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Wu X, Dickin DC, Bassette L, Ashton C, Wang H. Clinical gait analysis in older children with autism spectrum disorder. SPORTS MEDICINE AND HEALTH SCIENCE 2024; 6:154-158. [PMID: 38708319 PMCID: PMC11067783 DOI: 10.1016/j.smhs.2023.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 10/06/2023] [Accepted: 10/30/2023] [Indexed: 05/07/2024] Open
Abstract
Individuals with autism spectrum disorder (ASD) often exhibit motor deficits that increase their risk of falls. There is a lack of understanding regarding gait biomechanics demonstrated by older children with ASD. The purpose of the study was to determine differences in gait patterns between older children with ASD and typically developing children. Eleven children with ASD and 11 age- and gender-matched typically developing children were recruited for the study. Participants walked on a force-instrumented treadmill at a constant speed (1.1 m/s - 1.2 m/s) for five minutes (min). Participants performed maximal voluntary contractions to assess their knee muscular strength. Differences between individuals with ASD and matched control participants were examined through paired t-tests with a significance level of p ≤ 0.05. Individuals with ASD demonstrated a smaller knee extensor torque compared to controls (p = 0.002). Participants with ASD exhibited a shorter stride length (p = 0.04), a greater cadence (p = 0.03), and a higher variation in stride width (p = 0.04) compared to control participants. The individuals with ASD experienced a greater braking ground reaction force (p = 0.03) during loading response. The results indicate older children with ASD develop a unique gait pattern signified by a reduced stride length, increased cadence, and an increase of variation in stride width. This unique gait pattern may represent a movement strategy used by the individuals with ASD to compensate for the weakness associated with their knee extensor muscles. Individuals with ASD who demonstrate these unique gait deviations may face reduced postural stability and an increased risk of fall-related injuries.
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Affiliation(s)
- Xinye Wu
- School of Kinesiology, Ball State University, Muncie, IN, USA
| | - D. Clark Dickin
- School of Kinesiology, Ball State University, Muncie, IN, USA
| | - Laura Bassette
- Department of Special Education, Ball State University, Muncie, IN, USA
| | - Caroline Ashton
- School of Kinesiology, Ball State University, Muncie, IN, USA
| | - He Wang
- School of Kinesiology, Ball State University, Muncie, IN, USA
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Wilson RB, Burdekin ED, Jackson NJ, Hughart L, Anderson J, Dusing SC, Gulsrud A, Kasari C. Slower pace in early walking onset is related to communication, motor skills, and adaptive function in autistic toddlers. Autism Res 2024; 17:27-36. [PMID: 38009228 PMCID: PMC10842796 DOI: 10.1002/aur.3067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 11/06/2023] [Indexed: 11/28/2023]
Abstract
The onset of walking is a major developmental milestone in early childhood and is critical to the development of language and social communication. Delays in walking have been described in individuals with ASD. Yet, less is known about the quality of early gait development in toddlers with ASD and the relationship to motor skills, social communication, and language. Quantitative measures of locomotion can improve our ability to evaluate subtle and specific motor differences in toddlers with ASD and their relationship to other developmental domains. We used quantitative gait analysis to evaluate locomotion in toddlers with ASD (n = 51) and compared these data to a reference chronological aged (CA) and mental aged (MA) matched typically developing (TD) cohort (n = 45). We also examined the relationship of quantitative gait metrics to developmental measures among toddlers with ASD. We found that although toddlers with ASD achieved a typical age range of walking onset, they exhibited a pattern of slower pace compared to the TD cohort when matched by CA and MA. We also found that slower measures of pace were associated with lower developmental scores of communication, motor skills, and adaptive function. Our findings improve characterization of locomotion in toddlers with ASD and the relationship of motor skills to other developmental domains.
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Affiliation(s)
- Rujuta B Wilson
- Semel Institute for Neuroscience and Human Behavior, Division of Child Psychiatry, University of California, Los Angeles, California, USA
| | | | - Nicholas J Jackson
- Department of Medicine, Division of General Internal Medicine & Health Services Research, University of California, Los Angeles, California, USA
| | - Lauren Hughart
- Semel Institute for Neuroscience and Human Behavior, Division of Child Psychiatry, University of California, Los Angeles, California, USA
| | - Jeff Anderson
- Semel Institute for Neuroscience and Human Behavior, Division of Child Psychiatry, University of California, Los Angeles, California, USA
| | - Stacey C Dusing
- Ostrow School of Dentistry, Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California, USA
| | - Amanda Gulsrud
- Semel Institute for Neuroscience and Human Behavior, Division of Child Psychiatry, University of California, Los Angeles, California, USA
| | - Connie Kasari
- Semel Institute for Neuroscience and Human Behavior, Division of Child Psychiatry, University of California, Los Angeles, California, USA
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Mani H, Miyagishima S, Kozuka N, Inoue T, Hasegawa N, Asaka T. Development of the Relationships Among Dynamic Balance Control, Inter-limb Coordination, and Torso Coordination During Gait in Children Aged 3-10 Years. Front Hum Neurosci 2021; 15:740509. [PMID: 34776908 PMCID: PMC8582286 DOI: 10.3389/fnhum.2021.740509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/11/2021] [Indexed: 11/28/2022] Open
Abstract
Knowledge about the developmental process of dynamic balance control comprised of upper arms and upper legs coordination and trunk and pelvis twist coordination is important to advance effective balance assessment for abnormal development. However, the mechanisms of these coordination and stability control during gait in childhood are unknown.This study examined the development of dynamic postural stability, upper arm and upper leg coordination, and trunk and pelvic twist coordination during gait, and investigated the potential mechanisms integrating the central nervous system with inter-limb coordination and trunk and pelvic twist coordination to control extrapolated center of the body mass (XCOM). This study included 77 healthy children aged 3-10 years and 15 young adults. The child cohort was divided into four groups by age: 3-4, 5-6, 7-8, and 9-10 years. Participants walked barefoot at a self-selected walking speed along an 8 m walkway. A three-dimensional motion capture system was used for calculating the XCOM, the spatial margin of stability (MoS), and phase coupling movements of the upper arms, upper legs, trunk, and pelvic segments. MoS in the mediolateral axis was significantly higher in the young adults than in all children groups. Contralateral coordination (ipsilateral upper arm and contralateral upper leg combination) gradually changed to an in-phase pattern with increasing age until age 9 years. Significant correlations of XCOMML with contralateral coordination and with trunk and pelvic twist coordination (trunk/pelvis coordination) were found. Significant correlations between contralateral coordination and trunk/pelvis coordination were observed only in the 5-6 years and at 7-8 years groups.Dynamic postural stability during gait was not fully mature at age 10. XCOM control is associated with the development of contralateral coordination and trunk and pelvic twist coordination. The closer to in-phase pattern of contralateral upper limb coordination improved the XCOM fluctuations. Conversely, the out-of-phase pattern (about 90 degrees) of the trunk/pelvis coordination increased theXCOM fluctuation. Additionally, a different control strategy was used among children 3-8 years of age and individuals over 9 years of age, which suggests that 3-4-year-old children showed a disorderly coordination strategy between limb swing and torso movement, and in children 5-8 years of age, limb swing depended on trunk/pelvis coordination.
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Affiliation(s)
- Hiroki Mani
- Faculty of Welfare and Health Science, Physical Therapy Courses, Oita University, Oita, Japan
| | - Saori Miyagishima
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo Medical University, Sapporo, Japan
| | - Naoki Kozuka
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Takahiro Inoue
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Naoya Hasegawa
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Tadayoshi Asaka
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
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Roggio F, Ravalli S, Maugeri G, Bianco A, Palma A, Di Rosa M, Musumeci G. Technological advancements in the analysis of human motion and posture management through digital devices. World J Orthop 2021; 12:467-484. [PMID: 34354935 PMCID: PMC8316840 DOI: 10.5312/wjo.v12.i7.467] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/15/2021] [Accepted: 07/12/2021] [Indexed: 02/06/2023] Open
Abstract
Technological development of motion and posture analyses is rapidly progressing, especially in rehabilitation settings and sport biomechanics. Consequently, clear discrimination among different measurement systems is required to diversify their use as needed. This review aims to resume the currently used motion and posture analysis systems, clarify and suggest the appropriate approaches suitable for specific cases or contexts. The currently gold standard systems of motion analysis, widely used in clinical settings, present several limitations related to marker placement or long procedure time. Fully automated and markerless systems are overcoming these drawbacks for conducting biomechanical studies, especially outside laboratories. Similarly, new posture analysis techniques are emerging, often driven by the need for fast and non-invasive methods to obtain high-precision results. These new technologies have also become effective for children or adolescents with non-specific back pain and postural insufficiencies. The evolutions of these methods aim to standardize measurements and provide manageable tools in clinical practice for the early diagnosis of musculoskeletal pathologies and to monitor daily improvements of each patient. Herein, these devices and their uses are described, providing researchers, clinicians, orthopedics, physical therapists, and sports coaches an effective guide to use new technologies in their practice as instruments of diagnosis, therapy, and prevention.
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Affiliation(s)
- Federico Roggio
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo 90144, Italy
| | - Silvia Ravalli
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Catania 95123, Italy
| | - Grazia Maugeri
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Catania 95123, Italy
| | - Antonino Bianco
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo 90144, Italy
| | - Antonio Palma
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo 90144, Italy
| | - Michelino Di Rosa
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Catania 95123, Italy
| | - Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Catania 95123, Italy
- Research Center on Motor Activities, University of Catania, Catania 95123, Italy
- Department of Biology, College of Science and Technology, Temple University, Philadelphia, PA 19122, United States
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