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Seethapathi N, Clark BC, Srinivasan M. Exploration-based learning of a stabilizing controller predicts locomotor adaptation. Nat Commun 2024; 15:9498. [PMID: 39489737 PMCID: PMC11532365 DOI: 10.1038/s41467-024-53416-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/08/2024] [Indexed: 11/05/2024] Open
Abstract
Humans adapt their locomotion seamlessly in response to changes in the body or the environment. It is unclear how such adaptation improves performance measures like energy consumption or symmetry while avoiding falling. Here, we model locomotor adaptation as interactions between a stabilizing controller that reacts quickly to perturbations and a reinforcement learner that gradually improves the controller's performance through local exploration and memory. This model predicts time-varying adaptation in many settings: walking on a split-belt treadmill (i.e. with both feet at different speeds), with asymmetric leg weights, or using exoskeletons - capturing learning and generalization phenomena in ten prior experiments and two model-guided experiments conducted here. The performance measure of energy minimization with a minor cost for asymmetry captures a broad range of phenomena and can act alongside other mechanisms such as reducing sensory prediction error. Such a model-based understanding of adaptation can guide rehabilitation and wearable robot control.
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Affiliation(s)
- Nidhi Seethapathi
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA.
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA.
| | | | - Manoj Srinivasan
- Department of Mechanical and Aerospace Engineering, the Ohio State University, Columbus, OH, USA
- Program in Biophysics, the Ohio State University, Columbus, OH, USA
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2
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Wu MI, Stegall P, Siu HC, Stirling L. Impact of Haptic Cues and an Active Ankle Exoskeleton on Gait Characteristics. HUMAN FACTORS 2024; 66:904-915. [PMID: 35815866 DOI: 10.1177/00187208221113625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This study examined the interaction of gait-synchronized vibrotactile cues with an active ankle exoskeleton that provides plantarflexion assistance. BACKGROUND An exoskeleton that augments gait may support collaboration through feedback to the user about the state of the exoskeleton or characteristics of the task. METHODS Participants (N = 16) were provided combinations of torque assistance and vibrotactile cues at pre-specified time points in late swing and early stance while walking on a self-paced treadmill. Participants were either given explicit instructions (N = 8) or were allowed to freely interpret (N=8) how to coordinate with cues. RESULTS For the free interpretation group, the data support an 8% increase in stride length and 14% increase in speed with exoskeleton torque across cue timing, as well as a 5% increase in stride length and 7% increase in speed with only vibrotactile cues. When given explicit instructions, participants modulated speed according to cue timing-increasing speed by 17% at cues in late swing and decreasing speed 11% at cues in early stance compared to no cue when exoskeleton torque was off. When torque was on, participants with explicit instructions had reduced changes in speed. CONCLUSION These findings support that the presence of torque mitigates how cues were used and highlights the importance of explicit instructions for haptic cuing. Interpreting cues while walking with an exoskeleton may increase cognitive load, influencing overall human-exoskeleton performance for novice users. APPLICATION Interactions between haptic feedback and exoskeleton use during gait can inform future feedback designs to support coordination between users and exoskeletons.
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Affiliation(s)
- Man I Wu
- University of Michigan, Ann Arbor, Michigan, USA
| | - Paul Stegall
- Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Ho Chit Siu
- Massachusetts Institute of Technology Lincoln Laboratory, Cambridge, Massachusetts, USA
| | - Leia Stirling
- University of Michigan, Ann Arbor, Michigan, USA
- University of Michigan, Ann Arbor, Michigan, USA
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3
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Maidan I, Yam M, Glatt S, Nosatzki S, Goldstein L, Giladi N, Hausdorff JM, Mirelman A, Fahoum F. Abnormal gait and motor cortical processing in drug-resistant juvenile myoclonic epilepsy. Brain Behav 2023; 13:e2872. [PMID: 36602919 PMCID: PMC9927833 DOI: 10.1002/brb3.2872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 11/12/2022] [Accepted: 12/12/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Juvenile myoclonic epilepsy (JME) is characterized by generalized seizures. Nearly 30% of JME patients are drug-resistant (DR-JME), indicating a widespread cortical dysfunction. Walking is an important function that necessitates orchestrated coordination of frontocentral cortical regions. However, gait alterations in JME have been scarcely investigated. Our aim was to assess changes in gait and motor-evoked responses in DR-JME patients. METHODS Twenty-nine subjects (11 JME drug-responder, 8 DR-JME, and 10 healthy controls) underwent a gait analyses during usual walking and dual-task walking. Later, subjects underwent 64-channel EEG recordings while performing a simple motor task. We calculated the motor-evoked current source densities (CSD) at a priori chosen cortical regions. Gait and CSD measures were compared between groups and tasks using mixed model analysis. RESULTS DR-JME patients demonstrated an altered gait pattern that included slower gait speed (p = .018), reduced cadence (p = .003), and smaller arm-swing amplitude (p = .011). The DR-JME group showed higher motor-evoked CSD in the postcentral gyri compared to responders (p = .049) and both JME groups showed higher CSD in the superior frontal gyri compared to healthy controls (p < .011). Moreover, higher CSD in the superior frontal gyri correlated with worse performance in dual-task walking (r > |-0.494|, p < .008). CONCLUSIONS These alterations in gait and motor-evoked responses in DRE-JME patients reflect a more severe dysfunction of motor-cognitive neural processing in frontocentral regions, leading to poorer gait performance. Further studies are needed to investigate the predictive value of altered gait and cortical motor processing as biomarkers for poor response to treatment in JME and other epilepsy syndromes.
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Affiliation(s)
- Inbal Maidan
- Brain Electrophysiology and Epilepsy Lab, Epilepsy Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Laboratory of Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Mor Yam
- Brain Electrophysiology and Epilepsy Lab, Epilepsy Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Sigal Glatt
- Brain Electrophysiology and Epilepsy Lab, Epilepsy Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shai Nosatzki
- Brain Electrophysiology and Epilepsy Lab, Epilepsy Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Lilach Goldstein
- Brain Electrophysiology and Epilepsy Lab, Epilepsy Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Nir Giladi
- Brain Electrophysiology and Epilepsy Lab, Epilepsy Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Laboratory of Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Jeffrey M Hausdorff
- Laboratory of Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.,Sackler Faculty of Medicine, Department of Physical Therapy, Tel Aviv University, Tel Aviv, Israel.,Rush Alzheimer's Disease Center and Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois
| | - Anat Mirelman
- Laboratory of Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Firas Fahoum
- Brain Electrophysiology and Epilepsy Lab, Epilepsy Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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4
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Baye-Wallace L, Thalman CM, Lee H. Entrainment During Human Locomotion Using a Lightweight Soft Robotic Hip Exosuit (SR-HExo). IEEE Robot Autom Lett 2022. [DOI: 10.1109/lra.2022.3165225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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5
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Evans E, Dass M, Muter WM, Tuthill C, Tan AQ, Trumbower RD. A Wearable Mixed Reality Platform to Augment Overground Walking: A Feasibility Study. Front Hum Neurosci 2022; 16:868074. [PMID: 35754777 PMCID: PMC9218429 DOI: 10.3389/fnhum.2022.868074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/03/2022] [Indexed: 11/21/2022] Open
Abstract
Humans routinely modify their walking speed to adapt to functional goals and physical demands. However, damage to the central nervous system (CNS) often results in abnormal modulation of walking speed and increased risk of falls. There is considerable interest in treatment modalities that can provide safe and salient training opportunities, feedback about walking performance, and that may augment less reliable sensory feedback within the CNS after injury or disease. Fully immersive virtual reality technologies show benefits in boosting training-related gains in walking performance; however, they lack views of the real world that may limit functional carryover. Augmented reality and mixed reality head-mount displays (MR-HMD) provide partially immersive environments to extend the virtual reality benefits of interacting with virtual objects but within an unobstructed view of the real world. Despite this potential advantage, the feasibility of using MR-HMD visual feedback to promote goal-directed changes in overground walking speed remains unclear. Thus, we developed and evaluated a novel mixed reality application using the Microsoft HoloLens MR-HMD that provided real-time walking speed targets and augmented visual feedback during overground walking. We tested the application in a group of adults not living with disability and examined if they could use the targets and visual feedback to walk at 85%, 100%, and 115% of each individual’s self-selected speed. We examined whether individuals were able to meet each target gait speed and explored differences in accuracy across repeated trials and at the different speeds. Additionally, given the importance of task-specificity to therapeutic interventions, we examined if walking speed adjustment strategies were consistent with those observed during usual overground walking, and if walking with the MR-HMD resulted in increased variability in gait parameters. Overall, participants matched their overground walking speed to the target speed of the MR-HMD visual feedback conditions (all p-values > 0.05). The percent inaccuracy was approximately 5% across all speed matching conditions and remained consistent across walking trials after the first overall walking trial. Walking with the MR-HMD did not result in more variability in walking speed, however, we observed more variability in stride length and time when walking with feedback from the MR-HMD compared to walking without feedback. The findings offer support for mixed reality-based visual feedback as a method to provoke goal-specific changes in overground walking behavior. Further studies are necessary to determine the clinical safety and efficacy of this MR-HMD technology to provide extrinsic sensory feedback in combination with traditional treatments in rehabilitation.
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Affiliation(s)
- Emily Evans
- Spaulding Rehabilitation Hospital, Cambridge, MA, United States.,Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States
| | - Megan Dass
- Georgia Institute of Technology, School of Computer Science, Atlanta, GA, United States
| | - William M Muter
- Spaulding Rehabilitation Hospital, Cambridge, MA, United States
| | - Christopher Tuthill
- Spaulding Rehabilitation Hospital, Cambridge, MA, United States.,Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States
| | - Andrew Q Tan
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States.,Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Randy D Trumbower
- Spaulding Rehabilitation Hospital, Cambridge, MA, United States.,Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States
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Lee J, Huber ME, Hogan N. Gait Entrainment to Torque Pulses from a Hip Exoskeleton Robot. IEEE Trans Neural Syst Rehabil Eng 2022; 30:656-667. [PMID: 35286261 DOI: 10.1109/tnsre.2022.3155770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Robot-aided locomotor rehabilitation has proven challenging. To facilitate progress, it is important to first understand the neuro-mechanical dynamics and control of unimpaired human locomotion. Our previous studies found that human gait entrained to periodic torque pulses at the ankle when the pulse period was close to preferred stride duration. Moreover, synchronized gait exhibited constant phase relation with the pulses so that the robot provided mechanical assistance. To test the generality of mechanical gait entrainment, this study characterized unimpaired human subjects' responses to periodic torque pulses during overground walking. The intervention was applied by a hip exoskeleton robot, Samsung GEMS-H. Gait entrainment was assessed based on the time-course of the phase at which torque pulses occurred within each stride. Experiments were conducted for two consecutive days to evaluate whether the second day elicited more entrainment. Whether entrainment was affected by the difference between pulse period and preferred stride duration was also assessed. Results indicated that the intervention evoked gait entrainment that occurred more often when the period of perturbation was closer to subjects' preferred stride duration, but the difference between consecutive days was insignificant. Entrainment was accompanied by convergence of pulse phase to a similar value across all conditions, where the robot maximized mechanical assistance. Clear evidence of motor adaptation indicated the potential of the intervention for rehabilitation. This study quantified important aspects of the nonlinear neuro-mechanical dynamics underlying unimpaired human walking, which will inform the development of effective approaches to robot-aided locomotor rehabilitation, exploiting natural dynamics in a minimally-encumbering way.
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7
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Lee J, Huber ME, Hogan N. Applying Hip Stiffness With an Exoskeleton to Compensate Gait Kinematics. IEEE Trans Neural Syst Rehabil Eng 2021; 29:2645-2654. [PMID: 34871174 DOI: 10.1109/tnsre.2021.3132621] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Neurological disorders and aging induce impaired gait kinematics. Despite recent advances, effective methods using lower-limb exoskeleton robots to restore gait kinematics are as yet limited. In this study, applying virtual stiffness using a hip exoskeleton was investigated as a possible method to guide users to change their gait kinematics. With a view to applications in locomotor rehabilitation, either to provide assistance or promote recovery, this study assessed whether imposed stiffness induced changes in the gait pattern during walking; and whether any changes persisted upon removal of the intervention, which would indicate changes in central neuro-motor control. Both positive and negative stiffness induced immediate and persistent changes of gait kinematics. However, the results showed little behavioral evidence of persistent changes in neuro-motor control, not even short-lived aftereffects. In addition, stride duration was little affected, suggesting that at least two dissociable layers exist in the neuro-motor control of human walking. The lack of neuro-motor adaptation suggests that, within broad limits, the central nervous system is surprisingly indifferent to the details of lower limb kinematics. The lack of neuro-motor adaptation also suggests that alternative methods may be required to implement a therapeutic technology to promote recovery. However, the immediate, significant, and reproducible changes in kinematics suggest that applying hip stiffness with an exoskeleton may be an effective assistive technology for compensation.
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8
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Pinto-Fernandez D, Torricelli D, Sanchez-Villamanan MDC, Aller F, Mombaur K, Conti R, Vitiello N, Moreno JC, Pons JL. Performance Evaluation of Lower Limb Exoskeletons: A Systematic Review. IEEE Trans Neural Syst Rehabil Eng 2021; 28:1573-1583. [PMID: 32634096 DOI: 10.1109/tnsre.2020.2989481] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Benchmarks have long been used to verify and compare the readiness level of different technologies in many application domains. In the field of wearable robots, the lack of a recognized benchmarking methodology is one important impediment that may hamper the efficient translation of research prototypes into actual products. At the same time, an exponentially growing number of research studies are addressing the problem of quantifying the performance of robotic exoskeletons, resulting in a rich and highly heterogeneous picture of methods, variables and protocols. This review aims to organize this information, and identify the most promising performance indicators that can be converted into practical benchmarks. We focus our analysis on lower limb functions, including a wide spectrum of motor skills and performance indicators. We found that, in general, the evaluation of lower limb exoskeletons is still largely focused on straight walking, with poor coverage of most of the basic motor skills that make up the activities of daily life. Our analysis also reveals a clear bias towards generic kinematics and kinetic indicators, in spite of the metrics of human-robot interaction. Based on these results, we identify and discuss a number of promising research directions that may help the community to attain a comprehensive benchmarking methodology for robot-assisted locomotion more efficiently.
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9
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User-driven treadmill walking promotes healthy step width after stroke. Gait Posture 2021; 86:256-259. [PMID: 33812294 PMCID: PMC8085049 DOI: 10.1016/j.gaitpost.2021.03.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 02/11/2021] [Accepted: 03/22/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Walking with user-driven treadmill control is believed to be more like overground walking than fixed-speed treadmill walking. Walking speed and ground reaction forces differ between overground and fixed-speed treadmill walking, but not between overground and user-driven treadmill walking in healthy and post-stroke subjects. However, studies assessing spatiotemporal gait parameters during user-driven treadmill walking are limited. This information may help confirm that user-driven treadmill walking is more like overground walking than fixed-speed treadmill walking, as well as inform the development of post-stroke gait rehabilitation programs. RESEARCH QUESTION How do spatiotemporal gait parameters for individuals post-stroke differ between fixed-speed and user-driven treadmill walking? METHODS Eighteen subjects (10 M, 8 F; 62 ± 12 years; 1.73 ± 0.12 m; 84.9 ± 12.9 kg; 40 ± 30 months post-stroke) with chronic post-stroke hemiparesis participated in this study. Participants walked on an instrumented treadmill in its fixed-speed and user-driven modes at their self-selected and fastest comfortable walking speeds. Subjects wore retroreflective markers for motion capture. Shapiro-Wilk tests were used to assess for normality and one-way repeated measures ANOVAs were used to compare between conditions with α = 0.05. Bonferroni corrections were used for multiple comparisons. RESULTS Step width was significantly smaller with user-driven control (13.7 cm, 95 % CI: [0.131, 0.145]) than fixed-speed control (16.8 cm, 95 % CI:[0.160, 0.174]), while step length and step time did not differ across treadmill conditions. Step length and step time differed between self-selected and fast walking speeds, but not treadmill control conditions. SIGNIFICANCE The results of this study show that user-driven treadmill control encourages healthy gait biomechanics and a greater sense of stability in post-stroke subjects. Individuals post-stroke walked with smaller step width with user-driven treadmill control, which has been associated with increased balance. Post-stroke gait rehabilitation may benefit from programs with user-driven treadmill training paradigms to improve mobility following stroke.
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10
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Zhang Z, Sternad D. Back to reality: differences in learning strategy in a simplified virtual and a real throwing task. J Neurophysiol 2021; 125:43-62. [PMID: 33146063 PMCID: PMC8087380 DOI: 10.1152/jn.00197.2020] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 09/20/2020] [Accepted: 10/13/2020] [Indexed: 11/22/2022] Open
Abstract
Virtual environments have been widely used in motor neuroscience and rehabilitation, as they afford tight control of sensorimotor conditions and readily afford visual and haptic manipulations. However, typically, studies have only examined performance in the virtual testbeds, without asking how the simplified and controlled movement in the virtual environment compares to behavior in the real world. To test whether performance in the virtual environment was a valid representation of corresponding behavior in the real world, this study compared throwing in a virtual set-up with realistic throwing, where the task parameters were precisely matched. Even though the virtual task only required a horizontal single-joint arm movement, similar to many simplified movement assays in motor neuroscience, throwing accuracy and precision were significantly worse than in the real task that involved all degrees of freedom of the arm; only after 3 practice days did success rate and error reach similar levels. To gain more insight into the structure of the learning process, movement variability was decomposed into deterministic and stochastic contributions. Using the tolerance-noise-covariation decomposition method, distinct stages of learning were revealed: While tolerance was optimized first in both environments, it was higher in the virtual environment, suggesting that more familiarization and exploration was needed in the virtual task. Covariation and noise showed more contributions in the real task, indicating that subjects reached the stage of fine-tuning of variability only in the real task. These results showed that while the tasks were precisely matched, the simplified movements in the virtual environment required more time to become successful. These findings resonate with the reported problems in transfer of therapeutic benefits from virtual to real environments and alert that the use of virtual environments in research and rehabilitation needs more caution.NEW & NOTEWORTHY This study compared human performance of the same throwing task in a real and a matched virtual environment. With 3 days' practice, subjects improved significantly faster in the real task, even though the arm and hand movements were more complex. Decomposing variability revealed that performance in the virtual environment, despite its simplified hand movements, required more exploration. Additionally, due to fewer constraints in the real task, subjects could modify the geometry of the solution manifold, by shifting the release position, and thereby simplify the task.
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Affiliation(s)
- Zhaoran Zhang
- Department of Neuroscience, Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University, New York, New York
| | - Dagmar Sternad
- Department of Biology, Electrical and Computer Engineering, and Physics, Northeastern University, Boston, Massachusetts
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11
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Thorp JE, Adamczyk PG. Mechanisms of gait phase entrainment in healthy subjects during rhythmic electrical stimulation of the medial gastrocnemius. PLoS One 2020; 15:e0241339. [PMID: 33095823 PMCID: PMC7584166 DOI: 10.1371/journal.pone.0241339] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 10/13/2020] [Indexed: 01/14/2023] Open
Abstract
Studies have shown that human gait entrains to rhythmic bursts of ankle torque for perturbation intervals both slightly shorter and slightly longer than the natural stride period while walking on a treadmill and during overground walking, with phase alignment such that the torque adds to ankle push-off. This study investigated whether human gait also entrains to align the phase of rhythmic electrical stimulation of the gastrocnemius muscle with the timing of ankle push-off. In addition, this study investigated the muscle response to electrical stimulation at different phases of the gait cycle. We found that for both treadmill and overground walking entrainment was observed with phasing that aligned the stimuli with ankle push-off or just before foot contact. Achilles tendon wave speed measurements showed a significant difference (increase) in tendon load when electrical stimulation was applied just after foot contact and during swing phase, with a greater increase for higher amplitudes of electrical stimulation. However, stimulation did not increase tendon load when the timing coincided with push-off. Stride period measurements also suggest the effect of electrical stimulation is sensitive to the gait phase it is applied. These results confirmed that timing aligned with push-off is an attractor for electrical stimulation-induced perturbations of the medial gastrocnemius, and that the muscle response to stimulation is sensitive to timing and amplitude. Future research should investigate other muscles and timings and separate sensory vs. motor contributions to these phenomena.
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Affiliation(s)
- Jenna E. Thorp
- Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Peter Gabriel Adamczyk
- Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
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12
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Barsotti A, Khalaf K, Gan D. Muscle fatigue evaluation with EMG and Acceleration data: a case study. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:3138-3141. [PMID: 33018670 DOI: 10.1109/embc44109.2020.9175315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The design of effective rehabilitation protocols relies on the ability to accurately assess the physical condition and the rehabilitative needs of the patient. Monitoring muscle fatigue can increase the usability of rehabilitative and restorative devices as it helps avoiding premature tiring and injury of patients whose resistance is already compromised. In this study, we collected EMG and accelerometer data from one healthy subject during a 30-minute walk on treadmill to determine the variations of muscle activation, and gait acceleration patterns, which, however subtle, could be interpreted as early indicators of muscle fatigue. Results show an increasing Tibialis Anterior (TA) and decreasing Soleus (SOL) and Gastrocnemius (GASL, GASM) activation towards the end of the task as compared to the beginning, as well as increasing acceleration peaks during the middle swing phase. By following the approach outlined here we can assess the efficiency and reduction of metabolic cost achieved by an exoskeleton. Furthermore, muscle fatigue may be linked to the efficacy of gait rehabilitation, where decreased muscle fatigue across sessions possibly indicates longer retention of benefits after training and increased walking capacity. This methodology can be used to benchmark novel exoskeletons, monitor fatigue to avoid premature tiring of patients, and optimize rehabilitation therapies.
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13
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Rinaldi L, Yeung LF, Lam PCH, Pang MYC, Tong RKY, Cheung VCK. Adapting to the Mechanical Properties and Active Force of an Exoskeleton by Altering Muscle Synergies in Chronic Stroke Survivors. IEEE Trans Neural Syst Rehabil Eng 2020; 28:2203-2213. [DOI: 10.1109/tnsre.2020.3017128] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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14
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Wood JM, Kim HE, French MA, Reisman DS, Morton SM. Use-dependent plasticity explains aftereffects in visually guided locomotor learning of a novel step length asymmetry. J Neurophysiol 2020; 124:32-39. [PMID: 32432516 DOI: 10.1152/jn.00083.2020] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Studies of upper extremity reaching show that use-dependent plasticity, or learning from repetition, plays an important role in shaping motor behaviors. Yet the impact of repetition on locomotor learning is unclear, despite the fact that gait is developed and practiced over millions of repetitions. To test whether repetition alone can induce storage of a novel walking pattern, we instructed two groups of young healthy subjects to learn an asymmetric walking pattern through two distinct learning paradigms. The first group learned a new pattern through an established visual distortion paradigm, which provided both sensory prediction error and repetition of movement patterns to induce walking aftereffects, and the second received veridical feedback with a target change, which provided only repetition (use-dependent plasticity) to induce aftereffects. When feedback was removed, both groups demonstrated aftereffects in the primary outcome, step asymmetry index. Surprisingly, despite the different task demands, both groups produced similar aftereffect magnitudes, which also had similar rates of decay, suggesting that the addition of sensory prediction errors did not improve storage of learning beyond that induced by the use-dependent process alone. To further characterize the use-dependent process, we conducted a second experiment to quantify aftereffect size in a third group who practiced double the asymmetry magnitude. This new group showed a proportionately greater magnitude of the use-dependent aftereffect. Together, these findings show that the primary driver of storage of a new step length asymmetry during visually guided locomotor learning is repetition, not sensory prediction error, and this effect scales with the learning magnitude.NEW & NOTEWORTHY Use-dependent plasticity, or learning from repetition, is an important process for upper extremity reaching tasks, but its contribution to walking is not well established. Here, we demonstrate the existence of a dose-dependent, use-dependent process during visually guided treadmill walking. We also show that sensory prediction errors, previously thought to drive aftereffects in similar locomotor learning paradigms, do not appear to play a significant role in visually driven learning of a novel step asymmetry during treadmill walking.
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Affiliation(s)
- Jonathan M Wood
- Physical Therapy Department, University of Delaware, Newark, Delaware.,Graduate Program in Biomechanics and Movement Science, University of Delaware, Newark, Delaware
| | - Hyosub E Kim
- Physical Therapy Department, University of Delaware, Newark, Delaware.,Graduate Program in Biomechanics and Movement Science, University of Delaware, Newark, Delaware
| | - Margaret A French
- Physical Therapy Department, University of Delaware, Newark, Delaware.,Graduate Program in Biomechanics and Movement Science, University of Delaware, Newark, Delaware
| | - Darcy S Reisman
- Physical Therapy Department, University of Delaware, Newark, Delaware.,Graduate Program in Biomechanics and Movement Science, University of Delaware, Newark, Delaware
| | - Susanne M Morton
- Physical Therapy Department, University of Delaware, Newark, Delaware.,Graduate Program in Biomechanics and Movement Science, University of Delaware, Newark, Delaware
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15
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Sternad D, Hogan N. Control of goal-directed movements within (or beyond) reach?: Comment on "Muscleless motor synergies and actions without movements: From motor neuroscience to cognitive robotics" by Vishwanathan Mohan et al. Phys Life Rev 2019; 30:126-129. [PMID: 30948235 PMCID: PMC7362311 DOI: 10.1016/j.plrev.2019.03.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 03/25/2019] [Indexed: 11/15/2022]
Affiliation(s)
- Dagmar Sternad
- Departments of Biology, Electrical & Computer Engineering, and Physics, Northeastern University, United States of America.
| | - Neville Hogan
- Departments of Mechanical Engineering and Brain and Cognitive Sciences, Massachusetts Institute of Technology, United States of America.
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16
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Chambers C, Kong G, Wei K, Kording K. Pose estimates from online videos show that side-by-side walkers synchronize movement under naturalistic conditions. PLoS One 2019; 14:e0217861. [PMID: 31170214 PMCID: PMC6553729 DOI: 10.1371/journal.pone.0217861] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 05/20/2019] [Indexed: 11/18/2022] Open
Abstract
Marker-less video-based pose estimation promises to allow us to do movement science on existing video databases. We revisited the old question of how people synchronize their walking using real world data. We thus applied pose estimation to 348 video segments extracted from YouTube videos of people walking in cities. As in previous, more constrained, research, we find a tendency for pairs of people to walk in phase or in anti-phase with each other. Large video databases, along with pose-estimation algorithms, promise answers to many movement questions without experimentally acquiring new data.
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Affiliation(s)
- Claire Chambers
- Department of Bioengineering and Department of Neuroscience, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Gaiqing Kong
- Department of Bioengineering and Department of Neuroscience, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| | - Kunlin Wei
- School of Psychological and Cognitive Sciences, Peking University, Beijing, China
- Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Konrad Kording
- Department of Bioengineering and Department of Neuroscience, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
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17
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Zhang Z, Sternad D. The primacy of rhythm: how discrete actions merge into a stable rhythmic pattern. J Neurophysiol 2018; 121:574-587. [PMID: 30565969 DOI: 10.1152/jn.00587.2018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study examined how humans spontaneously merge a sequence of discrete actions into a rhythmic pattern, even when periodicity is not required. Two experiments used a virtual throwing task, in which subjects performed a long sequence of discrete throwing movements, aiming to hit a virtual target. In experiment 1, subjects performed the task for 11 sessions. Although there was no instruction to perform rhythmically, the variability of the interthrow intervals decreased to a level comparable to that of synchronizing with a metronome; furthermore, dwell times shortened or even disappeared with practice. Floquet multipliers and decreasing variability of the arm trajectories estimated in state space indicated an increasing degree of dynamic stability. Subjects who achieved a higher level of periodicity and stability also displayed higher accuracy in the throwing task. To directly test whether rhythmicity affected performance, experiment 2 disrupted the evolving continuity and periodicity by enforcing a pause between successive throws. This discrete group performed significantly worse and with higher variability in their arm trajectories than the self-paced group. These findings are discussed in the context of previous neuroimaging results showing that rhythmic movements involve significantly fewer cortical and subcortical activations than discrete movements and therefore may pose a computationally more parsimonious solution. Such emerging stable rhythms in neuromotor subsystems may serve as building blocks or dynamic primitives for complex actions. The tendency for humans to spontaneously fall into a rhythm in voluntary movements is consistent with the ubiquity of rhythms at all levels of the physiological system. NEW & NOTEWORTHY When performing a series of throws to hit a target, humans spontaneously merged successive actions into a continuous approximately periodic pattern. The degree of rhythmicity and stability correlated with hitting accuracy. Enforcing irregular pauses between throws to disrupt the rhythm deteriorated performance. Stable rhythmic patterns may simplify control of movement and serve as dynamic primitives for more complex actions. This observation reveals that biological systems tend to exhibit rhythmic behavior consistent with a plethora of physiological processes.
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Affiliation(s)
- Zhaoran Zhang
- Department of Bioengineering, Northeastern University , Boston, Massachusetts
| | - Dagmar Sternad
- Department of Biology, Electrical and Computer Engineering, and Physics, Northeastern University , Boston, Massachusetts
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18
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Pruziner AL, Shaw EP, Rietschel JC, Hendershot BD, Miller MW, Wolf EJ, Hatfield BD, Dearth CL, Gentili RJ. Biomechanical and neurocognitive performance outcomes of walking with transtibial limb loss while challenged by a concurrent task. Exp Brain Res 2018; 237:477-491. [PMID: 30460393 DOI: 10.1007/s00221-018-5419-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 10/26/2018] [Indexed: 01/19/2023]
Abstract
Individuals who have sustained loss of a lower limb may require adaptations in sensorimotor and control systems to effectively utilize a prosthesis, and the interaction of these systems during walking is not clearly understood for this patient population. The aim of this study was to concurrently evaluate temporospatial gait mechanics and cortical dynamics in a population with and without unilateral transtibial limb loss (TT). Utilizing motion capture and electroencephalography, these outcomes were simultaneously collected while participants with and without TT completed a concurrent task of varying difficulty (low- and high-demand) while seated and walking. All participants demonstrated a wider base of support and more stable gait pattern when walking and completing the high-demand concurrent task. The cortical dynamics were similarly modulated by the task demand for both groups, to include a decrease in the novelty-P3 component and increase in the frontal theta/parietal alpha ratio power when completing the high-demand task, although specific differences were also observed. These findings confirm and extend prior efforts indicating that dual-task walking can negatively affect walking mechanics and/or neurocognitive performance. However, there may be limited additional cognitive and/or biomechanical impact of utilizing a prosthesis in a stable, protected environment in TT who have acclimated to ambulating with a prosthesis. These results highlight the need for future work to evaluate interactions between these cognitive-motor control systems for individuals with more proximal levels of lower limb loss, and in more challenging (ecologically valid) environments.
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Affiliation(s)
- Alison L Pruziner
- DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD, USA. .,Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA. .,Department of Rehabilitation Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
| | - Emma P Shaw
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA.,Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, USA.,Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD, USA
| | - Jeremy C Rietschel
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, USA.,Baltimore Veterans Administration Medical Center, Baltimore, MD, USA
| | - Brad D Hendershot
- DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD, USA.,Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA.,Department of Rehabilitation Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Matthew W Miller
- Center for Neuroscience, School of Kinesiology, Auburn University, Auburn, AL, USA
| | - Erik J Wolf
- DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD, USA.,Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA.,Department of Rehabilitation Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Bradley D Hatfield
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, USA.,Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD, USA
| | - Christopher L Dearth
- DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD, USA.,Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA.,Department of Rehabilitation Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Rodolphe J Gentili
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, USA.,Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD, USA.,Maryland Robotics Center, University of Maryland, College Park, MD, USA
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19
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Robinson AG, Dennett AM, Snowdon DA. Treadmill training may be an effective form of task-specific training for improving mobility in people with Parkinson's disease and multiple sclerosis: a systematic review and meta-analysis. Physiotherapy 2018; 105:174-186. [PMID: 30876717 DOI: 10.1016/j.physio.2018.11.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 11/04/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Task-specific training is an effective form of rehabilitation for improving mobility in neurological conditions. However, it remains unclear if task-specific training is effective in people with progressive disease. OBJECTIVE To establish the efficacy of task-specific training on the mobility of individuals with progressive neurological conditions. DATA SOURCES Electronic databases MEDLINE, EMBASE, CINAHL and Cochrane Database of Systematic Reviews. STUDY ELIGIBILITY CRITERIA Randomised controlled trials investigating the effect of task-specific training on mobility and falls rate in individuals with progressive neurological conditions. STUDY APPRAISAL/SYNTHESIS METHODS Risk of bias of individual studies was assessed using the Physiotherapy Evidence Database (PEDro) Scale. Mean differences (MD) and 95% confidence intervals were calculated and combined in meta-analysis. RESULTS Analysis of 16 trials found treadmill training improved comfortable walking velocity (m/second) in people with Parkinson's disease (MD 0.21m/second, 95%CI 0.15 to 0.27) and multiple sclerosis (MD 0.36m/second, 95%CI 0.20 to 0.52). Treadmill training improved stride length (m) (MD 0.12m, 95%CI 0.02 to 0.23) and step length (m) (MD 0.12m, 95%CI 0.01 to 0.23) in people with Parkinson's disease and walking endurance in people with multiple sclerosis (MD 26.53m, 95%CI 12.23 to 40.84). Treadmill training had no effect on cadence and did not improve walking endurance in Parkinson's disease. Over-ground walking did not improve mobility in Parkinson's disease or multiple sclerosis. LIMITATIONS Study sample sizes were small and findings must be interpreted with caution. CONCLUSION Treadmill training may be effective for improving mobility in people with Parkinson's disease and multiple sclerosis. The effectiveness of over-ground walking is uncertain. SYSTEMATIC REVIEW PROSPERO REGISTRATION NUMBER CRD42016047334.
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Affiliation(s)
- Alexandra G Robinson
- Department of Physiotherapy, Eastern Health, Peter James Centre, Cnr. Mahoneys Road & Burwood Highway, Burwood East VIC, 3151, Australia.
| | - Amy M Dennett
- Allied Health Clinical Research Office, Eastern Health, and School of Allied Health, La Trobe University, Victoria, Australia.
| | - David A Snowdon
- Allied Health Clinical Research Office, Eastern Health, and School of Allied Health, La Trobe University, Victoria, Australia.
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20
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Roeder L, Boonstra TW, Smith SS, Kerr GK. Dynamics of corticospinal motor control during overground and treadmill walking in humans. J Neurophysiol 2018; 120:1017-1031. [PMID: 29847229 DOI: 10.1152/jn.00613.2017] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Increasing evidence suggests cortical involvement in the control of human gait. However, the nature of corticospinal interactions remains poorly understood. We performed time-frequency analysis of electrophysiological activity acquired during treadmill and overground walking in 22 healthy, young adults. Participants walked at their preferred speed (4.2, SD 0.4 km/h), which was matched across both gait conditions. Event-related power, corticomuscular coherence (CMC), and intertrial coherence (ITC) were assessed for EEG from bilateral sensorimotor cortices and EMG from the bilateral tibialis anterior (TA) muscles. Cortical power, CMC, and ITC at theta, alpha, beta, and gamma frequencies (4-45 Hz) increased during the double support phase of the gait cycle for both overground and treadmill walking. High beta (21-30 Hz) CMC and ITC of EMG was significantly increased during overground compared with treadmill walking, as well as EEG power in theta band (4-7 Hz). The phase spectra revealed positive time lags at alpha, beta, and gamma frequencies, indicating that the EEG response preceded the EMG response. The parallel increases in power, CMC, and ITC during double support suggest evoked responses at spinal and cortical populations rather than a modulation of ongoing corticospinal oscillatory interactions. The evoked responses are not consistent with the idea of synchronization of ongoing corticospinal oscillations but instead suggest coordinated cortical and spinal inputs during the double support phase. Frequency-band dependent differences in power, CMC, and ITC between overground and treadmill walking suggest differing neural control for the two gait modalities, emphasizing the task-dependent nature of neural processes during human walking. NEW & NOTEWORTHY We investigated cortical and spinal activity during overground and treadmill walking in healthy adults. Parallel increases in power, corticomuscular coherence, and intertrial coherence during double support suggest evoked responses at spinal and cortical populations rather than a modulation of ongoing corticospinal oscillatory interactions. These findings identify neurophysiological mechanisms that are important for understanding cortical control of human gait in health and disease.
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Affiliation(s)
- Luisa Roeder
- Movement Neuroscience Group, Institute of Health and Biomedical Innovation, Queensland University of Technology , Brisbane , Australia.,School of Exercise and Nutrition Sciences, Queensland University of Technology , Brisbane , Australia
| | - Tjeerd W Boonstra
- Black Dog Institute, University of New South Wales , Sydney , Australia.,Systems Neuroscience Group, QIMR Berghofer Medical Research Institute, Brisbane , Australia
| | - Simon S Smith
- Institute of Social Science Research, University of Queensland , Brisbane , Australia
| | - Graham K Kerr
- Movement Neuroscience Group, Institute of Health and Biomedical Innovation, Queensland University of Technology , Brisbane , Australia.,School of Exercise and Nutrition Sciences, Queensland University of Technology , Brisbane , Australia
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