Perceptions of an over-ground induced temporal gait asymmetry by healthy young adults

Quantifying Human Gait Symmetry During Blindfolded Treadmill Walking

Bilateral gait symmetry is an essential requirement for normal walking since asymmetric gait patterns increase the risk of falls and injuries. While human gait control heavily relies on the contribution of sensory inputs, the role of sensory systems in producing symmetric gait has remained unclear. This study evaluated the influence of vision as a dominant sensory system on symmetric gait production. Ten healthy adults performed treadmill walking with and without vision. Twenty-two gait parameters including ground reaction forces, joint range of motion, and other spatial-temporal gait variables were evaluated to quantify gait symmetry and compared between both visual conditions. Visual block caused increased asymmetry in most parameters of ground reaction force, however mainly in the vertical direction. When vision was blocked, symmetry of the ankle and knee joint range of motion decreased, but this change did not occur in the hip joint. Stance and swing time symmetry decreased during no-vision walking while no significant difference was found for step length symmetry between the two conditions. This study provides a comprehensive analysis to reveal how the visual system influences bilateral gait symmetry and highlights the important role of vision in gait control. This approach could be applied to investigate how vision alters gait symmetry in patients with disorders to help better understand the role of vision in pathological gaits.

Application of the participatory design in the testing of a baropodometric insole prototype for weight-bearing asymmetry after a stroke: A qualitative study

Introduction

Currently studies indicate the need to incorporate the user`s perspective in the testing of new assistive technologies. The objective of this paper is to test a baropodometric insole prototype for monitoring and treatment weight-bearing asymmetry, according to the Participatory Design.

Methods

We used a qualitative case study approach during the testing phase of the baropodometric insole prototype. The focus group approach addressed topics related to the experience and accessibility of the potential user in conjunction with professionals, researchers, and physiotherapy students. Facilitators, barriers, and requirements for the device were collected through audio recordings of the discussions during and after prototype testing.

Results

Key steps in the prototype testing process were divided into (1) Test of the prototype according to the Participatory Design, divided into Who, When, How, and Why the potential user was involved in the study; and (2) Facilitators, barriers and requirements to improve the prototype.

Conclusions

The baropodometric insole prototype can be seen as a promising device for monitoring and treating weight-bearing asymmetry.

The Development of a Wearable Biofeedback System to Elicit Temporal Gait Asymmetry using Rhythmic Auditory Stimulation and an Assessment of Immediate Effects

Temporal gait asymmetry (TGA) is commonly observed in individuals facing mobility challenges. Rhythmic auditory stimulation (RAS) can improve temporal gait parameters by promoting synchronization with external cues. While biofeedback for gait training, providing real-time feedback based on specific gait parameters measured, has been proven to successfully elicit changes in gait patterns, RAS-based biofeedback as a treatment for TGA has not been explored. In this study, a wearable RAS-based biofeedback gait training system was developed to measure temporal gait symmetry in real time and deliver RAS accordingly. Three different RAS-based biofeedback strategies were compared: open- and closed-loop RAS at constant and variable target levels. The main objective was to assess the ability of the system to induce TGA with able-bodied (AB) participants and evaluate and compare each strategy. With all three strategies, temporal symmetry was significantly altered compared to the baseline, with the closed-loop strategy yielding the most significant changes when comparing at different target levels. Speed and cadence remained largely unchanged during RAS-based biofeedback gait training. Setting the metronome to a target beyond the intended target may potentially bring the individual closer to their symmetry target. These findings hold promise for developing personalized and effective gait training interventions to address TGA in patient populations with mobility limitations using RAS.

Effect of unilateral ankle loading on gait symmetry in young adults

BACKGROUND

Walking requires constant adjustments to the changing environment. An asymmetrical perturbation can affect the gait symmetry, cause gait adaptations, and potentially induce retention of the adapted gait after removal of the perturbation. A unilateral ankle load has the potential to create asymmetry and facilitate the emergence of new gait patterns. However, few studies have examined the effect of unilateral loading on muscular adjustments during walking. The purpose of this study was to investigate gait adaptations and muscular adjustments after unilaterally loading or unloading the ankle.

RESEARCH QUESTION

What are the effects of unilateral loading and unloading on gait spatiotemporal parameters and muscle activation in young adults?

METHODS

Twenty young adults (10 M/10 F) walked on a treadmill at their preferred walking speeds in 3 conditions: 1) a 2-minute baseline trial; 2) three 5-minute trials with a load (3 % of bodyweight) on the dominant ankle (Loading); and 3) one 5-minute trial with the load removed (Unloading). Inertial measurement units (IMUs) and electromyography sensors (EMGs) were used for data collection. Early and late adaptation and post-adaptation were assessed using the first 5 strides and the last 30 strides of loading and unloading conditions. Outcome measures included symmetry index (SI) of spatiotemporal parameters, range-of-motion (ROM) of the lower body joints, and EMG integrals of leg muscles. Repeated measures ANOVA was conducted for statistical analysis (α = 0.05).

RESULTS

SI of swing phase percentage demonstrated rapid adaptation after unilateral loading or unloading. Stride length demonstrated an aftereffect following unloading. Young adults reduced ankle ROMs bilaterally in early adaptation and increased loaded-side knee and hip ROMs in late adaptation. Additionally, they increased the tibialis anterior activity bilaterally immediately after unilateral loading.

SIGNIFICANCE

Young adults showed an aftereffect in some variables after unilateral unloading, signifying that unilateral ankle loading can induce short term learning of a new gait pattern.

The Effect of Rhythm Abilities on Metronome-Cued Walking with an Induced Temporal Gait Asymmetry in Neurotypical Adults

ABSRACT. Human gait is inherently rhythmical, thus walking to rhythmic auditory stimulation is a promising intervention to improve temporal gait asymmetry (TGA) following neurologic injury such as stroke. However, the degree of benefit may relate to an individual's underlying rhythmic ability. We conducted an initial investigation into the relationship between rhythm abilities and responsiveness of TGA when walking to a metronome. TGA was induced in neurotypical young adults with ankle and thigh cuff weights. Participants were grouped by strong or weak rhythm ability based on beat perception and production tests. TGA was induced using a unilateral load affixed to the non-dominant leg. Participants walked under three conditions: uncued baseline, metronome set to 100% of baseline cadence, and metronome set to 90% of baseline cadence. Repeated measures analysis using generalized estimating equations was conducted to determine how rhythm ability affected TGA response in each walking condition. Most participants improved TGA when walking to a metronome at either tempo compared to baseline; however, this improvement did not differ between strong and weak rhythm ability groups. Those who scored worse on the rhythm perception test also were poorer at synchronizing their steps to the beat. The induced TGA is smaller than what is commonly experienced after stroke. A larger induced TGA may be necessary to reveal subtle differences in responsiveness to rhythmical auditory stimulation between those with strong and weak rhythm abilities.