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Malone AK, Hungerford ME, Smith SB, Chang NYN, Uchanski RM, Oh YH, Lewis RF, Hullar TE. Age-Related Changes in Temporal Binding Involving Auditory and Vestibular Inputs. Semin Hear 2024; 45:110-122. [PMID: 38370520 PMCID: PMC10872654 DOI: 10.1055/s-0043-1770137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024] Open
Abstract
Maintaining balance involves the combination of sensory signals from the visual, vestibular, proprioceptive, and auditory systems. However, physical and biological constraints ensure that these signals are perceived slightly asynchronously. The brain only recognizes them as simultaneous when they occur within a period of time called the temporal binding window (TBW). Aging can prolong the TBW, leading to temporal uncertainty during multisensory integration. This effect might contribute to imbalance in the elderly but has not been examined with respect to vestibular inputs. Here, we compared the vestibular-related TBW in 13 younger and 12 older subjects undergoing 0.5 Hz sinusoidal rotations about the earth-vertical axis. An alternating dichotic auditory stimulus was presented at the same frequency but with the phase varied to determine the temporal range over which the two stimuli were perceived as simultaneous at least 75% of the time, defined as the TBW. The mean TBW among younger subjects was 286 ms (SEM ± 56 ms) and among older subjects was 560 ms (SEM ± 52 ms). TBW was related to vestibular sensitivity among younger but not older subjects, suggesting that a prolonged TBW could be a mechanism for imbalance in the elderly person independent of changes in peripheral vestibular function.
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Affiliation(s)
| | - Michelle E. Hungerford
- VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon
- Department of Otolaryngology—Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon
| | - Spencer B. Smith
- Department of Speech, Language, and Hearing Sciences, University of Texas, Austin, Texas
| | - Nai-Yuan N. Chang
- Department of Oral and Maxillofacial Surgery, Oregon Health and Science University, Portland, Oregon
| | - Rosalie M. Uchanski
- Department of Otolaryngology - Head and Neck Surgery, Washington University in St. Louis, St. Louis, Missouri
| | - Yong-Hee Oh
- University of Louisville, Louisville, Kentucky
| | - Richard F. Lewis
- Departments of Otolaryngology and Neurology, Harvard Medical School, Boston, Massachusetts
| | - Timothy E. Hullar
- VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon
- Department of Otolaryngology—Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon
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Melo RS, Cardeira CSF, Rezende DSA, Guimarães-do-Carmo VJ, Lemos A, de Moura-Filho AG. Effectiveness of the aquatic physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in healthy community-dwelling older adults: A systematic review and meta-analysis. PLoS One 2023; 18:e0291193. [PMID: 37683025 PMCID: PMC10490910 DOI: 10.1371/journal.pone.0291193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Opting to use aquatic or land-based physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in community-dwelling older adults (CDOAs) is still a questionable clinical decision for physiotherapists. OBJECTIVE Assess the quality of evidence from randomized or quasi-randomized controlled trials that used aquatic physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in CDOAs. METHODS Articles were surveyed in the following databases: MEDLINE/PubMed, EMBASE, SCOPUS, LILACS, Web of Science, CENTRAL (Cochrane Central Register of Controlled Trials), PEDro, CINAHL, SciELO and Google Scholar, published in any language, up to July 31, 2023. Two independent reviewers extracted the data and assessed evidence quality. The risk of bias of the trials was evaluated by the Cochrane tool and evidence quality by GRADE approach. Review Manager software was used to conduct the meta-analyses. RESULTS 3007 articles were identified in the searches, remaining 33 studies to be read in full, with 11 trials being eligible for this systematic review. The trials included presented low evidence quality for the balance, gait, quality of life and fear of falling. Land-based and aquatic physical therapy exercises improved the outcomes analyzed; however, aquatic physical therapy exercises were more effective in improving balance, gait, quality of life and reducing fear of falling in CDOAs. The meta-analysis showed that engaging in aquatic physical therapy exercises increases the functional reach, through of the anterior displacement of the center of pressure of CDOAs by 6.36cm, compared to land-based physical therapy exercises, assessed by the Functional Reach test: [CI:5.22 to 7.50], (p<0.00001), presenting low quality evidence. CONCLUSIONS Aquatic physical therapy exercises are more effective than their land-based counterparts in enhancing balance, gait, quality of life and reducing the fear of falling in CDOAs. However, due to methodological limitations of the trials, this clinical decision remains inconclusive. It is suggested that new trials be conducted with greater methodological rigor, in order to provide high-quality evidence on the use of the aquatic physical therapy exercises to improve the outcomes analyzed in CDOAs.
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Affiliation(s)
- Renato S. Melo
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
- Post-Graduate Program in Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | | | | | | | - Andrea Lemos
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
- Post-Graduate Program in Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Alberto Galvão de Moura-Filho
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
- Post-Graduate Program in Physical Therapy, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil
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McIlroy RE, Barnett-Cowan M. Perceived timing of postural instability onset. Gait Posture 2023; 105:39-44. [PMID: 37478752 DOI: 10.1016/j.gaitpost.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 06/10/2023] [Accepted: 07/10/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND This study investigates the perceived onset of postural instability, a critical aspect of balance. Prior research using Temporal Order Judgment (TOJ) tasks revealed that postural perturbations must occur significantly earlier than an auditory reference stimulus for individuals to perceive them as simultaneous. However, there are methodological concerns with this previous work, particularly an unbalanced stimulus onset asynchrony (SOA) distribution. RESEARCH QUESTION Does the point of subjective simultaneity (PSS) between postural perturbation onset and an auditory reference stimulus differ between SOA distributions unequally (distribution 1) and equally (distribution 2) distributed around true simultaneity (0 ms)? METHODS A repeated measures design was employed, presenting two different SOA distributions to 10 participants using a TOJ task during both distribution 1 (88 trials) and distribution 2 (72 trials) SOA distributions. Paired t-tests were used to determine if there was a significant difference between the PSS of distribution 1 and 2. One-sample t-tests were also performed on the PSS values of both conditions in comparison to 0 ms (defined as true simultaneity) to determine if perceptual responses were delayed. RESULTS Distribution 1 led to a perceived delay of postural instability onset by 20.34 ms, while distribution 2 resulted in a perceived delay of the auditory stimulus of 3.52 ms. However, neither condition was significantly different from each other nor from true simultaneity. SIGNIFICANCE These findings suggest that the perception of postural instability onset is not slow, contrary to previous beliefs, and emphasize the importance of controlling methodological parameters when examining sensory cues. This understanding will help inform falls prevention strategies.
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Affiliation(s)
- Robert E McIlroy
- Department of Kinesiology and Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada.
| | - Michael Barnett-Cowan
- Department of Kinesiology and Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
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Campos JL, Marusic U, Mahoney JR. Editorial: The intersection of cognitive, motor, and sensory processing in aging: Links to functional outcomes, Volume I. Front Aging Neurosci 2022; 14:1009532. [PMID: 36110431 PMCID: PMC9470213 DOI: 10.3389/fnagi.2022.1009532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jennifer L. Campos
- KITE – Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Uros Marusic
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Department of Health Sciences, Alma Mater Europaea—ECM, Maribor, Slovenia
| | - Jeannette R. Mahoney
- Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Bronx, NY, United States
- *Correspondence: Jeannette R. Mahoney
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Gabriel GA, Harris LR, Gnanasegaram JJ, Cushing SL, Gordon KA, Haycock BC, Campos JL. Age-related changes to vestibular heave and pitch perception and associations with postural control. Sci Rep 2022; 12:6426. [PMID: 35440744 PMCID: PMC9018785 DOI: 10.1038/s41598-022-09807-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 03/21/2022] [Indexed: 11/09/2022] Open
Abstract
Falls are a common cause of injury in older adults (OAs), and age-related declines across the sensory systems are associated with increased falls risk. The vestibular system is particularly important for maintaining balance and supporting safe mobility, and aging has been associated with declines in vestibular end-organ functioning. However, few studies have examined potential age-related differences in vestibular perceptual sensitivities or their association with postural stability. Here we used an adaptive-staircase procedure to measure detection and discrimination thresholds in 19 healthy OAs and 18 healthy younger adults (YAs), by presenting participants with passive heave (linear up-and-down translations) and pitch (forward-backward tilt rotations) movements on a motion-platform in the dark. We also examined participants' postural stability under various standing-balance conditions. Associations among these postural measures and vestibular perceptual thresholds were further examined. Ultimately, OAs showed larger heave and pitch detection thresholds compared to YAs, and larger perceptual thresholds were associated with greater postural sway, but only in OAs. Overall, these results suggest that vestibular perceptual sensitivity declines with older age and that such declines are associated with poorer postural stability. Future studies could consider the potential applicability of these results in the development of screening tools for falls prevention in OAs.
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Affiliation(s)
- Grace A Gabriel
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Department of Psychology, University of Toronto, 500 University Avenue, Toronto, ON, M5G 2A2, Canada
| | - Laurence R Harris
- Department of Psychology and Centre for Vision Research, York University, Toronto, ON, Canada
| | - Joshua J Gnanasegaram
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Sharon L Cushing
- Department of Otolaryngology-Head and Neck Surgery, Hospital for Sick Children, Toronto, ON, Canada.,Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON, Canada.,Archie's Cochlear Implant Laboratory, Hospital for Sick Children, Toronto, ON, Canada
| | - Karen A Gordon
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON, Canada.,Archie's Cochlear Implant Laboratory, Hospital for Sick Children, Toronto, ON, Canada
| | - Bruce C Haycock
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,University of Toronto Institute for Aerospace Studies, Toronto, ON, Canada
| | - Jennifer L Campos
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada. .,Department of Psychology, University of Toronto, 500 University Avenue, Toronto, ON, M5G 2A2, Canada.
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Bolton DAE, Richardson JK. Inhibitory Control and Fall Prevention: Why Stopping Matters. Front Neurol 2022; 13:853787. [PMID: 35432150 PMCID: PMC9005868 DOI: 10.3389/fneur.2022.853787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/11/2022] [Indexed: 11/20/2022] Open
Affiliation(s)
- David A. E. Bolton
- Department of Kinesiology and Health Science, Utah State University, Logan, UT, United States
- *Correspondence: David A. E. Bolton
| | - James K. Richardson
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, United States
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Meulenberg CJW, de Bruin ED, Marusic U. A Perspective on Implementation of Technology-Driven Exergames for Adults as Telerehabilitation Services. Front Psychol 2022; 13:840863. [PMID: 35369192 PMCID: PMC8968106 DOI: 10.3389/fpsyg.2022.840863] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/09/2022] [Indexed: 12/11/2022] Open
Abstract
A major concern of public health authorities is to also encourage adults to be exposed to enriched environments (sensory and cognitive-motor activity) during the pandemic lockdown, as was recently the case worldwide during the COVID-19 outbreak. Games for adults that require physical activity, known as exergames, offer opportunities here. In particular, the output of the gaming industry nowadays offers computer games with extended reality (XR) which combines real and virtual environments and refers to human-machine interactions generated by computers and wearable technologies. For example, playing the game in front of a computer screen while standing or walking on a force plate or treadmill allows the user to react to certain infrastructural changes and obstacles within the virtual environment. Recent developments, optimization, and minimizations in wearable technology have produced wireless headsets and sensors that allow for unrestricted whole-body movement. This makes the virtual experience more immersive and provides the opportunity for greater engagement than traditional exercise. Currently, XR serves as an umbrella term for current immersive technologies as well as future realities that enhance the experience with features that produce new controllable environments. Overall, these technology-enhanced exergames challenge the adult user and modify the experience by increasing sensory stimulation and creating an environment where virtual and real elements interact. As a therapy, exergames can potentially create new environments and visualizations that may be more ecologically valid and thus simulate real activities of daily living that can be trained. Furthermore, by adding telemedicine features to the exergame, progress over time can be closely monitored and feedback provided, offering future opportunities for cognitive-motor assessment. To more optimally serve and challenge adults both physically and cognitively over time in future lockdowns, there is a need to provide long-term remote training and feedback. Particularly related to activities of daily living that create opportunities for effective and lasting rehabilitation for elderly and sufferers from chronic non-communicable diseases (CNDs). The aim of the current review is to envision the remote training and monitoring of physical and cognitive aspects for adults with limited mobility (due to disability, disease, or age), through the implementation of concurrent telehealth and exergame features using XR and wireless sensor technologies.
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Affiliation(s)
- Cécil J. W. Meulenberg
- Institute for Kinesiology Research, Science and Research Centre of Koper, Koper, Slovenia
| | - Eling D. de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, Zurich, Switzerland
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
- Department of Health, OST – University of Applied Sciences of Eastern Switzerland, St. Gallen, Switzerland
- *Correspondence: Eling D. de Bruin,
| | - Uros Marusic
- Institute for Kinesiology Research, Science and Research Centre of Koper, Koper, Slovenia
- Alma Mater Europaea – ECM, Department of Health Sciences, Maribor, Slovenia
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8
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Guyon M, Chea C, Laroche D, Fournel I, Baudet A, Toupet M, Bozorg Grayeli A. Measuring threshold and latency of motion perception on a swinging bed. PLoS One 2021; 16:e0252914. [PMID: 34242212 PMCID: PMC8270192 DOI: 10.1371/journal.pone.0252914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 05/26/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Our objective was to develop and to evaluate a system to measure latency and threshold of pendular motion perception based on a swinging bed. MATERIALS AND METHODS This prospective study included 30 healthy adults (age: 32 ± 12 years). All subjects were tested twice with a 10 min. interval. A second trial was conducted 2 to 15 days after. A rehabilitation swinging bed was connected to an electronic device emitting a beep at the beginning of each oscillation phase with an adjustable time lag. Subjects were blindfolded and auditory cues other than the beep were minimized. The acceleration threshold was measured by letting the bed oscillate freely until a natural break and asking the patient when he did not perceive any motion. The perception latency was determined by asking the patient to indicate whether the beep and the peak of each oscillation were synchronous. The time lag between sound and peak of the head position was swept from -750 to +750 ms by 50 ms increments. RESULTS The mean acceleration threshold was 9.2±4.60 cm/s2. The range width of the synchronous perception interval was estimated as 535±190 ms. The point of subjective synchronicity defined as the center of this interval was -195±106 ms (n = 30). The test-retest evaluation in the same trial showed an acceptable reproducibility for the acceleration threshold and good to excellent for all parameters related to sound-movement latency. CONCLUSION Swinging bed combined to sound stimulation can provide reproducible information on movement perception in a simple and non-invasive manner with highly reproducible results.
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Affiliation(s)
- Maxime Guyon
- Otolaryngology Department, Dijon University Hospital, Dijon, France
| | - Cyrielle Chea
- Otolaryngology Department, Dijon University Hospital, Dijon, France
| | - Davy Laroche
- INSERM CIC 1432, Plateforme d’Investigation Technologique, Dijon University Hospital, Dijon, France
- INSERM UMR1093, Cognition, Action et Plasticité Sensorimotrice, Université de Bourgogne Franche Comté, Dijon, France
| | - Isabelle Fournel
- INSERM CIC 1432, Module Epidémiologie Clinique/Essais Cliniques, Dijon, France
| | - Audrey Baudet
- INSERM CIC 1432, Plateforme d’Investigation Technologique, Dijon University Hospital, Dijon, France
| | - Michel Toupet
- Otolaryngology Department, Dijon University Hospital, Dijon, France
- Centre d’Explorations Fonctionnelles Otoneurologiques, Paris, France
| | - Alexis Bozorg Grayeli
- Otolaryngology Department, Dijon University Hospital, Dijon, France
- CNRS UMR 6306, Le2i Research Laboratory, Dijon, France
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Basharat A, Mahoney JR, Barnett-Cowan M. Temporal Metrics of Multisensory Processing Change in the Elderly. Multisens Res 2019; 32:715-744. [DOI: 10.1163/22134808-20191458] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 07/12/2019] [Indexed: 11/19/2022]
Abstract
Abstract
Older adults exhibit greater multisensory response time (RT) facilitation by violating the race model more than young adults; this is commonly interpreted as an enhancement in perception. Older adults typically exhibit wider temporal binding windows (TBWs) and points of subjective simultaneity (PSS) that typically lie farther from true simultaneity as compared to young adults when simultaneity judgment (SJ) and temporal-order judgment (TOJ) tasks are utilized; this is commonly interpreted as an impairment in perception. Here we explore the relation between the three tasks in order to better assess audiovisual multisensory temporal processing in both young and older adults. Our results confirm previous reports showing that audiovisual RT, TBWs and PSSs change with age; however, we show for the first time a significant positive relation between the magnitude of race model violation in young adults as a function of the PSS obtained from the audiovisual TOJ task (r: 0.49, p: 0.007), that is absent in older adults (r: 0.13, p: 0.58). Furthermore, we find no evidence for the relation between race model violation as a function of the PSS obtained from the audiovisual SJ task in both young (r: −0.01, p: 0.94) and older adults (r: 0.1, p: 0.66). Our results confirm previous reports that (i) audiovisual temporal processing changes with age; (ii) distinct processes are likely involved in simultaneity and temporal-order perception; and (iii) common processing between race model violation and temporal-order judgment is impaired in the elderly.
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Affiliation(s)
- Aysha Basharat
- 1Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada N2L 3G1
| | - Jeannette R. Mahoney
- 2The Department of Neurology, Division of Cognitive & Motor Aging, Albert Einstein College of Medicine, Bronx, NY, USA
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Wang P, Wang Y, Ru F. Develop a home-used EMG sensor system to identify pathological gait with less data via frequency analysis. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2019; 90:043113. [PMID: 31043035 DOI: 10.1063/1.5052567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 03/12/2019] [Indexed: 06/09/2023]
Abstract
In order to develop a low-cost wearable electromyography (EMG) sensor system that can be used at home, compacting the data size is studied first to extract potential features via frequency analysis. A low-cost wearable home-use EMG sensor is then developed. Results show the frequency band at 40-60 Hz of tibialis anterior offers significant differences to identify walking problems (p-value < 0.05), which can be used as a detection standard with a smaller data size. More significantly, data sizes are dramatically reduced by 95.06% compared to the original data size. This finding suggests a potential examining method for identifying pathological gait with the compacted data in satisfactory processing time that can be used at home.
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Affiliation(s)
- Ping Wang
- Key Laboratory of Road Construction and Equipment of MOE and School of Electronics and Control Engineering, Chang'an University, Xi'an, Shaanxi 710064, China
| | - Yabo Wang
- Key Laboratory of Road Construction and Equipment of MOE and School of Electronics and Control Engineering, Chang'an University, Xi'an, Shaanxi 710064, China
| | - Feng Ru
- Key Laboratory of Road Construction and Equipment of MOE and School of Electronics and Control Engineering, Chang'an University, Xi'an, Shaanxi 710064, China
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Community-dwelling adults with a history of falling report lower perceived postural stability during a foam eyes closed test than non-fallers. Exp Brain Res 2019; 237:769-776. [PMID: 30604020 DOI: 10.1007/s00221-018-5458-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 12/18/2018] [Indexed: 01/27/2023]
Abstract
Perceived postural stability has been reported to decrease as sway area increases on firm surfaces. However, changes in perceived stability under increasingly challenging conditions (e.g., removal of sensory inputs) and the relationship with sway area are not well characterized. Moreover, whether perceived stability varies as a function of age or history of falls is unknown. Here we investigate how perceived postural stability is related to sway area and whether this relationship varies as a function of age and fall history while vision and proprioceptive information are manipulated. Sway area was measured in 427 participants from the Baltimore Longitudinal Study of Aging while standing with eyes open and eyes closed on the floor and a foam cushion. Participants rated their stability [0 (completely unstable) to 10 (completely stable)] after each condition, and reported whether they had fallen in the past year. Perceived stability was negatively associated with sway area (cm2) such that individuals who swayed more felt less stable across all conditions (β = - 0.53, p < 0.001). Perceived stability decreased with increasing age (β = - 0.019, p < 0.001), independent of sway area. Fallers had a greater decline in perceived stability across conditions (F = 2.76, p = 0.042) compared to non-fallers, independent of sway area. Perceived postural stability declined as sway area increased during a multisensory balance test. A history of falling negatively impacts perceived postural stability when vision and proprioception are simultaneously challenged. Perceived postural stability may provide additional information useful for identifying individuals at risk of falls.
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Viveiro LAPD, Ferreira AFL, Pompeu JE. Cross-cultural adaptation, reliability, and validity of the St. Thomas’s Falls Risk Assessment Tool in Older Adults (STRATIFY). FISIOTERAPIA EM MOVIMENTO 2019. [DOI: 10.1590/1980-5918.032.ao27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Falls are an important adverse event among older adults. The St. Thomas’s Falls Risk Assessment Tool in Older Adults (STRATIFY) is a tool to assess the risk of falls; however, it is not translated and adapted to Portuguese. Objective: To translate and perform a cross-cultural adaptation of STRATIFY in Brazilian Portuguese, as well as to test the reliability and validity of the instrument. Method: The cross-cultural adaptation process was carried out in six stages: A) T1 and T2 translations; B) synthesis of translations (T12); C) T12 back translations (RT1 and RT2); D) expert committee review; E) pretesting of the version approved by the committee; F) adapted version of STRATIFY for Brazilian Portuguese. Inter-rater and test-retest reliability were performed using the intraclass correlation coefficient (ICC) and 95% confidence interval (CI). Validity was assessed by the Spearman’s correlation coefficient of the STRATIFY with the Morse Fall Scale (MFS). Data analysis was performed by the Microsoft Office Excel 2016 (translation and adaptation) and by the IBM SPSS Statistics 20.0 (reliability and validity). We used a level of significance of p<0.05. Results: Data were presented about the perception of 33 health professionals on the adapted version of STRATIFY. The following ICC and CI were found for inter-rater and test-retest reliability, respectively: ICC=0.729; CI=0.525-0.845 and ICC=0.876; CI=0.781-0.929. STRATIFY and MFS showed a moderate but significant correlation (ρ=0.50, p<0.001). Conclusion: The translated and adapted version of the STRATIFY presented moderate inter-rater reliability and good test-retest reliability, in addition to a moderate correlation to the MFS.
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Mahoney JR, Barnett-Cowan M. Introduction to the Special Issue on Multisensory Processing and Aging (Part II): Links to Clinically Meaningful Outcomes. Multisens Res 2019; 32:665-670. [PMID: 31648200 PMCID: PMC10502898 DOI: 10.1163/22134808-20191509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Jeannette R. Mahoney
- Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, 1225 Morris Park Avenue, Van Etten Building, Room 316G, Bronx, NY 10461, USA
| | - Michael Barnett-Cowan
- Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
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Shayman CS, Seo JH, Oh Y, Lewis RF, Peterka RJ, Hullar TE. Relationship between vestibular sensitivity and multisensory temporal integration. J Neurophysiol 2018; 120:1572-1577. [PMID: 30020839 DOI: 10.1152/jn.00379.2018] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A single event can generate asynchronous sensory cues due to variable encoding, transmission, and processing delays. To be interpreted as being associated in time, these cues must occur within a limited time window, referred to as a "temporal binding window" (TBW). We investigated the hypothesis that vestibular deficits could disrupt temporal visual-vestibular integration by determining the relationships between vestibular threshold and TBW in participants with normal vestibular function and with vestibular hypofunction. Vestibular perceptual thresholds to yaw rotation were characterized and compared with the TBWs obtained from participants who judged whether a suprathreshold rotation occurred before or after a brief visual stimulus. Vestibular thresholds ranged from 0.7 to 16.5 deg/s and TBWs ranged from 13.8 to 395 ms. Among all participants, TBW and vestibular thresholds were well correlated ( R2 = 0.674, P < 0.001), with vestibular-deficient patients having higher thresholds and wider TBWs. Participants reported that the rotation onset needed to lead the light flash by an average of 80 ms for the visual and vestibular cues to be perceived as occurring simultaneously. The wide TBWs in vestibular-deficient participants compared with normal functioning participants indicate that peripheral sensory loss can lead to abnormal multisensory integration. A reduced ability to temporally combine sensory cues appropriately may provide a novel explanation for some symptoms reported by patients with vestibular deficits. Even among normal functioning participants, a high correlation between TBW and vestibular thresholds was observed, suggesting that these perceptual measurements are sensitive to small differences in vestibular function. NEW & NOTEWORTHY While spatial visual-vestibular integration has been well characterized, the temporal integration of these cues is not well understood. The relationship between sensitivity to whole body rotation and duration of the temporal window of visual-vestibular integration was examined using psychophysical techniques. These parameters were highly correlated for those with normal vestibular function and for patients with vestibular hypofunction. Reduced temporal integration performance in patients with vestibular hypofunction may explain some symptoms associated with vestibular loss.
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Affiliation(s)
- Corey S Shayman
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University , Portland, Oregon
| | - Jae-Hyun Seo
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University , Portland, Oregon.,Department of Otolaryngology-Head and Neck Surgery, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yonghee Oh
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University , Portland, Oregon
| | - Richard F Lewis
- Department of Otolaryngology, Harvard Medical School , Boston, Massachusetts.,Department of Neurology, Harvard Medical School , Boston, Massachusetts.,Jenks Vestibular Physiology Laboratory, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
| | - Robert J Peterka
- National Center for Rehabilitative Auditory Research-VA Portland Health Care System , Portland, Oregon.,Department of Neurology, Oregon Health and Science University , Portland, Oregon
| | - Timothy E Hullar
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University , Portland, Oregon
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15
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Varghese JP, McIlroy RE, Barnett-Cowan M. Perturbation-evoked potentials: Significance and application in balance control research. Neurosci Biobehav Rev 2017; 83:267-280. [PMID: 29107828 DOI: 10.1016/j.neubiorev.2017.10.022] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 09/16/2017] [Accepted: 10/24/2017] [Indexed: 01/23/2023]
Abstract
Historically, balance control was thought to be mediated solely by subcortical structures based on animal research. However, recent findings provide compelling evidence of cortical involvement during balance reactions evoked by whole-body postural perturbations. In humans, an external perturbation elicits an evoked potential, termed the perturbation-evoked potential (PEP). PEPs are widely distributed over fronto-centro-parietal areas with maximal amplitude at the FCz/Cz electrode. From our literature review it is evident that the PEPs are comprised of a small positive potential (P1) that peaks around 30-90ms after perturbation onset, a large negative potential (N1) that peaks around 90-160ms, followed by positive (P2) and negative (N2) potentials between 200 and 400ms. Converging results across multiple studies suggest that these different PEP components are influenced by perturbation characteristics, postural set, environmental, and psychological factors. This review summarizes and integrates seminal research on the PEP, with a special emphasis on the PEP N1. Implications for future studies in PEP research are discussed to encourage further empirical investigation of PEP characteristics in healthy and patient populations.
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Affiliation(s)
- Jessy Parokaran Varghese
- Department of Kinesiology, University of Waterloo, 200 University Ave W, Waterloo, Ontario, N2L 3G1, Canada
| | - Robert E McIlroy
- Department of Kinesiology, University of Waterloo, 200 University Ave W, Waterloo, Ontario, N2L 3G1, Canada
| | - Michael Barnett-Cowan
- Department of Kinesiology, University of Waterloo, 200 University Ave W, Waterloo, Ontario, N2L 3G1, Canada
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