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Ghai S, Nilson F, Gustavsson J, Ghai I. Influence of compression garments on proprioception: A systematic review and meta-analysis. Ann N Y Acad Sci 2024; 1536:60-81. [PMID: 38722733 DOI: 10.1111/nyas.15144] [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] [Indexed: 06/19/2024]
Abstract
Compression garments (CGs) are commonly used in rehabilitation and sports contexts to enhance performance and speed up recovery. Despite the growing use of CGs in recent decades, there is no unanimous consensus on their overall influence on joint proprioception. In this current meta-analysis, we aim to fill this knowledge gap by assessing the impact of CGs on joint proprioception. We conducted a literature search across seven databases and one registry. Ultimately, we included 27 studies with 671 participants. The meta-analysis revealed that wearing CGs resulted in a significant reduction in absolute error during joint position sensing (Hedges' g: -0.64, p = 0.006) as compared to no CGs. However, further analyses of variables such as constant error (p = 0.308), variable error (p = 0.541) during joint position sense tests, threshold to detect passive motion (p = 0.757), and active movement extent discrimination (p = 0.842) did not show a significant impact of CGs. The review also identified gaps in the reporting of certain outcomes, such as parameters of CGs, reporting of performance, individual-reported outcomes, and lack of placebo comparators. Consequently, this review provides guidelines for future studies that may facilitate evidence-based synthesis and ultimately contribute to a better understanding of the overall influence of CGs on joint proprioception.
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Affiliation(s)
- Shashank Ghai
- Department of Political, Historical, Religious and Cultural Studies, Karlstad University, Karlstad, Sweden
- Centre for Societal Risk Research, Karlstad University, Karlstad, Sweden
| | - Finn Nilson
- Department of Political, Historical, Religious and Cultural Studies, Karlstad University, Karlstad, Sweden
- Centre for Societal Risk Research, Karlstad University, Karlstad, Sweden
- Institute of Civil Society Research, Marie Cederschiold University, Stockholm, Sweden
| | - Johanna Gustavsson
- Department of Political, Historical, Religious and Cultural Studies, Karlstad University, Karlstad, Sweden
- Centre for Societal Risk Research, Karlstad University, Karlstad, Sweden
| | - Ishan Ghai
- School of Life Sciences, Jacobs University Bremen, Bremen, Germany
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2
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Schilaty N, Bates N, Holmes B, Nagai T. Group differences and associations between patient-reported outcomes and physical characteristics in chronic low back pain patients and healthy controls. Clin Biomech (Bristol, Avon) 2023; 106:106009. [PMID: 37245281 DOI: 10.1016/j.clinbiomech.2023.106009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 04/11/2023] [Accepted: 05/18/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND Patients with chronic low back pain can exhibit altered slower gait, poor balance, and lower strength/power, and psychological dysfunctions such as pain catastrophizing and fear of movement. Few studies have investigated the relationships between physical and psychological dysfunctions. This study examined associations between patient-reported outcomes (pain interference, physical function, central sensitization, and kinesiophobia) and physical characteristics (gait, balance, and trunk sensorimotor characteristics). METHODS Laboratory testing included a 4-m walk, balance, and trunk sensorimotor testing with 18 patients and 15 controls. Gait and balance were collected with inertial measurement units. Isokinetic dynamometry measured trunk sensorimotor characteristics. Patient-reported outcomes included PROMIS Pain Interference / Physical Function, Central Sensitization Inventory, and Tampa Scale of Kinesiophobia. Independent t-tests or Mann-Whitney U tests were used to compare between groups. Additionally, Spearman's rank correlation coefficient (rs) established associations between physical and psychological domains, and Fisher z-tests compared correlation coefficient values between groups (significance P < 0.05). FINDINGS The patient group had worse tandem balance and all patient-reported outcomes (P < 0.05) while no group differences were observed in gait and trunk sensorimotor characteristics. There were significant correlations between worse central sensitization and poor tandem balance (rs = 0.446-0.619, P < 0.05) and lower peak force and rate of force development (rs = -0.429-0.702, P < 0.05). INTERPRETATION Observed group differences in tandem balance agree with previous studies, indicating impaired proprioception. The current findings provide preliminary evidence that balance and trunk sensorimotor characteristics were significantly associated with patient-reported outcomes in patients. Early and period screening could help clinicians further categorize patients and develop objective treatment plans.
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Affiliation(s)
- Nathan Schilaty
- University of South Florida, Tampa, FL, USA; Mayo Clinic, Rochester, MN, USA.
| | - Nathaniel Bates
- Mayo Clinic, Rochester, MN, USA; Ohio State University, Columbus, OH, USA
| | | | - Takashi Nagai
- Mayo Clinic, Rochester, MN, USA; United States Army Research Institute of Environmental Medicine, Natick, MA, USA
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3
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Park J, Nguyen VQ, Ho RLM, Coombes SA. The effect of chronic low back pain on postural control during quiet standing: A meta-analysis. Sci Rep 2023; 13:7928. [PMID: 37193730 DOI: 10.1038/s41598-023-34692-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 05/05/2023] [Indexed: 05/18/2023] Open
Abstract
Low back pain (LBP) has been associated with altered body sway during quiet standing, but the pattern of results is inconsistent. The purpose of this meta-analysis is to examine the effects of vision (eyes open, eyes closed) and changing the support surface (foam surface, firm surface) on postural sway during quiet standing in individuals with chronic LBP (cLBP). Five electronic databases were searched on March 27th, 2022. Of 2,856, 16 studies (n = 663) were included. Across all conditions, we found a positive and medium effect size (g = 0.77 [0.50, 1.04]) that represented greater body sway in individuals with cLBP. Subgroup analyses revealed medium effects during eyes open conditions (firm surface: g = 0.60 [0.33, 0.87]; foam surface: g = 0.68 [0.38, 0.97]), and large effects during eyes closed conditions (firm surface: g = 0.97 [0.60, 1.35]; foam surface: g = 0.89 [0.28, 1.51]). We quantified effects of self-reported pain and found a moderate effect during eyes closed plus firm surface conditions (Q = 3.28; p = 0.070). We conclude that cLBP is associated with increased postural sway, with largest effect sizes evident when vision is removed and when self-reported pain intensity is higher.
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Affiliation(s)
- Jinhan Park
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, PO Box 118206, Gainesville, FL, 32611, USA
| | - Vinh Q Nguyen
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, PO Box 118206, Gainesville, FL, 32611, USA
| | - Rachel L M Ho
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, PO Box 118206, Gainesville, FL, 32611, USA
| | - Stephen A Coombes
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, PO Box 118206, Gainesville, FL, 32611, USA.
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, 32611, USA.
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Smith JA, Stabbert H, Bagwell JJ, Teng HL, Wade V, Lee SP. Do people with low back pain walk differently? A systematic review and meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:450-465. [PMID: 35151908 PMCID: PMC9338341 DOI: 10.1016/j.jshs.2022.02.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 12/04/2021] [Accepted: 12/17/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND The biomechanics of the trunk and lower limbs during walking and running gait are frequently assessed in individuals with low back pain (LBP). Despite substantial research, it is still unclear whether consistent and generalizable changes in walking or running gait occur in association with LBP. The purpose of this systematic review was to identify whether there are differences in biomechanics during walking and running gait in individuals with acute and persistent LBP compared with back-healthy controls. METHODS A search was conducted in PubMed, CINAHL, SPORTDiscus, and PsycINFO in June 2019 and was repeated in December 2020. Studies were included if they reported biomechanical characteristics of individuals with and without LBP during steady-state or perturbed walking and running. Biomechanical data included spatiotemporal, kinematic, kinetic, and electromyography variables. The reporting quality and potential for bias of each study was assessed. Data were pooled where possible to compare the standardized mean differences (SMD) between back pain and back-healthy control groups. RESULTS Ninety-seven studies were included and reviewed. Two studies investigated acute pain and the rest investigated persistent pain. Nine studies investigated running gait. Of the studies, 20% had high reporting quality/low risk of bias. In comparison with back-healthy controls, individuals with persistent LBP walked slower (SMD = -0.59, 95% confidence interval (95%CI): -0.77 to -0.42)) and with shorter stride length (SMD = -0.38, 95%CI: -0.60 to -0.16). There were no differences in the amplitude of motion in the thoracic or lumbar spine, pelvis, or hips in individuals with LBP. During walking, coordination of motion between the thorax and the lumbar spine/pelvis was significantly more in-phase in the persistent LBP groups (SMD = -0.60, 95%CI: -0.90 to -0.30), and individuals with persistent LBP exhibited greater amplitude of activation in the paraspinal muscles (SMD = 0.52, 95%CI: 0.23-0.80). There were no consistent differences in running biomechanics between groups. CONCLUSION There is moderate-to-strong evidence that individuals with persistent LBP demonstrate differences in walking gait compared to back-healthy controls.
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Affiliation(s)
- Jo Armour Smith
- Department of Physical Therapy, Chapman University, Irvine, CA 92618, USA.
| | - Heidi Stabbert
- Department of Physical Therapy, Chapman University, Irvine, CA 92618, USA
| | - Jennifer J Bagwell
- Department of Physical Therapy, California State University, Long Beach, CA 90840, USA
| | - Hsiang-Ling Teng
- Department of Physical Therapy, California State University, Long Beach, CA 90840, USA
| | - Vernie Wade
- Department of Physical Therapy, Chapman University, Irvine, CA 92618, USA
| | - Szu-Ping Lee
- Department of Physical Therapy, University of Nevada, Las Vegas, NV 89154, USA
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5
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Natarajan P, Fonseka RD, Kim S, Betteridge C, Maharaj M, Mobbs RJ. Analysing gait patterns in degenerative lumbar spine diseases: a literature review. JOURNAL OF SPINE SURGERY (HONG KONG) 2022; 8:139-148. [PMID: 35441102 PMCID: PMC8990405 DOI: 10.21037/jss-21-91] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/06/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVES To collate the current state of knowledge and explore differences in the spatiotemporal gait patterns of degenerative lumbar spine diseases: lumbar spinal stenosis (LSS), lumbar disc herniation (LDH) and low back pain (LBP). BACKGROUND LBP is common presenting complaint with degenerative lumbar spine disease being a common cause. In particular, the gait patterns of LSS, LDH and mechanical-type (facetogenic and discogenic) LBP is not established. METHODS A search of the literature was conducted to determine the changes in spatial and temporal gait metrics involved with each type of degenerative lumbar spine disease. A search of databases including Medline, Embase and PubMed from their date of inception to April 18th, 2021 was performed to screen, review and identify relevant studies for qualitative synthesis. Seventeen relevant studies were identified for inclusion in the present review. Of these, 5 studies investigated gait patterns in LSS, 10 studies investigated LBP and 2 studies investigated LDH. Of these, 4 studies employed wearable accelerometry in LSS (2 studies) and LBP (2 studies). CONCLUSIONS Previous studies suggest degenerative diseases of the lumbar spine have unique patterns of gait deterioration. LSS is characterised by asymmetry and variability. Spatiotemporal gait deterioration in gait velocity, cadence with increased double-support duration and gait variability are distinguishing features in LDH. LBP involves marginal abnormalities in temporal and spatial gait metrics. Previous studies suggest degenerative diseases of the lumbar spine have unique patterns of gait deterioration. Gait asymmetry and variability, may be relevant metrics for distinguishing between the gait profiles of lumbar spine diseases.
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Affiliation(s)
- Pragadesh Natarajan
- NeuroSpine Surgery Research Group (NSURG), Sydney, Australia
- Neuro Spine Clinic, Prince of Wales Private Hospital, Randwick, Australia
- Faculty of Medicine, University of New South Wales (UNSW), Sydney, Australia
| | - R. Dineth Fonseka
- NeuroSpine Surgery Research Group (NSURG), Sydney, Australia
- Neuro Spine Clinic, Prince of Wales Private Hospital, Randwick, Australia
- Faculty of Medicine, University of New South Wales (UNSW), Sydney, Australia
| | - Sihyong Kim
- NeuroSpine Surgery Research Group (NSURG), Sydney, Australia
- Neuro Spine Clinic, Prince of Wales Private Hospital, Randwick, Australia
- Faculty of Medicine, University of New South Wales (UNSW), Sydney, Australia
| | - Callum Betteridge
- NeuroSpine Surgery Research Group (NSURG), Sydney, Australia
- Neuro Spine Clinic, Prince of Wales Private Hospital, Randwick, Australia
- Faculty of Medicine, University of New South Wales (UNSW), Sydney, Australia
| | - Monish Maharaj
- NeuroSpine Surgery Research Group (NSURG), Sydney, Australia
- Neuro Spine Clinic, Prince of Wales Private Hospital, Randwick, Australia
- Faculty of Medicine, University of New South Wales (UNSW), Sydney, Australia
| | - Ralph J. Mobbs
- NeuroSpine Surgery Research Group (NSURG), Sydney, Australia
- Neuro Spine Clinic, Prince of Wales Private Hospital, Randwick, Australia
- Faculty of Medicine, University of New South Wales (UNSW), Sydney, Australia
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6
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Al Bochi A, Delfi G, Dutta T. A Scoping Review on Minimum Foot Clearance: An Exploration of Level-Ground Clearance in Individuals with Abnormal Gait. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10289. [PMID: 34639597 PMCID: PMC8508348 DOI: 10.3390/ijerph181910289] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 11/29/2022]
Abstract
Background: Falls are a major health concern, with one in three adults over the age of 65 falling each year. A key gait parameter that is indicative of tripping is minimum foot clearance (MFC), which occurs during the mid-swing phase of gait. This is the second of a two-part scoping review on MFC literature. The aim of this paper is to identify vulnerable populations and conditions that impact MFC mean or median relative to controls. This information will inform future design/maintenance standards and outdoor built environment guidelines. Methods: Four electronic databases were searched to identify journal articles and conference papers that report level-ground MFC characteristics. Two independent reviewers screened papers for inclusion. Results: Out of 1571 papers, 43 relevant papers were included in this review. Twenty-eight conditions have been studied for effects on MFC. Eleven of the 28 conditions led to a decrease in mean or median MFC including dual-task walking in older adults, fallers with multiple sclerosis, and treadmill walking. All studies were conducted indoors. Conclusions: The lack of standardized research methods and covariates such as gait speed made it difficult to compare MFC values between studies for the purpose of defining design and maintenance standards for the outdoor built environment. Standardized methods for defining MFC and an emphasis on outdoor trials are needed in future studies.
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Affiliation(s)
- Abdulrahman Al Bochi
- KITE—Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, ON M5G 2A2, Canada; (A.A.B.); (G.D.)
| | - Ghazaleh Delfi
- KITE—Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, ON M5G 2A2, Canada; (A.A.B.); (G.D.)
| | - Tilak Dutta
- KITE—Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, ON M5G 2A2, Canada; (A.A.B.); (G.D.)
- Institute of Biomedical Engineering, University of Toronto, 164 College Street, Toronto, ON M5S 3G9, Canada
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7
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Rogge AK, Hamacher D, Cappagli G, Kuhne L, Hötting K, Zech A, Gori M, Röder B. Balance, gait, and navigation performance are related to physical exercise in blind and visually impaired children and adolescents. Exp Brain Res 2021; 239:1111-1123. [PMID: 33550429 PMCID: PMC8068618 DOI: 10.1007/s00221-021-06038-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 01/11/2021] [Indexed: 01/31/2023]
Abstract
Self-motion perception used for locomotion and navigation requires the integration of visual, vestibular, and proprioceptive input. In the absence of vision, postural stability and locomotor tasks become more difficult. Previous research has suggested that in visually deprived children, postural stability and levels of physical activity are overall lower than in sighted controls. Here we hypothesized that visually impaired and blind children and adolescents differ from sighted controls in postural stability and gait parameters, and that physically active individuals outperform sedentary peers in postural stability and gait parameters as well as in navigation performance. Fourteen blind and visually impaired children and adolescents (8-18 years of age) and 14 matched sighted individuals took part. Assessments included postural sway, single-leg stance time, parameters of gait variability and stability, self-reported physical activity, and navigation performance. Postural sway was larger and single-leg stance time was lower in blind and visually impaired participants than in blindfolded sighted individuals. Physical activity was higher in the sighted group. No differences between the group of blind and visually impaired and blindfolded sighted participants were observed for gait parameters and navigation performance. Higher levels of physical activity were related to lower postural sway, longer single-leg stance time, higher gait stability, and superior navigation performance in blind and visually impaired participants. The present data suggest that physical activity may enhance postural stability and gait parameters, and thereby promote navigation performance in blind and visually impaired children and adolescents.
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Affiliation(s)
- Ann-Kathrin Rogge
- Biological Psychology and Neuropsychology, University of Hamburg, Von-Melle-Park 11, 20146, Hamburg, Germany. .,Max Planck School of Cognition, Max-Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
| | - Daniel Hamacher
- Institute of Sport Science, Friedrich Schiller University, Jena, Germany.,Friedrich Schiller University, Statistics and Methods in Sports, Jena, Germany
| | - Giulia Cappagli
- Unit for Visually Impaired People, Istituto Italiano di Tecnologia, U-VIP, Genoa, Italy
| | - Laura Kuhne
- Biological Psychology and Neuropsychology, University of Hamburg, Von-Melle-Park 11, 20146, Hamburg, Germany
| | - Kirsten Hötting
- Biological Psychology and Neuropsychology, University of Hamburg, Von-Melle-Park 11, 20146, Hamburg, Germany
| | - Astrid Zech
- Institute of Sport Science, Friedrich Schiller University, Jena, Germany
| | - Monica Gori
- Unit for Visually Impaired People, Istituto Italiano di Tecnologia, U-VIP, Genoa, Italy
| | - Brigitte Röder
- Biological Psychology and Neuropsychology, University of Hamburg, Von-Melle-Park 11, 20146, Hamburg, Germany
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8
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Broscheid KC, Behrendt T, Hamacher D, Böker S, Gagelmann T, Schmidt C, Caspari C, Meiler K, Napiontek A, Franke J, Schega L. Effect of a Multimodal Movement Intervention in Patients With Neurogenic Claudication Based on Lumbar Spinal Stenosis and/or Degenerative Spondylolisthesis-A Pilot Study. Front Med (Lausanne) 2020; 7:540070. [PMID: 33364242 PMCID: PMC7753178 DOI: 10.3389/fmed.2020.540070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 10/14/2020] [Indexed: 11/22/2022] Open
Abstract
Chronic low-back pain is a major individual, social, and economic burden. The impairment ranges from deterioration of gait, limited mobility, to psychosocial distress. Due to this complexity, the demand for multimodal treatments is huge. Our purpose is to compare the effects of a multimodal movement intervention (MI) (coordinative–cognitive exercises and dancing program) with standard physical therapy (PT) on gait, physical function, and quality of life in patients with lumbar spinal stenosis (LSS). The study design is based on a 6-week intervention with a two (group: MI/PT) by two (measurement time points: pre-/post-test) parallel group design with random assignment. Twenty-four subjects (18 female/6 male, 70.8 ± 10.6 years old) diagnosed with LSS were included and randomly allocated to the MI or PT group. The primary outcomes are minimum toe clearance (MTC) and double step length (DSL) variability and the Timed “Up & Go” test (TUG). Secondary outcomes are the Brief Pain Inventory, the short Fall Efficacy Scale–International (sFES-I), and the Oswestry Disability Index. Nine subjects for each group could be analyzed. The MTC variability revealed a significant between-group difference in the posttest (p = 0.008) showing a lower MTC variability for the MI compared to the PT group. The MI group displayed an improved TUG (p = 0.031) and a reduced sFES-I (p = 0.044). The decreased MTC variability and fear of falling as well as the improved functional mobility may contribute to a reduced risk of falling. For the subsequent study, further kinematic and cognitive parameters should be analyzed, and the number of participants has to be increased. Clinical Trial Registration: German Clinical Trial Register (ID: DRKS00021026/URL: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00021026).
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Affiliation(s)
- Kim-Charline Broscheid
- Department Human Science, Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Tom Behrendt
- Department Human Science, Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Dennis Hamacher
- Department Human Science, Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Svantje Böker
- Department Human Science, Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Tabea Gagelmann
- Department Human Science, Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Christian Schmidt
- Department of Orthopaedic Surgery, Klinikum Magdeburg, Magdeburg, Germany
| | - Christina Caspari
- Department of Orthopaedic Surgery, Klinikum Magdeburg, Magdeburg, Germany
| | - Katharina Meiler
- Department of Orthopaedic Surgery, Klinikum Magdeburg, Magdeburg, Germany
| | - Andre Napiontek
- Association for Health, Exercise and Sport, Magdeburg, Germany
| | - Jörg Franke
- Department of Orthopaedic Surgery, Klinikum Magdeburg, Magdeburg, Germany
| | - Lutz Schega
- Department Human Science, Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
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9
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Ullauri JB, Akiyama Y, Okamoto S, Yamada Y. Technique to reduce the minimum toe clearance of young adults during walking to simulate the risk of tripping of the elderly. PLoS One 2019; 14:e0217336. [PMID: 31188860 PMCID: PMC6561532 DOI: 10.1371/journal.pone.0217336] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 01/22/2019] [Indexed: 12/02/2022] Open
Abstract
The elderly gait encompasses several disorders, including a lower minimum toe clearance (MTC) to the ground, which is a potential cause of tripping and falling while walking. Devices that assist in the MTC could reduce such risks. However, the development of effective assistive methods and their evaluation in the elderly might jeopardize their safety. To address this, young adults could take the place of the elderly. We present Muscle Activity Restriction Taping Technique (MARTT) that was devised to simulate the healthy-elderly gait characteristics in the young adults, particularly the lower MTC, by restricting the activity of lower-limb muscles. Two different restriction approaches, one that restricts muscles at the shank and the other at the shank and thigh, simultaneously, were tested at different walking speeds. Both approaches achieved a reduction in the MTC, regardless of the walking speed. The MTC was reduced to a median value lower than 10.1 mm, which is within the range of the MTC values reported for the elderly. The reduction of the MTC significantly increased toe contact to the ground. With the restriction of the shank muscles, the toe-contact frequency was more than twice as that in normal walking, and with the restriction of both the shank and thigh muscles, more than five times. In addition, MARTT reproduced the lower step length, the lower single support phase, and the joint motion compensation characteristic of the elderly gait, in the youth.
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Affiliation(s)
- Jessica Beltran Ullauri
- Dept. of Mechanical Systems Engineering, Mechano-Informatics and Systems, Nagoya University, Nagoya, Japan
| | - Yasuhiro Akiyama
- Dept. of Mechanical Systems Engineering, Mechano-Informatics and Systems, Nagoya University, Nagoya, Japan
- * E-mail:
| | - Shogo Okamoto
- Dept. of Mechanical Systems Engineering, Mechano-Informatics and Systems, Nagoya University, Nagoya, Japan
| | - Yoji Yamada
- Dept. of Mechanical Systems Engineering, Mechano-Informatics and Systems, Nagoya University, Nagoya, Japan
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10
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Filli L, Meyer C, Killeen T, Lörincz L, Göpfert B, Linnebank M, von Tscharner V, Curt A, Bolliger M, Zörner B. Probing Corticospinal Control During Different Locomotor Tasks Using Detailed Time-Frequency Analysis of Electromyograms. Front Neurol 2019; 10:17. [PMID: 30761064 PMCID: PMC6361808 DOI: 10.3389/fneur.2019.00017] [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: 10/11/2018] [Accepted: 01/07/2019] [Indexed: 12/11/2022] Open
Abstract
Locomotion relies on the fine-tuned coordination of different muscles which are controlled by particular neural circuits. Depending on the attendant conditions, walking patterns must be modified to optimally meet the demands of the task. Assessing neuromuscular control during dynamic conditions is methodologically highly challenging and prone to artifacts. Here we aim at assessing corticospinal involvement during different locomotor tasks using non-invasive surface electromyography. Activity in tibialis anterior (TA) and gastrocnemius medialis (GM) muscles was monitored by electromyograms (EMGs) in 27 healthy volunteers (11 female) during regular walking, walking while engaged in simultaneous cognitive dual tasks, walking with partial visual restriction, and skilled, targeted locomotion. Whereas EMG intensity of the TA and GM was considerably altered while walking with partial visual restriction and during targeted locomotion, dual-task walking induced only minor changes in total EMG intensity compared to regular walking. Targeted walking resulted in enhanced EMG intensity of GM in the frequency range associated with Piper rhythm synchronies. Likewise, targeted walking induced enhanced EMG intensity of TA at the Piper rhythm frequency around heelstrike, but not during the swing phase. Our findings indicate task- and phase-dependent modulations of neuromuscular control in distal leg muscles during various locomotor conditions in healthy subjects. Enhanced EMG intensity in the Piper rhythm frequency during targeted walking points toward enforced corticospinal drive during challenging locomotor tasks. These findings indicate that comprehensive time-frequency EMG analysis is able to gauge cortical involvement during different movement programs in a non-invasive manner and might be used as complementary diagnostic tool to assess baseline integrity of the corticospinal tract and to monitor changes in corticospinal drive as induced by neurorehabilitation interventions or during disease progression.
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Affiliation(s)
- Linard Filli
- Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland.,Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland
| | - Christian Meyer
- Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland
| | - Tim Killeen
- Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland
| | - Lilla Lörincz
- Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Beat Göpfert
- Department of Biomedical Engineering, Center for Biomechanics and Biocalorimetry, University of Basel, Basel, Switzerland
| | - Michael Linnebank
- Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland.,Department of Neurology, Helios-Klinik Hagen-Ambrock, Hagen, Germany
| | | | - Armin Curt
- Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland
| | - Marc Bolliger
- Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland
| | - Björn Zörner
- Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland.,Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland
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Brun C, Giorgi N, Pinard AM, Gagné M, McCabe CS, Mercier C. Exploring the Relationships Between Altered Body Perception, Limb Position Sense, and Limb Movement Sense in Complex Regional Pain Syndrome. THE JOURNAL OF PAIN 2018; 20:17-27. [PMID: 30099211 DOI: 10.1016/j.jpain.2018.07.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 06/25/2018] [Accepted: 07/17/2018] [Indexed: 11/19/2022]
Abstract
Chronic pain is often accompanied by patient-reported distorted body perception and an altered kinesthesia (referring to the senses of limb position and limb movement), but the association between these deficits is unknown. The objectives of this study were to assess body perception and the senses of limb position and limb movement in complex regional pain syndrome (CRPS) and to test whether these variables are related to each other and to pain intensity. Thirteen patients with upper limb CRPS (mean pain intensity, 4.2 ± 2.4 out of 10) and 13 controls were recruited. Body perception was self-reported with a questionnaire, and the senses of limb position (task 1) and of limb movement (task 2) were assessed with a robotic system combined with a 2D virtual reality display. The results showed altered kinesthesia in the patients with CRPS compared with controls (all P < .05). Moreover, in the CRPS group, greater pain intensity was associated with lower performance on task 2 (r = -.60; P < .05). Although alterations in participants' sense of limb position and limb movement were associated with each other (r = -.70, P < .01), they were not related to the altered body perception (all P > .26). Therefore, the results suggest that kinesthesia and body perception should be considered and evaluated separately in patients with CRPS. PERSPECTIVE: Senses of limb position and movement rely on sensorimotor integration. Both are altered in complex regional pain syndrome. However, they are not related to the subjective perception of the painful limb, and thus they should be assessed separately in rehabilitation.
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Affiliation(s)
- Clémentine Brun
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, QC, Canada.; Departments of Rehabilitation, Laval University, Quebec, QC, Canada
| | - Nicolas Giorgi
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, QC, Canada.; Departments of Medicine, Laval University, Quebec, QC, Canada
| | - Anne-Marie Pinard
- Departments of Anesthesiology, Laval University, Quebec, QC, Canada.; Departments of Anesthesiology, University Hospital of Quebec, Quebec, QC, Canada
| | - Martin Gagné
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, QC, Canada
| | - Candida S McCabe
- Royal National Hospital for Rheumatic Diseases, Bath, United Kingdom.; Departments of Nursing and Midwifery, University of the West of England, Bristol, United Kingdom
| | - Catherine Mercier
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, QC, Canada.; Departments of Rehabilitation, Laval University, Quebec, QC, Canada..
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12
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Shanbehzadeh S, Salavati M, Talebian S, Khademi-Kalantari K, Tavahomi M. Attention demands of postural control in non-specific chronic low back pain subjects with low and high pain-related anxiety. Exp Brain Res 2018; 236:1927-1938. [PMID: 29696316 DOI: 10.1007/s00221-018-5267-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 04/17/2018] [Indexed: 12/17/2022]
Abstract
Impaired postural control in chronic low back pain (CLBP) has been attributed to deficits in sensory and motor functions. However, it is not known if pain-related anxiety affects motor and cognitive function of postural control. The aim of this study was to compare the interactive effects of postural and cognitive function in CLBP patients with high and low pain-related anxiety and healthy subjects. Thirty-eight patients with nonspecific CLBP (19 with low and 19 with high pain-related anxiety levels) and 20 asymptomatic subjects participated. Postural control was assessed by center of pressure (COP) parameters including mean total sway velocity, area, anterior-posterior (A-P), and medial-lateral (Med-Lat) range. Postural task was assessed during four conditions (eyes open with and without ankle vibration-eyes closed with and without ankle vibrations). Participants performed the postural task with or without auditory Stroop task. Average reaction time and error ratio of auditory Stroop test were calculated as measures of the cognitive task performance. Significantly reduced sway area was observed in CLBP patients with high pain-related anxiety and control subjects during the dual-task condition as compared with the single task. In addition, A-P range was significantly reduced in CLBP patients with high pain-related anxiety during dual tasking when eyes were closed with ankle vibration. In addition, only the CLBP subjects with high pain-related anxiety showed significantly longer reaction times by increasing the difficulty of standing postural task. Pain-related anxiety may influence the postural cognitive interactions in CLBP patients. Furthermore, it may be considered as a contributing factor for postural strategies adopted by CLBP patients.
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Affiliation(s)
- Sanaz Shanbehzadeh
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mahyar Salavati
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Saeed Talebian
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Khosro Khademi-Kalantari
- Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahnaz Tavahomi
- Department of Physical Therapy, Iran University of Medical Sciences, Tehran, Iran
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13
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Brun C, Gagné M, McCabe CS, Mercier C. Sensory Disturbances, but Not Motor Disturbances, Induced by Sensorimotor Conflicts Are Increased in the Presence of Acute Pain. Front Integr Neurosci 2017; 11:14. [PMID: 28785209 PMCID: PMC5519624 DOI: 10.3389/fnint.2017.00014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 07/05/2017] [Indexed: 12/20/2022] Open
Abstract
Incongruence between our motor intention and the sensory feedback of the action (sensorimotor conflict) induces abnormalities in sensory perception in various chronic pain populations, and to a lesser extent in pain-free individuals. The aim of this study was to simultaneously investigate sensory and motor disturbances evoked by sensorimotor conflicts, as well as to assess how they are influenced by the presence of acute pain. It was hypothesized that both sensory and motor disturbances would be increased in presence of pain, which would suggest that pain makes body representations less robust. Thirty healthy participants realized cyclic asymmetric movements of flexion-extension with both upper limbs in a robotized system combined to a 2D virtual environment. The virtual environment provided a visual feedback (VF) about movements that was either congruent or incongruent, while the robotized system precisely measured motor performance (characterized by bilateral amplitude asymmetry and medio-lateral drift). Changes in sensory perception were assessed with a questionnaire after each trial. The effect of pain (induced with capsaicin) was compared to three control conditions (no somatosensory stimulation, tactile distraction and proprioceptive masking). Results showed that while both sensory and motor disturbances were induced by sensorimotor conflicts, only sensory disturbances were enhanced during pain condition comparatively to the three control conditions. This increase did not statistically differ across VF conditions (congruent or incongruent). Interestingly however, the types of sensations evoked by the conflict in the presence of pain (changes in intensity of pain or discomfort, changes in temperature or impression of a missing limb) were different than those evoked by the conflict alone (loss of control, peculiarity and the perception of having an extra limb). Finally, results showed no relationship between the amount of motor and sensory disturbances evoked in a given individual. Contrary to what was hypothesized, acute pain does not appear to make people more sensitive to the conflict itself, but rather impacts on the type and amount of sensory disturbances that they experienced in response to that conflict. Moreover, the results suggest that some sensorimotor integration processes remain intact in presence of acute pain, allowing us to maintain adaptive motor behavior.
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Affiliation(s)
- Clémentine Brun
- Center for Interdisciplinary Research in Rehabilitation and Social IntegrationQuébec, QC, Canada.,Department of Rehabilitation, Laval UniversityQuébec, QC, Canada
| | - Martin Gagné
- Center for Interdisciplinary Research in Rehabilitation and Social IntegrationQuébec, QC, Canada
| | - Candida S McCabe
- Royal National Hospital for Rheumatic DiseasesBath, United Kingdom.,Department of Nursing and Midwifery, University of the West of EnglandBristol, United Kingdom
| | - Catherine Mercier
- Center for Interdisciplinary Research in Rehabilitation and Social IntegrationQuébec, QC, Canada.,Department of Rehabilitation, Laval UniversityQuébec, QC, Canada
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14
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Killeen T, Easthope CS, Demkó L, Filli L, Lőrincz L, Linnebank M, Curt A, Zörner B, Bolliger M. Minimum toe clearance: probing the neural control of locomotion. Sci Rep 2017; 7:1922. [PMID: 28507300 PMCID: PMC5432520 DOI: 10.1038/s41598-017-02189-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 04/19/2017] [Indexed: 12/01/2022] Open
Abstract
Minimum toe clearance (MTC) occurs during a highly dynamic phase of the gait cycle and is associated with the highest risk of unintentional contact with obstacles or the ground. Age, cognitive function, attention and visual feedback affect foot clearance but how these factors interact to influence MTC control is not fully understood. We measured MTC in 121 healthy individuals aged 20–80 under four treadmill walking conditions; normal walking, lower visual field restriction and two Stroop colour/word naming tasks of two difficulty levels. Competition for cognitive and attentional resources from the Stroop task resulted in significantly lower mean MTC in older adults, with the difficult Stroop task associated with a higher frequency of extremely low MTC values and subsequently an increased modelled probability of tripping in this group. While older adults responded to visual restriction by markedly skewing MTC distributions towards higher values, this condition was also associated with frequent, extremely low MTC values. We reveal task-specific, age-dependent patterns of MTC control in healthy adults. Age-related differences are most pronounced during heavy, distracting cognitive load. Analysis of critically-low MTC values during dual-task walking may have utility in the evaluation of locomotor control and fall risk in older adults and patients with motor control deficits.
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Affiliation(s)
- Tim Killeen
- Spinal Cord Injury Center, University Hospital Balgrist, Forchstrasse 340, 8008, Zurich, Switzerland.
| | - Christopher S Easthope
- Spinal Cord Injury Center, University Hospital Balgrist, Forchstrasse 340, 8008, Zurich, Switzerland
| | - László Demkó
- Spinal Cord Injury Center, University Hospital Balgrist, Forchstrasse 340, 8008, Zurich, Switzerland
| | - Linard Filli
- Department of Neurology, University Hospital Zurich, Frauenklinikstrasse 26, 8091, Zurich, Switzerland
| | - Lilla Lőrincz
- Department of Neurology, University Hospital Zurich, Frauenklinikstrasse 26, 8091, Zurich, Switzerland
| | - Michael Linnebank
- Department of Neurology, Helios-Klinik Hagen-Ambrock, Ambrocker Weg 60, 58091, Hagen, Germany
| | - Armin Curt
- Spinal Cord Injury Center, University Hospital Balgrist, Forchstrasse 340, 8008, Zurich, Switzerland
| | - Björn Zörner
- Spinal Cord Injury Center, University Hospital Balgrist, Forchstrasse 340, 8008, Zurich, Switzerland.,Department of Neurology, University Hospital Zurich, Frauenklinikstrasse 26, 8091, Zurich, Switzerland
| | - Marc Bolliger
- Spinal Cord Injury Center, University Hospital Balgrist, Forchstrasse 340, 8008, Zurich, Switzerland
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Hamacher D, Hamacher D, Herold F, Schega L. Are there differences in the dual-task walking variability of minimum toe clearance in chronic low back pain patients and healthy controls? Gait Posture 2016; 49:97-101. [PMID: 27395449 DOI: 10.1016/j.gaitpost.2016.06.026] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 06/20/2016] [Accepted: 06/21/2016] [Indexed: 02/02/2023]
Abstract
The control of minimum toe clearance (MTC, as quantified with its stride-to-stride variability during walking) is a promising marker to evaluate motor control. The control of MTC, compared to other gait parameters, was reported to have higher priority. The relationship between the control of MTC and other gait parameters should be examined to elucidate tripping mechanisms. This study aimed at investigating the variability of MTC, stride time and stride length in normal walking and in dual-task walking in back pain sufferers. Twelve patients with chronic low back pain and twelve healthy controls walked with inertial sensors attached on their feet with and without a cognitive dual task. Standard deviations of stride time, stride length and MTC were calculated. Regarding the comparison of dual-task walking in pain patients vs. controls, we found higher variability in stride time in the back-pain group. Higher dual-task walking variability was observed in stride length and stride time only in back pain sufferers. Regarding MTC, however, neither a difference between groups nor between walking conditions were found. We observed that individuals with pain, who generally show higher gait variability, are able to control MTC in a dual-task condition indicating that their central nervous system might prioritize control of MTC over other gait parameters. Cases in which also MTC variability increase because of a dual task might characterize alarming fall risk. Dual-task MTC variability should, therefore, be estimated in individuals with severe fall risk as in old individuals with pain, frail people or neurological patients.
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Affiliation(s)
- Dennis Hamacher
- Department of Sport Science, Otto von Guericke University Magdeburg, Germany.
| | - Daniel Hamacher
- Department of Sport Science, Friedrich Schiller University Jena, Germany
| | - Fabian Herold
- Department of Sport Science, Otto von Guericke University Magdeburg, Germany
| | - Lutz Schega
- Department of Sport Science, Otto von Guericke University Magdeburg, Germany
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16
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Hamacher D, Hamacher D, Herold F, Schega L. Effect of dual tasks on gait variability in walking to auditory cues in older and young individuals. Exp Brain Res 2016; 234:3555-3563. [DOI: 10.1007/s00221-016-4754-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 08/05/2016] [Indexed: 11/29/2022]
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