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Naaman T, Hayek R, Gutman I, Springer S. Young, but not in the dark-The influence of reduced lighting on gait stability in middle-aged adults. PLoS One 2023; 18:e0280535. [PMID: 37200289 DOI: 10.1371/journal.pone.0280535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 05/04/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND The aim of this study was to investigate the effects of walking in reduced lighting with or without performing a secondary cognitive task on gait dynamics in middle-aged adults and to compare them with young and old adults. METHODS Twenty young (age 28.8±4.1), 20 middle-aged (age 50.2±4.4), and 19 elderly (age 70.7±4.2) subjects participated in the study. Subjects walked on an instrumented treadmill at a self-determined pace under four conditions in randomized order: (1) walking in usual lighting (1000 lumens); (2) walking in near-darkness (5 lumens); (3) walking in usual lighting with a serial-7 subtraction dual-task; and (4) walking in near-darkness with a serial-7 subtraction dual-task. Variability in stride time and variability in the trajectory of the center of pressure in the sagittal and frontal planes (anterior/posterior and lateral variability) were measured. Repeated measures ANOVA and planned comparisons were used to determine the effects of age, lighting conditions, and cognitive task on each gait outcome. RESULTS Under usual lighting, stride time variability and anterior/posterior variability of the middle-aged subjects were similar to those of the young and lower than those of the old. The lateral variability of the middle-aged subjects was higher than that of young adults under both lighting conditions. Similar to the older adults, the middle-aged participants increased their stride time variability when walking in near-darkness, but they were the only ones to exhibit increased lateral variability and anterior/posterior variability in near-darkness. Young adult gait was not affected by lighting, and concurrent performance of a cognitive task while walking did not affect gait stability in all groups under any of the lighting conditions. CONCLUSIONS Gait stability decreases in middle age when walking in the dark. Recognition of functional deficits in middle age could promote appropriate interventions to optimize aging and reduce fall risk.
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Affiliation(s)
- Tirtsa Naaman
- Faculty of Health Sciences, Department of Physical Therapy, The Neuromuscular & Human Performance Laboratory, Ariel University, Ariel, Israel
| | - Roee Hayek
- Faculty of Health Sciences, Department of Physical Therapy, The Neuromuscular & Human Performance Laboratory, Ariel University, Ariel, Israel
| | - Itai Gutman
- Faculty of Health Sciences, Department of Physical Therapy, The Neuromuscular & Human Performance Laboratory, Ariel University, Ariel, Israel
| | - Shmuel Springer
- Faculty of Health Sciences, Department of Physical Therapy, The Neuromuscular & Human Performance Laboratory, Ariel University, Ariel, Israel
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Sheehan RC, Grabiner MD, Kaufman KR. Military training alters the fractal behavior of step width. J Biomech 2022; 145:111365. [PMID: 36335824 DOI: 10.1016/j.jbiomech.2022.111365] [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: 04/19/2022] [Revised: 09/12/2022] [Accepted: 10/27/2022] [Indexed: 11/05/2022]
Abstract
Non-linear analyses have been successfully applied to gait with evidence that fractal behavior of gait-related variables provide insights into function. Specifically, shifts in the fractal behavior of step width from pink toward white noise reflects a loss of complexity and diminished adaptive capacity and functionality. We previously reported an apparent difference in the fractal behavior of step width during treadmill walking between Service members with transtibial amputations and able-bodied civilian. We now combine recently collected data and data from two previous studies to further explore the relationship between lower limb injury, military service, and step width fractal behavior. Service member, regardless of the presence or type of injury, demonstrate step width fractal behavior walked in a way that the fractal behavior of their gait was significantly closer to white noise (-0.5 dB/Hz2) than uninjured civilians (-0.82 dB/Hz2). This data suggests that military training/service leads to a change in step width fractal behavior. Further studies are needed to explore what may cause this difference and any implications this may have on stability or performance.
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Affiliation(s)
- Riley C Sheehan
- Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., 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.
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Shapiro M, Shaki S, Gottlieb U, Springer S. Random walk: Random number generation during backward and forward walking- the role of aging. Front Aging Neurosci 2022; 14:888979. [PMID: 36247999 PMCID: PMC9554272 DOI: 10.3389/fnagi.2022.888979] [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: 03/03/2022] [Accepted: 09/05/2022] [Indexed: 11/28/2022] Open
Abstract
Deficits in executive function, visuospatial abilities, and cognitive embodiment may impair gait performance. This study aimed to investigate the effect of age on random number generation (RNG) performance during forward and backward locomotion to assess cognitive flexibility and cognitive embodiment during walking. Another aim was to examine the effect of age on the associations of RNG performance during walking with stride time variability (STV), the percentage of double support (DS%), and visuospatial abilities as measured by a spatial orientation test (SOT). Twenty old (age 68.8 ± 5.3, 65% female) and 20 young (age 25.2 ± 2.2, 45% female) adults generated random numbers during backward walking (BW) and forward walking (FW) over-ground and over a treadmill with an internal focus of attention and visual-attentive distraction; six walking conditions in total. To assess cognitive flexibility, sample entropy was calculated for each RNG sequence. The average of the first 5 numbers in each RNG task was calculated to assess the relationship between small/large numbers and movement direction. STV and DS% were recorded using inertial measurement units, and spatial orientation was measured using a computerized test. The older subjects had less flexibility in generating random numbers in three of the six walking conditions. A negative correlation between RNG flexibility and STV was found in older adults during treadmill BW with visual-attentive distraction and forward over-ground walking, whereas no correlations were demonstrated in the young group. The spatial orientation score (a higher value means a worse outcome) correlated positively with RNG flexibility in the older group under all walking conditions, suggesting that older adults with better visuospatial orientation have lower cognitive flexibility, and vice versa. There was no correlation between small/large numbers and direction of motion in either group. The correlation between RNG flexibility and STV may indicate similar executive control of verbal and gait rhythmicity in old adults. Conversely, our results suggest that cognitive flexibility and visuospatial ability may decline differently.
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Affiliation(s)
- Maxim Shapiro
- The Neuromuscular and Human Performance Laboratory, Department of Physical Therapy, Faculty of Health Sciences, Ariel University, Ariel, Israel
| | - Samuel Shaki
- Department of Behavioral Sciences, Ariel University, Ariel, Israel
| | - Uri Gottlieb
- The Neuromuscular and Human Performance Laboratory, Department of Physical Therapy, Faculty of Health Sciences, Ariel University, Ariel, Israel
| | - Shmuel Springer
- The Neuromuscular and Human Performance Laboratory, Department of Physical Therapy, Faculty of Health Sciences, Ariel University, Ariel, Israel
- *Correspondence: Shmuel Springer,
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Van Bladel A, De Ridder R, Palmans T, Oostra K, Cambier D. Biomechanical differences between self-paced and fixed-speed treadmill walking in persons after stroke. Hum Mov Sci 2022; 85:102983. [PMID: 35933827 DOI: 10.1016/j.humov.2022.102983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/22/2022] [Accepted: 07/22/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Using self-paced treadmills for gait analysis requires less space compared to overground gait labs while a more natural walking pattern could be preserved compared to fixed-speed treadmill walking. Although self-paced treadmills have been used in stroke related intervention studies, studies comparing self-paced to fixed-speed treadmill walking in this population are scarce. METHODS Twenty-five persons after stroke (10 males/15 females; 53 ± 12.05 years; 40.72 ± 42.94 months post stroke) walked on a treadmill in a virtual environment (GRAIL, Motek) in two conditions (self-paced and fixed-speed). After familiarization, all participants completed two trials (3 min) at comfortable walking velocity in randomized order. A paired-sample t-test or Wilcoxon Signed Rank test was used to calculate differences between both conditions for spatiotemporal parameters. Statistical Parametric mapping was conducted using the t-tests (SPM(t)), to statistically compare the kinematic and kinetic curves. RESULTS The self-selected walking velocity on the treadmill was higher in the self-paced condition compared to the fixed-speed condition (p < 0.001). However, most variability and symmetry measures were similar in both conditions. Only the standard deviation of the step length at the paretic side was significant higher (p = 0.007) and step length symmetry was significantly better (p = 0.032) in the self-paced condition. Detected kinematic and kinetic differences were small (< 3°, < 0.1 Nm/kg) and stride to stride variability was comparable in both conditions. CONCLUSION Based on the results of the current study, self-paced walking can be used as an equivalent to fixed-speed treadmill walking in persons after stroke. Accordingly, this justifies the use of this more functional mode in clinical gait assessment and rehabilitation trials.
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Affiliation(s)
- Anke Van Bladel
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Department of Physical and Rehabilitation Medicine, Ghent University Hospital, Ghent, Belgium.
| | - Roel De Ridder
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
| | - Tanneke Palmans
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
| | - Kristine Oostra
- Department of Physical and Rehabilitation Medicine, Ghent University Hospital, Ghent, Belgium.
| | - Dirk Cambier
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
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Ravi DK, Marmelat V, Taylor WR, Newell KM, Stergiou N, Singh NB. Assessing the Temporal Organization of Walking Variability: A Systematic Review and Consensus Guidelines on Detrended Fluctuation Analysis. Front Physiol 2020; 11:562. [PMID: 32655400 PMCID: PMC7324754 DOI: 10.3389/fphys.2020.00562] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 05/05/2020] [Indexed: 12/18/2022] Open
Abstract
Human physiological signals are inherently rhythmic and have a hallmark feature in that even distant intrasignal measurements are related to each other. This relationship is termed long-range correlation and has been recognized as an indicator of the optimal state of the observed physiological systems, among which the locomotor system. Loss of long-range correlations has been found as a result of aging as well as disease, which can be evaluated with detrended fluctuation analysis (DFA). Recently, DFA and the scaling exponent α have been employed for understanding the degeneration of temporal regulation of human walking biorhythms in, for example, Parkinson disease (PD). However, heterogeneous evidence on scaling exponent α values reported in the literature across different population groups has put into question what constitutes a healthy physiological pattern. Therefore, the purpose of this systematic review was to investigate the functional thresholds of scaling exponent α in young vs. older adults, as well as between patients with PD and age-matched asymptomatic controls. Aging and PD exhibited a negative effect size (i.e., led to decreased long-range correlations) of -0.20 and -0.53, respectively. Our meta-analysis based on 14 studies provides evidence that a mean scaling exponent α threshold of 0.86 [2 standard error (0.76, 0.96)] is able to optimally discriminate temporal organization of stride interval between young and old, whereas 0.82 (0.72, 0.92) differentiates patients with PD and age-matched asymptomatic controls. The optimal thresholds presented in this review together with the consensus guidelines for using DFA might allow a more sensitive and reliable application of this metric for understanding human walking physiology than has been achieved to date.
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Affiliation(s)
- Deepak K Ravi
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Vivien Marmelat
- Department of Biomechanics and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE, United States
| | | | - Karl M Newell
- Department of Kinesiology, University of Georgia, Athens, GA, United States
| | - Nick Stergiou
- Department of Biomechanics and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE, United States
| | - Navrag B Singh
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
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Ducharme SW, Kent JA, van Emmerik REA. Comparable Stride Time Fractal Dynamics and Gait Adaptability in Active Young and Older Adults Under Normal and Asymmetric Walking. Front Physiol 2019; 10:1318. [PMID: 31708794 PMCID: PMC6823242 DOI: 10.3389/fphys.2019.01318] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 09/30/2019] [Indexed: 01/28/2023] Open
Abstract
Previous research indicates the correlation structure of gait parameters (i.e., fractal dynamics) decreases with age. This decrease is suggested to reflect a reduced capacity for locomotor adaptation in older adults. The purpose of this study was to investigate potential differences between physical activity-matched young and older adults’ fractal dynamics and gait adaptability during unperturbed and asymmetric walking, and to determine if fractal dynamics predict adaptive capacity. Fifteen young (28.9 ± 5.6 years, nine women) and 15 older (64.7 ± 2.7, nine women) adults with similar habitual physical activity levels walked at preferred speed, half of preferred speed, and asymmetrically whereby their dominant and non-dominant legs moved at preferred and half-preferred speed, respectively. Fractal correlations (scaling exponent α) of stride times were assessed through detrended fluctuation analysis, and gait adaptation to asymmetric walking on the basis of lower limb relative phase. Both cohorts displayed similar fractal dynamics at preferred speed and asymmetric walking, while older adults exhibited greater α during slow walking. Both groups exhibited comparable gait adaptation to split-belt walking based on analysis of lower limb relative phase. Fractal dynamics during preferred speed and asymmetric walking was moderately associated with gait adaptation in the young and older adult cohorts, respectively. In these activity-matched groups, there were no age-based reductions in fractal dynamics or gait adaptation, and fractal scaling α was moderately associated with gait adaptation. These findings suggest that stride time fractal dynamics and gait adaptation may be preserved in older adults who habitually perform moderate intensity physical activity.
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Affiliation(s)
- Scott W Ducharme
- Department of Kinesiology, California State University, Long Beach, Long Beach, CA, United States
| | - Jane A Kent
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, United States
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Castro P, Kaski D, Schieppati M, Furman M, Arshad Q, Bronstein A. Subjective stability perception is related to postural anxiety in older subjects. Gait Posture 2019; 68:538-544. [PMID: 30634135 DOI: 10.1016/j.gaitpost.2018.12.043] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 12/18/2018] [Accepted: 12/31/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Under static conditions, the objective and subjective measures of postural stability correlate well. However, age-related changes in postural control and task-related anxiety may modify the relationship between these subjective and objective measures. Ultimately, patients' symptoms represent subjective reports, thus understanding this relationship has clinical implications. AIMS This study investigates the relationship between subjective-objective measures of postural stability in dynamic conditions and whether this relationship is influenced by age or task-related anxiety. METHODS 50 healthy participants (aged 18-83 years) stood on a platform oscillating at variable amplitudes, with-without a fall-preventing harness to modulate task-related anxiety. Trunk sway path, hip velocity and foot lifts (objective measures) and subjective scores of instability and task-related anxiety were recorded. RESULTS The subjective perception of stability accurately matched objective body sway, following a logarithmic function profile (r2 = 0.72, p < 0.001). This function did not change significantly with age, harness or task presentation order. A strong relationship was observed between subjective measures of stability and task-related anxiety for all subjects (r = 0.81, p < 0.001). Task repetition reduced anxiety in the young, uncoupling anxiety changes from subjective instability, but not in the elderly who retained higher anxiety levels in line with subjective unsteadiness. DISCUSSION Subjects accurately rate their own instability during dynamic postural challenges, irrespective of age and actual fall risk. However, anxiety may selectively modulate the perception of instability in older subjects. The perception of stability relies upon the integration of sensory afferents but also recruits emotional-cognitive processes, particularly in older individuals. The use of a safety harness has no influence on subjective or objective postural stability.
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Affiliation(s)
- Patricia Castro
- Neuro-otology Unit, Division of Brain Sciences, Charing Cross Hospital Campus, Imperial College London, London, UK; Escuela de Fonoaudiologia, Facultad de Medicina, Clinica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Diego Kaski
- Neuro-otology Unit, Division of Brain Sciences, Charing Cross Hospital Campus, Imperial College London, London, UK
| | - Marco Schieppati
- Department of Exercise & Sport Science, International University of Health, Exercise and Sports, LUNEX University, Differdange, Luxembourg
| | - Michael Furman
- Neuro-otology Unit, Division of Brain Sciences, Charing Cross Hospital Campus, Imperial College London, London, UK
| | - Qadeer Arshad
- Neuro-otology Unit, Division of Brain Sciences, Charing Cross Hospital Campus, Imperial College London, London, UK
| | - Adolfo Bronstein
- Neuro-otology Unit, Division of Brain Sciences, Charing Cross Hospital Campus, Imperial College London, London, UK.
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8
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Grabiner MD, Marone JR, Wyatt M, Sessoms P, Kaufman KR. Performance of an attention-demanding task during treadmill walking shifts the noise qualities of step-to-step variation in step width. Gait Posture 2018; 63:154-158. [PMID: 29738957 DOI: 10.1016/j.gaitpost.2018.04.041] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 04/24/2018] [Accepted: 04/25/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND The fractal scaling evident in the step-to-step fluctuations of stepping-related time series reflects, to some degree, neuromotor noise. RESEARCH QUESTION The primary purpose of this study was to determine the extent to which the fractal scaling of step width, step width and step width variability are affected by performance of an attention-demanding task. We hypothesized that the attention-demanding task would shift the structure of the step width time series toward white, uncorrelated noise. METHODS Subjects performed two 10-min treadmill walking trials, a control trial of undisturbed walking and a trial during which they performed a mental arithmetic/texting task. Motion capture data was converted to step width time series, the fractal scaling of which were determined from their power spectra. RESULTS Fractal scaling decreased by 22% during the texting condition (p < 0.001) supporting the hypothesized shift toward white uncorrelated noise. Step width and step width variability increased 19% and five percent, respectively (p < 0.001). However, a stepwise discriminant analysis to which all three variables were input revealed that the control and dual task conditions were discriminated only by step width fractal scaling. SIGNIFICANCE The change of the fractal scaling of step width is consistent with increased cognitive demand and suggests a transition in the characteristics of the signal noise. This may reflect an important advance toward the understanding of the manner in which neuromotor noise contributes to some types of falls. However, further investigation of the repeatability of the results, the sensitivity of the results to progressive increases in cognitive load imposed by attention-demanding tasks, and the extent to which the results can be generalized to the gait of older adults seems warranted.
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Affiliation(s)
- Mark D Grabiner
- University of Illinois at Chicago, Department of Kinesiology and Nutrition, 1919 W. Taylor Street, Room 648, Chicago, IL 60612, United States.
| | - Jane R Marone
- University of Illinois at Chicago, Department of Kinesiology and Nutrition, 901 W. Roosevelt Rd, 336 PEB, Chicago, IL 60612, United States.
| | - Marilynn Wyatt
- Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134, United States.
| | - Pinata Sessoms
- Naval Health Research Center, San Diego, 140 Sylvester Rd., San Diego, CA 92106-3521, United States.
| | - Kenton R Kaufman
- Motion Analysis Laboratory, Dan Abraham Health Living Center 4-214A, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, United States.
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Nayak SK, Bit A, Dey A, Mohapatra B, Pal K. A Review on the Nonlinear Dynamical System Analysis of Electrocardiogram Signal. JOURNAL OF HEALTHCARE ENGINEERING 2018; 2018:6920420. [PMID: 29854361 PMCID: PMC5954865 DOI: 10.1155/2018/6920420] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 01/13/2018] [Accepted: 02/27/2018] [Indexed: 12/22/2022]
Abstract
Electrocardiogram (ECG) signal analysis has received special attention of the researchers in the recent past because of its ability to divulge crucial information about the electrophysiology of the heart and the autonomic nervous system activity in a noninvasive manner. Analysis of the ECG signals has been explored using both linear and nonlinear methods. However, the nonlinear methods of ECG signal analysis are gaining popularity because of their robustness in feature extraction and classification. The current study presents a review of the nonlinear signal analysis methods, namely, reconstructed phase space analysis, Lyapunov exponents, correlation dimension, detrended fluctuation analysis (DFA), recurrence plot, Poincaré plot, approximate entropy, and sample entropy along with their recent applications in the ECG signal analysis.
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Affiliation(s)
- Suraj K. Nayak
- Department of Biotechnology and Medical Engineering, National Institute of Technology, Rourkela, Odisha 769008, India
| | - Arindam Bit
- Department of Biomedical Engineering, National Institute of Technology, Raipur, Chhattisgarh 492010, India
| | - Anilesh Dey
- Department of Electronics and Communication Engineering, Kaziranga University, Jorhat, Assam 785006, India
| | | | - Kunal Pal
- Department of Biotechnology and Medical Engineering, National Institute of Technology, Rourkela, Odisha 769008, India
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Warlop T, Detrembleur C, Stoquart G, Lejeune T, Jeanjean A. Gait Complexity and Regularity Are Differently Modulated by Treadmill Walking in Parkinson's Disease and Healthy Population. Front Physiol 2018; 9:68. [PMID: 29467673 PMCID: PMC5808200 DOI: 10.3389/fphys.2018.00068] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 01/18/2018] [Indexed: 11/13/2022] Open
Abstract
Variability raises considerable interest as a promising and sensitive marker of dysfunction in physiology, in particular in neurosciences. Both internally (e.g., pathology) and/or externally (e.g., environment) generated perturbations and the neuro-mechanical responses to them contribute to the fluctuating dynamics of locomotion. Defective internal gait control in Parkinson's disease (PD), resulting in typical timing gait disorders, is characterized by the breakdown of the temporal organization of stride duration variability. Influence of external cue on gait pattern could be detrimental or advantageous depending on situations (healthy or pathological gait pattern, respectively). As well as being an interesting rehabilitative approach in PD, treadmills are usually implemented in laboratory settings to perform instrumented gait analysis including gait variability assessment. However, possibly acting as an external pacemaker, treadmill could modulate the temporal organization of gait variability of PD patients which could invalidate any gait variability assessment. This study aimed to investigate the immediate influence of treadmill walking (TW) on the temporal organization of stride duration variability in PD and healthy population. Here, we analyzed the gait pattern of 20 PD patients and 15 healthy age-matched subjects walking on overground and on a motorized-treadmill (randomized order) at a self-selected speed. The temporal organization and regularity of time series of walking were assessed on 512 consecutive strides and assessed by the application of non-linear mathematical methods (i.e., the detrended fluctuation analysis and power spectral density; and sample entropy, for the temporal organization and regularity of gait variability, respectively). A more temporally organized and regular gait pattern seems to emerge from TW in PD while no influence was observed on healthy gait pattern. Treadmill could afford the necessary framework to regulate gait rhythmicity in PD. Overall, the results support the hypothesis of a greater dependence to regulatory inputs as an explanatory factor of treadmill influence observed in PD. Also, since treadmill misrepresents the gait as more healthy than it is, the present findings underline that gait analysis using treadmill devices should be cautiously considered in PD and especially for gait variability assessment in gait lab.
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Affiliation(s)
- Thibault Warlop
- Physical and Rehabilitation Medicine Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium.,Neuro Musculo Skeletal Lab, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium.,Louvain Bionics, Université Catholique de Louvain, Brussels, Belgium.,Clinical Neuroscience (NEUR), Institute of Neurosciences (IoNS), Université Catholique de Louvain, Brussels, Belgium.,Department of Neurology, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Christine Detrembleur
- Neuro Musculo Skeletal Lab, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium.,Louvain Bionics, Université Catholique de Louvain, Brussels, Belgium
| | - Gaëtan Stoquart
- Physical and Rehabilitation Medicine Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium.,Neuro Musculo Skeletal Lab, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium.,Louvain Bionics, Université Catholique de Louvain, Brussels, Belgium
| | - Thierry Lejeune
- Physical and Rehabilitation Medicine Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium.,Neuro Musculo Skeletal Lab, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium.,Louvain Bionics, Université Catholique de Louvain, Brussels, Belgium
| | - Anne Jeanjean
- Clinical Neuroscience (NEUR), Institute of Neurosciences (IoNS), Université Catholique de Louvain, Brussels, Belgium.,Department of Neurology, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium
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11
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Sivakumaran S, Schinkel-Ivy A, Masani K, Mansfield A. Relationship between margin of stability and deviations in spatiotemporal gait features in healthy young adults. Hum Mov Sci 2017; 57:366-373. [PMID: 28987772 DOI: 10.1016/j.humov.2017.09.014] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 08/22/2017] [Accepted: 09/21/2017] [Indexed: 11/17/2022]
Abstract
Increased variability of spatio-temporal features while walking is related to increased risk of falls. It is thought that variability in foot placement and timing reflects responses to mechanical instability while walking. The purpose of this study was to determine whether 'extreme' values of step length, width and time follow transient periods of low mechanical stability during the single support phase of gait in healthy young adults. We conducted secondary analysis of a portion of an existing dataset. Eleven healthy adults walked on an instrumented treadmill. Participants were outfitted with reflective markers and completed two 1-min periods of walking at each of 3 speeds (0.8m/s, 1.2m/s, and 1.6m/s). Margins of stability were calculated relative to the anterior, posterior, lateral, and medial boundaries of the base of support, and the value at heel strike and the minimum value during the first half of each single-support phase were extracted. Step length, swing time, and step width were calculated from motion capture and ground reaction force data. Extreme values for consecutive steps were identified using Poincaré plots, and margins of stability in each direction were compared between 'normal' and 'extreme' steps. Margins of stability in both the anterior and medial direction were lower prior to long and wide steps, respectively. Margins of stability in the anterior and medial directions were lower prior to quick steps, and margins of stability in the posterior and lateral directions were lower prior to slow steps. There were either no significant differences in margin of stability between 'normal' and 'extreme' steps at heel strike, or the direction of the relationship was reversed to that observed during single support. These data suggest that spatio-temporal variability may reflect adjustments in step placement and timing to compensate for transient periods of low mechanical stability when walking.
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Affiliation(s)
- Shajicaa Sivakumaran
- Toronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada; Department of Kinesiology, University of Waterloo, Ontario, Canada
| | - Alison Schinkel-Ivy
- Toronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada; School of Physical & Health Education, Nipissing University, Ontario, Canada
| | - Kei Masani
- Toronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada; Institute of Biomaterials & Biomedical Engineering, University of Toronto, Ontario, Canada
| | - Avril Mansfield
- Toronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada; Department of Physical Therapy, University of Toronto, Ontario, Canada; Evaluative Clinical Sciences, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Ontario, Canada.
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Tanimoto K, Takahashi M, Tokuda K, Sawada T, Anan M, Shinkoda K. Lower limb kinematics during the swing phase in patients with knee osteoarthritis measured using an inertial sensor. Gait Posture 2017; 57:236-240. [PMID: 28668737 DOI: 10.1016/j.gaitpost.2017.06.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 06/11/2017] [Accepted: 06/20/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND During gait, the swing limb requires flexible control to adapt to ever changing environmental circumstances. However, few studies have focused on the mechanics of swing limb control in patients with knee osteoarthritis (OA). Investigating the variability of swing limb kinematics, which can be represented by variables such as the peak shank angular velocity during the swing phase obtained from an inertial sensor, provides insights into the adaptability of swing limb control. The purpose of this study was to investigate how patients with knee OA control the swing limb and whether the degree of impairment and disability due to knee OA affects swing limb control. METHODS Twelve subjects diagnosed with knee OA and 11 healthy control subjects participated in this study. Subjects walked on a treadmill for 10min. The mean, coefficient of variation, and fractal scaling exponent α of the peak shank angular velocity during the swing phase were calculated. FINDINGS There were no significant differences between the groups for any of the kinematic parameters. The Knee Injury and Osteoarthritis Outcome Score (KOOS) activities of daily living (ADL) subsection correlated with the coefficient of variation (r=-0.677, p=0.016) and the scaling exponent α (r=0.604, p=0.037) of the peak shank angular velocity. INTERPRETATION Control of the swing limb was associated with the degree of impairment and disability. Larger and more random variability of peak shank angular velocity may indicate decreased ADL ability in patients with knee OA.
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Affiliation(s)
- Kenji Tanimoto
- Graduate School of Biomedical and Health Sciences, Hiroshima University, 2-3, Kasumi 1-chome, Minami-ku, Hiroshima, 734-8553 Japan
| | - Makoto Takahashi
- Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, 2-3, Kasumi 1-chome, Minami-ku, Hiroshima, 734-8553 Japan; Center for Advanced Practice and Research of Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 2-3, Kasumi 1-chome, Minami-ku, Hiroshima, 734-8553 Japan
| | - Kazuki Tokuda
- Graduate School of Biomedical and Health Sciences, Hiroshima University, 2-3, Kasumi 1-chome, Minami-ku, Hiroshima, 734-8553 Japan
| | - Tomonori Sawada
- Graduate School of Biomedical and Health Sciences, Hiroshima University, 2-3, Kasumi 1-chome, Minami-ku, Hiroshima, 734-8553 Japan
| | - Masaya Anan
- Physical Therapy Course, Faculty of Welfare and Health Science, Oita University, 700, Dannoharu, Oita, 870-1192 Japan
| | - Koichi Shinkoda
- Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, 2-3, Kasumi 1-chome, Minami-ku, Hiroshima, 734-8553 Japan; Center for Advanced Practice and Research of Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, 2-3, Kasumi 1-chome, Minami-ku, Hiroshima, 734-8553 Japan.
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