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Ting LH, Gick B, Kesar TM, Xu J. Ethnokinesiology: towards a neuromechanical understanding of cultural differences in movement. Philos Trans R Soc Lond B Biol Sci 2024; 379:20230485. [PMID: 39155720 DOI: 10.1098/rstb.2023.0485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 05/15/2024] [Accepted: 06/18/2024] [Indexed: 08/20/2024] Open
Abstract
Each individual's movements are sculpted by constant interactions between sensorimotor and sociocultural factors. A theoretical framework grounded in motor control mechanisms articulating how sociocultural and biological signals converge to shape movement is currently missing. Here, we propose a framework for the emerging field of ethnokinesiology aiming to provide a conceptual space and vocabulary to help bring together researchers at this intersection. We offer a first-level schema for generating and testing hypotheses about cultural differences in movement to bridge gaps between the rich observations of cross-cultural movement variations and neurophysiological and biomechanical accounts of movement. We explicitly dissociate two interacting feedback loops that determine culturally relevant movement: one governing sensorimotor tasks regulated by neural signals internal to the body, the other governing ecological tasks generated through actions in the environment producing ecological consequences. A key idea is the emergence of individual-specific and culturally influenced motor concepts in the nervous system, low-dimensional functional mappings between sensorimotor and ecological task spaces. Motor accents arise from perceived differences in motor concept topologies across cultural contexts. We apply the framework to three examples: speech, gait and grasp. Finally, we discuss how ethnokinesiological studies may inform personalized motor skill training and rehabilitation, and challenges moving forward.This article is part of the theme issue 'Minds in movement: embodied cognition in the age of artificial intelligence'.
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Affiliation(s)
- Lena H Ting
- Coulter Department of Biomedical Engineering at Georgia Tech and Emory, Georgia Institute of Technology, Atlanta, GA 30332, USA
- Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University, Atlanta, GA 30322, USA
| | - Bryan Gick
- Department of Linguistics, The University British Columbia, Vancouver, BC V6T 1Z4, Canada
- Haskins Laboratories, Yale University, New Haven, CT 06520, USA
| | - Trisha M Kesar
- Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University, Atlanta, GA 30322, USA
| | - Jing Xu
- Department of Kinesiology, The University of Georgia, Athens, GA 30602, USA
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da Silva Costa AA, Moraes R, den Otter R, Gennaro F, Bakker L, Rocha Dos Santos PC, Hortobágyi T. Corticomuscular and intermuscular coherence as a function of age and walking balance difficulty. Neurobiol Aging 2024; 141:85-101. [PMID: 38850592 DOI: 10.1016/j.neurobiolaging.2024.05.004] [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: 09/25/2023] [Revised: 04/12/2024] [Accepted: 05/08/2024] [Indexed: 06/10/2024]
Abstract
We determined beta-band intermuscular (IMC) and corticomuscular coherence (CMC) as a function of age and walking balance difficulty. Younger (n=14, 23y) and older individuals (n=19, 71y) walked 13 m overground, on a 6-cm-wide ribbon overground, and on a 6-cm-wide (5-cm-high) beam. Walking distance as a proxy for walking balance and speed were computed. CMC was estimated between electroencephalographic signal at Cz electrode and surface electromyographic signals of seven leg muscles, while IMC was calculated in four pairs of leg muscles, during stance and swing gait phases. With increasing difficulty, walking balance decreased in old individuals and speed decreased gradually independent of age. Beam walking increased IMC, while age increased IMC in proximal muscle pairs, and decreased IMC in distal muscle pairs. Age and difficulty increased CMC independent of gait phases. Concluding, CMC and IMC increased with walking balance difficulty and age, except for distal muscle pairs, which had lower IMC with age. These findings suggest an age-related increase in corticospinal involvement in the neural control of walking balance. DATA AVAILABILITY: The datasets used in this study are available from the corresponding author upon reasonable request.
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Affiliation(s)
- Andréia Abud da Silva Costa
- Ribeirão Preto Medical School, Graduate Program in Rehabilitation and Functional Performance, University of São Paulo, Brazil; Biomechanics and Motor Control Lab, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil; Department of Human Movement Sciences, University of Groningen Medical Center, Groningen, the Netherlands.
| | - Renato Moraes
- Ribeirão Preto Medical School, Graduate Program in Rehabilitation and Functional Performance, University of São Paulo, Brazil; Biomechanics and Motor Control Lab, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil
| | - Rob den Otter
- Department of Human Movement Sciences, University of Groningen Medical Center, Groningen, the Netherlands
| | - Federico Gennaro
- Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Lisanne Bakker
- Department of Human Movement Sciences, University of Groningen Medical Center, Groningen, the Netherlands
| | - Paulo Cezar Rocha Dos Santos
- Department of Computer Science & Applied Mathematics, Weizmann Institute of Science, Israel; The Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Israel; IDOR/Pioneer Science Initiative, Rio de Janeiro, RJ, Brazil
| | - Tibor Hortobágyi
- Department of Human Movement Sciences, University of Groningen Medical Center, Groningen, the Netherlands; Department of Kinesiology, Hungarian University of Sports Science, Budapest 1123, Hungary; Department of Sport Biology, Institute of Sport Sciences and Physical Education, University of Pécs, Pécs, Hungary
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Richer N, Peterson SM, Ferris DP. Vision Is Not Required to Elicit Balance Improvements From Beam Walking Practice. Motor Control 2024:1-13. [PMID: 39159924 DOI: 10.1123/mc.2023-0145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 05/24/2024] [Accepted: 06/05/2024] [Indexed: 08/21/2024]
Abstract
BACKGROUND Beam walking is a highly studied assessment of walking balance. Recent research has demonstrated that brief intermittent visual rotations and occlusions can increase the efficacy of beam walking practice on subsequent beam walking without visual perturbations. We sought to examine the influence of full vision removal during practice walking on a treadmill-mounted balance beam. Although visual disruptions improved performance of this task, we hypothesized that removing visual feedback completely would lead to less balance improvements than with normal vision due to the specificity of practice. METHODS Twenty healthy young adults trained to walk at a fixed speed on a treadmill-mounted balance beam for 30 min, either with, or without, normal vision. We compared their balance pre-, during, and posttraining by calculating their step-offs per minute and the percentage change in step-offs per minute. RESULTS Balance improved in both groups after training, with no significant difference in percentage change in step-offs between the normal vision and the no vision participants. On average, the no vision participants had twice as many step-offs per minute as the normal vision group during training. CONCLUSION Although previous experiments show that intermittent visual perturbations led to large enhancements of the effectiveness of beam walking training, completely removing visual feedback did not alter training effectiveness compared with normal vision training. It is likely a result of sensory reweighting in the absence of vision, where a greater weight was placed on proprioceptive, cutaneous, and vestibular inputs.
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Affiliation(s)
- Natalie Richer
- Department of Kinesiology and Applied Health, University of Winnipeg, Winnipeg, MB, Canada
| | - Steven M Peterson
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Daniel P Ferris
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
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Kazanski ME, Cusumano JP, Dingwell JB. How older adults maintain lateral balance while walking on narrowing paths. Gait Posture 2024; 113:32-39. [PMID: 38833762 DOI: 10.1016/j.gaitpost.2024.05.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 05/09/2024] [Accepted: 05/27/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND Older adults have difficulty maintaining side-to-side balance while navigating daily environments. Losing balance in such circumstances can lead to falls. We need to better understand how older adults adapt lateral balance to navigate environment-imposed task constraints. RESEARCH QUESTION How do older adults adjust mediolateral balance while walking along continually-narrowing paths, and what are the stability implications of these adjustments? METHODS Eighteen older (71.6±6.0 years) and twenty younger (21.7±2.6 years) healthy adults traversed 25 m-long paths that gradually narrowed from 45 cm to 5 cm. Participants switched onto an adjacent path when they chose. We quantified participants' lateral center-of-mass dynamics and lateral Margins of Stability (MoSL) as paths narrowed. We quantified lateral Probability of Instability (PoIL) as the probability that participants would take a laterally unstable (MoSL<0) step as they walked. We also extracted these outcomes where participants switched paths. RESULTS As paths narrowed, all participants exhibited progressively smaller average MoSL and increasingly larger PoIL. However, their MoSL variability was largest at both the narrowest and widest path sections. Older adults exhibited consistently both larger average and more variable MoSL across path widths. Taken into account together, these resulted in either comparable or somewhat larger PoIL as paths narrowed. Older adults left the narrowing paths sooner, on average, than younger. As they did so, older adults exhibited significantly larger average and more variable MoSL, but somewhat smaller PoIL than younger. SIGNIFICANCE Our results directly challenge the predominant interpretation that larger average MoSL indicate "greater stability", which we argue is inconsistent with the principles underlying its derivation. In contrast, analyzing step-to-step gait dynamics, together with estimating PoIL allows one to properly quantify instability risk. Furthermore, the adaptive strategies uncovered using these methods suggest potential targets for future interventions to reduce falls in older adults.
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Affiliation(s)
- Meghan E Kazanski
- Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802, USA; Department of Medicine, Division of Geriatrics and Gerontology, Emory University School of Medicine, Atlanta, GA, USA
| | - Joseph P Cusumano
- Department of Engineering Science & Mechanics, The Pennsylvania State University, University Park, PA 16802, USA
| | - Jonathan B Dingwell
- Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802, USA.
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Harrison EC, Haussler AM, Tueth LE, Baudendistel ST, Earhart GM. Graceful gait: virtual ballet classes improve mobility and reduce falls more than wellness classes for older women. Front Aging Neurosci 2024; 16:1289368. [PMID: 38327499 PMCID: PMC10847569 DOI: 10.3389/fnagi.2024.1289368] [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: 09/05/2023] [Accepted: 01/04/2024] [Indexed: 02/09/2024] Open
Abstract
Introduction Dance is an effective and motivating form of exercise for older women, but few studies have quantified the benefits of virtual dance classes nor, specifically, ballet. This study tested the effectiveness of virtual ballet compared to virtual wellness classes, with the goal of reaching underserved populations. It is among the first to explore the effects of virtual classical ballet on functional gait mobility, balance, and quality of life measures in older women. Methods Older women were recruited in two waves and randomized to two groups: a ballet class modified for older adults and a wellness-based control class. Both groups received 12 weeks of online classes, meeting twice per week for 45-min sessions. Classes were taught by a local company that offers community-based ballet classes. The same instructor led both the ballet and the wellness classes. Pre- and post-intervention assessments include gait and balance testing using wearable inertial sensors and self-report outcomes including quality of life and mood questionnaires. Results Forty-four older women completed the study: Ballet group (n = 21, 67.81 ± 7.3 years); Wellness group (n = 23, 69.96 ± 6.7 years). Pre- to post-intervention, both groups increased velocity on the two-minute walk test (F1,42 = 25.36, p < 0.001) and improved their time on the Timed Up and Go (F1,42 = 4.744, p = 0.035). Both groups improved balance on the Mini-BESTest (F1,42 = 38.154, p < 0.001), increased their scores on the Activities-Specific Balance Confidence Scale (F1,42 = 10.688, p < 0.001), and increased quality of life via the Short Form Health Survey (F1,42 = 7.663, p = 0.008). The ballet group improved gait variability in the backward direction (F1,42 = 14.577, p < 0.001) and reduced fall rates more than the wellness group [χ2(1) = 5.096, p = 0.024]. Discussion Both virtual ballet and wellness classes improve select measures of gait, balance, and quality of life. The benefits seen in both groups highlight the importance of considering social interaction as a key component when developing future interventions to target mobility in older women.
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Affiliation(s)
- Elinor C. Harrison
- Program in Dance, Performing Arts Department, Washington University in St. Louis, St. Louis, MO, United States
- Program in Physical Therapy, Washington University in School of Medicine St. Louis, St. Louis, MO, United States
| | - Allison M. Haussler
- Program in Physical Therapy, Washington University in School of Medicine St. Louis, St. Louis, MO, United States
| | - Lauren E. Tueth
- Program in Physical Therapy, Washington University in School of Medicine St. Louis, St. Louis, MO, United States
| | - Sidney T. Baudendistel
- Program in Physical Therapy, Washington University in School of Medicine St. Louis, St. Louis, MO, United States
| | - Gammon M. Earhart
- Program in Physical Therapy, Washington University in School of Medicine St. Louis, St. Louis, MO, United States
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
- Department of Neuroscience, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
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Johansson R, Jensen L, Barnett CT, Rusaw DF. Quantitative methods used to evaluate balance, postural control, and the fear of falling in lower limb prosthesis users: A systematic review. Prosthet Orthot Int 2023; 47:586-598. [PMID: 37318276 DOI: 10.1097/pxr.0000000000000250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 04/23/2023] [Indexed: 06/16/2023]
Abstract
Problems with balance, postural control, and fear of falling are highly prevalent in lower limb prosthesis users, with much research conducted to understand these issues. The variety of tools used to assess these concepts presents a challenge when interpreting research outcomes. This systematic review aimed to provide a synthesis of quantifiable methods used in the evaluation of balance, postural control, and fear of falling in lower limb prosthesis users with an amputation level at or proximal to the ankle joint. A systematic search was conducted in CINAHL, Medline, AMED, Cochrane, AgeLine, Scopus, Web of Science, Proquest, PsycINFO, PsycArticles, and PubPsych databases followed by additional manual searching via reference lists in the reviewed articles databases. Included articles used quantitative measure of balance or postural control as one of the dependent variables, lower limb prosthesis users as a sample group, and were published in a peer-reviewed journal in English. Relevant assessment questions were created by the investigators to rate the assessment methods used in the individual studies. Descriptive and summary statistics are used to synthesize the results. The search yielded (n = 187) articles assessing balance or postural control (n = 5487 persons in total) and (n = 66) articles assessing fear of falling or balance confidence (n = 7325 persons in total). The most used test to measure balance was the Berg Balance Scale and the most used test to measure fear of falling was the Activities-specific Balance Confidence scale. A large number of studies did not present if the chosen methods were valid and reliable for the lower limb prosthesis users. Among study limitations, small sample size was common.
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Affiliation(s)
- Robin Johansson
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Louise Jensen
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Southern Älvsborg Hospital, Borås, Sweden
| | - Cleveland T Barnett
- School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - David F Rusaw
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
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García-Liñeira J, Leirós-Rodríguez R, Romo-Pérez V, García-Soidán JL. Static and dynamic postural control assessment in schoolchildren: Reliability and reference values of the Modified Flamingo Test and Bar Test. J Bodyw Mov Ther 2023; 36:14-19. [PMID: 37949550 DOI: 10.1016/j.jbmt.2023.05.006] [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: 06/14/2022] [Revised: 04/17/2023] [Accepted: 05/01/2023] [Indexed: 11/12/2023]
Abstract
INTRODUCTION Single-leg stance tests have been widely used to evaluate static balance, like the Modified Flamingo Test. The evaluation of dynamic balance on small support surfaces is the objective of some tests like the Bar Test. RESEARCH QUESTION How is the performance of postural control during the performance of these tests in schoolchildren between 6 and 11 years of age in both sexes? What are the reference values of these tests in this population? METHOD A cross-sectional study in which a total of 282 children. The evaluation included both tests. RESULTS The relative reliability was excellent (Intraclass Correlation Coefficient = 0.84-0.98), and the absolute reliability ranged between 4.5% and 7.1% for coefficient variation and between 0.5 and 1.5 for the standard error of measurement. The average results were 3.8 ± 2.7 floor touches for the Modified Flamingo Test and 5 ± 3.5 m for the Bar Test. The results of both tests improve progressively with the increase of age. DISCUSSION It can be asserted that children of different ages, as well as boys and girls of the same age, perform differently in these tests. Particularly, according to the analysis based on age subgroups, there were greater improvements in the performance of both tests between 8 and 11 years of age. CONCLUSIONS The girls obtained in both tests better results, although between 6 and 7 years of age the differences between sexes are not significant.
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Affiliation(s)
- Jesús García-Liñeira
- Faculty of Education and Sport Sciences, University of Vigo, Campus a Xunqueira, s/n, 36005, Pontevedra, Spain.
| | - Raquel Leirós-Rodríguez
- SALBIS Research Group. Faculty of Health Sciences, Nursing and Physical Therapy Department, University of León, Ave. Astorga, 15, 24401, Ponferrada, Spain.
| | - Vicente Romo-Pérez
- Faculty of Education and Sport Sciences, University of Vigo, Campus a Xunqueira, s/n, 36005, Pontevedra, Spain.
| | - Jose L García-Soidán
- Faculty of Education and Sport Sciences, University of Vigo, Campus a Xunqueira, s/n, 36005, Pontevedra, Spain.
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Symeonidou ER, Esposito NM, Reyes RD, Ferris DP. Practice walking on a treadmill-mounted balance beam modifies beam walking sacral movement and alters performance in other balance tasks. PLoS One 2023; 18:e0283310. [PMID: 37319297 PMCID: PMC10270570 DOI: 10.1371/journal.pone.0283310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/02/2023] [Indexed: 06/17/2023] Open
Abstract
The goals of this study were to determine if a single 30-minute session of practice walking on a treadmill mounted balance beam: 1) altered sacral marker movement kinematics during beam walking, and 2) affected measures of balance during treadmill walking and standing balance. Two groups of young, healthy human subjects practiced walking on a treadmill mounted balance beam for thirty minutes. One group trained with intermittent visual occlusions and the other group trained with unperturbed vision. We hypothesized that the subjects would show changes in sacrum movement kinematics after training and that there would be group differences due to larger improvements in beam walking performance by the visual occlusions group. We also investigated if there was any balance transfer from training on the beam to treadmill walking (margin of stability) and to standing static balance (center of pressure excursion). We found significant differences in sacral marker maximal velocity after training for both groups, but no significant differences between the two groups from training. There was limited evidence of balance transfer from beam-walking practice to gait margin of stability for treadmill walking and for single leg standing balance, but not for tandem stance balance. The number of step-offs while walking on a narrow beam had the largest change with training (partial η2 = 0.7), in accord with task specificity. Other balance metrics indicative of transfer had lower effect sizes (partial η2<0.5). Given the limited transfer across balance training tasks, future work should examine how intermittent visual occlusions during multi-task training improve real world functional outcomes.
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Affiliation(s)
- Evangelia-Regkina Symeonidou
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida, United States of America
- International Max Planck Research School for Systems and Cognitive Neuroscience, University of Tubingen, Tubingen, Germany
| | - Nicole M. Esposito
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida, United States of America
| | - Roehl-Dean Reyes
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida, United States of America
| | - Daniel P. Ferris
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida, United States of America
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Sheehan RC, Guerrero N, Wilson JB, Zai CZ, Kingsbury TD, Tullos ML, Acasio JC, Mahon CE, Miller E, Hendershot BD, Dearth CL, Grabiner MD, Kaufman KR. Common fall-risk indicators are not associated with fall prevalence in a high-functioning military population with lower limb trauma. Clin Biomech (Bristol, Avon) 2022; 100:105774. [PMID: 36208575 DOI: 10.1016/j.clinbiomech.2022.105774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 06/29/2022] [Accepted: 09/27/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Persons with lower limb trauma are at high risk for falls. Although there is a wide range of measures used to assess stability and fall-risk that include performance measures, temporal-spatial gait parameters, and nonlinear dynamic stability calculations, these measures are typically derived from fall-prone populations, such as older adults. Thus, it is unclear if these commonly used fall-risk indicators are effective at evaluating fall-risk in a younger, higher-functioning population of Service members with lower limb trauma. METHODS Twenty-one Service members with lower limb trauma completed a battery of fall-risk assessments that included performance measures (e.g., four-square-step-test), and gait parameters (e.g., step width, step length, step time) and dynamic stability measures (e.g., local divergence exponents) during 10 min of treadmill walking. Participants also reported the number of stumbles and falls over the previous 4 weeks. Negative Binomial and Quasibinomial Regressions were used to evaluate the strength of associations between fall-risk indicators and self-reported falls. FINDING Participants reported on average stumbling 6(4) times and falling 2(3) times in the previous 4 weeks. At least one fall was reported by 62% of the participants. None of the fall-risk indicators were significantly associated with fall prevalence in this population of Service members with lower limb trauma (p > 0.1). INTERPRETATION Despite the high number of reported falls in this young active population, none of the fall-risk indicators investigated effectively captured and quantified the fall-risk. Further research is needed to identify appropriate fall-risk assessments for young, high-functioning individuals with lower limb trauma.
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Affiliation(s)
- Riley C Sheehan
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA; Center for the Intrepid, Department of Rehabilitation Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA; Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
| | - Noel Guerrero
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA; Center for the Intrepid, Department of Rehabilitation Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA
| | - Jonathan B Wilson
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA; Center for the Intrepid, Department of Rehabilitation Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA; Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Claire Z Zai
- Naval Medical Center San Diego, San Diego, CA, USA
| | | | - Meghan L Tullos
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA; Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Julian C Acasio
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA; Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Caitlin E Mahon
- DoD-VA Extremity Trauma and Amputation Center of Excellence, Fort Sam Houston, TX, USA; Walter Reed National Military Medical Center, Bethesda, MD, USA
| | | | - Brad D Hendershot
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA; DoD-VA Extremity Trauma and Amputation Center of Excellence, Fort Sam Houston, TX, USA; Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Christopher L Dearth
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA; DoD-VA Extremity Trauma and Amputation Center of Excellence, Fort Sam Houston, TX, USA; Walter Reed National Military Medical Center, Bethesda, MD, USA
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Ito S, Kakuta Y, Yoshida K, Shirota Y, Mieda T, Iizuka Y, Chikuda H, Iizuka H, Nakamura K. A simple scoring of beam walking performance after spinal cord injury in mice. PLoS One 2022; 17:e0272233. [PMID: 35951582 PMCID: PMC9371269 DOI: 10.1371/journal.pone.0272233] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 07/14/2022] [Indexed: 11/18/2022] Open
Abstract
Precise evaluation of motor functions using simple and reproducible tests for mouse models of spinal cord injury (SCI) are required. Overground walking of SCI mice has been tested by Basso Mouse Scale for locomotion (BMS). In contrast, only a few works quantify walking performances of SCI mice on narrow beams, a different task. Here, we established a novel scoring system using a single beam walking apparatus for SCI mice. The scoring system uses binary judgments of values such as retention, moving forward and reaching the goal on a beam for rating. In addition, high score was given to SCI mouse when the mouse efficiently used hindlimbs for locomotion on the beam. A high rate of concordance of the score derived from positions of hindlimbs between two observers was obtained. Mice displayed the lowest total score on the beam immediately after the SCI, then the score gradually increased like time course of BMS score. Furthermore, the total scores reflected gradation of severity of SCI in 2 strains of mice. The beam walking score proved to be strongly correlated with that of BMS score, indicating that performances between overground walking and beam walking are partly correlated in SCI mice. Collectively, the novel scoring system offers an opportunity to easily evaluate motor performances of mice with SCI.
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Affiliation(s)
- Shunsuke Ito
- Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Yohei Kakuta
- Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Kosuke Yoshida
- Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Gunma, Japan
| | - Yuma Shirota
- Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Gunma, Japan
| | - Tokue Mieda
- Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Yoichi Iizuka
- Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Hirotaka Chikuda
- Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Haku Iizuka
- Department of Orthopaedic Surgery, Isesaki Municipal Hospital, Isesaki, Gunma, Japan
| | - Kazuhiro Nakamura
- Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Gunma, Japan
- * E-mail:
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Sawers A, Fatone S. Normalization alters the interpretation of hip strength in established unilateral lower limb prosthesis users. Clin Biomech (Bristol, Avon) 2022; 97:105702. [PMID: 35714413 DOI: 10.1016/j.clinbiomech.2022.105702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 05/29/2022] [Accepted: 06/01/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Valid comparisons of muscle strength between individuals or legs that differ in size requires normalization, often by simple anthropometric variables. Few studies of muscle strength in lower-limb prosthesis users have normalized strength data by any anthropometric variable, potentially confounding our understanding of strength deficits in lower-limb prosthesis users. The objective of this pilot study was to determine the need for as well as effectiveness and impact of normalizing hip strength in lower-limb prosthesis users. METHODS Peak isometric hip extension and abduction torques were collected from 28 lower-limb prosthesis users. Allometric scaling was used to determine if hip torque values were significantly associated with, and therefore needed to be adjusted for, body mass, thigh length, or body mass x thigh length, and whether normalization was effective in reducing any associations. Between limb differences in peak hip torque, and correlations with balance ability, were inspected pre- and post-normalization. FINDINGS Hip torques were consistently and significantly associated with body-mass x thigh length. Associations between peak hip torque and body-mass x thigh length were reduced by normalization. After normalization by body-mass x thigh length, between limb differences in hip extension torque, as well as the correlation between hip abduction torque and balance ability, changed from non-significant to significant. INTERPRETATION In the absence of normalization, hip strength (i.e., peak torque) in lower-limb prosthesis users remains dependent on basic anthropometric variables, masking relationships between hip strength and balance ability, as well as between limb differences.
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Affiliation(s)
- Andrew Sawers
- Department of Kinesiology, University of Illinois at Chicago, Chicago, IL 60612, United States of America.
| | - Stefania Fatone
- Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL 60611, United States of America; Department of Rehabilitation Medicine, University of Washington, Seattle, WA 98195, United States of America
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12
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Milani G, Costa AAS, Junqueira EB, Campoi EG, Campoi HG, Santiago PRP, Moraes R. Three days of beam walking practice improves dynamic balance control regardless of the use of haptic anchors in older adults. Neurosci Lett 2022; 781:136682. [PMID: 35588930 DOI: 10.1016/j.neulet.2022.136682] [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: 01/12/2022] [Revised: 05/12/2022] [Accepted: 05/13/2022] [Indexed: 11/19/2022]
Abstract
Balance deficits during walking increase the risk of falls in older adults. Providing haptic information through anchors improves dynamic balance control, but the benefits of practicing with anchors during walking need to be evaluated. We investigated the effect of practice with haptic anchors in the beam walking task in older adults. Twenty-five older adults participated in this study divided into 0% (G0, practice without the anchors) and 50% (G50, practice with the haptic anchors in 50% of the trials) groups. With the anchors, participants held in each hand a cable with a mass of 0.125 kg affixed to the end of the cable that contacted the ground. They walked and kept the anchors in contact with the ground such that they dragged them. Participants increased the distance walked on the beam and reduced the trunk angular acceleration after training, but this effect was independent of the anchors. The use of haptic anchors during beam walking training did not significantly affect older adults' performance and dynamic balance control. Both groups showed improvements in the post-test and 24-hr retention conditions, indicating that older adults can learn to adapt their gait to more challenging contexts.
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Affiliation(s)
- Geovana Milani
- Biomechanics and Motor Control Lab, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil
| | - Andréia A S Costa
- Biomechanics and Motor Control Lab, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil; Graduate Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil; Center for Human Movement Sciences, University of Groningen Medical Center, Groningen, The Netherlands
| | - Eduardo B Junqueira
- Biomechanics and Motor Control Lab, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil
| | - Eduardo G Campoi
- Biomechanics and Motor Control Lab, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil; Graduate Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Henrique G Campoi
- Biomechanics and Motor Control Lab, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil; Graduate Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Paulo R P Santiago
- Biomechanics and Motor Control Lab, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil; Graduate Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Renato Moraes
- Biomechanics and Motor Control Lab, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil; Graduate Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
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13
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Beam width and arm position but not cognitive task affect walking balance in older adults. Sci Rep 2022; 12:6854. [PMID: 35477729 PMCID: PMC9046185 DOI: 10.1038/s41598-022-10848-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 04/11/2022] [Indexed: 11/08/2022] Open
Abstract
Detection of changes in dynamic balance could help identify older adults at fall risk. Walking on a narrow beam with its width, cognitive load, and arm position manipulated could be an alternative to current tests. Therefore, we examined additive and interactive effects of beam width, cognitive task (CT), and arm position on dynamic balance during beam walking in older adults. Twenty older adults (69 ± 4y) walked on 6, 8, and 10-cm wide beams (2-cm high, 4-m-long), with and without CT, with three arm positions (free, crossed, akimbo). We determined cognitive errors, distance walked, step speed, root mean square (RMS) of center of mass (COM) displacement and trunk acceleration in the frontal plane. Beam width decrease progressively reduced distance walked and increased trunk acceleration RMS. Step speed decreased on the narrowest beam and with CT. Arm crossing decreased distance walked and step speed. COM displacement RMS and cognitive errors were not affected by any manipulation. In conclusion, distance walked indicated that beam width and arm position, but less so CT, affected dynamic balance, implying that beam walking has the potential to become a test of fall risk. Stability measurements suggested effective trunk adjustments to control COM position and keep dynamic balance during the task.
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14
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Symeonidou ER, Ferris DP. Intermittent Visual Occlusions Increase Balance Training Effectiveness. Front Hum Neurosci 2022; 16:748930. [PMID: 35547194 PMCID: PMC9083907 DOI: 10.3389/fnhum.2022.748930] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 04/06/2022] [Indexed: 11/20/2022] Open
Abstract
Improving dynamic balance can prevent falls in humans with neurological and mechanical deficits. Dynamic balance requires the neural integration of multisensory information to constantly assess the state of body mechanics. Prior research found that intermittent visual rotations improved balance training during walking on a narrow beam, but limitations from the immersive virtual reality headset hindered balance training effectiveness overall. We theorized that intermittent visual occlusions with electrically controlled liquid crystal glasses would overcome the previous limitations of the immersive virtual reality headset and provide a means to enhance dynamic balance training efficacy. Forty healthy young individuals walked on a treadmill-mounted balance beam for 30 min (20 subjects with intermittent visual occlusions and 20 subjects with unperturbed vision). Balance performance, in number of step-offs of the beam, improved by 78% for the visual occlusions group on the same day of the training, a near fourfold improvement compared to the 21% improvement for the unperturbed vision group (t(38) = -5.2, p < 0.001). The difference between groups was also apparent 2 weeks later testing for retention (60% improvement for the visual occlusions group, 5% for the unperturbed vision group; t(38) = -4.2, p < 0.001). Intermittent visual occlusions are likely a simple method for enhancing balance training in dynamic motor tasks.
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Affiliation(s)
- Evangelia-Regkina Symeonidou
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
- International Max Planck Research School for Systems and Cognitive Neuroscience, University of Tübingen, Tübingen, Germany
| | - Daniel P. Ferris
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
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15
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The identification of fall risk through tests of mediolateral stability during gait. Exp Gerontol 2022; 163:111803. [DOI: 10.1016/j.exger.2022.111803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/18/2022] [Accepted: 04/04/2022] [Indexed: 11/20/2022]
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16
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Huang L, Xiao D, Sun H, Qu Y, Su X. Behavioral tests for evaluating the characteristics of brain diseases in rodent models: Optimal choices for improved outcomes (Review). Mol Med Rep 2022; 25:183. [PMID: 35348193 DOI: 10.3892/mmr.2022.12699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/16/2022] [Indexed: 11/05/2022] Open
Abstract
Behavioral assessment is the dominant approach for evaluating whether animal models of brain diseases can successfully mimic the clinical characteristics of diseases. At present, most research regarding brain diseases involves the use of rodent models. While studies have reported numerous methods of behavioral assessments in rodent models of brain diseases, each with different principles, procedures, and assessment criteria, only few reviews have focused on characterizing and differentiating these methods based on applications for which they are most appropriate. Therefore, in the present review, the representative behavioral tests in rodent models of brain diseases were compared and differentiated, aiming to provide convenience for researchers in selecting the optimal methods for their studies.
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Affiliation(s)
- Lingyi Huang
- Department of Pediatrics/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Ministry of Education), West China Second University Hospital, Chengdu, Sichuan 610041, P.R. China
| | - Dongqiong Xiao
- Department of Pediatrics/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Ministry of Education), West China Second University Hospital, Chengdu, Sichuan 610041, P.R. China
| | - Hao Sun
- Department of Pediatrics/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Ministry of Education), West China Second University Hospital, Chengdu, Sichuan 610041, P.R. China
| | - Yi Qu
- Department of Pediatrics/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Ministry of Education), West China Second University Hospital, Chengdu, Sichuan 610041, P.R. China
| | - Xiaojuan Su
- Department of Pediatrics/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Ministry of Education), West China Second University Hospital, Chengdu, Sichuan 610041, P.R. China
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17
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Wu M, Drnach L, Bong SM, Song YS, Ting LH. Human-Human Hand Interactions Aid Balance During Walking by Haptic Communication. Front Robot AI 2021; 8:735575. [PMID: 34805289 PMCID: PMC8599825 DOI: 10.3389/frobt.2021.735575] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 10/20/2021] [Indexed: 11/23/2022] Open
Abstract
Principles from human-human physical interaction may be necessary to design more intuitive and seamless robotic devices to aid human movement. Previous studies have shown that light touch can aid balance and that haptic communication can improve performance of physical tasks, but the effects of touch between two humans on walking balance has not been previously characterized. This study examines physical interaction between two persons when one person aids another in performing a beam-walking task. 12 pairs of healthy young adults held a force sensor with one hand while one person walked on a narrow balance beam (2 cm wide x 3.7 m long) and the other person walked overground by their side. We compare balance performance during partnered vs. solo beam-walking to examine the effects of haptic interaction, and we compare hand interaction mechanics during partnered beam-walking vs. overground walking to examine how the interaction aided balance. While holding the hand of a partner, participants were able to walk further on the beam without falling, reduce lateral sway, and decrease angular momentum in the frontal plane. We measured small hand force magnitudes (mean of 2.2 N laterally and 3.4 N vertically) that created opposing torque components about the beam axis and calculated the interaction torque, the overlapping opposing torque that does not contribute to motion of the beam-walker’s body. We found higher interaction torque magnitudes during partnered beam-walking vs. partnered overground walking, and correlation between interaction torque magnitude and reductions in lateral sway. To gain insight into feasible controller designs to emulate human-human physical interactions for aiding walking balance, we modeled the relationship between each torque component and motion of the beam-walker’s body as a mass-spring-damper system. Our model results show opposite types of mechanical elements (active vs. passive) for the two torque components. Our results demonstrate that hand interactions aid balance during partnered beam-walking by creating opposing torques that primarily serve haptic communication, and our model of the torques suggest control parameters for implementing human-human balance aid in human-robot interactions.
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Affiliation(s)
- Mengnan Wu
- The Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA, United States
| | - Luke Drnach
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Sistania M Bong
- The Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA, United States
| | - Yun Seong Song
- Mechanical and Aerospace Engineering, Missouri University of Science and Technology, Rolla, MO, United States
| | - Lena H Ting
- The Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA, United States.,Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University School of Medicine, Atlanta, GA, United States
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18
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Fettrow T, Hupfeld K, Reimann H, Choi J, Hass C, Seidler R. Age differences in adaptation of medial-lateral gait parameters during split-belt treadmill walking. Sci Rep 2021; 11:21148. [PMID: 34707122 PMCID: PMC8551204 DOI: 10.1038/s41598-021-00515-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 10/12/2021] [Indexed: 11/10/2022] Open
Abstract
The split-belt treadmill has been used to examine the adaptation of spatial and temporal gait parameters. Historically, similar studies have focused on anterior-posterior (AP) spatiotemporal gait parameters because this paradigm is primarily a perturbation in the AP direction, but it is important to understand whether and how medial-lateral (ML) control adapts in this scenario. The ML control of balance must be actively controlled and adapted in different walking environments. Furthermore, it is well established that older adults have balance difficulties. Therefore, we seek to determine whether ML balance adaptation differs in older age. We analyzed split belt induced changes in gait parameters including variables which inform us about ML balance control in younger and older adults. Our primary finding is that younger adults showed sustained asymmetric changes in these ML balance parameters during the split condition. Specifically, younger adults sustained a greater displacement between their fast stance foot and their upper body, relative to the slow stance foot, in the ML direction. This finding suggests that younger adults may be exploiting passive dynamics in the ML direction, which may be more metabolically efficient. Older adults did not display the same degree of asymmetry, suggesting older adults may be more concerned about maintaining a stable gait.
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Affiliation(s)
- Tyler Fettrow
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32605, USA.
| | - Kathleen Hupfeld
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32605, USA
| | - Hendrik Reimann
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, 19713, USA
| | - Julia Choi
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32605, USA
| | - Chris Hass
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32605, USA
| | - Rachael Seidler
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32605, USA
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19
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Lee J, Zhang K, Hogan N. Identifying human postural dynamics and control from unperturbed balance. J Neuroeng Rehabil 2021; 18:54. [PMID: 33752698 PMCID: PMC7986509 DOI: 10.1186/s12984-021-00843-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 03/03/2021] [Indexed: 11/25/2022] Open
Abstract
Background Upright standing requires control of an inherently unstable multi-joint human body within a small base of support, despite biological motor and / or sensory noise which challenge balance. Without applying perturbations, system identification methods have been regarded as inadequate, because the relevant internal biological noise processes are not accessible to direct measurement. As a result, unperturbed balance studies have been limited to investigation of behavioral patterns rather than possible underlying control strategies. Methods In this paper, we present a mathemathically rigorous system identification method that is applicable to study the dynamics and control of unperturbed balance. The method is derived from autocorrelation matrices with non-zero time lags and identifies the system matrix of a discrete-time dynamic system in the presence of unknown noise processes, without requiring any information about the strength of the noise. Results Unlike reasonable ‘least-squares’ approaches, the performance of the new method is consistent across a range of different combinations of internal and measurement noise strengths, even when measurement noise is substantial. We present a numerical example of a model that simulates human upright balancing and show that its dynamics can be identified accurately. With a biomechanically reasonable choice of state and input variables, a state feedback controller can also be identified. Conclusions This study provides a new method to correctly identify the dynamics of human standing without the need for known external perturbations. The method was numerically validated using simulation that included realistic features of human balance. This method avoids potential issues of adaptation or possible reflex responses evoked by external perturbations, and does not require expensive in-lab, high-precision measurement equipment. It may eventually enable diagnosis and treatment of individuals with impaired balance, and the development of safe and effective assistive and / or rehabilitative technologies.
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Affiliation(s)
- Jongwoo Lee
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA.
| | - Kuangen Zhang
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA.,Department of Mechanical and Energy Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, 518055, China.,Department of Mechanical Engineering, The University of British Columbia, Vancouver, BC, V6T 1Z4, Canada
| | - Neville Hogan
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA.,Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
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20
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Ghosn NJ, Palmer JA, Borich MR, Ting LH, Payne AM. Cortical Beta Oscillatory Activity Evoked during Reactive Balance Recovery Scales with Perturbation Difficulty and Individual Balance Ability. Brain Sci 2020; 10:E860. [PMID: 33207570 PMCID: PMC7697848 DOI: 10.3390/brainsci10110860] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/06/2020] [Accepted: 11/12/2020] [Indexed: 11/16/2022] Open
Abstract
Cortical beta oscillations (13-30 Hz) reflect sensorimotor processing, but are not well understood in balance recovery. We hypothesized that sensorimotor cortical activity would increase under challenging balance conditions. We predicted greater beta power when balance was challenged, either by more difficult perturbations or by lower balance ability. In 19 young adults, we measured beta power over motor cortical areas (electroencephalography, Cz electrode) during three magnitudes of backward support -surface translations. Peak beta power was measured during early (50-150 ms), late (150-250 ms), and overall (0-400 ms) time bins, and wavelet-based analyses quantified the time course of evoked beta power. An ANOVA was used to compare peak beta power across perturbation magnitudes in each time bin. We further tested the association between perturbation-evoked beta power and individual balance ability measured in a challenging beam walking task. Beta power increased ~50 ms after perturbation, and to a greater extent in larger perturbations. Lower individual balance ability was associated with greater beta power in only the late (150-250 ms) time bin. These findings demonstrate greater sensorimotor cortical engagement under more challenging balance conditions, which may provide a biomarker for reduced automaticity in balance control that could be used in populations with neurological impairments.
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Affiliation(s)
- Nina J. Ghosn
- Georgia Institute of Technology, Atlanta, GA 30332, USA;
| | | | - Michael R. Borich
- Emory University, Atlanta, GA 30332, USA; (J.A.P.); (M.R.B.); (L.H.T.)
| | - Lena H. Ting
- Emory University, Atlanta, GA 30332, USA; (J.A.P.); (M.R.B.); (L.H.T.)
| | - Aiden M. Payne
- Emory University, Atlanta, GA 30332, USA; (J.A.P.); (M.R.B.); (L.H.T.)
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21
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Allen JL, Carey HD, Ting LH, Sawers A. Generalization of motor module recruitment across standing reactive balance and walking is associated with beam walking performance in young adults. Gait Posture 2020; 82:242-247. [PMID: 32979703 PMCID: PMC7718426 DOI: 10.1016/j.gaitpost.2020.09.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 09/06/2020] [Accepted: 09/07/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Recent studies provide compelling evidence that recruiting a common pool of motor modules across behaviors (i.e., motor module generalization) may facilitate motor performance. In particular, motor module generalization across standing reactive balance and walking is associated with both walking speed and endurance in neurologically impaired populations (e.g., stroke survivors and individual's with Parkinson's disease). To test whether this phenomenon is a general neuromuscular strategy associated with well-coordinated walking and not limited to motor impairment, this relationship must be confirmed in neurologically intact adults. RESEARCH QUESTION Is motor module generalization across standing reactive balance and walking related to walking performance in neurologically intact young adults? METHODS Two populations of young adults were recruited to capture a wide range of walking performance: professionally-trained ballet dancers (i.e., experts, n = 12) and novices (n = 8). Motor modules (a.k.a. muscle synergies) were extracted from muscles spanning the trunk, hip, knee and ankle during walking and multidirectional perturbations to standing. Motor module generalization was calculated as the number of modules common to these behaviors. Walking performance was assessed using self-selected walking speed and beam-walking proficiency (i.e., distance walked on a narrow beam). Motor module generalization between experts and novices was compared using rank-sum tests and the association between generalization and walking performance was assessed using correlation analyses. RESULTS Experts generalized more motor modules across standing reactive balance and walking than novices (p = 0.009). Across all subjects, motor module generalization was moderately associated with increased beam walking proficiency (r = 0.456, p = 0.022) but not walking speed (r = 0.092, p = 0.349). SIGNIFICANCE Similar relationships between walking performance and motor module generalization exist in neurologically intact and impaired populations, suggesting that motor module generalization across standing reactive balance and walking may be a general neuromuscular mechanism contributing to the successful control of walking.
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Affiliation(s)
- Jessica L. Allen
- Department of Chemical and Biomedical Engineering, West Virginia University, Morgantown, WV, USA
| | - Hannah D. Carey
- Department of Chemical and Biomedical Engineering, West Virginia University, Morgantown, WV, USA
| | - Lena H. Ting
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA, USA,Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University School of Medicine, Atlanta, GA, USA
| | - Andrew Sawers
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
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22
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Payne AM, Ting LH. Worse balance is associated with larger perturbation-evoked cortical responses in healthy young adults. Gait Posture 2020; 80:324-330. [PMID: 32593102 PMCID: PMC7436194 DOI: 10.1016/j.gaitpost.2020.06.018] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 06/11/2020] [Accepted: 06/12/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Reactive balance recovery evokes a negative peak of cortical electroencephalography (EEG) activity (N1) that is simultaneous to brainstem-mediated automatic balance-correcting muscle activity. This study follows up on an observation from a previous study, in which N1 responses were larger in individuals who seemed to have greater difficulty responding to support-surface perturbations. RESEARCH QUESTION We hypothesized that people engage more cortical activity when balance recovery is more challenging. We predicted that people with lower balance ability would exhibit larger cortical N1 responses during balance perturbations. METHODS In 20 healthy young adults (11 female, ages 19-38) we measured the amplitude of the cortical N1 response evoked by 48 backward translational support-surface perturbations of unpredictable timing and amplitude. Perturbations included a Small (8 cm) perturbation that was identical across participants, as well as Medium (13-15 cm) and Large (18-22 cm) perturbations scaled to participant height to control for height-related differences in perturbation difficulty. To assess individual differences in balance ability, we measured the distance traversed on a narrow (0.5-inch wide) 12-foot beam across 6 trials. We tested whether the cortical N1 response amplitude was correlated to balance ability across participants. RESULTS Cortical N1 amplitudes in response to standing balance perturbations (54 ± 18 μV) were inversely correlated to the distance traveled in the difficult beam-walking task (R2 = 0.20, p = 0.029). Further, there was a significant interaction between performance on the beam-walking task and the effect of perturbation magnitude on the cortical N1 response amplitude, whereby individuals who performed worse on the beam-walking task had greater increases in N1 amplitudes with increases in perturbation magnitude. SIGNIFICANCE Cortical N1 response amplitudes may reflect greater cortical involvement in balance recovery when challenged. This increased cortical involvement may reflect cognitive processes such as greater perceived threat or attention to balance, which have the potential to influence subsequent motor control.
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Affiliation(s)
- Aiden M. Payne
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Tech and Emory University, United States
| | - Lena H. Ting
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Tech and Emory University, United States,Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University, United States,Corresponding author at: 1760 Haygood Drive, Suite W200, Atlanta, GA, 30332, United States. (L.H. Ting)
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23
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Lavender AP, Rawlings S, Warnock A, McGonigle T, Hiles-Murison B, Nesbit M, Lam V, Hackett MJ, Fitzgerald M, Takechi R. Repeated Long-Term Sub-concussion Impacts Induce Motor Dysfunction in Rats: A Potential Rodent Model. Front Neurol 2020; 11:491. [PMID: 32547485 PMCID: PMC7274030 DOI: 10.3389/fneur.2020.00491] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 05/05/2020] [Indexed: 01/05/2023] Open
Abstract
Whilst detrimental effects of repeated sub-concussive impacts on neurophysiological and behavioral function are increasingly reported, the underlying mechanisms are largely unknown. Here, we report that repeated sub-concussion with a light weight drop (25 g) in wild-type PVG rats for 2 weeks does not induce detectable neuromotor dysfunction assessed by beamwalk and rotarod tests. However, after 12 weeks of repeated sub-concussion, the rats exhibited moderate neuromotor dysfunction. This is the first study to demonstrate development of neuromotor dysfunction following multiple long-term sub-concussive impacts in rats. The outcomes may offer significant opportunity for future studies to understand the mechanisms of sub-concussion-induced neuropsychological changes.
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Affiliation(s)
- Andrew P Lavender
- School of Health and Life Sciences, Federation University, Ballarat, VIC, Australia.,School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Samuel Rawlings
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Andrew Warnock
- Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia.,Perron Institute for Neurological and Translational Science, Ralph and Patricia Sarich Neuroscience Research Institute, Nedlands, WA, Australia
| | - Terry McGonigle
- Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia.,Perron Institute for Neurological and Translational Science, Ralph and Patricia Sarich Neuroscience Research Institute, Nedlands, WA, Australia
| | - Bailey Hiles-Murison
- Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia.,School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Michael Nesbit
- Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia.,School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Virginie Lam
- Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia.,School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Mark J Hackett
- Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia.,School of Molecular and Life Science, Faculty of Science and Engineering, Curtin University, Perth, WA, Australia
| | - Melinda Fitzgerald
- Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia.,Perron Institute for Neurological and Translational Science, Ralph and Patricia Sarich Neuroscience Research Institute, Nedlands, WA, Australia.,Experimental and Regenerative Neurosciences, School of Biological Sciences, The University of Western Australia, Perth, WA, Australia
| | - Ryusuke Takechi
- Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia.,School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
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Brandstadter R, Ayeni O, Krieger SC, Harel NY, Escalon MX, Katz Sand I, Leavitt VM, Fabian MT, Buyukturkoglu K, Klineova S, Riley CS, Lublin FD, Miller AE, Sumowski JF. Detection of subtle gait disturbance and future fall risk in early multiple sclerosis. Neurology 2020; 94:e1395-e1406. [PMID: 32102980 DOI: 10.1212/wnl.0000000000008938] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 10/05/2019] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To test the hypothesis that higher-challenge gait and balance tasks are more sensitive than traditional metrics to subtle patient-reported gait dysfunction and future fall risk in early multiple sclerosis (MS). METHODS Persons with early MS (n = 185; ≤5 years diagnosed) reported gait function (MS Walking Scale) and underwent traditional disability metrics (Expanded Disability Status Scale [EDSS], Timed 25 Foot Walk). Patients and healthy controls (n = 50) completed clinically feasible challenge tasks of gait endurance (2-Minute Walk Test), standing balance (NIH Toolbox), and dynamic balance (balance boards; tandem walk on 2 ten-foot boards of different widths, 4.5 and 1.5 in). MRI assessed global and regional brain volumes, total T2 lesion volume (T2LV), infratentorial T2LVs and counts, and cervical cord lesion counts. Falls, near falls, and fall-related injuries were assessed after 1 year. We examined links between all tasks and patient-reported gait, MRI markers, and fall data. RESULTS Patients performed worse on higher challenge balance, but not gait, tasks compared with healthy controls. Worse patient-reported gait disturbance was associated with worse performance on all tasks, but only dynamic balance was sensitive to mild patient-reported gait difficulty. Balance tasks were more correlated with MRI metrics than were walking tasks or EDSS score. Thirty percent of patients reported either a fall or near fall after 1 year, with poor dynamic balance as the only task independently predicting falls. CONCLUSIONS Balance plays a leading role in gait dysfunction early in MS. Clinically feasible higher-challenge balance tasks were most sensitive to patient-reported gait, MRI disease markers, and risk of future falls, highlighting potential to advance functional outcomes in clinical practice and trials.
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Affiliation(s)
- Rachel Brandstadter
- From the Department of Neurology (R.B.), University of Pennsylvania, Philadelphia; Department of Neurology (O.A.), Kaiser Permanente, Atlanta, GA; Department of Neurology (S.C.K., N.Y.H., M.X.E., I.K.S., M.T.F., S.K., F.D.L., A.E.M., J.F.S.), Icahn School of Medicine at Mount Sinai; James J. Peters Veterans Affairs Medical Center (N.Y.H.); and Department of Neurology (V.M.L, K.B., C.S.R..), Columbia University Medical Center, New York, NY
| | - Oluwasheyi Ayeni
- From the Department of Neurology (R.B.), University of Pennsylvania, Philadelphia; Department of Neurology (O.A.), Kaiser Permanente, Atlanta, GA; Department of Neurology (S.C.K., N.Y.H., M.X.E., I.K.S., M.T.F., S.K., F.D.L., A.E.M., J.F.S.), Icahn School of Medicine at Mount Sinai; James J. Peters Veterans Affairs Medical Center (N.Y.H.); and Department of Neurology (V.M.L, K.B., C.S.R..), Columbia University Medical Center, New York, NY
| | - Stephen C Krieger
- From the Department of Neurology (R.B.), University of Pennsylvania, Philadelphia; Department of Neurology (O.A.), Kaiser Permanente, Atlanta, GA; Department of Neurology (S.C.K., N.Y.H., M.X.E., I.K.S., M.T.F., S.K., F.D.L., A.E.M., J.F.S.), Icahn School of Medicine at Mount Sinai; James J. Peters Veterans Affairs Medical Center (N.Y.H.); and Department of Neurology (V.M.L, K.B., C.S.R..), Columbia University Medical Center, New York, NY
| | - Noam Y Harel
- From the Department of Neurology (R.B.), University of Pennsylvania, Philadelphia; Department of Neurology (O.A.), Kaiser Permanente, Atlanta, GA; Department of Neurology (S.C.K., N.Y.H., M.X.E., I.K.S., M.T.F., S.K., F.D.L., A.E.M., J.F.S.), Icahn School of Medicine at Mount Sinai; James J. Peters Veterans Affairs Medical Center (N.Y.H.); and Department of Neurology (V.M.L, K.B., C.S.R..), Columbia University Medical Center, New York, NY
| | - Miguel X Escalon
- From the Department of Neurology (R.B.), University of Pennsylvania, Philadelphia; Department of Neurology (O.A.), Kaiser Permanente, Atlanta, GA; Department of Neurology (S.C.K., N.Y.H., M.X.E., I.K.S., M.T.F., S.K., F.D.L., A.E.M., J.F.S.), Icahn School of Medicine at Mount Sinai; James J. Peters Veterans Affairs Medical Center (N.Y.H.); and Department of Neurology (V.M.L, K.B., C.S.R..), Columbia University Medical Center, New York, NY
| | - Ilana Katz Sand
- From the Department of Neurology (R.B.), University of Pennsylvania, Philadelphia; Department of Neurology (O.A.), Kaiser Permanente, Atlanta, GA; Department of Neurology (S.C.K., N.Y.H., M.X.E., I.K.S., M.T.F., S.K., F.D.L., A.E.M., J.F.S.), Icahn School of Medicine at Mount Sinai; James J. Peters Veterans Affairs Medical Center (N.Y.H.); and Department of Neurology (V.M.L, K.B., C.S.R..), Columbia University Medical Center, New York, NY
| | - Victoria M Leavitt
- From the Department of Neurology (R.B.), University of Pennsylvania, Philadelphia; Department of Neurology (O.A.), Kaiser Permanente, Atlanta, GA; Department of Neurology (S.C.K., N.Y.H., M.X.E., I.K.S., M.T.F., S.K., F.D.L., A.E.M., J.F.S.), Icahn School of Medicine at Mount Sinai; James J. Peters Veterans Affairs Medical Center (N.Y.H.); and Department of Neurology (V.M.L, K.B., C.S.R..), Columbia University Medical Center, New York, NY
| | - Michelle T Fabian
- From the Department of Neurology (R.B.), University of Pennsylvania, Philadelphia; Department of Neurology (O.A.), Kaiser Permanente, Atlanta, GA; Department of Neurology (S.C.K., N.Y.H., M.X.E., I.K.S., M.T.F., S.K., F.D.L., A.E.M., J.F.S.), Icahn School of Medicine at Mount Sinai; James J. Peters Veterans Affairs Medical Center (N.Y.H.); and Department of Neurology (V.M.L, K.B., C.S.R..), Columbia University Medical Center, New York, NY
| | - Korhan Buyukturkoglu
- From the Department of Neurology (R.B.), University of Pennsylvania, Philadelphia; Department of Neurology (O.A.), Kaiser Permanente, Atlanta, GA; Department of Neurology (S.C.K., N.Y.H., M.X.E., I.K.S., M.T.F., S.K., F.D.L., A.E.M., J.F.S.), Icahn School of Medicine at Mount Sinai; James J. Peters Veterans Affairs Medical Center (N.Y.H.); and Department of Neurology (V.M.L, K.B., C.S.R..), Columbia University Medical Center, New York, NY
| | - Sylvia Klineova
- From the Department of Neurology (R.B.), University of Pennsylvania, Philadelphia; Department of Neurology (O.A.), Kaiser Permanente, Atlanta, GA; Department of Neurology (S.C.K., N.Y.H., M.X.E., I.K.S., M.T.F., S.K., F.D.L., A.E.M., J.F.S.), Icahn School of Medicine at Mount Sinai; James J. Peters Veterans Affairs Medical Center (N.Y.H.); and Department of Neurology (V.M.L, K.B., C.S.R..), Columbia University Medical Center, New York, NY
| | - Claire S Riley
- From the Department of Neurology (R.B.), University of Pennsylvania, Philadelphia; Department of Neurology (O.A.), Kaiser Permanente, Atlanta, GA; Department of Neurology (S.C.K., N.Y.H., M.X.E., I.K.S., M.T.F., S.K., F.D.L., A.E.M., J.F.S.), Icahn School of Medicine at Mount Sinai; James J. Peters Veterans Affairs Medical Center (N.Y.H.); and Department of Neurology (V.M.L, K.B., C.S.R..), Columbia University Medical Center, New York, NY
| | - Fred D Lublin
- From the Department of Neurology (R.B.), University of Pennsylvania, Philadelphia; Department of Neurology (O.A.), Kaiser Permanente, Atlanta, GA; Department of Neurology (S.C.K., N.Y.H., M.X.E., I.K.S., M.T.F., S.K., F.D.L., A.E.M., J.F.S.), Icahn School of Medicine at Mount Sinai; James J. Peters Veterans Affairs Medical Center (N.Y.H.); and Department of Neurology (V.M.L, K.B., C.S.R..), Columbia University Medical Center, New York, NY
| | - Aaron E Miller
- From the Department of Neurology (R.B.), University of Pennsylvania, Philadelphia; Department of Neurology (O.A.), Kaiser Permanente, Atlanta, GA; Department of Neurology (S.C.K., N.Y.H., M.X.E., I.K.S., M.T.F., S.K., F.D.L., A.E.M., J.F.S.), Icahn School of Medicine at Mount Sinai; James J. Peters Veterans Affairs Medical Center (N.Y.H.); and Department of Neurology (V.M.L, K.B., C.S.R..), Columbia University Medical Center, New York, NY
| | - James F Sumowski
- From the Department of Neurology (R.B.), University of Pennsylvania, Philadelphia; Department of Neurology (O.A.), Kaiser Permanente, Atlanta, GA; Department of Neurology (S.C.K., N.Y.H., M.X.E., I.K.S., M.T.F., S.K., F.D.L., A.E.M., J.F.S.), Icahn School of Medicine at Mount Sinai; James J. Peters Veterans Affairs Medical Center (N.Y.H.); and Department of Neurology (V.M.L, K.B., C.S.R..), Columbia University Medical Center, New York, NY.
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25
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Sawers A, Hafner BJ. Conventional administration and scoring procedures suppress the diagnostic accuracy of a performance-based test designed to assess balance ability in lower limb prosthesis users. Prosthet Orthot Int 2019; 43:402-408. [PMID: 31117888 DOI: 10.1177/0309364619848274] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Practice effects have been observed among performance-based clinical tests administered to prosthesis-users. Their impact on test applications remains unknown. OBJECTIVE To determine whether scoring a clinical balance test using conventional procedures that do not accommodate practice effects reduces its diagnostic accuracy relative to scoring it using recommended procedures that do accommodate practice effects. STUDY DESIGN Cross-sectional study. METHODS Narrowing Beam Walking Test data from 40 prosthesis users was scored using recommended methods (i.e. average of trials 3-5) and conventional methods applied to other tests (i.e. mean or best of trials 1-3). Area under the receiver operating characteristic curve for each method was compared to 0.50, to determine if it was better than chance at identifying prosthesis-users with a history of falls, and to 0.80, to determine if it surpassed a threshold recommended for diagnostic accuracy. RESULTS Receiver operating characteristic curve area decreased when the Narrowing Beam Walking Test was scored using conventional rather than recommended procedures. Furthermore, when scored using conventional procedures, the NBWT no longer discriminated between prosthesis-users with and without a history of falls with a probability greater than chance, or exceeded recommended diagnostic thresholds. CONCLUSION Scoring the Narrowing Beam Walking Test using conventional procedures that do not accommodate practice effects decreased its diagnostic accuracy among prosthesis-users relative to recommended procedures. Conventional scoring procedures may limit the effectiveness of performance-based tests used to screen for fall risk in prosthesis-users because they do not mitigate practice effects. The influence of practice effects on other tests, and test applications (e.g. clinical evaluation and prediction), is warranted. CLINICAL RELEVANCE Scoring a clinical balance test using conventional procedures that do not mitigate practice effects reduced its diagnostic accuracy. Changing administration and scoring procedures to accommodate practice effects should be considered to improve the diagnostic accuracy of other performance-based balance tests.
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Affiliation(s)
- Andrew Sawers
- 1 Department of Kinesiology, University of Illinois at Chicago, Chicago, IL, USA
| | - Brian J Hafner
- 2 Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
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26
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Hill MW, Wdowski MM, Pennell A, Stodden DF, Duncan MJ. Dynamic Postural Control in Children: Do the Arms Lend the Legs a Helping Hand? Front Physiol 2019; 9:1932. [PMID: 30705636 PMCID: PMC6345241 DOI: 10.3389/fphys.2018.01932] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 12/21/2018] [Indexed: 11/13/2022] Open
Abstract
There is growing empirical evidence lending support to the existence of an "upper body strategy" to extend the ankle and hip strategies in maintaining upright postural stability among adults. Both postural stability and arm movement functions are still developing in children. Therefore, enquiry concerning arm contribution to postural stability among children is needed. This proof of concept study seeks to determine whether the arms play a functionally relevant role in dynamic postural control among children. Twenty-nine children (girls, n = 15; age, 10.6 ± 0.5 years; height, 1.48 ± 0.08 m; mass, 42.8 ± 11.4 kg; BMI, 19.2 ± 3.7 kg/m2) completed three dynamic balance tests; (1) Y Balance test®, (2) timed balance beam walking test, (3) transition from dynamic to static balance using the dynamic postural stability index (DPSI). Each test was performed with free and restricted arm movement. Restricting arm movements elicited a marked degradation in the Y Balance reach distance (all directions, P ≤ 0.001, d = -0.85 to -1.13) and timed balance beam walking test (P ≤ 0.001, d = 1.01), while the DPSI was the only metric that was not different between free and restricted arm movements (P = 0.335, d = -0.08). This study provides direct evidence that the arms play a functionally relevant role in dynamic balance performance among children. These findings may provide the impetus to develop training interventions to improve the use of the arms in activities of daily living.
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Affiliation(s)
- Mathew W Hill
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, United Kingdom
| | - Maximilian M Wdowski
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, United Kingdom
| | - Adam Pennell
- Human Performance and Development Laboratory, Department of Physical Education, University of South Carolina, Columbia, MO, United States
| | - David F Stodden
- Human Performance and Development Laboratory, Department of Physical Education, University of South Carolina, Columbia, MO, United States
| | - Michael J Duncan
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, United Kingdom
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27
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Uematsu A, Tsuchiya K, Suzuki S, Hortobágyi T. Cognitive dual-tasking augments age-differences in dynamic balance quantified by beam walking distance: A pilot study. Exp Gerontol 2018; 114:27-31. [DOI: 10.1016/j.exger.2018.10.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 09/26/2018] [Accepted: 10/22/2018] [Indexed: 01/27/2023]
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28
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Hortobágyi T, Uematsu A, Sanders L, Kliegl R, Tollár J, Moraes R, Granacher U. Beam Walking to Assess Dynamic Balance in Health and Disease: A Protocol for the "BEAM" Multicenter Observational Study. Gerontology 2018; 65:332-339. [PMID: 30336478 DOI: 10.1159/000493360] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 08/29/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Dynamic balance keeps the vertical projection of the center of mass within the base of support while walking. Dynamic balance tests are used to predict the risks of falls and eventual falls. The psychometric properties of most dynamic balance tests are unsatisfactory and do not comprise an actual loss of balance while walking. OBJECTIVES Using beam walking distance as a measure of dynamic balance, the BEAM consortium will determine the psychometric properties, lifespan and patient reference values, the relationship with selected "dynamic balance tests," and the accuracy of beam walking distance to predict falls. METHODS This cross-sectional observational study will examine healthy adults in 7 decades (n = 432) at 4 centers. Center 5 will examine patients (n = 100) diagnosed with Parkinson's disease, multiple sclerosis, stroke, and balance disorders. In test 1, all participants will be measured for demographics, medical history, muscle strength, gait, static balance, dynamic balance using beam walking under single (beam walking only) and dual task conditions (beam walking while concurrently performing an arithmetic task), and several cognitive functions. Patients and healthy participants age 50 years or older will be additionally measured for fear of falling, history of falls, miniBESTest, functional reach on a force platform, timed up and go, and reactive balance. All participants age 50 years or older will be recalled to report fear of falling and fall history 6 and 12 months after test 1. In test 2, seven to ten days after test 1, healthy young adults and age 50 years or older (n = 40) will be retested for reliability of beam walking performance. CONCLUSION We expect to find that beam walking performance vis-à-vis the traditionally used balance outcomes predicts more accurately fall risks and falls. CLINICAL TRIAL REGISTRATION NUMBER NCT03532984.
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Affiliation(s)
- Tibor Hortobágyi
- Center for Human Movement Sciences, University of Groningen Medical Center, Groningen, The Netherlands,
| | | | - Lianne Sanders
- Center for Human Movement Sciences, University of Groningen Medical Center, Groningen, The Netherlands
| | - Reinhold Kliegl
- Department of Psychology, University of Potsdam, Potsdam, Germany.,Division of Training and Movement Sciences, University of Potsdam, Potsdam, Germany
| | - József Tollár
- Department of Neurology, Somogy County Kaposi Mór Teaching Hospital, Kaposvár, Hungary
| | - Renato Moraes
- School of Physical Education and Sport of Ribeirão Preto, São Paulo, Brazil
| | - Urs Granacher
- Division of Training and Movement Sciences, University of Potsdam, Potsdam, Germany
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29
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Kemp GJ, Birrell F, Clegg PD, Cuthbertson DJ, De Vito G, van Dieën JH, Del Din S, Eastell R, Garnero P, Goljanek–Whysall K, Hackl M, Hodgson R, Jackson MJ, Lord S, Mazzà C, McArdle A, McCloskey EV, Narici M, Peffers MJ, Schiaffino S, Mathers JC. Developing a toolkit for the assessment and monitoring of musculoskeletal ageing. Age Ageing 2018; 47:iv1-iv19. [PMID: 30203052 PMCID: PMC6127513 DOI: 10.1093/ageing/afy143] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 08/03/2018] [Indexed: 12/12/2022] Open
Abstract
The complexities and heterogeneity of the ageing process have slowed the development of consensus on appropriate biomarkers of healthy ageing. The Medical Research Council–Arthritis Research UK Centre for Integrated research into Musculoskeletal Ageing (CIMA) is a collaboration between researchers and clinicians at the Universities of Liverpool, Sheffield and Newcastle. One of CIMA’s objectives is to ‘Identify and share optimal techniques and approaches to monitor age-related changes in all musculoskeletal tissues, and to provide an integrated assessment of musculoskeletal function’—in other words to develop a toolkit for assessing musculoskeletal ageing. This toolkit is envisaged as an instrument that can be used to characterise and quantify musculoskeletal function during ‘normal’ ageing, lend itself to use in large-scale, internationally important cohorts, and provide a set of biomarker outcome measures for epidemiological and intervention studies designed to enhance healthy musculoskeletal ageing. Such potential biomarkers include: biochemical measurements in biofluids or tissue samples, in vivo measurements of body composition, imaging of structural and physical properties, and functional tests. This review assesses candidate biomarkers of musculoskeletal ageing under these four headings, details their biological bases, strengths and limitations, and makes practical recommendations for their use. In addition, we identify gaps in the evidence base and priorities for further research on biomarkers of musculoskeletal ageing.
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Affiliation(s)
- Graham J Kemp
- Department of Musculoskeletal Biology, Faculty of Health and Life Sciences, Institute of Ageing and Chronic Disease (IACD), University of Liverpool, William Duncan Building, 6 West Derby Street, Liverpool, UK
- The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA)
| | - Fraser Birrell
- Institute of Cellular Medicine, Musculoskeletal Research Group, Newcastle University, Newcastle upon Tyne, UK
- The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA)
| | - Peter D Clegg
- Department of Musculoskeletal Biology, Faculty of Health and Life Sciences, Institute of Ageing and Chronic Disease (IACD), University of Liverpool, William Duncan Building, 6 West Derby Street, Liverpool, UK
- The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA)
| | - Daniel J Cuthbertson
- Department of Musculoskeletal Biology, Faculty of Health and Life Sciences, Institute of Ageing and Chronic Disease (IACD), University of Liverpool, William Duncan Building, 6 West Derby Street, Liverpool, UK
- The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA)
| | - Giuseppe De Vito
- School of Public Health, Physiotherapy and Sports Science, Institute for Sport and Health, University College Dublin, Belfield, Dublin, Ireland
| | - Jaap H van Dieën
- Department of Human Movement Sciences, VU University Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 9, Amsterdam, The Netherlands
| | - Silvia Del Din
- Clinical Ageing Research Unit, Institute of Neuroscience/Newcastle University Institute for Ageing, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Richard Eastell
- Mellanby Centre for Bone Research, University of Sheffield, Sheffield, UK
- The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA)
| | - Patrick Garnero
- Division of Bone Diseases, Geneva University Hospital and Faculty of Medicine, 1205 Geneva, Switzerland
| | - Katarzyna Goljanek–Whysall
- Department of Musculoskeletal Biology, Faculty of Health and Life Sciences, Institute of Ageing and Chronic Disease (IACD), University of Liverpool, William Duncan Building, 6 West Derby Street, Liverpool, UK
- The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA)
| | | | - Richard Hodgson
- Centre for Imaging Sciences, University of Manchester, Stopford Building, Oxford Road, Manchester, UK
| | - Malcolm J Jackson
- Department of Musculoskeletal Biology, Faculty of Health and Life Sciences, Institute of Ageing and Chronic Disease (IACD), University of Liverpool, William Duncan Building, 6 West Derby Street, Liverpool, UK
- The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA)
| | - Sue Lord
- Clinical Ageing Research Unit, Institute of Neuroscience/Newcastle University Institute for Ageing, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Claudia Mazzà
- Department of Mechanical Engineering & INSIGNEO Institute for in silico Medicine, University of Sheffield, Sheffield, UK
- The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA)
| | - Anne McArdle
- Department of Musculoskeletal Biology, Faculty of Health and Life Sciences, Institute of Ageing and Chronic Disease (IACD), University of Liverpool, William Duncan Building, 6 West Derby Street, Liverpool, UK
- The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA)
| | - Eugene V McCloskey
- Mellanby Centre for Bone Research, University of Sheffield, Sheffield, UK
- The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA)
| | - Marco Narici
- MRC-ARUK Centre of Excellence for Musculoskeletal Ageing Research, Derby Royal Hospital, Uttoxeter Road, Derby, UK
| | - Mandy J Peffers
- Department of Musculoskeletal Biology, Faculty of Health and Life Sciences, Institute of Ageing and Chronic Disease (IACD), University of Liverpool, William Duncan Building, 6 West Derby Street, Liverpool, UK
- The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA)
| | - Stefano Schiaffino
- Venetian Institute of Molecular Medicine (VIMM), Via Orus 2, Padova, Italy
| | - John C Mathers
- Human Nutrition Research Centre, Institute of Cellular Medicine and Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, UK
- The MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA)
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30
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Sawers A, Hafner BJ. Narrowing beam-walking is a clinically feasible approach for assessing balance ability in lower-limb prosthesis users. J Rehabil Med 2018; 50:457-464. [PMID: 29616279 DOI: 10.2340/16501977-2329] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Challenging clinical balance tests are needed to expose balance deficits in lower-limb prost-hesis users. This study examined whether narrowing beam-walking could overcome conceptual and practical limitations identified in fixed-width beam-walking. DESIGN Cross-sectional. PARTICIPANTS Unilateral lower-limb prosthesis users. METHODS Participants walked 10 times along a low, narrowing beam. Performance was quantified using the normalized distance walked. Heuristic rules were applied to determine whether the narrowing beam task was "too easy," "too hard," or "appropriately challenging" for each participant. Linear regression and Bland-Altman plots were used to determine whether combinations of the first 5 trials could predict participants' stable beam-walking performance. RESULTS Forty unilateral lower-limb prosthesis users participated. Narrowing beam-walking was appropriately challenging for 98% of participants. Performance stabilized for 93% of participants within 5 trials, while 62% were stable across all trials. The mean of trials 3-5 accurately predicted stable performance. CONCLUSION A clinical narrowing beam-walking test is likely to challenge a range of lower-limb prosthesis users, have minimal administrative burden, and exhibit no floor or ceiling effects. Narrowing beam-walking is therefore a clinically viable method to evaluate lower-limb prosthesis users' balance ability, but requires psychometric testing before it is used to assess fall risk.
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Affiliation(s)
- Andrew Sawers
- Kinesiology, University of Illinois at Chicago, 60612 Chicago, USA.
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31
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Validation of the Narrowing Beam Walking Test in Lower Limb Prosthesis Users. Arch Phys Med Rehabil 2018; 99:1491-1498.e1. [PMID: 29653108 DOI: 10.1016/j.apmr.2018.03.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Revised: 02/23/2018] [Accepted: 03/19/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate the content, construct, and discriminant validity of the Narrowing Beam Walking Test (NBWT), a performance-based balance test for lower limb prosthesis users. DESIGN Cross-sectional study. SETTING Research laboratory and prosthetics clinic. PARTICIPANTS Unilateral transtibial and transfemoral prosthesis users (N=40). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Content validity was examined by quantifying the percentage of participants receiving maximum or minimum scores (ie, ceiling and floor effects). Convergent construct validity was examined using correlations between participants' NBWT scores and scores or times on existing clinical balance tests regularly administered to lower limb prosthesis users. Known-groups construct validity was examined by comparing NBWT scores between groups of participants with different fall histories, amputation levels, amputation etiologies, and functional levels. Discriminant validity was evaluated by analyzing the area under each test's receiver operating characteristic (ROC) curve. RESULTS No minimum or maximum scores were recorded on the NBWT. NBWT scores demonstrated strong correlations (ρ=.70‒.85) with scores/times on performance-based balance tests (timed Up and Go test, Four Square Step Test, and Berg Balance Scale) and a moderate correlation (ρ=.49) with the self-report Activities-specific Balance Confidence scale. NBWT performance was significantly lower among participants with a history of falls (P=.003), transfemoral amputation (P=.011), and a lower mobility level (P<.001). The NBWT also had the largest area under the ROC curve (.81) and was the only test to exhibit an area that was statistically significantly >.50 (ie, chance). CONCLUSIONS The results provide strong evidence of content, construct, and discriminant validity for the NBWT as a performance-based test of balance ability. The evidence supports its use to assess balance impairments and fall risk in unilateral transtibial and transfemoral prosthesis users.
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Chiovetto E, Huber ME, Sternad D, Giese MA. Low-dimensional organization of angular momentum during walking on a narrow beam. Sci Rep 2018; 8:95. [PMID: 29311691 PMCID: PMC5758518 DOI: 10.1038/s41598-017-18142-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 12/06/2017] [Indexed: 12/03/2022] Open
Abstract
Walking on a beam is a challenging motor skill that requires the regulation of upright balance and stability. The difficulty in beam walking results from the reduced base of support compared to that afforded by flat ground. One strategy to maintain stability and hence avoid falling off the beam is to rotate the limb segments to control the body’s angular momentum. The aim of this study was to examine the coordination of the angular momentum variations during beam walking. We recorded movement kinematics of participants walking on a narrow beam and computed the angular momentum contributions of the body segments with respect to three different axes. Results showed that, despite considerable variability in the movement kinematics, the angular momentum was characterized by a low-dimensional organization based on a small number of segmental coordination patterns. When the angular momentum was computed with respect to the beam axis, the largest fraction of its variation was accounted for by the trunk segment. This simple organization was robust and invariant across all participants. These findings support the hypothesis that control strategies for complex balancing tasks might be easier to understand by investigating angular momentum instead of the segmental kinematics.
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Affiliation(s)
- Enrico Chiovetto
- Section for Computational Sensomotorics, Department of Cognitive Neurology, Hertie Institute for Clinical Brain Research, Centre for Integrative Neuroscience, University Clinic Tübingen, Tübingen, Germany.
| | - Meghan E Huber
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Dagmar Sternad
- Departments of Biology, Electrical and Computer Engineering, Physics, and Physical Therapy, Movement Science and Rehabilitation, Northeastern University, Boston, Massachusetts, USA
| | - Martin A Giese
- Section for Computational Sensomotorics, Department of Cognitive Neurology, Hertie Institute for Clinical Brain Research, Centre for Integrative Neuroscience, University Clinic Tübingen, Tübingen, Germany
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Costa AADS, Santos LOD, Mauerberg-deCastro E, Moraes R. Task difficulty has no effect on haptic anchoring during tandem walking in young and older adults. Neurosci Lett 2017; 666:133-138. [PMID: 29288044 DOI: 10.1016/j.neulet.2017.12.052] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 12/20/2017] [Accepted: 12/23/2017] [Indexed: 11/29/2022]
Abstract
This study assessed the contribution of the "anchor system's" haptic information to balance control during walking at two levels of difficulty. Seventeen young adults and seventeen older adults performed 20 randomized trials of tandem walking in a straight line, on level ground and on a slightly-raised balance beam, both with and without the use of the anchors. The anchor consists of two flexible cables, whose ends participants hold in each hand, to which weights (125 g) are attached at the opposing ends, and which rest on the ground. As the participants walk, they pull on the cables, dragging the anchors. Spatiotemporal gait variables (step speed and single- and double-support duration) were processed using retro-reflective markers on anatomical sites. An accelerometer positioned in the cervical region registered trunk acceleration. Walking on the balance beam increased single- and double-support duration and reduced step speed in older adults, which suggests that this condition was more difficult than walking on the level ground. The anchors reduced trunk acceleration in the frontal plane, but the level of difficulty of the walking task showed no effect. Thus, varying the difficulty of the task had no influence on the way in which participants used the anchor system while tandem walking. The older adults exhibited more difficulty in walking on the balance beam as compared to the younger adults; however, the effect of the anchor system was similar in both groups.
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Affiliation(s)
- Andréia Abud da Silva Costa
- Ribeirão Preto Medical School, Graduate Program in Rehabilitation and Functional Performance, University of São Paulo, Brazil; Biomechanics and Motor Control Lab, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil
| | - Luciana Oliveira Dos Santos
- Ribeirão Preto Medical School, Graduate Program in Rehabilitation and Functional Performance, University of São Paulo, Brazil; Biomechanics and Motor Control Lab, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil
| | | | - Renato Moraes
- Biomechanics and Motor Control Lab, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Brazil.
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Sawers A, Hafner BJ. A study to assess whether fixed-width beam walking provides sufficient challenge to assess balance ability across lower limb prosthesis users. Clin Rehabil 2017; 32:483-492. [PMID: 28948848 DOI: 10.1177/0269215517732375] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the feasibility of fixed-width beam walking for assessing balance in lower limb prosthesis users. DESIGN Cross-sectional. SETTING Laboratory. SUBJECTS Lower limb prosthesis users. METHODS Participants attempted 10 walking trials on three fixed-width beams (18.6, 8.60, and 4.01 wide; 5.5 m long; 3.8 cm high). MAIN MEASURES Beam-walking performance was quantified using the distance walked to balance failure. Heuristic rules applied to each participant's beam-walking distance to classify each beam as "too easy," "too hard," or "appropriately challenging" and determine whether any single beam provided an appropriate challenge to all participants. The number of trials needed to achieve stable beam-walking performance was quantified for appropriately challenging beams by identifying the last inflection point in the slope of each participant's trial-by-trial cumulative performance record. RESULTS In all, 30 unilateral lower limb prosthesis users participated in the study. Each of the fixed-width beams was either too easy or too hard for at least 33% of the sample. Thus, no single beam was appropriately challenging for all participants. Beam-walking performance was stable by trial 8 for all participants and by trial 6 for 90% of participants. There was no significant difference in the number of trials needed to achieve stable performance among beams ( P = 0.74). CONCLUSION Results suggest that a clinical beam-walking test would require multiple beams to evaluate balance across a range of lower limb prosthesis users, emphasizing the need for adaptive or progressively challenging balance tests. While the administrative burden of a multiple-beam balance test may limit clinical feasibility, alternatives to ease this administrative burden are proposed.
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Affiliation(s)
- Andrew Sawers
- 1 Department of Kinesiology, University of Illinois at Chicago, Chicago, IL, USA
| | - Brian J Hafner
- 2 Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
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Ko SU, Simonsick EM, Deshpande N, Studenski S, Ferrucci L. Ankle Proprioception-Associated Gait Patterns in Older Adults: Results from the Baltimore Longitudinal Study of Aging. Med Sci Sports Exerc 2017; 48:2190-2194. [PMID: 27327030 DOI: 10.1249/mss.0000000000001017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Ankle proprioception training has been found to improve balance-related gait disorders; however, the relationship between ankle proprioception and specific gait patterns in older adults with and without impaired balance has not been systematically examined. METHODS This study characterizes gait patterns of 230 older adults age 60-95 yr evaluated in the Baltimore Longitudinal Study of Aging gait laboratory with (n = 82) and without impaired balance (inability to successfully complete a narrow walk) and examines ankle proprioception performance. RESULTS Participants with impaired balance had a higher angle threshold for perceiving ankle movement than those without impaired balance even after controlling for the substantial age difference between groups (P = 0.017). Gait speed, stride length, hip and ankle range of motion, and mechanical work expenditure from the knee and ankle were associated with ankle proprioception performance (P < 0.050 for all) in the full sample, but these associations were evident only in participants with impaired balance in stratified analysis. CONCLUSION Ankle proprioception in older persons with balance impairment may play a role in balance-related gait disorders and should be targeted for intervention.
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Affiliation(s)
- Seung-Uk Ko
- 1Department of Mechanical Engineering, Chonnam National University, Yeosu, SOUTH KOREA; 2Translational Gerontology Branch, National Institute on Aging (NIA/NIH), Baltimore, MD; and 3School of Rehabilitation Therapy, Queen's University, Kingston, ON, CANADA
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Puntkattalee MJ, Whitmire CJ, Macklin AS, Stanley GB, Ting LH. Directional acuity of whole-body perturbations during standing balance. Gait Posture 2016; 48:77-82. [PMID: 27477713 PMCID: PMC5500239 DOI: 10.1016/j.gaitpost.2016.04.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 03/18/2016] [Accepted: 04/07/2016] [Indexed: 02/02/2023]
Abstract
The ability to perceive the direction of whole-body motion during standing may be critical to maintaining balance and preventing a fall. Our first goal was to quantify kinesthetic perception of whole-body motion by estimating directional acuity thresholds of support-surface perturbations during standing. The directional acuity threshold to lateral deviations in backward support-surface motion in healthy, young adults was quantified as 9.5±2.4° using the psychometric method (n=25 subjects). However, inherent limitations in the psychometric method, such as a large number of required trials and the predetermined stimulus set, may preclude wider use of this method in clinical populations. Our second goal was to validate an adaptive algorithm known as parameter estimation by sequential testing (PEST) as an alternative threshold estimation technique to minimize the required trial count without predetermined knowledge of the relevant stimulus space. The directional acuity threshold was estimated at 11.7±3.8° from the PEST method (n=11 of 25 subjects, psychometric threshold=10.1±3.1°) using only one-third the number of trials compared to the psychometric method. Furthermore, PEST estimates of the direction acuity threshold were highly correlated with the psychometric estimates across subjects (r=0.93) suggesting that both methods provide comparable estimates of the perceptual threshold. Computational modeling of both techniques revealed similar variance in the estimated thresholds across simulations of about 1°. Our results suggest that the PEST algorithm can be used to more quickly quantify whole-body directional acuity during standing in individuals with balance impairments.
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Affiliation(s)
- M. Jane Puntkattalee
- Coulter Department of Biomedical Engineering at Georgia Tech and Emory, Atlanta, GA 30332, USA
| | - Clarissa J. Whitmire
- Coulter Department of Biomedical Engineering at Georgia Tech and Emory, Atlanta, GA 30332, USA
| | - Alix S. Macklin
- Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Garrett B. Stanley
- Coulter Department of Biomedical Engineering at Georgia Tech and Emory, Atlanta, GA 30332, USA
| | - Lena H. Ting
- Coulter Department of Biomedical Engineering at Georgia Tech and Emory, Atlanta, GA 30332, USA,Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA,Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University, Atlanta, GA 30322, USA
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Zhang Y, Qiu B, Wang J, Yao Y, Wang C, Liu J. RETRACTED ARTICLE: Effects of BDNF-Transfected BMSCs on Neural Functional Recovery and Synaptophysin Expression in Rats with Cerebral Infarction. Mol Neurobiol 2016; 54:3813-3824. [DOI: 10.1007/s12035-016-9946-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 05/26/2016] [Indexed: 01/18/2023]
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Ingram TGJ, Duncan CA, Mansfield A, Byrne JM, McIlroy WE. The influence of previous experiences on participant performance during maritime simulation testing. THEORETICAL ISSUES IN ERGONOMICS SCIENCE 2016. [DOI: 10.1080/1463922x.2016.1138153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Nindl BC, Jaffin DP, Dretsch MN, Cheuvront SN, Wesensten NJ, Kent ML, Grunberg NE, Pierce JR, Barry ES, Scott JM, Young AJ, O'Connor FG, Deuster PA. Human Performance Optimization Metrics. J Strength Cond Res 2015; 29 Suppl 11:S221-45. [DOI: 10.1519/jsc.0000000000001114] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Sawers A, Allen JL, Ting LH. Long-term training modifies the modular structure and organization of walking balance control. J Neurophysiol 2015; 114:3359-73. [PMID: 26467521 DOI: 10.1152/jn.00758.2015] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 10/13/2015] [Indexed: 01/08/2023] Open
Abstract
How does long-term training affect the neural control of movements? Here we tested the hypothesis that long-term training leading to skilled motor performance alters muscle coordination during challenging, as well as nominal everyday motor behaviors. Using motor module (a.k.a., muscle synergy) analyses, we identified differences in muscle coordination patterns between professionally trained ballet dancers (experts) and untrained novices that accompanied differences in walking balance proficiency assessed using a challenging beam-walking test. During beam walking, we found that experts recruited more motor modules than novices, suggesting an increase in motor repertoire size. Motor modules in experts had less muscle coactivity and were more consistent than in novices, reflecting greater efficiency in muscle output. Moreover, the pool of motor modules shared between beam and overground walking was larger in experts compared with novices, suggesting greater generalization of motor module function across multiple behaviors. These differences in motor output between experts and novices could not be explained by differences in kinematics, suggesting that they likely reflect differences in the neural control of movement following years of training rather than biomechanical constraints imposed by the activity or musculoskeletal structure and function. Our results suggest that to learn challenging new behaviors, we may take advantage of existing motor modules used for related behaviors and sculpt them to meet the demands of a new behavior.
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Affiliation(s)
- Andrew Sawers
- Department of Kinesiology, University of Illinois at Chicago, Chicago, Illinois; and
| | - Jessica L Allen
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, Georgia
| | - Lena H Ting
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, Georgia
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