1
|
Harter MJ, Redfern MS, Sparto PJ, Geyer H. Modelling strategies supplemental to foot placement for frontal-plane stability in walking. J R Soc Interface 2024; 21:20240191. [PMID: 39226925 PMCID: PMC11371431 DOI: 10.1098/rsif.2024.0191] [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: 03/19/2024] [Revised: 06/14/2024] [Accepted: 07/16/2024] [Indexed: 09/05/2024] Open
Abstract
Walking is unstable and requires active control. Foot placement is the primary strategy to maintain frontal-plane balance with contributions from lateral ankle torques, ankle push-off and trunk postural adjustments. Because these strategies interact, their individual contributions are difficult to study. Here, we used computational modelling to understand these individual contributions to frontal-plane walking balance control. A three-dimensional bipedal model was developed based on linear inverted pendulum dynamics. The model included controllers that implement the stabilization strategies seen in human walking. The control parameters were optimized to mimic human gait biomechanics for typical spatio-temporal parameters during steady-state walking and when perturbed by mediolateral ground shifts. Using the optimized model as a starting point, the contributions of each stabilization strategy were explored by progressively removing strategies. The lateral ankle and trunk strategies were more important than ankle push-off, with their removal causing up to 20% worse balance recovery compared with the full model, while removing ankle push-off led to minimal changes. Our results imply a potential benefit of preferentially training these strategies in populations with poor balance. Moreover, the proposed model could be used in future work to investigate how walking stability may be preserved in conditions reflective of injury or disease.
Collapse
Affiliation(s)
- Michelle J. Harter
- Department of Bioengineering, University of Pittsburgh, 302 Benedum Hall 3700 O’Hara Street, Pittsburgh, PA15260, USA
| | - Mark S. Redfern
- Department of Bioengineering, University of Pittsburgh, 302 Benedum Hall 3700 O’Hara Street, Pittsburgh, PA15260, USA
| | - Patrick J. Sparto
- Department of Physical Therapy, University of Pittsburgh, 100 Technology Drive, Pittsburgh, PA15219, USA
| | - Harmut Geyer
- Robotics Institute, Carnegie Mellon University, 5000 Forbes Avenue, Pittsburgh, PA15213, USA
| |
Collapse
|
2
|
Wang Y, Mei Q, Jiang H, Hollander K, Van den Berghe P, Fernandez J, Gu Y. The Biomechanical Influence of Step Width on Typical Locomotor Activities: A Systematic Review. SPORTS MEDICINE - OPEN 2024; 10:83. [PMID: 39068296 PMCID: PMC11283446 DOI: 10.1186/s40798-024-00750-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 07/03/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND Step width is a spatial variable in the frontal plane, defined as the mediolateral distance between the heel (forefoot during sprinting) of bilateral feet at initial contact. Variations in step width may impact the lower limb biomechanics. This systematic review aimed to synthesize the published findings to determine the influence of acute changes in step width on locomotion biomechanics and provide implications for injury prevention and enhanced sports performance. METHODS Literature was identified, selected, and appraised in accordance with the methods of a systematic review. Four electronic databases (Web of Science, MEDLINE via PubMed, Scopus, and ScienceDirect) were searched up until May 2023 with the development of inclusion criteria based on the PICO model. Study quality was assessed using the Downs and Black checklist and the measured parameters were summarized. RESULTS Twenty-three articles and 399 participants were included in the systematic review. The average quality score of the 23 studies included was 9.39 (out of 14). Step width changed the kinematics and kinetics in the sagittal, frontal, and transverse planes of the lower limb, such as peak rearfoot eversion angle and moment, peak hip adduction angle and moment, knee flexion moment, peak knee internal rotation angle, as well as knee external rotation moment. Alteration of step width has the potential to change the stability and posture during locomotion, and evidence exists for the immediate biomechanical effects of variations in step width to alter proximal kinematics and cues to impact loading variables. CONCLUSION Short-term changes in step width during walking, running, and sprinting influenced multiple lower extremity biomechanics. Narrower step width may result in poor balance and higher impact loading on the lower extremities during walking and running and may limit an athlete's sprint performance. Increasing step width may be beneficial for injury rehabilitation, i.e., for patients with patellofemoral pain syndrome, iliotibial band syndrome or tibial bone stress injury. Wider steps increase the supporting base and typically enhance balance control, which in turn could reduce the risks of falling during daily activities. Altering the step width is thus proposed as a simple and non-invasive treatment method in clinical practice.
Collapse
Affiliation(s)
- Yuan Wang
- Faculty of Sports Science, Ningbo University, No. 818, Fenghua Rd, Jiangbei District, Ningbo, Zhejiang, China
- Research Academy of Grand Health, Ningbo University, Ningbo, China
| | - Qichang Mei
- Faculty of Sports Science, Ningbo University, No. 818, Fenghua Rd, Jiangbei District, Ningbo, Zhejiang, China.
- Research Academy of Grand Health, Ningbo University, Ningbo, China.
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand.
| | - Hanhui Jiang
- Faculty of Sports Science, Ningbo University, No. 818, Fenghua Rd, Jiangbei District, Ningbo, Zhejiang, China
- Research Academy of Grand Health, Ningbo University, Ningbo, China
| | - Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | | | - Justin Fernandez
- Faculty of Sports Science, Ningbo University, No. 818, Fenghua Rd, Jiangbei District, Ningbo, Zhejiang, China
- Research Academy of Grand Health, Ningbo University, Ningbo, China
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
- Department of Engineering Science, The University of Auckland, Auckland, New Zealand
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, No. 818, Fenghua Rd, Jiangbei District, Ningbo, Zhejiang, China.
- Research Academy of Grand Health, Ningbo University, Ningbo, China.
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand.
| |
Collapse
|
3
|
Curtze C, Shah VV, Stefanko AM, Dale ML, Nutt JG, Mancini M, Horak FB. Stride width and postural stability in frontal gait disorders and Parkinson's disease. J Neurol 2024; 271:3721-3730. [PMID: 38727734 DOI: 10.1007/s00415-024-12401-5] [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: 02/12/2024] [Revised: 04/17/2024] [Accepted: 04/22/2024] [Indexed: 07/10/2024]
Abstract
Older adults, as well as those with certain neurological disorders, may compensate for poor neural control of postural stability by widening their base of foot support while walking. However, the extent to which this wide-based gait improves postural stability or affects postural control strategies has not been explored. People with idiopathic Parkinson's disease (iPD, n = 72), frontal gait disorders (FGD, n = 16), and healthy older adults (n = 32) performed walking trials at their preferred speed over an 8-m-long, instrumented walkway. People with iPD were tested in their OFF medication state. Analyses of covariance were performed to determine the associations between stride width and measures of lateral stability control. People with FGD exhibited a wide-based gait compared to both healthy older adults and iPD. An increased stride width was associated with an increase in lateral margin of stability in FGD. Unlike healthy older adults or iPD, people with FGD did not externally rotate their feet (toe-out angle) or shift their center of pressure laterally to aid lateral dynamic stability during walking but slowed their gait instead to increase stability. By adopting a slow, wide-based gait, people with FGD take advantage of the passive, pendular mechanics of walking.
Collapse
Affiliation(s)
- Carolin Curtze
- Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE, 68182, USA.
| | - Vrutangkumar V Shah
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
- APDM Wearable Technologies-a Clario Company, Portland, OR, USA
| | - Alexa M Stefanko
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - Marian L Dale
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
- PADRECC, Portland VA Medical Center, Portland, OR, USA
| | - John G Nutt
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - Martina Mancini
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - Fay B Horak
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
- APDM Wearable Technologies-a Clario Company, Portland, OR, USA
| |
Collapse
|
4
|
Dunn JA, Gomez NG, Wong B, Sinclair SK, Henninger HB, Foreman KB, Bachus KN. Transhumeral prosthesis use affects upper body kinematics and kinetics. Gait Posture 2024; 112:59-66. [PMID: 38744022 DOI: 10.1016/j.gaitpost.2024.05.007] [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: 11/27/2023] [Revised: 05/03/2024] [Accepted: 05/08/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Transhumeral (TH) limb loss leads to loss of body mass and reduced shoulder range of motion. Despite most owning a prosthesis, prosthesis abandonment is common. The consequence of TH limb loss and prosthesis use and disuse during gait may be compensation in the upper body, contributing to back pain or injury. Understanding the impact of not wearing a TH prosthesis on upper body asymmetries and spatial-temporal aspects of gait will inform how TH prosthesis use and disuse affects the body. RESEARCH QUESTION Does TH limb loss alter upper body asymmetries and spatial-temporal parameters during gait when wearing and not wearing a prosthesis compared to able-bodied controls? METHODS Eight male TH limb loss participants and eight male control participants completed three gait trials at self-selected speeds. The TH limb loss group performed trials with and without their prosthesis. Arm swing, trunk angular displacement, trunk-pelvis moment, and spatial-temporal aspects were compared using non-parametric statistical analyses. RESULTS Both TH walking conditions showed greater arm swing in the intact limb compared to the residual (p≤0.001), resulting in increased asymmetry compared to the control group (p≤0.001). Without the prosthesis, there was less trunk flexion and lateral flexion compared to the control group (p≤0.001). Maximum moments between the trunk and pelvis were higher in the TH group than the control group (p≤0.05). Spatial-temporal parameters of gait did not differ between the control group and either TH limb loss condition. SIGNIFICANCE Prosthesis use affects upper body kinematics and kinetics, but does not significantly impact spatial-temporal aspects of gait, suggesting these are compensatory actions. Wearing a prosthesis helps achieve more normative upper body kinematics and kinetics than not wearing a prosthesis, which may help limit back pain. These findings emphasize the importance of encouraging at least passive use of prostheses for individuals with TH limb loss.
Collapse
Affiliation(s)
- Julia A Dunn
- Department of Biomedical Engineering University of Utah, 36 S Wasatch Dr, Salt Lake City, UT 84112, USA; Department of Orthopaedics University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
| | - Nicholas G Gomez
- Department of Physical Therapy and Athletic Training University of Utah, 520 Wakara Way, Salt Lake City, UT 84108, USA; College of Health, Human Services & Nursing California State University, 1000 E. Victoria Street, Carson, CA 90747, USA
| | - Bob Wong
- College of Nursing University of Utah, 10 2000 E, Salt Lake City, UT 84112, USA
| | - Sarina K Sinclair
- Department of Orthopaedics University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA; Department of Veterans Affairs, 500 Foothill Boulevard, Salt Lake City, UT 84148, USA
| | - Heath B Henninger
- Department of Biomedical Engineering University of Utah, 36 S Wasatch Dr, Salt Lake City, UT 84112, USA; Department of Orthopaedics University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
| | - K Bo Foreman
- Department of Orthopaedics University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA; Department of Physical Therapy and Athletic Training University of Utah, 520 Wakara Way, Salt Lake City, UT 84108, USA
| | - Kent N Bachus
- Department of Biomedical Engineering University of Utah, 36 S Wasatch Dr, Salt Lake City, UT 84112, USA; Department of Orthopaedics University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA; Department of Veterans Affairs, 500 Foothill Boulevard, Salt Lake City, UT 84148, USA.
| |
Collapse
|
5
|
Sansare A, Arcodia M, Lee SCK, Jeka J, Reimann H. Immediate application of low-intensity electrical noise reduced responses to visual perturbations during walking in individuals with cerebral palsy. J Neuroeng Rehabil 2024; 21:14. [PMID: 38281953 PMCID: PMC10822182 DOI: 10.1186/s12984-023-01299-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 12/19/2023] [Indexed: 01/30/2024] Open
Affiliation(s)
- Ashwini Sansare
- Department of Physical Therapy, University of Delaware, Newark, DE, USA
| | - Maelyn Arcodia
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA
| | - Samuel C K Lee
- Department of Physical Therapy, University of Delaware, Newark, DE, USA
| | - John Jeka
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA
| | - Hendrik Reimann
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA.
| |
Collapse
|
6
|
Symeonidou ER, Esposito NM, Reyes RD, Ferris DP. Practice walking on a treadmill-mounted balance beam modifies beam walking sacral movement and alters performance in other balance tasks. PLoS One 2023; 18:e0283310. [PMID: 37319297 PMCID: PMC10270570 DOI: 10.1371/journal.pone.0283310] [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: 01/27/2023] [Accepted: 03/02/2023] [Indexed: 06/17/2023] Open
Abstract
The goals of this study were to determine if a single 30-minute session of practice walking on a treadmill mounted balance beam: 1) altered sacral marker movement kinematics during beam walking, and 2) affected measures of balance during treadmill walking and standing balance. Two groups of young, healthy human subjects practiced walking on a treadmill mounted balance beam for thirty minutes. One group trained with intermittent visual occlusions and the other group trained with unperturbed vision. We hypothesized that the subjects would show changes in sacrum movement kinematics after training and that there would be group differences due to larger improvements in beam walking performance by the visual occlusions group. We also investigated if there was any balance transfer from training on the beam to treadmill walking (margin of stability) and to standing static balance (center of pressure excursion). We found significant differences in sacral marker maximal velocity after training for both groups, but no significant differences between the two groups from training. There was limited evidence of balance transfer from beam-walking practice to gait margin of stability for treadmill walking and for single leg standing balance, but not for tandem stance balance. The number of step-offs while walking on a narrow beam had the largest change with training (partial η2 = 0.7), in accord with task specificity. Other balance metrics indicative of transfer had lower effect sizes (partial η2<0.5). Given the limited transfer across balance training tasks, future work should examine how intermittent visual occlusions during multi-task training improve real world functional outcomes.
Collapse
Affiliation(s)
- Evangelia-Regkina Symeonidou
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida, United States of America
- International Max Planck Research School for Systems and Cognitive Neuroscience, University of Tubingen, Tubingen, Germany
| | - Nicole M. Esposito
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida, United States of America
| | - Roehl-Dean Reyes
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida, United States of America
| | - Daniel P. Ferris
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida, United States of America
| |
Collapse
|
7
|
van Dellen F, Aurich-Schuler T, Hesse N, Labruyère R. Clustering trunk movements of children and adolescents with neurological gait disorders undergoing robot-assisted gait therapy: the functional ability determines if actuated pelvis movements are clinically useful. J Neuroeng Rehabil 2023; 20:71. [PMID: 37270537 DOI: 10.1186/s12984-023-01200-0] [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: 02/02/2023] [Accepted: 05/26/2023] [Indexed: 06/05/2023] Open
Abstract
INTRODUCTION Robot-assisted gait therapy is frequently used for gait therapy in children and adolescents but has been shown to limit the physiological excursions of the trunk and pelvis. Actuated pelvis movements might support more physiological trunk patterns during robot-assisted training. However, not every patient is expected to react identically to actuated pelvis movements. Therefore, the aim of the present study was to identify different trunk movement patterns with and without actuated pelvis movements and compare them based on their similarity to the physiological gait pattern. METHODS AND RESULTS A clustering algorithm was used to separate pediatric patients into three groups based on different kinematic reactions of the trunk to walking with and without actuated pelvis movements. The three clusters included 9, 11 and 15 patients and showed weak to strong correlations with physiological treadmill gait. The groups also statistically differed in clinical assessment scores, which were consistent with the strength of the correlations. Patients with a higher gait capacity reacted with more physiological trunk movements to actuated pelvis movements. CONCLUSION Actuated pelvis movements do not lead to physiological trunk movements in patients with a poor trunk control, while patients with better walking functions can show physiological trunk movements. Therapists should carefully consider for whom and why they decide to include actuated pelvis movements in their therapy plan.
Collapse
Affiliation(s)
- Florian van Dellen
- Swiss Children's Rehab, Children's University Hospital Zurich, Mühlebergstrasse 104, 8910, Affoltern Am Albis, Switzerland.
- Sensory-Motor Systems Lab, Department of Health Sciences and Technology, ETH Zurich, Tannenstrasse 1, 8092, Zurich, Switzerland.
- Children's Research Center, Children's University Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland.
| | - Tabea Aurich-Schuler
- Swiss Children's Rehab, Children's University Hospital Zurich, Mühlebergstrasse 104, 8910, Affoltern Am Albis, Switzerland
- Children's Research Center, Children's University Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
| | - Nikolas Hesse
- Swiss Children's Rehab, Children's University Hospital Zurich, Mühlebergstrasse 104, 8910, Affoltern Am Albis, Switzerland
- Children's Research Center, Children's University Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
| | - Rob Labruyère
- Swiss Children's Rehab, Children's University Hospital Zurich, Mühlebergstrasse 104, 8910, Affoltern Am Albis, Switzerland
- Children's Research Center, Children's University Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
| |
Collapse
|
8
|
Buurke TJW, van de Venis L, Keijsers N, Nonnekes J. The effect of walking with reduced trunk motion on dynamic stability in healthy adults. Gait Posture 2023; 103:113-118. [PMID: 37156163 DOI: 10.1016/j.gaitpost.2023.05.004] [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: 11/03/2022] [Revised: 01/13/2023] [Accepted: 05/03/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Most people with Parkinson's disease (PD) walk with a smaller mediolateral base of support (BoS) compared to healthy people, but the underlying mechanisms remain unknown. Reduced trunk motion in people with PD might be related to this narrow-based gait. Here, we study the relationship between trunk motion and narrow-based gait in healthy adults. According to the extrapolated center of mass (XCoM) concept, a decrease in mediolateral XCoM excursion would require a smaller mediolateral BoS to maintain a constant margin of stability (MoS) and remain stable. RESEARCH QUESTION As proof of principle, we assessed whether walking with reduced trunk motion results in a smaller step width in healthy adults, without altering the mediolateral MoS. METHODS Fifteen healthy adults walked on a treadmill at preferred comfortable walking speed in two conditions. First, the 'regular walking' condition without any instructions, and second, the 'reduced trunk motion' condition with the instruction: 'Keep your trunk as still as possible'. Treadmill speed was kept the same in the two conditions. Trunk kinematics, step width, mediolateral XCoM excursion and mediolateral MoS were calculated and compared between the two conditions. RESULTS Walking with the instruction to keep the trunk still significantly reduced trunk kinematics. Walking with reduced trunk motion resulted in significant decreases in step width and mediolateral XCoM excursion, but not in the mediolateral MoS. Furthermore, step width and mediolateral XCoM excursion were strongly correlated during both conditions (r = 0.887 and r = 0.934). SIGNIFICANCE This study shows that walking with reduced trunk motion leads to a gait pattern with a smaller BoS in healthy adults, without altering the mediolateral MoS. Our findings indicate a strong coupling between CoM motion state and the mediolateral BoS. We expect that people with PD who walk narrow-based, have a similar mediolateral MoS as healthy people, which will be further investigated.
Collapse
Affiliation(s)
- Tom J W Buurke
- University of Groningen, University Medical Center Groningen, Department of Human Movement Sciences, Groningen, the Netherlands; KU Leuven, Department of Movement Sciences, Leuven, Belgium.
| | - Lotte van de Venis
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Center of Expertise for Parkinson & Movement Disorders, Department of Rehabilitation, Nijmegen, The Netherlands
| | - Noël Keijsers
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Center of Expertise for Parkinson & Movement Disorders, Department of Rehabilitation, Nijmegen, The Netherlands; Sint Maartenskliniek, Department of Research, Nijmegen, the Netherlands; Radboud University, Donders Institute for Brain, Cognition and Behaviour, Department of Sensorimotor Neuroscience, Nijmegen, The Netherlands
| | - Jorik Nonnekes
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Center of Expertise for Parkinson & Movement Disorders, Department of Rehabilitation, Nijmegen, The Netherlands; Sint Maartenskliniek, Department of Research, Nijmegen, the Netherlands
| |
Collapse
|
9
|
Zhai M, Huang Y, Zhou S, Jin Y, Feng J, Pei C, Wen L, Wen's L. Effects of age-related changes in trunk and lower limb range of motion on gait. BMC Musculoskelet Disord 2023; 24:234. [PMID: 36978129 PMCID: PMC10044394 DOI: 10.1186/s12891-023-06301-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 03/08/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND The ability to walk is crucial for maintaining independence and a high quality of life among older adults. Although gait characteristics have been extensively studied in older adults, most studies have investigated muscle activity in the joints of the trunk or the lower limbs without assessing their interactions. Thus, the causes of altered trunk and lower limb movement patterns in older adults remain to explore. Therefore, this study compared the joint kinematic parameters of both trunk and lower limbs between young and older adults to identify kinematic factors associated with changes in gait among older adults. METHODS In total, 64 older (32 males, aged 68.34 ± 7.38 years; 32 females, aged 67.16 ± 6.66 years) and 64 young (32 males, aged 19.44 ± 0.84 years; 32 females, aged 19.69 ± 0.86 years) healthy adults participated in this study. The range of motion (ROM) of the thorax, pelvis, and trunk in the horizontal plane and of the hip, knee, and ankle joints of the lower limbs in the sagittal plane were measured using a motion capture system with wearable sensors. Two-way analysis of variance assessed differences in ROM by group, sex, and spatio-temporal gait parameters; Pearson correlation analysis assessed the correlation of the trunk and lower limbs. RESULTS Step length, gait speed, and stride length were greater in young adults (p < 0.001) than in older adults, but older women displayed the fastest gait speed (p < 0.05). ROM values for the pelvis, thorax, trunk, knee joint, and ankle joint of young adults were greater (p < 0.05) than those in older adults. However, hip ROM in older adults was significantly greater than that in young adults (p < 0.05). CONCLUSION With increasing age, ROM of the lower limbs, especially the ankle joint, decreased significantly, resulting in a significant decrease in gait speed. As ROM of the pelvis decreased, stride length decreased significantly in older adults, who compensate through thoracic rotation. Thus, older adults should enhance muscle strength and increase ROM to improve gait patterns.
Collapse
Affiliation(s)
- Meiling Zhai
- School of Sports and Health, Nanjing Sport Institute, Nanjing, Jiangsu, China
| | - Yongchao Huang
- School of Sports and Health, Nanjing Sport Institute, Nanjing, Jiangsu, China
| | - Shi Zhou
- Physical Activity, Sport and Exercise Research Theme, Faculty of Health, Southern Cross University, 2480, Lismore, NSW, Australia
| | - Yahong Jin
- School of Physical Education and Humanities, Nanjing Sport Institute, Nanjing, Jiangsu, China.
| | - Jiayun Feng
- Institute of Sports Training, Tianjin University of Sport, Tianjin, China
| | - Chaolei Pei
- Institute of Physical Education, Shanxi Normal University, Taiyuan, China
| | - Li Wen
- School of Sports and Health, Nanjing Sport Institute, Nanjing, Jiangsu, China.
| | - Li Wen's
- School of Sports and Health, Nanjing Sport Institute, Nanjing, Jiangsu, China
| |
Collapse
|
10
|
Kreter N, Lybbert C, Gordon KE, Fino PC. The effects of physical and temporal certainty on human locomotion with discrete underfoot perturbations. J Exp Biol 2022; 225:jeb244509. [PMID: 36124619 PMCID: PMC9659331 DOI: 10.1242/jeb.244509] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 09/05/2022] [Indexed: 11/20/2022]
Abstract
Foot placement can be selected to anticipate upcoming perturbations, but it is unclear how this anticipatory strategy is influenced by available response time or precise knowledge of the perturbation's characteristics. This study investigates anticipatory and reactive locomotor strategies for repeated underfoot perturbations with varying levels of temporal certainty, physical certainty, and available response time. Thirteen healthy adults walked with random underfoot perturbations from a mechanized shoe. Temporal certainty was challenged by presenting the perturbations with or without warning. Available response time was challenged by adjusting the timing of the warning before the perturbation. Physical certainty was challenged by making perturbation direction (inversion or eversion) unpredictable for certain conditions. Linear-mixed effects models assessed the effect of each condition on the percentage change of margin of stability and step width. For perturbations with one stride or less of response time, we observed few changes to step width or margin of stability. As response time increased to two strides, participants adopted wider steps in anticipation of the perturbation (P=0.001). Physical certainty had little effect on gait for the step of the perturbation, but participants recovered normal gait sooner when the physical nature of the perturbation was predictable (P<0.001). Despite having information about the timing and direction of upcoming perturbations, individuals do not develop perturbation-specific feedforward strategies. Instead, they use feedback control to recover normal gait after a perturbation. However, physical certainty appears to make the feedback controller more efficient and allows individuals to recover normal gait sooner.
Collapse
Affiliation(s)
- Nicholas Kreter
- Department of Health and Kinesiology, University of Utah, 250 South 1850 East, Salt Lake City, UT 84112, USA
| | - Carter Lybbert
- Department of Health and Kinesiology, University of Utah, 250 South 1850 East, Salt Lake City, UT 84112, USA
| | - Keith E. Gordon
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, 645 N Michigan Ave, Suite. 1100, Chicago, IL 60611, USA
| | - Peter C. Fino
- Department of Health and Kinesiology, University of Utah, 250 South 1850 East, Salt Lake City, UT 84112, USA
| |
Collapse
|
11
|
The Functionality Verification through Pilot Human Subject Testing of MyFlex-δ: An ESR Foot Prosthesis with Spherical Ankle Joint. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12094575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Most biomechanical research has focused on level-ground walking giving less attention to other conditions. As a result, most lower limb prosthesis studies have focused on sagittal plane movements. In this paper, an ESR foot is presented, of which five different stiffnesses were optimized for as many weight categories of users. It is characterized by a spherical ankle joint, with which, combined with the elastic elements, the authors wanted to create a prosthesis that gives the desired stiffness in the sagittal plane but at the same time, gives flexibility in the other planes to allow the adaptation of the foot prosthesis to the ground conditions. The ESR foot was preliminarily tested by participants with transfemoral amputation. After a brief familiarization with the device, each participant was asked to wear markers and to walk on a sensorized treadmill to measure their kinematics and kinetics. Then, each participant was asked to leave feedback via an evaluation questionnaire. The measurements and feedback allowed us to evaluate the performance of the prosthesis quantitatively and qualitatively. Although there were no significant improvements on the symmetry of the gait, due also to very limited familiarization time, the participants perceived an improvement brought by the spherical ankle joint.
Collapse
|
12
|
Persine S, Leteneur S, Gillet C, Bassement J, Charlaté F, Simoneau-Buessinger E. Walking abilities improvements are associated with pelvis and trunk kinematic adaptations in transfemoral amputees after rehabilitation. Clin Biomech (Bristol, Avon) 2022; 94:105619. [PMID: 35306365 DOI: 10.1016/j.clinbiomech.2022.105619] [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: 09/24/2021] [Revised: 01/26/2022] [Accepted: 03/06/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Rehabilitation can be proposed to transfemoral amputees to improve functional abilities and limit the risk of early degeneration of the musculoskeletal system partly due to altered kinematic behavior. The main aim of this study was to assess the impact of functional rehabilitation on clinical walking tests, gait symmetry and pelvis and trunk kinematics in transfemoral amputees during overground walking. METHODS Eleven transfemoral amputees followed a functional rehabilitation program with objectives aimed at improving walking abilities and gait symmetry. Clinical functional tests, symmetry between prosthetic and intact sides and trunk and pelvis motions were recorded before and after rehabilitation. FINDINGS Clinical walking tests were improved after rehabilitation (p < 0.05), and step width was reduced (p = 0.04). Regarding symmetry between the single stances on the prosthesis and intact sides, only a significant decrease in trunk frontal inclination asymmetry was noted after rehabilitation (p = 0.01). Pelvic frontal obliquity was significantly increased during prosthetic (p = 0.02) and intact single stances (p = 0.005). INTERPRETATION Our study showed a positive effect of rehabilitation on transfemoral amputees functional abilities. These improvements were associated with higher pelvic mobility in frontal plane and a more symmetrical redistribution of the frontal trunk sway around the vertical axis during gait. These results suggest the importance of a postural reeducation program for transfemoral amputees aimed at improving pelvic dynamic control while repositioning the trunk by postural corrections during gait.
Collapse
Affiliation(s)
- S Persine
- Centre Jacques Calvé, Fondation HOPALE, Berck-sur-mer, France; Univ. Polytechnique Hauts-de-France, LAMIH, CNRS, UMR 8201, F-59313 Valenciennes, France.
| | - S Leteneur
- Univ. Polytechnique Hauts-de-France, LAMIH, CNRS, UMR 8201, F-59313 Valenciennes, France
| | - C Gillet
- Univ. Polytechnique Hauts-de-France, LAMIH, CNRS, UMR 8201, F-59313 Valenciennes, France
| | - J Bassement
- Centre Hospitalier de Valenciennes, Valenciennes, France
| | - F Charlaté
- Centre Jacques Calvé, Fondation HOPALE, Berck-sur-mer, France
| | - E Simoneau-Buessinger
- Univ. Polytechnique Hauts-de-France, LAMIH, CNRS, UMR 8201, F-59313 Valenciennes, France
| |
Collapse
|
13
|
Mezher C, Siragy T, Nantel J. Increased Arm Swing and Rocky Surfaces Reduces Postural Control in Healthy Young Adults. Front Bioeng Biotechnol 2021; 9:645581. [PMID: 34926413 PMCID: PMC8675128 DOI: 10.3389/fbioe.2021.645581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 11/08/2021] [Indexed: 11/16/2022] Open
Abstract
Fall-induced injuries can stem from a disruption in the postural control system and place a financial burden on the healthcare system. Most gait research focused on lower extremities and neglected the contribution of arm swing, which have been shown to affect the movement of the center of mass when walking. This study evaluated the effect of arm swing on postural control and stability during regular and rocky surface walking. Fifteen healthy young adults (age = 23.4 ± 2.8) walked on these two surfaces with three arm motions (normal, held, and active) using the CAREN Extended-System (Motek Medical, Amsterdam, NL). Mean, standard deviation and maximal values of trunk linear and angular velocity were calculated in all three axes. Moreover, step length, time and width mean and coefficient of variation as well as margin of stability mean and standard deviation were calculated. Active arm swing increased trunk linear and angular velocity variability and peak values compared to normal and held arm conditions. Active arm swing also increased participants’ step length and step time, as well as the variability of margin of stability. Similarly, rocky surface walking increased trunk kinematics variability and peak values compared to regular surface walking. Furthermore, rocky surface increased the average step width while reducing the average step time. Though this surface type increased the coefficient of variation of all spatiotemporal parameters, rocky surface also led to increased margin of stability mean and variation. The spatiotemporal adaptations showed the use of “cautious” gait to mitigate the destabilizing effects of both the active arm swing and rocky surface walking and, ultimately, maintain dynamic stability.
Collapse
Affiliation(s)
- Cezar Mezher
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Tarique Siragy
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Julie Nantel
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| |
Collapse
|
14
|
Craig JJ, Bruetsch AP, Lynch SG, Huisinga JM. Trunk and foot acceleration variability during walking relates to fall history and clinical disability in persons with multiple sclerosis. Clin Biomech (Bristol, Avon) 2020; 80:105100. [PMID: 32798813 PMCID: PMC7983701 DOI: 10.1016/j.clinbiomech.2020.105100] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 05/19/2019] [Accepted: 06/26/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Persons with multiple sclerosis are often at higher risk for falling, but clinical disability scales and fall risk questionnaires are subjective and don't provide specific feedback about why an individual is unstable. The purpose of this study was to determine how relationships between trunk and foot acceleration variability relate to physiological impairments, clinical disability scales, and mobility questionnaires in persons with multiple sclerosis. METHODS 15 fallers and 25 non-fallers with multiple sclerosis walked on a treadmill at normal walking speed while trunk and foot accelerations were recorded with wireless accelerometers and variability measures were extracted and used to calculate the gait stability index metrics as a ratio of trunk acceleration variability divided foot acceleration variability. Subjects' sensorimotor delays and lower extremity vibration sensitivity were tested. Subjects also completed clinical disability scales (Guy's Neurological Disability Scale and Patient Reported Expanded Disability Status Scale) and mobility questionnaires (Falls Efficacy Scale, Activities Balance Confidence Scale, 12 Item Multiple Sclerosis Walk Scale). FINDINGS Multiple gait stability index metrics were significantly correlated with clinical measures of disability and mobility in multiple sclerosis subjects (r = 0.354-0.528), but no correlations were found for sensorimotor delays or lower extremity sensation. Multiple gait stability indices performed at least as well as clinical questionnaires for separating fallers from non-fallers. INTERPRETATION The gait stability indices can potentially be used outside of a laboratory setting to measure walking characteristics related to fall history and disability level in people with multiple sclerosis.
Collapse
Affiliation(s)
- Jordan J Craig
- Landon Center on Aging, University of Kansas Medical Center, 3901 Rainbow Blvd., Mail Stop 1005, Kansas City, KS 66160, United States; Bioengineering Graduate Program, University of Kansas, 3135A Learned Hall, 1530 W 15(th) St, Lawrence, KS 66045, United States
| | - Adam P Bruetsch
- Landon Center on Aging, University of Kansas Medical Center, 3901 Rainbow Blvd., Mail Stop 1005, Kansas City, KS 66160, United States
| | - Sharon G Lynch
- Department of Neurology, 3901 Rainbow Blvd., Kansas City, KS 66160, United States
| | - Jessie M Huisinga
- Department of Physical Therapy and Rehabilitation Science, 3901 Rainbow Blvd., Mail Stop 2002, Kansas City, KS 66160, United States.
| |
Collapse
|
15
|
Shih HJS, Gordon J, Kulig K. Trunk control during gait: Walking with wide and narrow step widths present distinct challenges. J Biomech 2020; 114:110135. [PMID: 33285490 DOI: 10.1016/j.jbiomech.2020.110135] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/29/2020] [Accepted: 11/12/2020] [Indexed: 11/18/2022]
Abstract
The active control of the trunk plays an important role in frontal plane gait stability. We characterized trunk control in response to different step widths using a novel feedback system and examined the different effects of wide and narrow step widths as they each present unique task demands. Twenty healthy young adults walked on a treadmill at 1.25 m/s at five prescribed step widths: 0.33, 1.67, 1, 1.33, 1.67 times preferred step width. Motion capture was used to record trunk kinematics, and surface electromyography was used to record longissimus muscle activation bilaterally. Vector coding was used to analyze coordination between pelvis and thorax segments of the trunk. Results showed that while center of mass only varied across step width in the mediolateral direction, trunk kinematics in all three planes were affected by changes in step width. Angular excursions of the trunk segments increased only with wider widths in the transverse plane. Thorax-pelvis kinematic coordination was affected more by wider widths in transverse plane and by narrower widths in the frontal plane. Peak longissimus activation and bilateral co-activation increased as step widths became narrower. As a control task, walking with varied step widths is not simply a continuum of adjustments from narrow to wide. Rather, narrowing step width and widening step width from the preferred width represent distinct control challenges that are managed in different ways. This study provides foundation for future investigations on the trunk during gait in different populations.
Collapse
Affiliation(s)
- Hai-Jung Steffi Shih
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA.
| | - James Gordon
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
| | - Kornelia Kulig
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
16
|
Best AN, Wu AR. Upper body and ankle strategies compensate for reduced lateral stability at very slow walking speeds. Proc Biol Sci 2020; 287:20201685. [PMID: 33049173 DOI: 10.1098/rspb.2020.1685] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
At the typical walking speeds of healthy humans, step placement seems to be the primary strategy to maintain gait stability, with ankle torques and upper body momentum providing additional compensation. The average walking speeds of populations with an increased risk of falling, however, are much slower and may require differing control strategies. The purpose of this study was to analyse mediolateral gait stability and the contributions of the different control strategies at very slow walking speeds. We analysed an open dataset including kinematics and kinetics from eight healthy subjects walking at speeds from 0.1 to 0.6 m s-1 as well as a self-selected speed. As gait speed slowed, we found that the margin of stability (MoS) decreased linearly. Increased lateral excursions of the extrapolated centre of mass, caused by increased lateral excursions of the trunk, were not compensated for by an equivalent increase in the lateral centre of pressure, leading to decreased MoS. Additionally, both the ankle eversion torque and hip abduction torque at the minimum MoS event increased at the same rate as gait speed slowed. These results suggest that the contributions of both the ankle and the upper body to stability are more crucial than stepping at slow speeds, which have important implications for populations with slow gait and limited motor function.
Collapse
Affiliation(s)
- Aaron N Best
- Ingenuity Labs Research Institute, Department of Mechanical and Materials Engineering, Queen's University, Kingston, ON, Canada K7L 3N6
| | - Amy R Wu
- Ingenuity Labs Research Institute, Department of Mechanical and Materials Engineering, Queen's University, Kingston, ON, Canada K7L 3N6
| |
Collapse
|
17
|
Bannwart M, Bayer SL, König Ignasiak N, Bolliger M, Rauter G, Easthope CA. Mediolateral damping of an overhead body weight support system assists stability during treadmill walking. J Neuroeng Rehabil 2020; 17:108. [PMID: 32778127 PMCID: PMC7418206 DOI: 10.1186/s12984-020-00735-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 07/28/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Body weight support systems with three or more degrees of freedom (3-DoF) are permissive and safe environments that provide unloading and allow unrestricted movement in any direction. This enables training of walking and balance control at an early stage in rehabilitation. Transparent systems generate a support force vector that is near vertical at all positions in the workspace to only minimally interfere with natural movement patterns. Patients with impaired balance, however, may benefit from additional mediolateral support that can be adjusted according to their capacity. An elegant solution for providing balance support might be by rendering viscous damping along the mediolateral axis via the software controller. Before use with patients, we evaluated if control-rendered mediolateral damping evokes the desired stability enhancement in able-bodied individuals. METHODS A transparent, cable-driven robotic body weight support system (FLOAT) was used to provide transparent body weight support with and without mediolateral damping to 21 able-bodied volunteers while walking at preferred gait velocity on a treadmill. Stability metrics reflecting resistance to small and large perturbations were derived from walking kinematics and compared between conditions and to free walking. RESULTS Compared to free walking, the application of body weight support per-se resulted in gait alterations typically associated with body weight support, namely increased step length and swing phase. Frontal plane dynamic stability, measured by kinematic variability and nonlinear dynamics of the center of mass, was increased under body weight support, indicating reduced balance requirements in both damped and undamped support conditions. Adding damping to the body weight support resulted in a greater increase of frontal plane stability. CONCLUSION Adding mediolateral damping to 3-DoF body weight support systems is an effective method of increasing frontal plane stability during walking in able-bodied participants. Building on these results, adjustable mediolateral damping could enable therapists to select combinations of unloading and stability specifically for each patient and to adapt this in a task specific manner. This could extend the impact of transparent 3-DoF body weight support systems, enabling training of gait and active balance from an early time point onwards in the rehabilitation process for a wide range of mobility activities of daily life.
Collapse
Affiliation(s)
- M. Bannwart
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Sensory Motor Systems Laboratory, Department of Health Sciences and Technology, Swiss Federal Institute of Technology, Zurich, Switzerland
| | - S. L. Bayer
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | | | - M. Bolliger
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - G. Rauter
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Sensory Motor Systems Laboratory, Department of Health Sciences and Technology, Swiss Federal Institute of Technology, Zurich, Switzerland
- BIROMED-Laboratory, Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - C. A. Easthope
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- cereneo Center for Interdisciplinary Research, Vitznau, Switzerland
| |
Collapse
|
18
|
Herssens N, van Criekinge T, Saeys W, Truijen S, Vereeck L, van Rompaey V, Hallemans A. An investigation of the spatio-temporal parameters of gait and margins of stability throughout adulthood. J R Soc Interface 2020; 17:20200194. [PMID: 32429825 DOI: 10.1098/rsif.2020.0194] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Age-related changes in the way of walking may induce changes in dynamic stability. Therefore, the relationship between age, spatio-temporal characteristics and margins of stability was examined. One hundred and five healthy adults aged between 20 and 89 years old were analysed on spatio-temporal characteristics and margins of stability using three-dimensional motion analysis. Subjects walked barefoot over a 12-m-long walkway at their preferred walking speed. Covariance among gait characteristics was reduced using a factor analysis, identifying domains of gait. The influence of age, gender, body mass index (BMI) and leg length on domains of gait and margins of stability was investigated using linear mixed models. A stepwise linear regression identified domains of gait predicting the variance in margins of stability. Four domains of gait explaining 74.17% of the variance were identified. Age had a significant influence on the medio-lateral margin of stability and the 'variability', 'pace' and 'base of support' domain. BMI significantly influenced the medio-lateral margin of stability; gender and leg length had no influence on either of the margins of stability. The 'base of support' domain predicted 26% of the variance in the medio-lateral margin of stability. When considering the margins of stability, especially when comparing multiple groups, age, BMI and spatio-temporal parameters should be taken into account.
Collapse
Affiliation(s)
- Nolan Herssens
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium.,Multidisciplinary Motor Centre Antwerp (M²OCEAN), University of Antwerp, Wilrijk, Belgium
| | - Tamaya van Criekinge
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium.,Multidisciplinary Motor Centre Antwerp (M²OCEAN), University of Antwerp, Wilrijk, Belgium
| | - Wim Saeys
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium.,Multidisciplinary Motor Centre Antwerp (M²OCEAN), University of Antwerp, Wilrijk, Belgium
| | - Steven Truijen
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium.,Multidisciplinary Motor Centre Antwerp (M²OCEAN), University of Antwerp, Wilrijk, Belgium
| | - Luc Vereeck
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium.,Multidisciplinary Motor Centre Antwerp (M²OCEAN), University of Antwerp, Wilrijk, Belgium
| | - Vincent van Rompaey
- Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.,Department of Otorhinolaryngology and Head & Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Ann Hallemans
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium.,Multidisciplinary Motor Centre Antwerp (M²OCEAN), University of Antwerp, Wilrijk, Belgium
| |
Collapse
|
19
|
Selgrade BP, Childs ME, Franz JR. Effects of aging and target location on reaction time and accuracy of lateral precision stepping during walking. J Biomech 2020; 104:109710. [PMID: 32156445 DOI: 10.1016/j.jbiomech.2020.109710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 02/20/2020] [Accepted: 02/23/2020] [Indexed: 10/24/2022]
Abstract
Older adults have poorer lateral balance and deficits in precision stepping accuracy, but the way these deficits manifest with lateral step distance is unclear. The purpose of this study was to investigate aging effects on lateral precision stepping performance in reaction to near and distant foot placement targets during treadmill walking. We hypothesized that older adults would step to targets later and less accurately than young adults, and that these difference would be more pronounced for distant targets. During the study, young and older adults stepped on lateral targets projected onto the surface of a treadmill one stride prior to their targeting step. We measured stepping accuracy to the target, the time when the swing foot diverged from its normal swing trajectory, and swing phase gluteus medius activity. Both groups had similar performance stepping to near targets, suggesting that giving older subjects a full stride to react to target location mitigates visuomotor processing delays that have contributed to deficits in stepping performance in prior studies. However, when stepping to distant targets, older adults had larger errors and later divergence times than young adults. This suggests that age-related deficits other than those in visuomotor processing contribute to poorer performance for more difficult stepping tasks. Furthermore, while young adults increased early swing gluteus medius activity with lateral target distance, older adults did not. This is the first study to show a potential neuromuscular basis for precision stepping deficits in older adults.
Collapse
Affiliation(s)
- Brian P Selgrade
- Department of Movement Science, Sport and Leisure Studies, Westfield State University, Westfield, MA, USA
| | - Marcus E Childs
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC, USA
| | - Jason R Franz
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC, USA.
| |
Collapse
|
20
|
The impact of motor task and environmental constraints on gait patterns during treadmill walking in a fully immersive virtual environment. Gait Posture 2020; 77:243-249. [PMID: 32062404 DOI: 10.1016/j.gaitpost.2020.01.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 12/19/2019] [Accepted: 01/30/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Virtual environments (VE) are increasingly used in rehabilitation settings for gait training, and positive effects are reported. However, little is known about how walking under environmental constraints and solving motor tasks in fully immersive VEs impact gait patterns. RESEARCH QUESTION How are gait patterns in healthy adults impacted by walking under environmental constraints and solving motor tasks on a treadmill, in a fully immersive VE? METHODS 29 healthy adults (age: 28.9±4.8 yrs) were included. Basic gait parameters (step length, cadence, walk ratio) and gait variability in the anteroposterior, mediolateral and vertical directions were measured using an inertial sensor attached to the lower back. A familiarisation treadmill walk >2 min was performed, followed by 200 m familiarisation walk in the VE with no task or environmental constraints The participants were then exposed to height, two grabbing tasks, a balancing task and narrow-path walking. Gait patterns were captured for 15-25 seconds during each of the conditions. The Simulator Sickness Questionnaire was completed before and after the session. RESULTS Gait regularity decreased when solving all the motor tasks, and under all the environmental constraints, except when being familiarised to height exposure, where regularity returned to pre-exposure levels. Step length and walk ratio decreased, and cadence increased during height exposure and while performing the grabbing tasks and the balancing task. The different tasks and environments appeared to have specific impact on gait patterns. There was no increase in simulator sickness symptoms. SIGNIFICANCE Gait patterns were impacted by solving motor tasks, and by environmental constraints, in healthy young adults, suggesting increased need for balance control. We suggest that VE-training on a treadmill holds potential for improving gait and balance control.
Collapse
|
21
|
Kudo S, Fujimoto M, Sato T, Nagano A. Determination of the optimal number of linked rigid-bodies of the trunk during walking and running based on Akaike's information criterion. Gait Posture 2020; 77:264-268. [PMID: 32087596 DOI: 10.1016/j.gaitpost.2020.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 02/13/2020] [Accepted: 02/14/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND In the three-dimensional kinematic analysis of the trunk during human locomotion, a multi-segmental rigid-body model would be a better representation for the trunk compared with a single rigid-body model with regard to goodness-of-fit. However, there is a trade-off between data fitting and the simplicity of the model. RESEARCH QUESTION This study aimed to determine the optimal number of rigid-body segments during walking and running using Akaike's information criterion (AIC), which determines the model that has goodness-of-fit and is generalizable. METHODS Empirically obtained kinematic data for the trunk during walking and running were fitted by one-, two-, three-, and six-linked rigid-body models using a nonlinear optimization algorithm. The relative quality of these models was assessed using their bias-corrected AIC (AICc) value. RESULTS The AICc values of two- and three-linked rigid-body models were significantly smaller than those of one- or six-segment models for the walking trial. For the running trial, the AICc values of two-, three-, and six-segment models were significantly smaller than that of the single rigid-body model. DISCUSSION These results suggest that both two- and three-linked rigid-body models would be better than the one- and six-linked rigid-body representations for analyzing trunk movement during walking, whereas the two-, three-, and six-linked models would be comparably well-balanced models in terms of both the goodness-of-fit and generalizability for running analysis.
Collapse
Affiliation(s)
- Shoma Kudo
- Graduate School of Sport and Health Science, Ritsumeikan University, Japan; Research Fellow of Japan Society for the Promotion of Science, Japan.
| | - Masahiro Fujimoto
- National Institute of Advanced Industrial Science and Technology, Japan
| | - Takahiko Sato
- College of Sport and Health Science, Ritsumeikan University, Japan
| | - Akinori Nagano
- College of Sport and Health Science, Ritsumeikan University, Japan
| |
Collapse
|
22
|
Wu M, Brown GL, Woodward JL, Bruijn SM, Gordon KE. A novel Movement Amplification environment reveals effects of controlling lateral centre of mass motion on gait stability and metabolic cost. ROYAL SOCIETY OPEN SCIENCE 2020; 7:190889. [PMID: 32218932 PMCID: PMC7029926 DOI: 10.1098/rsos.190889] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 11/06/2019] [Indexed: 06/10/2023]
Abstract
During human walking, the centre of mass (COM) laterally oscillates, regularly transitioning its position above the two alternating support limbs. To maintain upright forward-directed walking, lateral COM excursion should remain within the base of support, on average. As necessary, humans can modify COM motion through various methods, including foot placement. How the nervous system controls these oscillations and the costs associated with control are not fully understood. To examine how lateral COM motions are controlled, healthy participants walked in a 'Movement Amplification' force field that increased lateral COM momentum in a manner dependent on the participant's own motion (forces were applied to the pelvis proportional to and in the same direction as lateral COM velocity). We hypothesized that metabolic cost to control lateral COM motion would increase with the gain of the field. In the Movement Amplification field, participants were significantly less stable than during baseline walking. Stability significantly decreased as the field gain increased. Participants also modified gait patterns, including increasing step width, which increased the metabolic cost of transport as the field gain increased. These results support previous research suggesting that humans modulate foot placement to control lateral COM motion, incurring a metabolic cost.
Collapse
Affiliation(s)
- Mengnan/Mary Wu
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1100, Chicago, IL, USA
| | - Geoffrey L. Brown
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1100, Chicago, IL, USA
| | | | - Sjoerd M. Bruijn
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Institute for Brain and Behaviour Amsterdam and Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Keith E. Gordon
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1100, Chicago, IL, USA
- Research Service, Edward Hines Jr. Veterans Administration Hospital, Hines, IL, USA
| |
Collapse
|
23
|
Mahaki M, Bruijn SM, van Dieën JH. The effect of external lateral stabilization on the use of foot placement to control mediolateral stability in walking and running. PeerJ 2019; 7:e7939. [PMID: 31681515 PMCID: PMC6822599 DOI: 10.7717/peerj.7939] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 09/23/2019] [Indexed: 11/20/2022] Open
Abstract
It is still unclear how humans control mediolateral (ML) stability in walking and even more so for running. Here, foot placement strategy as a main mechanism to control ML stability was compared between walking and running. Moreover, to verify the role of foot placement as a means to control ML stability in both modes of locomotion, this study investigated the effect of external lateral stabilization on foot placement control. Ten young adults participated in this study. Kinematic data of the trunk (T6) and feet were recorded during walking and running on a treadmill in normal and stabilized conditions. Correlation between ML trunk CoM state and subsequent ML foot placement, step width, and step width variability were assessed. Paired t-tests (either SPM1d or normal) were used to compare aforementioned parameters between normal walking and running. Two-way repeated measures ANOVAs (either SPM1d or normal) were used to test for effects of walking vs. running and of normal vs. stabilized condition. We found a stronger correlation between ML trunk CoM state and ML foot placement and significantly higher step width variability in walking than in running. The correlation between ML trunk CoM state and ML foot placement, step width, and step width variability were significantly decreased by external lateral stabilization in walking and running, and this reduction was stronger in walking than in running. We conclude that ML foot placement is coordinated to ML trunk CoM state to stabilize both walking and running and this coordination is stronger in walking than in running.
Collapse
Affiliation(s)
- Mohammadreza Mahaki
- Faculty of Behavioural and Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands, Netherlands.,Faculty of Physical Education and Sport Sciences, Kharazmi University Tehran, Tehran, Iran
| | - Sjoerd M Bruijn
- Faculty of Behavioural and Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands, Netherlands.,Biomechanics Laboratory, Fujian Medical University, Quanzhou, Fujian, China
| | - Jaap H van Dieën
- Faculty of Behavioural and Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands, Netherlands
| |
Collapse
|
24
|
Bruijn SM, van Dieën JH. Control of human gait stability through foot placement. J R Soc Interface 2019; 15:rsif.2017.0816. [PMID: 29875279 PMCID: PMC6030625 DOI: 10.1098/rsif.2017.0816] [Citation(s) in RCA: 199] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 05/08/2018] [Indexed: 12/17/2022] Open
Abstract
During human walking, the centre of mass (CoM) is outside the base of support for most of the time, which poses a challenge to stabilizing the gait pattern. Nevertheless, most of us are able to walk without substantial problems. In this review, we aim to provide an integrative overview of how humans cope with an underactuated gait pattern. A central idea that emerges from the literature is that foot placement is crucial in maintaining a stable gait pattern. In this review, we explore this idea; we first describe mechanical models and concepts that have been used to predict how foot placement can be used to control gait stability. These concepts, such as for instance the extrapolated CoM concept, the foot placement estimator concept and the capture point concept, provide explicit predictions on where to place the foot relative to the body at each step, such that gait is stabilized. Next, we describe empirical findings on foot placement during human gait in unperturbed and perturbed conditions. We conclude that humans show behaviour that is largely in accordance with the aforementioned concepts, with foot placement being actively coordinated to body CoM kinematics during the preceding step. In this section, we also address the requirements for such control in terms of the sensory information and the motor strategies that can implement such control, as well as the parts of the central nervous system that may be involved. We show that visual, vestibular and proprioceptive information contribute to estimation of the state of the CoM. Foot placement is adjusted to variations in CoM state mainly by modulation of hip abductor muscle activity during the swing phase of gait, and this process appears to be under spinal and supraspinal, including cortical, control. We conclude with a description of how control of foot placement can be impaired in humans, using ageing as a primary example and with some reference to pathology, and we address alternative strategies available to stabilize gait, which include modulation of ankle moments in the stance leg and changes in body angular momentum, such as rapid trunk tilts. Finally, for future research, we believe that especially the integration of consideration of environmental constraints on foot placement with balance control deserves attention.
Collapse
Affiliation(s)
- Sjoerd M Bruijn
- Department of Human Movement Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, van der Boechorststraat 9, 1081 BT Amsterdam, The Netherlands
| | - Jaap H van Dieën
- Department of Human Movement Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, van der Boechorststraat 9, 1081 BT Amsterdam, The Netherlands
| |
Collapse
|
25
|
Kent JA, Sommerfeld JH, Mukherjee M, Takahashi KZ, Stergiou N. Locomotor patterns change over time during walking on an uneven surface. ACTA ACUST UNITED AC 2019; 222:jeb.202093. [PMID: 31253712 DOI: 10.1242/jeb.202093] [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: 02/19/2019] [Accepted: 06/21/2019] [Indexed: 12/22/2022]
Abstract
During walking, uneven surfaces impose new demands for controlling balance and forward progression at each step. It is unknown to what extent walking may be refined given an amount of stride-to-stride unpredictability at the distal level. Here, we explored the effects of an uneven terrain surface on whole-body locomotor dynamics immediately following exposure and after a familiarization period. Eleven young, unimpaired adults walked for 12 min on flat and uneven terrain treadmills. The whole-body center of mass excursion range (COMexc) and peak velocity (COMvel), step length and width were estimated. On first exposure to uneven terrain, we saw significant increases in medial-lateral COMexc and lateral COMvel, and in the variability of COMexc, COMvel and foot placement in both anterior-posterior and medial-lateral directions. Increases in step width and decreases in step length supported the immediate adoption of a cautious, restrictive solution on uneven terrain. After familiarization, step length increased and the variability of anterior-posterior COMvel and step length reduced, while step width and lateral COMvel reduced, alluding to a refinement of movement and a reduction of conservative strategies over time. However, the variability of medial-lateral COMexc and lateral COMvel increased, consistent with the release of previously constrained degrees of freedom. Despite this increase in variability, a strong relationship between step width and medial-lateral center of mass movement was maintained. Our results indicate that movement strategies of unimpaired adults when walking on uneven terrain can evolve over time with longer exposure to the surface.
Collapse
Affiliation(s)
- Jenny A Kent
- Division of Biomechanics and Research Development, University of Nebraska at Omaha, 6160 University Drive, Omaha, NE 68182-0860, USA
| | - Joel H Sommerfeld
- Division of Biomechanics and Research Development, University of Nebraska at Omaha, 6160 University Drive, Omaha, NE 68182-0860, USA
| | - Mukul Mukherjee
- Division of Biomechanics and Research Development, University of Nebraska at Omaha, 6160 University Drive, Omaha, NE 68182-0860, USA
| | - Kota Z Takahashi
- Division of Biomechanics and Research Development, University of Nebraska at Omaha, 6160 University Drive, Omaha, NE 68182-0860, USA
| | - Nicholas Stergiou
- Division of Biomechanics and Research Development, University of Nebraska at Omaha, 6160 University Drive, Omaha, NE 68182-0860, USA.,College of Public Health, 984355 University of Nebraska Medical Center, Omaha, NE 68198-4355, USA
| |
Collapse
|
26
|
Coordination of trunk and foot acceleration during gait is affected by walking velocity and fall history in elderly adults. Aging Clin Exp Res 2019; 31:943-950. [PMID: 30194680 DOI: 10.1007/s40520-018-1036-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 08/30/2018] [Indexed: 01/14/2023]
Abstract
BACKGROUND Falling is a significant concern for many elderly adults but identifying individuals at risk of falling is difficult, and it is not clear how elderly adults adapt to challenging walking. AIMS The aim of the current study was to determine the effects of walking at non-preferred speeds on the coordination between foot and trunk acceleration variability in healthy elderly adults with and without fall history compared to healthy young adults. METHODS Subjects walked on a treadmill at 80%-120% of their preferred walking speed while trunk and foot accelerations were recorded with wireless inertial sensors. Variability of accelerations was measured by root mean square, range, sample entropy, and Lyapunov exponent. The gait stability index was calculated using each variability metric in the frontal and sagittal plane by taking the ratio of trunk acceleration variability divided by foot acceleration variability. RESULTS Healthy young adults demonstrated larger trunk accelerations relative to foot accelerations at faster walking speeds compared to elderly adults, but both young and elderly adults show similar adaption to their acceleration regularity. Between group differences showed that elderly adult fallers coordinate acceleration variability between the trunk and feet differently compared to elderly non-fallers and young adults. DISCUSSION The current results indicate that during gait, elderly fallers demonstrate more constrained, less adaptable trunk movement relative to their foot movement and this pattern is different compared to elderly non-fallers and healthy young. CONCLUSIONS Coordination between trunk and foot acceleration variability plays an important role in maintaining stability during gait.
Collapse
|
27
|
Raffalt PC, Vallabhajosula S, Renz JJ, Mukherjee M, Stergiou N. Lower limb joint angle variability and dimensionality are different in stairmill climbing and treadmill walking. ROYAL SOCIETY OPEN SCIENCE 2018; 5:180996. [PMID: 30662723 PMCID: PMC6304153 DOI: 10.1098/rsos.180996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 10/18/2018] [Indexed: 06/09/2023]
Abstract
The present study tested if the quadratic relationship which exists between stepping frequency and gait dynamics in walking can be generalized to stairmill climbing. To accomplish this, we investigated the joint angle dynamics and variability during continuous stairmill climbing at stepping frequencies both above and below the preferred stepping frequency (PSF). Nine subjects performed stairmill climbing at 80, 90, 100, 110 and 120% PSF and treadmill walking at preferred walking speed during which sagittal hip, knee and ankle angles were extracted. Joint angle dynamics were quantified by the largest Lyapunov exponent (LyE) and correlation dimension (CoD). Joint angle variability was estimated by the mean ensemble standard deviation (meanSD). MeanSD and CoD for all joints were significantly higher during stairmill climbing but there were no task differences in LyE. Changes in stepping frequency had only limited effect on joint angle variability and did not affect joint angle dynamics. Thus, we concluded that the quadratic relationship between stepping frequency and gait dynamics observed in walking is not present in stairmill climbing based on the investigated parameters.
Collapse
Affiliation(s)
- P. C. Raffalt
- Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - S. Vallabhajosula
- Department of Physical Therapy Education, School of Health Sciences, Elon University, Elon, NC, USA
| | - J. J. Renz
- Department of Biomechanics, College of Education, University of Nebraska Medical Center, Omaha, NE, USA
| | - M. Mukherjee
- Department of Biomechanics, College of Education, University of Nebraska Medical Center, Omaha, NE, USA
| | - N. Stergiou
- Department of Biomechanics, College of Education, University of Nebraska Medical Center, Omaha, NE, USA
- Department of Environmental Agricultural and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| |
Collapse
|
28
|
Arvin M, Hoozemans MJM, Pijnappels M, Duysens J, Verschueren SM, van Dieën JH. Where to Step? Contributions of Stance Leg Muscle Spindle Afference to Planning of Mediolateral Foot Placement for Balance Control in Young and Old Adults. Front Physiol 2018; 9:1134. [PMID: 30246780 PMCID: PMC6110888 DOI: 10.3389/fphys.2018.01134] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 07/30/2018] [Indexed: 01/24/2023] Open
Abstract
Stable gait requires active control of the mediolateral (ML) kinematics of the body center of mass (CoM) and the base of support (BoS) in relation to each other. Stance leg hip abductor (HA) muscle spindle afference may be used to guide contralateral swing foot placement and adequately position the BoS in relation to the CoM. We studied the role of HA spindle afference in control of ML gait stability in young and older adults by means of muscle vibration. Healthy young (n = 12) and older (age > 65 years, n = 18) adults walked on a treadmill at their preferred speed. In unperturbed trials, individual linear models using each subject's body CoM position and velocity at mid-swing as inputs accurately predicted foot placement at the end of the swing phase in the young [mean R2 = 0.73 (SD 0.11)], but less so in the older adults [mean R2 = 0.60 (SD 0.14)]. In vibration trials, HA afference was perturbed either left or right by vibration (90 Hz) in a random selection of 40% of the stance phases. After vibrated stance phases, but not after unvibrated stance phases in the same trials, the foot was placed significantly more inward than predicted by individual models for unperturbed gait. The effect of vibration was stronger in young adults, suggesting that older adults rely less on HA spindle afference. These results show that HA spindle afference in the stance phase of gait contributes to the control of subsequent ML foot placement in relation to the kinematics of the CoM, to stabilize gait in the ML direction and that this pocess is impaired in older adults.
Collapse
Affiliation(s)
- Mina Arvin
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Marco J. M. Hoozemans
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Mirjam Pijnappels
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Jacques Duysens
- Department of Movement Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Sabine M. Verschueren
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Jaap H. van Dieën
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| |
Collapse
|
29
|
Stimpson KH, Heitkamp LN, Horne JS, Dean JC. Effects of walking speed on the step-by-step control of step width. J Biomech 2017; 68:78-83. [PMID: 29306549 DOI: 10.1016/j.jbiomech.2017.12.026] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 12/10/2017] [Accepted: 12/17/2017] [Indexed: 11/17/2022]
Abstract
Young, healthy adults walking at typical preferred speeds use step-by-step adjustments of step width to appropriately redirect their center of mass motion and ensure mediolateral stability. However, it is presently unclear whether this control strategy is retained when walking at the slower speeds preferred by many clinical populations. We investigated whether the typical stabilization strategy is influenced by walking speed. Twelve young, neurologically intact participants walked on a treadmill at a range of prescribed speeds (0.2-1.2 m/s). The mediolateral stabilization strategy was quantified as the proportion of step width variance predicted by the mechanical state of the pelvis throughout a step (calculated as R2 magnitude from a multiple linear regression). Our ability to accurately predict the upcoming step width increased over the course of a step. The strength of the relationship between step width and pelvis mechanics at the start of a step was reduced at slower speeds. However, these speed-dependent differences largely disappeared by the end of a step, other than at the slowest walking speed (0.2 m/s). These results suggest that mechanics-dependent adjustments in step width are a consistent component of healthy gait across speeds and contexts. However, slower walking speeds may ease this control by allowing mediolateral repositioning of the swing leg to occur later in a step, thus encouraging slower walking among clinical populations with limited sensorimotor control.
Collapse
Affiliation(s)
- Katy H Stimpson
- Department of Health Sciences and Research, Medical University of South Carolina (MUSC), Charleston, SC, USA
| | - Lauren N Heitkamp
- Department of Health Sciences and Research, Medical University of South Carolina (MUSC), Charleston, SC, USA
| | | | - Jesse C Dean
- Department of Health Sciences and Research, Medical University of South Carolina (MUSC), Charleston, SC, USA; Division of Physical Therapy, MUSC, Charleston, SC, USA; Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA.
| |
Collapse
|