1
|
Si B, Zhu H, Wei X, Li S, Wu X. The mechanism of static postural control in the impact of lower limb muscle strength asymmetry on gait performance in the elderly. PeerJ 2024; 12:e17626. [PMID: 38948226 PMCID: PMC11214735 DOI: 10.7717/peerj.17626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 06/02/2024] [Indexed: 07/02/2024] Open
Abstract
Background Abnormal gait is prevalent among the elderly population, leading to reduced physical activity, increased risk of falls, and the potential development of dementia and disabilities, thus degrading the quality of life in later years. Numerous studies have highlighted the crucial roles of lower limb muscle strength asymmetry and static postural control in gait, and the reciprocal influence of lower limb muscle strength asymmetry on static postural control. However, research exploring the interrelationship between lower limb muscle strength asymmetry, static postural control, and gait performance has been limited. Methods A total of 55 elderly participants aged 60 to 75 years were recruited. Isokinetic muscle strength testing was used to assess bilateral knee extension strength, and asymmetry values were calculated. Participants with asymmetry greater than 15% were categorized as the Asymmetry Group (AG), while those with asymmetry less than 15% were classified in the Symmetry Group (SG). Gait parameters were measured using a plantar pressure gait analysis system to evaluate gait performance, and static postural control was assessed through comfortable and narrow stance tests. Results First, participants in the AG demonstrated inferior gait performance, characterized by slower gait speed, longer stance time and percentage of stance time in gait, and smaller swing time and percentage of swing time in gait. Spatial-temporal gait parameters of the weaker limb tended to be abnormal. Second, static postural control indices were higher in AG compared to SG in all aspects except for the area of ellipse during the comfortable stance with eyes open test. Third, abnormal gait parameters were associated with static postural control. Conclusion Firstly, elderly individuals with lower limb muscle strength asymmetry are prone to abnormal gait, with the weaker limb exhibiting poorer gait performance. Secondly, lower limb muscle strength asymmetry contributes to diminished static postural control in the elderly. Thirdly, the mechanism underlying abnormal gait in the elderly due to lower limb muscle strength asymmetry may be linked to a decline in static postural control.
Collapse
Affiliation(s)
- Beili Si
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Hao Zhu
- School of Psychology, Shanghai University of Sport, Shanghai, China
| | - Xinmei Wei
- School of Economics and Management, Shanghai University of Sport, Shanghai, China
| | - Shun Li
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Xueping Wu
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| |
Collapse
|
2
|
Pohl J, Ryser A, Veerbeek JM, Verheyden G, Vogt JE, Luft AR, Easthope CA. Accuracy of gait and posture classification using movement sensors in individuals with mobility impairment after stroke. Front Physiol 2022; 13:933987. [PMID: 36225292 PMCID: PMC9549863 DOI: 10.3389/fphys.2022.933987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Stroke leads to motor impairment which reduces physical activity, negatively affects social participation, and increases the risk of secondary cardiovascular events. Continuous monitoring of physical activity with motion sensors is promising to allow the prescription of tailored treatments in a timely manner. Accurate classification of gait activities and body posture is necessary to extract actionable information for outcome measures from unstructured motion data. We here develop and validate a solution for various sensor configurations specifically for a stroke population.Methods: Video and movement sensor data (locations: wrists, ankles, and chest) were collected from fourteen stroke survivors with motor impairment who performed real-life activities in their home environment. Video data were labeled for five classes of gait and body postures and three classes of transitions that served as ground truth. We trained support vector machine (SVM), logistic regression (LR), and k-nearest neighbor (kNN) models to identify gait bouts only or gait and posture. Model performance was assessed by the nested leave-one-subject-out protocol and compared across five different sensor placement configurations.Results: Our method achieved very good performance when predicting real-life gait versus non-gait (Gait classification) with an accuracy between 85% and 93% across sensor configurations, using SVM and LR modeling. On the much more challenging task of discriminating between the body postures lying, sitting, and standing as well as walking, and stair ascent/descent (Gait and postures classification), our method achieves accuracies between 80% and 86% with at least one ankle and wrist sensor attached unilaterally. The Gait and postures classification performance between SVM and LR was equivalent but superior to kNN.Conclusion: This work presents a comparison of performance when classifying Gait and body postures in post-stroke individuals with different sensor configurations, which provide options for subsequent outcome evaluation. We achieved accurate classification of gait and postures performed in a real-life setting by individuals with a wide range of motor impairments due to stroke. This validated classifier will hopefully prove a useful resource to researchers and clinicians in the increasingly important field of digital health in the form of remote movement monitoring using motion sensors.
Collapse
Affiliation(s)
- Johannes Pohl
- Department of Neurology, University of Zurich and University Hospital Zurich, Zurich, Switzerland
- Department of Rehabilitation Sciences, KU Leuven—University of Leuven, Leuven, Belgium
- *Correspondence: Johannes Pohl,
| | - Alain Ryser
- Department of Computer Science, ETH Zurich, Zurich, Switzerland
| | | | - Geert Verheyden
- Department of Rehabilitation Sciences, KU Leuven—University of Leuven, Leuven, Belgium
| | | | - Andreas Rüdiger Luft
- Department of Neurology, University of Zurich and University Hospital Zurich, Zurich, Switzerland
- Cereneo, Center for Neurology and Rehabilitation, Vitznau, Switzerland
| | - Chris Awai Easthope
- Cereneo Foundation, Center for Interdisciplinary Research (CEFIR), Vitznau, Switzerland
| |
Collapse
|
3
|
Donatoni da Silva L, Shiel A, Sheahan J, McIntosh C. Six weeks of Pilates improved functional mobility, postural balance and spatiotemporal parameters of gait to decrease the risk of falls in healthy older adults. J Bodyw Mov Ther 2022; 29:1-9. [DOI: 10.1016/j.jbmt.2021.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 05/04/2021] [Accepted: 06/08/2021] [Indexed: 10/21/2022]
|
4
|
Zemp DD, Giannini O, Quadri P, Rabuffetti M, Tettamanti M, de Bruin ED. Signatures of Gait Movement Variability in CKD Patients Scheduled for Hemodialysis Indicate Pathological Performance Before and After Hemodialysis: A Prospective, Observational Study. Front Med (Lausanne) 2021; 8:702029. [PMID: 34395481 PMCID: PMC8355421 DOI: 10.3389/fmed.2021.702029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 06/30/2021] [Indexed: 12/21/2022] Open
Abstract
Background: The frailty status of hemodialysis patients is well-known, but the role of the therapy in the frailty process is not yet clear. Nowadays gait analysis in nephrology is neglected, although gait performance is known to be related to frailty and kidney function. We hypothesized that gait quality and physical activity level is already affected before, and does not change because of the start of hemodialysis. Methods: Fourteen patients (72.3 ± 5.7 years old) in a pre-dialysis program underwent an instrumental gait analysis and their physical activity was monitored for a week. This protocol was repeated 3, 6, 12, and 24 months after the first hemodialysis session. Results: At baseline, our sample showed a conservative gait with pathologic gait variability, high dual-task cost, and a sedentary lifestyle. No statistically significant change was found in any parameter in the analyzed period, but there was a tendency toward an improvement of gait quality and physical activity in the first year of treatment, and a decline in the second year. Conclusion: Elderly patients in the pre-dialysis stage show a conservative gait, however variability was in a pathological range and did not change post-hemodialysis. This hints toward changes in the central nervous system due to the kidney disease. This finding suggests the importance of gait analysis in the early stages of renal disease in the diagnosis of changes in the nervous system due to kidney failure that affect gait. Early detection of these changes would potentially allow a prevention program tailored to this population to be developed.
Collapse
Affiliation(s)
- Damiano D Zemp
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland.,Geriatric Service, Ente Ospedaliero Cantonale, Ospedale Regionale della Beata Vergine, Mendrisio, Switzerland
| | - Olivier Giannini
- Department of Internal Medicine, Ente Ospedaliero Cantonale, Mendrisio, Switzerland.,Service of Nephrology, Ente Ospedaliero Cantonale, Ospedale Regionale della Beata Vergine, Mendrisio, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Pierluigi Quadri
- Geriatric Service, Ente Ospedaliero Cantonale, Ospedale Regionale della Beata Vergine, Mendrisio, Switzerland.,Department of Internal Medicine, Ente Ospedaliero Cantonale, Mendrisio, Switzerland
| | | | - Mauro Tettamanti
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCSS, Milan, Italy
| | - Eling D de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland.,Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.,OST - Eastern Swiss University of Applied Sciences, Department of Health, St. Gallen, Switzerland
| |
Collapse
|
5
|
Kulkarni S, Nagarkar A. Basic gait pattern and impact of fall risk factors on gait among older adults in India. Gait Posture 2021; 88:16-21. [PMID: 33951574 DOI: 10.1016/j.gaitpost.2021.04.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 04/21/2021] [Accepted: 04/24/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND An unstable gait pattern is an indicator of an increased risk of falls among older adults. Data on basic gait parameters is useful in the early identification of gait impairment. However, reference gait measurements are not available in low- and middle-income countries. RESEARCH QUESTION What are the normative reference values of gait parameters and do fall risk factors such as impaired balance, functional difficulty, and multimorbidity affect the gait patterns of older adults in India? METHODS A cross-sectional data of 659 older adults were collected using a semi-structured schedule. Gait parameters were measured using wearable sensors. Descriptive statistics, independent t-test, and one-way ANCOVA were used to determine the significant difference (p < 0.05) in gait parameters across the risk factors. RESULTS A mean stride length of 123.00 ± 15.19 cm, stride velocity of 110.57 ± 17.57 cm/s, and a cadence of 106.14 ± 11.44 steps/minute were reported in the study. Functional difficulties and balance impairment were the two major risk factors that affected stride velocity, stride length, and cadence after adjusting for age and height. No difference in gait parameters was observed among participants with and without multimorbidity. SIGNIFICANCE This study provides a baseline or reference values of various gait parameters measured on a large sample of population aged 60 and above from India. Assessment of gait patterns and associated risk factors in a clinical setup will help identify the older adults at risk of falls and reduce the enormous burden of fall injuries. Since gait parameters show a large variation across geographical regions, it is important to have region-specific reference values.
Collapse
Affiliation(s)
- Snehal Kulkarni
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India.
| | - Aarti Nagarkar
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India.
| |
Collapse
|
6
|
HRDepthNet: Depth Image-Based Marker-Less Tracking of Body Joints. SENSORS 2021; 21:s21041356. [PMID: 33672984 PMCID: PMC7918542 DOI: 10.3390/s21041356] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/05/2021] [Accepted: 02/07/2021] [Indexed: 11/17/2022]
Abstract
With approaches for the detection of joint positions in color images such as HRNet and OpenPose being available, consideration of corresponding approaches for depth images is limited even though depth images have several advantages over color images like robustness to light variation or color- and texture invariance. Correspondingly, we introduce High- Resolution Depth Net (HRDepthNet)—a machine learning driven approach to detect human joints (body, head, and upper and lower extremities) in purely depth images. HRDepthNet retrains the original HRNet for depth images. Therefore, a dataset is created holding depth (and RGB) images recorded with subjects conducting the timed up and go test—an established geriatric assessment. The images were manually annotated RGB images. The training and evaluation were conducted with this dataset. For accuracy evaluation, detection of body joints was evaluated via COCO’s evaluation metrics and indicated that the resulting depth image-based model achieved better results than the HRNet trained and applied on corresponding RGB images. An additional evaluation of the position errors showed a median deviation of 1.619 cm (x-axis), 2.342 cm (y-axis) and 2.4 cm (z-axis).
Collapse
|
7
|
Quijoux F, Bertin-Hugault F, Zawieja P, Lefèvre M, Vidal PP, Ricard D. Postadychute-AG, Detection, and Prevention of the Risk of Falling Among Elderly People in Nursing Homes: Protocol of a Multicentre and Prospective Intervention Study. Front Digit Health 2021; 2:604552. [PMID: 34713067 PMCID: PMC8521935 DOI: 10.3389/fdgth.2020.604552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 12/15/2020] [Indexed: 12/02/2022] Open
Abstract
Introduction: While falls among the elderly is a public health issue, because of the social, medical, and economic burden they represent, the tools to predict falls are limited. Posturography has been developed to distinguish fallers from non-fallers, however, there is too little data to show how predictions change as older adults' physical abilities improve. The Postadychute-AG clinical trial aims to evaluate the evolution of posturographic parameters in relation to the improvement of balance through adapted physical activity (APA) programs. Methods: In this prospective, multicentre clinical trial, institutionalized seniors over 65 years of age will be followed for a period of 6 months through computer-assisted posturography and automatic gait analysis. During the entire duration of the follow-up, they will benefit from a monthly measurement of their postural and locomotion capacities through a recording of their static balance and gait thanks to a software developed for this purpose. The data gathered will be correlated with the daily record of falls in the institution. Static and dynamic balance measurements aim to extract biomechanical markers and compare them with functional assessments of motor skills (Berg Balance Scale and Mini Motor Test), expecting their superiority in predicting the number of falls. Participants will be followed for 3 months without APA and 3 months with APA in homogeneous group exercises. An analysis of variance will evaluate the variability of monthly measures of balance in order to record the minimum clinically detectable change (MDC) as participants improve their physical condition through APA. Discussion: Previous studies have stated the MDC through repeated measurements of balance but, to our knowledge, none appear to have implemented monthly measurements of balance and gait. Combined with a reliable measure of the number of falls per person, motor capacities and other precipitating factors, this study aims to provide biomechanical markers predictive of fall risk with their sensitivity to improvement in clinical status over the medium term. This trial could provide the basis for posturographic and gait variable values for these elderly people and provide a solution to distinguish those most at risk to be implemented in current practice in nursing homes. Trial Registration: ID-RCB 2017-A02545-48. Protocol Version: Version 4.2 dated January 8, 2020.
Collapse
Affiliation(s)
- Flavien Quijoux
- Centre Borelli UMR 9010/Université Paris-Saclay, ENS Paris-Saclay, CNRS, SSA, Université de Paris, Inserm, Paris, France
- ORPEA Group, Puteaux, France
| | | | | | | | - Pierre-Paul Vidal
- Centre Borelli UMR 9010/Université Paris-Saclay, ENS Paris-Saclay, CNRS, SSA, Université de Paris, Inserm, Paris, France
- Institute of Information and Control, Hangzhou Dianzi University, Hangzhou, China
| | - Damien Ricard
- Centre Borelli UMR 9010/Université Paris-Saclay, ENS Paris-Saclay, CNRS, SSA, Université de Paris, Inserm, Paris, France
- Service de Neurologie de l'Hôpital d'Instruction des Armées de Percy, Service de Santé des Armées, Clamart, France
- Ecole du Val-de-Grâce, Ecole de Santé des Armées, Paris, France
| |
Collapse
|
8
|
Mobbs RJ, Ho D, Choy WJ, Betteridge C, Lin H. COVID-19 is shifting the adoption of wearable monitoring and telemedicine (WearTel) in the delivery of healthcare: opinion piece. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1285. [PMID: 33209865 PMCID: PMC7661877 DOI: 10.21037/atm-20-3678] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Ralph J Mobbs
- Faculty of Medicine, University of New South Wales, Sydney, Australia.,NeuroSpine Surgery Research Group (NSURG), Sydney, Australia.,Neurospine Clinic, Prince of Wales Private Hospital, Randwick, NSW 2031, Australia
| | - Daniel Ho
- Faculty of Medicine, University of New South Wales, Sydney, Australia.,NeuroSpine Surgery Research Group (NSURG), Sydney, Australia.,Neurospine Clinic, Prince of Wales Private Hospital, Randwick, NSW 2031, Australia
| | - Wen Jie Choy
- Faculty of Medicine, University of New South Wales, Sydney, Australia.,NeuroSpine Surgery Research Group (NSURG), Sydney, Australia.,Neurospine Clinic, Prince of Wales Private Hospital, Randwick, NSW 2031, Australia
| | - Callum Betteridge
- Faculty of Medicine, University of New South Wales, Sydney, Australia.,NeuroSpine Surgery Research Group (NSURG), Sydney, Australia.,Neurospine Clinic, Prince of Wales Private Hospital, Randwick, NSW 2031, Australia
| | - Henry Lin
- Department of Neurosurgery, Prince of Wales Hospital, Randwick, NSW 2031, Australia
| |
Collapse
|
9
|
Marques LBF, Moreira BDS, Ocarino JDM, Sampaio RF, Bastone ADC, Kirkwood RN. Construct and criterion validity of the functional gait assessment-Brazil in community-dwelling older adults. Braz J Phys Ther 2020; 25:186-193. [PMID: 32586617 DOI: 10.1016/j.bjpt.2020.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 05/18/2020] [Accepted: 05/20/2020] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND The functional gait assessment (FGA) is a reliable instrument to evaluate walking balance in the Brazilian older population. However, other measurement properties need investigation. OBJECTIVE To determine the construct and criterion validity of the FGA-Brazil and its ceiling and floor effects. METHODS Sociodemographic, clinical, and anthropometric data were collected from 126 older adults. Participants completed the Mini-mental state examination followed by the FGA-Brazil, Berg balance scale (BBS), gait speed, and the Falls Efficacy Scale-International. Six months later, the participants were interviewed by telephone about their fall history. Exploratory factor analysis was used to determine the structural validity. We also determined the construct validity of the FGA-Brazil, using hypothesis testing, by investigating the differences between groups using the Mann-Whitney U test. Criterion validity was determined using the Spearman correlation between the FGA-Brazil and the other balance and gait measures, and using the Receiver Operator Characteristic curve. RESULTS Participants' mean age was 69.3 ± 7.4 years, and 84 (69.4%) were female. Factor analysis resulted in two factors explaining 53.3% of the total variance. Moderate and high significant correlations were found between the FGA-Brazil and gait speed (r = 0.65) and BBS (r = 0.80). A significant difference in the FGA-Brazil median score between older adults with low and high concern about falls was observed. The cutoff score recommended for predicting falls was 22 or less. No ceiling and floor effects were observed. CONCLUSION We recommend the FGA-Brazil to determine the risk of falls in community-dwelling older adults.
Collapse
Affiliation(s)
| | - Bruno de Souza Moreira
- Graduate Program in Public Health, Faculty of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Juliana de Melo Ocarino
- Graduate Program in Rehabilitation Science, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Rosana Ferreira Sampaio
- Graduate Program in Rehabilitation Science, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Alessandra de Carvalho Bastone
- Graduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, MG, Brazil
| | - Renata Noce Kirkwood
- Graduate Program in Rehabilitation Science, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil; School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
| |
Collapse
|
10
|
Relevance of sex, age and gait kinematics when predicting fall-risk and mortality in older adults. J Biomech 2020; 105:109723. [PMID: 32151381 DOI: 10.1016/j.jbiomech.2020.109723] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 02/23/2020] [Accepted: 02/24/2020] [Indexed: 11/22/2022]
Abstract
Approximately one-third of elderly people fall each year with severe consequences, including death. The aim of this study was to identify the most relevant features to be considered to maximize the accuracy of a logistic regression model designed for prediction of fall/mortality risk among older people. This study included 261 adults, aged over 65 years. Men and women were analyzed separately because sex stratification was revealed as being essential for our purposes of feature ranking and selection. Participants completed a 3-m walk test at their own gait velocity. An inertial sensor attached to their lumbar spine was used to record acceleration data in the three spatial directions. Signal processing techniques allowed the extraction of 21 features representative of gait kinematics, to be used as predictors to train and test the model. Age and gait speed data were also considered as predictors. A set of 23 features was considered. These features demonstrate to be more or less relevant depending on the sex of the cohort under analysis and the classification label (risk of falls and mortality). In each case, the minimum size subset of relevant features is provided to show the maximum accuracy prediction capability. Gait speed has been largely used as the single feature for the prediction fall risk among older adults. Nevertheless, prediction accuracy can be substantially improved, reaching 70% in some cases, if the task of training and testing the model takes into account some other features, namely, sex, age and gait kinematic parameters. Therefore we recommend considering sex, age and step regularity to predict fall-risk.
Collapse
|
11
|
Grabiner MD, Marone JR, Wyatt M, Sessoms P, Kaufman KR. Performance of an attention-demanding task during treadmill walking shifts the noise qualities of step-to-step variation in step width. Gait Posture 2018; 63:154-158. [PMID: 29738957 DOI: 10.1016/j.gaitpost.2018.04.041] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 04/24/2018] [Accepted: 04/25/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND The fractal scaling evident in the step-to-step fluctuations of stepping-related time series reflects, to some degree, neuromotor noise. RESEARCH QUESTION The primary purpose of this study was to determine the extent to which the fractal scaling of step width, step width and step width variability are affected by performance of an attention-demanding task. We hypothesized that the attention-demanding task would shift the structure of the step width time series toward white, uncorrelated noise. METHODS Subjects performed two 10-min treadmill walking trials, a control trial of undisturbed walking and a trial during which they performed a mental arithmetic/texting task. Motion capture data was converted to step width time series, the fractal scaling of which were determined from their power spectra. RESULTS Fractal scaling decreased by 22% during the texting condition (p < 0.001) supporting the hypothesized shift toward white uncorrelated noise. Step width and step width variability increased 19% and five percent, respectively (p < 0.001). However, a stepwise discriminant analysis to which all three variables were input revealed that the control and dual task conditions were discriminated only by step width fractal scaling. SIGNIFICANCE The change of the fractal scaling of step width is consistent with increased cognitive demand and suggests a transition in the characteristics of the signal noise. This may reflect an important advance toward the understanding of the manner in which neuromotor noise contributes to some types of falls. However, further investigation of the repeatability of the results, the sensitivity of the results to progressive increases in cognitive load imposed by attention-demanding tasks, and the extent to which the results can be generalized to the gait of older adults seems warranted.
Collapse
Affiliation(s)
- Mark D Grabiner
- University of Illinois at Chicago, Department of Kinesiology and Nutrition, 1919 W. Taylor Street, Room 648, Chicago, IL 60612, United States.
| | - Jane R Marone
- University of Illinois at Chicago, Department of Kinesiology and Nutrition, 901 W. Roosevelt Rd, 336 PEB, Chicago, IL 60612, United States.
| | - Marilynn Wyatt
- Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134, United States.
| | - Pinata Sessoms
- Naval Health Research Center, San Diego, 140 Sylvester Rd., San Diego, CA 92106-3521, United States.
| | - Kenton R Kaufman
- Motion Analysis Laboratory, Dan Abraham Health Living Center 4-214A, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, United States.
| |
Collapse
|
12
|
Kirkwood RN, Gomes HA, Sampaio RF, Furtado SRC, Moreira BS. Spatiotemporal and variability gait data in community-dwelling elderly women from Brazil. Braz J Phys Ther 2017; 20:258-66. [PMID: 27437717 PMCID: PMC4946842 DOI: 10.1590/bjpt-rbf.2014.0157] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 11/26/2015] [Indexed: 12/02/2022] Open
Abstract
Background Gait is an extremely complex motor task; therefore, gait data should encompass as
many gait parameters as possible. Objective To provide reference values for gait measurements obtained from a Brazilian group
of community-dwelling elderly females between the ages of 65 and 89 years and to
apply the PCA-biplot to yield insight into different walking strategies that might
occur during the aging process. Method 305 elderly community-dwelling females living in Brazil were stratified into four
age groups: 65-69 years (N=103); 70-74 years (N=95); 75-79 years (N=77); and ≥80
years (N=30). Age, height, and BMI were assessed to describe the characteristics
of the groups. Gait spatiotemporal and variability data were obtained using the
GAITRite® system. Principal component analysis, followed by MANOVA and the
PCA-biplot approach were used to analyze the data. Results 95% CI showed that only three components – rhythm, variability, and support -
together explained 74.2% of the total variance in gait that were different among
the groups. The older groups (75-79 and ≥80 years) walked with lower than average
velocity, cadence, and step length and were above average for the variables
stance, step, swing, and double support time and the ≥80 year old group presented
the highest gait variability compared to the other groups. Conclusion Aging is associated with decreased gait velocity and cadence and increased stance,
step time, and variability, but not associated with changes in base of support. In
addition, the PCA-biplot indicates a decline towards decreased rhythm and
increased variability with aging.
Collapse
Affiliation(s)
- Renata N Kirkwood
- Programa de Pós-graduação em Ciências da Reabilitação, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Henrique A Gomes
- Programa de Pós-graduação em Ciências da Reabilitação, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Rosana F Sampaio
- Programa de Pós-graduação em Ciências da Reabilitação, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Sheyla R C Furtado
- Programa de Pós-graduação em Ciências da Reabilitação, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Bruno S Moreira
- Programa de Pós-graduação em Ciências da Reabilitação, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| |
Collapse
|
13
|
Gervásio FM, Santos GA, Ribeiro DM, Menezes RLD. Medidas temporoespaciais indicativas de quedas em mulheres saudáveis entre 50 e 70 anos avaliadas pela análise tridimensional da marcha. FISIOTERAPIA E PESQUISA 2016. [DOI: 10.1590/1809-2950/15661923042016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivou-se comparar e correlacionar medidas temporoespaciais da marcha indicativas de quedas. Participaram do estudo 35 mulheres saudáveis, sem histórico de quedas no ano da avaliação. A análise computadorizada tridimensional da marcha forneceu cinco medidas temporoespaciais de cada participante, dos membros inferiores direito (D) e esquerdo (E). A análise inferencial abordou dois grupos de mulheres: jovens (20 40 anos) e adultas-idosas (50-70 anos). Houve diferença estatística significativa entre os grupos para comprimento da passada D (p=0,003) e E (p=0,002); passo D (p=0,008) e E (p=0,001); tempo de apoio E (p=0,008); tempo de passo D (p=0,049); tempo de apoio duplo E (p=0,003); largura da base E (p=0,005); resposta à carga E (p=0,001); pré-balanço D (p=0,001) e E (p=0,001) e para algumas medidas em percentil do ciclo de marcha: apoio E (p=0,001); balanço E (p=0,001); apoio simples E (p=0,025); resposta à carga E (p=0,00); pré-balanço E (p=0,001) e pré-balanço D (p=0,014). A regressão linear indicou que a variação da idade modificou em média 18% as medidas de comprimento do passo e da passada e em 20% a velocidade da marcha. Com o avanço da idade, as medidas funcionais diminuíram; e, consequentemente, as medidas de estabilidade, como duração dos períodos de apoio, apoio duplo e pré-balanço, aumentaram. Essas modificações indicam risco de queda na faixa etária de 50 a 70 anos. Algumas medidas de marcha podem apresentar alteração em uma faixa etária ainda considerada de baixo risco.
Collapse
|
14
|
Rossetin LL, Rodrigues EV, Gallo LH, Macedo DS, Schieferdecker MEM, Pintarelli VL, Rabito EI, Gomes ARS. Indicators of sarcopenia and their relation to intrinsic and extrinsic factors relating to falls among active elderly women. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2016. [DOI: 10.1590/1809-98232016019.150028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction: Musculoskeletal aging can impair functional performance increasing the risk of falls. Objective: To analyze the correlation between sarcopenia and the intrinsic and extrinsic factors involved in falls among community-dwelling elderly women. Method: A cross-sectional study evaluated the number of falls of 85 active community-dwelling elderly women in the previous year and then divided them into two groups: non-fallers (n=61) and fallers (n=24). The sarcopenia indicators assessed were gait speed (GS, 10m); handgrip strength (HS); calf circumference; appendicular muscle mass index (DXA). Intrinsic factors: Mental State Examination (MSE); visual acuity; depression (GDS-30); hip , knee (Lequesne) and ankle/foot (FAOS) pain/function; vestibular function (Fukuda test); functional mobility and risk of falls (TUG); power (sitting and standing five times); gait (treadmill); fear of falling (FES-I-Brazil). Extrinsic factors: risk/security features in homes. The independent t test was applied for comparisons between groups and the Pearson and Spearman tests were used for correlations (p<0.05). Results: There was a moderate correlation between HS and GS in non-fallers (r=0.47; p=0.001) and fallers (r= 0.54; p=0.03). There was a moderate negative correlation (r= -0.52; p=0.03) between FES-I-Brazil and gait cadence in fallers. There was a greater presence of stairs (p=0.001) and throw rugs (p=0.03) in the homes of fallers than non-fallers. Conclusion: The elderly women were not sarcopenic. Elderly fallers presented inferior gait cadence and a greater fear of falling. Residential risks were determining factors for falls, and were more relevant than intrinsic factors in the evaluation of falls among active community-dwelling elders.
Collapse
|