotics & Prosthetics, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mohseni-Bandpei
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; Institute of Physical Therapy, Faculty of Allied Health Sciences, University of Lahore, Lahore, Pakistan.
| | - Mahmood Bahramizadeh
- Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Bijan Forogh
- Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Kalbasi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Akbar Biglarian
- Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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The effects of cryotherapy on athletes’ muscle strength, flexibility, and neuromuscular control: A systematic review of the literature. J Bodyw Mov Ther 2020; 24:175-188. [DOI: 10.1016/j.jbmt.2019.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 11/09/2019] [Indexed: 11/17/2022]
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Effect of Tai Chi Training on Plantar Loads during Walking in Individuals with Knee Osteoarthritis. BIOMED RESEARCH INTERNATIONAL 2020; 2020:3096237. [PMID: 32258112 PMCID: PMC7079237 DOI: 10.1155/2020/3096237] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 02/24/2020] [Indexed: 11/17/2022]
Abstract
Tai Chi is an available method for the treatment of knee osteoarthritis (KOA). The impacts of Tai Chi on plantar loads of individuals with KOA are not fully understood. 46 participants with knee osteoarthritis were randomly assigned into the Tai Chi group (n = 23) or the control group (n = 23). The Tai Chi group attended a 6-month Tai Chi program, and the control group participated in a wellness education program. Novel Pedar-X system was used to collect the peak pressure (PP) and maximum force (MF) during walking before and 6 months after the intervention. Significant higher peak pressure and maximum force were observed in the 4th and 5th metatarsophalangeal joints in the Tai Chi group. However, there were significant declines in the peak pressure of the whole foot and the 2nd and 3rd metatarsophalangeal joints and maximum force of the heel in the control group. These results suggested that individuals with KOA might change the pattern of plantar loads during walking through Tai Chi, and plantar loads would be useful as a parameter to assess the effect of Tai Chi on knee osteoarthritis. This trial is registered with Clinical Trials: CHiCTR-TRC-13003264.
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Rugelj D, Vidovič M, Vauhnik R. Sensory Sub- and Suprathreshold TENS Exhibit No Immediate Effect on Postural Steadiness in Older Adults with No Balance Impairments. BIOMED RESEARCH INTERNATIONAL 2020; 2020:2451291. [PMID: 32190655 PMCID: PMC7064865 DOI: 10.1155/2020/2451291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 01/29/2020] [Accepted: 02/05/2020] [Indexed: 11/18/2022]
Abstract
Transcutaneous electrical nerve stimulation (TENS) has been reported to attenuate postural sway; however, the results are inconclusive, with some indicating the effect and others not. The study aimed to evaluate the effect of sensory sub- and suprathreshold low-frequency TENS applied through the plantar surface and posterior aspect of shanks on postural sway. In a group of healthy community-dwelling older adults, TENS was delivered with two different current intensities: (1) subsensory which is below conscious perception and (2) suprasensory threshold which is within the range of conscious perception. Frequencies of the TENS stimulation were sweeping from 5 to 180 Hz and were delivered through the plantar surface and posterior shanks of both legs. Postural sway was measured with a force platform in eyes-open and eyes-closed conditions. To evaluate potential fast adaptability to TENS stimuli, the results were evaluated in two time intervals: 30 seconds and 60 seconds. The results indicated that TENS with the chosen frequencies and electrode placement did not affect postural sway in both the sub- and suprathreshold intensities of TENS, in eyes-open and eyes-closed conditions, and in 30-second and 60-second time intervals. In conclusion, given that in this study sub- and suprathreshold TENS applied via the plantar surface of the feet did not attenuate postural sway, it would be easy to conclude that this type of electrical stimuli is ineffective and no further research is required. We must caution against this, given the specificity of the electrode placements. We recommend that future research be performed consisting of individuals with balance impairments and with different positions of electrodes.
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Affiliation(s)
- Darja Rugelj
- University of Ljubljana, Faculty of Health Sciences, Biomechanical Laboratory, Ljubljana, Slovenia
| | - Marko Vidovič
- University Rehabilitation Institute, Republic of Slovenia, Ljubljana, Slovenia
| | - Renata Vauhnik
- University of Ljubljana, Faculty of Health Sciences, Biomechanical Laboratory, Ljubljana, Slovenia
- Arthron Institute for Joint and Sports Injuries, Celje, Slovenia
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65
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Zarkou A, Lee SCK, Prosser LA, Jeka JJ. Foot and Ankle Somatosensory Deficits Affect Balance and Motor Function in Children With Cerebral Palsy. Front Hum Neurosci 2020; 14:45. [PMID: 32161527 PMCID: PMC7054234 DOI: 10.3389/fnhum.2020.00045] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 01/31/2020] [Indexed: 01/03/2023] Open
Abstract
Sensory dysfunction is prevalent in cerebral palsy (CP). Evidence suggests that sensory deficits can contribute to manual ability impairments in children with CP, yet it is still unclear how they contribute to balance and motor performance. Therefore, the objective of this study was to investigate the relationship between lower extremity (LE) somatosensation and functional performance in children with CP. Ten participants with spastic diplegia (Gross Motor Function Classification Scale: I-III) and who were able to stand independently completed the study. Threshold of light touch pressure, two-point discriminatory ability of the plantar side of the foot, duration of cutaneous vibration sensation, and error in the joint position sense of the ankle were assessed to quantify somatosensory function. The balance was tested by the Balance Evaluation System Test (BESTest) and postural sway measures during a standing task. Motor performance was evaluated by using a battery of clinical assessments: (1) Gross Motor Function Measure (GMFM-66-IS) to test gross motor ability; (2) spatiotemporal gait characteristics (velocity, step length) to evaluate walking ability; (3) Timed Up and Go (TUG) and 6 Min Walk (6MWT) tests to assess functional mobility; and (4) an isokinetic dynamometer was used to test the Maximum Volitional Isometric Contraction (MVIC) of the plantar flexor muscles. The results showed that the light touch pressure measure was strongly associated only with the 6MWT. Vibration and two-point discrimination were strongly related to balance performance. Further, the vibration sensation of the first metatarsal head demonstrated a significantly strong relationship with motor performance as measured by GMFM-66-IS, spatiotemporal gait parameters, TUG, and ankle plantar flexors strength test. The joint position sense of the ankle was only related to one subdomain of the BESTest (Postural Responses). This study provides preliminary evidence that LE sensory deficits can possibly contribute to the pronounced balance and motor impairments in CP. The findings emphasize the importance of developing a thorough LE sensory test battery that can guide traditional treatment protocols toward a more holistic therapeutic approach by combining both motor and sensory rehabilitative strategies to improve motor function in CP.
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Affiliation(s)
- Anastasia Zarkou
- Spinal Cord Injury Research Laboratory, Crawford Research Institute, Shepherd Center, Atlanta, GA, United States
| | - Samuel C K Lee
- Department of Physical Therapy and Interdisciplinary Graduate Program in Biomechanics and Movement Science, University of Delaware, Newark, DE, United States.,Research Department, Shriners Hospital for Children, Philadelphia, PA, United States
| | - Laura A Prosser
- Department of Pediatrics, University of Pennsylvania & The Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - John J Jeka
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States
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Acute Effects of Whole-Body Vibration on Peripheral Blood Flow, Vibrotactile Perception and Balance in Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17031069. [PMID: 32046205 PMCID: PMC7037406 DOI: 10.3390/ijerph17031069] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 02/04/2020] [Accepted: 02/06/2020] [Indexed: 01/10/2023]
Abstract
Background: Non-invasive application of whole-body vibration (WBV) has the potential for inducing improvements in impaired peripheral circulation, cutaneous sensation and balance among older adults. However, relevant studies have frequently applied high magnitudes of vibration and show conflicting and inconclusive results. Therefore, we attempted to ascertain the acute responses in those parameters from exposure of thirty older subjects to WBV of three different magnitudes, defined according to ISO 2631-1 (1997). Methods: Each subject randomly underwent four sessions of intervention (three bouts of 1 min exposure with 1 min between-bout rests): WBV at 15, 20, or 25 Hz with a peak-to-peak displacement of 4 mm, or control condition. Results: Both during and after intervention, dorsal foot skin blood flow increased significantly under 20 and 25 Hz exposure conditions with greater responses under the latter condition, the magnitude of which slightly exceeded the recommended value. Plantar vibrotactile perception showed significant increases after WBV exposure with overall greater responses under higher frequencies of vibration. In contrast, no WBV-induced change in balance was observed. Conclusions: WBV at 20 Hz with a magnitude within the recommended limit can be effective in inducing enhancements in peripheral blood flow; however, the same magnitude of vibration seems insufficient in improving balance among older adults.
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Oshita K, Yano S. Influence of tactile sensitivity in the finger on postural control while using the light touch effect. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:5344-5347. [PMID: 31947063 DOI: 10.1109/embc.2019.8857511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Providing additional tactile sensory input, such as light finger touch, improves postural control while standing. This phenomenon is called light touch (LT) effect. The present study investigated influences of tactile sensitivity in a finger on the magnitude of improvement in postural sway owing to LT. The participants were 16 healthy men (20-33 years). They performed two upright postures with their eyes closed; their feet 1) comfortably apart (normal stance) and 2) together in a side-by-side stance (Romberg stance). These tasks were performed both with and without LT. The participants let their right index finger lightly touch a fixed surface. The tactile sensitivity in the finger was evaluated using a two-point discrimination test. Although postural sway decreased owing to the LT, the association between tactile sensitivity in the finger and the percentage change in postural sway was not statistically significant, regardless of the difficulty of the upright tasks. These results suggested that the person might not be able to perceive a change in direction in their posture through LT; however, the LT might be recognized as a reference point to detect relative changes in the alignment of the body. Therefore, tactile sensitivity in the finger might not be necessary to achieve the LT effect.
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Ostolin TLVDP, Gonze BDB, Jesus MOD, Arantes RL, Sperandio EF, Dourado VZ. Effects of obesity on postural balance and occurrence of falls in asymptomatic adults. FISIOTERAPIA EM MOVIMENTO 2020. [DOI: 10.1590/1980-5918.033.ao50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Previous studies suggested that body weight is a strong predictor for postural balance. High body mass index (BMI) presented an association with increased postural sway. However, it seems controversial since studies reported no difference between obese and control group regarding the position of the center of pressure in static postural balance (PB). Also, there is a lack of investigations about the impact of obesity on PB, free of the confound effect of cardiometabolic risk. Objective: The aim of this study was to evaluate the effects of obesity in static PB and occurrence of falls in asymptomatic adults and older adults over 40 years old. Method: The PB of 624 subjects divided into quartiles for BMI, waist-to-hip ratio, waist-to-height and fat body mass as percentage (%FBM) was assessed with and without vision using a force platform. An MANOVA was used to determine if there were differences between quartiles and a logistic regression analysis adjusted for confounders variables were applied to determine the obesity role in the occurrence of falls. Results: We found weak to moderate bivariate correlations between obesity and static PB, which became non-significant after adjustment. We found significant differences between first and fourth quartiles, especially using %FBM. Obesity was not related to the occurrence of falls since the odds ratio values became non-significant for all the indices of obesity after adjustment. Conclusion: Obesity presents little influence on maintaining static PB and seems not to determine the occurrence of falls among subjects over 40 years old.
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Affiliation(s)
| | | | | | - Rodolfo Leite Arantes
- Universidade Federal de São Paulo, Brazil; Instituto de Medicina Cardiovascular Angiocorpore, Brazil
| | - Evandro Fornias Sperandio
- Universidade Federal de São Paulo, Brazil; Instituto de Medicina Cardiovascular Angiocorpore, Brazil
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Cudejko T, Gardiner J, Akpan A, D'Août K. Minimal footwear improves stability and physical function in middle-aged and older people compared to conventional shoes. Clin Biomech (Bristol, Avon) 2020; 71:139-145. [PMID: 31739197 DOI: 10.1016/j.clinbiomech.2019.11.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 09/09/2019] [Accepted: 11/09/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Effects of minimal shoes on stability and physical function in older people are under-researched. No studies have systematically explored effects of a range of minimal footwear features on these factors in older people. METHODS A within-participant repeated-measures design was used. Participants were subjected to thirteen footwear conditions: (i) barefoot, (ii) a conventional shoe, (iii) a control minimal shoe, (iv-xiii) minimal shoes differing from the control minimal shoe by one design feature. The outcomes were: (i) postural stability expressed with movement of the center of pressure (CoP) during standing (ii) dynamic stability expressed with the CoP movement during walking, (iv) physical function assessed with the Timed Up and Go test (TUG), and (iv) perceptions of footwear assessed with the Monitor Orthopaedic Shoes questionnaire. Linear Mixed Models were applied for statistical analyses. FINDINGS Twenty-two people participated in the study. Compared to the conventional shoe, participants: (i) were more stable during standing and walking in the majority of minimal shoes, and (ii) completed the TUG test faster when wearing the minimal shoe with wider sole. Compared to the control minimal shoe, participants: (i) completed the TUG test faster when wearing the minimal shoe with wider sole; and (ii) perceived features such as a split toe and a higher ankle collar as less fashionable and wearable. INTERPRETATION Wearing minimal shoes might be more beneficial for stability and physical function in older adults than wearing conventional shoes. The results will be highly valuable for the design of minimal footwear for older adults.
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Affiliation(s)
- Tomasz Cudejko
- Department of Musculoskeletal Biology, Faculty of Health & Life Sciences, University of Liverpool, Liverpool, United Kingdom.
| | - James Gardiner
- Department of Musculoskeletal Biology, Faculty of Health & Life Sciences, University of Liverpool, Liverpool, United Kingdom.
| | - Asangaedem Akpan
- Department of Musculoskeletal Biology, Faculty of Health & Life Sciences, University of Liverpool, Liverpool, United Kingdom; Department of Medicine for the Elderly, Aintree University Hospital NHS Foundation Trust, Liverpool, United Kingdom.
| | - Kristiaan D'Août
- Department of Musculoskeletal Biology, Faculty of Health & Life Sciences, University of Liverpool, Liverpool, United Kingdom.
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70
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Human Balance in Response to Continuous, Predictable Translations of the Support Base: Integration of Sensory Information, Adaptation to Perturbations, and the Effect of Age, Neuropathy and Parkinson’s Disease. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9245310] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This short narrative review article moves from early papers that described the behaviour of healthy subjects balancing on a motorized platform continuously translating in the antero-posterior direction. Research from the laboratories of two of the authors and related investigations on dynamic balancing behaviour are briefly summarized. More recent findings challenging time-honoured views are considered, such as the statement that vision plays a head-in-space stabilizing role. The time interval to integrate vision or its withdrawal in the balancing pattern is mentioned as well. Similarities and differences between ageing subjects and patients with peripheral or central disorders are concisely reported. The muscle activities recorded during the translation cycles suggest that vision and amplitude changes of the anticipatory postural activities play a predominant role in controlling dynamic balance during prolonged administration of the predictable perturbation. The potential of this paradigm for rehabilitation of balance problems is discussed.
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71
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Hur P, Pan YT, DeBuys C. Free Energy Principle in Human Postural Control System: Skin Stretch Feedback Reduces the Entropy. Sci Rep 2019; 9:16870. [PMID: 31727928 PMCID: PMC6856340 DOI: 10.1038/s41598-019-53028-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 10/24/2019] [Indexed: 11/09/2022] Open
Abstract
Human upright standing involves an integration of multiple sensory inputs such as vision, vestibular and somatosensory systems. It has been known that sensory deficits worsen the standing balance. However, how the modulation of sensory information contributes to postural stabilization still remains an open question for researchers. The purpose of this work was to formulate the human standing postural control system in the framework of the free-energy principle, and to investigate the efficacy of the skin stretch feedback in enhancing the human standing balance. Previously, we have shown that sensory augmentation by skin stretch feedback at the fingertip could modulate the standing balance of the people with simulated sensory deficits. In this study, subjects underwent ten 30-second trials of quiet standing balance with and without skin stretch feedback. Visual and vestibular sensory deficits were simulated by having each subject close their eyes and tilt their head back. We found that sensory augmentation by velocity-based skin stretch feedback at the fingertip reduced the entropy of the standing postural sway of the people with simulated sensory deficits. This result aligns with the framework of the free energy principle which states that a self-organizing biological system at its equilibrium state tries to minimize its free energy either by updating the internal state or by correcting body movement with appropriate actions. The velocity-based skin stretch feedback at the fingertip may increase the signal-to-noise ratio of the sensory signals, which in turn enhances the accuracy of the internal states in the central nervous system. With more accurate internal states, the human postural control system can further adjust the standing posture to minimize the entropy, and thus the free energy.
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Affiliation(s)
- Pilwon Hur
- Texas A&M University, Department of Mechanical Engineering, College Station, TX, 77843, USA.
- Texas A&M Engineering Experiment Station, Center for Remote Health Technologies and Systems, College Station, TX, 77843, USA.
| | - Yi-Tsen Pan
- Texas A&M University, Department of Mechanical Engineering, College Station, TX, 77843, USA
| | - Christian DeBuys
- Texas A&M University, Department of Mechanical Engineering, College Station, TX, 77843, USA
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HYBRID: Ambulatory Robotic Gait Trainer with Movement Induction and Partial Weight Support. SENSORS 2019; 19:s19214773. [PMID: 31684102 PMCID: PMC6864532 DOI: 10.3390/s19214773] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 10/25/2019] [Accepted: 10/31/2019] [Indexed: 11/17/2022]
Abstract
Robotic exoskeletons that induce leg movement have proven effective for lower body rehabilitation, but current solutions offer limited gait patterns, lack stabilization, and do not properly stimulate the proprioceptive and balance systems (since the patient remains in place). Partial body weight support (PBWS) systems unload part of the patient’s body weight during rehabilitation, improving the locomotive capabilities and minimizing the muscular effort. HYBRID is a complete system that combines a 6DoF lower body exoskeleton (H1) with a PBWS system (REMOVI) to produce a solution apt for clinical practice that offers improves on existing devices, moves with the patient, offers a gait cycle extracted from the kinematic analysis of healthy users, records the session data, and can easily transfer the patient from a wheelchair to standing position. This system was developed with input from therapists, and its response times have been measured to ensure it works swiftly and without a perceptible delay.
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Fitzgibbon-Collins LK, Noguchi M, Heckman GA, Hughson RL, Robertson AD. Acute reduction in cerebral blood velocity on supine-to-stand transition increases postural instability in young adults. Am J Physiol Heart Circ Physiol 2019; 317:H1342-H1353. [PMID: 31674810 DOI: 10.1152/ajpheart.00360.2019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
We tested the hypothesis that transient deficits in cerebral blood flow are associated with postural sway. In 19 young, healthy adults, we examined the association between the drop in cerebral blood flow during supine-to-stand transitions, indexed by transcranial Doppler ultrasound [middle cerebral artery blood velocity at diastole (MCAdv)] and near-infrared spectroscopy [tissue saturation index (TSI)] and the center of pressure displacement while standing. Participants performed transitions under three conditions aimed at progressively increasing the drop in MCAdv, in a randomized order: 1) a control transition (Con); 2) a transition that coincided with deflation of bilateral thigh cuffs; and 3) a transition that coincided with both thigh-cuff deflation and 90 s of prior hyperventilation (HTC). The deficit in diastolic blood velocity (MCAdv deficit) was quantified as the difference between MCAdv and its preceding baseline value, summed over 10 s, beginning at the MCAdv nadir. Compared with Con, HTC led to greater drops in MCAdv (P = 0.003) and TSI (P < 0.001) at nadir. The MCAdv deficit was positively associated with the center of pressure displacement vector-average using repeated-measures correlation (repeated-measures correlation coefficient = 0.56, P < 0.001). An a posteriori analysis identified a sub-group of participants that showed an exaggerated increase in MCAdv deficit and greater postural instability in both the anterior-posterior (P = 0.002) and medial-lateral (P = 0.021) directions in response to the interventions. These findings support the theory that individuals who experience greater initial cerebral hypoperfusion on standing may be at a greater risk for falls.NEW & NOTEWORTHY Dizziness and risk for falls after standing might link directly to reduced delivery of oxygen to the brain. By introducing challenges that increased the drop in brain blood flow in healthy young adults, we have shown for the first time a direct link to greater postural instability. These results point to a need to measure cerebral blood flow and/or oxygenation after postural transitions in populations, such as older adults, to assist in fall risk assessment.
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Affiliation(s)
| | | | - George A Heckman
- Schlegel-University of Waterloo Research Institute for Aging, Waterloo, Ontario, Canada
| | - Richard L Hughson
- Schlegel-University of Waterloo Research Institute for Aging, Waterloo, Ontario, Canada
| | - Andrew D Robertson
- Schlegel-University of Waterloo Research Institute for Aging, Waterloo, Ontario, Canada
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Kenny RPW, Atkinson G, Eaves DL, Martin D, Burn N, Dixon J. The effects of textured materials on static balance in healthy young and older adults: A systematic review with meta-analysis. Gait Posture 2019; 71:79-86. [PMID: 31022658 DOI: 10.1016/j.gaitpost.2019.04.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 04/05/2019] [Accepted: 04/16/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Standing on textured materials can improve static balance, potentially by modulating somatosensory inputs from the soles of the feet. RESEARCH QUESTION To synthesise and quantify the immediate effects of textured materials on static balance in healthy young and older adults. METHODS Primary outcomes were the centre of pressure (COP) displacement and velocity, during eyes open and eyes closed conditions. Ten crossover studies (n = 318, 58% female) met the inclusion criteria. A random effects meta-analysis model derived pooled standardised mean differences (SMD; Hedges g) to quantify the effects of textured materials. Heterogeneity was quantified with the tau-statistic (τ). A 95% prediction interval quantified the likely range of true effects on COP outcomes in similar future studies. RESULTS There was a small to moderate beneficial effect for textured materials vs control conditions in: COP displacement during both eyes open (SMD: 0.29; 95% CI -0.06 to 0.64; τ = 0.32) and eyes closed (SMD: 0.75; 95% CI 0.18 to 1.33; τ = 0.55). A trivial to small beneficial effect was observed in COP velocity during eyes open (SMD: 0.14; 95% CI -0.14 to 0.43; τ = 0.18) and eyes closed (SMD: 0.20; 95% CI 0.01 to 0.40; τ = 0.18) for textured materials. The 95% prediction intervals showed texture may not consistently provide beneficial results across studies for all outcomes: COP displacement EC (-0.61 to 2.12), EO (-0.54 to 1.12), COP velocity EC (-0.27 to 0.68) and EO (-0.44 to 0.73). SIGNIFICANCE Overall, textured materials improved balance, but these effects were heterogeneous. This research may therefore inform applied investigations into balance improvements for healthy populations, for example, in functional movements and sports.
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Affiliation(s)
- Ryan P W Kenny
- School of Health and Social Care, Teesside University, Middlesbrough, UK.
| | - Greg Atkinson
- School of Health and Social Care, Teesside University, Middlesbrough, UK.
| | - Daniel L Eaves
- School of Health and Social Care, Teesside University, Middlesbrough, UK.
| | - Denis Martin
- School of Health and Social Care, Teesside University, Middlesbrough, UK.
| | - Naomi Burn
- School of Health and Social Care, Teesside University, Middlesbrough, UK.
| | - John Dixon
- School of Health and Social Care, Teesside University, Middlesbrough, UK.
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75
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Li L, Zhang S, Dobson J. The contribution of small and large sensory afferents to postural control in patients with peripheral neuropathy. JOURNAL OF SPORT AND HEALTH SCIENCE 2019; 8:218-227. [PMID: 31193300 PMCID: PMC6523875 DOI: 10.1016/j.jshs.2018.09.010] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 07/24/2018] [Accepted: 09/14/2018] [Indexed: 05/13/2023]
Abstract
Peripheral neuropathy (PN) is a multifarious disorder that is caused by damage to the peripheral nerves. Although the symptoms of PN vary with the etiology, most cases are characterized by impaired tactile and proprioceptive sensation that progresses in a distal to proximal manner. Balance also tends to deteriorate as the disorder becomes more severe, and those afflicted are substantially more likely to fall while walking compared with those who are healthy. Most patients with PN walk more cautiously and with greater stride variability than age-matched controls, but the majority of their falls occur when they must react to a perturbation such as a slippery or uneven surface. The purpose of this study was to first describe the role of somatosensory feedback in the control of posture and then discuss how that relationship is typically affected by the most common types of PN. A comprehensive review of the scientific literature was conducted using MEDLINE, and the relevant information was synthesized. The evidence indicates that the proprioceptive feedback that is conveyed primarily through larger type I afferents is important for postural control. However, the evidence indicates that the tactile feedback communicated through smaller type II afferents is particularly critical to the maintenance of balance. Many forms of PN often lead to chronic tactile desensitization in the soles of the feet and, although the central nervous system seems to adapt to this smaller type II afferent dysfunction by relying on more larger type I afferent reflex loops, the result is still decreased stability. We propose a model that is intended both to help explain the relationship between stability and the smaller type II afferent and the larger type I afferent feedback that may be impaired by PN and to assist in the development of pertinent rehabilitative interventions.
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Affiliation(s)
- Li Li
- College of Physical Education, Hunan Normal University, Changsha 410012, China
- Department of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, GA 30460, USA
- Corresponding author.
| | - Shuqi Zhang
- Department of Kinesiology and Physical Education, Northern Illinois University, DeKalb, IL 60115, USA
| | - John Dobson
- Department of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, GA 30460, USA
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Koehler-McNicholas SR, Danzl L, Cataldo AY, Oddsson LIE. Neuromodulation to improve gait and balance function using a sensory neuroprosthesis in people who report insensate feet - A randomized control cross-over study. PLoS One 2019; 14:e0216212. [PMID: 31039180 PMCID: PMC6490932 DOI: 10.1371/journal.pone.0216212] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 04/13/2019] [Indexed: 12/16/2022] Open
Abstract
Peripheral neuropathy may cause loss of sensory information from plantar cutaneous mechanoreceptors that is important for balance control and falls management. The current study investigated short-term effects of using Walkasins, an external lower-limb sensory neuroprosthesis, on clinical outcomes of balance and gait in persons who reported peripheral neuropathy and balance problems. The device replaces lost plantar sensation with tactile balance information that modulates cutaneous mechanoreceptors above the ankle where sensation is intact. Thirty-one male community-dwelling Veterans, 56–84 years old with insensate feet and balance problems participated. Initial Functional Gait Assessment, gait speed, and 4-Stage Balance Test outcomes were assessed. After initial assessment, subjects were randomly assigned to either wearing Walkasins turned ON, or OFF, and outcomes were re-assessed following a set of standardized balance exercises. Following a one-hour rest and washout period, treatments were crossed-over between groups and a third outcomes assessment was performed. Before cross-over, 10 of 15 subjects in the ON-then-OFF group improved their Functional Gait Assessment score by at least four points, the Minimal Clinically Important Difference, compared to 5 of 16 in the OFF-then-ON group. After cross-over, 7 of 16 subjects in the OFF-then-ON group improved by at least four points versus 2 of 15 in the ON-then-OFF group. ON treatment was associated with a Functional Gait Assessment improvement of 4.4 ± 3.7 points versus 1.5 ± 1.2 for the OFF treatment (p<0.01). Overall, Functional Gait Assessment scores changed from 15.2 ± 4.8 at initial assessment to 21.1 ± 5.2 after final assessment (p<0.001). At the end of the two treatment sessions, 16 of the 31 individuals had improved their Functional Gait Assessment score beyond 23, indicating normal fall-risk status. Future studies should investigate long-term benefits of the device to reduce fall risk and actual falls in patients with peripheral neuropathy and balance problems.
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Affiliation(s)
- Sara R. Koehler-McNicholas
- Minneapolis Department of Veterans Affairs Health Care System, Minneapolis, MN, United States of America
- * E-mail:
| | - Lori Danzl
- Minneapolis Department of Veterans Affairs Health Care System, Minneapolis, MN, United States of America
| | - Alana Y. Cataldo
- Minneapolis Department of Veterans Affairs Health Care System, Minneapolis, MN, United States of America
| | - Lars I. E. Oddsson
- Division of Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, MN, United States of America
- Recanati School of Community Health, Ben Gurion University of the Negev, Be’er Sheva, Israel
- RxFunction Inc., Eden Prairie, MN, United States of America
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77
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Abstract
BACKGROUND In the multidisciplinary treatment of obesity, the role of a plastic surgeon is to remove the excess of skin after weight loss to obtain cosmetic, functional, and psychological benefits. Obesity modifies body geometry, increases the mass of different segments, and imposes functional limitations in life activities that may predispose the obese to injury. The authors evaluated the postural conditions of obese patients, before and 12 months after surgery. METHODS The study included 15 obese patients of both genders affected by class II obesity. Postural function was evaluated preoperatively and 12 months postoperatively. Patients underwent conventional abdominoplasty surgical procedure. In all patients, plantar pressure distribution and balance (stabilometric test) were evaluated before and 3 months after surgery. RESULTS The static pedobarographic revealed a significant reduction in forefoot peak pressure; total plantar force; rearfoot plantar force percentage; midfoot plantar force percentage; and forefoot, midfoot, and rearfoot plantar contact areas percentage 3 months after surgery; the dynamic's one showed a reduction in the first metatarsal peak pressure and plantar contact. The stabilometric values showed a reduction in the range of center of foot pressure (CP) displacement along y axis, the average displacement of the CP speed from the mean (RMS y velocity), and CP mean peak in the condition of vision. CONCLUSIONS Our study demonstrates the beneficial effect of dermolipectomies and the consequential weight loss on postural stability of obese men. Such findings may support the hypothesis that dermolipectomy may improve postural stability with and without vision. The data demonstrate that the benefits are related to the magnitude of the resected tissue.
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78
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Coelho DB, Fernandes CA, Martinelli AR, Teixeira LA. Right in Comparison to Left Cerebral Hemisphere Damage by Stroke Induces Poorer Muscular Responses to Stance Perturbation Regardless of Visual Information. J Stroke Cerebrovasc Dis 2019; 28:954-962. [PMID: 30630757 DOI: 10.1016/j.jstrokecerebrovasdis.2018.12.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 11/22/2018] [Accepted: 12/14/2018] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Fast and scaled muscular activation is required to recover body balance following an external perturbation. An issue open to investigation is the extent to which the cerebral hemisphere lesioned by stroke leads to asymmetric deficits in postural reactive responses. In this experiment, we aimed to compare muscular responses to unanticipated stance perturbations between individuals who suffered unilateral stroke either to the right or to the left cerebral hemisphere. METHODS Stance perturbations were produced by releasing a load attached to the participant's trunk, inducing fast forward body oscillation. Electromyography was recorded from the gastrocnemius medialis and biceps femoris muscles. Muscular activation from age-matched healthy individuals was taken as reference. RESULTS Analysis indicated that damage to the right hemisphere induced delayed activation onset, and lower rate and magnitude of activation of the proximal and distal muscles of the paretic leg. Those deficits were associated with stronger activation of the nonparetic leg. Comparisons between left hemisphere damage and controls showed deficits limited to activation of the biceps femoris of the paretic leg. Manipulation of visual information led to no significant effects on muscular responses. CONCLUSIONS These results suggest that right cerebral hemisphere damage by stroke leads to more severe deficits in the generation of reactive muscular responses to stance perturbation than damage to the left cerebral hemisphere regardless of visual information.
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Affiliation(s)
- Daniel Boari Coelho
- Human Motor Systems Laboratory, School of Physical Education and Sport, University of São Paulo, SP, Brazil; Biomedical Engineering, Federal University of ABC, São Bernardo do Campo, SP, Brazil.
| | - Corina Aparecida Fernandes
- Human Motor Systems Laboratory, School of Physical Education and Sport, University of São Paulo, SP, Brazil
| | | | - Luis Augusto Teixeira
- Human Motor Systems Laboratory, School of Physical Education and Sport, University of São Paulo, SP, Brazil
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79
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Yang F, Qiao M, Su X, Lazarus J. Relative importance of physical and psychological factors to slowness in people with mild to moderate multiple sclerosis. Mult Scler Relat Disord 2019; 27:81-90. [DOI: 10.1016/j.msard.2018.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 09/17/2018] [Accepted: 10/08/2018] [Indexed: 11/28/2022]
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80
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Schmidt D, Germano AM, Milani TL. Effects of water immersion on sensitivity and plantar skin properties. Neurosci Lett 2018; 686:41-46. [DOI: 10.1016/j.neulet.2018.08.048] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 08/28/2018] [Accepted: 08/30/2018] [Indexed: 12/31/2022]
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81
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Knellwolf TP, Burton AR, Hammam E, Macefield VG. Microneurography from the posterior tibial nerve: a novel method of recording activity from the foot in freely standing humans. J Neurophysiol 2018; 120:953-959. [DOI: 10.1152/jn.00937.2017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
The posterior tibial nerve, located behind the medial malleolus of the ankle, supplies the intrinsic muscles of the foot and most of the skin of the sole. We describe a novel approach for recording from this nerve via a percutaneously inserted tungsten microelectrode and provide examples of recordings from presumed muscle spindle endings recorded in freely standing human subjects. The fact that the angular excursions of the ankle joint are small as the foot is loaded during the transition from the seated position to standing means that one can obtain stable recordings of neural traffic in unloaded, loaded, and freely standing conditions. We conclude that this novel approach will allow studies that will increase our understanding of the roles of muscle and cutaneous afferents in the foot in the control of upright posture. NEW & NOTEWORTHY We have performed the first microneurographic studies from the posterior tibial nerve at the ankle. Stability of the recording site allows one to record from muscle spindles in the intrinsic muscles of the foot as well as from cutaneous mechanoreceptors in the sole of the foot during the transition from seated to standing. This novel approach opens up new opportunities for studying the roles of muscle and cutaneous afferents in the foot in the control of upright stance.
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Affiliation(s)
- T. P. Knellwolf
- School of Medicine, Western Sydney University, Sydney, Australia
| | - A. R. Burton
- School of Medicine, Western Sydney University, Sydney, Australia
- Neuroscience Research Institute, Sydney, Australia
| | - E. Hammam
- School of Medicine, Western Sydney University, Sydney, Australia
| | - V. G. Macefield
- School of Medicine, Western Sydney University, Sydney, Australia
- Neuroscience Research Institute, Sydney, Australia
- Baker Heart and Diabetes Institute, Melbourne, Australia
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82
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Do plantar hyperkeratoses affect balance in people older than 65 years old? Foot (Edinb) 2018; 36:43-48. [PMID: 30326353 DOI: 10.1016/j.foot.2018.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 03/03/2018] [Accepted: 03/13/2018] [Indexed: 02/04/2023]
Abstract
UNLABELLED Tactile information picked up by plantar receptors provides afferent sensory information that is fundamental for controlling body balance. Plantar hyperkeratoses may alter the quality and quantity of such information, thereby modifying balance. AIM Analyse how plantar hyperkeratosis debridement affects static body balance in subjects of 65 years of age or older. METHODS In order to analyse the impact of hyperkeratoses on balance, 50 older people took part in this study. Pain caused by plantar hyperkeratoses was measured on a visual analogue scale. Static balance was assessed on a pressure sensitive platform. The treatment was scalpel debridement of hyperkeratoses. RESULTS Pain decreased significantly (p=0.03). Regarding the variables analysed, significant differences were found between pre- and post-treatment values in anteroposterior length (Length, mm) (p=0.032) and anteroposterior amplitude (Amp, mm) (p=0.044) of the centre of plantar pressure with eyes open. CONCLUSIONS Plantar hyperkeratosis debridement is capable of interfering favourably with sensory afferent inputs, thereby improving control of stability and modifying stabilometric readings in the AP component when a subject balance with eyes open.
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83
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Strzalkowski NDJ, Peters RM, Inglis JT, Bent LR. Cutaneous afferent innervation of the human foot sole: what can we learn from single-unit recordings? J Neurophysiol 2018; 120:1233-1246. [PMID: 29873612 PMCID: PMC6171067 DOI: 10.1152/jn.00848.2017] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 06/04/2018] [Accepted: 06/04/2018] [Indexed: 12/21/2022] Open
Abstract
Cutaneous afferents convey exteroceptive information about the interaction of the body with the environment and proprioceptive information about body position and orientation. Four classes of low-threshold mechanoreceptor afferents innervate the foot sole and transmit feedback that facilitates the conscious and reflexive control of standing balance. Experimental manipulation of cutaneous feedback has been shown to alter the control of gait and standing balance. This has led to a growing interest in the design of intervention strategies that enhance cutaneous feedback and improve postural control. The advent of single-unit microneurography has allowed the firing and receptive field characteristics of foot sole cutaneous afferents to be investigated. In this review, we consolidate the available cutaneous afferent microneurographic recordings from the foot sole and provide an analysis of the firing threshold, and receptive field distribution and density of these cutaneous afferents. This work enhances the understanding of the foot sole as a sensory structure and provides a foundation for the continued development of sensory augmentation insoles and other tactile enhancement interventions.
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Affiliation(s)
- Nicholas D J Strzalkowski
- Department of Human Health and Nutritional Science, University of Guelph , Guelph , Canada
- Department of Clinical Neuroscience, University of Calgary , Calgary , Canada
| | - Ryan M Peters
- School of Kinesiology, University of British Columbia , Vancouver , Canada
- Faculty of Kinesiology, University of Calgary , Calgary , Canada
| | - J Timothy Inglis
- School of Kinesiology, University of British Columbia , Vancouver , Canada
| | - Leah R Bent
- Department of Human Health and Nutritional Science, University of Guelph , Guelph , Canada
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84
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Jammes Y, Ferrand E, Fraud C, Boussuges A, Weber JP. Adding body load modifies the vibratory sensation of the foot sole and affects the postural control. Mil Med Res 2018; 5:28. [PMID: 30115124 PMCID: PMC6097325 DOI: 10.1186/s40779-018-0175-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 07/31/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Heavy backpacks are often used by soldiers and firefighters. Weight carrying could reduce the speed and efficiency in task completion by altering the foot sole sensitivity and postural control. METHODS In fifteen healthy subjects, we measured the changes in sensitivity to vibrations applied to the foot sole when standing upright or walking after load carrying (30% body weight). The participants were asked to judge different vibration amplitudes applied on the 2nd or 5th metatarsal head and the heel at two frequencies (25 and 150 Hz) to determine the vibration threshold and the global perceptual representation (Ѱ)of the vibration amplitude (Ф) given by the Stevens power function (Ѱ = k × Фn). Any increase in negative k value indicated a reduction in sensitivity to the lowest loads. Pedobarographic measurements, with computation of the center of pressure (COP) and its deviations, were performed during weight carrying. RESULTS The 25-Hz vibration threshold significantly increased after weight carrying when standing upright or walking. After standing with the added loads, the absolute negative k value increased for the 25 Hz frequency. After walking with the added loads, the k coefficient increased for the two vibration frequencies. Weight carrying significantly increased both the CoP surface and CoP lateral deviation. CONCLUSIONS Our data show that weight carrying reduces the sensory pathways from the foot sole and accentuates the center of pressure deviations.
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Affiliation(s)
- Yves Jammes
- School of Podiatry, 13014 Marseille, France
- C2VN Inra Inserm, Faculty of Medicine, Aix Marseille University, Bd. Pierre Dramard, 13916 cedex 20, Marseille, France
| | | | | | - Alain Boussuges
- C2VN Inra Inserm, Faculty of Medicine, Aix Marseille University, Bd. Pierre Dramard, 13916 cedex 20, Marseille, France
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85
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Ünver B, Akbaş E. Effects of plantar sensitivity on balance and mobility in community-dwelling older adults: A Turkish study. Australas J Ageing 2018; 37:288-292. [DOI: 10.1111/ajag.12558] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Banu Ünver
- Department of Physiotherapy and Rehabilitation; Faculty of Health Science; Zonguldak Karaelmas University; Zonguldak Turkey
| | - Eda Akbaş
- Department of Physiotherapy and Rehabilitation; Faculty of Health Science; Zonguldak Karaelmas University; Zonguldak Turkey
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86
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Aboutorabi A, Arazpour M, Bahramizadeh M, Farahmand F, Fadayevatan R. Effect of vibration on postural control and gait of elderly subjects: a systematic review. Aging Clin Exp Res 2018; 30:713-726. [PMID: 28918597 DOI: 10.1007/s40520-017-0831-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 09/05/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIM Gait and balance disorders are common in the elderly populations, and their prevalence increases with age. This systematic review was performed to summarize the current evidence for subthreshold vibration interventions on postural control and gait in elderly. METHOD A review of intervention studies including the following words in the title/abstract: insole, foot and ankle appliances, vibration, noise and elderly related to balance and gait. Databases searched included PubMed, ISI Web of Knowledge, Ovid, Scopus, and Google Scholar. Fifteen articles were selected for final evaluation. The procedure was followed using the preferred reporting items for systematic reviews and meta-analysis method. RESULTS There was reduction in center of pressure velocity and displacement especially with eyes closed using vibration in healthy elderly subjects and this effect was greater in elderly faller and patients with more balance deficiency. Vibration programme training increased speed of walking, cadence, step time and length in stroke subjects. The vibratory insoles significantly improved performance on the Timed Up and Go and Functional Reach tests in older people. CONCLUSION Vibration was effective on balance improvement in elderly subject especially elderly with more balance deficiency and it can improve gait parameters in patients with greater baseline variability.
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Affiliation(s)
- Atefeh Aboutorabi
- Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Kodakyarst., Daneshjo Blvd., Evin, Tehran, 1985713834, Iran
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mokhtar Arazpour
- Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Kodakyarst., Daneshjo Blvd., Evin, Tehran, 1985713834, Iran.
| | - Mahmood Bahramizadeh
- Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Kodakyarst., Daneshjo Blvd., Evin, Tehran, 1985713834, Iran
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Farzam Farahmand
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
| | - Reza Fadayevatan
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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87
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Ashtiani MN, Azghani MR. Open- and closed-loop responses of joint mechanisms in perturbed stance under visual and cognitive interference. Biomed Signal Process Control 2018. [DOI: 10.1016/j.bspc.2018.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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88
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Improvement of Balance Stability in Older Individuals by On-Water Training. J Aging Phys Act 2018; 26:222-226. [DOI: 10.1123/japa.2017-0041] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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89
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Horák S, Sovová E, Pastucha D, Konečný P, Radová L, Calabová N, Janoutová J, Janout V. Comprehensive Group Therapy of Obesity and Its Impact on Selected Anthropometric and Postural Parameters. Cent Eur J Public Health 2018; 25:326-331. [PMID: 29346858 DOI: 10.21101/cejph.a4780] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Obesity is a multifactorial disease. This non-infectious epidemic has reached pandemic proportions in the 21 century. Posture is a dynamic process referring to an active maintenance of body movement segments against the action of external forces. The aim of the study was to investigate the effect of comprehensive group therapy for obese persons on selected anthropometric and postural parameters. METHODS The study comprised 53 females with a mean age of 44.5 years (range 29–65 years, standard deviation 9.42 years, median 44 years), who completed a controlled weight loss programme. At the beginning and at the end of the programme, anthropometric parameters (Body Mass Index (BMI), weight and waist circumference) were measured and the posturography tests Limits of Stability (LOS) and Motor Control Test (MCT) were performed using the NeuroCom's SMART EquiTest system. The data were statistically analyzed using R software at a level of significance of 0.05. RESULTS There were positive changes after the controlled weight loss programme in anthropometric parameters (BMI reduction, with p<0.001; waist circumference reduction, with p<0.001; and weight loss, with p<0.001), postural stability with statistically significant (p<0.05) improvements in both postural activity (LOS test parameters) and reactions (MCT parameters). CONCLUSION The study showed a statistically significant effect of comprehensive group therapy for obesity in terms of reductions in waist circumference, body weight and BMI, and thus the overall reduction of both cardiovascular and metabolic risks, as well as improved postural skills (activity and reactions).
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Affiliation(s)
- Stanislav Horák
- Department of Rehabilitation, University Hospital Olomouc, Olomouc, Czech Republic.,Department of Physiotherapy, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czech Republic
| | - Eliška Sovová
- Department of Exercise Medicine and Cardiovascular Rehabilitation, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic
| | - Dalibor Pastucha
- Department of Rehabilitation, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.,ReFit Clinic, Olomouc, Czech Republic
| | - Petr Konečný
- Department of Physiotherapy, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czech Republic.,Department of Rehabilitation, Prostějov Hospital, Prostějov, Czech Republic.,Department of Physiotherapy and Rehabilitation, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Lenka Radová
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Naděžda Calabová
- Department of Rehabilitation, University Hospital Olomouc, Olomouc, Czech Republic.,Department of Physiotherapy, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czech Republic
| | - Jana Janoutová
- Centre for Research and Science, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czech Republic
| | - Vladimír Janout
- Centre for Research and Science, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czech Republic
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90
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Zhou J, Lo OY, Lipsitz LA, Zhang J, Fang J, Manor B. Transcranial direct current stimulation enhances foot sole somatosensation when standing in older adults. Exp Brain Res 2018; 236:795-802. [PMID: 29335751 DOI: 10.1007/s00221-018-5178-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 01/11/2018] [Indexed: 12/20/2022]
Abstract
Foot-sole somatosensation is critical for safe mobility in older adults. Somatosensation arises when afferent input activates a neural network that includes the primary somatosensory cortex. Transcranial direct current stimulation (tDCS), as a strategy to increase somatosensory cortical excitability, may, therefore, enhance foot-sole somatosensation. We hypothesized that a single session of tDCS would improve foot-sole somatosensation, and thus mobility, in older adults. Twenty healthy older adults completed this randomized, double-blinded, cross-over study consisting of two visits separated by one week. On each visit, standing vibratory threshold (SVT) of each foot and the timed-up-and-go test (TUG) of mobility were assessed immediately before and after a 20-min session of tDCS (2.0 mA) or sham stimulation with the anode placed over C3 (according to the 10/20 EEG placement system) and the cathode over the contralateral supraorbital margin. tDCS condition order was randomized. SVT was measured with a shoe insole system. This system automatically ramped up, or down, the amplitude of applied vibrations and the participant stated when they could or could no longer feel the vibration, such that lower SVT reflected better somatosensation. The SVTs of both foot soles were lower following tDCS as compared to sham and both pre-test conditions [F(1,76) > 3.4, p < 0.03]. A trend towards better TUG performance following tDCS was also observed [F(1,76) = 2.4, p = 0.07]. Greater improvement in SVT (averaged across feet) moderately correlated with greater improvement in TUG performance (r = 0.48, p = 0.03). These results suggest that tDCS may enhance lower-extremity somatosensory function, and potentially mobility, in healthy older adults.
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Affiliation(s)
- Junhong Zhou
- Hebrew SeniorLife Institute for Aging Research, Harvard Medical School, Roslindale, MA, USA. .,Beth Israel Deaconess Medical Center, Boston, MA, USA. .,Harvard Medical School, Boston, MA, USA. .,Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China.
| | - On-Yee Lo
- Hebrew SeniorLife Institute for Aging Research, Harvard Medical School, Roslindale, MA, USA.,Beth Israel Deaconess Medical Center, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Lewis A Lipsitz
- Hebrew SeniorLife Institute for Aging Research, Harvard Medical School, Roslindale, MA, USA.,Beth Israel Deaconess Medical Center, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Jue Zhang
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China. .,College of Engineering, Peking University, Beijing, China.
| | - Jing Fang
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China.,College of Engineering, Peking University, Beijing, China
| | - Brad Manor
- Hebrew SeniorLife Institute for Aging Research, Harvard Medical School, Roslindale, MA, USA.,Beth Israel Deaconess Medical Center, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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91
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Ashtiani MN, Azghani MR. Effects of visual and cognitive interference on joint contributions in perturbed standing: a temporal and spectral analysis. AUSTRALASIAN PHYSICAL & ENGINEERING SCIENCES IN MEDICINE 2017; 41:21-30. [PMID: 29210020 DOI: 10.1007/s13246-017-0606-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 11/20/2017] [Indexed: 11/25/2022]
Abstract
Postural balance requires using joint strategies which may be changed from normal conditions by interfering with the sensory information. The goal of the present study was to quantitatively evaluate the role of the joint mechanisms during perturbed stance. Visual and cognitive interference was imposed to sixteen healthy young males under rotational toes-down or up perturbations. Power spectral analysis was employed to distinguish the joint contribution and their in- or out-phase co-works. Results showed that addition of cognitive loads reduce the stability by increasing the center of mass (CoM) power to three times greater. Besides the CoM, the knee and hip powers were also significantly enhanced by the cognitive loads (p < .004), but the ankle was not influenced by cognition involvement (p > .05). Elimination of the vision had lower effect on the time and spectral functions of the knee and hip while the ankle rotations were increased due to the lack of visual feedback (p = .001). The toes-down perturbations resulted in more prominent contribution of the knee while the toes-up evoked the hip joint to keep the balance more than the other joints. Addition of the cognitive loads hindered the reactions of the joint mechanisms and vision caused more conservative responses of the joints.
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Affiliation(s)
- Mohammed N Ashtiani
- Faculty of Biomedical Engineering, Sahand University of Technology, P.O. Box 51335-1996, Tabriz, Iran.
| | - Mahmood-Reza Azghani
- Faculty of Biomedical Engineering, Sahand University of Technology, P.O. Box 51335-1996, Tabriz, Iran
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92
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Cruz-Montecinos C, Maas H, Pellegrin-Friedmann C, Tapia C. The importance of cutaneous feedback on neural activation during maximal voluntary contraction. Eur J Appl Physiol 2017; 117:2469-2477. [PMID: 29018954 DOI: 10.1007/s00421-017-3734-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Accepted: 10/02/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE The purpose of this study was to investigate the importance of cutaneous feedback on neural activation during maximal voluntary contraction (MVC) of the ankle plantar flexors. METHODS The effects of cutaneous plantar anaesthesia were assessed in 15 subjects and compared to 15 controls, using a one-day pre/post-repeated measures design. Cutaneous plantar anaesthesia was induced by lidocaine injection at the centre of forefoot, lateral midfoot, and heel. Each subject performed isometric MVCs of the ankle plantar flexors. During each isometric ramp contraction, the following variables were assessed: maximal isometric torque; surface electromyography (EMG) activity of the medial gastrocnemius (MG) and tibialis anterior (TA) muscles; and co-contraction index (CCI) between the MG and TA. RESULTS For ankle torque, two-way ANOVA showed no significant interaction between the pre/post-measurements × group (p = 0.166). However, MG activity presented significant interactions between the pre/post-measurements × group (p = 0.014). Post hoc comparisons indicated a decrease of MG activity in the experimental group, from 85.9 ± 11.9 to 62.7 ± 30.8% (p = 0.016). Additionally, the post-anaesthesia MG activity of the experimental group differed statistically with pre- and post-MG activity of the control group (p = 0.027 and p = 0.008, respectively). For TA activity and CCI, two-way ANOVA detected no significant interactions between the pre/post-measurements × group (p = 0.605 and p = 0.332, respectively). CONCLUSION Our results indicate that during MVC, cutaneous feedback modulates neural activity to MG muscle, without changing the extent of MG-TA co-contraction.
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Affiliation(s)
- Carlos Cruz-Montecinos
- Programa de Magister en Kinesiología y Biomecánica Clínica, Departamento de Kinesiología, Universidad Metropolitana de Ciencias de la Educación, Santiago, Chile.,Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile.,Laboratory of Biomechanics and Kinesiology, San José Hospital, Santiago, Chile
| | - Huub Maas
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 9, 1081 BT, Amsterdam, The Netherlands
| | | | - Claudio Tapia
- Facultad de Ciencias de la Rehabilitacion, Universidad Andres Bello, Fernandez Concha 700, Las Condes, Santiago, Chile. .,Department of Electrical Engineering, Universidad de Chile, Santiago, Chile.
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93
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Superficial plantar cutaneous sensation does not trigger barefoot running adaptations. Gait Posture 2017; 57:305-309. [PMID: 28728130 DOI: 10.1016/j.gaitpost.2017.06.269] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 06/13/2017] [Accepted: 06/26/2017] [Indexed: 02/02/2023]
Abstract
UNLABELLED It has long been proposed that the gait alterations associated with barefoot running are mediated by alterations in sensory feedback, yet there has been no data to support this claim. Thus, the purpose of this study was to examine the role of superficial plantar cutaneous feedback in barefoot and shod running. METHODS 10 healthy active subjects (6 male, 4 female); mass: 65.2+9.7kg; age: 27+7.1years participated in this study. 10 over-ground running trials were completed in each of the following conditions: barefoot (BF), shod (SHOD), anesthetized barefoot (ANEST BF) and anesthetized shod (ANEST SHOD). For the anesthetized conditions 0.1-0.3mL of 1% lidocaine was injected into the dermal layer of the plantar foot below the metatarsal heads, lateral column and heel. 3-dimensional motion analysis and ground reaction force (GRF) data were captured as subjects ran over a 20m runway with a force plate at 12m. Kinematic and kinetic differences were analyzed via two-way repeated measure ANOVAs. RESULTS The differences in gait between the BF and SHOD conditions were consistent with previous research, with subjects exhibiting a significant decrease in stride length and changing from rearfoot strike when SHOD to fore/midfoot strike when BF. Additionally, BF running was associated with decreased impact peak magnitudes and peak vertical GRFs. Despite anesthetizing the plantar surface, there was no difference between the BF and ANEST BF conditions in terms of stride length, foot strike or GRFs. CONCLUSION Superficial cutaneous sensory receptors are not primarily responsible for the gait changes associated with barefoot running.
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94
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Hu X, Ludvig D, Murray WM, Perreault EJ. Using Feedback Control to Reduce Limb Impedance during Forceful Contractions. Sci Rep 2017; 7:9317. [PMID: 28839242 PMCID: PMC5571169 DOI: 10.1038/s41598-017-10181-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 08/04/2017] [Indexed: 11/25/2022] Open
Abstract
Little is known about the ability to precisely regulate forces or torques during unexpected disturbances, as required during numerous tasks. Effective force regulation implies small changes in force responding to externally imposed displacements, a behavior characterized by low limb impedance. This task can be challenging, since the intrinsic impedance of muscles increases when generating volitional forces. The purpose of this study was to examine the ability to voluntarily reduce limb impedance during force regulation, and the neural mechanisms associated with that ability. Small displacement perturbations were used to quantify elbow impedance during the exertion of volitional elbow torques from 0% to 20% of maximum voluntary contraction. Subjects were instructed either to not intervene with the imposed perturbations or to explicitly intervene so as to minimize the influence of the perturbations on the elbow torque. Our results demonstrated that individuals can reduce the low frequency components of elbow impedance by 35%. Electromyographic analysis suggested that this behavior is mediated by volitional and possibly long-latency reflex pathways with delays of at least 120 ms. These results provide a context for understanding how feedback altered by aging or injuries may influence the ability to regulate forces precisely.
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Affiliation(s)
- Xiao Hu
- Departement of Biomedical Engineering, Northwestern University, Evanston, IL, USA. .,Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL, USA.
| | - Daniel Ludvig
- Departement of Biomedical Engineering, Northwestern University, Evanston, IL, USA.,Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL, USA.,Departement of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, USA
| | - Wendy M Murray
- Departement of Biomedical Engineering, Northwestern University, Evanston, IL, USA.,Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL, USA.,Departement of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, USA.,Research Service, Edward Hines, Jr. VA Hospital, Hines, IL, USA
| | - Eric J Perreault
- Departement of Biomedical Engineering, Northwestern University, Evanston, IL, USA.,Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL, USA.,Departement of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, USA
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95
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Strzalkowski NDJ, Ali RA, Bent LR. The firing characteristics of foot sole cutaneous mechanoreceptor afferents in response to vibration stimuli. J Neurophysiol 2017; 118:1931-1942. [PMID: 28679842 DOI: 10.1152/jn.00647.2016] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 06/12/2017] [Accepted: 06/27/2017] [Indexed: 12/13/2022] Open
Abstract
Single unit microneurography was used to record the firing characteristics of the four classes of foot sole cutaneous afferents [fast and slowly adapting type I and II (FAI, FAII, SAI, and SAII)] in response to sinusoidal vibratory stimuli. Frequency (3-250 Hz) and amplitude (0.001-2 mm) combinations were applied to afferent receptive fields through a 6-mm diameter probe. The impulses per cycle, defined as the number of action potentials evoked per vibration sine wave, were measured over 1 s of vibration at each frequency-amplitude combination tested. Afferent entrainment threshold (lowest amplitude at which an afferent could entrain 1:1 to the vibration frequency) and afferent firing threshold (minimum amplitude for which impulses per cycle was greater than zero) were then obtained for each frequency. Increases in vibration frequency are generally associated with decreases in expected impulses per cycle (P < 0.001), but each foot sole afferent class appears uniquely tuned to vibration stimuli. FAII afferents tended to have the lowest entrainment and firing thresholds (P < 0.001 for both); however, these afferents seem to be sensitive across frequency. In contrast to FAII afferents, SAI and SAII afferents tended to demonstrate optimal entrainment to frequencies below 20 Hz and FAI afferents faithfully encoded frequencies between 8 and 60 Hz. Contrary to the selective activation of distinct afferent classes in the hand, application of class-specific frequencies in the foot sole is confounded due to the high sensitivity of FAII afferents. These findings may aid in the development of sensorimotor control models or the design of balance enhancement interventions.NEW & NOTEWORTHY Our work provides a mechanistic look at the capacity of foot sole cutaneous afferents to respond to vibration of varying frequency and amplitude. We found that foot sole afferent classes are uniquely tuned to vibration stimuli; however, unlike in the hand, they cannot be independently activated by class-specific frequencies. Viewing the foot sole as a sensory structure, the present findings may aid in the refinement of sensorimotor control models and design of balance enhancement interventions.
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Affiliation(s)
| | - R Ayesha Ali
- Department of Mathematics and Statistics, University of Guelph, Guelph, Ontario, Canada; and
| | - Leah R Bent
- Department of Human Health and Nutritional Science, University of Guelph, Guelph, Ontario, Canada
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96
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Oshita K, Yano S. Influence of light finger touch on postural stability during upright stance with cold-induced plantar hypoesthesia. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2017:2526-2529. [PMID: 29060413 DOI: 10.1109/embc.2017.8037371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The present study investigated the influence of light finger touch on postural stability during an upright stance with or without cold-induced plantar hypoesthesia. Participants were 21 healthy right-handed men (20-33 years), randomly assigned to a normal temperature group (NML-group; n = 11) or cold-induced plantar hypoesthesia group (COLD-group; n = 10). Participants performed two standing tasks with their eyes closed: 1) stand upright with the feet comfortably apart (normal standing); and 2) with the feet together in a side-by-side stance (Romberg standing). The order of the tasks was randomized across participants. After a rest period, they were asked to perform each standing task and let their right index finger lightly touch the fixed surface. Before the each task, participants in the COLD group were conducted a plantar intermediate hypothermic exposure. Postural sway was decreased by providing additional haptic sensory input through the light touching regardless of standing task difficulty with a normal plantar temperature. Although postural sway under plantar hypoesthesia is decreased by light touching, the effect was greater during the difficult posture task. These results suggest that, when the sensory information from the plantar surface is decreased, additional haptic input from the hand or finger might provide supplementary information about the relative changes in one's own body orientation. Therefore, sensory information provided by touching became relatively more important to maintaining postural control during the relatively difficult postural task performed under the reduced plantar sensitivity condition.
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97
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Coelho DB, Teixeira LA. Cognition and balance control: does processing of explicit contextual cues of impending perturbations modulate automatic postural responses? Exp Brain Res 2017; 235:2375-2390. [PMID: 28493066 DOI: 10.1007/s00221-017-4980-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 05/06/2017] [Indexed: 01/12/2023]
Abstract
Processing of predictive contextual cues of an impending perturbation is thought to induce adaptive postural responses. Cueing in previous research has been provided through repeated perturbations with a constant foreperiod. This experimental strategy confounds explicit predictive cueing with adaptation and non-specific properties of temporal cueing. Two experiments were performed to assess those factors separately. To perturb upright balance, the base of support was suddenly displaced backwards in three amplitudes: 5, 10 and 15 cm. In Experiment 1, we tested the effect of cueing the amplitude of the impending postural perturbation by means of visual signals, and the effect of adaptation to repeated exposures by comparing block versus random sequences of perturbation. In Experiment 2, we evaluated separately the effects of cueing the characteristics of an impending balance perturbation and cueing the timing of perturbation onset. Results from Experiment 1 showed that the block sequence of perturbations led to increased stability of automatic postural responses, and modulation of magnitude and onset latency of muscular responses. Results from Experiment 2 showed that only the condition cueing timing of platform translation onset led to increased balance stability and modulation of onset latency of muscular responses. Conversely, cueing platform displacement amplitude failed to induce any effects on automatic postural responses in both experiments. Our findings support the interpretation of improved postural responses via optimized sensorimotor processes, at the same time that cast doubt on the notion that cognitive processing of explicit contextual cues advancing the magnitude of an impending perturbation can preset adaptive postural responses.
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Affiliation(s)
- Daniel Boari Coelho
- Human Motor Systems Laboratory, School of Physical Education and Sport, University of São Paulo, Av. Prof. Mello Moraes, 65, São Paulo, SP, 05508-030, Brazil.
| | - Luis Augusto Teixeira
- Human Motor Systems Laboratory, School of Physical Education and Sport, University of São Paulo, Av. Prof. Mello Moraes, 65, São Paulo, SP, 05508-030, Brazil
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98
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Hettigama IS, Punchihewa HKG, Heenkenda NK. Ergonomic footwear for Sri Lankan primary schoolchildren: A review of the literature. Work 2017; 55:285-295. [PMID: 27689598 DOI: 10.3233/wor-162415] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Foot ailments are common among schoolchildren, some of which may be attributed to wearing ill-fitting footwear. As schoolchildren often participate in athletic activity, they are doubly vulnerable to foot ailments, and are particularly vulnerable to conditions such as hallux valgus, Achilles tendonitis, athlete's foot, corns and calluses. Thus, there is an acute need for the design and manufacture of ergonomic footwear for this target group. While research on appropriate footwear for children has been carried out in relation to child populations in other societies, research on the circumstances of Sri Lankan schoolchildren is lacking. Neither the requisite design know-how nor the information for design is available to footwear manufacturers. OBJECTIVES This review of the literature is aimed at confirming the need for ergonomic footwear from the point of view of the effects of wearing ill-fitting shoes and at identifying the requirements in terms of design information, especially for schoolchildren of the age group five to ten years, to empower footwear manufacturers. METHODS PubMed, Google scholar and Science Direct were used for the literature search. RESULTS 208 publications were read in full, 94 of which are referenced in this review. CONCLUSION The review shows morphological measurements, behavior and activity patterns of schoolchildren and environmental conditions they are exposed to should be determined to formulate design information.
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Affiliation(s)
- I S Hettigama
- Department of Mechanical Engineering, University of Moratuwa, Sri Lanka
| | - H K G Punchihewa
- Department of Mechanical Engineering, University of Moratuwa, Sri Lanka
| | - N K Heenkenda
- Department of Textile and Clothing Technology, University of Moratuwa, Katubedda, Western Province, Sri Lanka
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Goel R, De Dios YE, Gadd NE, Caldwell EE, Peters BT, Reschke MF, Bloomberg JJ, Oddsson LIE, Mulavara AP. Assessing Somatosensory Utilization during Unipedal Postural Control. Front Syst Neurosci 2017; 11:21. [PMID: 28443004 PMCID: PMC5387047 DOI: 10.3389/fnsys.2017.00021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 03/27/2017] [Indexed: 11/13/2022] Open
Abstract
Multisensory-visual, vestibular and somatosensory information is integrated for appropriate postural control. The primary goal of this study was to assess somatosensory utilization during a functional motor task of unipedal postural control, in normal healthy adults. Assessing individual bias in the utilization of individual sensory contributions during postural control may help customization of rehabilitation protocols. In this study, a test paradigm of unipedal stance control in supine orientation with and without vision was assessed. Postural control in this test paradigm was hypothesized to utilize predominantly contributions of somatosensory information from the feet and ankle joint, with minimal vestibular input. Fourteen healthy subjects "stood" supine on their dominant leg while strapped to a backpack frame that was freely moving on air-bearings, to remove available otolith tilt cues with respect to gravity that influences postural control when standing upright. The backpack was attached through a cable to a pneumatic cylinder that provided a gravity-like load. Subjects performed three trials each with Eyes-open (EO) and Eyes-closed (EC) while loaded with 60% body weight. There was no difference in unipedal stance time (UST) across the two conditions with EC condition challenging the postural control system greater than the EO condition. Stabilogram-diffusion analysis (SDA) indicated that the critical mean square displacement was significantly different between the two conditions. Vestibular cues, both in terms of magnitude and the duration for which relevant information was available for postural control in this test paradigm, were minimized. These results support our hypothesis that maintaining unipedal stance in supine orientation without vision, minimizes vestibular contribution and thus predominantly utilizes somatosensory information for postural control.
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Affiliation(s)
- Rahul Goel
- Department of Health and Human Performance, University of HoustonHouston, TX, USA
| | | | | | | | | | | | | | - Lars I E Oddsson
- Department of Physical Medicine and Rehabilitation, Program in Rehabilitation Science, University of MinnesotaMinneapolis, MN, USA.,Recaniti School for Community Health Professions, Ben-Gurion University of the NegevBeersheba, Israel
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100
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Bae Y. Saccadic Eye Movement Improves Plantar Sensation and Postural Balance in Elderly Women. TOHOKU J EXP MED 2017; 239:159-64. [PMID: 27302207 DOI: 10.1620/tjem.239.159] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Vision, proprioception and plantar sensation contribute to the control of postural balance (PB). Reduced plantar sensation alters postural response and is at an increased risk of fall, and eye movements reduce the postural sway. Therefore, the aim of this study was to study the improvement of plantar sensation and PB after saccadic eye movement (SEM) and pursuit eye movement (PEM) in community-dwelling elderly women. Participants (104 females; 75.11 ± 6.25 years) were randomly allocated into the SEM group (n = 52) and PEM groups (n = 52). The SEM group performed eye fixation and SEM for 5 minutes, and the PEM group performed eye fixation and PEM for 5 minutes. The plantar sensation was measured according to the plantar surface area of the feet in contact with the floor surface before and after the intervention. Before and after SEM and PEM with the eyes open and closed, PB was measured as the area (mm(2)), length (cm), and velocity (cm/s) of the fluctuation of the center of pressure (COP). The plantar sensation of both feet improved in both groups (p < 0.01). Significant decreases in the area, length, and velocity of the COP were observed in the eye open and close in both groups (p < 0.01). The length and velocity of the COP significantly decreased in the SEM group compared to the PEM group (p < 0.05). In conclusion, SEM and PEM are effective interventions for improving plantar sensation and PB in elderly women, with greater PB improvement after SEM.
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Affiliation(s)
- Youngsook Bae
- Department of Physical Therapy, College of Health Science, Gachon University
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