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Hu CH, Lai YR, Huang CC, Lien CY, Chen YS, Yu CC, Lee SY, Lin WC, Cheng BC, Chiu WC, Chiang YF, Kung CF, Lu CH. Exploring the role of anticipatory postural adjustment duration within APA2 subphase as a potential mediator between clinical disease severity and fall risk in Parkinson's disease. Front Aging Neurosci 2024; 16:1354387. [PMID: 38988326 PMCID: PMC11234839 DOI: 10.3389/fnagi.2024.1354387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 06/05/2024] [Indexed: 07/12/2024] Open
Abstract
Introduction People with Parkinson's Disease (PD) often show reduced anticipatory postural adjustments (APAs) before voluntary steps, impacting their stability. The specific subphase within the APA stage contributing significantly to fall risk remains unclear. Methods We analyzed center of pressure (CoP) trajectory parameters, including duration, length, and velocity, throughout gait initiation. This examination encompassed both the postural phase, referred to as anticipatory postural adjustment (APA) (APA1, APA2a, APA2b), and the subsequent locomotor phases (LOC). Participants were instructed to initiate a step and then stop (initiating a single step). Furthermore, we conducted assessments of clinical disease severity using the Unified Parkinson's Disease Rating Scale (UPDRS) and evaluated fall risk using Tinetti gait and balance scores during off-medication periods. Results Freezing of gait (FOG) was observed in 18 out of 110 participants during the measurement of CoP trajectories. The Ramer-Douglas-Peucker algorithm successfully identified CoP displacement trajectories in 105 participants (95.5%), while the remaining 5 cases could not be identified due to FOG. Tinetti balance and gait score showed significant associations with levodopa equivalent daily dose, UPDRS total score, disease duration, duration (s) in APA2a (s) and LOC (s), length in APA1 (cm) and APA2b (cm), mediolateral velocity in APA1 (X) (cm/s), APA2a (X) (cm/s), APA2b (X) (cm/s) and LOC (X) (cm/s), and anterior-posterior velocity in APA2a (Z) (cm/s) and APA2b (Z) (cm/s). Multiple linear regression revealed that only duration (s) in APA2a and UPDRS total score was independently associated with Tinetti gait and balance score. Further mediation analysis showed that the duration (s) in APA2a served as a mediator between UPDRS total score and Tinetti balance and gait score (Sobel test, p = 0.047). Conclusion APA2 subphase duration mediates the link between disease severity and fall risk in PD, suggesting that longer APA2a duration may indicate reduced control during gait initiation, thereby increasing fall risk.
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Affiliation(s)
- Cheng-Hao Hu
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yun-Ru Lai
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Department of Hyperbaric Oxygen Therapy Center, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Cheng Huang
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chia-Yi Lien
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yueh-Sheng Chen
- Department of Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chiun-Chieh Yu
- Department of Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Sieh-Yang Lee
- Department of Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wei-Che Lin
- Department of Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ben-Chung Cheng
- Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wen-Chan Chiu
- Department of Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yi-Fang Chiang
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chien-Feng Kung
- Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Cheng-Hsien Lu
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Department of Intelligent Commerce, National Kaohsiung University of Science and Technology, Kaohsiung, Taiwan
- Department of Biological Science, National Sun Yat-Sen University, Kaohsiung, Taiwan
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Tafti N, Pourhoseingholi E, Nouri MJ. Determining the optimal leading limb for gait initiation in unilateral transtibial amputees: A systematic review. Prosthet Orthot Int 2024:00006479-990000000-00255. [PMID: 38896544 DOI: 10.1097/pxr.0000000000000363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 04/10/2024] [Indexed: 06/21/2024]
Abstract
The selection of the leading limb during gait initiation in individuals with unilateral transtibial amputations can significantly affect various biomechanical parameters. However, there is currently no established recommendation for the suitable leading limb in this population. The systematic review was aimed to propose a preferred leading limb for gait initiation in individuals with unilateral transtibial amputations based on biomechanical parameters. Databases including Google Scholar, PubMed, Science Direct, and ISI Web of Knowledge, were searched. The first selection criterion was based on abstracts and titles to address the research question. A total of seven studies were included in this review, and the Downs and Black's checklist was used by three researchers to assess the risk of bias. The review included a total of 61 adults with unilateral transtibial amputations, with a mean age range of 41 to 64.43 years. The confidence level of the included studies was poor, and the observational cohort was the most common study design (n = 5). Most of the studies were not replicable. Four of the included studies recommended the prosthetic limb as the preferred leading limb. Individuals with unilateral transtibial amputations may experience biomechanical benefits, including a more normal center of pressure path, reduced limb loading, and increased ankle energy generation, when leading with their prosthetic limb during gait initiation. However, further research is necessary to establish a more conclusive recommendation for the preferred leading limb in this population.
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Affiliation(s)
- Nahid Tafti
- Orthotics and Prosthetics Department, Hamadan University of Medical Sciences, Hamadan, Islamic Republic of Iran
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Chen Y, Tang H, Wang Y, Jin C, Wang L, Miao W, Wang X. The effect of complex cognitive context on the dynamic stability during gait initiation in older women. Front Aging Neurosci 2024; 15:1342570. [PMID: 38274990 PMCID: PMC10808313 DOI: 10.3389/fnagi.2023.1342570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 12/27/2023] [Indexed: 01/27/2024] Open
Abstract
Background Changes in cognitive control are considered potential factors affecting voluntary motor movements during gait initiation (GI). Simulating environments with higher cognitive resource demands have an effect on the stability of GI task performance, which is of significant importance for assessing fall risk in the older adults and devising fall risk management measures in multiple environments. This study aims to reveal the influence of complex cognitive competitive environment with increased cognitive demands on the dynamic stability during GI in the older women. Methods Twenty-three older females and twenty-three younger females performed walking tests under three conditions: voluntary initiation (SI), visual light reaction time task (LRT), and cognitive interference + visual light reaction time task (C + LRT). Eight cameras (Qualisys, Sweden, model: Oqus 600) and three force plates (Kistler, Switzerland, model: 9287C) are used to obtain kinematic and kinetic data. To recorde the trajectory of center of pressure (CoP) and the position of the foot placement, and compute the anterior-posterior (A-P) and medio-lateral (M-L) dynamic stability at the onset and end moments of the single-leg support by means of center of mass (CoM) and gait spatiotemporal parameters. Results Older women responded to the effect of complex environments involving cognitive competition on body stability by prolonging the lateral displacement time of the CoP during the anticipatory postural adjustments (APAs) phase, reducing step length and velocity, and increasing step width and foot inclination angle. Conclusion Complex initiation environments lead to competition for cognitive resources in the brain, resulting in decreased stability of GI motor control in older adults. The higher the complexity of the cognitive resource demands environment, the lower the stability of GI in older adults, and the greater the effect on their M-L stability at the onset of stepping.
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Affiliation(s)
- Yuxia Chen
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, School of Exercise and Health, Shanghai University of Sport, Shanghai, China
- Henan Sports Science and Technology Center (Henan Anti-Doping Center), Zhengzhou, Henan, China
| | - Hongyuan Tang
- Henan Sports Science and Technology Center (Henan Anti-Doping Center), Zhengzhou, Henan, China
| | - Yuanxin Wang
- Henan Provincial Third People's Hospital, Zhengzhou, Henan, China
| | - Chunxia Jin
- Huanghe Science and Technology College, Zhengzhou, Henan, China
| | - Lihong Wang
- School of Physical Education, Zhengzhou University, Zhengzhou, Henan, China
| | | | - Xiangdong Wang
- School of Physical Education, Jimei University, Xiamen, Fujian, China
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Kong L, Zhang Z, Bao J, Zhu X, Tan Y, Xia X, Zhang Q, Hao Y. Influences of cognitive load on center of pressure trajectory of young male adults with excess weight during gait initiation. Front Bioeng Biotechnol 2024; 11:1297068. [PMID: 38249798 PMCID: PMC10796550 DOI: 10.3389/fbioe.2023.1297068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction: Falls and fall-related injuries in young male adults with excess weight are closely related to an increased cognitive load. Previous research mainly focuses on analyzing the postural control status of these populations performing cognitive tasks while stabilized walking progress but overlooked a specific period of walking known as gait initiation (GI). It is yet unknown the influences of cognitive load on this population's postural control status during GI. Objective: This study aimed to determine the influences of cognitive load on the center of pressure (CoP) trajectory of young male adults with excess weight during GI. Design: A controlled laboratory study. Methods: Thirty-six male undergraduate students were recruited and divided into normal-weight, overweight, and obese groups based on their body mass index (BMI). Participants' CoP parameters during GI under single and dual-task conditions were collected by two force platforms. A mixed ANOVA was utilized to detect significant differences. Results: Compared with the normal-weight group, the obese group showed significant changes in the duration and CoP parameters during sub-phases of GI, mainly reflecting prolonged duration, increased CoP path length, higher mediolateral CoP displacement amplitude, and decreased velocity of anteroposterior CoP displacement. During GI with 1-back task, significantly increased mediolateral CoP displacement amplitude occurred in the obese group. During GI with 2-back task, the obese group had increased CoP path length, higher mediolateral CoP displacement amplitude, as well as a decreased velocity of CoP displacement. Conclusion: Based on the changes in CoP parameters during GI with cognitive tasks, young male adults with excess weight, mainly obese ones, have compromised postural stability. During GI with a difficult cognitive task, obese young male adults are more susceptible to deterioration in their lateral postural balance. These findings indicate that the increased cognitive load could exacerbate obese young male adults' postural control difficulty during GI under dual-task conditions, putting them at a higher risk of experiencing incidents of falls. Based on these findings, we offer suggestions for therapists to intervene with these young male adults to ensure their safety of GI.
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Affiliation(s)
- Lingyu Kong
- School of Physical Education, Soochow University, Suzhou, China
| | - Zhiqi Zhang
- School of Physical Education, Soochow University, Suzhou, China
| | - Jiawei Bao
- School of Mathematical Sciences, Soochow University, Suzhou, China
| | - Xinrui Zhu
- Rehabilitation Medicine Department, Xuzhou Rehabilitation Hospital, Xuzhou, China
| | - Yong Tan
- School of Physical Education, Soochow University, Suzhou, China
| | - Xihao Xia
- Wuxi 9th People’s Hospital Affiliated to Soochow University, Wuxi, China
| | - Qiuxia Zhang
- School of Physical Education, Soochow University, Suzhou, China
| | - Yuefeng Hao
- Orthopedics and Sports Medicine Center, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
- Gusu School, Nanjing Medical University, Suzhou, China
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Homagain A, Ehgoetz Martens KA. Emotional states affect steady state walking performance. PLoS One 2023; 18:e0284308. [PMID: 37708145 PMCID: PMC10501668 DOI: 10.1371/journal.pone.0284308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/25/2023] [Indexed: 09/16/2023] Open
Abstract
Gait is a large component and indicator of health. Many factors affect gait including age, disease, and even mood disorders. Few studies have looked at the influence of emotional states on gait. This study aimed to investigate the influence of emotional states on walking performance to understand whether an emotional state may be an important factor to consider when evaluating gait. Thirty-six young adults were recruited (23F, 13M) and performed a neutral baseline condition of walking which included six passes of walking across an 8m walkway (a total of 48m of walking). Participants then completed 6 pseudo-randomized emotional state induction conditions while immersive 360-degree videos were used to induce the following emotional conditions: happiness, excitement, sadness, fear, and anger. Participants viewed the emotion elicitation videos using a virtual reality head-mounted display (HMD), then rated their emotional state using self-assessment manikins and walked (without the HMD) over a pressure sensor walkway. One-way repeated measures ANOVA and pairwise comparisons were used to examine differences in gait parameters across the emotional conditions. Participants walked with significantly reduced step length and speed during the sadness condition compared to the other emotional conditions and the neutral condition. Furthermore, participants adjusted the timing of their walking during the sadness condition and walked with significantly increased step, stance, and swing times compared to other emotional conditions, but not the neutral condition. Step time was significantly reduced during the conditions of excitement and fear compared to the neutral condition. Emotions may impact variety of gait parameters involving pace and rhythm, however have little influence on gait variability and postural control. These results indicate that perhaps the emotions of sadness and excitement should be taken into account as potential confounds for future gait analysis.
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Affiliation(s)
- Abhishesh Homagain
- Faculty of Health, Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Kaylena A. Ehgoetz Martens
- Faculty of Health, Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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Casado-Hernández I, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias M, Gómez-Salgado J, López-López D, Bayod J. Variability of the lower limb symmetry index associated with the gait parameters in the overweight adult population with flatfoot: a case-control study. Front Bioeng Biotechnol 2023; 11:1189309. [PMID: 37388764 PMCID: PMC10303102 DOI: 10.3389/fbioe.2023.1189309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 06/05/2023] [Indexed: 07/01/2023] Open
Abstract
Background: Adult acquired flatfoot is characterized by a medial arch collapse during monopodal support in the stance phase, developing eversion of the calcaneus and abduction of the forefoot linked to the hindfoot. The purpose of our research was to analyze the dynamic symmetry index in the lower limbs comparing patients with flatfoot and normal foot. Methods: A case-control study was carried out with a sample of 62 participants divided into two groups consisting of 31 participants were overweight with bilateral flatfoot and 31 participants with healthy feet. A portable plantar pressure platform with piezoresistive sensors was used to measure the load symmetry index in the lower limbs in the foot areas and gait phases. Results: Gait pattern analysis showed statistically significant differences in the symmetry index for lateral load (p = 0.004), the initial contact phase (p = 0.025) and the forefoot phase (p < 0.001). Conclusion: The adults were overweight with bilateral flatfoot evidenced alterations in the symmetry index in the lateral load and in the initial contact and flatfoot contact phases, showing greater instability in overweight adult flatfoot compared to the people with normal feet.
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Affiliation(s)
- Israel Casado-Hernández
- Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, Madrid, Spain
| | | | | | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
| | - Daniel López-López
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Industrial Campus of Ferrol, Universidade da Coruña, Ferrol, Spain
| | - Javier Bayod
- Applied Mechanics and Bioengineering Group (AMB), Aragon Institute of Engineering Research (I3A), Universidad de Zaragoza, Zaragoza, Aragon, Spain
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Ferrario C, Condoluci C, Tarabini M, Manzia CM, Galli M. Anticipatory postural adjustments and kinematic analysis of step ascent and descent in adults with Down syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:475-487. [PMID: 36808671 DOI: 10.1111/jir.13022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 01/19/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Step ascent and descent is one of the most common daily tasks. Although it is generally considered a rather simple movement, it may not be so easy for participants with Down syndrome. METHODS A kinematic analysis of step ascent and descent was conducted, and a comparison between 11 adult participants with Down syndrome and 23 healthy participants was carried out. This analysis was accompanied by a posturographic analysis with the aim of evaluating aspects relating to balance. The principal aim of postural control was to investigate the trajectory of the centre of pressure, while the kinematic analysis of movement included the following: (1) the analysis of anticipatory postural adjustments, (2) the calculation of spatiotemporal parameters and (3) the evaluation of articular range of motion. RESULTS A general instability for participants with Down syndrome, highlighted in the postural control by an increased anteroposterior and mediolateral excursion, when the test was conducted with both open and closed eyes, was found out. Regarding anticipatory postural adjustments, this deficit in balance control was revealed by the execution of small steps before completing the movement and by a much longer preparation time anticipating the movement. In addition, the kinematic analysis reported a longer ascent and descent time and a lower velocity, accompanied by a greater rising of both limbs in ascent, which indicates an increased perception of the obstacle. Finally, a wider trunk range of motion in both the sagittal and frontal planes was revealed. CONCLUSIONS All the data confirm a compromised balance control that could be associated with damage to the sensorimotor centre.
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Affiliation(s)
- C Ferrario
- Dipartimento di Meccanica, Politecnico di Milano, Milan, Italy
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | | | - M Tarabini
- Dipartimento di Meccanica, Politecnico di Milano, Milan, Italy
| | | | - M Galli
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
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Kung CF, Lai YR, Chiu WC, Lien CY, Huang CC, Cheng BC, Lin WC, Chen YS, Yu CC, Chiang YF, Guo YR, Chen YH, Lu CH. Effectiveness of Center of Pressure Trajectory as Anticipatory Postural Adjustment Measurement in Parkinson's Disease With Freezing of Gait History. Neurorehabil Neural Repair 2023; 37:240-250. [PMID: 37083157 DOI: 10.1177/15459683231166934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
BACKGROUND Evidence showed that patients with Parkinson's disease (PD) who have a history of freezing of gait (FOG) have hypometric anticipatory postural adjustment (APA) during gait initiation (GI) compared to PD without FOG. OBJECTIVES This study aimed to test the feasibility of center of pressure (COP) displacement during GI as the measure of APA in PD with and without a history of FOG. METHODS Patients with PD underwent COP trajectory measurements, including duration, length, velocity, and acceleration in different phases of APA (APA1, APA2a, APA2, and LOC), as well as evaluation of New Freezing of Gait Questionnaire (NFOG-Q), Tinetti balance and gait score, and Postural Instability and Gait Difficulty (PIGD) score in the on and off medication states. RESULTS The duration (seconds) of APA2a, APA2b, and LOC were highest while velocity in mediolateral direction (X) (m/s), including APA1, APA2a, APA2b, and LOC showed lowest in PD with FOG. Velocity in the mediolateral direction in different phases of APA increased in patients with FOG after dopaminergic therapy. APA2a (seconds) and APA2b (X) (m/s) were significantly associated with NFOG-Q part II, APA2b (X) (m/s) was significantly associated with NFOG-Q part III, and APA2a (seconds) was significantly associated with Tinetti balance and gait and PIGD score. CONCLUSIONS PD with FOG history showed a favorable response of APAs to dopaminergic replacement. The APA parameters by COP trajectory, especially lateral COP shift toward the stance foot (APA2b (X) (m/s) and APA2a (seconds)) are surrogate markers to assess PD with FOG history.
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Affiliation(s)
- Chien-Feng Kung
- Department of Intelligent Commerce, National Kaohsiung University of Science and Technology, Kaohsiung
| | - Yun-Ru Lai
- Departments of Neurology, Chang Gung University College of Medicine, Kaohsiung
- Departments of Hyperbaric Oxygen Therapy Center, Chang Gung University College of Medicine, Kaohsiung
| | - Wen-Chan Chiu
- Departments of Internal Medicine, Chang Gung University College of Medicine, Kaohsiung
| | - Chia-Yi Lien
- Departments of Neurology, Chang Gung University College of Medicine, Kaohsiung
| | - Chih-Cheng Huang
- Departments of Neurology, Chang Gung University College of Medicine, Kaohsiung
| | - Ben-Chung Cheng
- Departments of Internal Medicine, Chang Gung University College of Medicine, Kaohsiung
| | - Wei-Che Lin
- Departments of Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung
| | - Yueh-Sheng Chen
- Departments of Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung
| | - Chiun-Chieh Yu
- Departments of Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung
| | - Yi-Fang Chiang
- Departments of Neurology, Chang Gung University College of Medicine, Kaohsiung
| | - Yan-Ru Guo
- Department of Intelligent Commerce, National Kaohsiung University of Science and Technology, Kaohsiung
| | - Yin-Hong Chen
- Department of Intelligent Commerce, National Kaohsiung University of Science and Technology, Kaohsiung
| | - Cheng-Hsien Lu
- Department of Biological Science, National Sun Yat-Sen University, Kaohsiung
- Department of Neurology, Xiamen Chang Gung Memorial Hospital, Xiamen, Fujian, China
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Effect of Gait Alteration on Fatigability during Walking in Adult Women with High Body Fat Composition. MEDICINA (KAUNAS, LITHUANIA) 2022; 59:medicina59010085. [PMID: 36676709 PMCID: PMC9866334 DOI: 10.3390/medicina59010085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/25/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023]
Abstract
Background and Objective: The risk factors for injury due to alterations in gait efficiency and fatigability during walking are a rising concern. Therefore, the aims of this study were to characterize the changes in gait pattern and performance fatigability among adult women with a high body fat percentage and to study the association between the gait pattern and performance fatigability during walking. Materials and Methods: A total of 160 adult women were enrolled in the study and were divided into two groups: a high-body-fat percentage group (HBF; n = 80; fat% = 42.49 ± 3.51) and a comparison group with a normal body fat percentage (NBF; n = 80; fat% = 29.68 ± 4.30). The 10 min walking test (10-MWT) was used to measure performance fatigability. Treadmill-based gait analysis was used for the acquisition of gait parameters. The correlation between the variables was examined using Pearson’s correlation coefficient. Forward stepwise linear regression was carried out to examine the association between all independent variables, and performance fatigability was adjusted for age and height. The level of statistical significant was set at p-value < 0.05 in all analyses. Results: The mean performance fatigability during the 10-MWT was reported to be high (1.4 ± 0.13) among the participants with HBF, as compared with a fatigability of 1.25 ± 0.11 in the NBF group. The data analysis of the spatial parameters indicated that stride length and step length were statistically smaller in the participants with HBF, as compared with the NBF group. The effects of average maximum force, speed, cadence, step length, and stride length explained the variation in the performance fatigability by 61% (p = 0.007). Conclusion: The findings of this study showed that gait alteration due to excess body fat induced a reduction in performance, as reflected by the high fatigability performance during walking. The study demonstrated a significant association between the severity of performance fatigability and spatial gait parameters.
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Kong L, Wang W, Zhu X, Zhang W, Li Q, Wang X, Wang L. Effect of frailty on kinematic characteristics of walking in community-dwelling elders. Z Gerontol Geriatr 2022; 55:689-695. [PMID: 34757468 DOI: 10.1007/s00391-021-01997-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 10/21/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Frailty has a high prevalence in elders and impairs motor ability. This study aimed to investigate the influence caused by frailty in kinematic characteristics of walking and walking strategy adjustment from static standing to stable walking. METHODS In this study, 80 community-dwelling elders performed tests. The Kihon checklist (KCL) was used to assess frailty. The timed up and go test (TUGT) and the 30-s chair stand test (30-s CST) were used to assess balance and muscle strength. The Xsens MVN BIOMECH Awinda was used to collect walking kinematic data. RESULTS This study included 25 robust, 30 prefrail, and 25 frail elders. The TUGT completed time (P < 0.001) and the 30-s CST completed number (P = 0.002) had statistical differences among groups. The maximum peak of knee internal rotation showed an interaction between the frailty and the walking phase (P = 0.015). The peak angle of hip adduction, hip and knee flexion, and knee and ankle internal rotation were significantly lower in frail elders than others (P < 0.05). CONCLUSION Frailty affects the kinematic characteristics of walking, resulting in the hip, knee, and ankle flexion, hip adduction, knee and ankle internal rotation reduced. Besides, frailty has a specific negative effect on the walking strategy adjustment from static standing to stable walking.
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Affiliation(s)
- Lingyu Kong
- School of Rehabilitation Medicine, Weifang Medical University, 261053, Weifang, China
| | - Wei Wang
- School of Basic Medical Sciences, Weifang Medical University, Weifang, China
| | - Xinrui Zhu
- School of Rehabilitation Medicine, Weifang Medical University, 261053, Weifang, China
| | - Wen Zhang
- School of Rehabilitation Medicine, Weifang Medical University, 261053, Weifang, China
| | - Qianqian Li
- School of Rehabilitation Medicine, Weifang Medical University, 261053, Weifang, China
| | - Xiaowen Wang
- Department of Rehabilitation Medicine, Affiliated Hospital, Weifang Medical University, Weifang, China
| | - Liduan Wang
- School of Rehabilitation Medicine, Weifang Medical University, 261053, Weifang, China.
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The Effect of Different Body Mass Index Levels on Static and Dynamic Postural Balance Performance in Adults. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2022. [DOI: 10.30621/jbachs.1079167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background and Purpose: It was aimed to examine the static and dynamic postural balance performance in adults with different Body Mass Index (BMI) levels.
Methods: Study was conducted in Üsküdar Diabetes and Obesity Treatment Center between September and October 2021. Participants were divided into 5 groups according to BMI scores: normal-weight, overweight, 1st degree obese, 2nd degree obese, and 3rd degree obese. The static and dynamic balance performance of participants were assessed by the Limits of Stability (LOS) and modified Clinical Test of Sensory Integration of Balance (m-CTSIB) tests.
Results: For LOS parameters, there was a significant difference between groups in reaction time scores only for the backward direction (p
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The evaluation of postural stability and fall risk in morbidly obese preoperative bariatric patients: A cross-sectional study. JOURNAL OF CONTEMPORARY MEDICINE 2021. [DOI: 10.16899/jcm.976662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Qu X, Hu X, Tao D. Gait initiation differences between overweight and normal weight individuals. ERGONOMICS 2021; 64:995-1001. [PMID: 33663344 DOI: 10.1080/00140139.2021.1896788] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 02/23/2021] [Indexed: 06/12/2023]
Abstract
Accidental falls often occur during gait initiation. Excess body weight has been identified as a risk factor for accidental falls. This study aimed to examine the differences of gait initiation between overweight and normal-weight individuals. Fourteen overweight and 14 normal-weight young adults participated in the study. They were instructed to perform the gait initiation task under single-task and dual-task conditions. Dependent variables for the assessment of gait initiation included spatial-temporal measures and postural stability measures. The results showed that overweight could compromise postural stability during gait initiation, primarily by decreasing margin of stability in the anterior-posterior direction. Cognitive task interference with gait initiation was found to be similar between the overweight and normal weight groups. The findings from the present study can aid in better understanding the mechanisms associated with increased fall risks among overweight individuals. They also highlight the importance of overweight control in fall prevention. Practitioner summary: Overweight was found to compromise postural stability during gait initiation, primarily by decreasing margin of stability in the anterior-posterior direction. The findings highlight the importance of overweight control in fall prevention. Abbreviations: ANOVA: analyses of variance; AP: anterior-posterior; APA: anticipatory postural adjustment; BOS: base of support; BW: Body weight; COM: centre-of-mass; COP: center-of-pressure; CT: cognitive task; GI: Gait initiation; GRF: ground reaction force; HC: heel-contact; HO: heel-off; ML: medial-lateral; MOS: margin of stability; SD: standard deviation; SE: step execution; SL: step length; SW: step width; VEL_COM: velocity of the COM; XCOM: extrapolated center of mass.
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Affiliation(s)
- Xingda Qu
- Institute of Human Factors and Ergonomics, Shenzhen University, Shenzhen, China
| | - Xinyao Hu
- Institute of Human Factors and Ergonomics, Shenzhen University, Shenzhen, China
| | - Da Tao
- Institute of Human Factors and Ergonomics, Shenzhen University, Shenzhen, China
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Kasahara S, Saito H. Mechanisms of postural control in older adults based on surface electromyography data. Hum Mov Sci 2021; 78:102803. [PMID: 33962246 DOI: 10.1016/j.humov.2021.102803] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 04/21/2021] [Accepted: 04/21/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The present study aimed to clarify the mechanisms of postural control during standing in older adults and document the mechanisms of age-related motor control based on changes in muscle activities. METHODS A total of 26 healthy male adults (older adult group, ≥65-78 years: n = 16; younger adult group, 20-23 years: n = 10) participated in this study. Ground reaction force and kinematic data of the lower limbs (hip, knee, and ankle), and electromyographic data from 6 postural muscles on the right side were recorded and quantified for each motor phase during rapid voluntary center of pressure (COP) shift. RESULTS Although hip strategy was more frequently observed in older adults than in young adults (56.3% vs. 20.0%), no muscle activity of hip agonists was observed in some (31.3%) older adults. Furthermore, older adults had a statistically significant delay in the inhibition of postural muscles during anticipatory postural adjustments (p < 0.05). After the onset of COP motion, the co-contraction time between agonists and antagonists was significantly prolonged in the older adults than in the younger adults (p < 0.05), and the reciprocal muscle pattern was unclear in the older adults. Prior to the termination of movement, agonist activity continued longer in the older adult group than in the younger adult group; that is, inhibition was insufficient in the older adult group. CONCLUSION A series of postural strategies during the voluntary movement task were altered in older adults, and this was significantly related not only with the activation but also the inhibition of postural muscles.
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Affiliation(s)
- Satoshi Kasahara
- Department of Rehabilitation Sciences, Faculty of Health Sciences, Hokkaido University, West 5, North 12, Kita-ku, Sapporo 060-0812, Japan.
| | - Hiroshi Saito
- Department of Physical Therapy, School of Rehabilitation, Tokyo Kasei University, Inariyama2-15-1, Sayama 350-1398, Japan.
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Caderby T, Caron N, Verkindt C, Bonazzi B, Dalleau G, Peyrot N. Obesity-related alterations in anticipatory postural mechanisms associated with gait initiation. Exp Brain Res 2020; 238:2557-2567. [DOI: 10.1007/s00221-020-05914-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 08/26/2020] [Indexed: 02/08/2023]
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Fabre M, Chavet P, Fornerone T, Juan B, Abossolo O, Pardo F, Blouin J, Dany L, Mouchnino L. Somatosensory cortical facilitation during step preparation restored by an improved body representation in obese patients. Gait Posture 2020; 80:246-252. [PMID: 32559643 DOI: 10.1016/j.gaitpost.2020.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 05/25/2020] [Accepted: 06/02/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND The anticipatory postural adjustments (APA) associated with step initiation are impaired in obese patients (e.g. longer duration, greater lateral center of pressure excursion). This could arise from the known altered internal representation of the body in obese individuals as this representation is crucial for enhancing the processing of foot cutaneous inputs prior to step initiation and for setting the APA. RESEARCH QUESTION The purpose of the study was to examine if the processing of foot cutaneous inputs and the preparation of the APA when planning a step are impaired in obese patients due to their damaged body internal representation (BIR). We also investigated whether these sensorimotor processes will be restored after a 15-day intervention program composed of motor and cognitive activities engaging the BIR without aiming weight loss. METHODS We compared, prior to (D1) and after (D15) the program, the amplitude of the cortical response evoked by foot cutaneous stimulation (SEP) occurring either during quiet standing or during the planning of a step in 18 obese patients (mean body mass index, BMI: 35). The APA were analyzed by measuring the amplitude and latency of the lateral force exerted on the ground. RESULTS AND SIGNIFICANCE The SEP amplitude was not significantly different between the standing and stepping tasks at D1, but increased in the stepping task at D15. This enhanced sensory processing was associated with an increased activation of the posterior parietal cortex, suggesting a stronger involvement of the body representation during the planning of the stepping movement after the program. These cortical changes could have contributed to the changes in the temporal dimension of the APA observed at D15. These results suggest that programs targeting different dimensions of the BIR could be beneficial in improving the dynamic balance in obesity.
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Affiliation(s)
- Marie Fabre
- Aix-Marseille Université, CNRS, Laboratoire de Neurosciences Cognitives, FR 3C, Marseille, France
| | - Pascale Chavet
- Aix-Marseille Université, CNRS, Institut des Sciences du Mouvement, Marseille, France
| | - Théo Fornerone
- Aix-Marseille Université, CNRS, Laboratoire de Neurosciences Cognitives, FR 3C, Marseille, France
| | - Benjamin Juan
- Aix-Marseille Université, CNRS, Laboratoire de Neurosciences Cognitives, FR 3C, Marseille, France
| | - Olivier Abossolo
- Equilibre Hôpital de jour, Clinique Saint-Christophe, Chemin de St Hilaire, 13320, Bouc-Bel-Air, France
| | - Fabrice Pardo
- Equilibre Hôpital de jour, Clinique Saint-Christophe, Chemin de St Hilaire, 13320, Bouc-Bel-Air, France
| | - Jean Blouin
- Aix-Marseille Université, CNRS, Laboratoire de Neurosciences Cognitives, FR 3C, Marseille, France
| | - Lionel Dany
- Aix Marseille Université, LPS, Aix-en-Provence, France; APHM, Timone, Service d'Oncologie Médicale, Marseille, France
| | - Laurence Mouchnino
- Aix-Marseille Université, CNRS, Laboratoire de Neurosciences Cognitives, FR 3C, Marseille, France.
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Balance Control in Obese Subjects during Quiet Stance: A State-of-the Art. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10051842] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Obese individuals are characterized by a reduced balance which has a significant effect on a variety of daily and occupational tasks. The presence of excessive adipose tissue and weight gain could increase the risk of falls; for this reason, obese individuals are at greater risk of falls than normal weight subjects in the presence of postural stress and disturbances. The quality of balance control could be measured with different methods and generally in clinics its integrity is generally assessed using platform stabilometry. The aim of this narrative review is to present an overview on the state of art on balance control in obese individuals during quiet stance. A summary of knowledge about static postural control in obese individuals and its limitations is important clinically, as it could give indications and suggestions to improve and personalize the development of specific clinical programs.
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Complexity-Based Measures of Postural Sway during Walking at Different Speeds and Durations Using Multiscale Entropy. ENTROPY 2019. [PMCID: PMC7514472 DOI: 10.3390/e21111128] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
: Participation in various physical activities requires successful postural control in response to the changes in position of our body. It is important to assess postural control for early detection of falls and foot injuries. Walking at various speeds and for various durations is essential in daily physical activities. The purpose of this study was to evaluate the changes in complexity of the center of pressure (COP) during walking at different speeds and for different durations. In this study, a total of 12 participants were recruited for walking at two speeds (slow at 3 km/h and moderate at 6 km/h) for two durations (10 and 20 minutes). An insole-type plantar pressure measurement system was used to measure and calculate COP as participants walked on a treadmill. Multiscale entropy (MSE) was used to quantify the complexity of COP. Our results showed that the complexity of COP significantly decreased (p < 0.05) after 20 min of walking (complexity index, CI = −3.51) compared to 10 min of walking (CI = −3.20) while walking at 3 km/h, but not at 6 km/h. Our results also showed that the complexity index of COP indicated a significant difference (p < 0.05) between walking at speeds of 3 km/h (CI = −3.2) and 6 km/h (CI = −3.6) at the walking duration of 10 minutes, but not at 20 minutes. This study demonstrated an interaction between walking speeds and walking durations on the complexity of COP.
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Accuracy and Reliability of Onset Detection Algorithms in Gait Initiation for Healthy Controls and Participants With Parkinson's Disease. J Appl Biomech 2019; 35:393–400. [PMID: 31629341 DOI: 10.1123/jab.2018-0431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 04/25/2019] [Accepted: 07/29/2019] [Indexed: 11/18/2022]
Abstract
Accurate and reliable detection of the onset of gait initiation is essential for the correct assessment of gait. Thus, this study was aimed at evaluation of the reliability and accuracy of 3 different center of pressure-based gait onset detection algorithms: A displacement baseline-based algorithm (method 1), a velocity baseline-based algorithm (method 2), and a velocity extrema-based algorithm (method 3). The center of pressure signal was obtained during 10 gait initiation trials from 16 healthy participants and 3 participants with Parkinson's disease. Intrasession and absolute reliability of each algorithm was assessed using the intraclass correlation coefficient and the coefficient of variation of center of pressure displacement during the postural phase of gait initiation. The accuracy was evaluated using the time error of the detected onset by each algorithm relative to that of visual inspection. The authors' results revealed that although all 3 algorithms had high to very high intrasession reliabilities in both healthy subjects and subjects with Parkinson's disease, methods 2 and 3 showed significantly better absolute reliability than method 1 in healthy controls (P = .001). Furthermore, method 2 outperformed the other 2 algorithms in both healthy subjects and subjects with Parkinson's disease with an overall accuracy of 0.80. Based on these results, the authors recommend using method 2 for accurate and reliable gait onset detection.
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Delafontaine A, Vialleron T, Fischer M, Laffaye G, Chèze L, Artico R, Genêt F, Fourcade PC, Yiou E. Acute Effects of Whole-Body Vibration on the Postural Organization of Gait Initiation in Young Adults and Elderly: A Randomized Sham Intervention Study. Front Neurol 2019; 10:1023. [PMID: 31616369 PMCID: PMC6768974 DOI: 10.3389/fneur.2019.01023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 09/09/2019] [Indexed: 11/13/2022] Open
Abstract
Whole-body vibration (WBV) is a training method that exposes the entire body to mechanical oscillations while standing erect or seated on a vibrating platform. This method is nowadays commonly used by clinicians to improve specific motor outcomes in various sub-populations such as elderly and young healthy adults, either sedentary or well-trained. The present study investigated the effects of acute WBV application on the balance control mechanisms during gait initiation (GI) in young healthy adults and elderly. It was hypothesized that the balance control mechanisms at play during gait initiation may compensate each other in case one or several components are perturbed following acute WBV application, so that postural stability and/or motor performance can be maintained or even improved. It is further hypothesized that this capacity of adaptation is altered with aging. Main results showed that the effects of acute WBV application on the GI postural organization depended on the age of participants. Specifically, a positive effect was observed on dynamic stability in the young adults, while no effect was observed in the elderly. An increased stance leg stiffness was also observed in the young adults only. The positive effect of WBV on dynamic stability was ascribed to an increase in the mediolateral amplitude of "anticipatory postural adjustments" following WBV application, which did overcompensate the potentially destabilizing effect of the increased stance leg stiffness. In elderly, no such anticipatory (nor corrective) postural adaptation was required since acute WBV application did not elicit any change in the stance leg stiffness. These results suggest that WBV application may be effective in improving dynamic stability but at the condition that participants are able to develop adaptive changes in balance control mechanisms, as did the young adults. Globally, these findings are thus in agreement with the hypothesis that balance control mechanisms are interdependent within the postural system, i.e., they may compensate each other in case one component (here the leg stiffness) is perturbed.
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Affiliation(s)
- Arnaud Delafontaine
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France.,ENKRE, Saint-Maurice, France
| | - Thomas Vialleron
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France
| | - Matthieu Fischer
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France
| | - Guillaume Laffaye
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France
| | | | - Romain Artico
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France.,ENKRE, Saint-Maurice, France
| | - François Genêt
- UMR End:icap équipe 3, UFR des Sciences de la Santé Simone Veil, UVSQ, Montigny le Bretonneux, France
| | - Paul Christian Fourcade
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France
| | - Eric Yiou
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France
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Symmetry of Gait in Underweight, Normal and Overweight Children and Adolescents. SENSORS 2019; 19:s19092054. [PMID: 31052569 PMCID: PMC6539288 DOI: 10.3390/s19092054] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 04/24/2019] [Accepted: 04/30/2019] [Indexed: 12/22/2022]
Abstract
Abnormal excess or lack of body mass can influence gait patterns, but in some cases such differences are subtle and not easy to detect, even with quantitative techniques for movement analysis. In these situations, the study of trunk accelerations may represent an effective way to detecting gait anomalies in terms of symmetry through the calculation of Harmonic Ratio (HR), a parameter obtained by processing trunk accelerations in the frequency domain. In the present study we used this technique to assess the existence of differences in HR during gait in a cohort of 75 healthy children and early adolescents (aged 7-14 years) stratified into 3 equally-sized age and gender-matched groups (Underweight: UW; Normal Weight: NW; Overweight: OW). The accelerometric signal, acquired using a single wearable inertial sensor, was processed to calculate stride length, speed, cadence and HR in antero-posterior, vertical and medio-lateral directions. No differences in spatio-temporal parameters were found among groups, while the HR in the medio-lateral direction was found significantly lower in UW children, while OW exhibited the highest values. On the basis of the results obtained, HR appears capable of discriminating gait symmetry in children with different body mass even when conventional gait parameters are unchanged.
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Corsi C, Cimolin V, Capodaglio P, Condoluci C, Galli M. A biomechanical study of gait initiation in Down syndrome. BMC Neurol 2019; 19:66. [PMID: 30987596 PMCID: PMC6466789 DOI: 10.1186/s12883-019-1288-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 03/31/2019] [Indexed: 12/17/2022] Open
Abstract
Background Gait Initiation (GI) is a functional task that challenges the balance control requiring weight shift and a transition from standing to walking. Individuals with Down Syndrome (DS) walk with low velocity, prolonged stance and shorter steps beside an increased support base. However, no studies performed GI analysis on this population. The aim of this study is to quantitatively characterize the GI task in subjects with DS compared with a typically developed control group. Methods Seventeen individuals with DS (17 to 40 years) and 19 healthy subjects (17 to 40 years) were enrolled in the study. Data were acquired using an optoelectronic motion capture system and force plates in order to measure the displacement and velocity of Center of Mass (CoM) and the trajectory of Center Of Pressure (CoP). All participants were asked to stand barefoot on the first force platform and received a verbal cue to begin walking for 6 gait initiation trials (three starting with each foot). The CoP duration, velocity, length and excursion were calculated during the anticipatory postural adjustments phases (APAs) and the locomotor (LOC) phase. For the analysis of the CoM, its displacements in antero-posterior (AP) and medio-lateral (ML) during the APAs and LOC phases. Statistical analysis was conducted to compare the two groups. Results Regarding CoP measures, when compared to control group, individuals with DS presented higher durations, lower velocities, longer lengths during the second APA and total phases, and shorter lengths during the first APA and LOC phases. The group with DS also presented longer CoP excursion during the second APA, whereas a shorter excursion was present during the first APA and LOC phases. The AP excursion in CoM is reduced in the participants with DS. Conclusions Our results could be useful in the rehabilitation of individuals with DS as they suggest to reinforce exercise programs to improve balance in AP and ML directions, which is demonstrated to be impaired in these subjects.
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Affiliation(s)
- Carolina Corsi
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133, Milan, Italy
| | - Veronica Cimolin
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133, Milan, Italy
| | - Paolo Capodaglio
- Orthopaedic Rehabilitation Unit and Clinical Lab for Gait Analysis and Posture, Ospedale San Giuseppe, Istituto Auxologico Italiano, IRCCS, Via Cadorna 90, I-28824, Piancavallo, VB, Italy
| | | | - Manuela Galli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133, Milan, Italy.
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Lim S, D'Souza C. Statistical prediction of load carriage mode and magnitude from inertial sensor derived gait kinematics. APPLIED ERGONOMICS 2019; 76:1-11. [PMID: 30642513 PMCID: PMC7079201 DOI: 10.1016/j.apergo.2018.11.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 10/23/2018] [Accepted: 11/22/2018] [Indexed: 05/25/2023]
Abstract
Load carriage induces systematic alterations in gait patterns and pelvic-thoracic coordination. Leveraging this information, the objective of this study was to develop and assess a statistical prediction algorithm that uses body-worn inertial sensor data for classifying load carrying modes and load levels. Nine men participated in an experiment carrying a hand load in four modes: one-handed right and left carry, and two-handed side and anterior carry, each at 50% and 75% of the participant's maximum acceptable weight of carry, and a no-load reference condition. Twelve gait parameters calculated from inertial sensor data for each gait cycle, including gait phase durations, torso and pelvis postural sway, and thoracic-pelvic coordination were used as predictors in a two-stage hierarchical random forest classification model with Bayesian inference. The model correctly classified 96.9% of the carrying modes and 93.1% of the load levels. Coronal thoracic-pelvic coordination and pelvis postural sway were the most relevant predictors although their relative importance differed between carrying mode and load level prediction models. This study presents an algorithmic framework for combining inertial sensing with statistical prediction with potential use for quantifying physical exposures from load carriage.
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Affiliation(s)
- Sol Lim
- Center for Ergonomics, Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, MI, USA.
| | - Clive D'Souza
- Center for Ergonomics, Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, MI, USA
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Kasahara S, Saito H. The effect of aging on termination of voluntary movement while standing: A study on community-dwelling older adults. Hum Mov Sci 2019; 64:347-354. [DOI: 10.1016/j.humov.2019.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 02/25/2019] [Accepted: 03/05/2019] [Indexed: 10/27/2022]
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Hirjaková Z, Šuttová K, Kimijanová J, Bzdúšková D, Hlavačka F. Postural changes during quiet stance and gait initiation in slightly obese adults. Physiol Res 2018; 67:985-992. [PMID: 30204472 DOI: 10.33549/physiolres.933870] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The study is aimed to examine balance control of slightly obese young adults during quiet stance and during gait initiation with and without crossing an obstacle. Forty-four young subjects were divided in two groups: control (BMI<25 kg/m(2)) and slightly obese (BMI from 25 to 35 kg/m(2)). Center of foot pressure (CoP) and kinematics of fifth lumbar vertebra (L5) were evaluated using a force plate and a motion capture system. During quiet stance with eyes open slightly obese group showed increased mean amplitude and velocity of CoP in anterior-posterior direction compared to normal weight subjects. During unloading phase of gait initiation significantly greater and faster lateral CoP shift was observed in slightly obese group compared to normal weight peers. Presence of an obstacle increased amplitude and velocity of the lateral CoP shift similarly in both groups. No BMI-related differences were found on L5 segment during gait initiation, which may indicate that postural control was already successfully performed in feet (CoP). We have shown that increased CoP parameters values and thus increased postural instability during quiet stance and during unloading phase of gait initiation is present not only in morbidly obese, but already in slightly obese subjects.
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Affiliation(s)
- Z Hirjaková
- Centre of Experimental Medicine Slovak Academy of Sciences, Institute of Normal and Pathological Physiology, Bratislava, Slovakia.
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Ghesmaty Sangachin M, Cavuoto LA, Wang Y. Use of various obesity measurement and classification methods in occupational safety and health research: a systematic review of the literature. BMC OBESITY 2018; 5:28. [PMID: 30410773 PMCID: PMC6211422 DOI: 10.1186/s40608-018-0205-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 06/21/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND This study systematically examined obesity research in occupational safety and health regarding the use of various obesity measurement and classification methods. METHODS A systematic search of the PubMed database on English language publications from 2000 to 2015 using related keywords and search of citations resulted in selection of 126 studies. They were categorized into two groups based on their main research question: 1) general physical or mental work-related functioning; and 2) task or body part specific functioning. RESULTS Regardless of the study group, body mass index (BMI) was the most frequently used measure. Over 63% of the studies relied solely on BMI to define obesity. In only 22% of the studies, body fat was directly measured by methods such as dual energy x-ray absorptiometry. Abdominal obesity was defined using waist circumference in recent years, and waist-hip ratio in earlier years. Inconsistent cut-offs have also been used across studies investigating similar topics. CONCLUSIONS Few authors acknowledged the limitations of using indirect obesity measures. This is in part due to the limited understanding of some occupational safety and health researchers regarding the complex issues surrounding obesity classification and also the mixed recommendations over the past 2-3 decades and across populations. Efforts need to be made to promote appropriate obesity measurement and reporting in this field.
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Affiliation(s)
| | - Lora A. Cavuoto
- Department of Industrial and Systems Engineering, University at Buffalo, 324 Bell Hall, Buffalo, NY 14260 USA
| | - Youfa Wang
- Department of Nutrition and Health Sciences, College of Health, Ball State University, Muncie, IN USA
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Silva D, Gabriel R, Moreira M, Abrantes J, Faria A. Differences in foot contact times between obese and non-obese postmenopausal women when crossing obstacles. Somatosens Mot Res 2018; 35:170-177. [PMID: 30299193 DOI: 10.1080/08990220.2018.1511537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE This study aimed to investigate the foot contact time differences between obese and non-obese subjects during walking when crossing obstacles. METHODS Ninety-eight postmenopausal women were assigned to four groups, and their plantar pressure temporal data were collected using a two-step protocol during walking when crossing an obstacle set at 30% height of lower limb length of each subject. The initial, final, and duration of contact of 10 foot areas were measured. RESULTS Leading limb: (1) the heel groups initiated foot contact using the heel, and the non-heel groups initiated contact using the metatarsals; (2) heel obese subjects showed an earlier initial contact and a longer contact duration of metatarsals 2-3; (3) non-heel obese subjects showed an earlier midfoot initial contact. Regarding the trailing limb: (4) heel obese subjects showed an earlier midfoot initial contact and a longer contact duration of metatarsal 5; (5) non-heel obese subjects showed an earlier initial contact and a longer contact duration of metatarsals 4-5. CONCLUSIONS (1) The non-heel groups' foot rollover pattern may result from an attempt of rapidly restoring stability; (2) the heel obese subjects seem to regulate their plantar foot muscles to overcome their overweight; (3) the overweight of the non-heel obese subjects leads to a quicker backward foot roll-over from the metatarsals to the heel; (4) the overweight of the heel obese subjects can distort their footprints and/or their higher inertia may precipitate an anticipation of the midfoot contact, which can also explain the result observed for 5.
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Affiliation(s)
- David Silva
- a Department of Sport Sciences, Exercise and Health, CITAB , University of Trás-os-Montes and Alto Douro , Vila Real , Portugal
| | - Ronaldo Gabriel
- a Department of Sport Sciences, Exercise and Health, CITAB , University of Trás-os-Montes and Alto Douro , Vila Real , Portugal
| | - Maria Moreira
- b Department of Sport Sciences, Exercise and Health, CIDESD , University of Trás-os-Montes and Alto Douro , Vila Real , Portugal
| | - João Abrantes
- c MovLab, CICANT, University Lusófona of Humanities and Technologies , Lisboa , Portugal
| | - Aurélio Faria
- d Department of Sport Science, CIDESD , University of Beira Interior , Covilhã , Portugal
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Wang D, Mahe G, Fang J, Piscione J, Couvet S, Retiere D, Laporte S, Vidal PP. Inconsistent anticipatory postural adjustments (APAs) in rugby players: a source of injuries? BMJ Open Sport Exerc Med 2018; 4:e000303. [PMID: 29955372 PMCID: PMC6018848 DOI: 10.1136/bmjsem-2017-000303] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 03/12/2018] [Indexed: 12/26/2022] Open
Abstract
Background We are developing since 2010 with Thales and the Fédération Française de Rugby (FFR) M-Rex, a new kind of rugby scrum simulator. The study questioned whether it could improve safety and protect players from injury by using it as a tool for training/coaching the packs. Aim To explore the anticipatory postural adjustments (APAs) during the engagement of the ruck, because these predictive neck and back muscles contractions protect the spinal cord at the time of impacts, which is crucial to prevent injuries. Methods We quantified the kinematics and the EMG activities in high-level front row players during their initial engagement, when scrummaging with M-Rex. All studies were performed with one player interacting with the robot, at first, and then with the three players acting together. Results For most of the tested high-level players, the APA latencies were highly variable from trial to trial even though the engagement resulted in similar impacts. At time, the onset of the electromyography activity in the neck and back muscles showed latencies inferior to 50 ms or even close to zero prior to the impact, which rendered muscle contractions inefficient as APAs. We were also unable to identify clear muscular synergies underlying the APAs because of their great variability on a trial-to-trial basis. Finally, the APAs were not related to the amplitude of the ensuing impact and were asymmetric in most trials. All these characteristics held true, whether the player was playing alone or with two other frontline players. Conclusion Our result suggest that APAs should be systematically tested in high-level rugby players as well as in any high-level sport men at risk of neck and back injuries. Because APAs can be efficiently trained, our study paves the way to design individual position-specific injury prevention programme.
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Affiliation(s)
- Danping Wang
- School of Automation, Hangzhou Dianzi University, Zhejiang, China
- Plateforme d’étude de la Sensorimotricité, Université Paris Descartes, Paris, France
| | - Gael Mahe
- UFR de mathématiques et informatique–LIPADE, Université Paris Descartes, Paris, France
| | - Junying Fang
- Faculté des sciences fondamentales et biomédicales, Université Paris Descartes, Paris, France
| | | | | | | | - Sébastien Laporte
- LBM/Institut de Biomécanique Humaine Georges Charpak, Arts et Metiers ParisTech, Paris, France
| | - Pierre-Paul Vidal
- School of Automation, Hangzhou Dianzi University, Zhejiang, China
- COGNition and ACtion Group (COGNAC-G), Université Paris Descartes–CNRS UMR-MD–SSA, Paris, France
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Skelton DA, Mavroeidi A. How do muscle and bone strengthening and balance activities (MBSBA) vary across the life course, and are there particular ages where MBSBA are most important? J Frailty Sarcopenia Falls 2018; 3:74-84. [PMID: 32300696 PMCID: PMC7155320 DOI: 10.22540/jfsf-03-074] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2018] [Indexed: 12/21/2022] Open
Abstract
This narrative review focuses on the role of strength and balance activities throughout the lifecycle to improve physical capacity and reduce all-cause mortality. The evidence suggests strong associations in middle and older age, with poor balance, poor strength or poor physical function having strong associations with mortality. Currently in the UK, the proportions of adults (69% of men and 76% of women) not meeting the strength and balance guidelines (of 2 or more sessions/week) is concerning. This report identifies specific time points in the lifecycle where specific promotion of and engagement with strength and balance activities would be most beneficial for health: 18-24y to maximize bone and muscle mass gains, 40-50y to maintain strength and reduce that downward cycle, and over 65s to preserve balance and strength and maintain independence). This review also suggests specific transition points/events in life where there may be an increase in sedentary behaviour or loss of muscle function (pregnancy, menopause, onset of on diagnosis of disease, retirement, on becoming a carer and following hospitalization), where it would be useful to initiate additional strength and balance exercises to improve future health outcomes.
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Affiliation(s)
- Dawn A Skelton
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Alexandra Mavroeidi
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
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Bussey MD, Castro MPD, Aldabe D, Shemmell J. Sex differences in anticipatory postural adjustments during rapid single leg lift. Hum Mov Sci 2018; 57:417-425. [DOI: 10.1016/j.humov.2017.10.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 10/02/2017] [Accepted: 10/11/2017] [Indexed: 11/30/2022]
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do Nascimento JA, Silva CC, Dos Santos HH, de Almeida Ferreira JJ, de Andrade PR. A preliminary study of static and dynamic balance in sedentary obese young adults: the relationship between BMI, posture and postural balance. Clin Obes 2017; 7:377-383. [PMID: 28801963 DOI: 10.1111/cob.12209] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 07/03/2017] [Accepted: 07/07/2017] [Indexed: 11/29/2022]
Abstract
The aim of this study was to evaluate the postural control of obese young adults with normal body mass index during different static (bipedic and unipedic support) and dynamic postural conditions (gait velocity and limits of stability) in order to compare the static and dynamic balance of these individuals. A cross-sectional quantitative study was carried out to evaluate static and dynamic balance in 25 sedentary individuals. The sample was divided into two groups, 10 in the normal-weight group (24.70 ± 3.89 years and 21.5 ± 1.66 kg m-2 ) and 15 in the obese group (26.80 ± 5.16 years and 35.66 ± 4.29 kg m-2 ). Postural evaluation was performed through visual inspection, and balance analyses were performed using the Timed Up & Go test (TUGT) and Balance System (Biodex). Descriptive analyses, Fisher's exact test and Mann Whitney U-tests were performed using the Statistical Package for Social Sciences (SPSS - 20.0, Armonk, NY) software. Most of the obese volunteers presented postural alterations, such as head protrusion (47.6%), hyperkyphosis (46.7%) and hyperlordosis (26.7%). Medial-lateral dynamic displacement, risk of falls and mean time to perform the limits of stability test and TUGT were higher for obese subjects (P < 0.05), while there were no significant differences between the groups (P > 0.05) for static balance tests for either bipedal or unipedal tasks. The disadvantage presented by the young obese subjects occurs in dynamic activities, representing worse balance and an increase in time needed to accomplish these activities.
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Affiliation(s)
- J A do Nascimento
- Academic Physiotherapy, Universidade Federal da Paraíba/UFPB, João Pessoa, PB, Brazil
| | - C C Silva
- Academic Physiotherapy, Universidade Federal da Paraíba/UFPB, João Pessoa, PB, Brazil
| | - H H Dos Santos
- Physical Therapy Department, Universidade Federal da Paraíba/UFPB, João Pessoa, PB, Brasil
| | | | - P R de Andrade
- Physical Therapy Department, Universidade Federal da Paraíba/UFPB, João Pessoa, PB, Brasil
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Buckley TA, Oldham JR, Munkasy BA, Evans KM. Decreased Anticipatory Postural Adjustments During Gait Initiation Acutely Postconcussion. Arch Phys Med Rehabil 2017; 98:1962-1968. [PMID: 28583462 DOI: 10.1016/j.apmr.2017.05.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 04/27/2017] [Accepted: 05/01/2017] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To investigate anticipatory postural adjustments (APAs) during the transitional movement task of gait initiation (GI) in individuals acutely after a concussion. DESIGN Cohort study. SETTING University research center. PARTICIPANTS A population-based sample of participants (N=84) divided into 2 equal groups of acutely postconcussion and healthy student athletes. INTERVENTION Participants were tested on 2 occasions: a preinjury baseline test and then the concussion group was retested acutely postconcussion and the healthy student athlete group again at a similar time. All participants completed 5 trials of GI on 4 forceplates. MAIN OUTCOME MEASURES The dependent variables were the displacement and velocity of the center of pressure (COP) during the APA phase and initial step kinematics. Comparisons were made with a 2 (group) × 2 (time) repeated-measures analysis of variance. RESULTS There was a significant interaction for COP posterior displacement (P<.001) and lateral displacement (P<.001). Posteriorly, post hoc testing identified a significant reduction in the concussion group (pretest: 5.7±1.6cm; posttest: 2.6±2.1cm; P<.001), but no difference in the healthy student athlete group (pretest: 4.0±1.6cm; posttest: 4.0±2.5cm; P=.921). Laterally, post hoc testing identified a significant reduction in the concussion group (pretest: 5.8±2.1cm; posttest: 3.8±1.8cm; P<.001), but no difference in the healthy student athlete group (pretest: 5.0±2.5cm; posttest: 5.2±2.4cm; P=.485). CONCLUSIONS The results of this study suggest difficulty in the planning and execution of GI acutely postconcussion, and posterior APA displacement and velocity are highly effective measures of impaired postural control. Finally, the APA phase is linked to the supplementary motor area, which suggests a supraspinal contribution to postconcussion impaired postural control.
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Affiliation(s)
- Thomas A Buckley
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE; Interdisciplinary Program in Biomechanics and Movement Science, University of Delaware, Newark, DE.
| | - Jessie R Oldham
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE
| | - Barry A Munkasy
- School of Health and Kinesiology, Georgia Southern University, Statesboro, GA
| | - Kelsey M Evans
- The Brody School of Medicine, East Carolina University, Greenville, NC
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Cimolin V, Cau N, Galli M, Santovito C, Grugni G, Capodaglio P. Gait initiation and termination strategies in patients with Prader-Willi syndrome. J Neuroeng Rehabil 2017; 14:44. [PMID: 28535762 PMCID: PMC5442593 DOI: 10.1186/s12984-017-0257-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 05/16/2017] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Gait Initiation (GI) is a functional task representing one of the first voluntary destabilizing behaviours observed in the development of a locomotor pattern as the whole body centre of mass transitions from a large to a small base of support. Conversely, Gait Termination (GT) consists in the transition from walking to standing which, in everyday life, is a very common movement. Compared to normal walking, it requires higher control of postural stability. For a safe GT, the forward movement of the body has to be slowed down to achieve a stable upright position. Stability requirements have to be fulfilled for safe GT. In individuals with Prader-Willi syndrome (PWS), excessive body weight negatively affects the movement, such as walking and posture, but there are no experimental studies about GI and GT in these individuals. The aim of this study was to quantitatively characterise the strategy of patients with PWS during GI and GT using parameters obtained by the Center of Pressure (CoP) track. METHODS Twelve patients with PWS, 20 obese (OG) and 19 healthy individuals (HG) were tested using a force platform during the GI and GT tasks. CoP plots were divided into different phases, and duration, length and velocity of the CoP trace in these phases were calculated and compared for each task. RESULTS As for GI, the results showed a significant reduction of the task duration and lower velocity and CoP length parameters in PWS, compared to OG and HG. In PWS, those parameters were reduced to a higher degree with respect to the OG. During GT, longer durations, similar to OG, were observed in PWS than HG. Velocity is reduced when compared to OG and HG, especially in medio-lateral direction and in the terminal part of GT. CONCLUSIONS From these data, GI appears to be a demanding task in most of its sub-phases for PWS individuals, while GT seems to require caution only towards the end of the task. Breaking the cycle of gait into the phases of GI and GT and implementing specific exercises focusing on weight transfer and foot clearance during the transition phase from the steady condition to gait will possibly improve the effectiveness of rehabilitation and fall and injury prevention.
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Affiliation(s)
- Veronica Cimolin
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci, 32, 20133 Milan, Italy
| | - Nicola Cau
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci, 32, 20133 Milan, Italy
| | - Manuela Galli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci, 32, 20133 Milan, Italy
- IRCCS “San Raffaele Pisana”, Tosinvest Sanità, Rome, Italy
| | - Cristina Santovito
- Orthopaedic Rehabilitation Unit and Clinical Lab for Gait Analysis and Posture, Ospedale San Giuseppe, Istituto Auxologico Italiano, IRCCS, Via Cadorna 90, I-28824 Piancavallo (VB), Italy
| | - Graziano Grugni
- Unit of Auxology, Ospedale San Giuseppe, Istituto Auxologico Italiano, IRCCS, Via Cadorna 90, I-28824 Piancavallo (VB), Italy
| | - Paolo Capodaglio
- Orthopaedic Rehabilitation Unit and Clinical Lab for Gait Analysis and Posture, Ospedale San Giuseppe, Istituto Auxologico Italiano, IRCCS, Via Cadorna 90, I-28824 Piancavallo (VB), Italy
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The effect of 3 months aerobic and resistance training on step initiation speed and foot tapping frequency in the overweight and obese. SPORT SCIENCES FOR HEALTH 2017. [DOI: 10.1007/s11332-017-0362-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Caderby T, Yiou E, Peyrot N, de Viviés X, Bonazzi B, Dalleau G. Effects of Changing Body Weight Distribution on Mediolateral Stability Control during Gait Initiation. Front Hum Neurosci 2017; 11:127. [PMID: 28396629 PMCID: PMC5366317 DOI: 10.3389/fnhum.2017.00127] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 03/06/2017] [Indexed: 12/16/2022] Open
Abstract
During gait initiation, anticipatory postural adjustments (APA) precede the execution of the first step. It is generally acknowledged that these APA contribute to forward progression but also serve to stabilize the whole body in the mediolateral direction during step execution. Although previous studies have shown that changes in the distribution of body weight between both legs influence motor performance during gait initiation, it is not known whether and how such changes affect a person's postural stability during this task. The aim of this study was to investigate the effects of changing initial body weight distribution between legs on mediolateral postural stability during gait initiation. Changes in body weight distribution were induced under experimental conditions by modifying the frontal plane distribution of an external load located at the participants' waists. Fifteen healthy adults performed a gait initiation series at a similar speed under three conditions: with the overload evenly distributed over both legs; with the overload strictly distributed over the swing-limb side; and with the overload strictly distributed over the stance-leg side. Our results showed that the mediolateral location of center-of-mass (CoM) during the initial upright posture differed between the experimental conditions, indicating modifications in the initial distribution of body weight between the legs according to the load distribution. While the parameters related to the forward progression remained unchanged, the alterations in body weight distribution elicited adaptive changes in the amplitude of APA in the mediolateral direction (i.e., maximal mediolateral shift of the center of pressure (CoP)), without variation in their duration. Specifically, it was observed that the amplitude of APA was modulated in such a way that mediolateral dynamic stability at swing foot-contact, quantified by the margin of stability (i.e., the distance between the base of support boundary and the extrapolated CoM position), did not vary between the conditions. These findings suggest that APA seem to be scaled as a function of the initial body weight distribution between both legs so as to maintain optimal conditions of stability during gait initiation.
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Affiliation(s)
- Teddy Caderby
- Laboratoire IRISSE, UFR des Sciences de l'Homme et de l'Environnement, Université de la Réunion Ile de la Réunion, France
| | - Eric Yiou
- Laboratoire CIAMS, Université Paris Sud, Université Paris-SaclayOrsay, France; Laboratoire CIAMS, Université d'OrléansOrléans, France
| | - Nicolas Peyrot
- Laboratoire IRISSE, UFR des Sciences de l'Homme et de l'Environnement, Université de la Réunion Ile de la Réunion, France
| | - Xavier de Viviés
- Laboratoire IRISSE, UFR des Sciences de l'Homme et de l'Environnement, Université de la Réunion Ile de la Réunion, France
| | - Bruno Bonazzi
- Laboratoire IRISSE, UFR des Sciences de l'Homme et de l'Environnement, Université de la Réunion Ile de la Réunion, France
| | - Georges Dalleau
- Laboratoire IRISSE, UFR des Sciences de l'Homme et de l'Environnement, Université de la Réunion Ile de la Réunion, France
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Vieira MF, de Brito AA, Lehnen GC, Rodrigues FB. Center of pressure and center of mass behavior during gait initiation on inclined surfaces: A statistical parametric mapping analysis. J Biomech 2017; 56:10-18. [PMID: 28284667 DOI: 10.1016/j.jbiomech.2017.02.018] [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: 07/29/2016] [Revised: 01/23/2017] [Accepted: 02/16/2017] [Indexed: 11/16/2022]
Abstract
This study analyzed gait initiation (GI) on inclined surfaces with 68 young adult subjects of both sexes. Ground reaction forces and moments were collected using two AMTI force platforms, of which one was in a horizontal position and the other was inclined by 8% in relation to the horizontal plane. Departing from a standing position, each participant executed three trials in the following conditions: horizontal position (HOR), inclined position at ankle dorsi-flexion (UP), and inclined position at ankle plantar-flexion (DOWN). Statistical parametric mapping analysis was performed over the entire center of pressure (COP) and center of mass (COM) time series. COP excursion did not show significant differences in the medial-lateral (ML) direction in both inclined conditions, but it was greater in the anterior-posterior (AP) direction for both inclined conditions. COP velocities are smaller in discrete portions of GI for the UP and DOWN conditions. COM displacement was greater in the ML direction during anticipatory postural adjustments (APA) in the UP condition, and COM moves faster in the ML direction during APA in the UP condition but slower at the end of GI for both the UP and the DOWN conditions. The COP-COM vector showed a greater angle in the DOWN condition. We observed changes for COP and COM in GI in both the UP and the DOWN conditions, with the latter showing changes for a great extent of the task. Both the UP and the DOWN conditions showed increased COM displacement and velocity. The predominant characteristic during GI on inclined surfaces, including APA, appears to be the displacement of the COM.
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Affiliation(s)
- Marcus Fraga Vieira
- Bioengineering and Biomechanics Laboratory, Federal University of Goiás, Goiânia, Goiás, Brazil.
| | - Ademir Alves de Brito
- Bioengineering and Biomechanics Laboratory, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Georgia Cristina Lehnen
- Bioengineering and Biomechanics Laboratory, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Fábio Barbosa Rodrigues
- Bioengineering and Biomechanics Laboratory, Federal University of Goiás, Goiânia, Goiás, Brazil
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The Alteration of Neuromuscular Control Strategies During Gait Initiation in Individuals with Chronic Ankle Instability. IRANIAN RED CRESCENT MEDICAL JOURNAL 2017. [DOI: 10.5812/ircmj.44534] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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The relative and absolute reliability of center of pressure trajectory during gait initiation in older adults. Gait Posture 2017; 52:194-201. [PMID: 27915224 DOI: 10.1016/j.gaitpost.2016.11.042] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 10/17/2016] [Accepted: 11/26/2016] [Indexed: 02/02/2023]
Abstract
It has been thought that for scientific acceptance of a parameter, its psychometric properties such as reliability, validity and responsiveness have critical roles. Therefore, this study was conducted to estimate how many trials are required to obtain a reliable center of pressure (COP) parameter during gait initiation (GI) and to investigate the effect of number of trials on the relative and absolute reliability. Twenty older adults participated in the study. Subjects began stepping over the force platform in response to an auditory stimulus. Ten trials were collected in one session. The displacement, velocity, mean and median frequency of the COP in the mediolateral (ML) and anteroposterior (AP) directions were evaluated. Relative reliability was determined using the intraclass correlation coefficient (ICC), and absolute reliability was evaluated using the standard error of measurement (SEM) and minimal detectable change (MDC95). The results revealed with respect to parameter, one to five trials should be averaged to ensure excellent reliability. Moreover, ICC, SEM% and MDC95% values were between 0.39-0.89, 4.84-41.5% and 13.4-115% for single trial and 0.86-0.99, 1.74-19.7% and 4.83-54.7% for ten trials averaged, respectively. Moreover, the ML and AP COP displacement in locomotor phase had the most relative reliability as well as the ML and AP median frequency in locomotor phase had the most absolute reliability. In general, the results showed that the COP-related parameters in time and frequency domains, based on average of five trials, provide reliable outcome measures for evaluation of dynamic postural control in older adults.
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Hansen C, LaRue J, Do MC, Latash ML. Postural Preparation to Stepping: Coupled Center of Pressure Shifts in the Anterior-Posterior and Medio-Lateral Directions. J Hum Kinet 2016; 54:5-14. [PMID: 28031752 PMCID: PMC5187956 DOI: 10.1515/hukin-2016-0030] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
We explored changes in the postural preparation to stepping introduced by modifications of the initial coordinates of the center of pressure (COP). We hypothesized that the postural adjustments in the anterior-posterior direction would persist across all initial COP manipulations while the adjustments in the medio-lateral direction would be highly sensitive to the initial COP coordinate. Healthy subjects stood on a force plate, shifted the body weight to one of the initial conditions that spanned the range of COP coordinates in both directions, and initiated a single step or started to walk. No major changes were observed between the stepping and walking conditions. Changes in the initial COP coordinate in the medio-lateral direction led to scaling of the magnitude of the COP shift in that direction prior to stepping accompanied by a nearly proportional change in the COP shift in the anterior-posterior direction. Changes in the initial COP coordinate in the anterior-posterior direction led to scaling of the magnitude of the COP shift in that direction prior to stepping without consistent changes in the COP shift in the medio-lateral direction. We interpret the results as reflecting a neural organization using a small set of referent body configurations for the postural adjustments.
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Affiliation(s)
- Clint Hansen
- Aspetar Orthopaedic and Sports Medicine Hospital, Research Department, Doha, Qatar
| | - Jacques LaRue
- Univ Paris-Sud. UR CIAMS, EA 4532 - Motor Control & Perception team, Orsay; UFR STAPS, Université d'Orléans, France
| | - Manh-Cuong Do
- Univ Paris-Sud. UR CIAMS, EA 4532 - Motor Control & Perception team, Orsay
| | - Mark L Latash
- The Pennsylvania State University, University Park, PA, USA
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Khanmohammadi R, Talebian S, Hadian MR, Olyaei G, Bagheri H. Characteristic muscle activity patterns during gait initiation in the healthy younger and older adults. Gait Posture 2016; 43:148-53. [PMID: 26497801 DOI: 10.1016/j.gaitpost.2015.09.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 09/06/2015] [Accepted: 09/17/2015] [Indexed: 02/02/2023]
Abstract
It is thought that gait initiation (GI) might be an optimal task for identifying postural control deficiencies. Thus, the aim of this study was to clarify the strategies adopted by older subjects during this task. 16 healthy younger and 15 healthy older adults participated in the study. Subjects were instructed to begin forward stepping with their dominant limb in response to an auditory stimulus. The mean muscle activity, co-contraction index, and intra-subject coefficients of variation (intra-subject CVs) of dominant limb muscles in different phases of GI were measured. The level of association between the co-contraction index and intra-subject CV of muscles was also explored. This study showed that in the anticipatory phase, the younger group had larger amplitudes and more intra-subject CVs than older the group, particularly for the tibialis anterior muscle. However, the co-contraction index was greater in older subjects relative to younger subjects. During the weight transition phase, tibialis anterior, semitendinosus and vastus lateralis muscles of older adults had a lower amplitude as compared to younger adults. However, during the locomotor phase, the activity of tibialis anterior was greater in comparison to younger adults. Also, during this phase, similar to the anticipatory phase, the co-contraction index between tibialis anterior and gastrocnemius muscles was greater in older subjects relative to younger subjects. Additionally, the larger co-contraction index of some muscles was associated with smaller intra-subject CV. These findings suggest that muscle behaviors are altered with aging and older adults employ different strategies in the different phases of GI as compared to younger adults.
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Affiliation(s)
- Roya Khanmohammadi
- Physical Therapy Department, Tehran university of Medical Sciences, Tehran, Iran.
| | - Saeed Talebian
- Physical Therapy Department, Tehran university of Medical Sciences, Tehran, Iran.
| | - Mohammad Reza Hadian
- Physical Therapy Department, Tehran university of Medical Sciences, Tehran, Iran.
| | - Gholamreza Olyaei
- Physical Therapy Department, Tehran university of Medical Sciences, Tehran, Iran.
| | - Hossein Bagheri
- Physical Therapy Department, Tehran university of Medical Sciences, Tehran, Iran.
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41
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Preparatory postural adjustments during gait initiation in healthy younger and older adults: Neurophysiological and biomechanical aspects. Brain Res 2015; 1629:240-9. [DOI: 10.1016/j.brainres.2015.09.039] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Revised: 08/28/2015] [Accepted: 09/30/2015] [Indexed: 11/22/2022]
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Changes of Plantar Pressure and Gait Parameters in Children with Mild Cerebral Palsy Who Used a Customized External Strap Orthosis: A Crossover Study. BIOMED RESEARCH INTERNATIONAL 2015; 2015:813942. [PMID: 26640796 PMCID: PMC4657403 DOI: 10.1155/2015/813942] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 10/17/2015] [Accepted: 10/21/2015] [Indexed: 11/18/2022]
Abstract
Toe-in gait and crouch gait can make children with mild cerebral palsy fall and suffer improper balance during walking or ambulation training. A customized external strap orthosis for correcting leg alignment was used to resolve this problem. The purpose of this study was to research the immediate effects while wearing the customized external strap orthosis. Pressure platform was used to assess the plantar pressure through static and dynamic assessments and to record the changes in path of pressure trajectory. Motion image analysis system was used to record the gait parameters, which included gait speed, stride length, and cadence. The influence of both wearing and removing the orthosis on the dominant leg of children with mild cerebral palsy was analyzed. Nine children with mild cerebral palsy, who all had a dominant right leg, were recruited. After wearing the orthosis, all gait parameters improved, and foot motion changed in the stance phase of the gait cycle. The path of pressure trajectory closing to the midline was also observed during dynamic assessment. Changes in plantar pressure and path of pressure trajectory were observed and the orthosis device could provide immediate assistance to correct the leg alignment and improve the gait performance in children with mild cerebral palsy.
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Sousa ASP, Silva A, Santos R. Ankle anticipatory postural adjustments during gait initiation in healthy and post-stroke subjects. Clin Biomech (Bristol, Avon) 2015. [PMID: 26220907 DOI: 10.1016/j.clinbiomech.2015.07.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Anticipatory postural adjustments during gait initiation have an important role in postural stability but also in gait performance. However, these first phase mechanisms of gait initiation have received little attention, particularly in subcortical post-stroke subjects, where bilateral postural control pathways can be impaired. This study aims to evaluate ankle anticipatory postural adjustments during gait initiation in chronic post-stroke subjects with lesion in the territory of middle cerebral artery. METHODS Eleven subjects with post-stroke hemiparesis with the ability to walk independently and twelve healthy controls participated in this study. Bilateral electromyographic activity of tibialis anterior, soleus and medial gastrocnemius was collected during gait initiation to assess the muscle onset timing, period of activation/deactivation and magnitude of muscle activity during postural phase of gait initiation. This phase was identified through centre of pressure signal. FINDINGS Post-stroke group presented only half of the tibialis anterior relative magnitude observed in healthy subjects in contralesional limb (t=2.38, P=0.027) and decreased soleus deactivation period (contralesional limb, t=2.25, P=0.04; ipsilesional limb, t=3.67, P=0.003) as well its onset timing (contralesional limb, t=3.2. P=0.005; ipsilesional limb, t=2.88, P=0.033) in both limbs. A decreased centre of pressure displacement backward (t=3.45, P=0.002) and toward the first swing limb (t=3.29, P=0.004) was observed in post-stroke subjects. INTERPRETATION These findings indicate that chronic post-stroke subjects with lesion at middle cerebral artery territory present dysfunction in ankle anticipatory postural adjustments in both limbs during gait initiation.
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Affiliation(s)
- Andreia S P Sousa
- Escola Superior da Tecnologia de Saúde do Instituto Politécnico do Porto, Área Científica de Fisioterapia, Centro de Estudos de Movimento e Actividade Humana, Rua Valente Perfeito, 322, 4400-330 Vila Nova de Gaia, Portugal.
| | - Augusta Silva
- Escola Superior da Tecnologia de Saúde do Instituto Politécnico do Porto, Área Científica de Fisioterapia, Centro de Estudos de Movimento e Actividade Humana, Rua Valente Perfeito, 322, 4400-330 Vila Nova de Gaia, Portugal.
| | - Rubim Santos
- Escola Superior da Tecnologia de Saúde do Porto, Área Científica de Física, Centro de Estudos de Movimento e Actividade Humana, Rua Valente Perfeito, 322, 4400-330 Vila Nova de Gai, Portugal.
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