1
|
Simonet A, Fourcade P, Loete F, Delafontaine A, Yiou E. Evaluation of the Margin of Stability during Gait Initiation in Young Healthy Adults, Elderly Healthy Adults and Patients with Parkinson's Disease: A Comparison of Force Plate and Markerless Motion Capture Systems. SENSORS (BASEL, SWITZERLAND) 2024; 24:3322. [PMID: 38894112 PMCID: PMC11174352 DOI: 10.3390/s24113322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 05/17/2024] [Accepted: 05/20/2024] [Indexed: 06/21/2024]
Abstract
Gait initiation (GI) is a functional task classically used in the literature to evaluate the capacity of individuals to maintain postural stability. Postural stability during GI can be evaluated through the "margin of stability" (MoS), a variable that is often computed from force plate recordings. The markerless motion capture system (MLS) is a recent innovative technology based on deep learning that has the potential to compute the MoS. This study tested the agreement between a force plate measurement system (FPS, gold standard) and an MLS to compute the MoS during GI. Healthy adults (young [YH] and elderly [EH]) and Parkinson's disease patients (PD) performed GI series at spontaneous (SVC) and maximum velocity (MVC) on an FPS while being filmed by a MLS. Descriptive statistics revealed a significant effect of the group (YH vs. EH vs. PD) and velocity condition (SVC vs. MVC) on the MoS but failed to reveal any significant effect of the system (MLS vs. PFS) or interaction between factors. Bland-Altman plot analysis further showed that mean MoS biases were zero in all groups and velocity conditions, while the Bayes factor 01 indicated "moderate evidence" that both systems provided equivalent MoS. Trial-by-trial analysis of Bland-Altman plots, however, revealed that differences of >20% between the two systems did occur. Globally taken, these findings suggest that the two systems are similarly effective in detecting an effect of the group and velocity on the MoS. These findings may have important implications in both clinical and laboratory settings due to the ease of use of the MLS compared to the FPS.
Collapse
Affiliation(s)
- Arnaud Simonet
- LADAPT Loiret, Centre de Soins de Suite et de Réadaptation, 45200 Amilly, France;
- CIAMS, Université Paris-Saclay, 91405 Orsay, France; (P.F.); (A.D.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | - Paul Fourcade
- CIAMS, Université Paris-Saclay, 91405 Orsay, France; (P.F.); (A.D.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | - Florent Loete
- Laboratoire GeePs—CENTRALESUPELEC, 91190 Gif-sur-Yvette, France;
| | - Arnaud Delafontaine
- CIAMS, Université Paris-Saclay, 91405 Orsay, France; (P.F.); (A.D.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
- Laboratoire d’Anatomie Fonctionnelle, Faculté des Sciences de la Motricité, Université Libre de Bruxelles, CP 619-1070 Brussels, Belgium
- Laboratoire d’Anatomie, de Biomécanique et d’Organogenèse, Faculté de Médecine, Université Libre de Bruxelles, CP 619-1070 Brussels, Belgium
| | - Eric Yiou
- CIAMS, Université Paris-Saclay, 91405 Orsay, France; (P.F.); (A.D.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
| |
Collapse
|
2
|
Ducas J, Memari S, Houle M, Schwendenmann Y, Abboud J, Yiou É, Descarreaux M. Impact of lumbar delayed-onset muscle soreness on postural stability in standing postures. Gait Posture 2024; 109:201-207. [PMID: 38350184 DOI: 10.1016/j.gaitpost.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/22/2024] [Accepted: 02/01/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Similar impact on proprioception has been observed in participants with lumbar delayed-onset muscle soreness (DOMS) and chronic low back pain (LBP), raising questions about the relevance of lumbar DOMS as a suitable pain model for LBP when assessing back pain-related postural stability changes. RESEARCH QUESTION Does lumbar DOMS impact postural stability? METHODS Twenty healthy adults participated in this experimental study and underwent a posturographic examination before and 24 to 36 h after a protocol designed to induce lumbar DOMS. Posturographic examination was assessed during quiet standing on both feet with eyes opened (EO), with eyes closed (EC), and on one-leg (OL) standing with eyes opened. Postural stability was assessed through center of pressure (COP) parameters (COP area, velocity, root mean square, mean power frequency) which were compared using repeated measure ANOVA. Moreover, pain, soreness and pressure pain threshold (PPT) on specific muscles were assessed. RESULTS There was a significant main effect of the postural condition on all COP variables investigated. More specifically, each COP variable reached a significantly higher value in the OL stance condition than in both EO and EC bipedal conditions (all with p < 0.001). In addition, the COP velocity and the mean power frequency along the anteroposterior direction both reached a significantly higher value in EC than in EO (p < 0.001). In contrast, there was no significant main effect of the DOMS nor significant DOMS X postural condition interaction on any of the COP variables. There was a significant decrease in the PPT value for both the left and right erector spinae muscles, as well as the left biceps femoris. SIGNIFICANCE Lumbar DOMS had no impact on postural stability, which contrasts findings in participants with clinical LBP. Although DOMS induces similar trunk sensorimotor adaptations to clinical LBP, it does not appear to trigger similar postural stability adaptations.
Collapse
Affiliation(s)
- Julien Ducas
- Department of Human Kinetics, Université du Québec à Trois-Rivières, 3351 Bd Des Forges, Trois-Rivières, QC G8Z 4M3, Canada; Groupe de Recherche sur les Affections Neuromusculosquelettiques (GRAN), Université du Québec à Trois-Rivières, 3351 Bd Des Forges, Trois-Rivières, QC G8Z 4M3, Canada
| | - Sahel Memari
- Department of Human Kinetics, Université du Québec à Trois-Rivières, 3351 Bd Des Forges, Trois-Rivières, QC G8Z 4M3, Canada; CIAMS Laboratory, Université Paris-Saclay, Orsay Cedex, France; CIAMS Laboratory, Université d'Orléans, Orléans, France; Research Department, Institut Franco-Européen de Chiropraxie, 94200 Ivry-Sur-Seine, France
| | - Mariève Houle
- Groupe de Recherche sur les Affections Neuromusculosquelettiques (GRAN), Université du Québec à Trois-Rivières, 3351 Bd Des Forges, Trois-Rivières, QC G8Z 4M3, Canada; Department of Anatomy, Université du Québec à Trois-Rivières, 3351 Bd Des Forges, Trois-Rivières, QC G8Z 4M3, Canada
| | - Yves Schwendenmann
- Department of Human Kinetics, Université du Québec à Trois-Rivières, 3351 Bd Des Forges, Trois-Rivières, QC G8Z 4M3, Canada; Groupe de Recherche sur les Affections Neuromusculosquelettiques (GRAN), Université du Québec à Trois-Rivières, 3351 Bd Des Forges, Trois-Rivières, QC G8Z 4M3, Canada
| | - Jacques Abboud
- Department of Human Kinetics, Université du Québec à Trois-Rivières, 3351 Bd Des Forges, Trois-Rivières, QC G8Z 4M3, Canada; Groupe de Recherche sur les Affections Neuromusculosquelettiques (GRAN), Université du Québec à Trois-Rivières, 3351 Bd Des Forges, Trois-Rivières, QC G8Z 4M3, Canada
| | - Éric Yiou
- CIAMS Laboratory, Université Paris-Saclay, Orsay Cedex, France; CIAMS Laboratory, Université d'Orléans, Orléans, France
| | - Martin Descarreaux
- Department of Human Kinetics, Université du Québec à Trois-Rivières, 3351 Bd Des Forges, Trois-Rivières, QC G8Z 4M3, Canada; Groupe de Recherche sur les Affections Neuromusculosquelettiques (GRAN), Université du Québec à Trois-Rivières, 3351 Bd Des Forges, Trois-Rivières, QC G8Z 4M3, Canada.
| |
Collapse
|
3
|
Delafontaine A, Vialleron T, Barbier G, Lardon A, Barrière M, García-Escudero M, Fabeck L, Descarreaux M. Effects of Manual Therapy on Parkinson's Gait: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2024; 24:354. [PMID: 38257446 PMCID: PMC10820786 DOI: 10.3390/s24020354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 12/28/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024]
Abstract
Manual therapy (MT) is commonly used in rehabilitation to deal with motor impairments in Parkinson's disease (PD). However, is MT an efficient method to improve gait in PD? To answer the question, a systematic review of clinical controlled trials was conducted. Estimates of effect sizes (reported as standard mean difference (SMD)) with their respective 95% confidence interval (95% CI) were reported for each outcome when sufficient data were available. If data were lacking, p values were reported. The PEDro scale was used for the quality assessment. Three studies were included in the review. MT improved Dynamic Gait Index (SMD = 1.47; 95% CI: 0.62, 2.32; PEDro score: 5/10, moderate level of evidence). MT also improved gait performances in terms of stride length, velocity of arm movements, linear velocities of the shoulder and the hip (p < 0.05; PEDro score: 2/10, limited level of evidence). There was no significant difference between groups after MT for any joint's range of motion during gait (p > 0.05; PEDro score: 6/10, moderate level of evidence). There is no strong level of evidence supporting the beneficial effect of MT to improve gait in PD. Further randomized controlled trials are needed to understand the impact of MT on gait in PD.
Collapse
Affiliation(s)
- Arnaud Delafontaine
- Department of Orthopedic Surgery, Université Libre de Bruxelles, 1050 Bruxelles, Belgium;
- Department of Sciences of Physical Activity, Université Québec Trois-Rivières, Trois-Rivières, QC G9A 5H7, Canada; (M.B.); (M.D.)
| | - Thomas Vialleron
- Laboratoire Interdisciplinaire en Neurosciences, Physiologie et Psychologie: Activité Physique, Santé et Apprentissages (LINP2), UFR STAPS, Université Paris Nanterre, 92000 Nanterre, France;
| | - Gaëtan Barbier
- Institut Franco-Européen de Chiropraxie, 94200 Ivry-sur-Seine, France; (G.B.); (A.L.)
- Complexité, Innovation, Activités Motrices et Sportives (CIAMS) Laboratory, Université Paris-Saclay, CEDEX 91405 Orsay, France
- Complexité, Innovation, Activités Motrices et Sportives (CIAMS) Laboratory, Université d’Orléans, 45067 Orléans, France
| | - Arnaud Lardon
- Institut Franco-Européen de Chiropraxie, 94200 Ivry-sur-Seine, France; (G.B.); (A.L.)
| | - Mélodie Barrière
- Department of Sciences of Physical Activity, Université Québec Trois-Rivières, Trois-Rivières, QC G9A 5H7, Canada; (M.B.); (M.D.)
| | - María García-Escudero
- Faculté de Médecine et des Sciences de la Santé, Université Catholique de Valence, San Vicente Martir, 46900 Valence, Spain;
| | - Laurent Fabeck
- Department of Orthopedic Surgery, Université Libre de Bruxelles, 1050 Bruxelles, Belgium;
| | - Martin Descarreaux
- Department of Sciences of Physical Activity, Université Québec Trois-Rivières, Trois-Rivières, QC G9A 5H7, Canada; (M.B.); (M.D.)
| |
Collapse
|
4
|
Salamci M, Salcı Y, Topuz S, Yalçın Aİ, Acar Özen P, Tuncer A. Gait initiation in multiple sclerosis patients with and without functional loss. Mult Scler Relat Disord 2023; 79:104990. [PMID: 37708821 DOI: 10.1016/j.msard.2023.104990] [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: 03/13/2023] [Revised: 07/25/2023] [Accepted: 09/01/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Gait initiation (GI) is an important functional task related to balance and gait performance. In addition, it has predictive importance for falls and postural instability in patient with multiple sclerosis (MS). However, it is uncertain how GI is affected in patients in the early stage of MS (Expanded Disability Status Scale (EDSS) ≤3). In this study, it was aimed to investigate the anticipatory postural adjustments (APAs), posterior center of pressure (COPap) displacement, and spatiotemporal variability during GI in patients with and without functional loss in the early stage of MS. METHODS Forty-four participants (31 MS patients and 13 healthy subjects) involved in this prospective cross-sectional study were divided into three groups: Group-I: Patients without functional loss (EDSS 0 to 1.5) (n = 14), Group-II: Patients with functional loss (EDSS 2 to 3) (n = 17) and Group-III: Healthy subjects (n = 13). Electromyographic activity of the bilateral tibialis anterior (TA) and gastrocnemius medialis (GM) and COPap displacement were recorded during the postural phase of GI. Additionally, spatiotemporal parameters were recorded within the first three steps, and the coefficient of variation was calculated with 40 walks for variability. RESULTS There were significant differences in the Kruskal-Wallis tests of variables (p<0.05). Group-I demonstrated smaller APAs magnitudes in TA [stance (p = 0.01), swing (p = 0.01)], GM of swing limb (p<0.0001), and smaller COPap displacement (p<0.0001) compared to group-III. Group-II demonstrated smaller APAs magnitudes in all muscles (p<0.0001) compared to group-III and the smallest COPap displacement (p<0.0001). Group-I showed a significant increase in stride width variability compared to group-III (p = 0.01). Group-II showed a significant increase in several variabilities [first stride length (p<0.0001), second stride time (p<0.0001), first double support time (p<0.0001), stride width (p<0.0001)] compared to group-III. CONCLUSION Patients in the early stage of MS had impairment in both the postural and locomotor phases of GI with more obvious in the patients with functional loss. The results indicate that MS patients without functional loss have difficulty initiating gait. Although there is no functional loss, the patients have a risk of falls, postural instability, and gait impairment due to their inability to initiate gait effectively. As a result, rehabilitation is necessary even if there is no functional loss in patients with MS.
Collapse
Affiliation(s)
- Mustafacan Salamci
- Department of Neurological Physiotherapy and Rehabilitation, Gazi University, Ankara, Turkey.
| | - Yeliz Salcı
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Semra Topuz
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Ali İmran Yalçın
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Pınar Acar Özen
- Department of Neurology, Hacettepe University, Ankara, Turkey
| | - Aslı Tuncer
- Department of Neurology, Hacettepe University, Ankara, Turkey
| |
Collapse
|
5
|
Delafontaine A, Vialleron T, Diakhaté DG, Fourcade P, Yiou E. Effects of experimentally induced cervical spine mobility alteration on the postural organisation of gait initiation. Sci Rep 2022; 12:6055. [PMID: 35410364 PMCID: PMC9001680 DOI: 10.1038/s41598-022-10101-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 03/28/2022] [Indexed: 11/09/2022] Open
Abstract
AbstractGait initiation (GI), the transient period between quiet standing and locomotion, is a functional task classically used in the literature to investigate postural control. This study aimed to investigate the influence of an experimentally-induced alteration of cervical spine mobility (CSM) on GI postural organisation. Fifteen healthy young adults initiated gait on a force-plate in (1) two test conditions, where participants wore a neck orthosis that passively simulated low and high levels of CSM alteration; (2) one control condition, where participants wore no orthosis; and (3) one placebo condition, where participants wore a cervical bandage that did not limit CSM. Centre-of-pressure and centre-of-mass kinematics were computed based on force-plate recordings according to Newton’s second law. Main results showed that anticipatory postural adjustments amplitude (peak backward centre-of-pressure shift and forward centre-of-mass velocity at toe-off) and motor performance (step length and forward centre-of-mass velocity at foot-contact) were altered under the condition of high CSM restriction. These effects of CSM restriction may reflect the implementation of a more cautious strategy directed to attenuate head-in-space destabilisation and ease postural control. It follows that clinicians should be aware that the prescription of a rigid neck orthosis to posturo-deficient patients could exacerbate pre-existing GI deficits.
Collapse
|
6
|
Vialleron T, Delafontaine A, Millerioux I, Memari S, Fourcade P, Yiou E. Acute effects of short-term stretching of the triceps surae on ankle mobility and gait initiation in patients with Parkinson's disease. Clin Biomech (Bristol, Avon) 2021; 89:105449. [PMID: 34418858 DOI: 10.1016/j.clinbiomech.2021.105449] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 05/17/2021] [Accepted: 08/10/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Ankle mobility is known to be of uttermost importance to generate propulsive forces and control balance during gait initiation. Impaired mobility of the postural chain occurs with normal ageing and is exacerbated in patients with Parkinson's disease. This study questions whether short-term stretching session applied to the triceps surae improves ankle mobility and, consequently, dynamical postural control in patients with Parkinson's disease performing gait initiation. METHOD Nineteen patients with Parkinson's disease participated in this study and were randomly assigned to an "intervention group" or a "sham group". In the intervention group, patients were exposed to a 4 × 60 seconds triceps surae stretching. In the sham group, they were exposed to forearm stretching. Additionally, ten age-matched healthy elderly, who were not exposed to any stretching-treatment, were assigned to a "control group". Participants performed series of gait initiation on a force-plate before and after their treatment. FINDINGS Ankle mobility was improved in the intervention group after triceps surae stretching. The forward velocity of the center-of-mass at heel-off and motor performance related-parameters (progression velocity, center-of-mass velocity at foot-contact and swing phase duration) were also improved in the intervention group, with large effect sizes (d ≥ 0.8). None of the stability parameters were modified by the treatments. INTERPRETATION Short-term triceps surae stretching is an efficient method to increase ankle mobility and improve the capacity to generate forward propulsive forces in patients with Parkinson's disease. These findings are congruent with the "posturo-kinetics capacity" theory according to which dynamical postural control depends on postural chain mobility.
Collapse
Affiliation(s)
- Thomas Vialleron
- CIAMS laboratory, Université Paris-Saclay, 91405 Orsay Cedex, France; CIAMS laboratory, Université d'Orléans, 45067 Orléans, France
| | - Arnaud Delafontaine
- CIAMS laboratory, Université Paris-Saclay, 91405 Orsay Cedex, France; CIAMS laboratory, Université d'Orléans, 45067 Orléans, France
| | - Isis Millerioux
- CIAMS laboratory, Université Paris-Saclay, 91405 Orsay Cedex, France; CIAMS laboratory, Université d'Orléans, 45067 Orléans, France
| | - Sahel Memari
- CIAMS laboratory, Université Paris-Saclay, 91405 Orsay Cedex, France; CIAMS laboratory, Université d'Orléans, 45067 Orléans, France
| | - Paul Fourcade
- CIAMS laboratory, Université Paris-Saclay, 91405 Orsay Cedex, France; CIAMS laboratory, Université d'Orléans, 45067 Orléans, France
| | - Eric Yiou
- CIAMS laboratory, Université Paris-Saclay, 91405 Orsay Cedex, France; CIAMS laboratory, Université d'Orléans, 45067 Orléans, France.
| |
Collapse
|
7
|
Yap YT, Gouwanda D, Gopalai AA, Chong YZ. The effect of asymmetrical gait induced by unilateral knee brace on the knee flexor and extensor muscles. Med Biol Eng Comput 2021; 59:711-720. [PMID: 33625670 DOI: 10.1007/s11517-021-02337-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 02/09/2021] [Indexed: 11/29/2022]
Abstract
Asymmetrical stiff knee gait is a mechanical pathology that can disrupt lower extremity muscle coordination. A better understanding of this condition can help identify potential complications. This study proposes the use of dynamic musculoskeletal modelling simulation to investigate the effect of induced mechanical perturbation on the kneeand to examine the muscle behaviour without invasive technique. Thirty-eight healthy participants were recruited. Asymmetrical gait was simulated using knee brace. Knee joint angle, joint moment and knee flexor and extensor muscle forces were computed using OpenSim. Differences inmuscle force between normal and abnormal conditions were investigated using ANOVA and Tukey-Kramer multiple comparison test.The results revealed that braced knee experienced limited range of motion with smaller flexion moment occuring at late swing phase. Significant differences were found in all flexormuscle forces and in several extensor muscle forces (p<0.05). Normal knee produced larger flexor muscle force than braced knee. Braced knee generated the largest extensor muscle force at early swing phase. In summary, musculoskeletal modelling simulation can be a computational tool to map and detect the differences between normal and asymmetrical gaits.
Collapse
Affiliation(s)
- Yi Ting Yap
- School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Selangor Darul Ehsan, Malaysia.
| | - Darwin Gouwanda
- School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Selangor Darul Ehsan, Malaysia
| | - Alpha A Gopalai
- School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Selangor Darul Ehsan, Malaysia
| | - Yu Zheng Chong
- Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Selangor Darul Ehsan, Malaysia
| |
Collapse
|
8
|
Tsai YY, Chang GC, Hwang IS. Changes in postural strategy of the lower limb under mechanical knee constraint on an unsteady stance surface. PLoS One 2020; 15:e0242790. [PMID: 33253285 PMCID: PMC7703948 DOI: 10.1371/journal.pone.0242790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 11/09/2020] [Indexed: 11/18/2022] Open
Abstract
Joint constraint could limit the available degrees of freedom in a kinematic chain for maintaining postural stability. This study investigated adaptive changes in postural synergy due to bracing of bilateral knee joints, usually thought to have a trifling impact on upright stance. Twenty-four young adults were requested to maintain balance on a stabilometer plate as steadily as possible while wearing a pair of knee orthoses, either unlocked (the non-constraint (NC) condition) or locked to restrict knee motion (the knee constraint (KC) condition). Knee constraint led to a significant increase in the regularity of the stabilometer angular velocity. More than 95% of the variance properties of the joint angular velocities in the lower limb were explained by the first and second principal components (PC1 and PC2), which represented the ankle strategy and the combined knee and hip strategy, respectively. In addition to the increase trend in PC1 regularity, knee constraint enhanced the mutual information of the stabilometer angular velocity and PC1 (MISTBV-PC1) but reduced the mutual information of the stabilometer angular velocity and PC2 (MISTBV-PC2). The MISTBV-PC1 was also positively correlated to stance steadiness on the stabilometer in the KC condition. In summary, in the knee constraint condition, postural synergy on the stabilometer was reorganized to increase reliance on ankle strategies to maintain equilibrium. In particular, a stable stabilometer stance under knee constraint is associated with a high level of coherent ankle–stabilometer interaction.
Collapse
Affiliation(s)
- Yi-Ying Tsai
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Gwo-Ching Chang
- Department of information Engineering, I-Shou University, Kaohsiung City, Taiwan
| | - Ing-Shiou Hwang
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
- * E-mail:
| |
Collapse
|
9
|
Esfandiari E, Sanjari MA, Jamshidi AA, Kamyab M, Yazdi HR. Gait initiation and lateral wedge insole for individuals with early knee osteoarthritis. Clin Biomech (Bristol, Avon) 2020; 80:105163. [PMID: 33010701 DOI: 10.1016/j.clinbiomech.2020.105163] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 07/22/2020] [Accepted: 08/25/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND People with knee osteoarthritis are at higher risk of postural deficits and locomotor adaptations which could be manifested in transient tasks like gait initiation. To better understand the effect of early knee osteoarthritis on gait initiation, we measured the gait initiation in two groups of early knee osteoarthritis and healthy age-matched controls and assessed the effect of lateral wedge insole in knee osteoarthritis group. METHODS Twenty-one individuals with early knee osteoarthritis, mean (SD) age = 53.1 (7.4, years), and 19 age- and sex-matched asymptomatic healthy individuals, mean (SD) age = 47.5 (11.2, years), participated. Centre of pressure trajectories were used to quantify the two phases of gait initiation in barefoot condition: anticipatory postural adjustment, and locomotor phase. The immediate and four-week effect of lateral wedge insole and shod condition were also compared for individuals in knee osteoarthritis group. FINDINGS Longer duration of anticipatory postural adjustment phase (P = 0.046), locomotor phase (P = 0.049), and total duration of gait initiation (P = 0.035) with lower length and velocity of the center of pressure trajectories in anticipatory postural adjustment phase (P = 0.002, and 0.008, respectively) were observed in knee osteoarthritis group compared to controls. Lateral wedge insole could increase the length and velocity of the centre of pressure in locomotor phase compared to barefoot condition (P = 0.001, and 0.002, respectively). INTERPRETATION Our study outlined that people with early knee osteoarthritis adopt different gait initiation strategies mainly in postural preparation phase. The potential effect of lateral wedge insole was shown with better performance of the locomotor phase. CLINICAL TRIAL REGISTRY NUMBER IRCT2016060628310N1.
Collapse
Affiliation(s)
- Elham Esfandiari
- Graduate Program in Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada; Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sanjari
- Department of Basic Rehabilitation Sciences, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Ali Ashraf Jamshidi
- Department of Physical Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Kamyab
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Yazdi
- Department of Orthopedic Surgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
10
|
Vialleron T, Delafontaine A, Ditcharles S, Fourcade P, Yiou E. Effects of stretching exercises on human gait: a systematic review and meta-analysis. F1000Res 2020; 9:984. [PMID: 33728043 PMCID: PMC7919610 DOI: 10.12688/f1000research.25570.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/23/2020] [Indexed: 12/16/2022] Open
Abstract
Background: Stretching is commonly used in physical therapy as a rehabilitation tool to improve range of motion and motor function. However, is stretching an efficient method to improve gait, and if so, for which patient category? Methods: A systematic review of randomized and non-randomized controlled trials with meta-analysis was conducted using relevant databases. Every patient category and every type of stretching programs were included without multicomponent programs. Data were meta-analysed where possible. Estimates of effect sizes (reported as standard mean difference (SMD)) with their respective 95% confidence interval (95% CI) were reported for each outcome. The PEDro scale was used for the quality assessment. Results: Twelve studies were included in the analysis. Stretching improved gait performance as assessed by walking speed and stride length only in a study with a frail elderly population, with small effect sizes (both SMD= 0.49; 95% CI: 0.03, 0.96; PEDro score: 3/10). The total distance and the continuous walking distance of the six-minute walking test were also improved only in a study in an elderly population who had symptomatic peripheral artery disease, with large effect sizes (SMD= 1.56; 95% CI: 0.66, 2.45 and SMD= 3.05; 95% CI: 1.86, 4.23, respectively; PEDro score: 5/10). The results were conflicting in healthy older adults or no benefit was found for most of the performance, spatiotemporal, kinetic and angular related variables. Only one study (PEDro score: 6/10) showed improvements in stance phase duration (SMD=-1.92; 95% CI: -3.04, -0.81), swing phase duration (SMD=1.92; 95 CI: 0.81, 3.04), double support phase duration (SMD= -1.69; 95% CI: -2.76, -0.62) and step length (SMD=1.37; 95% CI: 0.36, 2.38) with large effect sizes. Conclusions: There is no strong evidence supporting the beneficial effect of using stretching to improve gait. Further randomized controlled trials are needed to understand the impact of stretching on human gait.
Collapse
Affiliation(s)
- Thomas Vialleron
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, 91405, France
- CIAMS, Université d'Orléans, Orléans, Orléans, 45067, France
| | - Arnaud Delafontaine
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, 91405, France
- CIAMS, Université d'Orléans, Orléans, Orléans, 45067, France
| | - Sebastien Ditcharles
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, 91405, France
- CIAMS, Université d'Orléans, Orléans, Orléans, 45067, France
- ENKRE, Saint Maurice, Ile de France, 94410, France
| | - Paul Fourcade
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, 91405, France
- CIAMS, Université d'Orléans, Orléans, Orléans, 45067, France
| | - Eric Yiou
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, 91405, France
- CIAMS, Université d'Orléans, Orléans, Orléans, 45067, France
| |
Collapse
|
11
|
Vialleron T, Delafontaine A, Ditcharles S, Fourcade P, Yiou E. Effects of stretching exercises on human gait: a systematic review and meta-analysis. F1000Res 2020; 9:984. [PMID: 33728043 PMCID: PMC7919610 DOI: 10.12688/f1000research.25570.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2020] [Indexed: 04/01/2024] Open
Abstract
Background: Stretching is commonly used in physical therapy as a rehabilitation tool to improve range of motion and motor function. However, is stretching an efficient method to improve gait, and if so, for which patient category? Methods: A systematic review of randomized and non-randomized controlled trials with meta-analysis was conducted using relevant databases. Every patient category and every type of stretching programs were included without multicomponent programs. Data were meta-analysed where possible. Estimates of effect sizes (reported as standard mean difference (SMD)) with their respective 95% confidence interval (95% CI) were reported for each outcome. The PEDro scale was used for the quality assessment. Results: Twelve studies were included in the analysis. Stretching improved gait performance as assessed by walking speed and stride length only in a study with a frail elderly population, with small effect sizes (both SMD= 0.49; 95% CI: 0.03, 0.96; PEDro score: 3/10). The total distance and the continuous walking distance of the six-minute walking test were also improved only in a study in an elderly population who had symptomatic peripheral artery disease, with large effect sizes (SMD= 1.56; 95% CI: 0.66, 2.45 and SMD= 3.05; 95% CI: 1.86, 4.23, respectively; PEDro score: 5/10). The results were conflicting in healthy older adults or no benefit was found for most of the performance, spatiotemporal, kinetic and angular related variables. Only one study (PEDro score: 6/10) showed improvements in stance phase duration (SMD=-1.92; 95% CI: -3.04, -0.81), swing phase duration (SMD=1.92; 95 CI: 0.81, 3.04), double support phase duration (SMD= -1.69; 95% CI: -2.76, -0.62) and step length (SMD=1.37; 95% CI: 0.36, 2.38) with large effect sizes. Conclusions: There is no strong evidence supporting the beneficial effect of using stretching to improve gait. Further randomized controlled trials are needed to understand the impact of stretching on human gait.
Collapse
Affiliation(s)
- Thomas Vialleron
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, 91405, France
- CIAMS, Université d'Orléans, Orléans, Orléans, 45067, France
| | - Arnaud Delafontaine
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, 91405, France
- CIAMS, Université d'Orléans, Orléans, Orléans, 45067, France
| | - Sebastien Ditcharles
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, 91405, France
- CIAMS, Université d'Orléans, Orléans, Orléans, 45067, France
- ENKRE, Saint Maurice, Ile de France, 94410, France
| | - Paul Fourcade
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, 91405, France
- CIAMS, Université d'Orléans, Orléans, Orléans, 45067, France
| | - Eric Yiou
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, 91405, France
- CIAMS, Université d'Orléans, Orléans, Orléans, 45067, France
| |
Collapse
|
12
|
Delafontaine A, Vialleron T, Fischer M, Laffaye G, Chèze L, Artico R, Genêt F, Fourcade PC, Yiou E. Acute Effects of Whole-Body Vibration on the Postural Organization of Gait Initiation in Young Adults and Elderly: A Randomized Sham Intervention Study. Front Neurol 2019; 10:1023. [PMID: 31616369 PMCID: PMC6768974 DOI: 10.3389/fneur.2019.01023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 09/09/2019] [Indexed: 11/13/2022] Open
Abstract
Whole-body vibration (WBV) is a training method that exposes the entire body to mechanical oscillations while standing erect or seated on a vibrating platform. This method is nowadays commonly used by clinicians to improve specific motor outcomes in various sub-populations such as elderly and young healthy adults, either sedentary or well-trained. The present study investigated the effects of acute WBV application on the balance control mechanisms during gait initiation (GI) in young healthy adults and elderly. It was hypothesized that the balance control mechanisms at play during gait initiation may compensate each other in case one or several components are perturbed following acute WBV application, so that postural stability and/or motor performance can be maintained or even improved. It is further hypothesized that this capacity of adaptation is altered with aging. Main results showed that the effects of acute WBV application on the GI postural organization depended on the age of participants. Specifically, a positive effect was observed on dynamic stability in the young adults, while no effect was observed in the elderly. An increased stance leg stiffness was also observed in the young adults only. The positive effect of WBV on dynamic stability was ascribed to an increase in the mediolateral amplitude of "anticipatory postural adjustments" following WBV application, which did overcompensate the potentially destabilizing effect of the increased stance leg stiffness. In elderly, no such anticipatory (nor corrective) postural adaptation was required since acute WBV application did not elicit any change in the stance leg stiffness. These results suggest that WBV application may be effective in improving dynamic stability but at the condition that participants are able to develop adaptive changes in balance control mechanisms, as did the young adults. Globally, these findings are thus in agreement with the hypothesis that balance control mechanisms are interdependent within the postural system, i.e., they may compensate each other in case one component (here the leg stiffness) is perturbed.
Collapse
Affiliation(s)
- Arnaud Delafontaine
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France.,ENKRE, Saint-Maurice, France
| | - Thomas Vialleron
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France
| | - Matthieu Fischer
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France
| | - Guillaume Laffaye
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France
| | | | - Romain Artico
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France.,ENKRE, Saint-Maurice, France
| | - François Genêt
- UMR End:icap équipe 3, UFR des Sciences de la Santé Simone Veil, UVSQ, Montigny le Bretonneux, France
| | - Paul Christian Fourcade
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France
| | - Eric Yiou
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France
| |
Collapse
|