1
|
Yoon JY, Moon SW. Impacts of asymmetric hip rotation angle on gait biomechanics in patients with knee osteoarthritis. Knee Surg Relat Res 2024; 36:23. [PMID: 39004757 PMCID: PMC11247852 DOI: 10.1186/s43019-024-00226-5] [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: 02/19/2024] [Accepted: 06/28/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND Knee Osteoarthritis (OA) is a highly prevalent age-related disease. The altered kinematic pattern of the knee joint as well as the adjacent joints affects to progression of knee OA. However, there is a lack of research on how asymmetry of the hip rotation angle affects the gait pattern in knee OA patients. RESEARCH QUESTION What are the impacts of asymmetric hip rotation range on gait biomechanical characteristics and do the gait patterns differ between patients with knee OA and healthy elderly people? METHODS Twenty-nine female patients with knee OA and 15 healthy female elders as control group were enrolled in this study. The spatiotemporal parameters, kinematic and kinetic data during walking were measured using a three-dimensional motion capture system. The differences between knee OA and control group were analyzed using an independent t-test. RESULTS The knee OA group exhibited a significant reduction in hip internal rotation range and internal/external rotation ratio on more affected side (p < 0.05). Significant differences were found in spatiotemporal parameters except to the step width. Significant reductions were also found in kinematic parameters (pelvic lateral tilt range, sagittal angle ranges in hip, knee and ankle, knee adduction mean angle). There were also significant differences in vertical ground reaction force and knee adduction moment (p < 0.05). CONCLUSIONS Knee OA patients have asymmetric hip rotation ranges. Especially limited hip internal rotation could lead to the reduction of pelvic lateral tilt, which may cause greater knee joint loading. Therefore, it is necessary to pay attention to recovery of hip rotation after knee surgery.
Collapse
Affiliation(s)
- Ji-Yeon Yoon
- Department of Physical Therapy, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Sang Won Moon
- Department of Orthopedic Surgery, Inje University Haeundae-Paik Hospital, 875 Haeun-Daero, Haeundae-Gu, Busan, 48108, Korea.
| |
Collapse
|
2
|
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
|
3
|
Winters K, Tibbitts D, Mancini M, Stoyles S, Dieckmann N, Graff J, El-Gohary M, Horak F. Daily life mobility detects frailty, falls, and functioning in ADT-treated prostate cancer survivors. RESEARCH SQUARE 2024:rs.3.rs-4402624. [PMID: 38854112 PMCID: PMC11160906 DOI: 10.21203/rs.3.rs-4402624/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Background Androgen deprivation therapy (ADT) increases the risk of frailty, falls, and, poor physical functioning in prostate cancer survivors. Detection of frailty is limited to self-report instruments and performance measures, so unbiased tools are needed. We investigated relationships between an unbiased measure - daily life mobility - and ADT history, frailty, falls, and functioning in ADT-treated prostate cancer survivors. Methods ADT-treated prostate cancer survivors (N=99) were recruited from an exercise clinical trial, an academic medical center, and the community. Participants completed performance measures and surveys to assess frailty, fall history, and physical functioning, then wore instrumented socks to continuously monitor daily life mobility. We performed a principal component analysis on daily life mobility metrics and used regression analyses to investigate relationships between domains of daily life mobility and frailty, fall history, and physical functioning. Results Daily life mobility metrics clustered into four domains: Gait Pace, Rhythm, Activity, and Balance. Worse scores on Rhythm and Activity were associated with increased odds of frailty (OR 1.59, 95% CI: 1.04, 2.49 and OR 1.81, 95% CI: 1.19, 2.83, respectively). A worse score on Rhythm was associated with increased odds of ≥1 falls in the previous year (OR 1.60, 95% CI: 1.05, 2.47). Worse scores on Gait Pace, Rhythm, and Activity were associated with worse physical functioning. Mobility metrics were similar between current and past users of ADT. Conclusions Continuous passive monitoring of daily life mobility may identify prostate cancer survivors who have or are developing risk for frailty, falls, and declines in physical functioning.
Collapse
|
4
|
Mahaki M, van Leeuwen AM, Bruijn SM, van der Velde N, van Dieën JH. Mediolateral foot placement control can be trained: Older adults learn to walk more stable, when ankle moments are constrained. PLoS One 2023; 18:e0292449. [PMID: 37910445 PMCID: PMC10619794 DOI: 10.1371/journal.pone.0292449] [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: 04/02/2023] [Accepted: 09/20/2023] [Indexed: 11/03/2023] Open
Abstract
Falls are a problem, especially for older adults. Placing our feet accurately relative to the center-of-mass helps us to prevent falling during gait. The degree of foot placement control with respect to the center-of mass kinematic state is decreased in older as compared to young adults. Here, we attempted to train mediolateral foot placement control in healthy older adults. Ten older adults trained by walking on shoes with a narrow ridge underneath (LesSchuh), restricting mediolateral center-of-pressure shifts. As a training effect, we expected improved foot placement control during normal walking. A training session consisted of a normal walking condition, followed by a training condition on LesSchuh and finally an after-effect condition. Participants performed six of such training sessions, spread across three weeks. As a control, before the first training session, we included two similar sessions, but on normal shoes only. We evaluated whether a training effect was observed across sessions and weeks in a repeated-measures design. Whilst walking with LesSchuh, the magnitude of foot placement error reduced half-a-millimeter between sessions within a week (cohen's d = 0.394). As a training effect in normal walking, the magnitude of foot placement errors was significantly lower compared to the control week, by one millimeter in weeks 2 (cohen's d = 0.686) and 3 (cohen's d = 0.780) and by two millimeters in week 4 (cohen's d = 0.875). Local dynamic stability of normal walking also improved significantly. More precise foot placement may thus have led to improved stability. It remains to be determined whether the training effects were the result of walking on LesSchuh or from repeated treadmill walking itself. Moreover, enhancement of mechanisms beyond the scope of our outcome measures may have improved stability. At the retention test, gait stability returned to similar levels as in the control week. Yet, a reduction in foot placement error persisted.
Collapse
Affiliation(s)
- Mohammadreza Mahaki
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Research Program(s), Amsterdam, The Netherlands
| | - Anina Moira van Leeuwen
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Research Program(s), Amsterdam, The Netherlands
- Institute of Brain and Behavior, Amsterdam, The Netherlands
| | - Sjoerd M. Bruijn
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Research Program(s), Amsterdam, The Netherlands
- Institute of Brain and Behavior, Amsterdam, The Netherlands
| | - Nathalie van der Velde
- Amsterdam Movement Sciences, Research Program(s), Amsterdam, The Netherlands
- Department of Internal Medicine/Geriatrics, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Jaap H. van Dieën
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Research Program(s), Amsterdam, The Netherlands
| |
Collapse
|
5
|
Darici O, Kuo A. Humans plan for the near future to walk economically on uneven terrain. Proc Natl Acad Sci U S A 2023; 120:e2211405120. [PMID: 37126717 PMCID: PMC10175744 DOI: 10.1073/pnas.2211405120] [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: 07/21/2022] [Accepted: 01/10/2023] [Indexed: 05/03/2023] Open
Abstract
Humans experience small fluctuations in their gait when walking on uneven terrain. The fluctuations deviate from the steady, energy-minimizing pattern for level walking and have no obvious organization. But humans often look ahead when they walk, and could potentially plan anticipatory fluctuations for the terrain. Such planning is only sensible if it serves some an objective purpose, such as maintaining constant speed or reducing energy expenditure, that is also attainable within finite planning capacity. Here, we show that humans do plan and perform optimal control strategies on uneven terrain. Rather than maintaining constant speed, they make purposeful, anticipatory speed adjustments that are consistent with minimizing energy expenditure. A simple optimal control model predicts economical speed fluctuations that agree well with experiments with humans (N = 12) walking on seven different terrain profiles (correlated with model [Formula: see text] , [Formula: see text] all terrains). Participants made repeatable speed fluctuations starting about six to eight steps ahead of each terrain feature (up to ±7.5 cm height difference each step, up to 16 consecutive features). Nearer features matter more, because energy is dissipated with each succeeding step's collision with ground, preventing momentum from persisting indefinitely. A finite horizon of continuous look-ahead and motor working space thus suffice to practically optimize for any length of terrain. Humans reason about walking in the near future to plan complex optimal control sequences.
Collapse
Affiliation(s)
- Osman Darici
- Faculty of Kinesiology, University of Calgary, Calgary, ABT2N 1N4, Canada
| | - Arthur D. Kuo
- Faculty of Kinesiology, University of Calgary, Calgary, ABT2N 1N4, Canada
- Biomedical Engineering Program, University of Calgary, Calgary, ABT2N 1N4, Canada
| |
Collapse
|
6
|
Carlisle RE, Kuo AD. Optimization of energy and time predicts dynamic speeds for human walking. eLife 2023; 12:81939. [PMID: 36779697 PMCID: PMC10030114 DOI: 10.7554/elife.81939] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 01/11/2023] [Indexed: 02/14/2023] Open
Abstract
Humans make a number of choices when they walk, such as how fast and for how long. The preferred steady walking speed seems chosen to minimize energy expenditure per distance traveled. But the speed of actual walking bouts is not only steady, but rather a time-varying trajectory, which can also be modulated by task urgency or an individual's movement vigor. Here we show that speed trajectories and durations of human walking bouts are explained better by an objective to minimize Energy and Time, meaning the total work or energy to reach destination, plus a cost proportional to bout duration. Applied to a computational model of walking dynamics, this objective predicts dynamic speed vs. time trajectories with inverted U shapes. Model and human experiment (N=10) show that shorter bouts are unsteady and dominated by the time and effort of accelerating, and longer ones are steadier and faster and dominated by steady-state time and effort. Individual-dependent vigor may be characterized by the energy one is willing to spend to save a unit of time, which explains why some may walk faster than others, but everyone may have similar-shaped trajectories due to similar walking dynamics. Tradeoffs between energy and time costs can predict transient, steady, and vigor-related aspects of walking.
Collapse
Affiliation(s)
| | - Arthur D Kuo
- Biomedical Engineering Program, University of Calgary, Calgary, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| |
Collapse
|
7
|
Peterka RJ, Gruber-Fox A, Heeke PK. Asymmetry measures for quantification of mechanisms contributing to dynamic stability during stepping-in-place gait. Front Neurol 2023; 14:1145283. [PMID: 37153656 PMCID: PMC10157157 DOI: 10.3389/fneur.2023.1145283] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/28/2023] [Indexed: 05/10/2023] Open
Abstract
The goal of this study is to introduce and to motivate the use of new quantitative methods to improve our understanding of mechanisms that contribute to the control of dynamic balance during gait. Dynamic balance refers to the ability to maintain a continuous, oscillating center-of-mass (CoM) motion of the body during gait even though the CoM frequently moves outside of the base of support. We focus on dynamic balance control in the frontal plane or medial-lateral (ML) direction because it is known that active, neurally-mediated control mechanisms are necessary to maintain ML stability. Mechanisms that regulate foot placement on each step and that generate corrective ankle torque during the stance phase of gait are both known to contribute to the generation of corrective actions that contribute to ML stability. Less appreciated is the potential role played by adjustments in step timing when the duration of the stance and/or swing phases of gait can be shortened or lengthened to allow torque due to gravity to act on the body CoM over a shorter or longer time to generate corrective actions. We introduce and define four asymmetry measures that provide normalized indications of the contribution of these different mechanisms to gait stability. These measures are 'step width asymmetry', 'ankle torque asymmetry', 'stance duration asymmetry', and 'swing duration asymmetry'. Asymmetry values are calculated by comparing corresponding biomechanical or temporal gait parameters from adjacent steps. A time of occurrence is assigned to each asymmetry value. An indication that a mechanism is contributing to ML control is obtained by comparing asymmetry values to the ML body motion (CoM angular position and velocity) at the time points associated with the asymmetry measures. Example results are demonstrated with measures obtained during a stepping-in-place (SiP) gait performed on a stance surface that either remained fixed and level or was pseudorandomly tilted to disturb balance in the ML direction. We also demonstrate that the variability of asymmetry measures obtained from 40 individuals during unperturbed, self-paced SiP were highly correlated with corresponding coefficient of variation measures that have previously been shown to be associated with poor balance and fall risk.
Collapse
Affiliation(s)
- Robert J. Peterka
- Department of Veterans Affairs, National Center for Rehabilitative Auditory Research, Portland, OR, United States
- Department of Neurology, Oregon Health & Science University, Portland, OR, United States
- *Correspondence: Robert J. Peterka,
| | - Apollonia Gruber-Fox
- Department of Veterans Affairs, National Center for Rehabilitative Auditory Research, Portland, OR, United States
| | - Paige K. Heeke
- Department of Veterans Affairs, National Center for Rehabilitative Auditory Research, Portland, OR, United States
| |
Collapse
|
8
|
Hos M, van Iersel L, van Leeuwen A, Bruijn S. Differential effects of ankle constraints on foot placement control between normal and split belt treadmills. J Biomech 2022; 144:111349. [DOI: 10.1016/j.jbiomech.2022.111349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/26/2022] [Accepted: 10/06/2022] [Indexed: 10/31/2022]
|
9
|
Quantification of Gait Stability During Incline and Decline Walking: The Responses of Required Coefficient of Friction and Dynamic Postural Index. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:7716821. [PMID: 36275397 PMCID: PMC9581656 DOI: 10.1155/2022/7716821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 09/13/2022] [Accepted: 09/29/2022] [Indexed: 11/04/2022]
Abstract
This study aims to investigate the gait stability response during incline and decline walking for various surface inclination angles in terms of the required coefficient of friction (RCOF), postural stability index (PSI), and center of pressure (COP)-center of mass (COM) distance. A customized platform with different surface inclinations (0°, 5°, 7.5°, and 10°) was designed. Twenty-three male volunteers participated by walking on an inclined platform for each inclination. The process was then repeated for declined platform as well. Qualysis motion capture system was used to capture and collect the trajectories motion of ten reflective markers that attached to the subjects before being exported to a visual three-dimensional (3D) software and executed in Matlab to obtain the RCOF, PSI, as well as dynamic PSI (DPSI) and COP-COM distance parameters. According to the result for incline walking, during initial contact, the RCOF was not affected to inclination. However, it was affected during peak ground reaction force (GRF) starting at 7.5° towards 10° for both walking conditions. The most affected PSI was found at anterior-posterior PSI (APSI) even as low as 5° inclination during both incline and decline walking. On the other hand, DPSI was not affected during both walking conditions. Furthermore, COP-COM distance was most affected during decline walking in anterior-posterior direction. The findings of this research indicate that in order to decrease the risk of falling and manage the inclination demand, a suitable walking strategy and improved safety measures should be applied during slope walking, particularly for decline and anterior-posterior orientations. This study also provides additional understanding on the best incline walking technique for secure and practical incline locomotion.
Collapse
|
10
|
Kim D, Lewis CL, Silverman AK, Gill SV. Changes in dynamic balance control in adults with obesity across walking speeds. J Biomech 2022; 144:111308. [PMID: 36150320 DOI: 10.1016/j.jbiomech.2022.111308] [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: 03/14/2022] [Revised: 08/19/2022] [Accepted: 09/13/2022] [Indexed: 11/27/2022]
Abstract
Adults with obesity have gait instability, leading to increased fall risks and decreased physical activity. Whole-body angular momentum (WBAM) is regulated over a gait cycle, essential to avoid a fall. However, how obese adults regulate WBAM during walking is unknown. The current study investigated changes in WBAM about the body's center of mass (COM) during walking in obese and non-obese adults across different walking speeds. Twenty-eight young adults with obesity and normal weight walked barefoot at a fixed walking speed (FWS, 1.25 m/s) and at five different speeds based on their preferred walking speed (PWS): 50, 75, 100, 125, and 150 % of PWS. Adults with obesity walked slower with shorter step length, wider step width, and longer double support time (p < 0.01). The ranges of frontal- and transverse-plane WBAM were greater in obese adults (p < 0.01). We also found that the range of frontal-plane WBAM did not significantly change with walking speed (p > 0.05), while the range of transverse-plane WBAM increased with walking speed (p < 0.01). The ranges of frontal- and transverse-plane WBAM increased with the mediolateral ground reaction force and mediolateral moment arm (p < 0.01), which may be most affected by lateral foot placement relative to the body's COM. Our findings suggest that controlling mediolateral stability during walking is more challenging in obese adults, independent of their slow walking speed. Understanding whole-body rotational dynamics observed in obese walking provides an insight into the biomechanical link between obesity and gait instability, which may help find a way to reduce fall risks and increase physical activity.
Collapse
Affiliation(s)
- Daekyoo Kim
- College of Health and Rehabilitation Science: Sargent College, 635 Commonwealth Avenue, Boston University, Boston, MA 02215, USA.
| | - Cara L Lewis
- College of Health and Rehabilitation Science: Sargent College, 635 Commonwealth Avenue, Boston University, Boston, MA 02215, USA
| | - Anne K Silverman
- Department of Mechanical Engineering, Colorado School of Mines, Golden, CO, USA
| | - Simone V Gill
- College of Health and Rehabilitation Science: Sargent College, 635 Commonwealth Avenue, Boston University, Boston, MA 02215, USA
| |
Collapse
|
11
|
van den Bogaart M, Bruijn SM, Spildooren J, van Dieën JH, Meyns P. The effect of constraining mediolateral ankle moments and foot placement on the use of the counter-rotation mechanism during walking. J Biomech 2022; 136:111073. [DOI: 10.1016/j.jbiomech.2022.111073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/15/2022] [Accepted: 03/29/2022] [Indexed: 11/28/2022]
|
12
|
Hoogstad L, van Leeuwen A, van Dieën J, Bruijn S. Can foot placement during gait be trained? Adaptations in stability control when ankle moments are constrained. J Biomech 2022; 134:110990. [DOI: 10.1016/j.jbiomech.2022.110990] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 01/15/2022] [Accepted: 02/02/2022] [Indexed: 11/28/2022]
|
13
|
Darici O, Kuo AD. Humans optimally anticipate and compensate for an uneven step during walking. eLife 2022; 11:65402. [PMID: 35014609 PMCID: PMC8920505 DOI: 10.7554/elife.65402] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
The simple task of walking up a sidewalk curb is actually a dynamic prediction task. The curb is a disturbance that could cause a loss of momentum if not anticipated and compensated for. It might be possible to adjust momentum sufficiently to ensure undisturbed time of arrival, but there are infinite possible ways to do so. Much of steady, level gait is determined by energy economy, which should be at least as important with terrain disturbances. It is, however, unknown whether economy also governs walking up a curb, and whether anticipation helps. Here, we show that humans compensate with an anticipatory pattern of forward speed adjustments, predicted by a criterion of minimizing mechanical energy input. The strategy is mechanistically predicted by optimal control for a simple model of bipedal walking dynamics, with each leg’s push-off work as input. Optimization predicts a triphasic trajectory of speed (and thus momentum) adjustments, including an anticipatory phase. In experiment, human subjects ascend an artificial curb with the predicted triphasic trajectory, which approximately conserves overall walking speed relative to undisturbed flat ground. The trajectory involves speeding up in a few steps before the curb, losing considerable momentum from ascending it, and then regaining speed in a few steps thereafter. Descending the curb entails a nearly opposite, but still anticipatory, speed fluctuation trajectory, in agreement with model predictions that speed fluctuation amplitudes should scale linearly with curb height. The fluctuation amplitudes also decrease slightly with faster average speeds, also as predicted by model. Humans can reason about the dynamics of walking to plan anticipatory and economical control, even with a sidewalk curb in the way.
Collapse
Affiliation(s)
- Osman Darici
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Arthur D Kuo
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| |
Collapse
|
14
|
Hu J, Chien JH. Aging Affects the Demands and Patterns in Active Control Under Different Sensory-Conflicted Conditions. Front Aging Neurosci 2021; 13:742035. [PMID: 34803656 PMCID: PMC8602863 DOI: 10.3389/fnagi.2021.742035] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/20/2021] [Indexed: 11/19/2022] Open
Abstract
Most falls might be attributed to an unexpected perturbation such as a slip. It might be aggravated by the deterioration of the sensory system as people aged. This deterioration increases the demand in active control. However, what levels of demand in active control do older adults need? This study aimed to answer this question by using a novel assessment. Both young and old adults walked in three conditions: normal, slip, and slip with low light conditions. The amount of step length variability, step width variability, and the 95% confidence interval of the ellipse area of heel contact locations was measured to quantify and distinguish different levels of demand and patterns in active control. The results found that less sensory information led to a higher level of demand in active control in both anterior-posterior and medial-lateral directions. Importantly, different patterns in active control were found among different age groups and perturbation conditions. This study extended the current knowledge and further proposed the possibility of multiple patterns in active control. This study also suggests a new method to quantify the levels and patterns in active control under sensory perturbations, and this innovation can be used to guide age-related fall prevention training.
Collapse
Affiliation(s)
- Jing Hu
- Department of Health & Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, United States
| | - Jung Hung Chien
- Department of Health & Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, United States
| |
Collapse
|
15
|
van Leeuwen AM, van Dieën JH, Daffertshofer A, Bruijn SM. Ankle muscles drive mediolateral center of pressure control to ensure stable steady state gait. Sci Rep 2021; 11:21481. [PMID: 34728667 PMCID: PMC8563802 DOI: 10.1038/s41598-021-00463-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 10/07/2021] [Indexed: 11/08/2022] Open
Abstract
During steady-state walking, mediolateral gait stability can be maintained by controlling the center of pressure (CoP). The CoP modulates the moment of the ground reaction force, which brakes and reverses movement of the center of mass (CoM) towards the lateral border of the base of support. In addition to foot placement, ankle moments serve to control the CoP. We hypothesized that, during steady-state walking, single stance ankle moments establish a CoP shift to correct for errors in foot placement. We expected ankle muscle activity to be associated with this complementary CoP shift. During treadmill walking, full-body kinematics, ground reaction forces and electromyography were recorded in thirty healthy participants. We found a negative relationship between preceding foot placement error and CoP displacement during single stance; steps that were too medial were compensated for by a lateral CoP shift and vice versa, steps that were too lateral were compensated for by a medial CoP shift. Peroneus longus, soleus and tibialis anterior activity correlated with these CoP shifts. As such, we identified an (active) ankle strategy during steady-state walking. As expected, absolute explained CoP variance by foot placement error decreased when walking with shoes constraining ankle moments. Yet, contrary to our expectations that ankle moment control would compensate for constrained foot placement, the absolute explained CoP variance by foot placement error did not increase when foot placement was constrained. We argue that this lack of compensation reflects the interdependent nature of ankle moment and foot placement control. We suggest that single stance ankle moments do not only compensate for preceding foot placement errors, but also assist control of the subsequent foot placement. Foot placement and ankle moment control are 'caught' in a circular relationship, in which constraints imposed on one will also influence the other.
Collapse
Affiliation(s)
- A M van Leeuwen
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Institute of Brain and Behavior Amsterdam, Amsterdam, The Netherlands
| | - J H van Dieën
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - A Daffertshofer
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Institute of Brain and Behavior Amsterdam, Amsterdam, The Netherlands
| | - S M Bruijn
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.
- Institute of Brain and Behavior Amsterdam, Amsterdam, The Netherlands.
- Biomechanics Laboratory, Fujian Medical University, Quanzhou, Fujian, People's Republic of China.
| |
Collapse
|
16
|
Fettrow T, Hupfeld K, Reimann H, Choi J, Hass C, Seidler R. Age differences in adaptation of medial-lateral gait parameters during split-belt treadmill walking. Sci Rep 2021; 11:21148. [PMID: 34707122 PMCID: PMC8551204 DOI: 10.1038/s41598-021-00515-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 10/12/2021] [Indexed: 11/10/2022] Open
Abstract
The split-belt treadmill has been used to examine the adaptation of spatial and temporal gait parameters. Historically, similar studies have focused on anterior-posterior (AP) spatiotemporal gait parameters because this paradigm is primarily a perturbation in the AP direction, but it is important to understand whether and how medial-lateral (ML) control adapts in this scenario. The ML control of balance must be actively controlled and adapted in different walking environments. Furthermore, it is well established that older adults have balance difficulties. Therefore, we seek to determine whether ML balance adaptation differs in older age. We analyzed split belt induced changes in gait parameters including variables which inform us about ML balance control in younger and older adults. Our primary finding is that younger adults showed sustained asymmetric changes in these ML balance parameters during the split condition. Specifically, younger adults sustained a greater displacement between their fast stance foot and their upper body, relative to the slow stance foot, in the ML direction. This finding suggests that younger adults may be exploiting passive dynamics in the ML direction, which may be more metabolically efficient. Older adults did not display the same degree of asymmetry, suggesting older adults may be more concerned about maintaining a stable gait.
Collapse
Affiliation(s)
- Tyler Fettrow
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32605, USA.
| | - Kathleen Hupfeld
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32605, USA
| | - Hendrik Reimann
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, 19713, USA
| | - Julia Choi
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32605, USA
| | - Chris Hass
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32605, USA
| | - Rachael Seidler
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32605, USA
| |
Collapse
|
17
|
Shah VV, Rodriguez-Labrada R, Horak FB, McNames J, Casey H, Hansson Floyd K, El-Gohary M, Schmahmann JD, Rosenthal LS, Perlman S, Velázquez-Pérez L, Gomez CM. Gait Variability in Spinocerebellar Ataxia Assessed Using Wearable Inertial Sensors. Mov Disord 2021; 36:2922-2931. [PMID: 34424581 DOI: 10.1002/mds.28740] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Quantitative assessment of severity of ataxia-specific gait impairments from wearable technology could provide sensitive performance outcome measures with high face validity to power clinical trials. OBJECTIVES The aim of this study was to identify a set of gait measures from body-worn inertial sensors that best discriminate between people with prodromal or manifest spinocerebellar ataxia (SCA) and age-matched, healthy control subjects (HC) and determine how these measures relate to disease severity. METHODS One hundred and sixty-three people with SCA (subtypes 1, 2, 3, and 6), 42 people with prodromal SCA, and 96 HC wore 6 inertial sensors while performing a natural pace, 2-minute walk. Areas under the receiver operating characteristic curves (AUC) were compared for 25 gait measures, including standard deviations as variability, to discriminate between ataxic and normal gait. Pearson's correlation coefficient assessed the relationships between the gait measures and severity of ataxia. RESULTS Increased gait variability was the most discriminative gait feature of SCA; toe-out angle variability (AUC = 0.936; sensitivity = 0.871; specificity = 0.896) and double-support time variability (AUC = 0.932; sensitivity = 0.834; specificity = 0.865) were the most sensitive and specific measures. These variability measures were also significantly correlated with the scale for the assessment and rating of ataxia (SARA) and disease duration. The same gait measures discriminated gait of people with prodromal SCA from the gait of HC (AUC = 0.610, and 0.670, respectively). CONCLUSIONS Wearable inertial sensors provide sensitive and specific measures of excessive gait variability in both manifest and prodromal SCAs that are reliable and related to the severity of the disease, suggesting they may be useful as clinical trial performance outcome measures. © 2021 International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Vrutangkumar V Shah
- Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA
| | - Roberto Rodriguez-Labrada
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Cuban Center for Neuroscience, Havana, Cuba
| | - Fay B Horak
- Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA.,APDM Wearable Technologies, an ERT company, Portland, Oregon, USA
| | - James McNames
- APDM Wearable Technologies, an ERT company, Portland, Oregon, USA.,Department of Electrical and Computer Engineering, Portland State University, Portland, Oregon, USA
| | - Hannah Casey
- The University of Chicago, Chicago, Illinois, USA
| | | | | | - Jeremy D Schmahmann
- Department of Neurology, Ataxia Center, Laboratory for Neuroanatomy and Cerebellar Neurobiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Liana S Rosenthal
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Susan Perlman
- Department of Neurology, University of California, Los Angeles, California, USA
| | - Luis Velázquez-Pérez
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Cuban Academy of Sciences, La Habana, Cuba
| | - Christopher M Gomez
- Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA.,The University of Chicago, Chicago, Illinois, USA
| |
Collapse
|
18
|
Ryu HX, Kuo AD. An optimality principle for locomotor central pattern generators. Sci Rep 2021; 11:13140. [PMID: 34162903 PMCID: PMC8222298 DOI: 10.1038/s41598-021-91714-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 05/18/2021] [Indexed: 11/18/2022] Open
Abstract
Two types of neural circuits contribute to legged locomotion: central pattern generators (CPGs) that produce rhythmic motor commands (even in the absence of feedback, termed “fictive locomotion”), and reflex circuits driven by sensory feedback. Each circuit alone serves a clear purpose, and the two together are understood to cooperate during normal locomotion. The difficulty is in explaining their relative balance objectively within a control model, as there are infinite combinations that could produce the same nominal motor pattern. Here we propose that optimization in the presence of uncertainty can explain how the circuits should best be combined for locomotion. The key is to re-interpret the CPG in the context of state estimator-based control: an internal model of the limbs that predicts their state, using sensory feedback to optimally balance competing effects of environmental and sensory uncertainties. We demonstrate use of optimally predicted state to drive a simple model of bipedal, dynamic walking, which thus yields minimal energetic cost of transport and best stability. The internal model may be implemented with neural circuitry compatible with classic CPG models, except with neural parameters determined by optimal estimation principles. Fictive locomotion also emerges, but as a side effect of estimator dynamics rather than an explicit internal rhythm. Uncertainty could be key to shaping CPG behavior and governing optimal use of feedback.
Collapse
Affiliation(s)
- Hansol X Ryu
- Biomedical Engineering Program, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.
| | - Arthur D Kuo
- Biomedical Engineering Program, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.,Faculty of Kinesiology, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| |
Collapse
|
19
|
Grießbach E, Incagli F, Herbort O, Cañal-Bruland R. Body dynamics of gait affect value-based decisions. Sci Rep 2021; 11:11894. [PMID: 34088941 PMCID: PMC8178314 DOI: 10.1038/s41598-021-91285-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/20/2021] [Indexed: 11/24/2022] Open
Abstract
Choosing among different options typically entails weighing their anticipated costs and benefits. Previous research has predominantly focused on situations, where the costs and benefits of choices are known before an action is effectuated. Yet many decisions in daily life are made on the fly, for instance, making a snack choice while walking through the grocery store. Notably, the costs of actions change dynamically while moving. Therefore, in this study we examined whether the concurrent action dynamics of gait form part of and affect value-based decisions. In three experiments, participants had to decide which lateral (left vs. right) target (associated with different rewards) they would go to, while they were already walking. Results showed that the target choice was biased by the alternating stepping behavior, even at the expense of receiving less reward. These findings provide evidence that whole-body action dynamics affect value-based decisions.
Collapse
Affiliation(s)
- Eric Grießbach
- Department for the Psychology of Human Movement and Sport, Friedrich Schiller University Jena, Jena, Germany.
| | - Francesca Incagli
- Department of Psychology, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Oliver Herbort
- Department of Psychology, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Rouwen Cañal-Bruland
- Department for the Psychology of Human Movement and Sport, Friedrich Schiller University Jena, Jena, Germany.
| |
Collapse
|
20
|
van Leeuwen AM, van Dieën JH, Daffertshofer A, Bruijn SM. Active foot placement control ensures stable gait: Effect of constraints on foot placement and ankle moments. PLoS One 2020; 15:e0242215. [PMID: 33332421 PMCID: PMC7746185 DOI: 10.1371/journal.pone.0242215] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 10/28/2020] [Indexed: 12/25/2022] Open
Abstract
Step-by-step foot placement control, relative to the center of mass (CoM) kinematic state, is generally considered a dominant mechanism for maintenance of gait stability. By adequate (mediolateral) positioning of the center of pressure with respect to the CoM, the ground reaction force generates a moment that prevents falling. In healthy individuals, foot placement is complemented mainly by ankle moment control ensuring stability. To evaluate possible compensatory relationships between step-by-step foot placement and complementary ankle moments, we investigated the degree of (active) foot placement control during steady-state walking, and under either foot placement-, or ankle moment constraints. Thirty healthy participants walked on a treadmill, while full-body kinematics, ground reaction forces and EMG activities were recorded. As a replication of earlier findings, we first showed step-by-step foot placement is associated with preceding CoM state and hip ab-/adductor activity during steady-state walking. Tight control of foot placement appears to be important at normal walking speed because there was a limited change in the degree of foot placement control despite the presence of a foot placement constraint. At slow speed, the degree of foot placement control decreased substantially, suggesting that tight control of foot placement is less essential when walking slowly. Step-by-step foot placement control was not tightened to compensate for constrained ankle moments. Instead compensation was achieved through increases in step width and stride frequency.
Collapse
Affiliation(s)
- A. M. van Leeuwen
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Institute of Brain and Behavior Amsterdam, Amsterdam, The Netherlands
| | - J. H. van Dieën
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - A. Daffertshofer
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Institute of Brain and Behavior Amsterdam, Amsterdam, The Netherlands
| | - S. M. Bruijn
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Institute of Brain and Behavior Amsterdam, Amsterdam, The Netherlands
- Biomechanics Laboratory, Fujian Medical University, Quanzhou, Fujian, PR China
| |
Collapse
|
21
|
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
|
22
|
Velázquez-Pérez L, Rodriguez-Labrada R, González-Garcés Y, Arrufat-Pie E, Torres-Vega R, Medrano-Montero J, Ramirez-Bautista B, Vazquez-Mojena Y, Auburger G, Horak F, Ziemann U, Gomez CM. Prodromal Spinocerebellar Ataxia Type 2 Subjects Have Quantifiable Gait and Postural Sway Deficits. Mov Disord 2020; 36:471-480. [PMID: 33107647 DOI: 10.1002/mds.28343] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/14/2020] [Accepted: 09/29/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The search for valid preclinical biomarkers of cerebellar dysfunction is a key research goal for the upcoming era of early interventional approaches in spinocerebellar ataxias. This study aims to describe novel preclinical biomarkers of subtle gait and postural sway abnormalities in prodromal spinocerebellar ataxia type 2 (pre-SCA2). METHODS Thirty pre-SCA2 patients and their matched healthy controls underwent quantitative assessments of gait and postural sway using a wearable sensor-based system and semiquantitative evaluation of cerebellar features by SARA (Scale for the Assessment and Rating of Ataxia) score. RESULTS Quantitative analysis of natural gait showed a significantly larger variability of the swing period, toe-off angle and toe-out angle in pre-SCA2, and larger mean coronal and transverse ranges of motion of the trunk at the lumbar location and of the sagittal range of motion of the trunk at the sternum location compared to controls. During tandem gait, pre-SCA2 subjects showed larger lumbar, trunk, and arm ranges of motion than controls. Postural sway analysis showed excessive body oscillation that was increased in tandem stance. Overall, these abnormalities were detected in pre-SCA2 patients without clinical evidence of abnormalities in SARA. The toe-off angle and swing time variability were significantly correlated with the time to ataxia onset, whereas the toe-off angle and transverse range of motion at trunk position during tandem gait were significantly associated with the SARA score. CONCLUSIONS This study demonstrates early alteration of gait and postural sway control in prodromal SCA2 using a wearable sensor-based system. This offers new pathophysiological hints into this early disease stage and provides novel potential biomarkers for future clinical trials. © 2020 International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Luis Velázquez-Pérez
- Department of Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Cuban Academy of Sciences, La Habana Vieja, Cuba
| | - Roberto Rodriguez-Labrada
- Department of Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Department of Molecular Biology, Cuban Neuroscience Centre, Playa, Cuba
| | - Yasmani González-Garcés
- Department of Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba
| | - Eduardo Arrufat-Pie
- Department of Neurorehabilitation, Clinical & Surgical Hospital "Manuel Piti Fajardo,", Plaza de la Revolución, Cuba
| | - Reidenis Torres-Vega
- Department of Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba
| | - Jacqueline Medrano-Montero
- Department of Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba
| | | | - Yaimeé Vazquez-Mojena
- Department of Clinical Neurophysiology, Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.,Department of Molecular Biology, Cuban Neuroscience Centre, Playa, Cuba
| | - Georg Auburger
- Experimental Neurology, Department of Neurology, Experimental Neurology, Medical School, Goethe University, Frankfurt am Main, Germany
| | - Fay Horak
- Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA
| | - Ulf Ziemann
- Department of Neurology & Stroke, University of Tübingen, Tübingen, Germany.,Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | | |
Collapse
|
23
|
Darici O, Temeltas H, Kuo AD. Anticipatory Control of Momentum for Bipedal Walking on Uneven Terrain. Sci Rep 2020; 10:540. [PMID: 31953516 PMCID: PMC6969077 DOI: 10.1038/s41598-019-57156-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 12/19/2019] [Indexed: 11/09/2022] Open
Abstract
Humans and other walking bipeds often encounter and compensate for uneven terrain. They might, for example, regulate the body’s momentum when stepping on stones to cross a stream. We examined what to do and how far to look, as a simple optimal control problem, where forward momentum is controlled to compensate for a step change in terrain height, and steady gait regained with no loss of time relative to nominal walking. We modeled planar, human-like walking with pendulum-like legs, and found the most economical control to be quite stereotypical. It starts by gaining momentum several footfalls ahead of an upward step, in anticipation of the momentum lost atop that step, and then ends with another speed-up to regain momentum thereafter. A similar pattern can be scaled to a variety of conditions, including both upward or downward steps, yet allow for considerably reduced overall energy and peak power demands, compared to compensation without anticipation. We define a “persistence time” metric from the transient decay response after a disturbance, to describe how momentum is retained between steps, and how far ahead a disturbance should be planned for. Anticipatory control of momentum can help to economically negotiate uneven terrain.
Collapse
Affiliation(s)
- Osman Darici
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada. .,Istanbul Technical University, Department of Control and Automation Engineering, Istanbul, Turkey.
| | - Hakan Temeltas
- Istanbul Technical University, Department of Control and Automation Engineering, Istanbul, Turkey
| | - Arthur D Kuo
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Biomedical Engineering Program, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
24
|
Fettrow T, Reimann H, Grenet D, Thompson E, Crenshaw J, Higginson J, Jeka J. Interdependence of balance mechanisms during bipedal locomotion. PLoS One 2019; 14:e0225902. [PMID: 31800620 PMCID: PMC6892559 DOI: 10.1371/journal.pone.0225902] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 11/14/2019] [Indexed: 11/19/2022] Open
Abstract
Our main interest is to identify how humans maintain upright while walking. Balance during standing and walking is different, primarily due to a gait cycle which the nervous system must contend with a variety of body configurations and frequent perturbations (i.e., heel-strike). We have identified three mechanisms that healthy young adults use to respond to a visually perceived fall to the side. The lateral ankle mechanism and the foot placement mechanism are used to shift the center of pressure in the direction of the perceived fall, and the center of mass away from the perceived fall. The push-off mechanism, a systematic change in ankle plantarflexion angle in the trailing leg, results in fine adjustments to medial-lateral balance near the end of double stance. The focus here is to understand how the three basic balance mechanisms are coordinated to produce an overall balance response. The results indicate that lateral ankle and foot placement mechanisms are inversely related. Larger lateral ankle responses lead to smaller foot placement changes. Correlations involving the push-off mechanism, while significant, were weak. However, the consistency of the correlations across stimulus conditions suggest the push-off mechanism has the role of small adjustments to medial-lateral movement near the end of the balance response. This verifies that a fundamental feature of human bipedal gait is a highly flexible balance system that recruits and coordinates multiple mechanisms to maintain upright balance during walking to accommodate extreme changes in body configuration and frequent perturbations.
Collapse
Affiliation(s)
- Tyler Fettrow
- Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States of America
- Department of Kinesiology, Temple University, Philadelphia, PA, United States of America
| | - Hendrik Reimann
- Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States of America
- Department of Kinesiology, Temple University, Philadelphia, PA, United States of America
| | - David Grenet
- Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States of America
| | - Elizabeth Thompson
- Department of Physical Therapy, University of Delaware, Newark, DE, United States of America
- Department of Kinesiology, Temple University, Philadelphia, PA, United States of America
- Department of Physical Therapy, Temple University, Philadelphia, PA, United States of America
| | - Jeremy Crenshaw
- Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States of America
| | - Jill Higginson
- Department of Mechanical Engineering, University of Delaware, Newark, DE, United States of America
| | - John Jeka
- Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States of America
- Department of Kinesiology, Temple University, Philadelphia, PA, United States of America
| |
Collapse
|
25
|
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: 194] [Impact Index Per Article: 38.8] [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
|
26
|
Wang W, Adamczyk PG. Analyzing Gait in the Real World Using Wearable Movement Sensors and Frequently Repeated Movement Paths. SENSORS (BASEL, SWITZERLAND) 2019; 19:E1925. [PMID: 31022889 PMCID: PMC6515355 DOI: 10.3390/s19081925] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 04/17/2019] [Accepted: 04/22/2019] [Indexed: 11/22/2022]
Abstract
Assessing interventions for mobility disorders using real-life movement remains an unsolved problem. We propose a new method combining the strengths of traditional laboratory studies where environment is strictly controlled, and field-based studies where subjects behave naturally. We use a foot-mounted inertial sensor, a GPS receiver and a barometric altitude sensor to reconstruct a subject's path and detailed foot movement, both indoors and outdoors, during days-long measurement using strapdown navigation and sensor fusion algorithms. We cluster repeated movement paths based on location, and propose that on these paths, most environmental and behavioral factors (e.g., terrain and motivation) are as repeatable as in a laboratory. During each bout of movement along a frequently repeated path, any synchronized measurement can be isolated for study, enabling focused statistical comparison of different interventions. We conducted a 10-day test on one subject wearing athletic shoes and sandals each for five days. The algorithm detected four frequently-repeated straight walking paths with at least 300 total steps and repetitions on at least three days for each condition. Results on these frequently-repeated paths indicated significantly lower foot clearance and shorter stride length and a trend toward decreased stride width when wearing athletic shoes vs. sandals. Comparisons based on all straight walking were similar, showing greater statistical power, but higher variability in the data. The proposed method offers a new way to evaluate how mobility interventions affect everyday movement behavior.
Collapse
Affiliation(s)
- Weixin Wang
- Department of Mechanical Engineering, University of Wisconsin⁻Madison, Madison, WI 53706, USA.
| | - Peter Gabriel Adamczyk
- Department of Mechanical Engineering, University of Wisconsin⁻Madison, Madison, WI 53706, USA.
| |
Collapse
|
27
|
Influence of contextual task constraints on preferred stride parameters and their variabilities during human walking. Med Eng Phys 2015; 37:929-36. [PMID: 26250066 DOI: 10.1016/j.medengphy.2015.06.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 06/13/2015] [Accepted: 06/24/2015] [Indexed: 11/23/2022]
Abstract
Walking is not always a free and unencumbered task. Everyday activities such as walking in pairs, in groups, or on structured walkways can limit the acceptable gait patterns, leading to motor behavior that differs from that observed in more self-selected gait. Such different contexts may lead to gait performance different than observed in typical laboratory experiments, for example, during treadmill walking. We sought to systematically measure the impact of such task constraints by comparing gait parameters and their variability during walking in different conditions over-ground, and on a treadmill. We reconstructed foot motion from foot-mounted inertial sensors, and characterized forward, lateral and angular foot placement while subjects walked over-ground in a straight hallway and on a treadmill. Over-ground walking was performed in three variations: with no constraints (self-selected, SS); while deliberately varying walking speed (self-varied, SV); and while following a toy pace car programmed to vary speed (externally-varied, EV). We expected that these conditions would exhibit a statistically similar relationship between stride length and speed, and between stride length and stride period. We also expected treadmill walking (TM) would differ in two ways: first, that variability in stride length and stride period would conform to a constant-speed constraint opposite in slope from the normal relationship; and second, that stride length would decrease, leading to combinations of stride length and speed not observed in over-ground conditions. Results showed that all over-ground conditions used similar stride length-speed relationships, and that variability in treadmill walking conformed to a constant-speed constraint line, as expected. Decreased stride length was observed in both TM and EV conditions, suggesting adaptations due to heightened awareness or to prepare for unexpected changes or problems. We also evaluated stride variability in constrained and unconstrained tasks. We observed that in treadmill walking, lateral variability decreased while forward variability increased, and the normally-observed correlation between wider foot placement and external foot rotation was eliminated. Preferred stride parameters and their variability appear significantly influenced by the context and constraints of the walking task.
Collapse
|