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Burke L, Khokhlova L, O'Flynn B, Tedesco S. Utilising dynamic motor control index to identify age-related differences in neuromuscular control. Hum Mov Sci 2024; 95:103200. [PMID: 38461747 DOI: 10.1016/j.humov.2024.103200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 02/22/2024] [Accepted: 03/04/2024] [Indexed: 03/12/2024]
Abstract
PURPOSE Considering the relationship between aging and neuromuscular control decline, early detection of age-related changes can ensure that timely interventions are implemented to attenuate or restore neuromuscular deficits. The dynamic motor control index (DMCI), a measure based on variance accounted for (VAF) by one muscle synergy (MS), is a metric used to assess age-related changes in neuromuscular control. The aim of the study was to investigate the use of one-synergy VAF, and consecutively DMCI, in assessing age-related changes in neuromuscular control over a range of exercises with varying difficulty. METHODS Thirty-one subjects walked on a flat and inclined treadmill, as well as performed forward and lateral stepping up tasks. Motion and muscular activity were recorded, and muscle synergy analysis was conducted using one-synergy VAF, DMCI, and number of synergies. RESULTS Difference between older and younger group was observed for one-synergy VAF, DMCI for forward stepping up task (one-synergy VAF difference of 2.45 (0.22, 4.68) and DMCI of 9.21 (0.81, 17.61), p = 0.033), but not for lateral stepping up or walking. CONCLUSION The use of VAF based metrics and specifically DMCI, rather than number of MS, in combination with stepping forward exercise can provide a low-cost and easy to implement approach for assessing neuromuscular control in clinical settings.
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Affiliation(s)
- Laura Burke
- Tyndall National Institute, University College Cork, Lee Maltings Complex, Dyke Parade, T12R5CP Cork, Ireland
| | - Liudmila Khokhlova
- Tyndall National Institute, University College Cork, Lee Maltings Complex, Dyke Parade, T12R5CP Cork, Ireland
| | - Brendan O'Flynn
- Tyndall National Institute, University College Cork, Lee Maltings Complex, Dyke Parade, T12R5CP Cork, Ireland
| | - Salvatore Tedesco
- Tyndall National Institute, University College Cork, Lee Maltings Complex, Dyke Parade, T12R5CP Cork, Ireland.
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2
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Paramento M, Passarotto E, Maccarone MC, Agostini M, Contessa P, Rubega M, Formaggio E, Masiero S. Neurophysiological, balance and motion evidence in adolescent idiopathic scoliosis: A systematic review. PLoS One 2024; 19:e0303086. [PMID: 38776317 PMCID: PMC11111046 DOI: 10.1371/journal.pone.0303086] [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: 01/12/2024] [Accepted: 04/19/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS) is a spinal deformity that affects approximately 4% of the world's population. Several hypotheses regarding the etiology of AIS have been investigated. In the last decades, impaired visual-spatial perception, alterations in spatial body orientation and sensory integration deficits have been documented. OBJECTIVE We aimed to summarize the neurophysiological, balance, and motion evidence related to AIS published in the last fifteen years, between January 2008 and April 2023. Both observational and interventional studies were considered. Only studies using quantitative assessment methods, such as electroencephalography (EEG), electromyography (EMG), magnetic resonance imaging (MRI), somatosensory evoked potentials, force platform, or motion capture, were included. METHODS 1250 eligible records identified from online database searching were filtered by duplicate removal, title and abstract screening, and qualitative analysis. 61 articles met the inclusion criteria (i.e., Cobb range 10°-35°, age range 10-18 years) and were summarized. RESULTS We found significant evidence of impaired standing balance in individuals with AIS who greatly rely on visual and proprioceptive information to stay upright. EMG studies frequently reported an increased activity on the convex side of the intrinsic spinae muscles. EEG data show increased delta and theta power, higher alpha peak frequencies, and significant suppression in the alpha and beta bands in subjects with AIS during standing tasks. MRI studies report changes in white matter structures, differences in the vestibular system, and abnormal cortical activations over motor-related areas in subjects with AIS. Bracing appears to be an effective treatment for AIS, leading to improvements in static balance and gait. Methodological issues prevent reliable conclusions about the effects of other treatment options. CONCLUSIONS This review underscores the importance of quantitative assessment methods to explore the etiology and pathophysiology of AIS. Further research is needed to measure the impact of physical therapy and orthotic treatments on the neurophysiological mechanisms of the disease.
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Affiliation(s)
- Matilde Paramento
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Edoardo Passarotto
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
| | - Maria Chiara Maccarone
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
- Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Michela Agostini
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
| | - Paola Contessa
- Orthopedic Rehabilitation Unit, Padova University Hospital, Padova, Italy
| | - Maria Rubega
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
| | - Emanuela Formaggio
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
| | - Stefano Masiero
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
- Ospedale Riabilitativo di Alta Specializzazione di Motta di Livenza, Motta di Livenza, Treviso, Italy
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Qiu Y, Luo Z. Research on Brain Networks of Human Balance Based on Phase Estimation Synchronization. Brain Sci 2024; 14:448. [PMID: 38790427 PMCID: PMC11118820 DOI: 10.3390/brainsci14050448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 04/22/2024] [Accepted: 04/28/2024] [Indexed: 05/26/2024] Open
Abstract
Phase synchronization serves as an effective method for analyzing the synchronization of electroencephalogram (EEG) signals among brain regions and the dynamic changes of the brain. The purpose of this paper is to study the construction of the functional brain network (FBN) based on phase synchronization, with a special focus on neural processes related to human balance regulation. This paper designed four balance paradigms of different difficulty by blocking vision or proprioception and collected 19-channel EEG signals. Firstly, the EEG sequences are segmented by sliding windows. The phase-locking value (PLV) of core node pairs serves as the phase-screening index to extract the valid data segments, which are recombined into new EEG sequences. Subsequently, the multichannel weighted phase lag index (wPLI) is calculated based on the new EEG sequences to construct the FBN. The experimental results show that due to the randomness of the time points of body balance adjustment, the degree of phase synchronization of the datasets screened by PLV is more obvious, improving the effective information expression of the subsequent EEG data segments. The FBN topological structures of the wPLI show that the connectivity of various brain regions changes structurally as the difficulty of human balance tasks increases. The frontal lobe area is the core brain region for information integration. When vision or proprioception is obstructed, the EEG synchronization level of the corresponding occipital lobe area or central area decreases. The synchronization level of the frontal lobe area increases, which strengthens the synergistic effect among the brain regions and compensates for the imbalanced response caused by the lack of sensory information. These results show the brain regional characteristics of the process of human balance regulation under different balance paradigms, providing new insights into endogenous neural mechanisms of standing balance and methods of constructing brain networks.
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Affiliation(s)
| | - Zhizeng Luo
- Institute of Intelligent Control and Robotics, Hangzhou Dianzi University, Hangzhou 310018, China;
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Boldo M, Di Marco R, Martini E, Nardon M, Bertucco M, Bombieri N. On the reliability of single-camera markerless systems for overground gait monitoring. Comput Biol Med 2024; 171:108101. [PMID: 38340440 DOI: 10.1016/j.compbiomed.2024.108101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 01/16/2024] [Accepted: 02/04/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND AND OBJECTIVE Motion analysis is crucial for effective and timely rehabilitative interventions on people with motor disorders. Conventional marker-based (MB) gait analysis is highly time-consuming and calls for expensive equipment, dedicated facilities and personnel. Markerless (ML) systems may pave the way to less demanding gait monitoring, also in unsupervised environments (i.e., in telemedicine). However,scepticism on clinical usability of relevant outcome measures has hampered its use. ML is normally used to analyse treadmill walking, which is significantly different from the more physiological overground walking. This study aims to provide end-users with instructions on using a single-camera markerless system to obtain reliable motion data from overground walking, while clinicians will be instructed on the reliability of obtained quantities. METHODS The study compares kinematics obtained from ML systems to those concurrently obtained from marker-based systems, considering different stride counts and subject positioning within the capture volume. RESULTS The findings suggest that five straight walking trials are sufficient for collecting reliable kinematics with ML systems. Precision on joint kinematics decreased at the boundary of the capture volume. Excellent correlation was found between ML and MB systems for hip and knee angles (0.92 CONCLUSION Single-camera markerless motion capture systems have great potential in assessing human joint kinematics during overground walking. Clinicians can confidently rely on estimated joint kinematics while walking, enabling personalized interventions and improving accessibility to remote evaluation and rehabilitation services, as long as: (i) the camera is positioned to capture someone walking back and forth at least five times with good visibility of the entire body silhouette; (ii) the walking path is at least 2 m long; and (iii) images captured at the boundaries of the camera image plane should be discarded.
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Affiliation(s)
- Michele Boldo
- Department of Computer Science, University of Verona, Strada Le Grazie, 15, Verona, 37134, Italy.
| | - Roberto Di Marco
- Department of Engineering for Innovation Medicine, University of Verona, Strada Le Grazie, 15, Verona, 37134, Italy.
| | - Enrico Martini
- Department of Computer Science, University of Verona, Strada Le Grazie, 15, Verona, 37134, Italy.
| | - Mauro Nardon
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Via Casorati, 43, Verona, 37131, Italy.
| | - Matteo Bertucco
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Via Casorati, 43, Verona, 37131, Italy.
| | - Nicola Bombieri
- Department of Engineering for Innovation Medicine, University of Verona, Strada Le Grazie, 15, Verona, 37134, Italy.
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Huang HJ, Ferris DP. Non-invasive brain imaging to advance the understanding of human balance. CURRENT OPINION IN BIOMEDICAL ENGINEERING 2023; 28:100505. [PMID: 38250696 PMCID: PMC10795750 DOI: 10.1016/j.cobme.2023.100505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Affiliation(s)
- Helen J. Huang
- Department of Mechanical and Aerospace Engineering, University of Central Florida, Orlando, FL, USA
- Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL, USA
- Biionix (Bionic Materials, Implants & Interfaces) Cluster, University of Central Florida, Orlando, FL, USA
| | - Daniel P. Ferris
- J. Crayton Pruitt Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
- Department of Mechanical and Aerospace Engineering, University of Florida, Gainesville, FL, USA
- Department of Neurology, University of Florida, Gainesville, FL, USA
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Tong CY, Zhu RTL, Ling YT, Scheeren EM, Lam FMH, Fu H, Ma CZH. Muscular and Kinematic Responses to Unexpected Translational Balance Perturbation: A Pilot Study in Healthy Young Adults. Bioengineering (Basel) 2023; 10:831. [PMID: 37508858 PMCID: PMC10376184 DOI: 10.3390/bioengineering10070831] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/24/2023] [Accepted: 07/03/2023] [Indexed: 07/30/2023] Open
Abstract
Falls and fall-related injuries are significant public health problems in older adults. While balance-controlling strategies have been extensively researched, there is still a lack of understanding regarding how fast the lower-limb muscles contract and coordinate in response to a sudden loss of standing balance. Therefore, this pilot study aims to investigate the speed and timing patterns of multiple joint/muscles' activities among the different challenges in standing balance. Twelve healthy young subjects were recruited, and they received unexpected translational balance perturbations with randomized intensities and directions. Electromyographical (EMG) and mechanomyographical (MMG) signals of eight dominant-leg's muscles, dominant-leg's three-dimensional (3D) hip/knee/ankle joint angles, and 3D postural sways were concurrently collected. Two-way ANOVAs were used to examine the difference in timing and speed of the collected signals among muscles/joint motions and among perturbation intensities. This study has found that (1) agonist muscles resisting the induced postural sway tended to activate more rapidly than the antagonist muscles, and ankle muscles contributed the most with the fastest rate of response; (2) voluntary corrective lower-limb joint motions and postural sways could occur as early as the perturbation-induced passive ones; (3) muscles reacted more rapidly under a larger perturbation intensity, while the joint motions or postural sways did not. These findings expand the current knowledge on standing-balance-controlling mechanisms and may potentially provide more insights for developing future fall-prevention strategies in daily life.
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Affiliation(s)
- Cheuk Ying Tong
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Ringo Tang-Long Zhu
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Yan To Ling
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
- Centre for Developmental Neurobiology, King's College London, London SE1 1UL, UK
| | - Eduardo Mendonça Scheeren
- Graduate Program in Health Technology, Pontifícia Universidade Católica do Paraná, Curitiba 80215-901, Brazil
| | - Freddy Man Hin Lam
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Hong Fu
- Department of Mathematics and Information Technology, The Education University of Hong Kong, Hong Kong SAR 999077, China
| | - Christina Zong-Hao Ma
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
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Koźlenia D, Domaradzki J. Risk of Single and Multiple Injuries Due to Static Balance and Movement Quality in Physically Active Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912197. [PMID: 36231497 PMCID: PMC9564762 DOI: 10.3390/ijerph191912197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 09/22/2022] [Accepted: 09/24/2022] [Indexed: 06/02/2023]
Abstract
BACKGROUND Static balance is a reliable indicator of the musculoskeletal and nervous systems, which is a basis for movement stabilization development. The disorders in this area may increase injury risk (IR). This study investigated the musculoskeletal injury risk due to static balance and movement quality regarding single and multiple injury occurrences in physically active women. METHODS The study sample was 88 women aged 21.48 ± 1.56. The injury data were obtained with a questionnaire, and Deep Squat (DS), In-line lunge (IL), and Hurdle Step (HS) tests were conducted. Static balance was assessed with a stabilometric platform measured center of gravity area circle (AC) and path length (PL) with open (OE) and closed eyes (CE), maintaining a standing position for the 30 s. RESULTS The logistic regression models revealed the general injury occurrence was predicted by AC-CE (OR = 0.70; p = 0.03) and IL (OR = 0.49; p = 0.03), and the two-factor model AC-CE*IL, (OR = 1.40; p < 0.01). When the single injury was predicted by the same factors AC-CE (OR = 0.49; p < 0.01), IL (OR = 0.36; p = 0.01), and AC-CE*IL (OR = 1.58; p < 0.01). CONCLUSION Static balance and movement stability predict musculoskeletal injury risk alone and in one model. A further study is needed to verify the efficiency of indicated factors in prospective terms. Using both quantitative and qualitative tests could be helpful in IR prediction.
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Bertuccelli M, Ciringione L, Rubega M, Bisiacchi P, Masiero S, Del Felice A. Cognitive impairment in people with previous COVID-19 infection: A scoping review. Cortex 2022; 154:212-230. [PMID: 35780756 PMCID: PMC9187867 DOI: 10.1016/j.cortex.2022.06.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 04/15/2022] [Accepted: 06/02/2022] [Indexed: 11/28/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 is a worldwide public health issue. Almost 2 years into the pandemic, the persistence of symptoms after the acute phase is a well-recognized phenomenon. We conducted a scoping review to map cognitive domain impairments, their frequency, and associated psycho-affective disorders in people with a previous COVID-19 infection. We searched PubMed/MEDLINE, Scopus, and PsycInfo to identify relevant reports published between December 1, 2019 and February 21, 2022. We followed the PRISMA (Preferred-Reporting-Items-for-Systematic-Reviews-and-Meta-Analyses) extension for scoping review guidelines. Three independent reviewers selected and charted 25 records out of 922. Memory, attention, and executive functions appeared to be the most affected domains. Delayed recall and learning were the most impaired domains of memory. Among the executive functions, abstraction, inhibition, set shifting, and sustained and selective attention were most commonly impaired. Language and visuo-spatial abilities were rarely affected, although this finding might be biased by the scarcity of reports. Neurological and respiratory conditions were often reported in association with cognitive deficits. Results on psycho-affective conditions were inconclusive due to the low frequency of reported data. Admission to an intensive care unit is not related to cognitive deficits. This review highlighted a potential effect of a previous post-COVID-19 infection on a pattern of memory, attention, and executive functions impairments. These findings need to be confirmed on larger cohorts with comprehensive neuropsychological batteries and correlated to neurophysiological and neurobiological substrates.
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Affiliation(s)
- Margherita Bertuccelli
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Via Giustiniani 3, 35128 Padova, Italy; Padova Neuroscience Center, University of Padova, 35131 Padova, Italy
| | - Luciana Ciringione
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Via Giustiniani 3, 35128 Padova, Italy
| | - Maria Rubega
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Via Giustiniani 3, 35128 Padova, Italy
| | - Patrizia Bisiacchi
- Padova Neuroscience Center, University of Padova, 35131 Padova, Italy; Department of General Psychology, University of Padova, Padova, Italy
| | - Stefano Masiero
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Via Giustiniani 3, 35128 Padova, Italy; Padova Neuroscience Center, University of Padova, 35131 Padova, Italy
| | - Alessandra Del Felice
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Via Giustiniani 3, 35128 Padova, Italy; Padova Neuroscience Center, University of Padova, 35131 Padova, Italy.
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Di Marco R, Rubega M, Antonini A, Formaggio E, Masiero S, Del Felice A. Fractal Analysis of Lower Back Acceleration Profiles in balance tasks. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:7381-7384. [PMID: 34892803 DOI: 10.1109/embc46164.2021.9629870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The body sway during standing displays fractal properties that can possibly describe motion complexity. This study aimed to use the Higuchi's fractal dimension (HFD) and Tortuosity on lower back accelerations recorded on younger (< 35 y) and older adults (> 64 y). One wearable sensor was secured on participants lower back (i.e., fifth lumbar vertebra), which were asked to perform three different postural tasks while standing barefoot as still as possible with and without performing a visual oddball task. Results of HFD and Tortuosity, applied to global anterior-posterior and medial-lateral accelerations of the body, were not dependent from signal amplitude, nor from any parametrization and allowed distinguishing between different postural tasks (p < 0.001). The proposed fractal analysis is promising to describe the complexity of postural control in both younger and older adults, paving the way to a wider use in pathological populations.
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Tortora S, Rubega M, Formaggio E, Marco RD, Masiero S, Menegatti E, Tonin L, Felice AD. Age-related differences in visual P300 ERP during dual-task postural balance. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:6511-6514. [PMID: 34892601 DOI: 10.1109/embc46164.2021.9630088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Standing and concurrently performing a cognitive task is a very common situation in everyday life. It is associated with a higher risk of falling in the elderly. Here, we aim at evaluating the differences of the P300 evoked potential elicited by a visual oddball paradigm between healthy younger (< 35 y) and older (> 64 y) adults during a simultaneous postural task. We found that P300 latency increases significantly (p < 0.001) when the elderly are engaged in more challenging postural tasks; younger adults show no effect of balance condition. Our results demonstrate that, even if the elderly have the same accuracy in odd stimuli detection as younger adults do, they require a longer processing time for stimulus discrimination. This finding suggests an increased attentional load which engages additional cerebral reserves.
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Bahmani M, Bahram A, Mohammadi Sanjani F, Diekfuss JA. Systematically Increased External Loads Secured Inferior to Younger and Older Adults' Center of Mass Improves Postural Control without Compromising Functional Motor Performance. J Mot Behav 2021; 54:291-303. [PMID: 34369322 DOI: 10.1080/00222895.2021.1960788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Few studies have investigated the effect of external loads secured inferior to the center of mass (COM) on postural control and motor performance in younger and older adults. In the present study, we investigated the effect of systematically increased external loads secured inferior to the COM on young (N = 15, age [years]: M = 26.67, SD= 3.45) and older adults' (N = 15, age [years]: M = 67.4, SD= 7.69) center of pressure displacement and velocity, and also dart throwing performance in four different load conditions: 1) no load (control condition), 2) loading with 5% of body mass, 3) loading with 10% of body mass, and 4) loading with 20% of body mass. Overall, older adults had higher COP displacement and velocity in both anterior/posterior (AP) and Medio-lateral (ML) directions and poorer dart throwing scores than younger adults. Despite no significant difference in dart throwing performance for the different load conditions within each age group, loading with 10% and 20% of body mass reduced AP COP displacement relative to control for both study groups, with 20% body mass also reducing AP COP velocity relative to control for both study groups. In conclusion the present findings reveal that external loads secured inferior to older and younger adults' COM may enhance postural control without compromising motor performance. The findings were discussed in the context of fall-prevention and athletic performance.
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Affiliation(s)
- Moslem Bahmani
- Department of motor behavior, Kharazmi University, Tehran, Iran
| | - Abbas Bahram
- Department of motor behavior, Kharazmi University, Tehran, Iran
| | | | - Jed A Diekfuss
- Emory Sports Performance and Research Center, Flowery Branch, GA, USA.,Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA, USA
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Di Marco R, Rubega M, Lennon O, Formaggio E, Sutaj N, Dazzi G, Venturin C, Bonini I, Ortner R, Cerrel Bazo HA, Tonin L, Tortora S, Masiero S, Del Felice A. Experimental Protocol to Assess Neuromuscular Plasticity Induced by an Exoskeleton Training Session. Methods Protoc 2021; 4:48. [PMID: 34287357 PMCID: PMC8293335 DOI: 10.3390/mps4030048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/01/2021] [Accepted: 07/07/2021] [Indexed: 12/13/2022] Open
Abstract
Exoskeleton gait rehabilitation is an emerging area of research, with potential applications in the elderly and in people with central nervous system lesions, e.g., stroke, traumatic brain/spinal cord injury. However, adaptability of such technologies to the user is still an unmet goal. Despite important technological advances, these robotic systems still lack the fine tuning necessary to adapt to the physiological modification of the user and are not yet capable of a proper human-machine interaction. Interfaces based on physiological signals, e.g., recorded by electroencephalography (EEG) and/or electromyography (EMG), could contribute to solving this technological challenge. This protocol aims to: (1) quantify neuro-muscular plasticity induced by a single training session with a robotic exoskeleton on post-stroke people and on a group of age and sex-matched controls; (2) test the feasibility of predicting lower limb motor trajectory from physiological signals for future use as control signal for the robot. An active exoskeleton that can be set in full mode (i.e., the robot fully replaces and drives the user motion), adaptive mode (i.e., assistance to the user can be tuned according to his/her needs), and free mode (i.e., the robot completely follows the user movements) will be used. Participants will undergo a preparation session, i.e., EMG sensors and EEG cap placement and inertial sensors attachment to measure, respectively, muscular and cortical activity, and motion. They will then be asked to walk in a 15 m corridor: (i) self-paced without the exoskeleton (pre-training session); (ii) wearing the exoskeleton and walking with the three modes of use; (iii) self-paced without the exoskeleton (post-training session). From this dataset, we will: (1) quantitatively estimate short-term neuroplasticity of brain connectivity in chronic stroke survivors after a single session of gait training; (2) compare muscle activation patterns during exoskeleton-gait between stroke survivors and age and sex-matched controls; and (3) perform a feasibility analysis on the use of physiological signals to decode gait intentions.
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Affiliation(s)
- Roberto Di Marco
- Department of Neurosciences, Section of Rehabilitation, University of Padova, via Belzoni, 160, 35121 Padova, Italy; (E.F.); (G.D.); (C.V.); (S.M.); (A.D.F.)
| | - Maria Rubega
- Department of Neurosciences, Section of Rehabilitation, University of Padova, via Belzoni, 160, 35121 Padova, Italy; (E.F.); (G.D.); (C.V.); (S.M.); (A.D.F.)
| | - Olive Lennon
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, 4 Dublin, Ireland;
| | - Emanuela Formaggio
- Department of Neurosciences, Section of Rehabilitation, University of Padova, via Belzoni, 160, 35121 Padova, Italy; (E.F.); (G.D.); (C.V.); (S.M.); (A.D.F.)
| | - Ngadhnjim Sutaj
- g.tec Medical Engineering GmbH, 4521 Schiedlberg, Austria; (N.S.); (R.O.)
| | - Giacomo Dazzi
- Department of Neurosciences, Section of Rehabilitation, University of Padova, via Belzoni, 160, 35121 Padova, Italy; (E.F.); (G.D.); (C.V.); (S.M.); (A.D.F.)
| | - Chiara Venturin
- Department of Neurosciences, Section of Rehabilitation, University of Padova, via Belzoni, 160, 35121 Padova, Italy; (E.F.); (G.D.); (C.V.); (S.M.); (A.D.F.)
| | - Ilenia Bonini
- Ospedale Riabilitativo di Alta Specializzazione di Motta di Livenza, 31045 Treviso, Italy; (I.B.); (H.A.C.B.)
| | - Rupert Ortner
- g.tec Medical Engineering GmbH, 4521 Schiedlberg, Austria; (N.S.); (R.O.)
| | | | - Luca Tonin
- Department of Information Engineering, University of Padova, 35131 Padova, Italy; (L.T.); (S.T.)
| | - Stefano Tortora
- Department of Information Engineering, University of Padova, 35131 Padova, Italy; (L.T.); (S.T.)
| | - Stefano Masiero
- Department of Neurosciences, Section of Rehabilitation, University of Padova, via Belzoni, 160, 35121 Padova, Italy; (E.F.); (G.D.); (C.V.); (S.M.); (A.D.F.)
- Padova Neuroscience Center, University of Padova, 35129 Padova, Italy
| | - Alessandra Del Felice
- Department of Neurosciences, Section of Rehabilitation, University of Padova, via Belzoni, 160, 35121 Padova, Italy; (E.F.); (G.D.); (C.V.); (S.M.); (A.D.F.)
- Padova Neuroscience Center, University of Padova, 35129 Padova, Italy
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Rubega M, Formaggio E, Di Marco R, Bertuccelli M, Tortora S, Menegatti E, Cattelan M, Bonato P, Masiero S, Del Felice A. Cortical correlates in upright dynamic and static balance in the elderly. Sci Rep 2021; 11:14132. [PMID: 34238987 PMCID: PMC8266885 DOI: 10.1038/s41598-021-93556-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 06/24/2021] [Indexed: 02/06/2023] Open
Abstract
Falls are the second most frequent cause of injury in the elderly. Physiological processes associated with aging affect the elderly's ability to respond to unexpected balance perturbations, leading to increased fall risk. Every year, approximately 30% of adults, 65 years and older, experiences at least one fall. Investigating the neurophysiological mechanisms underlying the control of static and dynamic balance in the elderly is an emerging research area. The study aimed to identify cortical and muscular correlates during static and dynamic balance tests in a cohort of young and old healthy adults. We recorded cortical and muscular activity in nine elderly and eight younger healthy participants during an upright stance task in static and dynamic (core board) conditions. To simulate real-life dual-task postural control conditions, the second set of experiments incorporated an oddball visual task. We observed higher electroencephalographic (EEG) delta rhythm over the anterior cortex in the elderly and more diffused fast rhythms (i.e., alpha, beta, gamma) in younger participants during the static balance tests. When adding a visual oddball, the elderly displayed an increase in theta activation over the sensorimotor and occipital cortices. During the dynamic balance tests, the elderly showed the recruitment of sensorimotor areas and increased muscle activity level, suggesting a preferential motor strategy for postural control. This strategy was even more prominent during the oddball task. Younger participants showed reduced cortical and muscular activity compared to the elderly, with the noteworthy difference of a preferential activation of occipital areas that increased during the oddball task. These results support the hypothesis that different strategies are used by the elderly compared to younger adults during postural tasks, particularly when postural and cognitive tasks are combined. The knowledge gained in this study could inform the development of age-specific rehabilitative and assistive interventions.
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Affiliation(s)
- Maria Rubega
- Department of Neuroscience, Section of Rehabilitation, University of Padua, Padova, 35128, Italy
| | - Emanuela Formaggio
- Department of Neuroscience, Section of Rehabilitation, University of Padua, Padova, 35128, Italy
| | - Roberto Di Marco
- Department of Neuroscience, Section of Rehabilitation, University of Padua, Padova, 35128, Italy
| | - Margherita Bertuccelli
- Department of Neuroscience, Section of Rehabilitation, University of Padua, Padova, 35128, Italy
| | - Stefano Tortora
- Department of Information Engineering, University of Padua, Padova, Italy, 35131
| | - Emanuele Menegatti
- Department of Information Engineering, University of Padua, Padova, Italy, 35131
| | - Manuela Cattelan
- Department of Statistical Sciences, University of Padua, Padova, 35121, Italy
| | - Paolo Bonato
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Charlestown, Boston, MA, 02129, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, 02115, USA
| | - Stefano Masiero
- Department of Neuroscience, Section of Rehabilitation, University of Padua, Padova, 35128, Italy
- Padova Neuroscience Center, Padova, 35128, Italy
| | - Alessandra Del Felice
- Department of Neuroscience, Section of Rehabilitation, University of Padua, Padova, 35128, Italy.
- Padova Neuroscience Center, Padova, 35128, Italy.
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