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Siragy T, Russo Y, Young W, Lamb SE. Comparison of over-ground and treadmill perturbations for simulation of real-world slips and trips: A systematic review. Gait Posture 2023; 100:201-209. [PMID: 36603326 DOI: 10.1016/j.gaitpost.2022.12.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 12/01/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Trips and slips increase fall risk for young and older adults. To examine recovery responses, studies utilized treadmill and/or over-ground methods to simulate real-world perturbations. However, differences in the recovery response between treadmill and over-ground perturbations remain unexamined. RESEARCH QUESTION To assess the current literature on the reactive recovery responses between over-ground- and split-belt treadmill trips and slips as well as the effect of aging on these responses. METHODS PubMed, Medline, Web of Science, SCOPUS, and Cochrane databases were searched for publications examining trips and slips in healthy young, healthy older adults, and older adults who fall. Included articles were in English, full-text accessible, and biomechanically quantified the reactive recovery responses for slips and trips during either over-ground or split-belt treadmill protocols. The initial database search yielded 1075 articles and 31 articles were included after title, abstract, and full-text screening. RESULTS For slips, 7 articles utilized lubricated surfaces while 5 articles used treadmills. Further, 3 studies examined differences between older and younger adults. For trips, 9 articles utilized obstacles and 7 used treadmills. Further, 4 articles examined differences between older and young adults and 1 article only examined older adults during over-ground trips. For both perturbations, treadmill and over-ground protocols demonstrated similar anteroposterior destabilization on the center of mass. In the mediolateral direction, over-ground slips consistently found a lateral destabilization while treadmill articles did not examine this direction. Foot placement recovery responses varied less for both perturbation directions on a treadmill compared to over-ground. SIGNIFICANCE Although treadmill and over-ground perturbations destabilize the center of mass similarly, the recovery response to these perturbations were different on treadmills. Specifically, recovery responses were more consistent for both slips and trips on treadmills. As older adults have difficulty in perturbation recovery scaling, treadmills may be limited in their ability to investigate the variety of aging impairments on perturbation recovery responses.
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Affiliation(s)
- Tarique Siragy
- University of Exeter, Department of Public Health & Sport Sciences, Exeter, UK; St. Pölten University of Applied Sciences Center of Digital Health and Social Innovation, St. Pölten, Austria.
| | - Yuri Russo
- University of Exeter, Department of Public Health & Sport Sciences, Exeter, UK.
| | - Will Young
- University of Exeter, Department of Public Health & Sport Sciences, Exeter, UK.
| | - Sallie E Lamb
- University of Exeter, Department of Public Health & Sport Sciences, Exeter, UK.
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2
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Mitchell A, Martin AE. Quantifying the effect of sagittal plane joint angle variability on bipedal fall risk. PLoS One 2022; 17:e0262749. [PMID: 35081142 PMCID: PMC8791504 DOI: 10.1371/journal.pone.0262749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 01/04/2022] [Indexed: 11/19/2022] Open
Abstract
Falls are a major issue for bipeds. For elderly adults, falls can have a negative impact on their quality of life and lead to increased medical costs. Fortunately, interventional methods are effective at reducing falls assuming they are prescribed. For biped robots, falls prevent them from completing required tasks. Thus, it is important to understand what aspects of gait increase fall risk. Gait variability may be associated with increased fall risk; however, previous studies have not investigated the variation in the movement of the legs. The purpose of this study was to determine the effect of joint angle variability on falling to determine which component(s) of variability were statistically significant. In order to investigate joint angle variability, a physics-based simulation model that captured joint angle variability as a function of time through Fourier series was used. This allowed the magnitude, the frequency mean, and the frequency standard deviation of the variability to be altered. For the values tested, results indicated that the magnitude of the variability had the most significant impact on falling, and specifically that the stance knee flexion variability magnitude was the most significant factor. This suggests that increasing the joint variability magnitude may increase fall risk, particularly if the controller is not able to actively compensate. Altering the variability frequency had little to no effect on falling.
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Affiliation(s)
- Amy Mitchell
- Department of Mechanical Engineering, The Pennsylvania State University, University Park, PA, United States of America
| | - Anne E. Martin
- Department of Mechanical Engineering, The Pennsylvania State University, University Park, PA, United States of America
- * E-mail:
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3
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Flux E, van der Krogt MM, Harlaar J, Buizer AI, Sloot LH. Functional assessment of stretch hyperreflexia in children with cerebral palsy using treadmill perturbations. J Neuroeng Rehabil 2021; 18:151. [PMID: 34663392 PMCID: PMC8522046 DOI: 10.1186/s12984-021-00940-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 09/08/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND As hyperactive muscle stretch reflexes hinder movement in patients with central nervous system disorders, they are a common target of treatment. To improve treatment evaluation, hyperactive reflexes should be assessed during activities as walking rather than passively. This study systematically explores the feasibility, reliability and validity of sudden treadmill perturbations to evoke and quantify calf muscle stretch reflexes during walking in children with neurological disorders. METHODS We performed an observational cross-sectional study including 24 children with cerebral palsy (CP; 6-16 years) and 14 typically developing children (TD; 6-15 years). Short belt accelerations were applied at three different intensities while children walked at comfortable speed. Lower leg kinematics, musculo-tendon lengthening and velocity, muscle activity and spatiotemporal parameters were measured to analyze perturbation responses. RESULTS We first demonstrated protocol feasibility: the protocol was completed by all but three children who ceased participation due to fatigue. All remaining children were able to maintain their gait pattern during perturbation trials without anticipatory adaptations in ankle kinematics, spatiotemporal parameters and muscle activity. Second, we showed the protocol's reliability: there was no systematic change in muscle response over time (P = 0.21-0.54) and a bootstrapping procedure indicated sufficient number of perturbations, as the last perturbation repetition only reduced variability by ~ 2%. Third, we evaluated construct validity by showing that responses comply with neurophysiological criteria for stretch reflexes: perturbations superimposed calf muscle lengthening (P < 0.001 for both CP and TD) in all but one participant. This elicited increased calf muscle activity (359 ± 190% for CP and 231 ± 68% for TD, both P < 0.001) in the gastrocnemius medialis muscle, which increased with perturbation intensity (P < 0.001), according to the velocity-dependent nature of stretch reflexes. Finally, construct validity was shown from a clinical perspective: stretch reflexes were 1.7 times higher for CP than TD for the gastrocnemius medialis muscle (P = 0.017). CONCLUSIONS The feasibility and reliability of the protocol, as well as the construct validity-shown by the exaggerated velocity-dependent nature of the measured responses-strongly support the use of treadmill perturbations to quantify stretch hyperreflexia during gait. We therefore provided a framework which can be used to inform clinical decision making and treatment evaluation.
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Affiliation(s)
- Eline Flux
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Boelelaan 1117, PO Box 7057, 1007MB, Amsterdam, The Netherlands.
| | - Marjolein M van der Krogt
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Boelelaan 1117, PO Box 7057, 1007MB, Amsterdam, The Netherlands
| | - Jaap Harlaar
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Boelelaan 1117, PO Box 7057, 1007MB, Amsterdam, The Netherlands
- Department Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands
- Department Orthopedics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Annemieke I Buizer
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Boelelaan 1117, PO Box 7057, 1007MB, Amsterdam, The Netherlands
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Amsterdam, The Netherlands
| | - Lizeth H Sloot
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Boelelaan 1117, PO Box 7057, 1007MB, Amsterdam, The Netherlands
- Institute for Computer Engineering, Heidelberg University, Heidelberg, Germany
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4
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Siragy T, Hill A, Nantel J. Recovery of dynamic stability during slips unaffected by arm swing in people with Parkinson's Disease. PLoS One 2021; 16:e0249303. [PMID: 33822806 PMCID: PMC8023478 DOI: 10.1371/journal.pone.0249303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 03/15/2021] [Indexed: 11/18/2022] Open
Abstract
The arm elevation strategy assists in recovering stability during slips in healthy young and elderly individuals. However, in people with Parkinson's Disease, one of the main motor symptoms affecting the upper limbs is reduced arm swing which intensifies throughout the course of the disease before becoming absent. This holds direct implications for these individuals when encountering slips as the arm elevation strategy is an integral component in the interlimb slip response to restore stability. Arm swing's effect in recovering from slips in people with Parkinson's Disease though remains unexamined. Twenty people with Parkinson's Disease (63.78 ± 8.97 years) walked with restricted and unrestricted arm swing conditions on a dual-belt treadmill where slips were induced on the least and most affected sides. Data were collected on the CAREN Extended System (Motek Medical, Amsterdam, NL). The Margin of Stability, linear and angular trunk velocities, as well as step length, time, and width were calculated. Data were examined during the slipped step and recovery step. The restricted arm swing condition, compared to unrestricted, caused a faster step time during the slipped step. Compared to the most affected leg, the least affected had a wider step width during the slipped step. During the recovery step, the least affected leg had a larger anteroposterior Margin of Stability and longer step time than the most affected. No differences between our arm swing conditions suggests that the normal arm swing in our participants was not more effective at restoring stability after an induced slip compared to when their arm motion was restricted. This may be due to the arm elevation strategy being ineffective in counteracting the slip's backward destabilization in these individuals. Differences between the legs revealed that our participants were asymmetrically impaired in their slip recovery response.
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Affiliation(s)
- Tarique Siragy
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Allen Hill
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Julie Nantel
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- * E-mail:
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Clark BC, Carson RG. Sarcopenia and Neuroscience: Learning to Communicate. J Gerontol A Biol Sci Med Sci 2021; 76:1882-1890. [PMID: 33824986 DOI: 10.1093/gerona/glab098] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Indexed: 12/11/2022] Open
Abstract
In the 1990s and early 2000s, the common definition for sarcopenia was age-related loss of skeletal muscle, and low levels of muscle mass were central to sarcopenia diagnosis. In more recent consensus definitions, however, low muscle strength displaces low muscle mass as a defining feature of sarcopenia. The change stems from growing evidence that muscle weakness is a better predictor of adverse health outcomes (e.g., mobility limitations) than muscle mass. This evidence accompanies an emerging recognition that central neural mechanisms are critical determinants of age-related changes in strength and mobility that can occur independently of variations in muscle mass. However, strikingly little practical attention is typically given to the potential role of the central nervous system in the aetiology or remediation of sarcopenia (i.e., low muscle function). In this article, we provide an overview of some mechanisms that mediate neural regulation of muscle contraction and control, and highlight the specific contributions of neural hypoexcitability, dopaminergic dysfunction, and degradation of functional and structural brain connectivity in relation to sarcopenia. We aim to enhance the lines of communication between the domains of sarcopenia and neuroscience. We believe that appreciation of the neural regulation of muscle contraction and control is fundamental to understanding sarcopenia and to developing targeted therapeutic strategies for its treatment.
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Affiliation(s)
- Brian C Clark
- Ohio Musculoskeletal & Neurological Institute and the Department of Biomedical Sciences, Ohio University, Athens, Ohio, USA
| | - Richard G Carson
- Trinity College Institute of Neuroscience and School of Psychology, Trinity College Dublin, Dublin, Ireland.,School of Psychology, Queen's University Belfast, Belfast, Northern Ireland, UK.,School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
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Handelzalts S, Steinberg-Henn F, Soroker N, Shani G, Melzer I. Characteristics of upper-extremity reactions to sudden lateral loss of balance in persons with stroke. Clin Biomech (Bristol, Avon) 2021; 82:105255. [PMID: 33515867 DOI: 10.1016/j.clinbiomech.2020.105255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 12/09/2020] [Accepted: 12/18/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Upper-extremity reactions are part of a whole-body response to counterweight the falling center of mass after unexpected balance loss. Impairments in upper-extremity reactions due to unilateral hemiparesis may contribute to stroke survivors propensity for falling. We aimed to characterize upper-extremity (paretic and non-paretic sides) reactive movements in response to lateral balance perturbations in Persons with Stroke vs. healthy controls. METHODS Twenty-six subacute persons with stroke and 15 healthy controls were exposed to multidirectional sudden unannounced surface translations in stance. Spatiotemporal parameters of upper- and lower-extremity balance responses to lateral perturbations were analyzed. FINDINGS In both groups reactive upper-extremity movement initiation preceded reactive step initiation. In response to a loss of balance toward the paretic side, persons with stroke demonstrated delayed movement initiation of both upper- and lower-extremity compared with healthy controls (In persons with stroke: 234.7 ± 60.0 msec and 227.1 ± 39.6 msec for upper extremities vs. 272.1 ± 59.1 msec for lower-extremity; and in controls: 180.1 ± 39.9 msec and 197.8 ± 61.3 msec for upper-extremities vs. 219.3 ± 40.8 msec for lower-extremity; p = 0.001, Cohen's d's: 0.59-1.03) and a greater abduction excursion in the ipsilateral upper-extremity compared with the contralateral upper-extremity (In persons with stroke: 39.3 ± 23.6 cm vs. 24.9 ± 10.1 cm, respectively; In Controls: 42.6 ± 21.8 cm vs. 29.3 ± 17.3 cm, respectively). INTERPRETATION The faster upper-extremity reactive movement reactions compared to reactive step initiation in both persons with stroke and healthy controls suggests that balance recovery is an automatic "reflex-like" response. Delayed upper-extremity reactive reactions in conditions of surface translation toward the non-paretic side in persons with stroke may increase the risk of falls in the direction of the paretic side.
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Affiliation(s)
- Shirley Handelzalts
- Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel; Loewenstein Rehabilitation Hospital, Ra'anana, Israel
| | - Flavia Steinberg-Henn
- Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel; Loewenstein Rehabilitation Hospital, Ra'anana, Israel
| | - Nachum Soroker
- Loewenstein Rehabilitation Hospital, Ra'anana, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Guy Shani
- Department of Information Systems, Faculty of Engineering Sciences, Ben-Gurion University, Beer-Sheva, Israel
| | - Itshak Melzer
- Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel.
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Siragy T, MacDonald ME, Nantel J. Restricted Arm Swing in People With Parkinson's Disease Decreases Step Length and Time on Destabilizing Surfaces. Front Neurol 2020; 11:873. [PMID: 33101159 PMCID: PMC7545030 DOI: 10.3389/fneur.2020.00873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/09/2020] [Indexed: 11/24/2022] Open
Abstract
Introduction: Fall rates in people with Parkinson's Disease range between 35 and 68% with the majority of falls occurring while walking. Initial evidence suggests that when walking without arm swing, people with Parkinson's Disease adapt their stepping foot placement as a means to preserve dynamic stability. However, it remains unexamined what arm swing's effect has on dynamic stability when walking on destabilizing surfaces. Methods: Twenty people with Parkinson's Disease (63.78 ± 8.97 years) walked with restricted and unrestricted arm swing on unperturbed, rocky, rolling-hills, and mediolateral translational surfaces. Data were collected on a split-belt treadmill CAREN Extended-System (Motek Medical, Amsterdam, NL). Bilateral averages and coefficient of variations for step time, length, and width; and mediolateral margin of stability were calculated. Results: Results were examined in three separate analyses that included arm conditions during each of the destabilizing surfaces compared to unperturbed walking (arm-rolling hills, arm-rocky, and arm-mediolateral). Compared to unrestricted arm swing, restricted arm swing reduced average step length (arm-rolling hills) and time (arm-rocky), and increased COV step time (arm-rolling hills). The arm-rolling hills analysis revealed that the most affected leg had a shorter step length than the least affected. The destabilizing surface effects revealed that during the arm-rolling hills and arm-rocky analyses, step time decreased, step width increased, and the COV for step time, length and width increased. No main effects occurred for the arm-mediolateral analysis. Conclusion: Results indicate that foot placement in response to restricted arm swing, in people with Parkinson's Disease, depends on the encountered destabilizing surface. The arm-rolling hills analysis revealed that participants appropriately reduced step length as compensation to their restricted arm swing. However, the arm-rocky analysis revealed that individuals prioritized forward progression over dynamic stability as they decreased average step time. Additionally, the increased spatiotemporal variability in response to the rocky and rolling hills conditions indicate partial foot placement adaptation to maintain an already existing level of global dynamic stability as no changes in the Margin of Stability occurred. Adaptation is further corroborated by the decreased step time and increased step width. These responses reflect attempts to pass the destabilizing terrains faster while increasing their base of support.
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Affiliation(s)
- Tarique Siragy
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | | | - Julie Nantel
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
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8
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Age-Related Differences in Arm and Trunk Responses to First and Repeated Exposure to Laterally Induced Imbalances. Brain Sci 2020; 10:brainsci10090574. [PMID: 32825342 PMCID: PMC7564542 DOI: 10.3390/brainsci10090574] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/11/2020] [Accepted: 08/14/2020] [Indexed: 11/24/2022] Open
Abstract
The objective of this study was to examine age-related differences in arm and trunk responses during first and repeated step induced balance perturbations. Young and older adults received 10 trials of unpredictable lateral platform translations. Outcomes included maximum arm and trunk displacement within 1 s of perturbation and at first foot lift off (FFLO), arm and neck muscle activity as recorded using electromyography (EMG), initial step type, balance confidence, and percentage of harness-assisted trials. Compared to young adults, older adults demonstrated greater arm and trunk angular displacements during the first trial, which were present at FFLO and negatively associated with balance confidence. Unlike young adults, recovery steps in older adults were directed towards the fall with a narrowed base of support. Over repeated trials, rapid habituation of first-trial responses of bilateral arm and trunk displacement and EMG amplitude was demonstrated in young adults, but was absent or limited in older adults. Older adults also relied more on harness assistance during balance recovery. Exaggerated arm and trunk responses to sudden lateral balance perturbations in older adults appear to influence step type and balance recovery. Associations of these persistently amplified movements with an increased reliance on harness assistance suggest that training to reduce these deficits could have positive effects in older adults with and without neurological disorders.
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9
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Siragy T, Nantel J. Absent Arm Swing and Dual Tasking Decreases Trunk Postural Control and Dynamic Balance in People With Parkinson's Disease. Front Neurol 2020; 11:213. [PMID: 32362863 PMCID: PMC7180219 DOI: 10.3389/fneur.2020.00213] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 03/09/2020] [Indexed: 11/29/2022] Open
Abstract
Introduction: Falling during walking is a common occurrence in people with Parkinson's disease and is closely associated with severe social and medical consequences. Recent evidence demonstrates that arm swing affects dynamic balance in healthy young adults; however, it remains unexamined what its effect is in people with Parkinson's disease, particularly when combined with a secondary dual task. Methods: Twenty people with Parkinson's disease (63.78 ± 8.97) walked with two arm swing conditions (absent and normal) with and without a secondary dual task. Data were collected on a split-belt treadmill CAREN Extended-System (Motek Medical, Amsterdam, NL). Average and standard deviations for trunk linear and angular velocity were calculated along with their instantaneous values (during foot strikes) in all three axes. Averages and coefficient of variations for step length, time, and width; margin of stability; and harmonic ratios were also calculated. Results: Compared with normal arm swing, absent arm swing reduced the least affected leg's average step length and increased its step length coefficient of variation while increasing step time coefficient of variation in the most affected leg. Further, absent arm swing reduced trunk anteroposterior instantaneous angular velocity (least affected leg) and reduced anteroposterior instantaneous linear velocity (bilaterally). For the vertical axis, absent arm swing increased the trunk's average angular velocity but reduced its instantaneous linear velocity and angular velocity standard deviation (least affected leg). Additionally, the margin of stability increased when the arms were absent (least affected leg). Alternatively, dual tasking reduced average step time (most affected leg) and increased the step width coefficient of variation (bilaterally). Additionally, dual tasking increased the mediolateral average angular velocity, instantaneous linear velocity standard deviation (bilaterally), and instantaneous angular velocity standard deviation (least affected leg). For the vertical axis, dual tasking increased average linear and angular velocity standard deviation as well as instantaneous angular velocity standard deviation (bilaterally). Conclusion: Findings suggest that participants attempted to control extraneous trunk movement (due to absent arm swing) through compensatory responses in both lower and upper extremities. However, participants appeared to predominately compensate on their least affected side. Contrastingly, modifying mediolateral foot placement appeared to be the main means of maintaining walking stability while dual tasking.
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Affiliation(s)
- Tarique Siragy
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Julie Nantel
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
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10
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Zhang Y, Smeets JBJ, Brenner E, Verschueren S, Duysens J. Fast responses to stepping-target displacements when walking. J Physiol 2020; 598:1987-2000. [PMID: 32128815 PMCID: PMC7317495 DOI: 10.1113/jp278986] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 03/02/2020] [Indexed: 11/25/2022] Open
Abstract
Key points Goal‐directed arm movements can be adjusted at short latency to target shifts. We tested whether similar adjustments are present during walking on a treadmill with shifting stepping targets. Participants responded at short latency with an adequate gain to small shifts of the stepping targets. Movements of the feet during walking are controlled in a similar way to goal‐directed arm movements if balance is not violated.
Abstract It is well‐known that goal‐directed hand movements can be adjusted to small changes in target location with a latency of about 100 ms. We tested whether people make similar fast adjustments when a target location for foot placement changes slightly as they walk over a flat surface. Participants walked at 3 km/h on a treadmill on which stepping stones were projected. The stones were 50 cm apart in the walking direction. Every 5–8 steps, a stepping stone was unexpectedly displaced by 2.5 cm in the medio‐lateral direction. The displacement took place during the first half of the swing phase. We found fast adjustments of the foot trajectory, with a latency of about 155 ms, initiated by changes in muscle activation 123 ms after the perturbation. The responses corrected for about 80% of the perturbation. We conclude that goal‐directed movements of the foot are controlled in a similar way to those of the hand, thus also giving very fast adjustments. Goal‐directed arm movements can be adjusted at short latency to target shifts. We tested whether similar adjustments are present during walking on a treadmill with shifting stepping targets. Participants responded at short latency with an adequate gain to small shifts of the stepping targets. Movements of the feet during walking are controlled in a similar way to goal‐directed arm movements if balance is not violated.
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Affiliation(s)
- Yajie Zhang
- Department of Rehabilitation Sciences, FaBer, KU Leuven, Leuven, Belgium.,Department of Human Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jeroen B J Smeets
- Department of Human Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Eli Brenner
- Department of Human Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sabine Verschueren
- Department of Rehabilitation Sciences, FaBer, KU Leuven, Leuven, Belgium
| | - Jacques Duysens
- Motor Control Laboratory, Movement Control and Neuroplasticity Research Group, FaBeR, KU Leuven, Leuven, Belgium
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Siragy T, Mezher C, Hill A, Nantel J. Active arm swing and asymmetric walking leads to increased variability in trunk kinematics in young adults. J Biomech 2019; 99:109529. [PMID: 31839359 DOI: 10.1016/j.jbiomech.2019.109529] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/17/2019] [Accepted: 11/17/2019] [Indexed: 11/25/2022]
Abstract
Fall induced injuries are a leading cause for occupational injuries with the majority originating from challenging same-level walking surfaces. Despite current perturbation and fall prevention paradigms, occupational fall prevalence remains stable. Typically, these paradigms do not account for arm swing which has been demonstrated to affect the center of mass' movement during walking. This study examined the effect of different arm swing on postural control during symmetric and asymmetric walking. Fifteen healthy young adults (age = 23.4 ± 2.8) walked symmetrically and asymmetrically with three arm motions (normal, held, and active) on a split-belt treadmill CAREN Extended-System (Motek Medical, Amsterdam, NL). Mean, standard deviation and maximal values of trunk linear and angular velocity, and whole-body angular momentum were calculated in all three axes; additionally, step length, time and width mean and Coefficient of Variation, Margin of Stability and Harmonic Ratios were calculated. Compared to normal and held conditions, active arm increased trunk linear and angular velocity standard deviation, max velocity values, mean step length and time, as well as the Coefficient of Variation for step length, time, and width. Furthermore, whole-body angular momentum increased as a function of arm swing amplitude. Active arm swing further reduced Harmonic Ratios in the mediolateral and anteroposterior directions. Asymmetric walking increased average step time, and width as well as increased the Coefficient of Variation for step length and time but reduced left average step length and step width Coefficient of Variation. Further, asymmetric walking increased mediolateral Margin of Stability and reduced anteroposterior and mediolateral Harmonic Ratios. Finally, results demonstrated that actively increasing arm swing increases trunk linear and angular velocity variability in healthy young adults during symmetric and asymmetric treadmill walking. Findings may be due to active arm swing and asymmetric walking causing a disproportional contribution to trunk and center of mass movement causing participants to modify their base of support to maintain stability.
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Affiliation(s)
- Tarique Siragy
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada.
| | - Cezar Mezher
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada.
| | - Allen Hill
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada.
| | - Julie Nantel
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada.
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Ribeiro de Souza C, Betelli MT, Takazono PS, de Oliveira JÁ, Coelho DB, Duysens J, Teixeira LA. Evaluation of balance recovery stability from unpredictable perturbations through the compensatory arm and leg movements (CALM) scale. PLoS One 2019; 14:e0221398. [PMID: 31461500 PMCID: PMC6713348 DOI: 10.1371/journal.pone.0221398] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 08/06/2019] [Indexed: 11/30/2022] Open
Abstract
Following unpredictable large-magnitude stance perturbations diverse patterns of arm and leg movements are performed to recover balance stability. Stability of these compensatory movements could be properly estimated through qualitative evaluation. In the present study, we present a scale for evaluation of compensatory arm and leg movements (CALM) in response to unpredictable displacements of the support base in the mediolateral direction. We tested the CALM scale for intra- and inter-rater reliability, correlation with kinematics of arm and leg movement amplitudes, and sensitivity to mode (rotation, translation and combined) and magnitude (velocity) of support base displacements, and also to perturbation-based balance training. Results showed significant intra- and inter-rater coefficients of agreement, ranging from moderate (0.46–0.53) for inter-rater reliability in the arm and global scores, to very high (0.87–0.99) for inter-rater leg scores and all intra-rater scores. Analysis showed significant correlation values between scale scores and the respective movement amplitudes both for arm and leg movements. Assessment of sensitivity revealed that the scale discriminated the responses between perturbation modes, platform velocities, in addition to higher balance recovery stability as a result of perturbation-based balance training. As a conclusion, the CALM scale was shown to provide adequate integrative evaluation of compensatory arm and leg movements for balance recovery stability after challenging stance perturbations, with potential application in fall risk prediction.
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Affiliation(s)
- Caroline Ribeiro de Souza
- Human Motor Systems Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil Centre for Engineering, Modeling and Applied Social Sciences (CECS), Federal University of ABC, São Paulo, Brazil
- * E-mail:
| | - Marina Torres Betelli
- Human Motor Systems Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil Centre for Engineering, Modeling and Applied Social Sciences (CECS), Federal University of ABC, São Paulo, Brazil
| | - Patrícia Sayuri Takazono
- Human Motor Systems Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil Centre for Engineering, Modeling and Applied Social Sciences (CECS), Federal University of ABC, São Paulo, Brazil
| | - Julia Ávila de Oliveira
- Human Motor Systems Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil Centre for Engineering, Modeling and Applied Social Sciences (CECS), Federal University of ABC, São Paulo, Brazil
| | - Daniel Boari Coelho
- Centre for Engineering, Modeling and Applied Social Sciences (CECS), Federal University of ABC, São Paulo, Brazil
| | - Jacques Duysens
- Department of Movement Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Catholic University of Leuven, Leuven, Belgium
| | - Luis Augusto Teixeira
- Human Motor Systems Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil Centre for Engineering, Modeling and Applied Social Sciences (CECS), Federal University of ABC, São Paulo, Brazil
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A single session of trip-specific training modifies trunk control following treadmill induced balance perturbations in stroke survivors. Gait Posture 2019; 70:222-228. [PMID: 30904789 PMCID: PMC6508877 DOI: 10.1016/j.gaitpost.2019.03.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 02/28/2019] [Accepted: 03/04/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Individuals with stroke are at significant risk of falling. Trip-specific training is a targeted training approach that has been shown to reduce falls in older adults and amputees by enhancing the compensatory stepping response required to prevent a fall. Still, individuals with stroke have unique deficits (e.g. spasticity) which draws into question if this type of training will be effective for this population. OBJECTIVE Evaluate if a single session of trip-specific training can modify the compensatory stepping response (trunk movement, step length/duration, reaction time) of individuals with chronic stroke. METHODS Sixteen individuals with unilateral chronic stroke participated in a single session of trip-specific training consisting of 15 treadmill perturbations. A falls assessment consisting of 3 perturbations was completed before and after training. Recovery step kinematics measured during the pre- and post-test were compared using a repeated measures design. Furthermore, Fallers (those who experienced at least one fall during the pre- or post-test) were compared to Non-fallers. RESULTS Trip-specific training decreased trunk movement post perturbation. Specifically following training, Trunk flexion was 48 and 19 percent smaller on the small and medium perturbations at the end of the first compensatory step. Fallers (9 out of 16 subjects) post-training resembled Non-Fallers pre-training. Specifically, Trunk flexion at the completion of the first step during small and medium perturbations was not different between Fallers post-training and Non-Fallers pre-training. Still enthusiasm was tempered because Trunk flexion at the largest perturbation (where most falls occurred) was not changed and therefore total falls were not reduced as a result of this training. SIGNIFICANCE Our results indicate that trip-specific training modifies the dynamic falls response immediately following trip-like treadmill perturbations. However, the incidence of falls was not reduced with a single training session. Further study of the implications and length of the observed intervention effect are warranted.
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14
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Siragy T, Nantel J. Quantifying Dynamic Balance in Young, Elderly and Parkinson's Individuals: A Systematic Review. Front Aging Neurosci 2018; 10:387. [PMID: 30524270 PMCID: PMC6262057 DOI: 10.3389/fnagi.2018.00387] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 11/05/2018] [Indexed: 01/03/2023] Open
Abstract
Introduction: Falling is one of the primary concerns for people with Parkinson's Disease and occurs predominately during dynamic movements, such as walking. Several methods have been proposed to quantify dynamic balance and to assess fall risk. However, no consensus has been reached concerning which method is most appropriate for examining walking balance during unperturbed and perturbed conditions, particularly in Parkinson's Disease individuals. Therefore, this systematic review aimed to assess the current literature on quantifying dynamic balance in healthy young, elderly and Parkinson's individuals during unperturbed and perturbed walking. Methods: The PubMed database was searched by title and abstract for publications quantifying dynamic balance during unperturbed and mechanically perturbed walking conditions in elderly adults and PD. Inclusion criteria required publications to be published in English, be available in full-text, and implement a dynamic balance quantification method. Exclusion criteria included clinical dynamic balance measures, non-mechanical perturbations, pathologies other than PD, and dual-tasking conditions. The initial database search yielded 280 articles, however, only 81 articles were included after title, abstract and full-text screening. Methodological quality and data were extracted from publications included in the final synthesis. Results: The dynamic balance articles included 26 Coefficient of Variation of Spatiotemporal Variability, 10 Detrended Fluctuation Analysis, 20 Lyapunov Exponent, 7 Maximum Floquet Multipliers, 17 Extrapolated Center of Mass, 11 Harmonic Ratios, 4 Center of Mass-Center of Pressure Separation, 2 Gait Stability Ratio, 1 Entropy, 3 Spatiotemporal Variables, 2 Center of Gravity and Center of Pressure, and 2 Root Mean Square in the final synthesis. Assessment of methodological quality determined that 58 articles had a low methodological rating, a 22 moderate rating, and 1 having a high rating. Conclusion: Careful consideration must be given when selecting a method to quantify dynamic balance because each method defines balance differently, reflects a unique aspect of neuromuscular stability mechanisms, and is dependent on the walking condition (unperturbed vs. perturbed). Therefore, each method provides distinct information into stability impairment in elderly and PD individuals.
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Affiliation(s)
- Tarique Siragy
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Julie Nantel
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
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15
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Teixeira LA, Coutinho JDFS, Coelho DB. Regulation of dynamic postural control to attend manual steadiness constraints. J Neurophysiol 2018; 120:693-702. [DOI: 10.1152/jn.00941.2017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
In daily living activities, performance of spatially accurate manual movements in upright stance depends on postural stability. In the present investigation, we aimed to evaluate the effect of the required manual steadiness (task constraint) on the regulation of dynamic postural control. A single group of young participants ( n = 20) were evaluated in the performance of a dual posturo-manual task of balancing on a platform oscillating in sinusoidal translations at 0.4-Hz (low) or 1-Hz (high) frequencies while stabilizing a cylinder on a handheld tray. Manual task constraint was manipulated by comparing the conditions of keeping the cylinder stationary on its flat or round side, corresponding to low and high manual task constraints, respectively. Results showed that in the low oscillation frequency the high manual task constraint led to lower oscillation amplitudes of the head, center of mass, and tray, in addition to higher relative phase values between ankle/hip-shoulder oscillatory rotations and between center of mass/center of pressure-feet oscillations as compared with values observed in the low manual task constraint. Further analyses showed that the high manual task constraint also affected variables related to both postural (increased amplitudes of center of pressure oscillation) and manual (increased amplitude of shoulder rotations) task components in the high oscillation frequency. These results suggest that control of a dynamic posturo-manual task is modulated in distinct parameters to attend the required manual steadiness in a complex and flexible way. NEW & NOTEWORTHY We evaluated dynamic postural control on a platform oscillating in sinusoidal translations at different frequencies while performing a manual task with low or high steadiness constraints. Results showed that high manual task constraint led to modulation of metric and coordination variables associated with greater postural stability. Our findings suggest that motor control is regulated in an integrative mode at the posturo-manual task level, with reciprocal interplay between the postural and manual components.
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Affiliation(s)
- Luis Augusto Teixeira
- Human Motor Systems Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | | | - Daniel Boari Coelho
- Human Motor Systems Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
- Biomedical Engineering, Federal University of ABC, São Bernardo do Campo, São Paulo, Brazil
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16
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Hejrati B, Merryweather AS, Abbott JJ. Generating Arm-Swing Trajectories in Real-Time Using a Data-Driven Model for Gait Rehabilitation With Self-Selected Speed. IEEE Trans Neural Syst Rehabil Eng 2018; 26:115-124. [DOI: 10.1109/tnsre.2017.2740060] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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17
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Monaco V, Tropea P, Aprigliano F, Martelli D, Parri A, Cortese M, Molino-Lova R, Vitiello N, Micera S. An ecologically-controlled exoskeleton can improve balance recovery after slippage. Sci Rep 2017; 7:46721. [PMID: 28492520 PMCID: PMC5426188 DOI: 10.1038/srep46721] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 03/23/2017] [Indexed: 12/03/2022] Open
Abstract
The evolution to bipedalism forced humans to develop suitable strategies for dynamically controlling their balance, ensuring stability, and preventing falling. The natural aging process and traumatic events such as lower-limb loss can alter the human ability to control stability significantly increasing the risk of fall and reducing the overall autonomy. Accordingly, there is an urgent need, from both end-users and society, for novel solutions that can counteract the lack of balance, thus preventing falls among older and fragile citizens. In this study, we show a novel ecological approach relying on a wearable robotic device (the Active Pelvis Orthosis, APO) aimed at facilitating balance recovery after unexpected slippages. Specifically, if the APO detects signs of balance loss, then it supplies counteracting torques at the hips to assist balance recovery. Experimental tests conducted on eight elderly persons and two transfemoral amputees revealed that stability against falls improved due to the “assisting when needed” behavior of the APO. Interestingly, our approach required a very limited personalization for each subject, and this makes it promising for real-life applications. Our findings demonstrate the potential of closed-loop controlled wearable robots to assist elderly and disabled subjects and to improve their quality of life.
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Affiliation(s)
- V Monaco
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.,IRCSS Don Carlo Gnocchi Foundation, Firenze, Italy
| | - P Tropea
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - F Aprigliano
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - D Martelli
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.,Department of Mechanical Engineering, Columbia University, New York, NY 10027 USA
| | - A Parri
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - M Cortese
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | | | - N Vitiello
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.,IRCSS Don Carlo Gnocchi Foundation, Firenze, Italy
| | - S Micera
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.,Bertarelli Foundation Chair in Translational NeuroEngineering, Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, Ecole Polytechnique Federale de Lausanne, Lausanne, Switzerland
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18
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Engel T, Mueller J, Kopinski S, Reschke A, Mueller S, Mayer F. Unexpected walking perturbations: Reliability and validity of a new treadmill protocol to provoke muscular reflex activities at lower extremities and the trunk. J Biomech 2017; 55:152-155. [PMID: 28320506 DOI: 10.1016/j.jbiomech.2017.02.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 10/28/2016] [Accepted: 02/26/2017] [Indexed: 11/16/2022]
Abstract
Instrumented treadmills offer the potential to generate standardized walking perturbations, which are particularly rapid and powerful. However, technical requirements to release adequate perturbations regarding timing, duration and amplitude are demanding. This study investigated the test-retest reliability and validity of a new treadmill perturbation protocol releasing rapid and unexpected belt perturbations to provoke muscular reflex responses at lower extremities and the trunk. Fourteen healthy participants underwent two identical treadmill walking protocols, consisting of 10 superimposed one-sided belt perturbations (100ms duration; 2m/s amplitude), triggered by a plantar pressure insole 200ms after heel contact. Delay, duration and amplitude of applied perturbations were recorded by 3D-motion capture. Muscular reflex responses (within 200ms) were measured at lower extremities and the trunk (10-lead EMG). Data was analyzed descriptively (mean±SD). Reliability was analyzed using test-retest variability (TRV%) and limits of agreement (LoA, bias±1.96∗SD). Perturbation delay was 202±14ms, duration was 102±4ms and amplitude was 2.1±0.01m/s. TRV for perturbation delay, duration and amplitude ranged from 5.0% to 5.7%. LoA reached 3±36ms for delay, 2±13ms for duration and 0.0±0.3m/s for amplitude. EMG amplitudes following perturbations ranged between 106±97% and 909±979% of unperturbed gait and EMG latencies between 82±14ms and 106±16ms. Minor differences between preset and observed perturbation characteristics and results of test-retest analysis prove a high validity with excellent reliability of the setup. Therefore, the protocol tested can be recommended to provoke muscular reflex responses at lower extremities and the trunk in perturbed walking.
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Affiliation(s)
- Tilman Engel
- University Outpatient Clinic Potsdam, Sports Medicine & Sports Orthopaedics, University of Potsdam, Am Neuen Palais 10, Haus 12, D-14469 Potsdam, Germany.
| | - Juliane Mueller
- University Outpatient Clinic Potsdam, Sports Medicine & Sports Orthopaedics, University of Potsdam, Am Neuen Palais 10, Haus 12, D-14469 Potsdam, Germany
| | - Stephan Kopinski
- University Outpatient Clinic Potsdam, Sports Medicine & Sports Orthopaedics, University of Potsdam, Am Neuen Palais 10, Haus 12, D-14469 Potsdam, Germany
| | - Antje Reschke
- University Outpatient Clinic Potsdam, Sports Medicine & Sports Orthopaedics, University of Potsdam, Am Neuen Palais 10, Haus 12, D-14469 Potsdam, Germany
| | - Steffen Mueller
- University Outpatient Clinic Potsdam, Sports Medicine & Sports Orthopaedics, University of Potsdam, Am Neuen Palais 10, Haus 12, D-14469 Potsdam, Germany
| | - Frank Mayer
- University Outpatient Clinic Potsdam, Sports Medicine & Sports Orthopaedics, University of Potsdam, Am Neuen Palais 10, Haus 12, D-14469 Potsdam, Germany
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19
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Hejrati B, Chesebrough S, Bo Foreman K, Abbott JJ, Merryweather AS. Comprehensive quantitative investigation of arm swing during walking at various speed and surface slope conditions. Hum Mov Sci 2016; 49:104-15. [PMID: 27367784 DOI: 10.1016/j.humov.2016.06.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 06/05/2016] [Accepted: 06/05/2016] [Indexed: 11/29/2022]
Abstract
Previous studies have shown that inclusion of arm swing in gait rehabilitation leads to more effective walking recovery in patients with walking impairments. However, little is known about the correct arm-swing trajectories to be used in gait rehabilitation given the fact that changes in walking conditions affect arm-swing patterns. In this paper we present a comprehensive look at the effects of a variety of conditions on arm-swing patterns during walking. The results describe the effects of surface slope, walking speed, and physical characteristics on arm-swing patterns in healthy individuals. We propose data-driven mathematical models to describe arm-swing trajectories. Thirty individuals (fifteen females and fifteen males) with a wide range of height (1.58-1.91m) and body mass (49-98kg), participated in our study. Based on their self-selected walking speed, each participant performed walking trials with four speeds on five surface slopes while their whole-body kinematics were recorded. Statistical analysis showed that walking speed, surface slope, and height were the major factors influencing arm swing during locomotion. The results demonstrate that data-driven models can successfully describe arm-swing trajectories for normal gait under varying walking conditions. The findings also provide insight into the behavior of the elbow during walking.
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Affiliation(s)
- Babak Hejrati
- Department of Mechanical Engineering, University of Utah, United States.
| | - Sam Chesebrough
- Department of Mechanical Engineering, University of Utah, United States
| | - K Bo Foreman
- Department of Physical Therapy, University of Utah, United States
| | - Jake J Abbott
- Department of Mechanical Engineering, University of Utah, United States
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20
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Aprigliano F, Martelli D, Micera S, Monaco V. Intersegmental coordination elicited by unexpected multidirectional slipping-like perturbations resembles that adopted during steady locomotion. J Neurophysiol 2015; 115:728-40. [PMID: 26561598 DOI: 10.1152/jn.00327.2015] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 11/09/2015] [Indexed: 11/22/2022] Open
Abstract
This study aimed at testing the hypothesis that reactive biomechanical responses elicited by unexpected slipping-like perturbations delivered during steady walking are characterized by an intersegmental coordination strategy resembling that adopted during unperturbed walking. Fifteen healthy subjects were asked to manage multidirectional slipping-like perturbations delivered while they walked steadily. The planar covariation law of elevation angles related to lower limb segments was the main observed variable related to unperturbed and perturbed strides. Principal component analysis was used to verify whether elevation angles covaried, both before and after the onset of the perturbation, and, if so, the orientation of the related planes of covariation was compared. Results revealed that the planar covariation law of the unperturbed limb after onset of the perturbation was systematically similar to that seen during steady walking. This occurred despite differences in range of motion and intersubject variability of both elevation and joint angles. The analysis strongly corroborates the hypothesis that the planar covariation law emerges from the interaction between spinal neural networks and limb mechanical oscillators. In particular, fast and stereotyped reactive strategies may result from the interaction among activities of downstream neural networks encrypting well-trained motor schemes, such as those related to walking, limb dynamics, and sensory motor information gathered during the perturbation. In addition, our results allowed us to speculate that rehabilitative treatment based on unexpected perturbations and relying on the plasticity of the central nervous system may also be effective in eliciting unimpaired intralimb coordination in neurological patients.
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Affiliation(s)
- Federica Aprigliano
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Pisa, Italy
| | - Dario Martelli
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Pisa, Italy; Department of Mechanical Engineering, Columbia University, New York, New York
| | - Silvestro Micera
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Pisa, Italy; Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland; and
| | - Vito Monaco
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Pisa, Italy; MARE Lab, Don Carlo Gnocchi Foundation, Florence, Italy
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21
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Mavor MP, Graham RB. Exploring the relationship between local and global dynamic trunk stabilities during repetitive lifting tasks. J Biomech 2015; 48:3955-60. [DOI: 10.1016/j.jbiomech.2015.09.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 09/10/2015] [Accepted: 09/24/2015] [Indexed: 10/23/2022]
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22
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Forero J, Misiaszek JE. The amplitude of interlimb cutaneous reflexes in the leg is influenced by fingertip touch and vision during treadmill locomotion. Exp Brain Res 2015; 233:1773-82. [DOI: 10.1007/s00221-015-4250-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 03/06/2015] [Indexed: 11/28/2022]
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23
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Wilbur S, Meyer HB, Baker MR, Smiarowski K, Suarez CA, Ames D, Rubin RT. Dance for Veterans: A complementary health program for veterans with serious mental illness. Arts Health 2015. [DOI: 10.1080/17533015.2015.1019701] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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24
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Levin O, Vanwanseele B, Thijsen JRJ, Helsen WF, Staes FF, Duysens J. Proactive and reactive neuromuscular control in subjects with chronic ankle instability: evidence from a pilot study on landing. Gait Posture 2015; 41:106-11. [PMID: 25439444 DOI: 10.1016/j.gaitpost.2014.09.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 08/27/2014] [Accepted: 09/14/2014] [Indexed: 02/02/2023]
Abstract
To understand why subjects with chronic ankle instability (CAI) have frequent sprains, one must study the preparation/reactions of these subjects to situations related to ankle inversion in real life. In the present pilot study, we examined whether subjects with CAI altered their neuromuscular control and reflex responses during and after ankle perturbations in landing. EMG signals were collected from the tibialis anterior (TA), peroneus longus (PL), medial gastrocnemius (MG), and gluteus medius (GLM) of both legs in 9 subjects with CAI and 9 subjects with intact ankles (control). A trapdoor was used to produce an ankle inversion of 25° with the left leg (control) or the affected leg (CAI) in 0%, 50% or 100% of the landing trials. As compared to controls, subjects with CAI had increased proactive activity in the contralateral side prior to touchdown during landing trials with 50% (PL) and 100% (PL and MG) chance of inversion (all, p < 0.05). The increase proactive control on the contralateral side could be part of a strategy to smooth the impact of landing on the affected side in subjects with CAI. Following touchdown, the CAI group showed decreased ipsilateral short latency reflex (SLR) responses in all test conditions both in distal (PL and MG) and in proximal muscles (GLM) on the affected side (all, p < 0.05). Finally, subjects with CAI adjusted their reflex gain differently as compared to controls when exposed to a possible inversion. Overall, individuals with CAI displayed different neuromuscular strategies from controls while landing.
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Affiliation(s)
- Oron Levin
- KU Leuven Movement Control and Neuroplasticity Research Group, Leuven, Belgium.
| | | | - Jo R J Thijsen
- KU Leuven Movement Control and Neuroplasticity Research Group, Leuven, Belgium
| | - Werner F Helsen
- KU Leuven Movement Control and Neuroplasticity Research Group, Leuven, Belgium
| | - Filip F Staes
- KU Leuven Research Group for Musculoskeletal Rehabilitation, Faculty of Kinesiology and Rehabilitation Sciences, Group Biomedical Sciences, 3001 Leuven, Belgium
| | - Jacques Duysens
- KU Leuven Movement Control and Neuroplasticity Research Group, Leuven, Belgium; Department of Research, Development & Education, Sint Maartenskliniek, Nijmegen, The Netherlands
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25
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Forero J, Misiaszek JE. Balance-corrective responses to unexpected perturbations at the arms during treadmill walking. J Neurophysiol 2014; 112:1790-800. [DOI: 10.1152/jn.00719.2013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The arms have been shown to be involved in the regulation of balance during walking. The use of a walking aid enhances balance by increasing the base of support and reducing the load on the legs by partly transferring it to the arms. However, when actively engaged during a balance task, perturbations to the arms can destabilize balance. Previous studies have investigated postural adjustments associated with focal arm movements during standing and walking. However, balance-corrective reactions to unexpected perturbations to the arms during walking have not been well studied. In the present study, subjects walked on a treadmill while grasping a pair of handles when sudden perturbations were delivered by displacing the handles in the forward or backward direction. Instructing subjects to oppose the displacement of the handles resulted in strong responses in the arms that were accompanied by activation of muscles in the legs, comparable to those observed in other balance disturbance studies. Conversely, when subjects were instructed to allow the handles to move when displaced, no responses were observed in the arms. However, similar responses were observed in the legs whether subjects opposed the displacement of the handles or not when perturbations were applied at heel strike. The results from this study show that balance reactions can be elicited in the legs in response to perturbations applied at the arms, and that the expression of these responses is affected by the task engaged in by the arms.
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Affiliation(s)
- Juan Forero
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada; and
| | - John E. Misiaszek
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada; and
- Centre for Neuroscience, University of Alberta, Edmonton, Alberta, Canada
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26
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The effect of light touch on the amplitude of cutaneous reflexes in the arms during treadmill walking. Exp Brain Res 2014; 232:2967-76. [DOI: 10.1007/s00221-014-3979-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 04/26/2014] [Indexed: 10/25/2022]
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27
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Martelli D, Artoni F, Monaco V, Sabatini AM, Micera S. Pre-impact fall detection: optimal sensor positioning based on a machine learning paradigm. PLoS One 2014; 9:e92037. [PMID: 24658093 PMCID: PMC3962372 DOI: 10.1371/journal.pone.0092037] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 02/19/2014] [Indexed: 11/24/2022] Open
Abstract
The aim of this study was to identify the best subset of body segments that provides for a rapid and reliable detection of the transition from steady walking to a slipping event. Fifteen healthy young subjects managed unexpected perturbations during walking. Whole-body 3D kinematics was recorded and a machine learning algorithm was developed to detect perturbation events. In particular, the linear acceleration of all the body segments was parsed by Independent Component Analysis and a Neural Network was used to classify walking from unexpected perturbations. The Mean Detection Time (MDT) was 351±123 ms with an Accuracy of 95.4%. The procedure was repeated with data related to different subsets of all body segments whose variability appeared strongly influenced by the perturbation-induced dynamic modifications. Accordingly, feet and hands accounted for most data information and the performance of the algorithm were slightly reduced using their combination. Results support the hypothesis that, in the framework of the proposed approach, the information conveyed by all the body segments is redundant to achieve effective fall detection, and suitable performance can be obtained by simply observing the kinematics of upper and lower distal extremities. Future studies are required to assess the extent to which such results can be reproduced in older adults and in different experimental conditions.
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Affiliation(s)
- Dario Martelli
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Fiorenzo Artoni
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Vito Monaco
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | | | - Silvestro Micera
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Translational Neural Engineering Lab, Center for Neuroprosthetics, Swiss Federal Institute of Technology Lausanne (EPFL), Lausanne, Switzerland
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28
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Sarraf TA, Marigold DS, Robinovitch SN. Maintaining standing balance by handrail grasping. Gait Posture 2014; 39:258-64. [PMID: 23948334 DOI: 10.1016/j.gaitpost.2013.07.117] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 07/16/2013] [Accepted: 07/24/2013] [Indexed: 02/02/2023]
Abstract
Maintaining balance while standing on a moving bus or subway is challenging, and falls among passengers are a significant source of morbidity. Standing passengers often rely on handrail grasping to resist perturbations to balance. We conducted experiments that simulated vehicle starts, to examine how handrail location (overhead or shoulder-height), perturbation direction (forward, backward, left or right), and perturbation magnitude (1 or 2m/s(2)) affected the biomechanical effort (peak centre-of-pressure (COP) excursion and hand force) and muscle activations (onset and integrated EMG activity) involved in balance maintenance. COP excursions, hand forces and muscle activations were altered in a functional manner based on task constraints and perturbation characteristics. Handrail position affected normalized values of peak COP and hand force during forward and backward, but not sideways perturbations. During backward perturbations, COP excursion was greater when grasping overhead than shoulder-height. During forward perturbations, hand force was greater when grasping shoulder-height than overhead. Biceps activations were earlier during shoulder-height than overhead grasping, while tibialis anterior activity was higher during overhead than shoulder-height grasping. Our results indicate that, when facing forward or backward to the direction of vehicle motion, overhead grasping minimizes hand force, while shoulder-height grasping minimizes COP excursion. In contrast, grasping with a sideways stance eliminates the effect of handrail location, and was associated with equal or lower biomechanical effort. This suggests that, at least for vehicle starts, the most reasonable strategy may be to stand sideways to the direction of the vehicle movement, and grasp either at shoulder-height or overhead.
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Affiliation(s)
- Thiago A Sarraf
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, BC, Canada
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29
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Bilateral coupling facilitates recovery of rhythmical movements from perturbation in healthy and post-stroke subjects. Exp Brain Res 2013; 227:263-74. [DOI: 10.1007/s00221-013-3509-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2012] [Accepted: 04/02/2013] [Indexed: 10/26/2022]
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30
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Effects of spatial-memory decay and dual-task interference on perturbation-evoked reach-to-grasp reactions in the absence of online visual feedback. Hum Mov Sci 2013; 32:328-42. [DOI: 10.1016/j.humov.2012.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 08/03/2012] [Accepted: 11/01/2012] [Indexed: 11/20/2022]
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31
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Forero J, Misiaszek JE. The contribution of light touch sensory cues to corrective reactions during treadmill locomotion. Exp Brain Res 2013; 226:575-84. [PMID: 23483209 DOI: 10.1007/s00221-013-3470-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 02/25/2013] [Indexed: 10/27/2022]
Abstract
The arms play an important role in balance regulation during walking. In general, perturbations delivered during walking trigger whole-body corrective responses. For instance, holding to stable handles can largely attenuate and even suppress responses in the leg muscles to perturbations during walking. Particular attention has been given to the influence of light touch on postural control. During standing, lightly touching a stable contact greatly reduces body sway and enhances corrective responses to postural perturbations, whereas light touch during walking allows subjects to continue to walk on a treadmill with the eyes closed. We hypothesized that in the absence of mechanical support from the arms, sensory cues from the hands would modulate responses in the legs to balance disturbing perturbations delivered at the torso during walking. To test this, subjects walked on a treadmill while periodically being pulled backwards at the waist while walking. The amplitude of the responses evoked in tibialis anterior to these perturbations was compared across 4 test conditions, in a 2 × 2 design. Subjects either (a) lightly touched or (b) did not touch a stable contact, while the eyes were (c) open or (d) closed. Allowing the subjects to touch a stable contact resulted in a reduction in the amount of fore-aft oscillation of the body on the treadmill, which was accompanied by a reduction in the ongoing electromyographic activity in both tibialis anterior and soleus during undisturbed walking. In contrast, the provision of touch resulted in an increase in the amplitude of the evoked responses in tibialis anterior to the backward perturbations that was more evident when subjects walked with the eyes closed. These results indicate that light touch provides a sensory cue that can be used to assist in stabilizing the body while walking. In addition, the sensory information provided by light touch contributes to the regulation of corrective reactions initiated by balance disturbances encountered during walking.
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Affiliation(s)
- Juan Forero
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, T6G 2G4, Canada
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32
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Martelli D, Monaco V, Bassi Luciani L, Micera S. Angular momentum during unexpected multidirectional perturbations delivered while walking. IEEE Trans Biomed Eng 2013; 60:1785-95. [PMID: 23358944 DOI: 10.1109/tbme.2013.2241434] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
This study investigated the hypothesis that the coupled contribution of all body segments to the whole-body response during both walking and managing unexpected perturbations is characterized by similar features which do not depend on the laterality (i.e., right versus left sides), but can be influenced by the direction (e.g., north, east, south, etc.) of the perturbation. The whole-body angular momentum was estimated as summation of segmental angular momenta, while 15 young adults managed ten unexpected unilateral perturbations during walking. Then, the Principal component analysis was used to extract primitive features describing intersegment coordination. Results showed that intersegment coupling was similar even though the reactive response to the perturbations elicited more consistent motor schemes across body segments than during walking, especially in the frontal plane. The direction of the perturbation significantly affected angular momentum regulation documenting the attitude of the central nervous system to interpret multiple sensory inputs in order to produce context-dependent reactive responses. With respect to the side, results highlighted anisotropic features of the elicited motor schemes that seemed to depend on subjects' dominance. Finally, results confirm that the coordination of upper and lower body segments is synergistically achieved strengthening the hypothesis that it may result from common neural pathways.
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Affiliation(s)
- Dario Martelli
- The BioRobotics Institute, Scuola Superiore Sant’Anna, 56026-Pontedera (PI), Italy.
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33
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Krasovsky T, Lamontagne A, Feldman AG, Levin MF. Reduced gait stability in high-functioning poststroke individuals. J Neurophysiol 2012; 109:77-88. [PMID: 23054600 DOI: 10.1152/jn.00552.2012] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Falls during walking are a major cause of poststroke injury, and walking faster may decrease the ability to recover following a gait perturbation. We compared gait stability between high-functioning poststroke individuals and controls and evaluated the effect of gait speed on gait stability. Ten stroke subjects and ten age-matched controls walked on a self-paced treadmill at two speeds (matched/faster). Movement of the nonparetic/dominant leg was arrested unexpectedly at early swing. Poststroke individuals lowered the perturbed leg following perturbation (58% of cases) while controls maintained the leg elevated (49% of cases; P < 0.01). In poststroke individuals, double-support duration was restored later than in controls (4.6 ± 0.8 vs. 3.2 ± 0.3 strides; P < 0.007), and long-term phase shifts of arm and leg movements were larger and less coordinated on the paretic side. A moderate speed increase (~20%) enhanced the incidence of leg lowering in controls but not in stroke subjects. Faster walkers in both groups had a more coordinated response, limited to the nonparetic side in the stroke group. However, faster walkers were not more stable following perturbation. Our results suggest that gait perturbations can target basic control processes and identify neurological locomotor deficits in individuals with fall risk. Central regulation of body translation in space is involved in recovery of steady-state walking. Impaired descending control (stroke) decreases the ability of the motor system to recover from perturbations and regulate interlimb phase relationships, especially when changing gait speed. However, interlimb coordination may not be a major factor in the recovery of gait stability.
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Affiliation(s)
- Tal Krasovsky
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.
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34
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Cheng KC, McKay SM, King EC, Maki BE. Does Aging Impair the Capacity to Use Stored Visuospatial Information or Online Visual Control to Guide Reach-to-Grasp Reactions Evoked by Unpredictable Balance Perturbation? J Gerontol A Biol Sci Med Sci 2012; 67:1238-45. [DOI: 10.1093/gerona/gls116] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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35
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Bolton DAE, Misiaszek JE. Compensatory balance reactions during forward and backward walking on a treadmill. Gait Posture 2012; 35:681-4. [PMID: 22225851 DOI: 10.1016/j.gaitpost.2011.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Revised: 11/28/2011] [Accepted: 12/01/2011] [Indexed: 02/02/2023]
Abstract
Previous work suggests that balance perturbations to the body opposing the direction of progression during walking lead to larger amplitude corrective reactions than perturbations concurrent with walking direction. To test this hypothesis, subjects received forward and backward perturbations applied to the pelvis through a padded harness, while walking forwards or backwards on a treadmill. Contrary to our hypothesis, the greatest responses were associated with backward perturbations regardless of the direction of walking.
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Affiliation(s)
- D A E Bolton
- Centre for Neuroscience, University of Alberta, Canada
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36
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Cheng KC, McKay SM, King EC, Maki BE. Reaching to recover balance in unpredictable circumstances: Is online visual control of the reach-to-grasp reaction necessary or sufficient? Exp Brain Res 2012; 218:589-99. [DOI: 10.1007/s00221-012-3051-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Accepted: 02/24/2012] [Indexed: 10/28/2022]
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37
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Krasovsky T, Baniña MC, Hacmon R, Feldman AG, Lamontagne A, Levin MF. Stability of gait and interlimb coordination in older adults. J Neurophysiol 2012; 107:2560-9. [PMID: 22298827 DOI: 10.1152/jn.00950.2011] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Most falls in older adults occur when walking, specifically following a trip. This study investigated the short- and longer term responses of young (n = 24, 27.6 ± 4.5 yr) and older adults (n = 18, 69.1 ± 4.2 yr) to a trip during gait at comfortable speed and the role of interlimb coordination in recovery from tripping. Subjects walked on a self-paced treadmill when forward movement of their dominant leg was unexpectedly arrested for 250 ms. Recovery of center of mass (COM) movements and of double-support duration following perturbation was determined. In addition, the disruption and recovery of interlimb coordination of the arms and legs was evaluated. Although young and older subjects used similar lower limb strategies in response to the trip, older adults had less stable COM movement patterns before perturbation, had longer transient destabilization (>25%) after perturbation, required more gait cycles to recover double-support duration (older, 3.48 ± 0.7 cycles; young, 2.88 ± 0.4 cycles), and had larger phase shifts that persisted after perturbation (older, -83° to -90°; young, -39° to -42°). Older adults also had larger disruptions to interlimb coordination of the arms and legs. The timing of the initial disruption in coordination was correlated with the disturbance in gait stability only in young adults. In older adults, greater initial COM instability was related to greater longer term arm incoordination. These results suggest a relationship between interlimb coordination and gait stability, which may be associated with fall risk in older adults. Reduced coordination and gait stability suggest a need for stability-related functional training even in high-functioning older adults.
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Affiliation(s)
- T Krasovsky
- School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir William Osler, Montreal, Quebec, Canada.
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38
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Jankowska E, Nilsson E, Hammar I. Processing information related to centrally initiated locomotor and voluntary movements by feline spinocerebellar neurones. J Physiol 2011; 589:5709-25. [PMID: 21930605 DOI: 10.1113/jphysiol.2011.213678] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Feed-back information on centrally initiated movements is processed at both supraspinal and spinal levels and is forwarded by a variety of neurones. The aim of the present study was to examine how descending commands relayed by reticulospinal neurones are monitored by a population of spinocerebellar tract neurones. Our main question was whether a spinal border (SB) subpopulation of ventral spinocerebellar tract (VSCT) neurones monitor actions of reticulospinal neurones with input from the mesencephalic locomotor region (MLR) as well as from pyramidal tract (PT) neurones. In the majority of intracellularly recorded SB neurons, stimuli applied in the MLR and in the medullary pyramids evoked EPSPs in parallel with EPSPs evoked by stimulation of axons of reticulospinal neurones in the medial longitudinal fascicle (MLF). In extracellularly recorded neurones short trains of stimuli applied in the ipsilateral and contralateral pyramids potently facilitated discharges evoked from the MLF, as well as EPSPs recorded intracellularly. In both cases the facilitation involved the disynaptic but not the monosynaptic actions. These results indicate that reticulospinal neurones activating SB neurones (or more generally VSCT neurones) are co-excited by axon-collaterals of other reticulospinal neurones and by fibres stimulated within the MLR and PTs. The study leads to the conclusion that these spinocerebellar neurones monitor descending commands for centrally initiated voluntary as well as locomotor movements relayed by reticulospinal neurones. Thereby they may provide the cerebellum with feed-back information on the likely outcome of these commands and any corrections needed to avoid errors in the issuing movements.
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Affiliation(s)
- E Jankowska
- Department Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 405 30 Göteborg, Sweden.
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39
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Feldman AG, Krasovsky T, Baniña MC, Lamontagne A, Levin MF. Changes in the referent body location and configuration may underlie human gait, as confirmed by findings of multi-muscle activity minimizations and phase resetting. Exp Brain Res 2011; 210:91-115. [DOI: 10.1007/s00221-011-2608-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Accepted: 02/14/2011] [Indexed: 11/29/2022]
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40
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Bruijn SM, Meijer OG, Beek PJ, van Dieën JH. The effects of arm swing on human gait stability. J Exp Biol 2010; 213:3945-52. [DOI: 10.1242/jeb.045112] [Citation(s) in RCA: 168] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
SUMMARY
Arm swing during human gait has been shown to reduce both angular momentum about the vertical and energy expenditure, and has been hypothesized to enhance gait stability. To examine this hypothesis, we studied the effect of arm swing on the local and global stability of steady-state gait, as well as the ability to perform adequate recovery actions following a perturbation. Trunk kinematics of 11 male subjects was measured in treadmill walking with normal and with restricted arm swing. In half of the trials, gait was perturbed by a position-controlled forward pull to the trunk. We constructed state spaces using data recorded from the unperturbed steady-state walking trials, and quantified local gait stability by calculating maximum Lyapunov exponents. In addition, we analyzed perturbation forces, the distance from the unperturbed gait pattern, and the return toward the normal gait pattern following an external perturbation. Walking without arm swing led to a non-significantly lower Lyapunov exponent (P=0.06), significantly higher perturbation forces (P<0.05), and significantly slower movements away from the attractor (P<0.01). These results suggest that gait without arm swing is characterized by similar local stability to gait with arm swing and a higher perturbation resistance. However, return towards the normal gait pattern was significantly slower (P<0.05) when walking with restricted arms, suggesting that the arms play an important role in the recovery from a perturbation. Collectively, the results suggest that arm swing as such does not enhance gait stability, but rather that recovery movements of the arms contribute to the overall stability of human gait.
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Affiliation(s)
- Sjoerd M. Bruijn
- Research Institute MOVE, Faculty of Human Movement Sciences, VU University Van der Boechorststraat 9, NL-1081 BT, Amsterdam, The Netherlands
| | - Onno G. Meijer
- Research Institute MOVE, Faculty of Human Movement Sciences, VU University Van der Boechorststraat 9, NL-1081 BT, Amsterdam, The Netherlands
- Second Affiliated Hospital of Fujian Medical University, Zhongshan Northern Road 34, Quanzhou, 362000 Fujian Province, PR China
| | - Peter J. Beek
- Research Institute MOVE, Faculty of Human Movement Sciences, VU University Van der Boechorststraat 9, NL-1081 BT, Amsterdam, The Netherlands
| | - Jaap H. van Dieën
- Research Institute MOVE, Faculty of Human Movement Sciences, VU University Van der Boechorststraat 9, NL-1081 BT, Amsterdam, The Netherlands
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King EC, McKay SM, Cheng KC, Maki BE. The use of peripheral vision to guide perturbation-evoked reach-to-grasp balance-recovery reactions. Exp Brain Res 2010; 207:105-18. [PMID: 20957351 PMCID: PMC5142842 DOI: 10.1007/s00221-010-2434-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2010] [Accepted: 09/26/2010] [Indexed: 10/18/2022]
Abstract
For a reach-to-grasp reaction to prevent a fall, it must be executed very rapidly, but with sufficient accuracy to achieve a functional grip. Recent findings suggest that the CNS may avoid potential time delays associated with saccade-guided arm movements by instead relying on peripheral vision (PV). However, studies of volitional arm movements have shown that reaching is slower and/or less accurate when guided by PV, rather than central vision (CV). The present study investigated how the CNS resolves speed-accuracy trade-offs when forced to use PV to guide perturbation-evoked reach-to-grasp balance-recovery reactions. These reactions were evoked, in 12 healthy young adults, via sudden unpredictable antero-posterior platform translation (barriers deterred stepping reactions). In PV trials, subjects were required to look straight-ahead at a visual target while a small cylindrical handhold (length 25%> hand-width) moved intermittently and unpredictably along a transverse axis before stopping at a visual angle of 20°, 30°, or 40°. The perturbation was then delivered after a random delay. In CV trials, subjects fixated on the handhold throughout the trial. A concurrent visuo-cognitive task was performed in 50% of PV trials but had little impact on reach-to-grasp timing or accuracy. Forced reliance on PV did not significantly affect response initiation times, but did lead to longer movement times, longer time-after-peak-velocity and less direct trajectories (compared to CV trials) at the larger visual angles. Despite these effects, forced reliance on PV did not compromise ability to achieve a functional grasp and recover equilibrium, for the moderately large perturbations and healthy young adults tested in this initial study.
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Affiliation(s)
- Emily C King
- Centre for Studies in Aging, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
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42
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Hof AL, Vermerris SM, Gjaltema WA. Balance responses to lateral perturbations in human treadmill walking. ACTA ACUST UNITED AC 2010; 213:2655-64. [PMID: 20639427 DOI: 10.1242/jeb.042572] [Citation(s) in RCA: 151] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
During walking on a treadmill 10 human subjects (mean age 20 years) were perturbed by 100 ms pushes or pulls to the left or the right, of various magnitudes and in various phases of the gait cycle. Balance was maintained by (1) a stepping strategy (synergy), in which the foot at the next step is positioned a fixed distance outward of the 'extrapolated centre of mass', and (2) a lateral ankle strategy, which comprises a medial or lateral movement of the centre of pressure under the foot sole. The extrapolated centre of mass is defined as the centre of mass position plus the centre of mass velocity multiplied by a parameter related to the subject's leg length. The ankle strategy is the fastest, with a mechanical delay of about 200 ms (20% of a stride), but it can displace the centre of pressure no more than 2 cm. The stepping strategy needs at least 300 ms (30% of a stride) before foot placement, but has a range of 20 cm. When reaction time is sufficient, the magnitude of the total response is in good agreement with our hypothesis: mean centre of pressure (foot) position is a constant distance outward of the extrapolated centre of mass. If the reaction time falls short, a further correction is applied in the next step. In the healthy subjects studied here, no further corrections were necessary, so balance was recovered within two steps (one stride).
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Affiliation(s)
- A L Hof
- Centre for Human Movement Sciences, University of Groningen, PO Box 196, Groningen, 9700 AD, The Netherlands.
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