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Norrbrand L, Johannesson B, Grönkvist M. Increased Metabolic Demand During Nighttime Walking in Hilly Forest Terrain While Wearing Night Vision Goggles. Mil Med 2024:usae317. [PMID: 38913444 DOI: 10.1093/milmed/usae317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/24/2024] [Accepted: 06/19/2024] [Indexed: 06/26/2024] Open
Abstract
INTRODUCTION Foot-borne soldiers sometimes carry out nighttime operations. It has previously been reported an elevated metabolic demand and impaired walking economy during outdoor walking on a gravel road in darkness wearing night vision goggles (NVG), compared with wearing a headlamp. The aim of the present study was to evaluate the effect of wearing NVG while walking in a hilly forest terrain and compare the results between experienced and inexperienced NVG users. MATERIALS AND METHODS At nighttime, two different groups, inexperienced (five men and six women) and experienced (nine men) NVG users, walked 1.1 km at a self-selected comfortable pace in a hilly forest. Part I was mainly uphill, and Part II was mainly downhill. Walks were performed wearing a headlamp (light), monocular NVG (mono), binocular NVG (bino), or mono with a 25 kg extra weight (backpack). Walking economy calculated from oxygen uptake in relation to body mass and covered distance (V̇O2 (mL/[kg · km])), heart rate, gait, and walking speed were measured. RESULTS In both groups, walking economy was deteriorated in all three conditions with limited vision (mono, bino, and backpack) compared to the light condition, both during Part I (mono/bino, experienced: +26/+25%, inexperienced: +34/+28%) and Part II (mono/bino, experienced: +44/+46%, inexperienced: +63/+49%). In the backpack condition, the relative change of walking economy was greater for the inexperienced group than the experienced group: Part I (experienced: +46%, inexperienced: +70%), Part II (experienced: +71%, inexperienced: +111%). Concurrently, the step length was shorter in all three conditions with limited vision during Part I (mono/bino/backpack, experienced: -7/-7/-15%, inexperienced: -12/-12/-19%) and Part II (mono/bino/backpack; experienced: -8/-8/-14%, inexperienced: -17/-15/-24%) than in the light condition. The experienced NVG users walked faster during all conditions, but there was no difference in heart rate between groups. CONCLUSIONS Despite that foveal vision using NVG is adequate, it appears that the mechanical efficiency during nighttime walking in hilly terrain was markedly lower while wearing NVG than with full vision, regardless of whether the soldier was an experienced or inexperienced NVG user. Moreover, the walking economy was even more affected when adding the 25-kg extra weight. It is probable that the deteriorated mechanical efficiency was partly due to the shorter step length in all three conditions with limited vision.
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Affiliation(s)
- Lena Norrbrand
- Division of Environmental Physiology, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Solna 171 65, Sweden
| | - Björn Johannesson
- Division of Environmental Physiology, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Solna 171 65, Sweden
| | - Mikael Grönkvist
- Division of Environmental Physiology, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Solna 171 65, Sweden
- Division of Health Informatics and Logistics, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Flemingsberg 141 57, Sweden
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Yamagata M, Nagai R, Morihiro K, Nonaka T. Relation between the kinematic synergy controlling swing foot and visual exploration during obstacle crossing. J Biomech 2023; 157:111702. [PMID: 37429178 DOI: 10.1016/j.jbiomech.2023.111702] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 05/24/2023] [Accepted: 06/26/2023] [Indexed: 07/12/2023]
Abstract
To step over obstacles of varying heights, two distinct ongoing streams of activities-visual exploration of the environment and gait adjustment- were required to occur concurrently without interfering each other. Yet, it remains unclear whether and how the manner of embodied behavior of visual exploration is related to the synergistic control of foot trajectory to negotiate with the irregular terrain. Thus, we aimed to explore that how the synergistic control of the vertical trajectory of the swing foot (i.e., obstacle clearance) crossing an obstacle is related to the manner of visual exploration of the environment during approach. Twenty healthy young adults crossed an obstacle (depth: 1 cm, width: 60 cm, height: 8 cm) during their comfortable-speed walking. The visual exploration was evaluated as the amount of time spent in fixating the vicinity of the obstacle on the floor during the period from two to four steps prior to crossing the obstacle, and the strengths of kinematic synergy to control obstacle clearance were estimated using the uncontrolled manifold approach. We found that the participants with relatively weak synergy spent more time fixating at the vicinity of the obstacle from two to four steps prior to crossing the obstacle, and those participants exhibited greater amount of head flexion movement compared to those with stronger kinematic synergy. Taking advantage of this complex relationship between exploratory activities (e.g. looking movement) and performative activities (e.g. adjustment of ground clearance) would be crucial to adapt walking in a complex environment.
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Affiliation(s)
- Momoko Yamagata
- Faculty of Rehabilitation, Kansai Medical University, 18-89 Uyama Higashimachi, Hirakata, Osaka 573-1136, Japan; Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo Kyoto 606-8507, Japan.
| | - Rira Nagai
- Department of Human Development, Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada-ku, Kobe, Hyogo 657-0011, Japan
| | - Kaoru Morihiro
- Department of Human Development, Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada-ku, Kobe, Hyogo 657-0011, Japan
| | - Tetsushi Nonaka
- Department of Human Development, Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada-ku, Kobe, Hyogo 657-0011, Japan
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Norrbrand L, Grönkvist M, Kounalakis S, Halvorsen K, Eiken O. Metabolic Demands and Kinematics During Level Walking in Darkness With No Vision or With Visual Aid. Mil Med 2023; 188:e2010-e2017. [PMID: 36331591 PMCID: PMC10363013 DOI: 10.1093/milmed/usac327] [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: 07/19/2022] [Revised: 10/03/2022] [Accepted: 10/18/2022] [Indexed: 07/25/2023] Open
Abstract
INTRODUCTION Uniformed services commonly perform foot-borne operations at night, while using visual aid in terms of night vision goggles (NVG). During slow-level walking, complete lack of visual input alters kinematics and markedly increases the metabolic demand, whereas the effect on kinematics and energy expenditure of restricting the peripheral visual field by wearing NVG is still unknown. The purpose was to evaluate whether metabolic demands and kinematics during level walking are affected by complete darkness with and without visual aid. MATERIALS AND METHODS Eleven healthy men walked on a treadmill (inclination: +2.3°, velocity: 4 km/h) with full vision in a lighted laboratory (Light), and in complete darkness wearing either a blindfold (Dark), or restricting the visual field to about 40° by wearing monocular (Mono) or binocular (Bino) NVG. Oxygen uptake ($\dot{\text{V}}$O2) was measured to evaluate metabolic demands. Inertial measurement units were used to estimate kinematics, and the outcome was validated by using a motion capture system. Ratings of perceived exertion, discomfort, and mental stress were evaluated after each condition using a Borg ratio scale. Physiologic and kinematic variables were evaluated using repeated measures analysis of variance (ANOVA), whereas ratings were evaluated using non-parametric Friedman ANOVA. RESULTS $\dot{\text{V}}$ O2 was 20% higher in the Dark (1.2 ± 0.2 L/min) than the Light (1.0 ± 0.2 L/min) condition. Nominally, $\dot{\text{V}}$O2 in the Mono (1.1 ± 0.2 L/min) and Bino (1.1 ± 0.2 L/min) conditions fell in between those in the Light and Dark conditions but was not statistically different from either the Light or the Dark condition. Step length was shorter in the Dark (-9%, 1.22 ± 0.16 m) and Mono (-6%, 1.27 ± 0.09 m) conditions than in the Light condition (1.35 ± 0.11 m), whereas the Bino (1.28 ± 0.08 m) condition was not statistically different from either the Light or the Dark condition. The three conditions with no or limited vision were perceived more physically demanding, more uncomfortable, and more mentally stressful than the Light condition, and the Dark condition was perceived more mentally stressful than both NVG conditions. CONCLUSIONS The study confirms that complete lack of visual cues markedly reduces the mechanical efficiency during level walking, even under obstacle-free and highly predictable conditions. That $\dot{\text{V}}$O2 and step length values for the NVG conditions fell in between those of the Light and Dark conditions suggest that both foveal and peripheral vision may play important roles in optimizing the mechanical efficiency during level walking.
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Affiliation(s)
- Lena Norrbrand
- Division of Environmental Physiology, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Solna 171 65, Sweden
| | - Mikael Grönkvist
- Division of Environmental Physiology, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Solna 171 65, Sweden
| | - Stylianos Kounalakis
- Faculty of Physical and Cultural Education, Evelpidon Hellenic Army Academy, Vari 16673, Greece
| | - Kjartan Halvorsen
- Department of Information Technology, Division of Systems and Control, Uppsala University, Uppsala 751 05, Sweden
- Department of Mechatronics, School of Engineering and Sciences, Campus Estado de Mexico, Tecnologico de Monterrey, Ciudad López Mateos 52926, Mexico
| | - Ola Eiken
- Division of Environmental Physiology, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Solna 171 65, Sweden
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Campoi HG, Campoi EG, Moraes R. Occlusion of the lower visual field when wearing a facial mask does not compromise gait control when stepping into a hole in older adults. Hum Mov Sci 2023; 88:103063. [PMID: 36696831 DOI: 10.1016/j.humov.2023.103063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/29/2022] [Accepted: 01/16/2023] [Indexed: 01/25/2023]
Abstract
Visual exproprioception obtained from the lower visual field (LVF) is used to control locomotion on uneven terrain. Wearing a facial mask obstructs the LVF and can compromise gait control. Therefore, this study aimed to investigate the effect of occluding the LVF when wearing a facial mask on gait control while walking and stepping into a hole in older adults. Fifteen older adults walked along a wooden walkway under two different surface conditions (without and with a hole [60 cm wide and long, with a depth of 9.5 cm] and three visual conditions (control, mask, and basketball goggles with an occluded LVF). We found that occlusion of the LVF with masks or goggles did not affect the adaptations necessary to step into a hole. Neither behavioral (gait speed, margin of stability, foot landing position) nor neuromuscular (EMG activation and co-activation) parameters were affected by either visual manipulation. Older adults used a downward head pitch strategy to compensate for visual obstruction and plan the anticipatory adjustments to step into the hole. The absence of lower limb visual exproprioception due to wearing a mask did not affect locomotion control when stepping into a hole in older adults. Older adults compensated for the obstruction of the LVF through head downward tilt, which allowed them to obtain visual information about the hole two steps ahead to make anticipatory locomotor adjustments.
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Affiliation(s)
- Henrique G Campoi
- Biomechanics and Motor Control Lab, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil; Graduate Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Eduardo G Campoi
- Biomechanics and Motor Control Lab, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, 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, Ribeirão Preto, Brazil; Graduate Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
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Khan Z, Jiao X, Hu T, Shao Q, Sun X, Zhao X, Gu D. Investigation of gait, balance and lower extremity muscle activity during walking in patients with cervical spondylotic myelopathy using wearable sensors. Spine J 2023:S1529-9430(23)00106-7. [PMID: 36934793 DOI: 10.1016/j.spinee.2023.03.004] [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: 10/31/2022] [Revised: 02/28/2023] [Accepted: 03/10/2023] [Indexed: 03/21/2023]
Abstract
BACKGROUND CONTEXT Cervical spondylotic myelopathy (CSM) is a degenerative disease caused by cervical cord compression and can lead to the significant impairment of motor function including gait and balance disturbances and changes in lower extremity muscle activity. PURPOSE This study aimed to characterize gait, balance and lower extremity muscle activity in patients with CSM compared to age-matched healthy controls (HCs) using wearable sensors in the clinical setting. STUDY DESIGN Non-Randomized, prospective cohort study. PATIENT SAMPLE 10 CSM patients and 10 age-matched HCs were recruited for this study. OUTCOME MEASURES Gait and balance function parameters contained spatial temporal parameters, step regularity (SR1), stride regularity (SR2) and harmonic ratio (HR). EMG muscle activity parameters included time to peak and peak value during loading, stance, and swing phase. METHODS In this study, parameters of gait and balance function were extracted using triaxial accelerometer attached to the spinous processes of Lumbar 5 while participants performed an overground walking at a self-preferred speed. Moreover, muscular activity was simultaneously recorded via sEMG sensors attached to tibialis anterior (TA), rectus femoris (RF), bicep femoris (BF) and gastrocnemius lateral (GL). Independent sample t-test was used to find the differences between CSM patients and HCs. RESULTS Gait analysis showed cadence, step length and walking speed were statistically significantly lower in CSM patients than HCs. Stride time was significantly higher for CSM patients in comparison to HCs. Lower root mean square ratio (RMSR) of acceleration in the mediolateral (ML) direction, HR in the anteroposterior (AP) direction, SR1 in the AP direction and SR2 in all three directions were observed in CSM patients. For muscle activity analysis, EMG RMS for TA and RF during loading phase and RMS for GL during midstance phase was significantly lower for CSM patients, while significantly higher value was observed for RF RMS during midstance phase and GL RMS during swing phase in CSM patients. CONCLUSION Our pilot study shows that wearable sensors are able to detect the changes of gait, balance and lower extremity muscle activities of CSM patients in the clinical setting. This pilot study sets the stage for future researches on the diagnosis and monitor progression of CSM disease using wearable technology.
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Affiliation(s)
- Zawar Khan
- Shanghai Key Laboratory of Orthopaedic Implants and Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai 200011, China; School of Biomedical Engineering & Med-X Research Institute, Shanghai Jiao Tong University, Shanghai 200030, China; Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai 200030, China
| | - Xin Jiao
- Shanghai Key Laboratory of Orthopaedic Implants and Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai 200011, China; School of Biomedical Engineering & Med-X Research Institute, Shanghai Jiao Tong University, Shanghai 200030, China; Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai 200030, China
| | - Tianyi Hu
- Shanghai Key Laboratory of Orthopaedic Implants and Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai 200011, China; School of Biomedical Engineering & Med-X Research Institute, Shanghai Jiao Tong University, Shanghai 200030, China; Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai 200030, China
| | - Qineng Shao
- School of Biomedical Engineering & Med-X Research Institute, Shanghai Jiao Tong University, Shanghai 200030, China; Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai 200030, China
| | - Xin Sun
- Shanghai Key Laboratory of Orthopaedic Implants and Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai 200011, China
| | - Xin Zhao
- Shanghai Key Laboratory of Orthopaedic Implants and Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai 200011, China.
| | - Dongyun Gu
- Shanghai Key Laboratory of Orthopaedic Implants and Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai 200011, China; School of Biomedical Engineering & Med-X Research Institute, Shanghai Jiao Tong University, Shanghai 200030, China; Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai 200030, China.
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Kunimune S, Okada S. Sex Differences in the Visuomotor Control of Obstacle Crossing When Walking are not Age-Related. Percept Mot Skills 2022; 129:362-377. [DOI: 10.1177/00315125221077566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
To ensure stable obstacle crossing when walking, visual information is required two steps before reaching the obstacle. As possible age-related sex differences in visuomotor control have not been investigated, we assessed sex differences in obstacle crossing while walking, as examined by toe clearance (TC) and postural stability. Participants were 14 younger and 14 older adults (equal numbers of men and women) who wore goggles for visual field adjustment while obstacle crossing during gait. We manipulated three visual field occlusion conditions (total, lower, and no visual field occlusions) two steps before the obstacle and analyzed the TC of the lead limb, and the participants’ step width and root mean square of trunk acceleration as indices of postural stability. We found a significant interaction between sex and visual condition in step width, with men showing larger step width values than women in all visual field conditions. Moreover, while women showed no step-width differences across visual field conditions, men had a larger step width with the lower visual field occluded than in the other visual conditions. We found no other significant sex differences. Our results suggest that men may be more dependent than women on the upper visual field for postural stability during obstacle crossing. Sex differences in visuomotor control were not affected by age.
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Affiliation(s)
- Sho Kunimune
- Department of Physical Therapy, Faculty of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan
| | - Shuichi Okada
- Graduate School of Human Development and Environment, Kobe University, Hyogo, Japan
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Zhang Y, Wang H, Yao Y, Liu J, Sun X, Gu D. Walking stability in patients with benign paroxysmal positional vertigo: an objective assessment using wearable accelerometers and machine learning. J Neuroeng Rehabil 2021; 18:56. [PMID: 33789693 PMCID: PMC8011133 DOI: 10.1186/s12984-021-00854-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 03/17/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Benign paroxysmal positional vertigo (BPPV) is one of the most common peripheral vestibular disorders leading to balance difficulties and increased fall risks. This study aims to investigate the walking stability of BPPV patients in clinical settings and propose a machine-learning-based classification method for determining the severity of gait disturbances of BPPV. METHODS Twenty-seven BPPV outpatients and twenty-seven healthy subjects completed level walking trials at self-preferred speed in clinical settings while wearing two accelerometers on the head and lower trunk, respectively. Temporo-spatial variables and six walking stability related variables [root mean square (RMS), harmonic ratio (HR), gait variability, step/stride regularity, and gait symmetry] derived from the acceleration signals were analyzed. A support vector machine model (SVM) based on the gait variables of BPPV patients were developed to differentiate patients from healthy controls and classify the handicapping effects of dizziness imposed by BPPV. RESULTS The results showed that BPPV patients employed a conservative gait and significantly reduced walking stability compared to the healthy controls. Significant different mediolateral HR at the lower trunk and anteroposterior step regularity at the head were found in BPPV patients among mild, moderate, and severe DHI (dizziness handicap inventory) subgroups. SVM classification achieved promising accuracies with area under the curve (AUC) of 0.78, 0.83, 0.85 and 0.96 respectively for differentiating patients from healthy controls and classifying the three stages of DHI subgroups. Study results suggest that the proposed gait analysis that is based on the coupling of wearable accelerometers and machine learning provides an objective approach for assessing gait disturbances and handicapping effects of dizziness imposed by BPPV.
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Affiliation(s)
- Yuqian Zhang
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People's Republic of China.,School of Biomedical Engineering and Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, 200030, People's Republic of China.,Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education of People's Republic China, Shanghai, 200030, People's Republic of China
| | - He Wang
- School of Biomedical Engineering and Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, 200030, People's Republic of China.,Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education of People's Republic China, Shanghai, 200030, People's Republic of China
| | - Yifei Yao
- School of Biomedical Engineering and Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, 200030, People's Republic of China.,Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education of People's Republic China, Shanghai, 200030, People's Republic of China
| | - Jianren Liu
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People's Republic of China
| | - Xuhong Sun
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People's Republic of China.
| | - Dongyun Gu
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People's Republic of China. .,School of Biomedical Engineering and Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, 200030, People's Republic of China. .,Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education of People's Republic China, Shanghai, 200030, People's Republic of China.
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Michalska J, Kamieniarz A, Sobota G, Stania M, Juras G, Słomka KJ. Age-related changes in postural control in older women: transitional tasks in step initiation. BMC Geriatr 2021; 21:17. [PMID: 33407197 PMCID: PMC7789726 DOI: 10.1186/s12877-020-01985-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 12/22/2020] [Indexed: 02/06/2023] Open
Abstract
Background Aging, being a natural process, involves many functional and structural changes within the body. Identifying the age-related postural changes will provide insight into the role of aging on postural control during locomotion. The aim of this study was to identify age-related postural changes during a transitional task under different conditions. Methods Sixty healthy females divided into three age groups: A (50-60 y/o), B (60-70 y/o), and C (70-80 y/o). The transitional task was measured by two force platforms. The procedure consisted of three phases: quiet standing, transfer onto a second platform, and quiet standing on the second platform. Four different conditions were applied: unperturbed transfer, obstacle crossing, step-up, and step-down. Double-support time, transit time, and stability time before and after the step task were analyzed. Results The transit time was longer by 30% for subjects over 70 y/o. The double-support time was longer by 11% among adults 60-70 y/o, while in people over 70 y/o it was longer by almost 50% compared to the 50-60 y/o subjects. The stability time before the transitional task was longer by 17% among adults over 60 y/o compared to middle-age subjects. The stability times before and after the transitional task were longer for adults in the 50-60 y/o category. Conclusion The proposed procedure is adequate for assessing age-related changes in postural control while undergoing a transitional task. An analysis of the double-support time and stability time before and after the step task enabled the detection of early signs of balance changes in middle-age adults. Independent of age, the transitional task parameters changed with the increasing difficulty of the tasks.
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Affiliation(s)
- Justyna Michalska
- Institute of Sport Sciences, Academy of Physical Education in Katowice, Katowice, Poland
| | - Anna Kamieniarz
- Institute of Sport Sciences, Academy of Physical Education in Katowice, Katowice, Poland.
| | - Grzegorz Sobota
- Institute of Sport Sciences, Academy of Physical Education in Katowice, Katowice, Poland
| | - Magdalena Stania
- Institute of Sport Sciences, Academy of Physical Education in Katowice, Katowice, Poland
| | - Grzegorz Juras
- Institute of Sport Sciences, Academy of Physical Education in Katowice, Katowice, Poland
| | - Kajetan J Słomka
- Institute of Sport Sciences, Academy of Physical Education in Katowice, Katowice, Poland
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Hunter SW, Divine A, Madou E, Omana H, Hill KD, Johnson AM, Holmes JD, Wittich W. Executive function as a mediating factor between visual acuity and postural stability in cognitively healthy adults and adults with Alzheimer's dementia. Arch Gerontol Geriatr 2020; 89:104078. [PMID: 32388070 DOI: 10.1016/j.archger.2020.104078] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/20/2020] [Accepted: 04/09/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Falls in older adults, notably those with Alzheimer's dementia (AD), are prevalent. Vision and balance impairments are prominent falls risk factors in older adults. However, recent literature in the cognitively impaired suggests that executive function (EF) is important for falls risk assessments. The study objectives were to: 1) to compare balance among people with AD, healthy older adults (OA), and healthy young adults (YA) and 2) to quantify the interaction of visual acuity and EF on postural stability. METHODS We recruited 165 individuals (51 YA, 48 OA, and 66 AD). Trail Making Tests (A and B) quantified EF and the Colenbrander mixed contrast chart measured high and low contrast visual acuity. Accelerometers recorded postural sway during the Modified Test for Sensory Integration. A two-way repeated measures ANOVA examined postural sway differences across groups. Mediation analysis quantified the association of EF in the relationship between contrast sensitivity and postural sway. RESULTS Significant EF and visual acuity between-group differences were observed (p < 0.001). For postural sway, a significant interaction existed between group and balance condition (p < 0.001). In general, EF was a significant mediator between visual acuity and postural sway. Visual acuity, EF and postural sway was worse with increased age, particularly in the AD group. CONCLUSIONS Mediation analysis revealed that individuals with poorer visual acuity had poorer EF, and those with poorer executive function had poorer balance control. These results highlight the importance of assessing not only vision and balance but also EF, especially in older individuals living with AD.
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Affiliation(s)
- Susan W Hunter
- School of Physical Therapy, University of Western Ontario, London, Ontario, Canada; School of Health Studies, University of Western Ontario, London, Ontario, Canada.
| | - Alison Divine
- Faculty of Biological Sciences, University of Leeds, Leeds, England, United Kingdom
| | - Edward Madou
- School of Physical Therapy, University of Western Ontario, London, Ontario, Canada
| | - Humberto Omana
- School of Health Studies, University of Western Ontario, London, Ontario, Canada
| | - Keith D Hill
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Melbourne, Australia
| | - Andrew M Johnson
- School of Health Studies, University of Western Ontario, London, Ontario, Canada
| | - Jeffrey D Holmes
- School of Occupational Therapy, University of Western Ontario, London, Ontario, Canada
| | - Walter Wittich
- École d'optométrie, Université de Montréal, Montreal, Quebec, Canada
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Jehu DA, Saunders D, Richer N, Paquet N, Lajoie Y. The influence of carrying an anterior load on attention demand and obstacle clearance before, during, and after obstacle crossing. Exp Brain Res 2019; 237:3313-3319. [PMID: 31690972 DOI: 10.1007/s00221-019-05673-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 10/21/2019] [Indexed: 10/25/2022]
Abstract
Carrying an anterior load during obstacle negotiation increases attention demand, which may differ at various crossing stages. Less is known on the impact of lower visual field obstruction and the weight of the anterior load on obstacle negotiation and attention demand. The objectives of this study were to: (1) determine if carrying a weighted anterior load, lower visual field occlusion, or both, modify obstacle clearance and/or reaction time (RT); and (2) examine whether RT is modulated across obstacle crossing phases as measured by a probe RT protocol. Sixteen young adults crossed an obstacle while carrying no load, a clear 5 kg load, and an opaque 5 kg load, while performing a simple RT task. Auditory stimuli were presented at five locations: (1) two steps before the obstacle; (2) one step before the obstacle; (3) as the leading limb crossed the obstacle; (4) as the lead limb touched down after the obstacle; and (5) as the trail limb crossed the obstacle. The toe clearance height of the leading limb was greatest for the weighted opaque box load type followed by the weighted clear box type compared to the no box load type. Carrying an anterior load during obstacle crossing did not influence RT. RTs were longer at the pre-crossing and beginning of the crossing phases compared to after-crossing phases. Results suggest that carrying a weighted anterior load and lower visual field occlusion increase the risk for tripping. Attention demands differ across obstacle crossing phases during dual-tasking and should be considered in fall-risk assessments.
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Affiliation(s)
- Deborah A Jehu
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.,Djavad Mowafaghian Centre for Brain Health, Aging, Mobility and Cognitive Neuroscience Laboratory, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.,Centre for Hip Health and Mobility, Aging, Mobility and Cognitive Neuroscience Laboratory, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Deanna Saunders
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, 125 University Avenue, Ottawa, ON, K1N 6N5, Canada
| | - Natalie Richer
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Nicole Paquet
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Yves Lajoie
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, 125 University Avenue, Ottawa, ON, K1N 6N5, Canada.
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