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Hill CM, Sebastião E, Barzi L, Wilson M, Wood T. Reinforcement feedback impairs locomotor adaptation and retention. Front Behav Neurosci 2024; 18:1388495. [PMID: 38720784 PMCID: PMC11076767 DOI: 10.3389/fnbeh.2024.1388495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 04/10/2024] [Indexed: 05/12/2024] Open
Abstract
Introduction Locomotor adaptation is a motor learning process used to alter spatiotemporal elements of walking that are driven by prediction errors, a discrepancy between the expected and actual outcomes of our actions. Sensory and reward prediction errors are two different types of prediction errors that can facilitate locomotor adaptation. Reward and punishment feedback generate reward prediction errors but have demonstrated mixed effects on upper extremity motor learning, with punishment enhancing adaptation, and reward supporting motor memory. However, an in-depth behavioral analysis of these distinct forms of feedback is sparse in locomotor tasks. Methods For this study, three groups of healthy young adults were divided into distinct feedback groups [Supervised, Reward, Punishment] and performed a novel locomotor adaptation task where each participant adapted their knee flexion to 30 degrees greater than baseline, guided by visual supervised or reinforcement feedback (Adaptation). Participants were then asked to recall the new walking pattern without feedback (Retention) and after a washout period with feedback restored (Savings). Results We found that all groups learned the adaptation task with external feedback. However, contrary to our initial hypothesis, enhancing sensory feedback with a visual representation of the knee angle (Supervised) accelerated the rate of learning and short-term retention in comparison to monetary reinforcement feedback. Reward and Punishment displayed similar rates of adaptation, short-term retention, and savings, suggesting both types of reinforcement feedback work similarly in locomotor adaptation. Moreover, all feedback enhanced the aftereffect of locomotor task indicating changes to implicit learning. Discussion These results demonstrate the multi-faceted nature of reinforcement feedback on locomotor adaptation and demonstrate the possible different neural substrates that underly reward and sensory prediction errors during different motor tasks.
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Affiliation(s)
- Christopher M. Hill
- Department of Kinesiology and Physical Education, Northern Illinois University, Dekalb, IL, United States
- School of Kinesiology, Louisiana State University, Baton Rouge, LA, United States
| | - Emerson Sebastião
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, IL, United States
| | - Leo Barzi
- Department of Kinesiology and Physical Education, Northern Illinois University, Dekalb, IL, United States
| | - Matt Wilson
- School of Allied Health and Communicative Disorders, Northern Illinois University, Dekalb, IL, United States
| | - Tyler Wood
- Department of Kinesiology and Physical Education, Northern Illinois University, Dekalb, IL, United States
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2
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Kowalczyk K, Mukherjee M, Malcolm P. Can a passive unilateral hip exosuit diminish walking asymmetry? A randomized trial. J Neuroeng Rehabil 2023; 20:88. [PMID: 37438846 DOI: 10.1186/s12984-023-01212-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/03/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Asymmetric walking gait impairs activities of daily living in neurological patient populations, increases their fall risk, and leads to comorbidities. Accessible, long-term rehabilitation methods are needed to help neurological patients restore symmetrical walking patterns. This study aimed to determine if a passive unilateral hip exosuit can modify an induced asymmetric walking gait pattern. We hypothesized that a passive hip exosuit would diminish initial- and post-split-belt treadmill walking after-effects in healthy young adults. METHODS We divided 15 healthy young adults evenly between three experimental groups that each completed a baseline trial, an adaptation period with different interventions for each group, and a post-adaptation trial. To isolate the contribution of the exosuit we compared a group adapting to the exosuit and split-belt treadmill (Exo-Sb) to groups adapting to exosuit-only (Exo-only) and split-belt only (Sb-only) conditions. The independent variables step length, stance time, and swing time symmetry were analyzed across five timepoints (baseline, early- and late adaptation, and early- and late post-adaptation) using a 3 × 5 mixed ANOVA. RESULTS We found significant interaction and time effects on step length, stance time and swing time symmetry. Sb-only produced increased step length asymmetry at early adaptation compared to baseline (p < 0.0001) and an after-effect with increased asymmetry at early post-adaptation compared to baseline (p < 0.0001). Exo-only increased step length asymmetry (in the opposite direction as Sb-only) at early adaptation compared to baseline (p = 0.0392) but did not influence the participants sufficiently to result in a post-effect. Exo-Sb produced similar changes in step length asymmetry in the same direction as Sb-only (p = 0.0014). However, in contrast to Sb-only there was no significant after-effect between early post-adaptation and baseline (p = 0.0885). CONCLUSION The passive exosuit successfully diminished asymmetrical step length after-effects induced by the split-belt treadmill in Exo-Sb. These results support the passive exosuit's ability to alter walking gait patterns.
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Affiliation(s)
- Kayla Kowalczyk
- Department of Biomechanics and Center for Research in Human Movement Variability, University of Nebraska at Omaha, 6160 University Drive, Omaha, NE, 68182-0860, USA
- UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens, GA, USA
| | - Mukul Mukherjee
- Department of Biomechanics and Center for Research in Human Movement Variability, University of Nebraska at Omaha, 6160 University Drive, Omaha, NE, 68182-0860, USA
| | - Philippe Malcolm
- Department of Biomechanics and Center for Research in Human Movement Variability, University of Nebraska at Omaha, 6160 University Drive, Omaha, NE, 68182-0860, USA.
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3
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Price M, Huber ME, Hoogkamer W. Minimum effort simulations of split-belt treadmill walking exploit asymmetry to reduce metabolic energy expenditure. J Neurophysiol 2023; 129:900-913. [PMID: 36883759 PMCID: PMC10110733 DOI: 10.1152/jn.00343.2022] [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: 08/09/2022] [Revised: 02/15/2023] [Accepted: 02/28/2023] [Indexed: 03/09/2023] Open
Abstract
Walking on a split-belt treadmill elicits an adaptation response that changes baseline step length asymmetry. The underlying causes of this adaptation, however, are difficult to determine. It has been proposed that effort minimization may drive this adaptation, based on the idea that adopting longer steps on the fast belt, or positive step length asymmetry (SLA), can cause the treadmill to exert net-positive mechanical work on a bipedal walker. However, humans walking on split-belt treadmills have not been observed to reproduce this behavior when allowed to freely adapt. To determine if an effort-minimization motor control strategy would result in experimentally observed adaptation patterns, we conducted simulations of walking on different combinations of belt speeds with a human musculoskeletal model that minimized muscle excitations and metabolic rate. The model adopted increasing amounts of positive SLA and decreased its net metabolic rate with increasing belt speed difference, reaching +42.4% SLA and -5.7% metabolic rate relative to tied-belt walking at our maximum belt speed ratio of 3:1. These gains were primarily enabled by an increase in braking work and a reduction in propulsion work on the fast belt. The results suggest that a purely effort minimization driven split-belt walking strategy would involve substantial positive SLA, and that the lack of this characteristic in human behavior points to additional factors influencing the motor control strategy, such as aversion to excessive joint loads, asymmetry, or instability.NEW & NOTEWORTHY Behavioral observations of split-belt treadmill adaptation have been inconclusive toward its underlying causes. To estimate gait patterns when driven exclusively by one of these possible underlying causes, we simulated split-belt treadmill walking with a musculoskeletal model that minimized its summed muscle excitations. Our model took significantly longer steps on the fast belt and reduced its metabolic rate below tied-belt walking, unlike experimental observations. This suggests that asymmetry is energetically optimal, but human adaptation involves additional factors.
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Affiliation(s)
- Mark Price
- Department of Kinesiology, University of Massachusetts, Amherst, Massachusetts, United States
- Department of Mechanical and Industrial Engineering, University of Massachusetts, Amherst, Massachusetts, United States
| | - Meghan E Huber
- Department of Mechanical and Industrial Engineering, University of Massachusetts, Amherst, Massachusetts, United States
| | - Wouter Hoogkamer
- Department of Kinesiology, University of Massachusetts, Amherst, Massachusetts, United States
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4
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Hirata K, Hanawa H, Miyazawa T, Masugi Y. Movement-synchronized cerebellum rhythm coordinates multi-joint movements in young and elderly adults. Biol Open 2023; 12:286723. [PMID: 36688850 PMCID: PMC10003071 DOI: 10.1242/bio.059776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/13/2023] [Indexed: 01/24/2023] Open
Abstract
Rhythmic limb multi-joint movement like locomotion is controlled by intralimb coordination. Intralimb coordination changes entail immediate alterations in movement patterns and be related with cerebellum function. Synchronized cerebellum activity has known to modulate the frequency of walking, but not known the effect of only intralimb coordination. The purpose of this study was to reveal the effect of synchronized and unsynchronized cerebellum activity on the coordination of multi-joint movements of the unilateral leg in young and elderly people. To achieve our purpose, we applied synchronized and unsynchronized cerebellum transcranial alternating current stimulation during cyclic unilateral multi-joint movement by visual tracking task. The results showed that the reduction in comprehensive synchrony between targets and movements through trials had no significant differences under all stimulus conditions in young and elderly people. However, the reduction in variation of synchronization through trials was significantly smaller under the synchronized transcranial alternating current stimulation condition in both young and elderly groups. Variation of synchronization was remarkably reduced under the synchronized transcranial alternating current stimulation condition for the elderly group. This study showed that movement-synchronized cerebellum activity contributes to reducing fluctuations in movement synchrony by coordinating unilateral multi-joint movements. Moreover, this reduction was remarkable in the elderly group.
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Affiliation(s)
- Keisuke Hirata
- Department of Rehabilitation, Faculty of Health Sciences, Tokyo Kasei University, Saitama, 350-1398, Japan.,Graduate Course of Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, 343-8540, Japan
| | - Hiroki Hanawa
- Department of Rehabilitation, Faculty of Health Science, University of Human Arts and Sciences, Saitama, 339-8555, Japan
| | - Taku Miyazawa
- Graduate Course of Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, 343-8540, Japan.,Department of Rehabilitation, Faculty of Health Science, University of Human Arts and Sciences, Saitama, 339-8555, Japan
| | - Yohei Masugi
- Department of Physical Therapy, School of Health Sciences, Tokyo International University, Saitama, 350-1197, Japan
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5
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Lora-Millan JS, Sanchez-Cuesta FJ, Romero JP, Moreno JC, Rocon E. A unilateral robotic knee exoskeleton to assess the role of natural gait assistance in hemiparetic patients. J Neuroeng Rehabil 2022; 19:109. [PMID: 36209096 PMCID: PMC9548210 DOI: 10.1186/s12984-022-01088-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 09/29/2022] [Indexed: 11/30/2022] Open
Abstract
Background Hemiparetic gait is characterized by strong asymmetries that can severely affect the quality of life of stroke survivors. This type of asymmetry is due to motor deficits in the paretic leg and the resulting compensations in the nonparetic limb. In this study, we aimed to evaluate the effect of actively promoting gait symmetry in hemiparetic patients by assessing the behavior of both paretic and nonparetic lower limbs. This paper introduces the design and validation of the REFLEX prototype, a unilateral active knee–ankle–foot orthosis designed and developed to naturally assist the paretic limbs of hemiparetic patients during gait. Methods REFLEX uses an adaptive frequency oscillator to estimate the continuous gait phase of the nonparetic limb. Based on this estimation, the device synchronically assists the paretic leg following two different control strategies: (1) replicating the movement of the nonparetic leg or (2) inducing a healthy gait pattern for the paretic leg. Technical validation of the system was implemented on three healthy subjects, while the effect of the generated assistance was assessed in three stroke patients. The effects of this assistance were evaluated in terms of interlimb symmetry with respect to spatiotemporal gait parameters such as step length or time, as well as the similarity between the joint’s motion in both legs. Results Preliminary results proved the feasibility of the REFLEX prototype to assist gait by reinforcing symmetry. They also pointed out that the assistance of the paretic leg resulted in a decrease in the compensatory strategies developed by the nonparetic limb to achieve a functional gait. Notably, better results were attained when the assistance was provided according to a standard healthy pattern, which initially might suppose a lower symmetry but enabled a healthier evolution of the motion of the nonparetic limb. Conclusions This work presents the preliminary validation of the REFLEX prototype, a unilateral knee exoskeleton for gait assistance in hemiparetic patients. The experimental results indicate that assisting the paretic leg of a hemiparetic patient based on the movement of their nonparetic leg is a valuable strategy for reducing the compensatory mechanisms developed by the nonparetic limb.
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Affiliation(s)
- Julio Salvador Lora-Millan
- Centro de Automática y Robótica, Consejo Superior de Investigaciones Científicas - Universidad Politécnica de Madrid, Madrid, Spain. .,Electronic Technology Department, Universidad Rey Juan Carlos, Madrid, Spain.
| | | | - Juan Pablo Romero
- Facultad de Ciencias Experimentales, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain.,Brain Damage Unit, Hospital Beata María Ana, Madrid, Spain
| | - Juan C Moreno
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Madrid, Spain
| | - Eduardo Rocon
- Centro de Automática y Robótica, Consejo Superior de Investigaciones Científicas - Universidad Politécnica de Madrid, Madrid, Spain
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6
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Mitoma H, Kakei S, Manto M. Development of Cerebellar Reserve. Cells 2022; 11:cells11193013. [PMID: 36230975 PMCID: PMC9562018 DOI: 10.3390/cells11193013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/22/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022] Open
Abstract
The cerebellar reserve is defined as the capacity of the cerebellum for compensation and restoration following injury. This unique cerebellar ability is attributed to various forms of synaptic plasticity that incorporate multimodal and redundant cerebellar inputs, two major features of the cerebellar circuitry. It is assumed that the cerebellar reserve is acquired from the age of 12 years after the maturation of both the cerebellar adaptative behaviors and cerebellar functional connectivity. However, acquiring the cerebellar reserve is also affected by two other factors: vulnerability and growth potential in the developing cerebellum. First, cerebellar injury during the critical period of neural circuit formation (especially during fetal and neonatal life and infancy) leads to persistent dysfunction of the cerebellum and its targets, resulting in the limitation of the cerebellar reserve. Secondly, growth potential appears to facilitate cerebellar reserve during the stage when the cerebellar reserve is still immature. Based on these findings, the present mini-review proposes a possible developmental trajectory underlying the acquisition of cerebellar reserve. We highlight the importance of studies dedicated to the understanding of the cerebellar resilience to injuries.
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Affiliation(s)
- Hiroshi Mitoma
- Department of Medical Education, Tokyo Medical University, Tokyo 160-0023, Japan
- Correspondence:
| | - Shinji Kakei
- Department of Anatomy and Physiology, Jissen Women’s University, Tokyo 191-8510, Japan
| | - Mario Manto
- Service de Neurologie, Médiathèque Jean Jacquy, CHU-Charleroi, 6000 Charleroi, Belgium
- Service des Neurosciences, University of Mons, 7000 Mons, Belgium
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7
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Cabaraux P, Agrawal SK, Cai H, Calabro RS, Casali C, Damm L, Doss S, Habas C, Horn AKE, Ilg W, Louis ED, Mitoma H, Monaco V, Petracca M, Ranavolo A, Rao AK, Ruggieri S, Schirinzi T, Serrao M, Summa S, Strupp M, Surgent O, Synofzik M, Tao S, Terasi H, Torres-Russotto D, Travers B, Roper JA, Manto M. Consensus Paper: Ataxic Gait. CEREBELLUM (LONDON, ENGLAND) 2022; 22:394-430. [PMID: 35414041 DOI: 10.1007/s12311-022-01373-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/20/2022] [Indexed: 12/19/2022]
Abstract
The aim of this consensus paper is to discuss the roles of the cerebellum in human gait, as well as its assessment and therapy. Cerebellar vermis is critical for postural control. The cerebellum ensures the mapping of sensory information into temporally relevant motor commands. Mental imagery of gait involves intrinsically connected fronto-parietal networks comprising the cerebellum. Muscular activities in cerebellar patients show impaired timing of discharges, affecting the patterning of the synergies subserving locomotion. Ataxia of stance/gait is amongst the first cerebellar deficits in cerebellar disorders such as degenerative ataxias and is a disabling symptom with a high risk of falls. Prolonged discharges and increased muscle coactivation may be related to compensatory mechanisms and enhanced body sway, respectively. Essential tremor is frequently associated with mild gait ataxia. There is growing evidence for an important role of the cerebellar cortex in the pathogenesis of essential tremor. In multiple sclerosis, balance and gait are affected due to cerebellar and spinal cord involvement, as a result of disseminated demyelination and neurodegeneration impairing proprioception. In orthostatic tremor, patients often show mild-to-moderate limb and gait ataxia. The tremor generator is likely located in the posterior fossa. Tandem gait is impaired in the early stages of cerebellar disorders and may be particularly useful in the evaluation of pre-ataxic stages of progressive ataxias. Impaired inter-joint coordination and enhanced variability of gait temporal and kinetic parameters can be grasped by wearable devices such as accelerometers. Kinect is a promising low cost technology to obtain reliable measurements and remote assessments of gait. Deep learning methods are being developed in order to help clinicians in the diagnosis and decision-making process. Locomotor adaptation is impaired in cerebellar patients. Coordinative training aims to improve the coordinative strategy and foot placements across strides, cerebellar patients benefiting from intense rehabilitation therapies. Robotic training is a promising approach to complement conventional rehabilitation and neuromodulation of the cerebellum. Wearable dynamic orthoses represent a potential aid to assist gait. The panel of experts agree that the understanding of the cerebellar contribution to gait control will lead to a better management of cerebellar ataxias in general and will likely contribute to use gait parameters as robust biomarkers of future clinical trials.
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Affiliation(s)
- Pierre Cabaraux
- Unité Des Ataxies Cérébelleuses, Department of Neurology, CHU de Charleroi, Charleroi, Belgium.
| | | | - Huaying Cai
- Department of Neurology, Neuroscience Center, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310016, China
| | | | - Carlo Casali
- Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, Latina, Italy
| | - Loic Damm
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, Montpellier, France
| | - Sarah Doss
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, USA
| | - Christophe Habas
- Université Versailles Saint-Quentin, Versailles, France.,Service de NeuroImagerie, Centre Hospitalier National des 15-20, Paris, France
| | - Anja K E Horn
- Institute of Anatomy and Cell Biology I, Ludwig Maximilians-University Munich, Munich, Germany
| | - Winfried Ilg
- Section Computational Sensomotorics, Hertie Institute for Clinical Brain Research, University Tübingen, Tübingen, Germany
| | - Elan D Louis
- Department of Neurology, University of Texas Southwestern, Dallas, TX, USA
| | - Hiroshi Mitoma
- Department of Medical Education, Tokyo Medical University, Tokyo, Japan
| | - Vito Monaco
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Maria Petracca
- Department of Human Neurosciences, University of Rome Sapienza, Rome, Italy
| | - Alberto Ranavolo
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, Rome, Italy
| | - Ashwini K Rao
- Department of Rehabilitation & Regenerative Medicine (Programs in Physical Therapy), Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Serena Ruggieri
- Department of Human Neurosciences, University of Rome Sapienza, Rome, Italy.,Neuroimmunology Unit, IRCSS Fondazione Santa Lucia, Rome, Italy
| | - Tommaso Schirinzi
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Mariano Serrao
- Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, Latina, Italy.,Movement Analysis LAB, Policlinico Italia, Rome, Italy
| | - Susanna Summa
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy
| | - Michael Strupp
- Department of Neurology and German Center for Vertigo and Balance Disorders, Hospital of the Ludwig Maximilians-University Munich, Munich, Germany
| | - Olivia Surgent
- Neuroscience Training Program and Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Matthis Synofzik
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research and Centre of Neurology, Tübingen, Germany
| | - Shuai Tao
- Dalian Key Laboratory of Smart Medical and Health, Dalian University, Dalian, 116622, China
| | - Hiroo Terasi
- Department of Neurology, Tokyo Medical University, Tokyo, Japan
| | - Diego Torres-Russotto
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, USA
| | - Brittany Travers
- Department of Kinesiology and Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Jaimie A Roper
- School of Kinesiology, Auburn University, Auburn, AL, USA
| | - Mario Manto
- Unité Des Ataxies Cérébelleuses, Department of Neurology, CHU de Charleroi, Charleroi, Belgium.,Service Des Neurosciences, University of Mons, UMons, Mons, Belgium
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Rossi C, Roemmich RT, Schweighofer N, Bastian AJ, Leech KA. Younger and Late Middle-Aged Adults Exhibit Different Patterns of Cognitive-Motor Interference During Locomotor Adaptation, With No Disruption of Savings. Front Aging Neurosci 2021; 13:729284. [PMID: 34899267 PMCID: PMC8664558 DOI: 10.3389/fnagi.2021.729284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 10/21/2021] [Indexed: 11/13/2022] Open
Abstract
It has been proposed that motor adaptation and subsequent savings (or faster relearning) of an adapted movement pattern are mediated by cognitive processes. Here, we evaluated the pattern of cognitive-motor interference that emerges when young and late middle-aged adults perform an executive working memory task during locomotor adaptation. We also asked if this interferes with savings of a newly learned walking pattern, as has been suggested by a study of reaching adaptation. We studied split-belt treadmill adaptation and savings in young (21 ± 2 y/o) and late middle-aged (56 ± 6 y/o) adults with or without a secondary 2-back task during adaptation. We found that young adults showed similar performance on the 2-back task during baseline and adaptation, suggesting no effect of the dual-task on cognitive performance; however, dual-tasking interfered with adaptation over the first few steps. Conversely, dual-tasking caused a decrement in cognitive performance in late middle-aged adults with no effect on adaptation. To determine if this effect was specific to adaptation, we also evaluated dual-task interference in late middle-aged adults that dual-tasked while walking in a complex environment that did not induce motor adaptation. This group exhibited less cognitive-motor interference than late middle-aged adults who dual-tasked during adaptation. Savings was unaffected by dual-tasking in both young and late middle-aged adults, which may indicate different underlying mechanisms for savings of reaching and walking. Collectively, our findings reveal an age-dependent effect of cognitive-motor interference during dual-task locomotor adaptation and no effect of dual-tasking on savings, regardless of age. Young adults maintain cognitive performance and show a mild decrement in locomotor adaptation, while late middle-aged adults adapt locomotion at the expense of cognitive performance.
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Affiliation(s)
- Cristina Rossi
- Center for Movement Studies, Kennedy Krieger Institute, Baltimore, MD, United States
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Ryan T. Roemmich
- Center for Movement Studies, Kennedy Krieger Institute, Baltimore, MD, United States
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Nicolas Schweighofer
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, United States
| | - Amy J. Bastian
- Center for Movement Studies, Kennedy Krieger Institute, Baltimore, MD, United States
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Kristan A. Leech
- Center for Movement Studies, Kennedy Krieger Institute, Baltimore, MD, United States
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, United States
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9
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Fettrow T, Hupfeld K, Reimann H, Choi J, Hass C, Seidler R. Age differences in adaptation of medial-lateral gait parameters during split-belt treadmill walking. Sci Rep 2021; 11:21148. [PMID: 34707122 PMCID: PMC8551204 DOI: 10.1038/s41598-021-00515-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 10/12/2021] [Indexed: 11/10/2022] Open
Abstract
The split-belt treadmill has been used to examine the adaptation of spatial and temporal gait parameters. Historically, similar studies have focused on anterior-posterior (AP) spatiotemporal gait parameters because this paradigm is primarily a perturbation in the AP direction, but it is important to understand whether and how medial-lateral (ML) control adapts in this scenario. The ML control of balance must be actively controlled and adapted in different walking environments. Furthermore, it is well established that older adults have balance difficulties. Therefore, we seek to determine whether ML balance adaptation differs in older age. We analyzed split belt induced changes in gait parameters including variables which inform us about ML balance control in younger and older adults. Our primary finding is that younger adults showed sustained asymmetric changes in these ML balance parameters during the split condition. Specifically, younger adults sustained a greater displacement between their fast stance foot and their upper body, relative to the slow stance foot, in the ML direction. This finding suggests that younger adults may be exploiting passive dynamics in the ML direction, which may be more metabolically efficient. Older adults did not display the same degree of asymmetry, suggesting older adults may be more concerned about maintaining a stable gait.
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Affiliation(s)
- Tyler Fettrow
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32605, USA.
| | - Kathleen Hupfeld
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32605, USA
| | - Hendrik Reimann
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, 19713, USA
| | - Julia Choi
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32605, USA
| | - Chris Hass
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32605, USA
| | - Rachael Seidler
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32605, USA
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10
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Sato S, Choi JT. Neural Control of Human Locomotor Adaptation: Lessons about Changes with Aging. Neuroscientist 2021; 28:469-484. [PMID: 34014124 DOI: 10.1177/10738584211013723] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Walking patterns are adaptable in response to different environmental demands, which requires neural input from spinal and supraspinal structures. With an increase in age, there are changes in walking adaptation and in the neural control of locomotion, but the age-related changes in the neural control of locomotor adaptation is unclear. The purpose of this narrative review is to establish a framework where the age-related changes of neural control of human locomotor adaptation can be understood in terms of reactive feedback and predictive feedforward control driven by sensory feedback during locomotion. We parse out the effects of aging on (a) reactive adaptation to split-belt walking, (b) predictive adaptation to split-belt walking, (c) reactive visuomotor adaptation, and (d) predictive visuomotor adaptation, and hypothesize that specific neural circuits are influenced differentially with age, which influence locomotor adaptation. The differences observed in the age-related changes in walking adaptation across different locomotor adaptation paradigms will be discussed in light of the age-related changes in the neural mechanisms underlying locomotion.
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Affiliation(s)
- Sumire Sato
- Neuroscience and Behavior Program, University of Massachusetts Amherst, Amherst, MA, USA.,Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - Julia T Choi
- Neuroscience and Behavior Program, University of Massachusetts Amherst, Amherst, MA, USA.,Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
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Hinton DC, Conradsson DM, Paquette C. Understanding Human Neural Control of Short-term Gait Adaptation to the Split-belt Treadmill. Neuroscience 2020; 451:36-50. [DOI: 10.1016/j.neuroscience.2020.09.055] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 09/22/2020] [Accepted: 09/27/2020] [Indexed: 12/31/2022]
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12
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Cerebral Contribution to the Execution, But Not Recalibration, of Motor Commands in a Novel Walking Environment. eNeuro 2020; 7:ENEURO.0493-19.2020. [PMID: 32001549 PMCID: PMC7053171 DOI: 10.1523/eneuro.0493-19.2020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 12/24/2019] [Accepted: 01/03/2020] [Indexed: 11/25/2022] Open
Abstract
Human movements are flexible as they continuously adapt to changes in the environment. The recalibration of corrective responses to sustained perturbations (e.g., constant force) altering one’s movement contributes to this flexibility. We asked whether the recalibration of corrective actions involve cerebral structures using stroke as a disease model. We characterized changes in muscle activity in stroke survivors and control subjects before, during, and after walking on a split-belt treadmill moving the legs at different speeds. The recalibration of corrective muscle activity was comparable between stroke survivors and control subjects, which was unexpected given the known deficits in feedback responses poststroke. Also, the intact recalibration in stroke survivors contrasted their limited ability to adjust their muscle activity during steady-state split-belt walking. Our results suggest that the recalibration and execution of motor commands are partially dissociable: cerebral lesions interfere with the execution, but not the recalibration, of motor commands on novel movement demands.
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13
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Sathyanesan A, Gallo V. Cerebellar contribution to locomotor behavior: A neurodevelopmental perspective. Neurobiol Learn Mem 2019; 165:106861. [PMID: 29723669 PMCID: PMC7303045 DOI: 10.1016/j.nlm.2018.04.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 04/06/2018] [Accepted: 04/24/2018] [Indexed: 12/30/2022]
Abstract
The developmental trajectory of the formation of cerebellar circuitry has significant implications for locomotor plasticity and adaptive learning at later stages. While there is a wealth of knowledge on the development of locomotor behavior in human infants, children, and adolescents, pre-clinical animal models have fallen behind on the study of the emergence of behavioral motifs in locomotor function across postnatal development. Since cerebellar development is protracted, it is subject to higher risk of genetic or environmental disruption, potentially leading to abnormal behavioral development. This highlights the need for more sophisticated and specific functional analyses of adaptive cerebellar behavior within the context of whole-body locomotion across the entire span of postnatal development. Here we review evidence on cerebellar contribution to adaptive locomotor behavior, highlighting methodologies employed to quantify and categorize behavior at different developmental stages, with the ultimate goal of following the course of early behavioral alterations in neurodevelopmental disorders. Since experimental paradigms used to study cerebellar behavior are lacking in both specificity and applicability to locomotor contexts, we highlight the use of the Erasmus Ladder - an advanced, computerized, fully automated system to quantify adaptive cerebellar learning in conjunction with locomotor function. Finally, we emphasize the need to develop objective, quantitative, behavioral tasks which can track changes in developmental trajectories rather than endpoint measurement at the adult stage of behavior.
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Affiliation(s)
- Aaron Sathyanesan
- Center for Neuroscience Research, Children's Research Institute, Children's National Health System, Washington, DC, USA.
| | - Vittorio Gallo
- Center for Neuroscience Research, Children's Research Institute, Children's National Health System, Washington, DC, USA; George Washington University School of Medicine and Health Sciences, USA
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14
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Roper JA, Brinkerhoff SA, Harrison BR, Schmitt AC, Roemmich RT, Hass CJ. Persons with essential tremor can adapt to new walking patterns. J Neurophysiol 2019; 122:1598-1605. [DOI: 10.1152/jn.00320.2019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Essential tremor (ET) is a common movement disorder that causes motor deficits similar to those seen in cerebellar disorders. These include kinetic tremor, gait ataxia, and impaired motor adaptation. Previous studies of motor adaptation in ET have focused on reaching while the effects of ET on gait adaptation are currently unknown. The purpose of this study was to contrast locomotor adaptation in persons with and without ET. We hypothesized that persons with ET would show impaired gait adaptation. In a cross-sectional study, persons with ET ( n = 14) and healthy matched controls ( n = 12) walked on a split-belt treadmill. Participants walked with the belts moving at a 2:1 ratio, followed by overground walking to test transfer, followed by a readaptation period and finally a deadaptation period. Step length asymmetry was measured to assess the rate of adaptation, amount of transfer, and rates of readaptation and deadaptation. Spatial, temporal, and velocity contributions to step length asymmetry were analyzed during adaptation. There were no group by condition interactions in step length asymmetry or contributions to step length asymmetry. Regardless of condition, persons with ET walked slower and exhibited lower temporal ( P < 0.001) and velocity ( P = 0.001) contributions to step length asymmetry than controls. Persons with ET demonstrated a preserved ability to adapt to, store, and transfer a new walking pattern. Despite probable cerebellar involvement in ET, locomotor adaptation is an available mechanism to teach persons with ET new gait patterns. NEW & NOTEWORTHY This study is the first to investigate walking adaptation abilities of people with essential tremor. Despite evidence of cerebellar impairment in this population, people with essential tremor can adapt their walking patterns. However, people with essential tremor do not modulate the timing of their footsteps to meet walking demands. Therefore, this study is the first to report impairments in the temporal aspects of walking in people with essential tremor during both typical and locomotor learning.
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Affiliation(s)
| | | | - Benjamin R. Harrison
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida
| | - Abigail C. Schmitt
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida
| | - Ryan T. Roemmich
- Center for Movement Studies, Kennedy Krieger Institute, Baltimore, Maryland
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Chris J. Hass
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida
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15
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Making Sense of Cerebellar Contributions to Perceptual and Motor Adaptation. THE CEREBELLUM 2019; 17:111-121. [PMID: 28840476 DOI: 10.1007/s12311-017-0879-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The cerebellum is thought to adapt movements to changes in the environment in order to update an implicit understanding of the association between our motor commands and their sensory consequences. This trial-by-trial motor recalibration in response to external perturbations is frequently impaired in people with cerebellar damage. In healthy people, adaptation to motor perturbations is also known to induce a form of sensory perceptual recalibration. For instance, hand-reaching adaptation tasks produce transient changes in the sense of hand position, and walking adaptation tasks can lead to changes in perceived leg speed. Though such motor adaptation tasks are heavily dependent on the cerebellum, it is not yet understood how the cerebellum is associated with these accompanying sensory recalibration processes. Here we asked if the cerebellum is required for the recalibration of leg-speed perception that normally occurs alongside locomotor adaptation, as well as how ataxia severity is related to sensorimotor recalibration deficits in patients with cerebellar damage. Cerebellar patients performed a speed-matching task to assess perception of leg speed before and after walking on a split-belt treadmill, which has two belts driving each leg at a different speed. Healthy participants update their perception of leg speed following split-belt walking such that the "fast" leg during adaptation feels slower afterwards, whereas cerebellar patients have significant deficits in this sensory perceptual recalibration. Furthermore, our analysis demonstrates that ataxia severity is a crucial factor for both the sensory and motor adaptation impairments that affect patients with cerebellar damage.
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16
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Abstract
Walking on a split-belt treadmill (each of the two belts running at a different speed) has been proposed as an experimental paradigm to investigate the flexibility of the neural control of gait and as a form of therapeutic exercise. However, the scarcity of dynamic investigations challenges the validity of the available findings. The aim of the present study was to investigate the dynamic asymmetries of lower limbs of healthy adults during adaptation to gait on a split-belt treadmill. Ten healthy adults walked on a split-belt treadmill mounted on force sensors, with belts running either at the same speed ('tied' condition) or at different speeds ('split' condition, 0.4 vs. 0.8 or 0.8 vs. 1.2 m/s). The sagittal power and work provided by ankle, knee and hip joints, joint rotations, muscle lengthening, and surface electromyography were recorded simultaneously. Various tied/split walking sequences were requested. In the split condition a marked asymmetry between the parameters recorded from each of the two lower limbs, in particular from the ankle joint, was recorded. The work provided by the ankle (the main engine of body propulsion) was 4.8 and 2.2 times higher (in the 0.4 vs. 0.8, and 0.8 vs. 1.2 m/s conditions, respectively) compared with the slower side, and 1.2 and 1.1 times higher compared with the same speed in the tied condition. Compared with overground gait in hemiplegia, split gait entails an opposite spatial and dynamic asymmetry. The faster leg mimics the paretic limb temporally, but the unimpaired limb from the spatial and dynamic point of view. These differences challenge the proposed protocols of split gait as forms of therapeutic exercise.
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17
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Duysens J, Forner-Cordero A. Walking with perturbations: a guide for biped humans and robots. BIOINSPIRATION & BIOMIMETICS 2018; 13:061001. [PMID: 30109860 DOI: 10.1088/1748-3190/aada54] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This paper provides an update on the neural control of bipedal walking in relation to bioinspired models and robots. It is argued that most current models or robots are based on the construct of a symmetrical central pattern generator (CPG). However, new evidence suggests that CPG functioning is basically asymmetrical with its flexor half linked more tightly to the rhythm generator. The stability of bipedal gait, which is an important problem for robots and biological systems, is also addressed. While it is not possible to determine how biological biped systems guarantee stability, robot solutions can be useful to propose new hypotheses for biology. In the second part of this review, the focus is on gait perturbations, which is an important topic in robotics in view of the frequent falls of robots when faced with perturbations. From the human physiology it is known that the initial reaction often consists of a brief interruption followed by an adequate response. For instance, the successful recovery from a trip is achieved using some basic reactions (termed elevating and lowering strategies), that depend on the phase of the step cycle of the trip occurrence. Reactions to stepping unexpectedly in a hole depend on comparing expected and real feedback. Implementation of these ideas in models and robotics starts to emerge, with the most advanced robots being able to learn how to fall safely and how to deal with complicated disturbances such as provided by walking on a split-belt.
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Affiliation(s)
- Jacques Duysens
- Biomechatronics Lab., Mechatronics Department, Escola Politécnica da Universidade de São Paulo, Av. Prof. Mello Moraes, 2231, Cidade Universitária 05508-030, São Paulo-SP, Brasil. Department of Kinesiology, FaBeR, Katholieke Universiteit Leuven, Leuven, Belgium
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18
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Neonatal brain injury causes cerebellar learning deficits and Purkinje cell dysfunction. Nat Commun 2018; 9:3235. [PMID: 30104642 PMCID: PMC6089917 DOI: 10.1038/s41467-018-05656-w] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 07/16/2018] [Indexed: 11/08/2022] Open
Abstract
Premature infants are more likely to develop locomotor disorders than term infants. In a chronic sub-lethal hypoxia (Hx) mouse model of neonatal brain injury, we recently demonstrated the presence of cellular and physiological changes in the cerebellar white matter. We also observed Hx-induced delay in Purkinje cell (PC) arborization. However, the behavioral consequences of these cellular alterations remain unexplored. Using the Erasmus Ladder to study cerebellar behavior, we report the presence of locomotor malperformance and long-term cerebellar learning deficits in Hx mice. Optogenetics experiments in Hx mice reveal a profound reduction in spontaneous and photoevoked PC firing frequency. Finally, treatment with a gamma-aminobutyric acid (GABA) reuptake inhibitor partially rescues locomotor performance and improves PC firing. Our results demonstrate a long-term miscoordination phenotype characterized by locomotor malperformance and cerebellar learning deficits in a mouse model of neonatal brain injury. Our findings also implicate the developing GABA network as a potential therapeutic target for prematurity-related locomotor deficits.
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Yokoyama H, Sato K, Ogawa T, Yamamoto SI, Nakazawa K, Kawashima N. Characteristics of the gait adaptation process due to split-belt treadmill walking under a wide range of right-left speed ratios in humans. PLoS One 2018; 13:e0194875. [PMID: 29694404 PMCID: PMC5918641 DOI: 10.1371/journal.pone.0194875] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 03/12/2018] [Indexed: 11/18/2022] Open
Abstract
The adaptability of human bipedal locomotion has been studied using split-belt treadmill walking. Most of previous studies utilized experimental protocol under remarkably different split ratios (e.g. 1:2, 1:3, or 1:4). While, there is limited research with regard to adaptive process under the small speed ratios. It is important to know the nature of adaptive process under ratio smaller than 1:2, because systematic evaluation of the gait adaptation under small to moderate split ratios would enable us to examine relative contribution of two forms of adaptation (reactive feedback and predictive feedforward control) on gait adaptation. We therefore examined a gait behavior due to on split-belt treadmill adaptation under five belt speed difference conditions (from 1:1.2 to 1:2). Gait parameters related to reactive control (stance time) showed quick adjustments immediately after imposing the split-belt walking in all five speed ratios. Meanwhile, parameters related to predictive control (step length and anterior force) showed a clear pattern of adaptation and subsequent aftereffects except for the 1:1.2 adaptation. Additionally, the 1:1.2 ratio was distinguished from other ratios by cluster analysis based on the relationship between the size of adaptation and the aftereffect. Our findings indicate that the reactive feedback control was involved in all the speed ratios tested and that the extent of reaction was proportionally dependent on the speed ratio of the split-belt. On the contrary, predictive feedforward control was necessary when the ratio of the split-belt was greater. These results enable us to consider how a given split-belt training condition would affect the relative contribution of the two strategies on gait adaptation, which must be considered when developing rehabilitation interventions for stroke patients.
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Affiliation(s)
- Hikaru Yokoyama
- Department of Life Sciences, Graduate School of Arts and Sciences, University of Tokyo, Meguro, Tokyo, Japan.,Department of Rehabilitation for the Movement Functions, Research Institute, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Japan.,Japan Society for the Promotion of Science, Chiyoda, Tokyo, Japan
| | - Koji Sato
- Department of Rehabilitation for the Movement Functions, Research Institute, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Japan.,Department of Bioscience and Engineering, Graduate School of Engineering and Science, Shibaura Institute of Technology, Minuma, Saitama, Japan
| | - Tetsuya Ogawa
- Department of Life Sciences, Graduate School of Arts and Sciences, University of Tokyo, Meguro, Tokyo, Japan
| | - Shin-Ichiro Yamamoto
- Department of Bioscience and Engineering, Graduate School of Engineering and Science, Shibaura Institute of Technology, Minuma, Saitama, Japan
| | - Kimitaka Nakazawa
- Department of Life Sciences, Graduate School of Arts and Sciences, University of Tokyo, Meguro, Tokyo, Japan
| | - Noritaka Kawashima
- Department of Rehabilitation for the Movement Functions, Research Institute, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Japan
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20
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Abstract
The cerebellum plays an integral role in the control of limb and ocular movements, balance, and walking. Cerebellar disorders may be classified as sporadic or hereditary with clinical presentation varying with the extent and site of cerebellar damage and extracerebellar signs. Deficits in balance and walking reflect the cerebellum's proposed role in coordination, sensory integration, coordinate transformation, motor learning, and adaptation. Cerebellar dysfunction results in increased postural sway, hypermetric postural responses to perturbations and optokinetic stimuli, and postural responses that are poorly coordinated with volitional movement. Gait variability is characteristic and may arise from a combination of balance impairments, interlimb incoordination, and incoordination between postural activity and leg movement. Intrinsic problems with balance lead to a high prevalence of injurious falls. Evidence for pharmacologic management is limited, although aminopyridines reduce attacks in episodic ataxias and may have a role in improving gait ataxia in other conditions. Intensive exercises targeting balance and coordination lead to improvements in balance and walking but require ongoing training to maintain/maximize any effects. Noninvasive brain stimulation of the cerebellum may become a useful adjunct to therapy in the future. Walking aids, orthoses, specialized footwear and seating may be required for more severe cases of cerebellar ataxia.
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Affiliation(s)
- Jonathan F Marsden
- Department of Rehabilitation, School of Health Professions, University of Plymouth, Plymouth, United Kingdom.
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21
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Hoogkamer W, Potocanac Z, Van Calenbergh F, Duysens J. Quick foot placement adjustments during gait are less accurate in individuals with focal cerebellar lesions. Gait Posture 2017; 58:390-393. [PMID: 28888908 DOI: 10.1016/j.gaitpost.2017.08.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 07/19/2017] [Accepted: 08/30/2017] [Indexed: 02/02/2023]
Abstract
Online gait corrections are frequently used to restore gait stability and prevent falling. They require shorter response times than voluntary movements which suggests that subcortical pathways contribute to the execution of online gait corrections. To evaluate the potential role of the cerebellum in these pathways we tested the hypotheses that online gait corrections would be less accurate in individuals with focal cerebellar damage than in neurologically intact controls and that this difference would be more pronounced for shorter available response times and for short step gait corrections. We projected virtual stepping stones on an instrumented treadmill while some of the approaching stepping stones were shifted forward or backward, requiring participants to adjust their foot placement. Varying the timing of those shifts allowed us to address the effect of available response time on foot placement error. In agreement with our hypothesis, individuals with focal cerebellar lesions were less accurate in adjusting their foot placement in reaction to suddenly shifted stepping stones than neurologically intact controls. However, the cerebellar lesion group's foot placement error did not increase more with decreasing available response distance or for short step versus long step adjustments compared to the control group. Furthermore, foot placement error for the non-shifting stepping stones was also larger in the cerebellar lesion group as compared to the control group. Consequently, the reduced ability to accurately adjust foot placement during walking in individuals with focal cerebellar lesions appears to be a general movement control deficit, which could contribute to increased fall risk.
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Affiliation(s)
- Wouter Hoogkamer
- Department of Integrative Physiology, University of Colorado, Boulder, USA.
| | - Zrinka Potocanac
- Department for Automation, Biocybernetics and Robotics, Jožef Stefan Institute, Ljubljana, Slovenia
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22
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Bekkers EMJ, Hoogkamer W, Bengevoord A, Heremans E, Verschueren SMP, Nieuwboer A. Freezing-related perception deficits of asymmetrical walking in Parkinson's disease. Neuroscience 2017; 364:122-129. [PMID: 28927894 DOI: 10.1016/j.neuroscience.2017.09.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 09/07/2017] [Accepted: 09/08/2017] [Indexed: 01/21/2023]
Abstract
Patients with Parkinson's disease (PD), and especially those with freezing of gait (FOG), are known to experience impairments in gait rhythmicity, symmetry, and bilateral coordination between both legs. In the current study, we investigated whether deficits in perception of gait speed between limbs were more pronounced in freezers than in non-freezers and could explain some of these gait impairments. We also assessed cognitive ability and proprioception. Twenty-five PD patients (13 freezers, 12 non-freezers) and 12 healthy controls walked on a split-belt treadmill, while the speed of one of the belts was gradually increased. Participants had to indicate the moment at which they perceived belt speeds to be different. The main outcome variables were the number of correct responses (perception accuracy) and the difference in belt speeds at the moment the participants perceived belt speeds to be different (perception threshold). In addition, gait characteristics during both split- and tied-belt walking were determined. Results showed significantly lower perception accuracy in freezers, whereas the perception threshold did not differ between groups. During tied-belt walking, freezers exhibited more asymmetrical step lengths and limb excursions than non-freezers and healthy controls. Greater step length and limb excursions were associated with better perception, whereas more variable gait was associated with more impaired perception. The results confirm the hypothesis that freezers have impaired perception of locomotor asymmetry. While proprioceptive and cognitive ability did not explain these findings, the possible causal link with the occurrence of FOG needs further corroboration.
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Affiliation(s)
- Esther M J Bekkers
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Belgium.
| | - Wouter Hoogkamer
- Department of Integrative Physiology, University of Colorado Boulder, CO, USA.
| | - Aniek Bengevoord
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Belgium.
| | - Elke Heremans
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Belgium.
| | - Sabine M P Verschueren
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Belgium.
| | - Alice Nieuwboer
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Belgium.
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23
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Bulea TC, Stanley CJ, Damiano DL. Part 2: Adaptation of Gait Kinematics in Unilateral Cerebral Palsy Demonstrates Preserved Independent Neural Control of Each Limb. Front Hum Neurosci 2017; 11:50. [PMID: 28243195 PMCID: PMC5303755 DOI: 10.3389/fnhum.2017.00050] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 01/23/2017] [Indexed: 11/13/2022] Open
Abstract
Motor adaptation, or alteration of neural control in response to a perturbation, is a potential mechanism to facilitate motor learning for rehabilitation. Central nervous system deficits are known to affect locomotor adaptation; yet we demonstrated that similar to adults following stroke, children with unilateral brain injuries can adapt step length in response to unilateral leg weighting. Here, we extend our analysis to explore kinematic strategies underlying step length adaptation and utilize dynamical systems approaches to elucidate how neural control may differ in those with hemiplegic CP across legs and compared to typically developing controls. Ten participants with hemiplegic CP and ten age-matched controls participated in this study. Knee and hip joint kinematics were analyzed during unilateral weighting of each leg in treadmill walking to assess adaptation and presence and persistence of after-effects. Peak joint angle displacement was used to represent changes in joint angles during walking. We examined baseline and task-specific variability and local dynamic stability to evaluate neuromuscular control across groups and legs. In contrast to controls, children with unilateral CP had asymmetries in joint angle variability and local dynamic stability at baseline, showing increased variability and reduced stability in the dominant limb. Kinematic variability increased and local stability decreased during weighting of ipsilateral and contralateral limbs in both groups compared to baseline. After weight removal both measures returned to baseline. Analogous to the temporal-spatial results, children with unilateral CP demonstrated similar capability as controls to adapt kinematics to unilateral leg weighting, however, the group with CP differed across sides after weight removal with dominant limb after-effects fading more quickly than in controls. The change in kinematics did not completely return to baseline in the non-dominant limb of the CP group, producing a transient improvement in joint angle symmetry. Recent studies demonstrate that neural control of gait is multi-layered with distinct circuits for different types of walking and for each leg. Remarkably, our results demonstrate that children with unilateral brain injury retain these separate circuits for each leg during walking and, importantly, that those networks can be adapted independently from one another to improve symmetry in the short term.
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Affiliation(s)
- Thomas C Bulea
- Functional and Applied Biomechanics Section, Rehabilitation Medicine Department, National Institutes of Health, Bethesda MD, USA
| | - Christopher J Stanley
- Functional and Applied Biomechanics Section, Rehabilitation Medicine Department, National Institutes of Health, Bethesda MD, USA
| | - Diane L Damiano
- Functional and Applied Biomechanics Section, Rehabilitation Medicine Department, National Institutes of Health, Bethesda MD, USA
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24
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Abstract
Optimization of gait rehabilitation using split-belt treadmills critically depends on our understanding of the roles of somatosensory perception and sensorimotor recalibration in perceiving gait asymmetry and adapting to split-belt walking. Recent evidence justifies the hypothesis that perception of gait asymmetry is based mainly on detection of temporal mismatches between afferent inputs at the spinal level.
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Affiliation(s)
- Wouter Hoogkamer
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
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25
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Nakajima T, Suzuki S, Futatsubashi G, Ohtsuska H, Mezzarane RA, Barss TS, Klarner T, Zehr EP, Komiyama T. Regionally distinct cutaneous afferent populations contribute to reflex modulation evoked by stimulation of the tibial nerve during walking. J Neurophysiol 2016; 116:183-90. [PMID: 27075541 DOI: 10.1152/jn.01011.2015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 04/11/2016] [Indexed: 11/22/2022] Open
Abstract
During walking, cutaneous reflexes in ankle flexor muscle [tibialis anterior (TA)] evoked by tibial nerve (TIB) stimulation are predominantly facilitatory at early swing phase but reverse to suppression at late swing phase. Although the TIB innervates a large portion of the skin of the foot sole, the extent to which specific foot-sole regions contribute to the reflex reversals during walking remains unclear. Therefore, we investigated regional cutaneous contributions from discrete portions of the foot sole on reflex reversal in TA following TIB stimulation during walking. Summation effects on reflex amplitudes, when applying combined stimulation from foot-sole regions with TIB, were examined. Middle latency responses (MLRs; 70-120 ms) after TIB stimulation were strongly facilitated during the late stance to mid-swing phases and reversed to suppression just before heel (HL) strike. Both forefoot-medial (f-M) and forefoot-lateral stimulation in the foot sole induced facilitation during stance-to-swing transition phases, but HL stimulation evoked suppression during the late stance to the end of swing phases. At the stance-to-swing transition, a summation of MLR amplitude occurred only for combined f-M&TIB stimulation. However, the same was not true for the combined HL&TIB stimulation. At the swing-to-stance transition, there was a suppressive reflex summation only for HL&TIB stimulation. In contrast, this summation was not observed for the f-M&TIB stimulation. Our results suggest that reflex reversals evoked by TIB stimulation arise from distinct reflex pathways to TA produced by separate afferent populations innervating specific regions of the foot sole.
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Affiliation(s)
- Tsuyoshi Nakajima
- Department of Integrative Physiology, Kyorin University School of Medicine, Tokyo, Japan;
| | - Shinya Suzuki
- Department of Integrative Physiology, Kyorin University School of Medicine, Tokyo, Japan; Division of Sports and Health Science, Chiba University, Chiba, Japan; United Graduate School of Education, Tokyo Gakugei University, Tokyo, Japan
| | - Genki Futatsubashi
- Division of Sports and Health Science, Chiba University, Chiba, Japan; United Graduate School of Education, Tokyo Gakugei University, Tokyo, Japan; Faculty of Business and Information Sciences, Jobu University, Gunma, Japan
| | - Hiroyuki Ohtsuska
- Division of Sports and Health Science, Chiba University, Chiba, Japan; Health Sciences University of Hokkaido, School of Rehabilitation Science, Hokkaido, Japan
| | - Rinaldo A Mezzarane
- Division of Sports and Health Science, Chiba University, Chiba, Japan; Laboratory of Signal Processing and Motor Control, College of Physical Education, University of Brasília, Brasília, Brazil; Biomedical Engineering Laboratory, Escola Politécnica da Universidade de São Paulo, Telecomunicações e Controle, University of São Paulo, São Paulo, Brazil
| | - Trevor S Barss
- Rehabilitation Neuroscience Laboratory, University of Victoria, Victoria, British Columbia, Canada; Centre for Biomedical Research, University of Victoria, Victoria, British Columbia, Canada; Human Discovery Science, International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada; and
| | - Taryn Klarner
- Rehabilitation Neuroscience Laboratory, University of Victoria, Victoria, British Columbia, Canada; Centre for Biomedical Research, University of Victoria, Victoria, British Columbia, Canada; Human Discovery Science, International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada; and
| | - E Paul Zehr
- Rehabilitation Neuroscience Laboratory, University of Victoria, Victoria, British Columbia, Canada; Centre for Biomedical Research, University of Victoria, Victoria, British Columbia, Canada; Human Discovery Science, International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada; and Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - Tomoyoshi Komiyama
- Division of Sports and Health Science, Chiba University, Chiba, Japan; United Graduate School of Education, Tokyo Gakugei University, Tokyo, Japan
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26
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Hoogkamer W, Bruijn SM, Potocanac Z, Van Calenbergh F, Swinnen SP, Duysens J. Gait asymmetry during early split-belt walking is related to perception of belt speed difference. J Neurophysiol 2015. [PMID: 26203114 DOI: 10.1152/jn.00937.2014] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Gait adaptation is essential for humans to walk according to the different demands of the environment. Although locomotor adaptation has been studied in different contexts and in various patient populations, the mechanisms behind locomotor adaptation are still not fully understood. The aim of the present study was to test two opposing hypotheses about the control of split-belt walking, one based on avoidance of limping and the other on avoiding limb excursion asymmetry. We assessed how well cerebellar patients with focal lesions and healthy control participants could sense differences between belt speeds during split-belt treadmill walking and correlated this to split-belt adaptation parameters. The ability to perceive differences between belt speeds was similar between the cerebellar patients and the healthy controls. After combining all participants, we observed a significant inverse correlation between stance time symmetry and limb excursion symmetry during the early phase of split-belt walking. Participants who were better able to perceive belt speed differences (e.g., they had a lower threshold and hence were able to detect a smaller speed difference) walked with the smallest asymmetry in stance time and the largest asymmetry in limb excursion. Our data support the hypothesis that humans aim to minimize (temporal) limping rather than (spatial) limb excursion asymmetry when using their perception of belt speed differences in the early phase of adaptation to split-belt walking.
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Affiliation(s)
- Wouter Hoogkamer
- Movement Control and Neuroplasticity Research Group, Department of Kinesiology, KU Leuven, Leuven, Belgium;
| | - Sjoerd M Bruijn
- Movement Control and Neuroplasticity Research Group, Department of Kinesiology, KU Leuven, Leuven, Belgium; Department of Orthopedics, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China; MOVE Research Institute, VU University Amsterdam, Amsterdam, The Netherlands
| | - Zrinka Potocanac
- Movement Control and Neuroplasticity Research Group, Department of Kinesiology, KU Leuven, Leuven, Belgium
| | | | - Stephan P Swinnen
- Movement Control and Neuroplasticity Research Group, Department of Kinesiology, KU Leuven, Leuven, Belgium
| | - Jacques Duysens
- Movement Control and Neuroplasticity Research Group, Department of Kinesiology, KU Leuven, Leuven, Belgium; Biomechatronics Lab, Mechatronics Department, Escola Politécnica, University of Sao Paulo, Sao Paulo, Brazil
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