1
|
Padulo J, Rampichini S, Borrelli M, Buono DM, Doria C, Esposito F. Gait Variability at Different Walking Speeds. J Funct Morphol Kinesiol 2023; 8:158. [PMID: 37987494 PMCID: PMC10660777 DOI: 10.3390/jfmk8040158] [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: 10/08/2023] [Revised: 10/31/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023] Open
Abstract
Gait variability (GV) is a crucial measure of inconsistency of muscular activities or body segmental movements during repeated tasks. Hence, GV might serve as a relevant and sensitive measure to quantify adjustments of walking control. However, it has not been clarified whether GV is associated with walking speed, a clarification needed to exploit effective better bilateral coordination level. For this aim, fourteen male students (age 22.4 ± 2.7 years, body mass 74.9 ± 6.8 kg, and body height 1.78 ± 0.05 m) took part in this study. After three days of walking 1 km each day at a self-selected speed (SS) on asphalt with an Apple Watch S. 7 (AppleTM, Cupertino, CA, USA), the participants were randomly evaluated on a treadmill at three different walking speed intensities for 10 min at each one, SS - 20%/SS + 20%/ SS, with 5 min of passive recovery in-between. Heart rate (HR) was monitored and normalized as %HRmax, while the rate of perceived exertion (RPE) (CR-10 scale) was asked after each trial. Kinematic analysis was performed, assessing the Contact Time (CT), Swing Time (ST), Stride Length (SL), Stride Cycle (SC), and Gait Variability as Phase Coordination Index (PCI). RPE and HR increased as the walking speed increased (p = 0.005 and p = 0.035, respectively). CT and SC decreased as the speed increased (p = 0.0001 and p = 0.013, respectively), while ST remained unchanged (p = 0.277). SL increased with higher walking speed (p = 0.0001). Conversely, PCI was 3.81 ± 0.88% (high variability) at 3.96 ± 0.47 km·h-1, 2.64 ± 0.75% (low variability) at SS (4.94 ± 0.58 km·h-1), and 3.36 ± 1.09% (high variability) at 5.94 ± 0.70 km·h-1 (p = 0.001). These results indicate that while the metabolic demand and kinematics variables change linearly with increasing speed, the most effective GV was observed at SS. Therefore, SS could be a new methodological approach to choose the individual walking speed, normalize the speed intensity, and avoid a gait pattern alteration.
Collapse
Affiliation(s)
- Johnny Padulo
- Department of Biomedical Sciences for Health (SCIBIS), Università degli Studi di Milano, 20133 Milan, Italy; (S.R.); (M.B.); (D.M.B.); (C.D.); (F.E.)
| | - Susanna Rampichini
- Department of Biomedical Sciences for Health (SCIBIS), Università degli Studi di Milano, 20133 Milan, Italy; (S.R.); (M.B.); (D.M.B.); (C.D.); (F.E.)
| | - Marta Borrelli
- Department of Biomedical Sciences for Health (SCIBIS), Università degli Studi di Milano, 20133 Milan, Italy; (S.R.); (M.B.); (D.M.B.); (C.D.); (F.E.)
| | - Daniel Maria Buono
- Department of Biomedical Sciences for Health (SCIBIS), Università degli Studi di Milano, 20133 Milan, Italy; (S.R.); (M.B.); (D.M.B.); (C.D.); (F.E.)
| | - Christian Doria
- Department of Biomedical Sciences for Health (SCIBIS), Università degli Studi di Milano, 20133 Milan, Italy; (S.R.); (M.B.); (D.M.B.); (C.D.); (F.E.)
| | - Fabio Esposito
- Department of Biomedical Sciences for Health (SCIBIS), Università degli Studi di Milano, 20133 Milan, Italy; (S.R.); (M.B.); (D.M.B.); (C.D.); (F.E.)
- IRCCS Galeazzi Orthopedic Institute, 20161 Milan, Italy
| |
Collapse
|
2
|
Koren Y, Handelzalts S, Parmet Y, Bar-Haim S. Older adults and stroke survivors are steadier when gazing down. PLoS One 2023; 18:e0285361. [PMID: 37205706 DOI: 10.1371/journal.pone.0285361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 04/22/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Advanced age and brain damage have been reported to increase the propensity to gaze down while walking, a behavior that is thought to enhance stability through anticipatory stepping control. Recently, downward gazing (DWG) has been shown to enhance postural steadiness in healthy adults, suggesting that it can also support stability through a feedback control mechanism. These results have been speculated to be the consequence of the altered visual flow when gazing down. The main objective of this cross-sectional, exploratory study was to investigate whether DWG also enhances postural control in older adults and stroke survivors, and whether such effect is altered with aging and brain damage. METHODS Posturography of older adults and stroke survivors, performing a total of 500 trials, was tested under varying gaze conditions and compared with a cohort of healthy young adults (375 trials). To test the involvement of the visual system we performed spectral analysis and compared the changes in the relative power between gaze conditions. RESULTS Reduction in postural sway was observed when participants gazed down 1 and 3 meters ahead whereas DWG towards the toes decreased steadiness. These effects were unmodulated by age but were modulated by stroke. The relative power in the spectral band associated with visual feedback was significantly reduced when visual input was unavailable (eyes-closed condition) but was unaffected by the different DWG conditions. CONCLUSIONS Like young adults, older adults and stroke survivors better control their postural sway when gazing down a few steps ahead, but extreme DWG can impair this ability, especially in people with stroke.
Collapse
Affiliation(s)
- Yogev Koren
- Physical Therapy Department, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
- Translational Neurorehabilitation Laboratory, Ofakim, Israel
| | - Shirley Handelzalts
- Physical Therapy Department, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
- Translational Neurorehabilitation Laboratory, Ofakim, Israel
| | - Yisrael Parmet
- Industrial Engineering and Management Department, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
| | - Simona Bar-Haim
- Physical Therapy Department, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
- Translational Neurorehabilitation Laboratory, Ofakim, Israel
- Zlotowski Center for Neuroscience, Ben Gurion University of the Negev, Be'er-Sheva, Israel
| |
Collapse
|
3
|
Koren Y, Mairon R, Sofer I, Parmet Y, Ben-Shahar O, Bar-Haim S. Gazing down increases standing and walking postural steadiness. ROYAL SOCIETY OPEN SCIENCE 2021; 8:201556. [PMID: 33959324 PMCID: PMC8074885 DOI: 10.1098/rsos.201556] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 02/23/2021] [Indexed: 05/30/2023]
Abstract
When walking on an uneven surface or complex terrain, humans tend to gaze downward. This behaviour is usually interpreted as an attempt to acquire useful information to guide locomotion. Visual information, however, is not used exclusively for guiding locomotion; it is also useful for postural control. Both locomotive and postural control have been shown to be sensitive to the visual flow arising from the respective motion of the individual and the three-dimensional environment. This flow changes when a person gazes downward and may present information that is more appropriate for postural control. To investigate whether downward gazing can be used for postural control, rather than exclusively for guiding locomotion, we quantified the dynamics of standing and walking posture in healthy adults, under several visual conditions. Through these experiments we were able to demonstrate that gazing downward, just a few steps ahead, resulted in a steadier standing and walking posture. These experiments indicate that gazing downward may serve more than one purpose and provide sufficient evidence of the possible interplay between the visual information used for guiding locomotion and that used for postural control. These findings contribute to our understanding of the control mechanism/s underlying gait and posture and have possible clinical implications.
Collapse
Affiliation(s)
- Yogev Koren
- Physical Therapy Department, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Rotem Mairon
- Computer Science Department, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ilay Sofer
- Physical Therapy Department, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yisrael Parmet
- Industrial Engineering and Management Department, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ohad Ben-Shahar
- Computer Science Department, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Simona Bar-Haim
- Physical Therapy Department, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| |
Collapse
|
4
|
Michelini A, Eshraghi A, Andrysek J. Two-dimensional video gait analysis: A systematic review of reliability, validity, and best practice considerations. Prosthet Orthot Int 2020; 44:245-262. [PMID: 32507049 DOI: 10.1177/0309364620921290] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Motion capture systems are widely used to quantify human gait. Two-dimensional (2D) video systems are simple to use, easily accessible, and affordable. However, their performance as compared to other systems (i.e. three-dimensional (3D) gait analysis) is not well established. OBJECTIVES This work provides a comprehensive review of design specifications and performance characteristics (validity and reliability) of two-dimensional motion capture systems. STUDY DESIGN Systematic review. METHODS A systematic literature search was conducted in three databases from 1990 to 2019 and identified 30 research articles that met the inclusion/exclusion criteria. RESULTS Reliability of measurements of two-dimensional video motion capture was found to vary greatly from poor to excellent. Results relating to validity were also highly variable. Comparisons between the studies were challenging due to differences in protocols, instrumentation, parameters assessed, and analyses performed. CONCLUSIONS Variability in performance could be attributed to study design, gait parameters being measured, and technical aspects. The latter includes camera specifications (i.e. resolution and frame rate), setup (i.e. camera position), and analysis software. Given the variability in performance, additional validation testing may be needed for specific applications involving clinical or research-based assessments, including specific patient populations, gait parameters, mobility tasks, and data collection protocols. CLINICAL RELEVANCE This review article provides guidance on the application of 2D video gait analysis in a clinical or research setting. While not suitable in all instances, 2D gait analysis has promise in specific applications. Recommendations are provided about the patient populations, gait parameters, mobility tasks, and data collection protocols.
Collapse
Affiliation(s)
- Alexandria Michelini
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada.,Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Arezoo Eshraghi
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Jan Andrysek
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada.,Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| |
Collapse
|
5
|
Magnani RM, Bruijn SM, van Dieën JH, Vieira MF. Head orientation and gait stability in young adults, dancers and older adults. Gait Posture 2020; 80:68-73. [PMID: 32492622 DOI: 10.1016/j.gaitpost.2020.05.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 04/07/2020] [Accepted: 05/20/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Control of body orientation requires head motion detection by the vestibular system and small changes with respect to the gravitational acceleration vector could cause destabilization. RESEARCH QUESTION We aimed to compare the effects of different head orientations on gait stability in young adults, dancers and older adults. METHODS Three groups of 10 subjects were evaluated, the first composed of young adults (aged 18-30 years), the second composed of young healthy dancers under high performance dance training (aged 18-30 years), and the third group composed of community-dwelling older adults (aged 65-80 years). Participants walked on a treadmill at their preferred speed in four distinct head orientation conditions for four minutes each: control (neutral orientation); dynamic yaw (following a target over 45° bilaterally); up (15° neck extension), and down (40° neck flexion). Foot and trunk kinematic data were acquired using a 3D motion capture system and the gait pattern was assessed by basic gait parameters (step length, stride width and corresponding variability) and gait stability (local divergence exponents and margins of stability). Main effects of conditions and groups, as well as their interaction effects, were evaluated by repeated-measures analysis of variance. RESULTS Interactions of group and head orientation were found for both step length and stride width variability; main effects of head orientation were found for all evaluated parameters and main effects of group were found for step length and its variability and local divergence exponents in all directions. SIGNIFICANCE As expected, the older adults group showed less stable gait (higher local divergence exponent), the shortest step length and greater step length variability. However, contrary to expectation, the dancers were not more stable. The yaw condition was the most challenging for all groups and the down condition seemed to be least challenging.
Collapse
Affiliation(s)
- Rina M Magnani
- Bioengineering and Biomechanics Laboratory, Federal University of Goiás, Goiânia, Brazil.
| | - Sjoerd M Bruijn
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Science, Amsterdam, The Netherlands
| | - Jaap H van Dieën
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Science, Amsterdam, The Netherlands
| | - Marcus F Vieira
- Bioengineering and Biomechanics Laboratory, Federal University of Goiás, Goiânia, Brazil
| |
Collapse
|
6
|
Thomas NM, Donovan T, Dewhurst S, Bampouras TM. Visually fixating or tracking another person decreases balance control in young and older females walking in a real-world scenario. Neurosci Lett 2018; 677:78-83. [PMID: 29689345 DOI: 10.1016/j.neulet.2018.04.038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 04/16/2018] [Accepted: 04/19/2018] [Indexed: 11/26/2022]
Abstract
Balance control during overground walking was assessed in 10 young (23.6 ± 3.4) and 10 older (71.0 ± 5.5 years) healthy females during free gaze, and when fixating or tracking another person in an everyday use waiting room. Balance control was characterised by medial/lateral sacrum acceleration dispersion, and gaze fixations were simultaneously assessed with eye tracking equipment. The results showed decreased balance control when fixating a stationary (p = 0.003, gav = 0.19) and tracking a walking (p = 0.027, gav = 0.16) person compared to free gaze. The older adults exhibited reduced baseline stability throughout, but the decrease caused by the visual tasks was not more profound than the younger adults. The decreased balance control when fixating on or tracking the observed person was likely due to more challenging conditions for interpreting retinal flow, which facilitated less reliable estimates of self-motion through vision. The older adults either processed retinal flow during the tasks as effectively as the young adults, or they adopted a more rigid posture to facilitate visual stability, which masked any ageing effect of the visual tasks. The decrease in balance control, the first to be shown in this context, may warrant further investigation in those with ocular or vestibular dysfunction.
Collapse
Affiliation(s)
- Neil M Thomas
- Department of Medical and Sport Sciences, Active Ageing Research Group, University of Cumbria, Lancaster, LA1 4DH, UK; Research Institute for Sports and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK.
| | - Tim Donovan
- Department of Medical and Sport Sciences, Active Ageing Research Group, University of Cumbria, Lancaster, LA1 4DH, UK
| | - Susan Dewhurst
- Department of Sport and Physical Activity, Bournemouth University, Dorset, BH12 5BB, UK
| | - Theodoros M Bampouras
- Department of Medical and Sport Sciences, Active Ageing Research Group, University of Cumbria, Lancaster, LA1 4DH, UK
| |
Collapse
|