1
|
Galor N, Zeilig G, Plotnik M. A New Measure for Quantifying Four-Limb Coordination of Human Gait Based on Mobility Sensors. SENSORS (BASEL, SWITZERLAND) 2024; 24:6105. [PMID: 39338850 PMCID: PMC11435969 DOI: 10.3390/s24186105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 08/22/2024] [Accepted: 08/24/2024] [Indexed: 09/30/2024]
Abstract
Coordinated movement of four limbs is a hallmark of healthy locomotion. No measures exist to quantify four-limb coordination. This study aimed to investigate temporal four-limb coordination and proposed a new metric for quantifying the inter-limb phase of rhythmic locomotion-related movements. Kinetic data of arm and leg movements generated during walking (self-selected speed) from healthy adults were used to extract the phases (φ) between all possible limb pairings. The φ series were used to calculate each pair's Phase Coordination Index (PCI). The PCI quantifies the accuracy and consistency of generating anti-phased rhythmic movements (lower PCI values mean better coordination). We also calculated the Quadruple-PCI (Q-PCI) by combining all φ values of all limb pairs. We found a significant correlation between the PCI values of all limb pairings and the Q-PCI (pairs involving arms: Pearson's R > 0.79, p < 0.001; leg-leg: Pearson's R = 0.3, p < 0.01). The PCI values that involve arms (median values between 6.5% and 8.3%) were significantly higher than the leg-leg PCI (median values between 3.8% and 4.1%), and the Q-PCI (median values between 8.3% and 9.7%) was significantly higher than all other PCI values. We also found a negative correlation between the arm swing amplitude and the PCI values (Spearman's Rho of different limb pairings ranging from -0.25 to -0.5, p < 0.05), suggesting that higher arm swing amplitude leads to better coordination. Four-limb coordination analysis is a novel method for comprehensive assessment of gait coordination, which is often compromised among persons with disabilities.
Collapse
Affiliation(s)
- Noam Galor
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Ramat Gan 5266202, Israel;
| | - Gabi Zeilig
- Department of Neurological Rehabilitation, Sheba Medical Center, Ramat Gan 5266202, Israel;
- Department of Physical and Rehabilitation Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- School of Health Professions, Ono Academic College, Kiryat Ono 5545001, Israel
| | - Meir Plotnik
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Ramat Gan 5266202, Israel;
- Department of Physiology and Pharmacology, Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| |
Collapse
|
2
|
Voß M, Zieschang T, Schmidt L, Hackbarth M, Koschate J, Stuckenschneider T. Reduced adaptability to balance perturbations in older adults with probable cognitive impairment after a severe fall. PLoS One 2024; 19:e0305067. [PMID: 38985810 PMCID: PMC11236103 DOI: 10.1371/journal.pone.0305067] [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: 02/12/2024] [Accepted: 05/22/2024] [Indexed: 07/12/2024] Open
Abstract
Falls in older individuals often result from unexpected balance disturbances during walking, necessitating the analysis of recovery strategies for effective falls prevention. This becomes particularly crucial for individuals with cognitive impairment, who face a higher fall risk compared to cognitively healthy adults. Hence, our study aimed to compare the recovery response to standardized walking perturbations on a treadmill between older adults with cognitive impairment and cognitively healthy older adults. 36 individuals with a recent history of a severe fall, leading to an emergency department visit without subsequent admission, were stratified into two groups (with and without probable cognitive impairment) based on scores of the Montreal Cognitive Assessment. Recovery performance was quantified using force plate data from a perturbation treadmill (M-Gait, Motek Medical B.V., Amsterdam, the Netherlands), specifically evaluating the number of steps needed to restore step length and width to pre perturbation baseline across two trials of nine different perturbations. Individuals with cognitive impairment (n = 18, mean age: 74.7) required significantly (p = 0.045, Cohen's d = 0.69) more steps to recover total steps after perturbations compared to cognitively healthy individuals (n = 18, mean age: 69.7). While step width recovery was similar between the groups, those with probable cognitive impairment required significantly more steps to recover their step length (p = 0.039, Cohen's d = 0.72). Thus, our findings indicate that older adults with probable cognitive impairment manifest inferior gait adaptability, especially in adapting step length, potentially underscoring a critical aspect for effective falls prevention in this population.
Collapse
Affiliation(s)
- Malte Voß
- Department for Health Services Research, Geriatric Medicine, School of Medicine and Health Services, Carl von Ossietzky University, Oldenburg, Lower Saxony, Germany
| | - Tania Zieschang
- Department for Health Services Research, Geriatric Medicine, School of Medicine and Health Services, Carl von Ossietzky University, Oldenburg, Lower Saxony, Germany
| | - Laura Schmidt
- Department for Health Services Research, Geriatric Medicine, School of Medicine and Health Services, Carl von Ossietzky University, Oldenburg, Lower Saxony, Germany
| | - Michel Hackbarth
- Department for Health Services Research, Geriatric Medicine, School of Medicine and Health Services, Carl von Ossietzky University, Oldenburg, Lower Saxony, Germany
| | - Jessica Koschate
- Department for Health Services Research, Geriatric Medicine, School of Medicine and Health Services, Carl von Ossietzky University, Oldenburg, Lower Saxony, Germany
| | - Tim Stuckenschneider
- Department for Health Services Research, Geriatric Medicine, School of Medicine and Health Services, Carl von Ossietzky University, Oldenburg, Lower Saxony, Germany
| |
Collapse
|
3
|
Boekesteijn RJ, Keijsers NLW, Defoort K, Geurts ACH, Smulders K. Individuals with knee osteoarthritis show few limitations in balance recovery responses after moderate gait perturbations. Clin Biomech (Bristol, Avon) 2024; 114:106218. [PMID: 38479343 DOI: 10.1016/j.clinbiomech.2024.106218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 03/03/2024] [Accepted: 03/04/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Knee osteoarthritis causes structural joint damage. The resultant symptoms can impair the ability to recover from unexpected gait perturbations. This study compared balance recovery responses to moderate gait perturbations between individuals with knee osteoarthritis and healthy individuals. METHODS Kinematic data of 35 individuals with end-stage knee osteoarthritis, and 32 healthy individuals in the same age range were obtained during perturbed walking on a treadmill at 1.0 m/s. Participants received anteroposterior (acceleration or deceleration) or mediolateral perturbations during the stance phase. Changes from baseline in margin of stability, step length, step time, and step width during the first two steps after perturbation were compared between groups using a linear regression model. Extrapolated center of mass excursion was descriptively analyzed. FINDINGS After all perturbation modes, extrapolated center of mass trajectories overlapped between individuals with knee osteoarthritis and healthy individuals. Participants predominantly responded to mediolateral perturbations by adjusting their step width, and to anteroposterior perturbations by adjusting step length and step time. None of the perturbation modes yielded between-group differences in changes in margin of stability and step width during the first two steps after perturbation. Small between-group differences were observed for step length (i.e. 2 cm) of the second step after mediolateral and anteroposterior perturbations, and for step time (i.e. 0.01-0.02 s) of first step after mediolateral perturbations and the second step after outward and belt acceleration perturbations. INTERPRETATION Despite considerable pain and damage to the knee joint, individuals with knee osteoarthritis showed comparable balance recovery responses after moderate gait perturbations to healthy participants.
Collapse
Affiliation(s)
- R J Boekesteijn
- Department of Research, Sint Maartenskliniek, Nijmegen, the Netherlands; Department of Rehabilitation, Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Center, the Netherlands.
| | - N L W Keijsers
- Department of Research, Sint Maartenskliniek, Nijmegen, the Netherlands; Department of Rehabilitation, Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Center, the Netherlands; Department of Sensorimotor Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
| | - K Defoort
- Department of Orthopedic Surgery, Sint Maartenskliniek, Nijmegen, the Netherlands
| | - A C H Geurts
- Department of Rehabilitation, Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Center, the Netherlands
| | - K Smulders
- Department of Research, Sint Maartenskliniek, Nijmegen, the Netherlands
| |
Collapse
|
4
|
Brough LG, Neptune RR. A comparison of the effects of mediolateral surface and foot placement perturbations on balance control and response strategies during walking. Gait Posture 2024; 108:313-319. [PMID: 38199090 DOI: 10.1016/j.gaitpost.2023.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 11/21/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Balance perturbation studies during walking have improved our understanding of balance control in various destabilizing conditions. However, it is unknown to what extent balance recovery strategies can be generalized across different types of mediolateral balance perturbations. RESEARCH QUESTION Do similar mediolateral perturbations (foot placement versus surface translation) have similar effects on balance control and corresponding balance response strategies? METHODS Kinetic and kinematic data were previously collected during two separate studies, each with 15 young, healthy participants walking on an instrumented treadmill. In both studies, medial and lateral balance perturbations were applied at 80% of the gait cycle either by a treadmill surface translation or a pneumatic force applied to the swing foot. Differences in balance control (frontal plane whole body angular momentum) and balance response strategies (hip abduction moment, ankle inversion moment, center of pressure excursion and frontal plane trunk moment) between perturbed and unperturbed gait cycles were evaluated using statistical parametric mapping. RESULTS Balance disruptions after foot placement perturbations were larger and sustained longer compared to surface translations. Changes in joint moment responses were also larger for the foot placement perturbations compared to the surface translation perturbations. Lateral hip, ankle, and trunk strategies were used to maintain balance after medial foot placement perturbations, while a trunk strategy was primarily used after surface translations. SIGNIFICANCE Surface and foot placement perturbations influence balance control and corresponding response strategies differently. These results can help inform the development of perturbation-based balance training interventions aimed at reducing fall risk in clinical populations.
Collapse
Affiliation(s)
- Lydia G Brough
- Walker Department of Mechanical Engineering, University of Texas at Austin, Austin, TX, USA
| | - Richard R Neptune
- Walker Department of Mechanical Engineering, University of Texas at Austin, Austin, TX, USA.
| |
Collapse
|
5
|
Heimler B, Koren O, Inzelberg R, Rosenblum U, Hassin-Baer S, Zeilig G, Bartsch RP, Plotnik M. Heart-rate variability as a new marker for freezing predisposition in Parkinson's disease. Parkinsonism Relat Disord 2023:105476. [PMID: 37321936 DOI: 10.1016/j.parkreldis.2023.105476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/22/2023] [Accepted: 05/29/2023] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Freezing of gait (FoG) is a debilitating symptom of advanced Parkinson's disease (PD) characterized by a sudden, episodic stepping arrest despite the intention to continue walking. The etiology of FoG is still unknown, but accumulating evidence unraveled physiological signatures of the autonomic nervous system (ANS) around FoG episodes. Here we aim to investigate for the first time whether detecting a predisposition for upcoming FoG events from ANS activity measured at rest is possible. METHODS We recorded heart-rate for 1-min while standing in 28 persons with PD with FoG (PD + FoG), while OFF, and in 21 elderly controls (EC). Then, PD + FoG participants performed walking trials containing FoG-triggering events (e.g., turns). During these trials, n = 15 did experience FoG (PD + FoG+), while n = 13 did not (PD + FoG-). Most PD participants (n = 20: 10 PD + FoG+ and 10 PD + FoG-) repeated the experiment 2-3 weeks later, while ON, and none experienced FoG. We then analyzed heart-rate variability (HRV), i.e., the fluctuations in time intervals between adjacent heartbeats, mainly generated by brain-heart interactions. RESULTS During OFF, HRV was significantly lower in PD + FoG + participants, reflecting imbalanced sympathetic/parasympathetic activity and disrupted self-regulatory capacity. PD + FoG- and EC participants showed comparable (higher) HRV. During ON, HRV did not differ among groups. HRV values did not correlate with age, PD duration, levodopa consumption, nor motor -symptoms severity scores. CONCLUSIONS Overall, these results document for the first time a relation between HRV at rest and FoG presence/absence during gait trials, expanding previous evidence regarding the involvement of ANS in FoG.
Collapse
Affiliation(s)
- Benedetta Heimler
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Ramat Gan, Israel.
| | - Or Koren
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Ramat Gan, Israel
| | - Rivka Inzelberg
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Uri Rosenblum
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Ramat Gan, Israel
| | - Sharon Hassin-Baer
- Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Neurology, Movement Disorders Institute, Sheba Medical Center, Ramat Gan, Israel
| | - Gabi Zeilig
- Department of Neurological Rehabilitation, Sheba Medical Center, Ramat Gan, Israel; Department of Physical and Rehabilitation Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; School of Health Professions, Ono Academic College, Kiryat Ono, Israel
| | - Ronny P Bartsch
- Department of Physics, Bar-Ilan University, Ramat Gan, Israel
| | - Meir Plotnik
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Ramat Gan, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
6
|
Cano Porras D, Heimler B, Jacobs JV, Naor SK, Inzelberg R, Zeilig G, Plotnik M. Upward perturbations trigger a stumbling effect. Hum Mov Sci 2023; 88:103069. [PMID: 36871477 DOI: 10.1016/j.humov.2023.103069] [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: 04/21/2022] [Revised: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 03/06/2023]
Abstract
BACKGROUND Vertical perturbations are one major cause of falling. Incidentally, while conducting a comprehensive study comparing effects of vertical versus horizontal perturbations, we commonly observed a stumbling-like response induced by upward perturbations. The present study describes and characterizes this stumbling effect. METHODS Fourteen individuals (10 male; 27 ± 4 yr) walked self-paced on a treadmill embedded in a moveable platform and synchronized to a virtual reality system. Participants experienced 36 perturbations (12 types). Here, we report only on upward perturbations. We determined stumbling based on visual inspection of recorded videos, and calculated stride time and anteroposterior, whole-body center of mass (COM) distance relative to the heel, i.e., COM-to-heel distance, extrapolated COM (xCOM) and margin of stability (MOS) before and after perturbation. RESULTS From 68 upward perturbations across 14 participants, 75% provoked stumbling. During the first gait cycle post-perturbation, stride time decreased in the perturbed foot and the unperturbed foot (perturbed = 1.004 s vs. baseline = 1.119 s and unperturbed = 1.017 s vs. baseline = 1.125 s, p < 0.001). In the perturbed foot, the difference was larger in stumbling-provoking perturbations (stumbling: 0.15 s vs. non-stumbling: 0.020 s, p = 0.004). In addition, the COM-to-heel distance decreased during the first and second gait cycles after perturbation in both feet (first cycle: 0.58 m, second cycle: 0.665 m vs. baseline: 0.72 m, p-values<0.001). During the first gait cycle, COM-to-heel distance was larger in the perturbed foot compared to the unperturbed foot (perturbed foot: 0.61 m vs. unperturbed foot: 0.55 m, p < 0.001). MOS decreased during the first gait cycle, whereas the xCOM increased during the second through fourth gait cycles post-perturbation (maximal xCOM at baseline: 0.5 m, second cycle: 0.63 m, third cycle: 0.66 m, fourth cycle: 0.64 m, p < 0.001). CONCLUSIONS Our results show that upward perturbations can induce a stumbling effect, which - with further testing - has the potential to be translated into balance training to reduce fall risk, and for method standardization in research and clinical practice.
Collapse
Affiliation(s)
- Desiderio Cano Porras
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Ramat Gan, Israel; Brightlands Institute for Smart Society-BISS, Maastricht University, Maastricht, the Netherlands
| | - Benedetta Heimler
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Ramat Gan, Israel
| | - Jesse V Jacobs
- Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA
| | - Shani Kimel Naor
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Ramat Gan, Israel
| | - Rivka Inzelberg
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gabriel Zeilig
- Department of Neurological Rehabilitation, Sheba Medical Center, Ramat Gan, Israel; Department of Physical and Rehabilitation Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; School of Health Professions, Ono Academic College, Kiryat Ono, Israel
| | - Meir Plotnik
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Ramat Gan, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| |
Collapse
|
7
|
Moreira J, Silva B, Faria H, Santos R, Sousa ASP. Systematic Review on the Applicability of Principal Component Analysis for the Study of Movement in the Older Adult Population. SENSORS (BASEL, SWITZERLAND) 2022; 23:205. [PMID: 36616803 PMCID: PMC9823400 DOI: 10.3390/s23010205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/28/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
Principal component analysis (PCA) is a dimensionality reduction method that has identified significant differences in older adults' motion analysis previously not detected by the discrete exploration of biomechanical variables. This systematic review aims to synthesize the current evidence regarding PCA use in the study of movement in older adults (kinematics and kinetics), summarizing the tasks and biomechanical variables studied. From the search results, 1685 studies were retrieved, and 19 studies were included for review. Most of the included studies evaluated gait or quiet standing. The main variables considered included spatiotemporal parameters, range of motion, and ground reaction forces. A limited number of studies analyzed other tasks. Further research should focus on the PCA application in tasks other than gait to understand older adults' movement characteristics that have not been identified by discrete analysis.
Collapse
Affiliation(s)
- Juliana Moreira
- Center for Rehabilitation Research–Human Movement System (Re)habilitation Area, Department of Physiotherapy, School of Health, Polytechnic of Porto, 4200-072 Porto, Portugal
- Research Center in Physical Activity, Health and Leisure, Faculty of Sports, University of Porto, 4200-450 Porto, Portugal
| | - Bruno Silva
- School of Health, Polytechnic of Porto, 4200-072 Porto, Portugal
| | - Hugo Faria
- School of Health, Polytechnic of Porto, 4200-072 Porto, Portugal
| | - Rubim Santos
- Center for Rehabilitation Research–Human Movement System (Re)habilitation Area, Department of Physics, School of Health, Polytechnic of Porto, 4200-072 Porto, Portugal
| | - Andreia S. P. Sousa
- Center for Rehabilitation Research–Human Movement System (Re)habilitation Area, Department of Physiotherapy, School of Health, Polytechnic of Porto, 4200-072 Porto, Portugal
| |
Collapse
|
8
|
Taylor Z, Walsh GS, Hawkins H, Inacio M, Esser P. Perturbations during Gait: A Systematic Review of Methodologies and Outcomes. SENSORS (BASEL, SWITZERLAND) 2022; 22:5927. [PMID: 35957484 PMCID: PMC9371403 DOI: 10.3390/s22155927] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/04/2022] [Accepted: 08/05/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Despite extensive literature regarding laboratory-based balance perturbations, there is no up-to-date systematic review of methods. This systematic review aimed to assess current perturbation methods and outcome variables used to report participant biomechanical responses during walking. METHODS Web of Science, CINAHL, and PubMed online databases were searched, for records from 2015, the last search was on 30th of May 2022. Studies were included where participants were 18+ years, with or without clinical conditions, conducted in non-hospital settings. Reviews were excluded. Participant descriptive, perturbation method, outcome variables and results were extracted and summarised. Bias was assessed using the Appraisal tool for Cross-sectional Studies risk of bias assessment tool. Qualitative analysis was performed as the review aimed to investigate methods used to apply perturbations. RESULTS 644 records were identified and 33 studies were included, totaling 779 participants. The most frequent method of balance perturbation during gait was by means of a treadmill translation. The most frequent outcome variable collected was participant step width, closely followed by step length. Most studies reported at least one spatiotemporal outcome variable. All included studies showed some risk of bias, generally related to reporting of sampling approaches. Large variations in perturbation type, duration and intensity and outcome variables were reported. CONCLUSIONS This review shows the wide variety of published laboratory perturbation methods. Moreover, it demonstrates the significant impact on outcome measures of a study based on the type of perturbation used. REGISTRATION PROSPERO ID: CRD42020211876.
Collapse
Affiliation(s)
- Zoe Taylor
- Centre for Movement, Occupation and Rehabilitation Sciences, Oxford Brookes University, Oxford OX3 0BP, UK
- Department of Sport Health Sciences and Social Work, Oxford Brookes University, Oxford OX3 0BP, UK
| | - Gregory S. Walsh
- Centre for Movement, Occupation and Rehabilitation Sciences, Oxford Brookes University, Oxford OX3 0BP, UK
- Department of Sport Health Sciences and Social Work, Oxford Brookes University, Oxford OX3 0BP, UK
| | - Hannah Hawkins
- Centre for Movement, Occupation and Rehabilitation Sciences, Oxford Brookes University, Oxford OX3 0BP, UK
- Department of Sport Health Sciences and Social Work, Oxford Brookes University, Oxford OX3 0BP, UK
| | - Mario Inacio
- Centre for Movement, Occupation and Rehabilitation Sciences, Oxford Brookes University, Oxford OX3 0BP, UK
- Research Centre in Sport Sciences, Health Sciences and Human Development, University Institute of Maia, 4475-690 Maia, Portugal
| | - Patrick Esser
- Centre for Movement, Occupation and Rehabilitation Sciences, Oxford Brookes University, Oxford OX3 0BP, UK
- Department of Sport Health Sciences and Social Work, Oxford Brookes University, Oxford OX3 0BP, UK
| |
Collapse
|
9
|
Rosenblum U, Melzer I, Zeilig G, Plotnik M. Muscle activation profile is modulated by unexpected balance loss in walking. Gait Posture 2022; 93:64-72. [PMID: 35091185 DOI: 10.1016/j.gaitpost.2022.01.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/30/2021] [Accepted: 01/16/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND During an unexpected loss of balance, avoiding a fall requires people to readjust their footing rapidly and effectively. A deeper understanding of muscle activation patterns in response to unexpected balance loss will provide insights into the mechanisms of balance recovery responses. This could have implications for treatment of people with balance deficits. RESEARCH QUESTION Explore the differences in balance recovery responses to perturbations in different phases of the gait cycle (single-support vs. double-support) in terms of biomechanical behavior (i.e., stepping and dynamic stability characteristics) and lower-limb muscle activation patterns. METHODS Muscle activation patterns of the ankle and knee muscles and muscle fiber type recruitment resulting from unannounced, mediolateral (i.e., right/left) horizontal-surface perturbations during walking was investigated in twenty healthy adults (27.00 ± 2.79 years, ten females). Surface electromyography (sEMG) total spectral power for specific frequency bands (40-60 Hz, 60-150 Hz, 150-250 Hz, 250-400 Hz and 400-1000 Hz), from tibialis anterior (TA) and vastus lateralis (VL) muscles were analyzed. Three mixed-effects models assessed behavioral and lower-limb muscle activation patterns resulting from perturbations in the gait cycle's single- and double-support phases. Statistical significance was set a priori at p < 0.05. RESULTS Compared to non-perturbed walking, we found a significant increase in the total spectral power of lower-extremity muscles during the first three seconds after perturbation. During the double-support phase of gait, we found a different muscle fiber type recruitment pattern between VL and TA muscles. However, there were no significant differences between VL and TA muscles for perturbations implemented in single-support phases. SIGNIFICANCE Our findings support the notion that muscle operating frequency is modulated in real-time to fit functional goal requirements, such as a rapid change of footing in response to unexpected loss of balance in single and double-support phases of gait.
Collapse
Affiliation(s)
- Uri Rosenblum
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Tel Hashomer, Israel; Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
| | - Itshak Melzer
- Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Gabi Zeilig
- Department of Neurological Rehabilitation, Sheba Medical Center, Tel HaShomer, Israel; Department of Physical and Rehabilitation Medicine, Faculty of Medicine, Tel Aviv University, Israel; School of Health Professions, Ono Academic College, Kiryat Ono, Israel
| | - Meir Plotnik
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Tel Hashomer, Israel; Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
| |
Collapse
|
10
|
Liu C, Audu ML, Triolo RJ, Quinn RD. Neural Networks Trained via Reinforcement Learning Stabilize Walking of a Three-Dimensional Biped Model With Exoskeleton Applications. Front Robot AI 2021; 8:710999. [PMID: 34422915 PMCID: PMC8378504 DOI: 10.3389/frobt.2021.710999] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 07/22/2021] [Indexed: 11/13/2022] Open
Abstract
Our group is developing a cyber-physical walking system (CPWS) for people paralyzed by spinal cord injuries (SCI). The current CPWS consists of a functional neuromuscular stimulation (FNS) system and a powered lower-limb exoskeleton for walking with leg movements in the sagittal plane. We are developing neural control systems that learn to assist the user of this CPWS to walk with stability. In a previous publication (Liu et al., Biomimetics, 2019, 4, 28), we showed a neural controller that stabilized a simulated biped in the sagittal plane. We are considering adding degrees of freedom to the CPWS to allow more natural walking movements and improved stability. Thus, in this paper, we present a new neural network enhanced control system that stabilizes a three-dimensional simulated biped model of a human wearing an exoskeleton. Results show that it stabilizes human/exoskeleton models and is robust to impact disturbances. The simulated biped walks at a steady pace in a range of typical human ambulatory speeds from 0.7 to 1.3 m/s, follows waypoints at a precision of 0.3 m, remains stable, and continues walking forward despite impact disturbances and adapts its speed to compensate for persistent external disturbances. Furthermore, the neural network controller stabilizes human models of different statures from 1.4 to 2.2 m tall without any changes to the control parameters. Please see videos at the following link: 3D biped walking control.
Collapse
Affiliation(s)
- Chujun Liu
- Department of Mechanical Engineering, Case Western Reserve University, Cleveland, OH, United States
| | - Musa L Audu
- Advanced Platform Technology Center, Louis Stokes VA Medical Center, Cleveland, OH, United States.,Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States
| | - Ronald J Triolo
- Advanced Platform Technology Center, Louis Stokes VA Medical Center, Cleveland, OH, United States.,Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States
| | - Roger D Quinn
- Department of Mechanical Engineering, Case Western Reserve University, Cleveland, OH, United States.,Advanced Platform Technology Center, Louis Stokes VA Medical Center, Cleveland, OH, United States
| |
Collapse
|
11
|
Ravi DK, Bartholet M, Skiadopoulos A, Kent JA, Wickstrom J, Taylor WR, Singh NB, Stergiou N. Rhythmic auditory stimuli modulate movement recovery in response to perturbation during locomotion. J Exp Biol 2021; 224:jeb.237073. [PMID: 33536309 PMCID: PMC7938806 DOI: 10.1242/jeb.237073] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 01/20/2021] [Indexed: 12/11/2022]
Abstract
The capacity to recover after a perturbation is a well-known intrinsic property of physiological systems, including the locomotor system, and can be termed ‘resilience’. Despite an abundance of metrics proposed to measure the complex dynamics of bipedal locomotion, analytical tools for quantifying resilience are lacking. Here, we introduce a novel method to directly quantify resilience to perturbations during locomotion. We examined the extent to which synchronizing stepping with two different temporal structured auditory stimuli (periodic and 1/f structure) during walking modulates resilience to a large unexpected perturbation. Recovery time after perturbation was calculated from the horizontal velocity of the body's center of mass. Our results indicate that synchronizing stepping with a 1/f stimulus elicited greater resilience to mechanical perturbations during walking compared with the periodic stimulus (3.3 s faster). Our proposed method may help to gain a comprehensive understanding of movement recovery behavior of humans and other animals in their ecological contexts. Summary: A new method for the evaluation of intrinsic resilience during unsteady locomotion in humans and animals, analysing the relationship between the structure of movement variability and resilience.
Collapse
Affiliation(s)
- Deepak K Ravi
- Institute for Biomechanics, ETH Zürich, 8093 Zürich, Switzerland
| | - Marc Bartholet
- Institute for Biomechanics, ETH Zürich, 8093 Zürich, Switzerland
| | - Andreas Skiadopoulos
- Department of Biomechanics and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE 68182, USA
| | - Jenny A Kent
- Department of Biomechanics and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE 68182, USA
| | - Jordan Wickstrom
- Department of Biomechanics and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE 68182, USA
| | - William R Taylor
- Institute for Biomechanics, ETH Zürich, 8093 Zürich, Switzerland
| | - Navrag B Singh
- Institute for Biomechanics, ETH Zürich, 8093 Zürich, Switzerland
| | - Nick Stergiou
- Department of Biomechanics and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE 68182, USA .,Department of Environmental Agricultural and Occupational Health, University of Nebraska Medical Center, Omaha, NE 68198-4388, USA
| |
Collapse
|