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Shoja O, Shojaei M, Hassanlouei H, Towhidkhah F, Zhang L. Quantifying Human Gait Symmetry During Blindfolded Treadmill Walking. Motor Control 2024; 28:225-240. [PMID: 38402881 DOI: 10.1123/mc.2023-0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 12/20/2023] [Accepted: 01/05/2024] [Indexed: 02/27/2024]
Abstract
Bilateral gait symmetry is an essential requirement for normal walking since asymmetric gait patterns increase the risk of falls and injuries. While human gait control heavily relies on the contribution of sensory inputs, the role of sensory systems in producing symmetric gait has remained unclear. This study evaluated the influence of vision as a dominant sensory system on symmetric gait production. Ten healthy adults performed treadmill walking with and without vision. Twenty-two gait parameters including ground reaction forces, joint range of motion, and other spatial-temporal gait variables were evaluated to quantify gait symmetry and compared between both visual conditions. Visual block caused increased asymmetry in most parameters of ground reaction force, however mainly in the vertical direction. When vision was blocked, symmetry of the ankle and knee joint range of motion decreased, but this change did not occur in the hip joint. Stance and swing time symmetry decreased during no-vision walking while no significant difference was found for step length symmetry between the two conditions. This study provides a comprehensive analysis to reveal how the visual system influences bilateral gait symmetry and highlights the important role of vision in gait control. This approach could be applied to investigate how vision alters gait symmetry in patients with disorders to help better understand the role of vision in pathological gaits.
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Affiliation(s)
- Otella Shoja
- Faculty of Sport Sciences, Department of Motor Behavior, Alzahra University, Tehran, Iran
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada
- Department of Neuroscience, Institute of Biomedical Engineering, University of Montreal, Montreal, QC, Canada
| | - Masoumeh Shojaei
- Faculty of Sport Sciences, Department of Motor Behavior, Alzahra University, Tehran, Iran
| | - Hamidollah Hassanlouei
- Faculty of Sport Science and Health, Department of Motor Behavior, Shahid Beheshti University, Tehran, Iran
| | - Farzad Towhidkhah
- Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Lei Zhang
- Institute for Neural Computation, Ruhr University Bochum, Bochum, Germany
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Carretti G, Manetti M, Marini M. Physical activity and sport practice to improve balance control of visually impaired individuals: a narrative review with future perspectives. Front Sports Act Living 2023; 5:1260942. [PMID: 37780118 PMCID: PMC10534048 DOI: 10.3389/fspor.2023.1260942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 08/31/2023] [Indexed: 10/03/2023] Open
Abstract
Visual disability negatively impacts balance, everyday self-efficacy, and mobility and often leads affected subjects to perceive physical exercise as a burdensome challenge thus discouraging them from practicing. Despite the well-proven benefits of regular physical activity in visually impaired people, especially addressing postural control, there are no specific guidelines and most of the available literature seems to be flawed by critical issues. Given the wide heterogeneity and the multidimensional needs of this population, a more realistic and target-specific perspective is needed in order to properly investigate and promote exercise practice and adherence for balance improvement. On this basis, through a critical overview of the recent literature, the present article aimed to enrich the current knowledge about this topic by providing innovative suggestions, both practical and methodological, and specifically deepening the disability-related deficits and peculiarities of different age ranges. Moreover, since a multidisciplinary approach is advisable when designing and leading exercise protocols tailored to visually impaired individuals, such innovative hints also highlighted the central role of the adapted physical activity specialist, hence contributing to foster its official professional recognition and involvement in this field.
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Affiliation(s)
| | | | - Mirca Marini
- Section of Anatomy and Histology, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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Carretti G, Bianco R, Sgambati E, Manetti M, Marini M. Reactive Agility and Pitching Performance Improvement in Visually Impaired Competitive Italian Baseball Players: An Innovative Training and Evaluation Proposal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6166. [PMID: 37372753 DOI: 10.3390/ijerph20126166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 05/26/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023]
Abstract
Visual input significantly affects kinesthesis skills and, hence, visually impaired individuals show less developed sensorimotor control, especially in an unfamiliar outdoor environment. Regular blind baseball practice can counteract such a deficit but, given the complex kinetic chain model required, a targeted workout proposal is needed to improve the main athletic gesture performance. On these premises, we investigated, for the first time, the running and pitching performance of a competitive Italian blind baseball team through quantitative tools and parameters such as Libra Easytech sensorized proprioceptive board, goniometric active range of motion, chronometric speed, and pitching linear length. Moreover, the perceived physical exertion was assessed by the Borg CR10 scale. Consequently, an adapted athletic training protocol was designed and tested on the field during the competitive season, with the aim to strengthen sport specific-gesture coordination and efficacy as well as to prevent injuries. Quantitative assessments showed an improvement in ankle stability index, bilateral upper limb and hip mobility, reactive agility, running braking phase control during second base approaching, and auditory target-related pitching accuracy along with a decrease in perceived physical exertion. This protocol might therefore represent an effective and easily reproducible training and evaluation approach to tailor management of visually impaired baseball players, and safely improve their athletic performance under the supervision of an adapted exercise specialist.
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Affiliation(s)
- Giuditta Carretti
- Section of Anatomy and Histology, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Raffaele Bianco
- Section of Anatomy and Histology, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Eleonora Sgambati
- Department of Biosciences and Territory, University of Molise, 86090 Pesche, Italy
| | - Mirko Manetti
- Section of Anatomy and Histology, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Mirca Marini
- Section of Anatomy and Histology, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
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Shoja O, Shojaei M, Hassanlouei H, Towhidkhah F, Amiri M, Boroomand H, Rahimi N, Zhang L. Lack of visual information alters lower limb motor coordination to control center of mass trajectory during walking. J Biomech 2023; 155:111650. [PMID: 37245385 DOI: 10.1016/j.jbiomech.2023.111650] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 05/09/2023] [Accepted: 05/19/2023] [Indexed: 05/30/2023]
Abstract
Vision, as queen of the senses, plays a critical role in guiding locomotion. Little is known about the effects of vision on gait coordination in terms of variability. The uncontrolled manifold (UCM) approach offers a window to the structure of motor variability that has been difficult to obtain from the traditional correlation analysis. In this study, we used the UCM analysis to quantify how the lower limb motion is coordinated to control the center of mass (COM) while walking under different visual conditions. We also probed how synergy strength evolved along the stance phase. Ten healthy participants walked on the treadmill with and without visual information. Leg joint angle variance with respect to the whole-body COM was partitioned into good (i.e., the one that kept the COM) and bad (i.e., the one that changed the COM) variances. We observed that after vision was eliminated, both variances increased throughout the stance phase while the strength of the synergy (the normalized difference between the two variances) decreased significantly and even reduced to zero at heel contact. Thus, walking with restricted vision alters the strength of the kinematic synergy to control COM in the plane of progression. We also found that the strength of this synergy varied across different walking phases and gait events in both visual conditions. We concluded that the UCM analysis can quantify altered coordination of COM when vision is blocked and sheds insights on the role of vision in the synergistic control of locomotion.
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Affiliation(s)
- Otella Shoja
- Department of Motor Behavior, Faculty of Sport Sciences, Alzahra University, Tehran, Iran; Department of Neuroscience, University of Montreal, Montreal, QC, Canada.
| | - Masoumeh Shojaei
- Department of Motor Behavior, Faculty of Sport Sciences, Alzahra University, Tehran, Iran
| | - Hamidollah Hassanlouei
- Department of Motor Behavior, Faculty of Sport Sciences and Health, Shahid Beheshti University, Tehran, Iran
| | - Farzad Towhidkhah
- Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Mohsen Amiri
- Department of Mechanical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Hesam Boroomand
- Department of Mechanical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Negar Rahimi
- Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Lei Zhang
- Institute for Neural Computation, Ruhr University Bochum, Germany
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Crisafulli O, Ravizzotti E, Mezzarobba S, Cosentino C, Bonassi G, Botta A, Abbruzzese G, Marchese R, Avanzino L, Pelosin E. A gait-based paradigm to investigate central body representation in cervical dystonia patients. Neurol Sci 2023; 44:1311-1318. [PMID: 36534193 DOI: 10.1007/s10072-022-06548-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Cervical dystonia (CD) is a common adult-onset idiopathic form of dystonia characterized by an abnormal head posture caused by an excessive activity of the neck muscles. The position of the head is important to direct viewpoint in the rounding environment, and the body orientation, during gait, must be coherent with the subjective straight ahead (SSA). An alteration of the SSA, as in the case of CD patients, could affect gait when visual input is not available. The aim of this study was to probe the behavior of patients with CD during blindfolded walking, investigating the ability to walk straight ahead based only on somatosensory and vestibular information. METHODS In this observational cross-sectional study, patients with CD and healthy control subjects (HC) were compared. All participants were evaluated through a gait analysis during blindfolded walking on a GAITRite carpet, relying on their own sense of straightness. RESULTS Patients with CD showed lower values of path length (p < 0.001), a lower number of steps on the carpet (p < 0.001). A higher number of CD patients deviated during the task, walking out of the carpet, (p < 0.005) compared to HS. No relation was found between the dystonic side and the gait trajectory deviation. A significant correlation was found between pain symptom and gait performance. CONCLUSIONS CD patients showed dysfunctions in controlling dynamic body location during walking without visual afferences, while the dystonic side does not seem to be related to the lateral deviation of the trajectory. Our results would assume that a general proprioceptive impairment could lead to an improper body position awareness in patients with CD.
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Affiliation(s)
- O Crisafulli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - E Ravizzotti
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health (DINOGMI), University of Genoa, Largo P. Daneo 3, 16132, Rehabilitation Genoa, Ophthalmology, Italy
| | - S Mezzarobba
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health (DINOGMI), University of Genoa, Largo P. Daneo 3, 16132, Rehabilitation Genoa, Ophthalmology, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - C Cosentino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health (DINOGMI), University of Genoa, Largo P. Daneo 3, 16132, Rehabilitation Genoa, Ophthalmology, Italy
| | - G Bonassi
- S.C. Medicina Fisica e Riabilitazione Ospedaliera, Azienda Sanitaria Locale Chiavarese, 16043, Chiavari, Italy
| | - A Botta
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - G Abbruzzese
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health (DINOGMI), University of Genoa, Largo P. Daneo 3, 16132, Rehabilitation Genoa, Ophthalmology, Italy
| | - R Marchese
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - L Avanzino
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Experimental Medicine (DIMES), Section of Human Physiology, University of Genoa, Genoa, Italy
| | - E Pelosin
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health (DINOGMI), University of Genoa, Largo P. Daneo 3, 16132, Rehabilitation Genoa, Ophthalmology, Italy.
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
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Ao M, Ren S, Yu Y, Huang H, Miao X, Ao Y, Wang W. The effects of blurred visual inputs with different levels on the cerebral activity during free level walking. Front Neurosci 2023; 17:1151799. [PMID: 37139527 PMCID: PMC10149992 DOI: 10.3389/fnins.2023.1151799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 03/20/2023] [Indexed: 05/05/2023] Open
Abstract
Objective The aim of this study was to evaluate the effects of blurred vision on electrocortical activities at different levels during walking. Materials and methods A total of 22 healthy volunteers (all men; mean age: 24.4 ± 3.9 years) underwent an electroencephalography (EEG) test synchronous with free level walking. Visual status was simulated by goggles covered by the occlusion foil targeted at a Snellen visual acuity of 20/60 (V0.3), 20/200 (V0.1), and light perception (V0). At each of these conditions, the participants completed barefoot walking for five blocks of 10 m. The EEG signals were recorded by a wireless EEG system with electrodes of interest, namely, Cz, Pz, Oz, O1, and O2. The gait performances were assessed by the Vicon system. Results During walking with normal vision (V1.0), there were cerebral activities related to visual processing, characterized as higher spectral power of delta (Oz and O2 vs. Cz, Pz, and O1, p ≤ 0.033) and theta (Oz vs. Cz and O1, p = 0.044) bands in occipital regions. Moderately blurred vision (V0.3) would attenuate the predominance of delta- and theta-band activities at Oz and O2, respectively. At the statuses of V0.1 and V0, the higher power of delta (at V0.1 and V0, Oz, and O2 vs. Cz, Pz, and O1, p ≤ 0.047) and theta bands (at V0.1, Oz vs. Cz, p = 0.010; at V0, Oz vs. Cz, Pz, and O1, p ≤ 0.016) emerged again. The cautious gait pattern, characterized by a decrease in gait speed (p < 0.001), a greater amplitude of deviation from the right ahead (p < 0.001), a prolonged stance time (p = 0.001), a restricted range of motion in the hip on the right side (p ≤ 0.010), and an increased knee flexion during stance on the left side (p = 0.014), was only detected at the status of V0. The power of the alpha band at the status of V0 was higher than that at V1.0, V0.3, and V0.1 (p ≤ 0.011). Conclusion Mildly blurred visual inputs would elicit generalization of low-frequency band activity during walking. In circumstance to no effective visual input, locomotor navigation would rely on cerebral activity related to visual working memory. The threshold to trigger the shift might be the visual status that is as blurred as the level of Snellen visual acuity of 20/200.
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Affiliation(s)
- Mingxin Ao
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Shuang Ren
- Department of Sports Medicine, Institute of Sports Medicine of Peking University, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Beijing, China
| | - Yuanyuan Yu
- Department of Sports Medicine, Institute of Sports Medicine of Peking University, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Beijing, China
| | - Hongshi Huang
- Department of Sports Medicine, Institute of Sports Medicine of Peking University, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Beijing, China
| | - Xin Miao
- Department of Sports Medicine, Institute of Sports Medicine of Peking University, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Beijing, China
| | - Yingfang Ao
- Department of Sports Medicine, Institute of Sports Medicine of Peking University, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Beijing, China
- *Correspondence: Yingfang Ao
| | - Wei Wang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
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Kreter N, Lybbert C, Gordon KE, Fino PC. The effects of physical and temporal certainty on human locomotion with discrete underfoot perturbations. J Exp Biol 2022; 225:jeb244509. [PMID: 36124619 PMCID: PMC9659331 DOI: 10.1242/jeb.244509] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 09/05/2022] [Indexed: 11/20/2022]
Abstract
Foot placement can be selected to anticipate upcoming perturbations, but it is unclear how this anticipatory strategy is influenced by available response time or precise knowledge of the perturbation's characteristics. This study investigates anticipatory and reactive locomotor strategies for repeated underfoot perturbations with varying levels of temporal certainty, physical certainty, and available response time. Thirteen healthy adults walked with random underfoot perturbations from a mechanized shoe. Temporal certainty was challenged by presenting the perturbations with or without warning. Available response time was challenged by adjusting the timing of the warning before the perturbation. Physical certainty was challenged by making perturbation direction (inversion or eversion) unpredictable for certain conditions. Linear-mixed effects models assessed the effect of each condition on the percentage change of margin of stability and step width. For perturbations with one stride or less of response time, we observed few changes to step width or margin of stability. As response time increased to two strides, participants adopted wider steps in anticipation of the perturbation (P=0.001). Physical certainty had little effect on gait for the step of the perturbation, but participants recovered normal gait sooner when the physical nature of the perturbation was predictable (P<0.001). Despite having information about the timing and direction of upcoming perturbations, individuals do not develop perturbation-specific feedforward strategies. Instead, they use feedback control to recover normal gait after a perturbation. However, physical certainty appears to make the feedback controller more efficient and allows individuals to recover normal gait sooner.
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Affiliation(s)
- Nicholas Kreter
- Department of Health and Kinesiology, University of Utah, 250 South 1850 East, Salt Lake City, UT 84112, USA
| | - Carter Lybbert
- Department of Health and Kinesiology, University of Utah, 250 South 1850 East, Salt Lake City, UT 84112, USA
| | - Keith E. Gordon
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, 645 N Michigan Ave, Suite. 1100, Chicago, IL 60611, USA
| | - Peter C. Fino
- Department of Health and Kinesiology, University of Utah, 250 South 1850 East, Salt Lake City, UT 84112, USA
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Nam SM, Lee DY. Effects of Visual Cue Deprivation Balance Training with Head Control on Balance and Gait Function in Stroke Patients. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:629. [PMID: 35630046 PMCID: PMC9148052 DOI: 10.3390/medicina58050629] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Visual cue deprivation is the instability of head control is increased. The purpose of this study is to investigate the effects of visual cue deprivation balance training by applying head control feedback to the balance and gait ability of stroke patients. Materials and Methods: The study was conducted on 41 patients diagnosed with hemiplegia due to stroke. Subjects were randomly assigned to any of the following groups: the experimental group I, the experimental group II or the control group. The randomization method used a simple randomization method. To evaluate changes in balance function, a LOS (Limit of Stability) and a BBS (Berg Balance Scale) were performed. In addition, to evaluate changes in ST (stride time), SL (stride length), and cadence, a LEGSys were performed. Results: A two-way repeated ANOVA was conducted to analyze the differences between groups. There were significant differences between groups in all variables for the balance function. There were significant differences between groups in all variables for the balance function. There were significant differences between groups in SL and cadence for the gait function. Conclusions: Visual cue deprivation balance training applying head control feedback is effective in improving dynamic balance ability and cadence. It is necessary to constantly maintain the head orientation by feedback and to properly control the head movement.
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Affiliation(s)
- Seung-Min Nam
- Department of Sports Rehabilitation & Exercise Management, Yeungnam University College, Daegu-si 42415, Korea;
| | - Do-Youn Lee
- Department of Physical Therapy, Daegu University, Gyeongsan-si 38541, Korea
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Luo Y, Yang F, Yerebakan MO, Zhang J, Hu B. Load Carriage Modes and Limb Crossing Patterns Altered Gait during Obstacle Negotiation. J Mot Behav 2022; 54:525-536. [PMID: 35021959 DOI: 10.1080/00222895.2021.2017837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Personal and environmental factors both increase the likelihood of falling injuries while negotiating obstacles. Eighteen male participants (seven older, eleven young) were recruited to walk over an obstacle with and without loads on their hands to study the effects of age, load carriage modes, and limb crossing patterns on gait during obstacle negotiation. Participants initiated tasks with either their dominant or non-dominant leg. Step length (SL), toe clearance (TC), step velocity (V), and step width (SW) were extracted from four critical steps. Results showed that during obstacle negotiation (1) older adults had more TC than younger adults, (2) hand loads affected SL and TC, (3) gait parameters are dissimilar between the dominant limb and non-dominant limb.
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Affiliation(s)
- Yue Luo
- Human System Engineering Laboratory, Department of Industrial and Systems Engineering, University of Florida, Gainesville, Florida
| | - Fang Yang
- School of Mechanical Engineering, Tianjin University of Science and Technology, Tianjin, China
| | - Mustafa Ozkan Yerebakan
- Human System Engineering Laboratory, Department of Industrial and Systems Engineering, University of Florida, Gainesville, Florida
| | - Junxia Zhang
- School of Mechanical Engineering, Tianjin University of Science and Technology, Tianjin, China
| | - Boyi Hu
- Human System Engineering Laboratory, Department of Industrial and Systems Engineering, University of Florida, Gainesville, Florida
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Kimijanová J, Hirjaková Z, Bzdúšková D, Hlavačka F. Influence of vision on gait initiation and first step kinematics in young and older adults. Physiol Res 2021; 70:S409-S417. [PMID: 35099259 DOI: 10.33549/physiolres.934813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The study investigated whether anticipatory postural adjustments (APAs) of gait initiation and kinematics of the first step are modified with absence of vision in relation to age. Twenty-two young and twenty-two older subjects initiated a self-paced gait with the vision available and deprived. APAs were measured by: (1) force platform and evaluated by maximal amplitude of the center of pressure (CoP) displacements; (2) two inertial sensors attached to the trunk and evaluated by maximal accelerations. Step kinematics was recorded using a motion capture system and evaluated by duration, length and maximal velocity of the first step. Visual deprivation led to a significant reduction of forward trunk accelerations during the anticipatory phase of stepping in older adults. Moreover, they significantly reduced first step length and maximal velocity and prolonged duration of the first step. Contrary, young adults did not respond to absence of vision by significant changes of neither APAs, nor first step kinematics. These findings suggest that gait initiation is strongly associated with increased reliance on vision in older adults. We further indicate that trunk accelerations during the anticipatory phase of stepping may be a more sensitive measure to detect age-related changes of APAs due to absent visual information compared to CoP.
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Affiliation(s)
- J Kimijanová
- Department of Behavioural Neuroscience, Institute of Normal and Pathological Physiology, Centre of Experimental Medicine, Slovak Academy of Sciences, Bratislava, Slovak Republic.
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Anticipatory control of human gait following simulated slip exposure. Sci Rep 2020; 10:9599. [PMID: 32541837 PMCID: PMC7295774 DOI: 10.1038/s41598-020-66305-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 05/15/2020] [Indexed: 01/10/2023] Open
Abstract
A cautious gait (CG), marked by wider and shorter steps, is typically employed to mitigate expected perturbations proactively. However, it is not well understood if and how CG is informed by the task requirements. Therefore, we assessed how CG is adjusted to these requirements. Three groups of ten healthy young adults were exposed to a single uninterrupted protocol of treadmill walking that consisted of three distinct phases. Spatiotemporal step characteristics and margins of stability of the unperturbed strides were compared when participants were (i) only warned of a perturbation, (ii) exposed to fifty unilateral (right) slip-like perturbations and (iii) kept unaware of perturbation removal. Only the perturbation intensity predictability differed between groups. This was either kept consistent or pseudo-randomly or randomly varied. Participants walked with wider and shorter steps following the perturbation warning. However, this extinguished in continuing perturbation absence. Next, during perturbation exposure, participants shortened the step of the perturbed but increased the step of the unperturbed leg. This did not differ between groups. Finally, participants persisted in displaying CG on perturbation removal, but this extinguished over time. Collectively, we show that CG is functionally adjusted to the task requirements. These findings may have practical implications for fall-prevention training.
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Visual deprivation is met with active changes in ground reaction forces to minimize worsening balance and stability during walking. Exp Brain Res 2020; 238:369-379. [PMID: 31927697 DOI: 10.1007/s00221-020-05722-0] [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] [Received: 07/20/2019] [Accepted: 01/02/2020] [Indexed: 10/25/2022]
Abstract
Previous studies suggest that visual information is essential for balance and stability of locomotion. We investigated whether visual deprivation is met with active reactions tending to minimize worsening balance and stability during walking in humans. We evaluated effects of vision on kinetic characteristics of walking on a treadmill-ground reaction forces (GRFs) and shifts in the center of mass (COM). Young adults (n = 10) walked on a treadmill at a comfortable speed. We measured three orthogonal components of GRFs and COM shifts during no-vision (NV) and full-vision (FV) conditions. We also computed the dynamic balance index (DN)-the perpendicular distance from the projection of center of mass (pCOM) to the inter-foot line (IFL) normalized to half of the foot length. Locally weighted regression smoothing with alpha-adjusted serial T tests was used to compare GRFs and DN between two conditions during the entire stance phase. Results showed significant differences in GRFs between FV and NV conditions in vertical and ML directions. Variability of peak forces of all three components of GRF increased in NV condition. We also observed significant increase in DN for NV condition in eight out of ten subjects. The pCOM was kept within BOS during walking, in both conditions, suggesting that body stability was actively controlled by adjusting three components of GRFs during NV walking to minimize stability loss and preserve balance.
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The higher they go the harder they could fall: The impact of risk-glorifying commercials on risk behavior. PLoS One 2019; 14:e0225884. [PMID: 31794575 PMCID: PMC6890243 DOI: 10.1371/journal.pone.0225884] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 11/14/2019] [Indexed: 11/19/2022] Open
Abstract
Previous research on risk-glorifying media has provided encompassing evidence for a positive connection between risk-glorifying contents and (a) risk-positive emotions, (b) risk-positive cognitions and attitudes, and (c) risk-positive behavioral inclinations. Nevertheless, little evidence shows whether risk-glorifying content increases actual risk behavior. We conducted three experimental studies to assess whether risk-glorifying commercials increase risk behavior. In all studies, participants were randomly assigned to a risk-glorifying or a neutral commercial. Additionally, in Study 2 participants were randomly assigned to an arousal or a non-arousal condition to test the mediating effect of arousal. In Study 3, we tested the mediating effect of the accessibility to risk-positive cognitions. We measured participants’ risk behavior via the risk assessment ramp (RAR). Our results revealed that participants who watched the risk-glorifying commercial walked faster to the jumping-off point (Studies 1, 2, & 3) and would have jumped from a higher level (Studies 2 & 3), thus, indicating the exposure to risk-glorifying media content increases people’s risk behavior. Neither arousal nor the accessibility to risk-positive cognitions mediated the effect of risk-glorifying media content. Beyond our findings, we offer a new tool to assess risk behavior that is effective and easy to apply.
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14
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Alghadir AH, Alotaibi AZ, Iqbal ZA. Postural stability in people with visual impairment. Brain Behav 2019; 9:e01436. [PMID: 31578824 PMCID: PMC6851802 DOI: 10.1002/brb3.1436] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 09/04/2019] [Accepted: 09/14/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The visual system enables the brain to assess information regarding the position of the body in space. Congenital or acquired blindness leads to the development of abnormal sensory-motor interactions that results in development of typical musculoskeletal deformities and gait patterns that cause disability. Diabetes and related complications are expected to increase exponentially in the next 10 years; thus, the number of people with visual impairment is expected to increase. However, there have been few studies regarding etio-pathogenesis of postural alteration and balance impairment in people with visual impairment; moreover, no previous study has investigated postural stability in this population. This study aimed to assess the center of gravity (COG) velocity in subjects with visual impairment and compared with that in sighted subjects. METHODS Seventy male subjects, 20-40 years of age, participated in this study; they were divided into sighted (control) and visually impaired groups. COG velocity while standing on an unstable surface was measured using the NeuroCom® Balance Master Version 8.5.0. For the sighted group, data were recorded with eyes open and then with eyes closed. For the visually impaired group, no instructions were given with respect to eyes during data collection. RESULTS Mean COG velocity was significantly higher in the visually impaired group than in the sighted group with eyes open. However, there was no difference in mean COG velocity between the visually impaired group and the sighted group with eyes closed. The difference in mean COG velocity between sighted subjects with eyes open and eyes closed was also significant. Mean COG velocity while standing on a foam surface varied among visually impaired subjects and sighted subjects with eyes open and closed. CONCLUSION This study showed that subjects with visual impairment, regardless of eye opening or closure, behave in the same manner as sighted subjects with eyes closed.
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Affiliation(s)
- Ahmad H Alghadir
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah Z Alotaibi
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Zaheen A Iqbal
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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15
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Felgerolle C, Hébert B, Ardourel M, Meyer-Dilhet G, Menuet A, Pinto-Morais K, Bizot JC, Pichon J, Briault S, Perche O. Visual Behavior Impairments as an Aberrant Sensory Processing in the Mouse Model of Fragile X Syndrome. Front Behav Neurosci 2019; 13:228. [PMID: 31680892 PMCID: PMC6797836 DOI: 10.3389/fnbeh.2019.00228] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 09/12/2019] [Indexed: 12/02/2022] Open
Abstract
Fragile X Syndrome (FXS), the most common inherited form of human intellectual disability (ID) associated with autistic-like behaviors, is characterized by dys-sensitivity to sensory stimuli, especially vision. In the absence of Fragile Mental Retardation Protein (FMRP), both retinal and cerebral structures of the visual pathway are impaired, suggesting that perception and integration of visual stimuli are altered. However, behavioral consequences of these defects remain unknown. In this study, we used male Fmr1−/y mice to further define visual disturbances from a behavioral perspective by focusing on three traits characterizing visual modality: perception of depth, contrasts and movements. We performed specific tests (Optomotor Drum, Visual Cliff) to evaluate these visual modalities, their evolution from youth to adulthood, and to assess their involvement in a cognitive task. We show that Fmr1−/y mice exhibit alteration in their visual skills, displaying impaired perspective perception, a drop in their ability to understand a moving contrasted pattern, and a defect in contrasts discrimination. Interestingly, Fmr1−/y phenotypes remain stable over time from adolescence to late adulthood. Besides, we report that color and shape are meaningful for the achievement of a cognitive test involving object recognition. Altogether, these results underline the significance of visual behavior alterations in FXS conditions and relevance of assessing visual skills in neuropsychiatric models before performing behavioral tasks, such as cognitive assessments, that involve visual discrimination.
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Affiliation(s)
- Chloé Felgerolle
- UMR7355, CNRS, Orléans, France.,Experimental and Molecular Immunology and Neurogenetics, University of Orléans, Orléans, France
| | - Betty Hébert
- UMR7355, CNRS, Orléans, France.,Experimental and Molecular Immunology and Neurogenetics, University of Orléans, Orléans, France
| | - Maryvonne Ardourel
- UMR7355, CNRS, Orléans, France.,Experimental and Molecular Immunology and Neurogenetics, University of Orléans, Orléans, France
| | - Géraldine Meyer-Dilhet
- UMR7355, CNRS, Orléans, France.,Experimental and Molecular Immunology and Neurogenetics, University of Orléans, Orléans, France
| | - Arnaud Menuet
- UMR7355, CNRS, Orléans, France.,Experimental and Molecular Immunology and Neurogenetics, University of Orléans, Orléans, France
| | - Kimberley Pinto-Morais
- UMR7355, CNRS, Orléans, France.,Experimental and Molecular Immunology and Neurogenetics, University of Orléans, Orléans, France
| | | | - Jacques Pichon
- UMR7355, CNRS, Orléans, France.,Experimental and Molecular Immunology and Neurogenetics, University of Orléans, Orléans, France
| | - Sylvain Briault
- UMR7355, CNRS, Orléans, France.,Experimental and Molecular Immunology and Neurogenetics, University of Orléans, Orléans, France.,Department of Genetics, Regional Hospital, Orléans, France
| | - Olivier Perche
- UMR7355, CNRS, Orléans, France.,Experimental and Molecular Immunology and Neurogenetics, University of Orléans, Orléans, France.,Department of Genetics, Regional Hospital, Orléans, France
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16
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El Shemy SA. Effect of Treadmill Training With Eyes Open and Closed on Knee Proprioception, Functional Balance and Mobility in Children With Spastic Diplegia. Ann Rehabil Med 2018; 42:854-862. [PMID: 30613079 PMCID: PMC6325311 DOI: 10.5535/arm.2018.42.6.854] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 06/15/2018] [Indexed: 01/14/2023] Open
Abstract
Objective To investigate the effect of treadmill training with eyes open (TEO) and closed (TEC) on the knee joint position sense (JPS), functional balance and mobility in children with spastic diplegia. Methods Forty-five children with spastic diplegia aged 11–13 years participated in this study. They were randomly assigned to three groups of equal number. The control group (CON) underwent designed physical therapy program whereas, the study groups (TEO and TEC) underwent the same program, in addition to treadmill gait training with eyes open and closed, respectively. Outcome measures were the degree of knee joint position error, functional balance and mobility. Measurements were taken before and after 12 weeks of intervention. Results After training, the three groups showed statistically significant improvement in all measured outcomes, compared to the baseline with non-significant change in the knee JPS in the CON group. When comparing posttreatment results, the TEC group showed greater significant improvement in all measured outcomes, than the TEO and CON groups. Conclusion Treadmill training with eyes open and closed is effective in rehabilitation of children with diplegia, but blocked vision treadmill training has more beneficial effect.
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Affiliation(s)
- Samah Attia El Shemy
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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17
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Yılmaz Topçuoğlu MS, Krautwurst BK, Klotz M, Dreher T, Wolf SI. How do children with bilateral spastic cerebral palsy manage walking on inclines? Gait Posture 2018; 66:172-180. [PMID: 30195221 DOI: 10.1016/j.gaitpost.2018.08.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 07/27/2018] [Accepted: 08/27/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Walking on inclined surfaces is an everyday task, which challenges stability and propulsion even in healthy adults. Children with cerebral palsy adapt similarly to inclines like healthy children do. However, how stability and propulsion in these subjects are influenced by different inclines remained unaddressed as of yet. RESEARCH QUESTION The aim was to examine the feeling of safety, stability and propulsion of children with cerebral palsy when walking on inclines to gain insight into the challenges they might face on these conditions. METHODS Eighteen children with bilateral spastic cerebral palsy with gross motor function classification scale level I and II and nineteen healthy children underwent instrumented 3D gait analysis on level ground and on a 5° and a 10° incline. A mixed linear model was used to draw between and within group comparisons. RESULTS Reduced lateral trunk sway, a relative lengthening of the lower limb at initial contact and a controlled walking speed were employed during downhill gait compared to level walking. Patients showed an increased sagittal ROM of trunk (3-4°) and pelvis (2-3°) and a decreased sagittal knee ROM (13°) compared to the typically developed children. During uphill gait, an insufficient increase of push-off power at the ankle (increase by 0.48 W/kg) was noted in children with CP, which appeared to lead to particularly shorter strides (about 0.1 m) in patients compared to healthy children (increase by 1.32 W/kg). SIGNIFICANCE Depending on inclination angle, children with cerebral palsy managed to walk on inclines in a controlled manner. The steeper the incline, the more the gait appeared to be affected: decreased feeling of safety, increased need for stabilising mechanisms for downhill gait and less sufficient uphill propulsion were seen. Helping these patients to attain better control during downhill gait and strengthening uphill gait mechanisms may support their participation in everyday life.
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Affiliation(s)
- Miray-Su Yılmaz Topçuoğlu
- Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118 Heidelberg, Germany.
| | - Britta K Krautwurst
- Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118 Heidelberg, Germany.
| | - Matthias Klotz
- Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118 Heidelberg, Germany.
| | - Thomas Dreher
- Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118 Heidelberg, Germany.
| | - Sebastian I Wolf
- Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118 Heidelberg, Germany.
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18
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Santos D, Abrantes JMCS, Lewis P, Macedo AF. Influence of the use of cane on the gait cycle of individuals who are blind. BRITISH JOURNAL OF VISUAL IMPAIRMENT 2018. [DOI: 10.1177/0264619618782576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Diana Santos
- Low Vision and Visual Rehabilitation Lab, Department and Center of Physics—Optometry and Vision Science, University of Minho, Portugal
| | - João MCS Abrantes
- MovLab / CIC.Digital Pólo CICANT, Universidade Lusófona de Humanidades e Tecnologias, Lisboa, Portugal
| | - Peter Lewis
- Department of Medicine and Optometry, Linnaeus University, Kalmar, Sweden
| | - António Filipe Macedo
- Department of Medicine and Optometry, Linnaeus University, Kalmar, Sweden; and Low Vision and Visual Rehabilitation Lab, Department and Center of Physics—Optometry and Vision Science, University of Minho, Portugal
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19
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The impact of strabismus surgery on gait pattern in patients with congenital or starting within one year of age strabismus. Neurosci Lett 2018; 670:22-30. [DOI: 10.1016/j.neulet.2018.01.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 01/08/2018] [Accepted: 01/11/2018] [Indexed: 12/30/2022]
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20
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Hallemans A, Mertens G, Van de Heyning P, Van Rompaey V. Playing Music May Improve the Gait Pattern in Patients with Bilateral Caloric Areflexia Wearing a Cochlear Implant: Results from a Pilot Study. Front Neurol 2017; 8:404. [PMID: 28861034 PMCID: PMC5562687 DOI: 10.3389/fneur.2017.00404] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 07/27/2017] [Indexed: 12/26/2022] Open
Abstract
Hypothesis Auditory information through an active cochlear implant (CI) influences gait parameters in adults with bilateral caloric areflexia and profound sensorineural hearing loss. Background Patients with bilateral caloric areflexia suffer from imbalance, resulting in an increased risk of falling. In case of simultaneous deafness, the lack of auditory feedback results in less awareness of the auditory scene. This combination might produce significant challenges while walking and navigating. Auditory cues can be restored to some extent with a CI. Electrical stimulation through a CI can also produce a vestibulocollic reflex through current spread, which can be measured as cervical vestibular-evoked myogenic potentials. Methods Adults (seven males, one female, mean age 61 ± 14 years), wearing a CI to treat profound sensorineural hearing loss and presenting with bilateral caloric areflexia walked barefoot, over ground, at self-selected speed in three different conditions: with CI turned on, while listening to music and with CI turned off. Spatiotemporal and kinematic parameters of gait were calculated using the conventional gait model. Results Removing auditory feedback by turning off the CI decreased stride time (mean difference 0.03 ± 0.15 s) and slightly increased stride length (mean difference 0.5 ± 1.2 cm) compared to the control condition with the CI on. Walking while playing music positively affected gait compared to walking with the CI on but without auditory feedback. By increasing the motion of the pelvis (mean difference 1.3° ± 0.4°), the knee (mean difference 3.9° ± 0.8°) and the ankle (mean difference 2.2° ± 0.2°), stride length increased (7.8 ± 1.2 cm), while stride time decreased (0.059 ± 0.016 s). Conclusion Although a practice effect cannot be completely ruled out, this pilot study suggests that playing music while wearing an active CI may improve gait in patients with bilateral otovestibular loss. It remains unclear if the musical cues boost balance control or the CI might produce current spread and electrical stimulation to the vestibular afferents, thereby boosting its detection threshold, through stochastic resonance, and improving gait.
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Affiliation(s)
- Ann Hallemans
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerp, Belgium.,Multidisciplinary Motor Center Antwerp, University of Antwerp, Antwerp, Belgium
| | - Griet Mertens
- Faculty of Medicine and Health Sciences, Department of Translational Neurosciences, University of Antwerp, Antwerp, Belgium.,Department of Otorhinolaryngology and Head & Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Paul Van de Heyning
- Multidisciplinary Motor Center Antwerp, University of Antwerp, Antwerp, Belgium.,Faculty of Medicine and Health Sciences, Department of Translational Neurosciences, University of Antwerp, Antwerp, Belgium.,Department of Otorhinolaryngology and Head & Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Vincent Van Rompaey
- Faculty of Medicine and Health Sciences, Department of Translational Neurosciences, University of Antwerp, Antwerp, Belgium.,Department of Otorhinolaryngology and Head & Neck Surgery, Antwerp University Hospital, Edegem, Belgium
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21
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Oliveira AS, Schlink BR, Hairston WD, König P, Ferris DP. Restricted vision increases sensorimotor cortex involvement in human walking. J Neurophysiol 2017; 118:1943-1951. [PMID: 28679843 DOI: 10.1152/jn.00926.2016] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 06/28/2017] [Accepted: 07/04/2017] [Indexed: 11/22/2022] Open
Abstract
This study aimed to determine whether there is electrocortical evidence of augmented participation of sensory brain areas in walking modulation during walking with eyes closed. Healthy subjects (n = 10) walked on a treadmill at 1 m/s while alternating 5 min of walking with the eyes open or closed while we recorded ground reaction forces (GRFs) and high-density scalp electroencephalography (EEG). We applied independent component analysis to parse EEG signals into maximally independent component (IC) processes and then computed equivalent current dipoles for each IC. We clustered cortical source ICs and analyzed event-related spectral perturbations synchronized to gait events. Our results indicated that walking with eyes closed reduced the first peak of the vertical GRFs and induced shorter stride duration. Regarding the EEG, we found that walking with eyes closed induced significantly increased relative theta desynchronization in the frontal and premotor cortex during stance, as well as greater desynchronization from theta to beta bands during transition to single support for both left and right somatosensory cortex. These results suggest a phase-specific increased participation of brain areas dedicated to sensory processing and integration when vision is not available for locomotor guidance. Furthermore, the lack of vision demands higher neural processing related to motor planning and execution. Our findings provide evidence supporting the use of eyes-closed tasks in clinical practice, such as gait rehabilitation and improvements in balance control, as there is higher demand for additional sensory integration for achieving postural control.NEW & NOTEWORTHY We measured electrocortical dynamics in sighted individuals while walking with eyes open and eyes closed to induce the participation of other sensory systems in postural control. Our findings show that walking with visual restriction increases the participation of brain areas dedicated to sensory processing, motor planning, and execution. These results confirm the essential participation of supraspinal inputs to postural control in human locomotion, supporting the use of eyes-closed tasks in clinical practice.
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Affiliation(s)
- Anderson S Oliveira
- Human Neuromechanics Laboratory, School of Kinesiology, University of Michigan, Ann Arbor, Michigan; .,Department of Materials and Production, Aalborg University, Aalborg, Denmark
| | - Bryan R Schlink
- Human Neuromechanics Laboratory, School of Kinesiology, University of Michigan, Ann Arbor, Michigan
| | - W David Hairston
- Human Research and Engineering Directorate, U.S. Army Research Laboratory, Aberdeen Proving Ground, Maryland
| | - Peter König
- Institute of Cognitive Science, University of Osnabrück, Osnabrück, Germany; and.,Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Daniel P Ferris
- Human Neuromechanics Laboratory, School of Kinesiology, University of Michigan, Ann Arbor, Michigan
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Kunimune S, Okada S. The effects of object height and visual information on the control of obstacle crossing during locomotion in healthy older adults. Gait Posture 2017; 55:126-130. [PMID: 28437760 DOI: 10.1016/j.gaitpost.2017.04.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 04/05/2017] [Accepted: 04/12/2017] [Indexed: 02/02/2023]
Abstract
In order to safely avoid obstacles, humans must rely on visual information regarding the position and shape of the object obtained in advance. The present study aimed to reveal the duration of obstacle visibility necessary for appropriate visuomotor control during obstacle avoidance in healthy older adults. Participants included 13 healthy young women (mean age: 21.5±1.4years) and 15 healthy older women (mean age: 68.5±3.5years) who were instructed to cross over an obstacle along a pressure-sensitive pathway at a self-selected pace while wearing liquid crystal shutter goggles. Participants were evaluated during three visual occlusion conditions: (i) full visibility, (ii) occlusion at T-1 step (T: time of obstacle crossing), and (iii) occlusion at T-2 steps. Toe clearances of both the lead and trail limb (LTC and TTC) were calculated. LTC in the occlusion at T-2 steps condition was significantly greater than that in other conditions. Furthermore, a significant correlation was observed between LTC and TTC in both groups, regardless of the condition or obstacle height. In the older adult group alone, step width in the occlusion at T-2 steps condition increased relative to that in full visibility conditions. The results of the present study suggest that there is no difference in the characteristics of visuomotor control for appropriate obstacle crossing based on age. However, older adults may exhibit increased dependence on visual information for postural stability; they may also need an increased step width when lacking information regarding their positional relationship to obstacles.
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Affiliation(s)
- Sho Kunimune
- Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada-ku, Kobe-shi, Hyogo, 657-8501, Japan; Department of Rehabilitation, Midorigaoka Hospital, 3-13-1, Makamicho, Takatsuki-shi, Osaka, 569-1121, Japan.
| | - Shuichi Okada
- Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada-ku, Kobe-shi, Hyogo, 657-8501, Japan
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23
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Sung PS, Zipple JT, Andraka JM, Danial P. The kinetic and kinematic stability measures in healthy adult subjects with and without flat foot. Foot (Edinb) 2017; 30:21-26. [PMID: 28257946 DOI: 10.1016/j.foot.2017.01.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 12/05/2016] [Accepted: 01/25/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND Flat foot problems are associated with impaired mobility and postural stability. The purpose of this study was to compare the kinematic and kinetic indices during one leg standing between subjects with and without flat foot. METHODS Forty-four participants enrolled in the study, including 22 subjects with flat foot and 22 control subjects. The measurements included kinematic stability on the trunk as well as kinetic stability from a force plate. All participants were asked to maintain one leg standing with the contralateral hip and knee flexed to approximately 90° for 25seconds. RESULTS The kinetic index decreased in the flat foot group (t=-5.08, p=0.001) during one leg standing without visual input. There were strong correlations between kinetic and kinematic stabilities (0.75-0.86) with visual input and moderate correlations (0.49-0.67) without visual input in the control group. DISCUSSION The flat foot group exhibited a significantly decreased kinetic index without visual input. The more effective postural stability in the control group might be due to efficient compensatory strategies utilized without visual input to maintain one leg standing. These outcome measures could help to develop a practical test leading to kinematic postural changes.
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Affiliation(s)
- Paul S Sung
- Department of Physical Therapy, Motion Analysis Center, Central Michigan University, United States.
| | - J Timothy Zipple
- Department of Physical Therapy, Motion Analysis Center, Central Michigan University, United States
| | - John M Andraka
- Department of Physical Therapy, Motion Analysis Center, Central Michigan University, United States
| | - Pamela Danial
- Department of Physical Therapy, Motion Analysis Center, Central Michigan University, United States
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24
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Choi ET, Kim YN, Cho WS, Lee DK. The effects of visual control whole body vibration exercise on balance and gait function of stroke patients. J Phys Ther Sci 2016; 28:3149-3152. [PMID: 27942138 PMCID: PMC5140818 DOI: 10.1589/jpts.28.3149] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 07/21/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study aims to verify the effects of visual control whole body vibration
exercise on balance and gait function of stroke patients. [Subjects and Methods] A total
of 22 stroke patients were randomly assigned to two groups; 11 to the experimental group
and 11 to the control group. Both groups received 30 minutes of Neuro-developmental
treatment 5 times per week for 4 weeks. The experimental group additionally performed 10
minutes of visual control whole body vibration exercise 5 times per week during the 4
weeks. Balance was measured using the Functional Reach Test. Gait was measured using the
Timed Up and Go Test. [Results] An in-group comparison in the experimental group showed
significant differences in the Functional Reach Test and Timed Up and Go Test. In
comparing the groups, the Functional Reach Test and Timed Up and Go Test of the
experimental group were more significantly different compared to the control group.
[Conclusion] These results suggest that visual control whole body vibration exercise has a
positive effect on the balance and gait function of stroke patients.
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Affiliation(s)
- Eon-Tak Choi
- Department of Physical Therapy, Graduate School of Nambu University, Republic of Korea
| | - Yong-Nam Kim
- Department of Physical Therapy, Nambu University, Republic of Korea
| | - Woon-Soo Cho
- Department of Physical Therapy, Nambu University, Republic of Korea
| | - Dong-Kyu Lee
- Department of Rehabilitation Science, Graduate School of Daegu University, Republic of Korea; Department of Physical Therapy, Sunhan Hospital, Republic of Korea
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Aydın E, Çakmak H, Kocatürk T, Eroğlu M, Erkan E, Ömürlü IK, Şendur ÖF. The influence of monocular vision on the plantar pressure distribution. Clin Biomech (Bristol, Avon) 2016; 35:23-6. [PMID: 27111880 DOI: 10.1016/j.clinbiomech.2016.04.003] [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: 10/01/2015] [Revised: 04/01/2016] [Accepted: 04/06/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although the influence of monocular vision to upper limb biomechanics has been well documented, data about lower extremity biomechanics are limited. The objective of the present study was to demonstrate pedobarographic differences between both feet of the individuals with monocular vision in static and dynamic conditions. METHODS Pedobarographic analysis of twenty-four participants with monocular vision was performed. Relative static pressure load (%) and dynamic peak plantar pressure (N/cm(2)), force (N) distributions and contact area percentages (%) were recorded under both low vision and normal vision side foot. FINDINGS The results showed that relative static pressure loads did not differ between low vision and normal vision foot. Under midfoot of low vision side, a significant increment was found in peak plantar pressures (2.42 (SD 1.09) N/cm(2)) and forces (136.77 (SD 64.96) N) compared to normal vision side foot (1.87 (SD 0.96) N/cm(2); 106.94 (SD 65.03) N). No difference in contact area percentages was detected. INTERPRETATION These results indicate that there are differences in plantar pressure measurements between feet of individuals with monocular vision. These pedobarographic differences reported here appear to support the assumption that individuals with monocular vision have adaptive gait strategies such as, decreased walking speed, limited ankle motion and postural compensations.
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Affiliation(s)
- Elif Aydın
- Adnan Menderes University, School of Medicine, Department of Physical Medicine and Rehabilitation, 09100 Aydin, Turkey.
| | - Harun Çakmak
- Adnan Menderes University, School of Medicine, Department of Ophtalmology, 09100 Aydin, Turkey.
| | - Tolga Kocatürk
- Adnan Menderes University, School of Medicine, Department of Ophtalmology, 09100 Aydin, Turkey.
| | - Mürüvvet Eroğlu
- Adnan Menderes University, School of Medicine, Department of Physical Therapy and Rehabilitation, 09100 Aydin, Turkey.
| | - Erol Erkan
- Adnan Menderes University, School of Medicine, Department of Ophtalmology, 09100 Aydin, Turkey.
| | - Imran Kurt Ömürlü
- Adnan Menderes University, School of Medicine, Department of Biostatistics, 09100 Aydin, Turkey.
| | - Ömer Faruk Şendur
- Adnan Menderes University, School of Medicine, Department of Physical Medicine and Rehabilitation, 09100 Aydin, Turkey.
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Gazzellini S, Lispi ML, Castelli E, Trombetti A, Carniel S, Vasco G, Napolitano A, Petrarca M. The impact of vision on the dynamic characteristics of the gait: strategies in children with blindness. Exp Brain Res 2016; 234:2619-27. [PMID: 27165507 DOI: 10.1007/s00221-016-4666-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 04/27/2016] [Indexed: 11/26/2022]
Abstract
Visually impaired persons present an atypical gait pattern characterized by slower walking speed, shorter stride length and longer time of stance. Three explanatory hypotheses have been advanced in the literature: balance deficit, lack of an anticipatory mechanisms and foot probing the ground. In the present study, we compared the three hypotheses by applying their predictions to gait analysis and posturography of blind children without neurological impairment and compared their performance with that of an age-matched control group. The gait analysis results documented that blind children presented reduced walking velocity and step length, increased step width and external rotation of the foot progression angle, reduced ground reaction force and ankle maximum angle, moment and power in late stance, increased head flexion, decreased thorax flexion and pelvis anteversion, compared with the control group. The posturographic analysis showed equal skill level between blind children and normally sighted children when they close their eyes. The results are consistent with only one of the three hypotheses: namely, they prove that blind children's gait is influenced only by the absence of visually driven anticipatory control mechanisms. Finally, rehabilitative recommendations for children with blindness are advanced in discussion.
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Affiliation(s)
- Simone Gazzellini
- MARlab (Movement Analysis and Robotics Laboratory), Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, IRCCS, Via Torre di Palidoro, Passoscuro-Fiumicino, 00050, Rome, Italy.
| | - Maria Luisa Lispi
- MARlab (Movement Analysis and Robotics Laboratory), Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, IRCCS, Via Torre di Palidoro, Passoscuro-Fiumicino, 00050, Rome, Italy
| | - Enrico Castelli
- MARlab (Movement Analysis and Robotics Laboratory), Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, IRCCS, Via Torre di Palidoro, Passoscuro-Fiumicino, 00050, Rome, Italy
| | | | - Sacha Carniel
- MARlab (Movement Analysis and Robotics Laboratory), Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, IRCCS, Via Torre di Palidoro, Passoscuro-Fiumicino, 00050, Rome, Italy
| | - Gessica Vasco
- MARlab (Movement Analysis and Robotics Laboratory), Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, IRCCS, Via Torre di Palidoro, Passoscuro-Fiumicino, 00050, Rome, Italy
| | - Antonio Napolitano
- Enterprise Risk Management, Medical Physics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Maurizio Petrarca
- MARlab (Movement Analysis and Robotics Laboratory), Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, IRCCS, Via Torre di Palidoro, Passoscuro-Fiumicino, 00050, Rome, Italy
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Choi JS, Kang DW, Seo JW, Kim DH, Yang ST, Tack GR. Effects of low light on the stability of the head and pelvis of the healthy elderly. J Phys Ther Sci 2015; 27:3365-8. [PMID: 26696699 PMCID: PMC4681906 DOI: 10.1589/jpts.27.3365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 07/31/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to evaluate the changes in body stability of the
elderly while walking on even surface ground under low light. [Subjects] Ten young males
and ten elderly males participated in this experiment. [Methods] Each subject walked along
a 7 m walkway five times at their preferred walking speed under normal (>300 lux, NORM)
and low light conditions (<5 lux, LOW). To compare the changes in body stability, the
root mean square of acceleration (RMSacc) at the head and pelvis was used. [Results] The
results show that the body stability of young adults showed a similar RMSacc in all
directions at the head and pelvis between the normal and low light walking conditions. In
contrast, the RMSacc in all directions at the head and pelvis during low light walking by
elderly adults was significantly greater than that of normal light walking. [Conclusion]
It was confirmed that, despite walking on even ground, low light condition affects the
body stability of the elderly. To clearly evaluate the effect of low light with aging on
gait pattern, further study will be necessary to perform additional experiments under
various environmental conditions to investigate walking speed, multi-tasking, stairs, and
uneven walkway performance.
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Affiliation(s)
- Jin-Seung Choi
- School of Biomedical Engineering, Konkuk University, Republic of Korea ; BK21 Plus Research Institute of Biomedical Engineering, Konkuk University, Republic of Korea
| | - Dong-Won Kang
- School of Biomedical Engineering, Konkuk University, Republic of Korea
| | - Jeong-Woo Seo
- School of Biomedical Engineering, Konkuk University, Republic of Korea
| | - Dae-Hyeok Kim
- School of Biomedical Engineering, Konkuk University, Republic of Korea
| | - Seung-Tae Yang
- School of Biomedical Engineering, Konkuk University, Republic of Korea
| | - Gye-Rae Tack
- School of Biomedical Engineering, Konkuk University, Republic of Korea ; BK21 Plus Research Institute of Biomedical Engineering, Konkuk University, Republic of Korea
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Cha J, Kim H, Park J, Song C. Effects of mobile texting and gaming on gait with obstructions under different illumination levels. ACTA ACUST UNITED AC 2015. [DOI: 10.14474/ptrs.2015.4.1.32] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Jaeyun Cha
- Department of Rehabilitation Medicine, Sahmyook Seoul Medical Center, Seoul, Republic of Korea
| | - Hyunjin Kim
- Department of Rehabilitation Medicine, Hanyang University Guri Hospital, Guri, Republic of Korea
| | - Jaemyoung Park
- Department of Rehabilitation Medicine, Seoul Medical Center, Seoul, Republic of Korea
| | - Changho Song
- Department of Physical Therapy, College of Health and Welfare, Sahmyook University, Seoul, Republic of Korea
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Forero J, Misiaszek JE. The amplitude of interlimb cutaneous reflexes in the leg is influenced by fingertip touch and vision during treadmill locomotion. Exp Brain Res 2015; 233:1773-82. [DOI: 10.1007/s00221-015-4250-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 03/06/2015] [Indexed: 11/28/2022]
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Brandt T, Kugler G, Schniepp R, Wuehr M, Huppert D. Acrophobia impairs visual exploration and balance during standing and walking. Ann N Y Acad Sci 2015; 1343:37-48. [DOI: 10.1111/nyas.12692] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Thomas Brandt
- German Center for Vertigo and Balance Disorders; Ludwig-Maximilians-University of Munich; Munich Germany
| | - Günter Kugler
- German Center for Vertigo and Balance Disorders; Ludwig-Maximilians-University of Munich; Munich Germany
| | - Roman Schniepp
- German Center for Vertigo and Balance Disorders; Ludwig-Maximilians-University of Munich; Munich Germany
- Department of Neurology; Ludwig-Maximilians-University of Munich; Munich Germany
| | - Max Wuehr
- German Center for Vertigo and Balance Disorders; Ludwig-Maximilians-University of Munich; Munich Germany
| | - Doreen Huppert
- German Center for Vertigo and Balance Disorders; Ludwig-Maximilians-University of Munich; Munich Germany
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31
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Reynard F, Terrier P. Role of visual input in the control of dynamic balance: variability and instability of gait in treadmill walking while blindfolded. Exp Brain Res 2014; 233:1031-40. [PMID: 25534228 DOI: 10.1007/s00221-014-4177-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 12/08/2014] [Indexed: 10/24/2022]
Abstract
While vision obviously plays an essential role in orienting and obstacle avoidance, its role in the regulation of dynamic balance is not yet fully understood. The objective of this study was to assess dynamic stability while blindfolded, under optimal conditions that minimized the fear of falling. The hypothesis was that visual deprivation could be compensated for by using other sensory strategies to stabilize gait. One hundred healthy adults (aged 20-69 years) participated in the study. They were previously accustomed to blindfolded treadmill walking wearing a safety harness. Their preferred walking speeds (PWS) were assessed with eyes open (PWSEO) and with eyes closed (blindfolded, PWSEC). Three five-minute tests were performed: (A) normal walking at PWSEO, (B) blindfolded walking at PWSEC, and (C) normal walking at PWSEC. Trunk acceleration was measured with a lightweight inertial sensor. Dynamic stability was assessed by using (1) acceleration root mean square (RMS), which estimates the variability of the signal, and hence, the smoothness of the trunk movement and (2) local dynamic stability (LDS), which reflects the efficiency of the motor control to stabilize the trunk. Although walking at PWSEC with eyes open (comparing conditions A and C) had a slight impact on gait stability (relative difference: RMS +4 %, LDS -5 %), no destabilizing effect of visual deprivation (B vs. C, RMS -4 %, LDS -1 %) was observed. Therefore, it is concluded that when reassuring conditions are offered to individuals while walking, they are able to adopt alternative sensory strategies to control dynamic equilibrium without the help of vision.
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Affiliation(s)
- Fabienne Reynard
- Clinique romande de réadaptation SUVACare, Av. Gd-Champsec 90, 1951, Sion, Switzerland
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Visual exploration during locomotion limited by fear of heights. PLoS One 2014; 9:e105906. [PMID: 25165822 PMCID: PMC4148313 DOI: 10.1371/journal.pone.0105906] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 07/28/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Visual exploration of the surroundings during locomotion at heights has not yet been investigated in subjects suffering from fear of heights. METHODS Eye and head movements were recorded separately in 16 subjects susceptible to fear of heights and in 16 non-susceptible controls while walking on an emergency escape balcony 20 meters above ground level. Participants wore mobile infrared eye-tracking goggles with a head-fixed scene camera and integrated 6-degrees-of-freedom inertial sensors for recording head movements. Video recordings of the subjects were simultaneously made to correlate gaze and gait behavior. RESULTS Susceptibles exhibited a limited visual exploration of the surroundings, particularly the depth. Head movements were significantly reduced in all three planes (yaw, pitch, and roll) with less vertical head oscillations, whereas total eye movements (saccade amplitudes, frequencies, fixation durations) did not differ from those of controls. However, there was an anisotropy, with a preference for the vertical as opposed to the horizontal direction of saccades. Comparison of eye and head movement histograms and the resulting gaze-in-space revealed a smaller total area of visual exploration, which was mainly directed straight ahead and covered vertically an area from the horizon to the ground in front of the feet. This gaze behavior was associated with a slow, cautious gait. CONCLUSIONS The visual exploration of the surroundings by susceptibles to fear of heights differs during locomotion at heights from the earlier investigated behavior of standing still and looking from a balcony. During locomotion, anisotropy of gaze-in-space shows a preference for the vertical as opposed to the horizontal direction during stance. Avoiding looking into the abyss may reduce anxiety in both conditions; exploration of the "vertical strip" in the heading direction is beneficial for visual control of balance and avoidance of obstacles during locomotion.
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Aprile I, Ferrarin M, Padua L, Di Sipio E, Simbolotti C, Petroni S, Tredici C, Dickmann A. Walking strategies in subjects with congenital or early onset strabismus. Front Hum Neurosci 2014; 8:484. [PMID: 25071514 PMCID: PMC4090756 DOI: 10.3389/fnhum.2014.00484] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 06/16/2014] [Indexed: 11/13/2022] Open
Abstract
Introduction: In congenital strabismus, sensory adaptations occur hampering the correct development of normal binocular vision. The aim of this study is to investigate if patients with congenital or early onset exotropic or esotropic strabismus adopt different walking strategies with respect to healthy subjects. Our hypothesis is that the abnormal binocular cooperation, occurring in patients with exotropic or esotropic strabismus, could influence neurosensorial adaptation of the gait pattern. Materials and Methods: Twenty-five patients were enrolled: 19 with esotropic (ESO) and 6 with exotropic strabismus (EXO). All patients underwent an ophthalmological and orthoptic evaluation. Biomechanical data were collected using a stereophotogrammetric system and a force platform. Twenty-seven age-matched healthy subjects (HS) were used as controls. Results: The comparison between patients with ESO and patients with EXO strabismus showed that the maximal power at the knee and at the ankle was lower in EXO group (p < 0.01 and p < 0.05, respectively). The step width was statistically different between ESO and EXO groups (p < 0.01), lower in patients with ESO and higher in patients with EXO strabismus when compared with HS (though not statistically significant). The deviation angle values showed a relationship with the step width (at the near fixation p < 0.05) and with the maximal power at the knee and at the ankle (at the far fixation for the knee p < 0.001 and for the ankle p < 0.05; at the near fixation for the knee p < 0.05): in the patients with EXO the increased angle deviation is related to larger step width and to lower power at the knee and at the ankle. In the patients with ESO strabismus this relationship is less robust. Discussion: Patients with EXO and ESO strabismus adopt different strategies to compensate their walking difficulties, and these strategies are likely due to an expanded binocular visual field in patients with EXO and to a reduced visual field in patients with ESO strabismus.
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Affiliation(s)
- Irene Aprile
- SM Provvidenza Movement Laboratory, Don Carlo Gnocchi Foundation, IRCCS Milan, Rome, Italy
| | - Maurizio Ferrarin
- Biomedical Technology Department, Don Carlo Gnocchi Foundation, IRCCS Milan, Italy
| | - Luca Padua
- SM Provvidenza Movement Laboratory, Don Carlo Gnocchi Foundation, IRCCS Milan, Rome, Italy ; Neuroscience Department of Catholic University Rome, Italy
| | - Enrica Di Sipio
- SM Provvidenza Movement Laboratory, Don Carlo Gnocchi Foundation, IRCCS Milan, Rome, Italy
| | - Chiara Simbolotti
- SM Provvidenza Movement Laboratory, Don Carlo Gnocchi Foundation, IRCCS Milan, Rome, Italy
| | - Sergio Petroni
- Ophthalmology Department, Bambino Gesù Children's Hospital Rome, Italy
| | - Costanza Tredici
- Department of Surgical Sciences of Head and Neck, Institute of Ophtalmology, Catholic University Rome, Italy
| | - Anna Dickmann
- Department of Surgical Sciences of Head and Neck, Institute of Ophtalmology, Catholic University Rome, Italy
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34
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The effect of light touch on the amplitude of cutaneous reflexes in the arms during treadmill walking. Exp Brain Res 2014; 232:2967-76. [DOI: 10.1007/s00221-014-3979-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 04/26/2014] [Indexed: 10/25/2022]
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Iosa M, Fusco A, Morone G, Paolucci S. Development and decline of upright gait stability. Front Aging Neurosci 2014; 6:14. [PMID: 24550829 PMCID: PMC3913994 DOI: 10.3389/fnagi.2014.00014] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 01/22/2014] [Indexed: 11/13/2022] Open
Abstract
Upright gait is a peculiar characteristic of humans that requires the ability to manage upper body dynamic balance while walking, despite the perturbations that are generated by movements of the lower limbs. Most of the studies on upright gait stability have compared young adults and the elderly to determine the effects of aging. In other studies, the comparison was between healthy subjects and patients to examine specific pathologies. Fewer researches have also investigated the development of upright gait stability in children. This review discusses these studies in order to provide an overview of this relevant aspect of human locomotion. A clear trend from development to decline of upright gait stability has been depicted across the entire lifespan, from toddlers at first steps to elderly. In old individuals, even if healthy, the deterioration of skeletal muscle, combined with sensorial and cognitive performance, reduces the ability to maintain an upright trunk during walking, increasing the instability and the risk of falls. Further, the pathological causes of altered development or of a sudden loss of gait stability, as well as the environmental influence are investigated. The last part of this review is focused on the control of upper body accelerations during walking, a particularly interesting topic for the recent development of low-cost wearable accelerometers.
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Affiliation(s)
- Marco Iosa
- Clinical Laboratory of Experimental Neurorehabilitation, Fondazione Santa Lucia, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Augusto Fusco
- Clinical Laboratory of Experimental Neurorehabilitation, Fondazione Santa Lucia, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Giovanni Morone
- Clinical Laboratory of Experimental Neurorehabilitation, Fondazione Santa Lucia, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Stefano Paolucci
- Clinical Laboratory of Experimental Neurorehabilitation, Fondazione Santa Lucia, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
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Iosa M, Fusco A, Morone G, Paolucci S. Effects of visual deprivation on gait dynamic stability. ScientificWorldJournal 2012; 2012:974560. [PMID: 22645490 PMCID: PMC3356761 DOI: 10.1100/2012/974560] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Accepted: 12/28/2011] [Indexed: 12/18/2022] Open
Abstract
Vision can improve bipedal upright stability during standing and affect spatiotemporal parameters during walking. However, little is known about the effects of visual deprivation on gait dynamic stability. We have tested 28 subjects during walking under two different visual conditions, full vision (FV) and no vision (NV), measuring their upper body accelerations. Lower accelerations were found in NV for the reduced walking speed. However, the normalized accelerations were higher in the NV than in the FV condition, both in anteroposterior (1.05 ± 0.21 versus 0.88 ± 0.16, P = 0.001) and laterolateral (0.99 ± 0.26 versus 0.78 ± 0.19, P < 0.001) directions. Vision also affected the gait anteroposterior harmony (P = 0.026) and, interacting with the environment, also the latero-lateral one (P = 0.017). Directly (as main factor of the ANOVA) or indirectly (by means of significant interactions with other factors), vision affected all the measured parameters. In conclusion, participants showed an environment-dependent reduction of upper body stability and harmony when deprived by visual feedback.
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Affiliation(s)
- Marco Iosa
- Clinical Laboratory of Experimental Neurorehabilitation, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy.
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Hallemans A, Ortibus E, Truijen S, Meire F. Development of independent locomotion in children with a severe visual impairment. RESEARCH IN DEVELOPMENTAL DISABILITIES 2011; 32:2069-2074. [PMID: 21985990 DOI: 10.1016/j.ridd.2011.08.017] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Revised: 08/22/2011] [Accepted: 08/22/2011] [Indexed: 05/31/2023]
Abstract
Locomotion of children and adults with a visual impairment (ages 1-44, n = 28) was compared to that of age-related individuals with normal vision (n = 60). Participants walked barefoot at preferred speed while their gait was recorded by a Vicon(®) system. Walking speed, heading angle, step frequency, stride length, step width, stance phase duration and double support time were determined. Differences between groups, relationships with age and possible interaction effects were investigated. With increasing age overall improvements in gait parameters are observed. Differences between groups were a slower walking speed, a shorter stride length, a prolonged duration of stance and of double support in the individuals with a visual impairment. These may be considered either as adaptations to balance problems or as strategies to allow to foot to probe the ground.
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Affiliation(s)
- Ann Hallemans
- University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium.
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Magalhães FH, Kohn AF. Vibration-enhanced posture stabilization achieved by tactile supplementation: may blind individuals get extra benefits? Med Hypotheses 2011; 77:301-4. [PMID: 21601993 DOI: 10.1016/j.mehy.2011.04.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Accepted: 04/28/2011] [Indexed: 10/18/2022]
Abstract
Diminished balance ability poses a serious health risk due to the increased likelihood of falling, and impaired postural stability is significantly associated with blindness and poor vision. Noise stimulation (by improving the detection of sub-threshold somatosensory information) and tactile supplementation (i.e., additional haptic information provided by an external contact surface) have been shown to improve the performance of the postural control system. Moreover, vibratory noise added to the source of tactile supplementation (e.g., applied to a surface that the fingertip touches) has been shown to enhance balance stability more effectively than tactile supplementation alone. In view of the above findings, in addition to the well established consensus that blind subjects show superior abilities in the use of tactile information, we hypothesized that blind subjects may take extra benefits from the vibratory noise added to the tactile supplementation and hence show greater improvements in postural stability than those observed for sighted subjects. If confirmed, this hypothesis may lay the foundation for the development of noise-based assistive devices (e.g., canes, walking sticks) for improving somatosensation and hence prevent falls in blind individuals.
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Affiliation(s)
- Fernando Henrique Magalhães
- Neuroscience Program and Biomedical Engineering Laboratory, Universidade de São Paulo, EPUSP, PTC, Avenida Professor Luciano Gualberto, Travessa 3, n.158, São Paulo, SP, Brazil.
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Effect of narrowing the base of support on the gait, gaze and quiet eye of elite ballet dancers and controls. Cogn Process 2011; 12:267-76. [PMID: 21384271 DOI: 10.1007/s10339-011-0395-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Accepted: 02/21/2011] [Indexed: 10/18/2022]
Abstract
We determined the gaze and stepping behaviours of elite ballet dancers and controls as they walked normally and along progressively narrower 3-m lines (l0.0, 2.5 cm). The ballet dancers delayed the first step and then stepped more quickly through the approach area and onto the lines, which they exited more slowly than the controls, which stepped immediately but then slowed their gait to navigate the line, which they exited faster. Contrary to predictions, the ballet group did not step more precisely, perhaps due to the unique anatomical requirements of ballet dance and/or due to releasing the degrees of freedom under their feet as they fixated ahead more than the controls. The ballet group used significantly fewer fixations of longer duration, and their final quiet eye (QE) duration prior to stepping on the line was significantly longer (2,353.39 ms) than the controls (1,327.64 ms). The control group favoured a proximal gaze strategy allocating 73.33% of their QE fixations to the line/off the line and 26.66% to the exit/visual straight ahead (VSA), while the ballet group favoured a 'look-ahead' strategy allocating 55.49% of their QE fixations to the exit/VSA and 44.51% on the line/off the line. The results are discussed in the light of the development of expertise and the enhanced role of fixations and visual attention when more tasks become more constrained.
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40
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The role of vision in obese and normal-weight children's gait control. Gait Posture 2011; 33:179-84. [PMID: 21094609 DOI: 10.1016/j.gaitpost.2010.10.090] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Revised: 10/18/2010] [Accepted: 10/24/2010] [Indexed: 02/02/2023]
Abstract
Previous research has suggested that perceptual-motor difficulties may account for obese children's lower motor competence; however, specific evidence is currently lacking. Therefore, this study examined the effect of altered visual conditions on spatiotemporal and kinematic gait parameters in obese versus normal-weight children. Thirty-two obese and normal-weight children (11.2±1.5 years) walked barefoot on an instrumented walkway at constant self-selected speed during LIGHT and DARK conditions. Three-dimensional motion analysis was performed to calculate spatiotemporal parameters, as well as sagittal trunk segment and lower extremity joint angles at heel-strike and toe-off. Self-selected speed did not significantly differ between groups. In the DARK condition, all participants walked at a significantly slower speed, decreased stride length, and increased stride width. Without normal vision, obese children had a more pronounced increase in relative double support time compared to the normal-weight group, resulting in a significantly greater percentage of the gait cycle spent in stance. Walking in the DARK, both groups showed greater forward tilt of the trunk and restricted hip movement. All participants had increased knee flexion at heel-strike, as well as decreased knee extension and ankle plantarflexion at toe-off in the DARK condition. The removal of normal vision affected obese children's temporal gait pattern to a larger extent than that of normal-weight peers. Results suggest an increased dependency on vision in obese children to control locomotion. Next to the mechanical problem of moving excess mass, a different coupling between perception and action appears to be governing obese children's motor coordination and control.
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41
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Hallemans A, Ortibus E, Meire F, Aerts P. Low vision affects dynamic stability of gait. Gait Posture 2010; 32:547-51. [PMID: 20801658 DOI: 10.1016/j.gaitpost.2010.07.018] [Citation(s) in RCA: 120] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2010] [Revised: 07/20/2010] [Accepted: 07/25/2010] [Indexed: 02/02/2023]
Abstract
The objective of this study was to demonstrate specific differences in gait patterns between those with and without a visual impairment. We performed a biomechanical analysis of the gait pattern of young adults (27 ± 13 years old) with a visual impairment (n=10) in an uncluttered environment and compared it to the gait pattern of age matched controls (n=20). Normally sighted adults were tested in a full vision and no vision condition. Differences are found in gait between both groups and both situations. Adults with a visual impairment walked with a shorter stride length (1.14 ± 0.21m), less trunk flexion (4.55 ± 5.14°) and an earlier plantar foot contact at heel strike (1.83 ± 3.49°) than sighted individuals (1.39 ± 0.08 m; 11.07 ± 4.01°; 5.10 ± 3.53°). When sighted individuals were blindfolded (no vision condition) they showed similar gait adaptations as well as a slower walking speed (0.84 ± 0.28 ms(-1)), a lower cadence (96.88 ± 13.71 steps min(-1)) and limited movements of the hip (38.24 ± 6.27°) and the ankle in the saggital plane (-5.60 ± 5.07°) compared to a full vision condition (1.27 ± 0.13 ms(-1); 110.55 ± 7.09 steps min(-1); 45.32 ± 4.57°; -16.51 ± .59°). Results showed that even in an uncluttered environment vision is important for locomotion control. The differences between those with and without a visual impairment, and between the full vision and no vision conditions, may reflect a more cautious walking strategy and adaptive changes employed to use the foot to probe the ground for haptic exploration.
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Affiliation(s)
- Ann Hallemans
- Research group of Functional Morphology, Department of Biology, University of Antwerp, Belgium.
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Hallemans A, Aerts P. Effects of visual deprivation on intra-limb coordination during walking in children and adults. Exp Brain Res 2009; 198:95-106. [PMID: 19618172 DOI: 10.1007/s00221-009-1937-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2008] [Accepted: 06/30/2009] [Indexed: 10/20/2022]
Abstract
Following the laws of planar covariation, intersegmental coordination is defined with respect to the vertical and heading direction. This vertical reference can be estimated using multisensory information, amongst others visual cues play a role. In the past it was already shown that visual deprivation and/or perturbation of visual information largely affect gait kinematics. The goal of this study is to investigate the impact of visual deprivation on intra-limb movement coordination. Children aged between 3 and 11 years and young adults are included in this study to investigate age-related differences in the visual control of locomotion. Intersegmental coordination was tested under two different conditions: full vision (FV) and no vision (NV). Heading direction and walking speed were taken into account. A significant interaction effect was observed between visual condition and age for walking speed. Between age groups, no differences are observed in the FV condition but in the NV condition children walk significantly slower than adults. This shows that the relative importance of visual information is age dependent. Between age groups significant differences were found in heading direction. Coordination was characterized using the planar covariation technique, by constructing thigh versus shank and shank versus foot angle-angle plots and by cross-correlation function analysis. Regardless of the presence or absence of visual information, the planarity index remains high, indicating that the laws of planar covariation hold in the absence of visual afferent information. On the other hand, the shape of the gait loop does show significant differences between FV and NV conditions. Changes in the shape of the gait loop are primarily determined by changes in the coupling between the thigh and shank elevation angles. The coupling between the shank and foot elevation angles is dependent upon walking speed and does not differ between FV and NV conditions. Between age groups significant differences are observed in covariation plane orientation.
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Affiliation(s)
- Ann Hallemans
- Research Group of Functional Morphology, Department of Biology, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium.
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