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Krasovsky T, Holtzer R, Jahjah E, Fruchter E. Trait anxiety increases the attentional cost of walking in young adults: A cross-sectional study. J Affect Disord 2024; 362:716-722. [PMID: 39009319 DOI: 10.1016/j.jad.2024.07.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 06/05/2024] [Accepted: 07/12/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND Anxiety is a prevalent mental health disorder, with debilitating symptoms causing avoidance and decreased quality of life. Balance impairments during standing and walking are common in anxiety. However, understanding of gait control mechanisms in people with trait anxiety, particularly when walking requires increased attention (dual-task), is still limited. This work examined the attentional cost of walking in people with varying levels of trait anxiety. Since people with anxiety are often prone to Space and Motion Discomfort (SMD), this work also evaluated the potential role of SMD in the attentional cost of walking. METHODS Fifty-six participants, aged 18-51, classified as anxious and non-anxious, were asked to walk under single- and two dual-task conditions (cognitive: counting backwards; visuomotor: texting on a mobile phone). Task performance (walking, counting and texting) was measured. Prefrontal cortex (PFC) activation was recorded using functional near infrared spectroscopy (fNIRS) for a subset of participants (n = 29). RESULTS Anxious individuals walked slower under dual-task conditions, with smaller increases in PFC activation from single to dual-task conditions in the cognitive task. Dual-task walking was unrelated to SMD. LIMITATIONS sample size was limited, particularly for fNIRS data. CONCLUSIONS To the best of our knowledge, this study is the first to identify anxiety-related deficits in attentional gait control in the general population, including during the everyday task of texting on a mobile phone. Since decrements in dual-task walking are linked to poor health outcomes, results from this work may have functional implications for people with anxiety.
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Affiliation(s)
- Tal Krasovsky
- Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel; Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, Israel.
| | - Roee Holtzer
- Department of Neurology, Albert Einstein College of Medicine, New York, NY, USA; Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | | | - Eyal Fruchter
- Rambam Health Care Campus, Haifa, Israel; Bruce Rappaport Faculty of Medicine, Technion- Israel Institute of Technology, Haifa, Israel
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Richer N, Bradford JC, Ferris DP. Mobile neuroimaging: What we have learned about the neural control of human walking, with an emphasis on EEG-based research. Neurosci Biobehav Rev 2024; 162:105718. [PMID: 38744350 DOI: 10.1016/j.neubiorev.2024.105718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 04/18/2024] [Accepted: 05/08/2024] [Indexed: 05/16/2024]
Abstract
Our understanding of the neural control of human walking has changed significantly over the last twenty years and mobile brain imaging methods have contributed substantially to current knowledge. High-density electroencephalography (EEG) has the advantages of being lightweight and mobile while providing temporal resolution of brain changes within a gait cycle. Advances in EEG hardware and processing methods have led to a proliferation of research on the neural control of locomotion in neurologically intact adults. We provide a narrative review of the advantages and disadvantages of different mobile brain imaging methods, then summarize findings from mobile EEG studies quantifying electrocortical activity during human walking. Contrary to historical views on the neural control of locomotion, recent studies highlight the widespread involvement of many areas, such as the anterior cingulate, posterior parietal, prefrontal, premotor, sensorimotor, supplementary motor, and occipital cortices, that show active fluctuations in electrical power during walking. The electrocortical activity changes with speed, stability, perturbations, and gait adaptation. We end with a discussion on the next steps in mobile EEG research.
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Affiliation(s)
- Natalie Richer
- Department of Kinesiology and Applied Health, University of Winnipeg, Winnipeg, Manitoba, Canada.
| | - J Cortney Bradford
- US Army Combat Capabilities Development Command US Army Research Laboratory, Adelphi, MD, USA
| | - Daniel P Ferris
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
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Papin LJ, Esche M, Scanlon JEM, Jacobsen NSJ, Debener S. Investigating cognitive-motor effects during slacklining using mobile EEG. Front Hum Neurosci 2024; 18:1382959. [PMID: 38818032 PMCID: PMC11137308 DOI: 10.3389/fnhum.2024.1382959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 04/24/2024] [Indexed: 06/01/2024] Open
Abstract
Balancing is a very important skill, supporting many daily life activities. Cognitive-motor interference (CMI) dual-tasking paradigms have been established to identify the cognitive load of complex natural motor tasks, such as running and cycling. Here we used wireless, smartphone-recorded electroencephalography (EEG) and motion sensors while participants were either standing on firm ground or on a slackline, either performing an auditory oddball task (dual-task condition) or no task simultaneously (single-task condition). We expected a reduced amplitude and increased latency of the P3 event-related potential (ERP) component to target sounds for the complex balancing compared to the standing on ground condition, and a further decrease in the dual-task compared to the single-task balancing condition. Further, we expected greater postural sway during slacklining while performing the concurrent auditory attention task. Twenty young, experienced slackliners performed an auditory oddball task, silently counting rare target tones presented in a series of frequently occurring standard tones. Results revealed similar P3 topographies and morphologies during both movement conditions. Contrary to our predictions we observed neither significantly reduced P3 amplitudes, nor significantly increased latencies during slacklining. Unexpectedly, we found greater postural sway during slacklining with no additional task compared to dual-tasking. Further, we found a significant correlation between the participant's skill level and P3 latency, but not between skill level and P3 amplitude or postural sway. This pattern of results indicates an interference effect for less skilled individuals, whereas individuals with a high skill level may have shown a facilitation effect. Our study adds to the growing field of research demonstrating that ERPs obtained in uncontrolled, daily-life situations can provide meaningful results. We argue that the individual CMI effects on the P3 ERP reflects how demanding the balancing task is for untrained individuals, which draws on limited resources that are otherwise available for auditory attention processing. In future work, the analysis of concurrently recorded motion-sensor signals will help to identify the cognitive demands of motor tasks executed in natural, uncontrolled environments.
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Affiliation(s)
- Lara J. Papin
- Neuropsychology Lab, Department of Psychology, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Manik Esche
- Neuropsychology Lab, Department of Psychology, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Joanna E. M. Scanlon
- Neuropsychology Lab, Department of Psychology, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
- Oldenburg Branch for Hearing, Speech and Audio Technology (HSA), Fraunhofer Institute for Digital Media Technology (IDMT), Oldenburg, Germany
| | - Nadine S. J. Jacobsen
- Neuropsychology Lab, Department of Psychology, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Stefan Debener
- Neuropsychology Lab, Department of Psychology, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
- Oldenburg Branch for Hearing, Speech and Audio Technology (HSA), Fraunhofer Institute for Digital Media Technology (IDMT), Oldenburg, Germany
- Cluster of Excellence Hearing4all, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
- Center for Neurosensory Science and Systems, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
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4
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Bath JE, Wang DD. Unraveling the threads of stability: A review of the neurophysiology of postural control in Parkinson's disease. Neurotherapeutics 2024; 21:e00354. [PMID: 38579454 PMCID: PMC11000188 DOI: 10.1016/j.neurot.2024.e00354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/18/2024] [Accepted: 03/23/2024] [Indexed: 04/07/2024] Open
Abstract
Postural instability is a detrimental and often treatment-refractory symptom of Parkinson's disease. While many existing studies quantify the biomechanical deficits among various postural domains (static, anticipatory, and reactive) in this population, less is known regarding the neural network dysfunctions underlying these phenomena. This review will summarize current studies on the cortical and subcortical neural activities during postural responses in healthy subjects and those with Parkinson's disease. We will also review the effects of current therapies, including neuromodulation and feedback-based wearable devices, on postural instability symptoms. With recent advances in implantable devices that allow chronic, ambulatory neural data collection from patients with Parkinson's disease, combined with sensors that can quantify biomechanical measurements of postural responses, future work using these devices will enable better understanding of the neural mechanisms of postural control. Bridging this knowledge gap will be the critical first step towards developing novel neuromodulatory interventions to enhance the treatment of postural instability in Parkinson's disease.
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Affiliation(s)
- Jessica E Bath
- Department of Physical Therapy & Rehabilitation Science, University of California, San Francisco, USA; Department of Neurological Surgery, University of California, San Francisco, USA
| | - Doris D Wang
- Department of Neurological Surgery, University of California, San Francisco, USA.
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Mailankody P, Kamble N, Bhattacharya A, Shubha Bhat GS, Arumugam T, Thennarasu K, Arasappa R, Varambally S, Yadav R, Pal PK. Yoga as an Add-on Therapy in Parkinson's Disease: A Single Group Open-label Trial. Can J Neurol Sci 2024:1-8. [PMID: 38525880 DOI: 10.1017/cjn.2024.43] [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: 03/26/2024]
Abstract
OBJECTIVE We aimed to evaluate the effect of yoga on motor and non-motor symptoms and cortical excitability in patients with Parkinson's disease (PD). METHODS We prospectively evaluated 17 patients with PD at baseline, after one month of conventional care, and after one month of supervised yoga sessions. The motor and non-motor symptoms were evaluated using the Unified Parkinson's disease Rating Scale (motor part III), Hoehn and Yahr stage, Montreal Cognitive Assessment, Hamilton depression rating scale, Hamilton anxiety rating scale, non-motor symptoms questionnaire and World Health Organization quality of life questionnaire. Transcranial magnetic stimulation was used to record resting motor threshold, central motor conduction time, ipsilateral silent period (iSP), contralateral silent period (cSP), short interval intracortical inhibition (SICI), and intracortical facilitation. RESULTS The mean age of the patients was 55.5 ± 10.8 years, with a mean duration of illness of 4.0 ± 2.5 years. The postural stability of the patients significantly improved following yoga (0.59 ± 0.5 to 0.18 ± 0.4, p = 0.039). There was a significant reduction in the cSP from baseline (138.07 ± 27.5 ms) to 4 weeks of yoga therapy (116.94 ± 18.2 ms, p = 0.004). In addition, a significant reduction in SICI was observed after four weeks of yoga therapy (0.22 ± 0.10) to (0.46 ± 0.23), p = 0.004). CONCLUSION Yoga intervention can significantly improve postural stability in patients with PD. A significant reduction of cSP and SICI suggests a reduction in GABAergic neurotransmission following yoga therapy that may underlie the improvement observed in postural stability. CLINICALTRIALSGOV IDENTIFIER CTRI/2019/02/017564.
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Affiliation(s)
- Pooja Mailankody
- Department of Neurology, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
| | - Nitish Kamble
- Department of Neurology, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
| | - Amitabh Bhattacharya
- Department of Neurology, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
| | - G S Shubha Bhat
- Department of Neurology, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
| | - Thamodharan Arumugam
- Department of Neurology, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
| | - K Thennarasu
- Department of Biostatistics, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
| | - Rashmi Arasappa
- Department of Psychiatry, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
| | - Shivarama Varambally
- Department of Psychiatry, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
| | - Ravi Yadav
- Department of Neurology, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health & Neuro Sciences, Bangalore, Karnataka, India
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Lathouwers E, Tassignon B, Maricot A, Radwan A, Naeyaert M, Raeymaekers H, Van Schuerbeek P, Sunaert S, De Mey J, De Pauw K. Human-Prosthetic Interaction (HumanIT): A study protocol for a clinical trial evaluating brain neuroplasticity and functional performance after lower limb loss. PLoS One 2024; 19:e0299869. [PMID: 38512879 PMCID: PMC10956762 DOI: 10.1371/journal.pone.0299869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 02/13/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Lower limb amputation contributes to structural and functional brain alterations, adversely affecting gait, balance, and overall quality of life. Therefore, selecting an appropriate prosthetic ankle is critical in enhancing the well-being of these individuals. Despite the availability of various prostheses, their impact on brain neuroplasticity remains poorly understood. OBJECTIVES The primary objective is to examine differences in the degree of brain neuroplasticity using magnetic resonance imaging (MRI) between individuals wearing a new passive ankle prosthesis with an articulated ankle joint and a standard passive prosthesis, and to examine changes in brain neuroplasticity within these two prosthetic groups. The second objective is to investigate the influence of prosthetic type on walking performance and quality of life. The final objective is to determine whether the type of prosthesis induces differences in the walking movement pattern. METHODS Participants with a unilateral transtibial amputation will follow a 24-week protocol. Prior to rehabilitation, baseline MRI scans will be performed, followed by allocation to the intervention arms and commencement of rehabilitation. After 12 weeks, baseline functional performance tests and a quality of life questionnaire will be administered. At the end of the 24-week period, participants will undergo the same MRI scans, functional performance tests and questionnaire to evaluate any changes. A control group of able-bodied individuals will be included for comparative analysis. CONCLUSION This study aims to unravel the differences in brain neuroplasticity and prosthesis type in patients with a unilateral transtibial amputation and provide insights into the therapeutic benefits of prosthetic devices. The findings could validate the therapeutic benefits of more advanced lower limb prostheses, potentially leading to a societal impact ultimately improving the quality of life for individuals with lower limb amputation. TRIAL REGISTRATION NCT05818410 (Clinicaltrials.gov).
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Affiliation(s)
- Elke Lathouwers
- Human Physiology and Sports Physiotherapy research group, Vrije Universiteit Brussel, Brussels, Belgium
- BruBotics, Vrije Universiteit Brussel, Brussels, Belgium
| | - Bruno Tassignon
- Human Physiology and Sports Physiotherapy research group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Alexandre Maricot
- Human Physiology and Sports Physiotherapy research group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ahmed Radwan
- KU Leuven, Department of Imaging and pathology, Translational MRI, Leuven, Belgium
| | - Maarten Naeyaert
- Department of Radiology and Magnetic Resonance, UZ Brussel, Jette, Belgium
| | - Hubert Raeymaekers
- Department of Radiology and Magnetic Resonance, UZ Brussel, Jette, Belgium
| | | | - Stefan Sunaert
- KU Leuven, Department of Imaging and pathology, Translational MRI, Leuven, Belgium
- UZ Leuven, Department of Radiology, Leuven, Belgium
| | - Johan De Mey
- Department of Radiology and Magnetic Resonance, UZ Brussel, Jette, Belgium
| | - Kevin De Pauw
- Human Physiology and Sports Physiotherapy research group, Vrije Universiteit Brussel, Brussels, Belgium
- BruBotics, Vrije Universiteit Brussel, Brussels, Belgium
- Strategic Research Program ‘Exercise and the Brain in Health & Disease: The Added Value of Human-Centered Robotics’, Vrije Universiteit Brussel, Brussels, Belgium
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7
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Purohit R, Varas-Diaz G, Bhatt T. Functional electrical stimulation to enhance reactive balance among people with hemiparetic stroke. Exp Brain Res 2024; 242:559-570. [PMID: 38214733 DOI: 10.1007/s00221-023-06729-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 10/23/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Individuals with stroke demonstrate a twofold higher fall incidence compared to healthy counterparts, potentially associated with deficits in reactive balance control, which is crucial for regaining balance from unpredictable perturbations to the body. Moreover, people with higher stroke-related motor impairment exhibit greater falls and cannot recover balance during higher perturbation intensities. Thus, they might need supplemental agents for fall prevention or even to be included in a perturbation-based protocol. Functional electrical stimulation is a widely used clinical modality for improving gait performance; however, it remains unknown whether it can enhance or interfere with reactive balance control. METHODS We recruited twelve ambulatory participants with hemiparetic stroke (61.48 ± 6.77 years) and moderate-to-high motor impairment (Chedoke-McMaster Stroke Leg Assessment ≤ 4/7). Each participant experienced 4 unpredicted paretic gait-slips, with and without functional electrical stimulation (provided 50-500 ms after perturbation) in random order. The paretic quadriceps muscle group was chosen to receive electrical stimulation, considering the role of support limb knee extensors for preventing limb-collapse. Outcomes including primary (laboratory falls), secondary (reactive stability, vertical limb support) and tertiary (compensatory step length, step initiation, execution time) measures were compared between the two conditions. RESULTS Participants demonstrated fewer falls, higher reactive stability, and higher vertical limb support (p < 0.05) following gait-slips with functional electrical stimulation compared to those without. This was accompanied by reduced step initiation time and a longer compensatory step (p < 0.05). CONCLUSION The application of functional electrical stimulation to paretic quadriceps following gait-slips reduced laboratory fall incidence with enhanced reactive balance outcomes among people with higher stroke-related motor impairment. Our results lay the preliminary groundwork for understanding the instantaneous neuromodulatory effect of functional electrical stimulation in preventing gait-slip falls, future studies could test its therapeutic effect on reactive balance. Clinical registry number: NCT04957355.
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Affiliation(s)
- Rudri Purohit
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W Taylor Street, Chicago, IL, 60612, USA
- Ph.D. Program in Rehabilitation Sciences, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W Taylor Street, Chicago, IL, 60612, USA
| | - Gonzalo Varas-Diaz
- Carrera de Kinesiología, Departamento Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Tanvi Bhatt
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W Taylor Street, Chicago, IL, 60612, USA.
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Weisberg SM, Ebner NC, Seidler RD. Getting LOST: A conceptual framework for supporting and enhancing spatial navigation in aging. WILEY INTERDISCIPLINARY REVIEWS. COGNITIVE SCIENCE 2024; 15:e1669. [PMID: 37933623 PMCID: PMC10939954 DOI: 10.1002/wcs.1669] [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: 06/05/2023] [Revised: 10/09/2023] [Accepted: 10/10/2023] [Indexed: 11/08/2023]
Abstract
Spatial navigation is more difficult and effortful for older than younger individuals, a shift which occurs for a variety of neurological, physical, and cognitive reasons associated with aging. Despite a large body of evidence documenting age-related deficits in spatial navigation, comparatively less research addresses how to facilitate more effective navigation behavior for older adults. Since navigation challenges arise for a variety of reasons in old age, a one-size-fits-all solution is unlikely to work. Here, we introduce a framework for the variety of spatial navigation challenges faced in aging, which we call LOST-Location, Orientation, Spatial mapping, and Transit. The LOST framework builds on evidence from the cognitive neuroscience of spatial navigation, which reveals distinct components underpinning human wayfinding. We evaluate research on navigational aids-devices and depictions-which help people find their way around; and we reflect on how navigation aids solve (or fail to solve) specific wayfinding difficulties faced by older adults. In summary, we emphasize a bespoke approach to improving spatial navigation in aging, which focuses on tailoring navigation solutions to specific navigation challenges. Our hope is that by providing precise support to older navigators, navigation opportunities can facilitate independence and exploration, while minimizing the danger of becoming lost. We conclude by delineating critical knowledge gaps in how to improve older adults' spatial navigation capacities that the novel LOST framework could guide to address. This article is categorized under: Psychology > Development and Aging Neuroscience > Cognition Neuroscience > Behavior.
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Affiliation(s)
- Steven M. Weisberg
- Department of Psychology, University of Florida, 945 Center Dr., Gainesville, FL 32611
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, University of Florida, 1225 Center Dr., Gainesville, FL 32611
| | - Natalie C. Ebner
- Department of Psychology, University of Florida, 945 Center Dr., Gainesville, FL 32611
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, University of Florida, 1225 Center Dr., Gainesville, FL 32611
- Institute on Aging, University of Florida, 2004 Mowry Rd., Gainesville, FL 32611
- Department of Physiology and Aging, University of Florida, 1345 Center Drive, Gainesville, FL 32610-0274
| | - Rachael D. Seidler
- Department of Applied Physiology & Kinesiology, University of Florida, 1864 Stadium Rd., Gainesville, FL 32611
- Department of Neurology, University of Florida, 1149 Newell Dr., Gainesville, FL 32611
- Normal Fixel Institute for Neurological Diseases, University of Florida, 3009 SW Williston Rd. 1864 Stadium Rd., Gainesville, FL 32608
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Peng X, Srivastava S, Sutton F, Zhang Y, Badran BW, Kautz SA. Compensatory increase in ipsilesional supplementary motor area and premotor connectivity is associated with greater gait impairments: a personalized fMRI analysis in chronic stroke. Front Hum Neurosci 2024; 18:1340374. [PMID: 38487103 PMCID: PMC10937543 DOI: 10.3389/fnhum.2024.1340374] [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: 11/23/2023] [Accepted: 02/16/2024] [Indexed: 03/17/2024] Open
Abstract
Background Balance and mobility impairments are prevalent post-stroke and a large number of survivors require walking assistance at 6 months post-stroke which diminishes their overall quality of life. Personalized interventions for gait and balance rehabilitation are crucial. Recent evidence indicates that stroke lesions in primary motor pathways, such as corticoreticular pathways (CRP) and corticospinal tract (CST), may lead to reliance on alternate motor pathways as compensation, but the current evidence lacks comprehensive knowledge about the underlying neural mechanisms. Methods In this study, we investigate the functional connectivity (FC) changes within the motor network derived from an individualized cortical parcellation approach in 33 participants with chronic stroke compared to 17 healthy controls. The correlations between altered motor FC and gait deficits (i.e., walking speed and walking balance) were then estimated in the stroke population to understand the compensation mechanism of the motor network in motor function rehabilitation post-stroke. Results Our results demonstrated significant FC increases between ipsilesional medial supplementary motor area (SMA) and premotor in stroke compared to healthy controls. Furthermore, we also revealed a negative correlation between ipsilesional SMA-premotor FC and self-selected walking speed, as well as the Functional Gait Assessment (FGA) scores. Conclusion The increased FC between the ipsilesional SMA and premotor regions could be a compensatory mechanism within the motor network following a stroke when the individual can presumably no longer rely on the more precise CST modulation of movements to produce a healthy walking pattern. These findings enhance our understanding of individualized motor network FC changes and their connection to gait and walking balance impairments post-stroke, improving stroke rehabilitation interventions.
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Affiliation(s)
- Xiaolong Peng
- Department of Psychiatry and Behavioral Sciences, Neuro-X Lab, Medical University of South Carolina, Charleston, SC, United States
| | - Shraddha Srivastava
- Ralph H. Johnson VA Medical Center, Charleston, SC, United States
- Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, United States
| | - Falon Sutton
- Department of Psychiatry and Behavioral Sciences, Neuro-X Lab, Medical University of South Carolina, Charleston, SC, United States
| | - Yongkuan Zhang
- Department of Psychiatry and Behavioral Sciences, Neuro-X Lab, Medical University of South Carolina, Charleston, SC, United States
| | - Bashar W. Badran
- Department of Psychiatry and Behavioral Sciences, Neuro-X Lab, Medical University of South Carolina, Charleston, SC, United States
| | - Steven A. Kautz
- Ralph H. Johnson VA Medical Center, Charleston, SC, United States
- Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, United States
- Division of Physical Therapy, Department of Rehabilitation Sciences, College of Health Professions, Medical University of South Carolina, Charleston, SC, United States
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Bakker LBM, Lamoth CJC, Vetrovsky T, Gruber M, Caljouw SR, Nieboer W, Taube W, van Dieën JH, Granacher U, Hortobágyi T. Neural Correlates of Balance Skill Learning in Young and Older Individuals: A Systematic Review and Meta-analysis. SPORTS MEDICINE - OPEN 2024; 10:3. [PMID: 38185708 PMCID: PMC10772137 DOI: 10.1186/s40798-023-00668-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 12/16/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Despite the increasing number of research studies examining the effects of age on the control of posture, the number of annual fall-related injuries and deaths continues to increase. A better understanding of how old age affects the neural mechanisms of postural control and how countermeasures such as balance training could improve the neural control of posture to reduce falls in older individuals is therefore necessary. The aim of this review is to determine the effects of age on the neural correlates of balance skill learning measured during static (standing) and dynamic (walking) balance tasks in healthy individuals. METHODS We determined the effects of acute (1-3 sessions) and chronic (> 3 sessions) balance skill training on balance in the trained and in untrained, transfer balance tasks through a systematic review and quantified these effects by robust variance estimation meta-analysis in combination with meta-regression. We systematically searched PubMed, Web of Science, and Cochrane databases. Balance performance and neural plasticity outcomes were extracted and included in the systematic synthesis and meta-analysis. RESULTS Forty-two studies (n = 622 young, n = 699 older individuals) were included in the systematic synthesis. Seventeen studies with 508 in-analysis participants were eligible for a meta-analysis. The overall analysis revealed that acute and chronic balance training had a large effect on the neural correlates of balance skill learning in the two age groups combined (g = 0.79, p < 0.01). Both age groups similarly improved balance skill performance in 1-3 training sessions and showed little further improvements with additional sessions. Improvements in balance performance mainly occurred in the trained and less so in the non-trained (i.e., transfer) balance tasks. The systematic synthesis and meta-analysis suggested little correspondence between improved balance skills and changes in spinal, cortical, and corticospinal excitability measures in the two age groups and between the time courses of changes in balance skills and neural correlates. CONCLUSIONS Balance skill learning and the accompanying neural adaptations occur rapidly and independently of age with little to no training dose-dependence or correspondence between behavioral and neural adaptations. Of the five types of neural correlates examined, changes in only spinal excitability seemed to differ between age groups. However, age or training dose in terms of duration did not moderate the effects of balance training on the changes in any of the neural correlates. The behavioral and neural mechanisms of strong task-specificity and the time course of skill retention remain unclear and require further studies in young and older individuals. REGISTRATION PROSPERO registration number: CRD42022349573.
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Affiliation(s)
- Lisanne B M Bakker
- Department of Human Movement Sciences, Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, A. Deusinglaan 1, 9700 AD, Groningen, The Netherlands.
| | - Claudine J C Lamoth
- Department of Human Movement Sciences, Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, A. Deusinglaan 1, 9700 AD, Groningen, The Netherlands
| | - Tomas Vetrovsky
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Markus Gruber
- Department of Sport Science, Human Performance Research Centre, University of Konstanz, Constance, Germany
| | - Simone R Caljouw
- Department of Human Movement Sciences, Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, A. Deusinglaan 1, 9700 AD, Groningen, The Netherlands
| | - Ward Nieboer
- Department of Human Movement Sciences, Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, A. Deusinglaan 1, 9700 AD, Groningen, The Netherlands
| | - Wolfgang Taube
- Department of Neurosciences and Movement Sciences, University of Fribourg, Fribourg, Switzerland
| | - Jaap H van Dieën
- Department of Human Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Urs Granacher
- Department of Sport and Sport Science, Exercise and Human Movement Science, University of Freiburg, Freiburg, Germany
| | - Tibor Hortobágyi
- Department of Human Movement Sciences, Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, A. Deusinglaan 1, 9700 AD, Groningen, The Netherlands
- Department of Kinesiology, Hungarian University of Sports Science, Budapest, Hungary
- Institute of Sport Sciences and Physical Education, University of Pécs, Pecs, Hungary
- Somogy County Kaposi Mór Teaching Hospital, Kaposvár, Hungary
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11
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Modi AD, Parekh A, Patel ZH. Methods for evaluating gait associated dynamic balance and coordination in rodents. Behav Brain Res 2024; 456:114695. [PMID: 37783346 DOI: 10.1016/j.bbr.2023.114695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/29/2023] [Accepted: 09/30/2023] [Indexed: 10/04/2023]
Abstract
Balance is the dynamic and unconscious control of the body's centre of mass to maintain postural equilibrium. Regulated by the vestibular system, head movement and acceleration are processed by the brain to adjust joints. Several conditions result in a loss of balance, including Alzheimer's Disease, Parkinson's Disease, Menière's Disease and cervical spondylosis, all of which are caused by damage to certain parts of the vestibular pathways. Studies about the impairment of the vestibular system are challenging to carry out in human trials due to smaller study sizes limiting applications of the results and a lacking understanding of the human balance control mechanism. In contrast, more controlled research can be performed in animal studies which have fewer confounding factors than human models and allow specific conditions that affect balance to be replicated. Balance control can be studied using rodent balance-related behavioural tests after spinal or brain lesions, such as the Basso, Beattie and Bresnahan (BBB) Locomotor Scale, Foot Fault Scoring System, Ledged Beam Test, Beam Walking Test, and Ladder Beam Test, which are discussed in this review article along with their advantages and disadvantages. These tests can be performed in preclinical rodent models of femoral nerve injury, stroke, spinal cord injury and neurodegenerative diseases.
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Affiliation(s)
- Akshat D Modi
- Department of Biological Sciences, University of Toronto, Scarborough, Ontario M1C 1A4, Canada; Department of Genetics and Development, Krembil Research Institute, Toronto, Ontario M5T 0S8, Canada.
| | - Anavi Parekh
- Department of Neuroscience, University of Toronto, Toronto, Ontario M5S 1A1, Canada
| | - Zeenal H Patel
- Department of Biological Sciences, University of Toronto, Scarborough, Ontario M1C 1A4, Canada; Department of Biochemistry, University of Toronto, Scarborough, Ontario M1C 1A4, Canada
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12
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Khajuria A, Sharma R, Joshi D. EEG Dynamics of Locomotion and Balancing: Solution to Neuro-Rehabilitation. Clin EEG Neurosci 2024; 55:143-163. [PMID: 36052404 DOI: 10.1177/15500594221123690] [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] [Indexed: 11/17/2022]
Abstract
The past decade has witnessed tremendous growth in analyzing the cortical representation of human locomotion and balance using Electroencephalography (EEG). With the advanced developments in miniaturized electronics, wireless brain recording systems have been developed for mobile recordings, such as in locomotion. In this review, the cortical dynamics during locomotion are presented with extensive focus on motor imagery, and employing the treadmill as a tool for performing different locomotion tasks. Further, the studies that examine the cortical dynamics during balancing, focusing on two types of balancing tasks, ie, static and dynamic, with the challenges in sensory inputs and cognition (dual-task), are presented. Moreover, the current literature demonstrates the advancements in signal processing methods to detect and remove the artifacts from EEG signals. Prior studies show the electrocortical sources in the anterior cingulate, posterior parietal, and sensorimotor cortex was found to be activated during locomotion. The event-related potential has been observed to increase in the fronto-central region for a wide range of balance tasks. The advanced knowledge of cortical dynamics during mobility can benefit various application areas such as neuroprosthetics and gait/balance rehabilitation. This review will be beneficial for the development of neuroprostheses, and rehabilitation devices for patients suffering from movement or neurological disorders.
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Affiliation(s)
- Aayushi Khajuria
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India
| | - Richa Sharma
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India
| | - Deepak Joshi
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India
- Department of Biomedical Engineering, All India Institute of Medical Sciences, New Delhi, India
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13
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de Rond V, D'Cruz N, Hulzinga F, McCrum C, Verschueren S, de Xivry JJO, Nieuwboer A. Neural correlates of weight-shift training in older adults: a randomized controlled study. Sci Rep 2023; 13:19609. [PMID: 37949995 PMCID: PMC10638445 DOI: 10.1038/s41598-023-46645-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 11/03/2023] [Indexed: 11/12/2023] Open
Abstract
Mediolateral weight-shifting is an important aspect of postural control. As it is currently unknown whether a short training session of mediolateral weight-shifting in a virtual reality (VR) environment can improve weight-shifting, we investigated this question and also probed the impact of practice on brain activity. Forty healthy older adults were randomly allocated to a training (EXP, n = 20, age = 70.80 (65-77), 9 females) or a control group (CTR, n = 20, age = 71.65 (65-82), 10 females). The EXP performed a 25-min weight-shift training in a VR-game, whereas the CTR rested for the same period. Weight-shifting speed in both single- (ST) and dual-task (DT) conditions was determined before, directly after, and 24 h after intervention. Functional Near-Infrared Spectroscopy (fNIRS) assessed the oxygenated hemoglobin (HbO2) levels in five cortical regions of interest. Weight-shifting in both ST and DT conditions improved in EXP but not in CTR, and these gains were retained after 24 h. Effects transferred to wider limits of stability post-training in EXP versus CTR. HbO2 levels in the left supplementary motor area were significantly increased directly after training in EXP during ST (change < SEM), and in the left somatosensory cortex during DT (change > SEM). We interpret these changes in the motor coordination and sensorimotor integration areas of the cortex as possibly learning-related.
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Affiliation(s)
- Veerle de Rond
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Nicholas D'Cruz
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- Motor Control and Neuroplasticity Research Group, Department of Kinesiology, KU Leuven, Leuven, Belgium
| | - Femke Hulzinga
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Christopher McCrum
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Sabine Verschueren
- Research Group for Musculoskeletal Rehabilitation, Department of Kinesiology, KU Leuven, Leuven, Belgium
| | - Jean-Jacques Orban de Xivry
- Motor Control and Neuroplasticity Research Group, Department of Kinesiology, KU Leuven, Leuven, Belgium
- Leuven Brain Institute (LBI), Leuven, Belgium
| | - Alice Nieuwboer
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
- Leuven Brain Institute (LBI), Leuven, Belgium.
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14
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Adeniyi A, Stramel DM, Rahman D, Rahman M, Yadav A, Zhou J, Kim GY, Agrawal SK. Utilizing mobile robotics for pelvic perturbations to improve balance and cognitive performance in older adults: a randomized controlled trial. Sci Rep 2023; 13:19381. [PMID: 37938618 PMCID: PMC10632386 DOI: 10.1038/s41598-023-46145-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 10/27/2023] [Indexed: 11/09/2023] Open
Abstract
Late-life balance disorders remain a severe problem with fatal consequences. Perturbation-based balance training (PBT), a form of rehabilitation that intentionally introduces small, unpredictable disruptions to an individual's gait cycle, can improve balance. The Tethered Pelvic Assist Device (TPAD) is a cable-driven robotic trainer that applies perturbations to the user's pelvis during treadmill walking. Earlier work showcased improved gait stability and the first evidence of increased cognition acutely. The mobile Tethered Pelvic Assist Device (mTPAD), a portable version of the TPAD, applies perturbations to a pelvic belt via a posterior walker during overground gait, as opposed to treadmill walking. Forty healthy older adults were randomly assigned to a control group (CG, n = 20) without mTPAD PBT or an experimental group (EG, n = 20) with mTPAD PBT for a two-day study. Day 1 consisted of baseline anthropometrics, vitals, and functional and cognitive measurements. Day 2 consisted of training with the mTPAD and post-interventional cognitive and functional measurements. Results revealed that the EG significantly outperformed the CG in several cognitive (SDMT-C and TMT-B) and functional (BBS and 4-Stage Balance: one-foot stand) measurements while showcasing increased confidence in mobility based on FES-I. To our knowledge, our study is the first randomized, large group (n = 40) clinical study exploring new mobile perturbation-based robotic gait training technology.
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Affiliation(s)
- Adedeji Adeniyi
- Department of Rehabilitation and Regenerative Medicine, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA.
| | - Danielle M Stramel
- Department of Mechanical Engineering, Fu Foundation School of Engineering and Applied Science, Columbia University, New York, NY, USA
| | - Danish Rahman
- Department of Mechanical Engineering, Fu Foundation School of Engineering and Applied Science, Columbia University, New York, NY, USA
| | - Montaha Rahman
- Department of Rehabilitation and Regenerative Medicine, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
| | - Arihant Yadav
- Department of Mechanical Engineering, Fu Foundation School of Engineering and Applied Science, Columbia University, New York, NY, USA
| | - Jingzong Zhou
- Department of Mechanical Engineering, Fu Foundation School of Engineering and Applied Science, Columbia University, New York, NY, USA
| | - Grace Y Kim
- Department of Rehabilitation and Regenerative Medicine, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
| | - Sunil K Agrawal
- Department of Rehabilitation and Regenerative Medicine, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA.
- Department of Mechanical Engineering, Fu Foundation School of Engineering and Applied Science, Columbia University, New York, NY, USA.
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15
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Schmoigl-Tonis M, Schranz C, Müller-Putz GR. Methods for motion artifact reduction in online brain-computer interface experiments: a systematic review. Front Hum Neurosci 2023; 17:1251690. [PMID: 37920561 PMCID: PMC10619676 DOI: 10.3389/fnhum.2023.1251690] [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: 07/02/2023] [Accepted: 09/11/2023] [Indexed: 11/04/2023] Open
Abstract
Brain-computer interfaces (BCIs) have emerged as a promising technology for enhancing communication between the human brain and external devices. Electroencephalography (EEG) is particularly promising in this regard because it has high temporal resolution and can be easily worn on the head in everyday life. However, motion artifacts caused by muscle activity, fasciculation, cable swings, or magnetic induction pose significant challenges in real-world BCI applications. In this paper, we present a systematic review of methods for motion artifact reduction in online BCI experiments. Using the PRISMA filter method, we conducted a comprehensive literature search on PubMed, focusing on open access publications from 1966 to 2022. We evaluated 2,333 publications based on predefined filtering rules to identify existing methods and pipelines for motion artifact reduction in EEG data. We present a lookup table of all papers that passed the defined filters, all used methods, and pipelines and compare their overall performance and suitability for online BCI experiments. We summarize suitable methods, algorithms, and concepts for motion artifact reduction in online BCI applications, highlight potential research gaps, and discuss existing community consensus. This review aims to provide a comprehensive overview of the current state of the field and guide researchers in selecting appropriate methods for motion artifact reduction in online BCI experiments.
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Affiliation(s)
- Mathias Schmoigl-Tonis
- Laboratory of Collaborative Robotics, Department of Human Motion Analytics, Salzburg Research GmbH, Salzburg, Austria
- Institute of Neural Engineering, Laboratory of Brain-Computer Interfaces, Graz University of Technology, Graz, Austria
| | - Christoph Schranz
- Laboratory of Collaborative Robotics, Department of Human Motion Analytics, Salzburg Research GmbH, Salzburg, Austria
| | - Gernot R. Müller-Putz
- Institute of Neural Engineering, Laboratory of Brain-Computer Interfaces, Graz University of Technology, Graz, Austria
- BioTechMed Graz, Graz, Austria
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16
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Mofateh R, Bakhshi Feleh F, Orakifar N, Behdarvandan A. Differences in dynamic balance control based on pain catastrophizing level in individuals with nonspecific chronic low back pain. Physiother Theory Pract 2023:1-10. [PMID: 37377096 DOI: 10.1080/09593985.2023.2228896] [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: 04/17/2023] [Revised: 06/08/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Pain catastrophization (PC) is related to motor control changes in individuals with nonspecific chronic low back pain (NSCLBP). However, differences in dynamic balance control based on the level of PC still remain unclear in these individuals. OBJECTIVE The aim of this study was to compare the dynamic balance control between healthy controls and individuals with NSCLBP with high and low PC. METHODS Forty individuals with NSCLBP and 20 healthy participants were enrolled in this cross-sectional study. Individuals with NSCLBP were classified into two groups of high and low PC. Dynamic balance control was assessed using the Modified Star Excursion Balance Test (MSEBT), Five-Time Sit-to-Stand Test (FTSST), and Timed Up and Go Test (TUGT). RESULTS Statistical analyses showed that mean values of reach distances in the anterior, posteromedial, and posterolateral directions of the MSEBT were significantly lower in individuals with NSCLBP with high PC compared to low PC (p = .04, p = .01, and p = .04, respectively) and healthy controls (p < .001, p = .001, and p = .006, respectively). In addition, for both the FTSS and TUG tests, the mean time was significantly greater in individuals with NSCLBP with high PC compared to low PC (p < .001 and p = .004, respectively) and healthy controls (p < .001). CONCLUSIONS Our results showed poor dynamic balance control in individuals with NSCLBP with high PC. This suggests that PC could contribute to the impaired dynamic balance control in individuals with NSCLBP. Combining balance exercises and cognitive-behavioral treatments targeting PC may be useful for the improvement of dynamic balance control in individuals with NSCLBP with high PC.
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Affiliation(s)
- Razieh Mofateh
- Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Physiotherapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fatemeh Bakhshi Feleh
- Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Student Research Committee, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Neda Orakifar
- Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Physiotherapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Amin Behdarvandan
- Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Physiotherapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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17
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Adeniyi A, Stramel DM, Rahman D, Rahman M, Yadav A, Zhou J, Kim GY, Agrawal SK. Utilizing Mobile Robotics for Pelvic Perturbations to Improve Balance and Cognitive Performance in Older Adults: A Randomized Controlled Trial. RESEARCH SQUARE 2023:rs.3.rs-2997218. [PMID: 37333360 PMCID: PMC10275047 DOI: 10.21203/rs.3.rs-2997218/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Late-life balance disorders remain a severe problem with fatal consequences. Perturbation-based balance training (PBT), a form of rehabilitation that intentionally introduces small, unpredictable disruptions to an individual's gait cycle, can improve balance. The Tethered Pelvic Assist Device (TPAD) is a cable-driven robotic trainer that applies perturbations to the user's pelvis during treadmill walking. Earlier work showcased improved gait stability and the first evidence of increased cognition acutely. The mobile Tethered Pelvic Assist Device (mTPAD), a portable version of the TPAD, applies perturbations to a pelvic belt via a posterior walker during overground gait, as opposed to treadmill walking. Forty healthy older adults were randomly assigned to a control group (CG, n = 20) without mTPAD PBT or an experimental group (EG, n = 20) with mTPAD PBT for a two-day study. Day 1 consisted of baseline anthropometrics, vitals, and functional and cognitive measurements. Day 2 consisted of training with the mTPAD and post-interventional cognitive and functional measurements. Results revealed that the EG significantly outperformed the CG in cognitive and functional tasks while showcasing increased confidence in mobility. Gait analysis demonstrated that the mTPAD PBT significantly improved mediolateral stability during lateral perturbations. To our knowledge, our study is the first randomized, large group (n = 40) clinical study exploring new mobile perturbation-based robotic gait training technology.
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Affiliation(s)
- Adedeji Adeniyi
- Vagelos College of Physicians & Surgeons, Columbia University Irvine Medical Center
| | | | | | | | | | | | - Grace Y Kim
- Vagelos College of Physicians & Surgeons, Columbia University Irvine Medical Center
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18
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Sherman DA, Baumeister J, Stock MS, Murray AM, Bazett-Jones DM, Norte GE. Brain activation and single-limb balance following anterior cruciate ligament reconstruction. Clin Neurophysiol 2023; 149:88-99. [PMID: 36933325 DOI: 10.1016/j.clinph.2023.02.175] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 02/11/2023] [Accepted: 02/21/2023] [Indexed: 03/11/2023]
Abstract
OBJECTIVE To compare brain activity between individuals with anterior cruciate ligament reconstruction (ACLR) and controls during balance. To determine the influence of neuromodulatory interventions (external focus of attention [EF] and transcutaneous electrical nerve stimulation [TENS]) on cortical activity and balance performance. METHODS Individuals with ACLR (n = 20) and controls (n = 20) performed a single-limb balance task under four conditions: internal focus (IF), object-based-EF, target-based-EF, and TENS. Electroencephalographic signals were decomposed, localized, and clustered to generate power spectral density in theta and alpha-2 frequency bands. RESULTS Participants with ACLR had higher motor-planning (d = 0.5), lower sensory (d = 0.6), and lower motor activity (d = 0.4-0.8), while exhibiting faster sway velocity (d = 0.4) than controls across all conditions. Target-based-EF decreased motor-planning (d = 0.1-0.4) and increased visual (d = 0.2), bilateral sensory (d = 0.3-0.4), and bilateral motor (d = 0.4-0.5) activity in both groups compared to all other conditions. Neither EF conditions nor TENS changed balance performance. CONCLUSIONS Individuals with ACLR exhibit lower sensory and motor processing, higher motor planning demands, and greater motor inhibition compared to controls, suggesting visual-dependence and less automatic balance control. Target-based-EF resulted in favorable reductions in motor-planning and increases in somatosensory and motor activity, transient effects in line with impairments after ACLR. SIGNIFICANCE Sensorimotor neuroplasticity underlies balance deficits in individuals with ACLR. Neuromodulatory interventions such as focus of attention may induce favorable neuroplasticity along with performance benefits.
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Affiliation(s)
- David A Sherman
- Live4 Physical Therapy and Wellness, Acton, MA, USA; Dept. of Physical Therapy & Athletic Training, College of Health & Rehabilitation Science: Sargent College, Boston University, Boston, MA, USA; Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA.
| | - Jochen Baumeister
- Exercise Science & Neuroscience Unit, Department of Exercise & Health, Faculty of Science, Paderborn University, Paderborn, Germany
| | - Matt S Stock
- College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA.
| | - Amanda M Murray
- Department of Exercise and Rehabilitation Sciences, College of Health and Human Services, University of Toledo, Toledo, OH, USA
| | - David M Bazett-Jones
- Department of Exercise and Rehabilitation Sciences, College of Health and Human Services, University of Toledo, Toledo, OH, USA
| | - Grant E Norte
- Department of Exercise and Rehabilitation Sciences, College of Health and Human Services, University of Toledo, Toledo, OH, USA.
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19
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Single-leg stance on a challenging surface can enhance cortical activation in the right hemisphere - A case study. Heliyon 2023; 9:e13628. [PMID: 36846707 PMCID: PMC9950900 DOI: 10.1016/j.heliyon.2023.e13628] [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: 09/15/2022] [Revised: 02/02/2023] [Accepted: 02/06/2023] [Indexed: 02/12/2023] Open
Abstract
Maintaining body balance, whether static or dynamic, is critical in performing everyday activities and developing and optimizing basic motor skills. This study investigates how a professional alpine skier's brain activates on the contralateral side during a single-leg stance. Continuous-wave functional near-infrared spectroscopy (fNIRS) signals were recorded with sixteen sources and detectors over the motor cortex to investigate brain hemodynamics. Three different tasks were performed: barefooted walk (BFW), right-leg stance (RLS), and left-leg stance (LLS). The signal processing pipeline includes channel rejection, the conversation of raw intensities into hemoglobin concentration changes using modified Beer-Lambert law, baseline zero-adjustments, z-normalization, and temporal filtration. The hemodynamic brain signal was estimated using a general linear model with a 2-gamma function. Measured activations (t-values) with p-value <0.05 were only considered as statistically significant active channels. Compared to all other conditions, BFW has the lowest brain activation. LLS is associated with more contralateral brain activation than RLS. During LLS, higher brain activation was observed across all brain regions. The right hemisphere has comparatively more activated regions-of-interest. Higher ΔHbO demands in the dorsolateral prefrontal, pre-motor, supplementary motor cortex, and primary motor cortex were observed in the right hemisphere relative to the left which explains higher energy demands for balancing during LLS. Broca's temporal lobe was also activated during both LLS and RLS. Comparing the results with BFW- which is considered the most realistic walking condition-, it is concluded that higher demands of ΔHbO predict higher motor control demands for balancing. The participant struggled with balance during the LLS, showing higher ΔHbO in both hemispheres compared to two other conditions, which indicates the higher requirement for motor control to maintain balance. A post-physiotherapy exercise program is expected to improve balance during LLS, leading to fewer changes to ΔHbO.
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20
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Son M, Jung J, Hwang D, Beck D, Park W. The effect of backpack weight on the performance of basic short-term/working memory tasks while walking along a pre-determined route. ERGONOMICS 2023; 66:227-245. [PMID: 35532033 DOI: 10.1080/00140139.2022.2075941] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 05/02/2022] [Indexed: 06/14/2023]
Abstract
This study investigated possible backpack weight effects on the performance of three basic short-term/working memory (STM/WM) tasks conducted concurrently with the physical task of route walking. The STM/WM tasks were the Corsi block-tapping, digit span, and 3-back tasks, and, were employed to examine the visuo-spatial sketchpad, phonological loop and central executive components of the WM system. Four backpack weight levels (0%, 15%, 25% and 40% of body mass) were considered. Thirty participants conducted the three experimental tasks requiring physical-cognitive multitasking. Data analyses revealed that: (1) increased backpack weight resulted in decreases in the performance of the Corsi block-tapping and the 3-back task, but (2) backpack weight did not significantly affect the digit span task performance. The study results suggest that reducing backpack weight could benefit the performance of various cognitive tasks during route walking. The study findings may be useful for the ergonomics design of body-worn equipment and human-system interfaces.Practitioner summary: This study examined the backpack weight effects on the performance of three basic short-term/working memory tasks conducted concurrently with the physical task of route walking. The study revealed that reducing backpack weight could benefit various cognitive tasks during physical-cognitive multitasking, especially cognitive tasks that require visuospatial processing and executive control.
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Affiliation(s)
- Minseok Son
- Digital Appliances Business, Samsung Electronics Co. Ltd, Seoul, South Korea
| | - Jaemoon Jung
- Department of Industrial Engineering, Seoul National University, Seoul, South Korea
| | - Dongwook Hwang
- School of Media and Communication, Kwangwoon University, Seoul, South Korea
| | - Donghyun Beck
- Department of Safety Engineering, Incheon National University, Incheon, South Korea
| | - Woojin Park
- Department of Industrial Engineering, Seoul National University, Seoul, South Korea
- Department of Industrial Engineering and Institute for Industrial Systems Innovation, Seoul National University, Seoul, South Korea
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21
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Lathouwers E, Díaz MA, Maricot A, Tassignon B, Cherelle C, Cherelle P, Meeusen R, De Pauw K. Therapeutic benefits of lower limb prostheses: a systematic review. J Neuroeng Rehabil 2023; 20:4. [PMID: 36639655 PMCID: PMC9840272 DOI: 10.1186/s12984-023-01128-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 01/07/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Enhancing the quality of life of people with a lower limb amputation is critical in prosthetic development and rehabilitation. Yet, no overview is available concerning the impact of passive, quasi-passive and active ankle-foot prostheses on quality of life. OBJECTIVE To systematically review the therapeutic benefits of performing daily activities with passive, quasi-passive and active ankle-foot prostheses in people with a lower limb amputation. METHODS We searched the Pubmed, Web of Science, Scopus and Pedro databases, and backward citations until November 3, 2021. Only English-written randomised controlled trials, cross-sectional, cross-over and cohort studies were included when the population comprised individuals with a unilateral transfemoral or transtibial amputation, wearing passive, quasi-passive or active ankle-foot prostheses. The intervention and outcome measures had to include any aspect of quality of life assessed while performing daily activities. We synthesised the participants' characteristics, type of prosthesis, intervention, outcome and main results, and conducted risk of bias assessment using the Cochrane risk of bias tool. This study is registered on PROSPERO, number CRD42021290189. RESULTS We identified 4281 records and included 34 studies in total. Results indicate that quasi-passive and active prostheses are favoured over passive prostheses based on biomechanical, physiological, performance and subjective measures in the short-term. All studies had a moderate or high risk of bias. CONCLUSION Compared to passive ankle-foot prostheses, quasi-passive and active prostheses significantly enhance the quality of life. Future research should investigate the long-term therapeutic benefits of prosthetics devices.
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Affiliation(s)
- Elke Lathouwers
- grid.8767.e0000 0001 2290 8069Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050 Brussels, Belgium ,grid.8767.e0000 0001 2290 8069Brussels Human Robotics Research Center (BruBotics), Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - María Alejandra Díaz
- grid.8767.e0000 0001 2290 8069Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050 Brussels, Belgium ,grid.8767.e0000 0001 2290 8069Brussels Human Robotics Research Center (BruBotics), Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Alexandre Maricot
- grid.8767.e0000 0001 2290 8069Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Bruno Tassignon
- grid.8767.e0000 0001 2290 8069Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | | | | | - Romain Meeusen
- grid.8767.e0000 0001 2290 8069Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050 Brussels, Belgium ,grid.8767.e0000 0001 2290 8069Brussels Human Robotics Research Center (BruBotics), Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Kevin De Pauw
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium. .,Brussels Human Robotics Research Center (BruBotics), Vrije Universiteit Brussel, 1050, Brussels, Belgium.
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22
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Hu Y, Petruzzello SJ, Hernandez ME. Beta cortical oscillatory activities and their relationship to postural control in a standing balance demanding test: influence of aging. Front Aging Neurosci 2023; 15:1126002. [PMID: 37213543 PMCID: PMC10196243 DOI: 10.3389/fnagi.2023.1126002] [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: 12/16/2022] [Accepted: 04/14/2023] [Indexed: 05/23/2023] Open
Abstract
Background Age-related changes in the cortical control of standing balance may provide a modifiable mechanism underlying falls in older adults. Thus, this study examined the cortical response to sensory and mechanical perturbations in older adults while standing and examined the relationship between cortical activation and postural control. Methods A cohort of community dwelling young (18-30 years, N = 10) and older adults (65-85 years, N = 11) performed the sensory organization test (SOT), motor control test (MCT), and adaptation test (ADT) while high-density electroencephalography (EEG) and center of pressure (COP) data were recorded in this cross-sectional study. Linear mixed models examined cohort differences for cortical activities, using relative beta power, and postural control performance, while Spearman correlations were used to investigate the relationship between relative beta power and COP indices in each test. Results Under sensory manipulation, older adults demonstrated significantly higher relative beta power at all postural control-related cortical areas (p < 0.01), while under rapid mechanical perturbations, older adults demonstrated significantly higher relative beta power at central areas (p < 0.05). As task difficulty increased, young adults had increased relative beta band power while older adults demonstrated decreased relative beta power (p < 0.01). During sensory manipulation with mild mechanical perturbations, specifically in eyes open conditions, higher relative beta power at the parietal area in young adults was associated with worse postural control performance (p < 0.001). Under rapid mechanical perturbations, specifically in novel conditions, higher relative beta power at the central area in older adults was associated with longer movement latency (p < 0.05). However, poor reliability measures of cortical activity assessments were found during MCT and ADT, which limits the ability to interpret the reported results. Discussion Cortical areas are increasingly recruited to maintain upright postural control, even though cortical resources may be limited, in older adults. Considering the limitation regarding mechanical perturbation reliability, future studies should include a larger number of repeated mechanical perturbation trials.
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Affiliation(s)
- Yang Hu
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States
- Department of Kinesiology, College of Health and Human Science, San José State University, San Jose, CA, United States
- *Correspondence: Yang Hu,
| | - Steven J. Petruzzello
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Manuel E. Hernandez
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States
- Department of Biomedical and Translational Sciences, Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, United States
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23
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Levin O, Vints WAJ, Ziv G, Katkutė G, Kušleikienė S, Valatkevičienė K, Sheoran S, Drozdova-Statkevičienė M, Gleiznienė R, Pääsuke M, Dudonienė V, Himmelreich U, Česnaitienė VJ, Masiulis N. Neurometabolic correlates of posturography in normal aging and older adults with mild cognitive impairment: Evidence from a 1H-MRS study. Neuroimage Clin 2023; 37:103304. [PMID: 36580713 PMCID: PMC9827054 DOI: 10.1016/j.nicl.2022.103304] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 12/03/2022] [Accepted: 12/22/2022] [Indexed: 12/25/2022]
Abstract
Proton magnetic resonance spectroscopy (1H-MRS) holds promise for revealing and understanding neurodegenerative processes associated with cognitive and functional impairments in aging. In the present study, we examined the neurometabolic correlates of balance performance in 42 cognitively intact older adults (healthy controls - HC) and 26 older individuals that were diagnosed with mild cognitive impairment (MCI). Neurometabolite ratios of total N-acetyl aspartate (tNAA), glutamate-glutamine complex (Glx), total choline (tCho) and myo-inositol (mIns) relative to total creatine (tCr) were assessed using single voxel 1H-MRS in four different brain regions. Regions of interest were the left hippocampus (HPC), dorsal posterior cingulate cortex (dPCC), left sensorimotor cortex (SM1), and right dorsolateral prefrontal cortex (dlPFC). Center-of-pressure velocity (Vcop) and dual task effect (DTE) were used as measures of balance performance. Results indicated no significant group differences in neurometabolite ratios and balance performance measures. However, our observations revealed that higher tCho/tCr and mIns/tCr in hippocampus and dPCC were generic predictors of worse balance performance, suggesting that neuroinflammatory processes in these regions might be a driving factor for impaired balance performance in aging. Further, we found that higher tNAA/tCr and mIns/tCr and lower Glx/tCr in left SM1 were predictors of better balance performance in MCI but not in HC. The latter observation hints at the possibility that individuals with MCI may upregulate balance control through recruitment of sensorimotor pathways.
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Affiliation(s)
- Oron Levin
- Department of Health Promotion and Rehabilitation, Lithuanian Sports University, LT-44221 Kaunas, Lithuania; Movement Control & Neuroplasticity Research Group, Group Biomedical Sciences, KU Leuven, Heverlee 3001, Belgium
| | - Wouter A J Vints
- Department of Health Promotion and Rehabilitation, Lithuanian Sports University, LT-44221 Kaunas, Lithuania; Department of Rehabilitation Medicine Research School CAPHRI, Maastricht University P.O. Box 616, 6200 MD Maastricht, the Netherlands; Centre of Expertise in Rehabilitation and Audiology, Adelante Zorggroep, Hoensbroek, The Netherlands.
| | - Gal Ziv
- The Academic College at Wingate, Netanya 4290200, Israel
| | - Gintarė Katkutė
- Department of Health Promotion and Rehabilitation, Lithuanian Sports University, LT-44221 Kaunas, Lithuania
| | - Simona Kušleikienė
- Department of Health Promotion and Rehabilitation, Lithuanian Sports University, LT-44221 Kaunas, Lithuania
| | - Kristina Valatkevičienė
- Department of Radiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Samrat Sheoran
- Department of Health Promotion and Rehabilitation, Lithuanian Sports University, LT-44221 Kaunas, Lithuania; Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | | | - Rymantė Gleiznienė
- Department of Radiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Mati Pääsuke
- Institute of Sport Sciences and Physiotherapy, University of Tartu, Estonia
| | - Vilma Dudonienė
- Department of Health Promotion and Rehabilitation, Lithuanian Sports University, LT-44221 Kaunas, Lithuania
| | - Uwe Himmelreich
- Biomedical MRI Unit, Department of Imaging and Pathology, Group Biomedical Sciences, KU Leuven, Leuven 3000, Belgium
| | - Vida J Česnaitienė
- Department of Health Promotion and Rehabilitation, Lithuanian Sports University, LT-44221 Kaunas, Lithuania
| | - Nerijus Masiulis
- Department of Health Promotion and Rehabilitation, Lithuanian Sports University, LT-44221 Kaunas, Lithuania; Department of Rehabilitation, Physical and Sports Medicine, Institute of Health Science, Vilnius University, Vilnius, Lithuania
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24
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Kahya M, Gouskova NA, Lo OY, Zhou J, Cappon D, Finnerty E, Pascual-Leone A, Lipsitz LA, Hausdorff JM, Manor B. Brain activity during dual-task standing in older adults. J Neuroeng Rehabil 2022; 19:123. [PMID: 36369027 PMCID: PMC9652829 DOI: 10.1186/s12984-022-01095-3] [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: 07/19/2022] [Accepted: 10/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background In older adults, the extent to which performing a cognitive task when standing diminishes postural control is predictive of future falls and cognitive decline. The neurophysiology of such “dual-tasking” and its effect on postural control (i.e., dual-task cost) in older adults are poorly understood. The purpose of this study was to use electroencephalography (EEG) to examine the effects of dual-tasking when standing on brain activity in older adults. We hypothesized that compared to single-task “quiet” standing, dual-task standing would decrease alpha power, which has been linked to decreased motor inhibition, as well as increase the ratio of theta to beta power, which has been linked to increased attentional control. Methods Thirty older adults without overt disease completed four separate visits. Postural sway together with EEG (32-channels) were recorded during trials of standing with and without a concurrent verbalized serial subtraction dual-task. Postural control was measured by average sway area, velocity, and path length. EEG metrics included absolute alpha-, theta-, and beta-band powers as well as theta/beta power ratio, within six demarcated regions-of-interest: the left and right anterior, central, and posterior regions of the brain. Results Most EEG metrics demonstrated moderate-to-high between-day test–retest reliability (intra-class correlation coefficients > 0.70). Compared with quiet standing, dual-tasking decreased alpha-band power particularly in the central regions bilaterally (p = 0.002) and increased theta/beta power ratio in the anterior regions bilaterally (p < 0.001). A greater increase in theta/beta ratio from quiet standing to dual-tasking in numerous demarcated brain regions correlated with greater dual-task cost (i.e., absolute increase, indicative of worse performance) to postural sway metrics (r = 0.45–0.56, p < 0.01). Lastly, participants who exhibited greater alpha power during dual-tasking in the anterior-right (r = 0.52, p < 0.01) and central-right (r = 0.48, p < 0.01) regions had greater postural sway velocity during dual-tasking. Conclusion In healthy older adults, alpha power and theta/beta power ratio change with dual-task standing. The change in theta/beta power ratio in particular may be related to the ability to regulate standing postural control when simultaneously performing unrelated, attention-demanding cognitive tasks. Modulation of brain oscillatory activity might therefore be a novel target to minimize dual-task cost in older adults.
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25
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Purohit R, Bhatt T. Mobile Brain Imaging to Examine Task-Related Cortical Correlates of Reactive Balance: A Systematic Review. Brain Sci 2022; 12:1487. [PMID: 36358413 PMCID: PMC9688648 DOI: 10.3390/brainsci12111487] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 02/18/2024] Open
Abstract
This systematic review examined available findings on spatial and temporal characteristics of cortical activity in response to unpredicted mechanical perturbations. Secondly, this review investigated associations between cortical activity and behavioral/biomechanical measures. Databases were searched from 1980-2021 and a total of 35 cross-sectional studies (31 EEG and 4 fNIRS) were included. Majority of EEG studies assessed perturbation-evoked potentials (PEPs), whereas other studies assessed changes in cortical frequencies. Further, fNIRS studies assessed hemodynamic changes. The PEP-N1, commonly identified at sensorimotor areas, was most examined and was influenced by context prediction, perturbation magnitude, motor adaptation and age. Other PEPs were identified at frontal, parietal and sensorimotor areas and were influenced by task position. Further, changes in cortical frequencies were observed at prefrontal, sensorimotor and parietal areas and were influenced by task difficulty. Lastly, hemodynamic changes were observed at prefrontal and frontal areas and were influenced by task prediction. Limited studies reported associations between cortical and behavioral outcomes. This review provided evidence regarding the involvement of cerebral cortex for sensory processing of unpredicted perturbations, error-detection of expected versus actual postural state, and planning and execution of compensatory stepping responses. There is still limited evidence examining cortical activity during reactive balance tasks in populations with high fall-risk.
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Affiliation(s)
- Rudri Purohit
- Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL 60612, USA
- Ph.D. Program in Rehabilitation Sciences, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Tanvi Bhatt
- Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL 60612, USA
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26
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Ragothaman A, Mancini M, Nutt JG, Fair DA, Miranda-Dominguez O, Horak FB. Resting state functional networks predict different aspects of postural control in Parkinson's disease. Gait Posture 2022; 97:122-129. [PMID: 35931013 DOI: 10.1016/j.gaitpost.2022.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 06/17/2022] [Accepted: 07/05/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Parkinson's disease (PD) is a neurodegenerative disorder causing postural control impairments. Postural control involves multiple domains, such as control of postural sway in stance, automatic postural responses (APRs) and anticipatory postural adjustments (APAs). We hypothesize that impairments in each postural domain is associated with resting-state functional connectivity (rsFC), accounted by predictive modeling and that cortical and cerebellar networks would predict postural control in people with PD (PwPD). OBJECTIVE To determine whether rsFC can predict three domains of postural control independently in PwPD and older adults (OA) based on predictive accuracy of models. METHODS The cohort consisted of 65 PwPD (67.7 +8.1 age) tested in their OFF-state and 42 OA (69.7 +8.2 age). Six body-worn, inertial sensors measured postural sway area while standing on foam, step length of APRs to a backward push-and-release perturbation, and magnitude of lateral APAs prior to voluntary gait initiation. Resting state-fMRI data was reported on 384 regions of interest that were grouped into 13 functional brain networks. Associations between rsFC and postural metrics were characterized using predictive modeling, with an independent training (n = 67) and validation (n = 40) dataset. Models were trained in the training sample and performance of the best model was validated in the independent test dataset. RESULTS rsFC of different brain networks predicted each domain of postural control in PD: Frontoparietal and Ventral Attention rsFC for APAs; Cerebellar-Subcortical and Visual rsFC and Auditory and Cerebellar-Subcortical rsFC for APRs; Ventral Attention and Ventral Multimodal rsFC for postural sway. In OA, CinguloOpercular and Somatomotor rsFC predicted APAs. CONCLUSIONS Our findings suggest that cortical networks predict postural control in PD and there is little overlap in brain network connectivities that predict different domains of postural control, given the rsFC methodology used. PwPD use different cortical networks for APAs compared to OA.
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Affiliation(s)
| | - Martina Mancini
- Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR 97239, USA; Department of Neurology, Oregon Health and Science University, Portland, OR 97239, USA
| | - John G Nutt
- Department of Neurology, Oregon Health and Science University, Portland, OR 97239, USA
| | - Damien A Fair
- Masonic Institute for the Developing Brain (MIDB), University of Minnesota, Minneapolis, MN 55455, USA; Institute of Child Development, College of Education and Human Development, University of Minnesota, Minneapolis, MN 55455, USA; Department of Pediatrics, University of Minnesota Medical School, University of Minnesota, Minneapolis, MN 55455, USA; Department of Behavioral Neuroscience, Oregon Health and Science University, Portland, OR 97239, USA
| | - Oscar Miranda-Dominguez
- Masonic Institute for the Developing Brain (MIDB), University of Minnesota, Minneapolis, MN 55455, USA; Department of Pediatrics, University of Minnesota Medical School, University of Minnesota, Minneapolis, MN 55455, USA
| | - Fay B Horak
- Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR 97239, USA; Department of Neurology, Oregon Health and Science University, Portland, OR 97239, USA.
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27
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Lobanov AA, Irina A Grishechkina, Andronov SV, Gleb N Barashkov, Andrey I Popov, Anatoliy D Fesyun, Elena P Ivanova, Maccarone MC, Stefano Masiero. Can aquatic exercises contribute to the improvement of the gait stereotype function in patients with Long COVID outcomes? Eur J Transl Myol 2022; 32. [PMID: 35833897 PMCID: PMC9580543 DOI: 10.4081/ejtm.2022.10698] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 06/25/2022] [Indexed: 12/11/2022] Open
Abstract
A variety of rehabilitation programmes can be offered to Long COVID patients, specifically physical training. Indeed 90% of these patients reports impairments of verticalization, stability and spatial orientation, making difficult exercise in the gym. The aim of our study was to assess the effectiveness and safety of aquatic exercise techniques as part of a comprehensive rehabilitation program for patients with Long COVID. The first of a two-stage program involved development of aquatic exercises technique, which was evaluated in 12 patients with impaired upright posture control before and after exercising by "Habilect" video gait analysis system. During the second phase, effectiveness and safety of aqua exercises were tested in water pool as part of a comprehensive rehabilitation programme conducted in 23 patients with Long COVID outcomes. Physical examination, 6-minute step test, Euro-QL-5D questionnaire, Borg scale, laser Doppler flowmetry, cardiointervalography, and spirometry were performed before and after the aquatic exercises program. After the training with aquatic exercises, indices of deviations of the main body axes of the head and the body mass centre ameliorated, as well as direction of body movement vector decreased (p<0.05). This study demonstrated a statistically significant improvement in exercise tolerance in both groups, as measured by the 6-minute step test after rehabilitation. The comparison group averaged 236.7 metres [126; 380] (T=8, p=0.047) after the rehabilitation course and the intervention group averaged 233.71 metres [150; 320] (T=8.0, p=0.047). When tested with the Euro-QL-5D questionnaire, a post-treatment improvement was noted in the comparison group on the anxiety/depression subscale (3 [3;3] (T=0, p=0.043)). In the intervention group, laser Doppler flowmetry revealed a statistically significant increase in microcirculation (6.36 standard units after rehabilitation) [5.54; 8.17] (T=7.0, p=0.004), and a decrease of oxidative metabolism index of 6.89 standard units. [4.76; 6.96] (T=4.0, p=0.03). No serious adverse events were reported. In conclusion, the developed aquatic exercises technique seems to contribute to recovery of impaired upright posture and motor function, normalizing the walking pattern.
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Affiliation(s)
- Andrey A Lobanov
- National Medical Research Center, National Research Medical Center, Moscow.
| | | | - Sergei V Andronov
- National Medical Research Center, National Research Medical Center, Moscow.
| | | | - Andrey I Popov
- National Medical Research Center, National Research Medical Center, Moscow.
| | - Anatoliy D Fesyun
- National Medical Research Center, National Research Medical Center, Moscow.
| | - Elena P Ivanova
- National Medical Research Center, National Research Medical Center, Moscow.
| | | | - Stefano Masiero
- Physical Medicine and Rehabilitation School, University of Padova, Padua, Italy; Rehabilitation Unit, Department of Neuroscience, University of Padova, Padua.
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28
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Blodgett JM, Cooper R, Pinto Pereira SM, Hamer M. Stability of Balance Performance From Childhood to Midlife. Pediatrics 2022; 150:188250. [PMID: 35670126 DOI: 10.1542/peds.2021-055861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/05/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Balance ability underlies most physical movement across life, with particular importance for older adults. No study has investigated if balance ability is established in childhood nor if associations are independent of adult factors. We investigated associations between balance performance in early (age 10) and midlife (age 46), and whether associations were independent of contributors to adult balance. METHODS Up to 6024 individuals from the 1970 British Cohort Study were included. At age 10, static (1-legged stand) and dynamic (backward toe-to-heel walk) balance were categorized as poor, medium, or high. Eyes open and closed 1-legged balance performance (max: 30 seconds) was assessed at age 46 with 5 categories. RESULTS Poor static balance at age 10 was strongly associated with worse balance ability at age 46. Relative to the highest balance group at age 46 (ie, eyes open and closed for 30 seconds), those with poor static balance had a 7.07 (4.92-10.16) greater risk of being in the poorest balance group (ie, eyes open <15 seconds). Associations were robust to adjustment for childhood illness, cognition, and socioeconomic position and adult measures of height, BMI, education, exercise, word recall, and grip strength (adjusted relative risk: 5.04 [95% confidence interval: 3.46-7.37]). Associations between dynamic balance at age 10 and balance at age 46 were weaker (adjusted relative risk) of the poorest balance group: 1.84 [1.30-2.62]). CONCLUSIONS Early childhood may represent an important period for maturation of postural strategies involved in balance, indicating the potential for early intervention and policy changes alongside existing interventions that currently target older adults.
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Affiliation(s)
- Joanna M Blodgett
- Institute of Sport Exercise & Health, Division of Surgery & Interventional Science, University College London, London, United Kingdom
| | - Rachel Cooper
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, United Kingdom
| | - Snehal M Pinto Pereira
- Institute of Sport Exercise & Health, Division of Surgery & Interventional Science, University College London, London, United Kingdom
| | - Mark Hamer
- Institute of Sport Exercise & Health, Division of Surgery & Interventional Science, University College London, London, United Kingdom
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29
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Visual Demands of Walking Are Reflected in Eye-Blink-Evoked EEG-Activity. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12136614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Blinking is a natural user-induced response which paces visual information processing. This study investigates whether blinks are viable for segmenting continuous electroencephalography (EEG) activity, for inferring cognitive demands in ecologically valid work environments. We report the blink-related EEG measures of participants who performed auditory tasks either standing, walking on grass, or whilst completing an obstacle course. Blink-related EEG activity discriminated between different levels of cognitive demand during walking. Both behavioral parameters (e.g., blink duration or head motion) and blink-related EEG activity varied with walking conditions. Larger occipital N1 was observed during walking, relative to standing and traversing an obstacle course, which reflects differences in bottom-up visual perception. In contrast, the amplitudes of top-down components (N2, P3) significantly decreased with increasing walking demands, which reflected narrowing attention. This is consistent with blink-related EEG, specifically in Theta and Alpha power that, respectively, increased and decreased with increasing demands of the walking task. This work presents a novel and robust analytical approach to evaluate the cognitive demands experienced in natural work settings, which precludes the use of artificial task manipulations for data segmentation.
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30
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Gebel A, Busch A, Stelzel C, Hortobágyi T, Granacher U. Effects of Physical and Mental Fatigue on Postural Sway and Cortical Activity in Healthy Young Adults. Front Hum Neurosci 2022; 16:871930. [PMID: 35774482 PMCID: PMC9237223 DOI: 10.3389/fnhum.2022.871930] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/26/2022] [Indexed: 11/13/2022] Open
Abstract
Physical fatigue (PF) negatively affects postural control, resulting in impaired balance performance in young and older adults. Similar effects on postural control can be observed for mental fatigue (MF) mainly in older adults. Controversial results exist for young adults. There is a void in the literature on the effects of fatigue on balance and cortical activity. Therefore, this study aimed to examine the acute effects of PF and MF on postural sway and cortical activity. Fifteen healthy young adults aged 28 ± 3 years participated in this study. MF and PF protocols comprising of an all-out repeated sit-to-stand task and a computer-based attention network test, respectively, were applied in random order. Pre and post fatigue, cortical activity and postural sway (i.e., center of pressure displacements [CoPd], velocity [CoPv], and CoP variability [CV CoPd, CV CoPv]) were tested during a challenging bipedal balance board task. Absolute spectral power was calculated for theta (4–7.5 Hz), alpha-2 (10.5–12.5 Hz), beta-1 (13–18 Hz), and beta-2 (18.5–25 Hz) in frontal, central, and parietal regions of interest (ROI) and baseline-normalized. Inference statistics revealed a significant time-by-fatigue interaction for CoPd (p = 0.009, d = 0.39, Δ 9.2%) and CoPv (p = 0.009, d = 0.36, Δ 9.2%), and a significant main effect of time for CoP variability (CV CoPd: p = 0.001, d = 0.84; CV CoPv: p = 0.05, d = 0.62). Post hoc analyses showed a significant increase in CoPd (p = 0.002, d = 1.03) and CoPv (p = 0.003, d = 1.03) following PF but not MF. For cortical activity, a significant time-by-fatigue interaction was found for relative alpha-2 power in parietal (p < 0.001, d = 0.06) areas. Post hoc tests indicated larger alpha-2 power increases after PF (p < 0.001, d = 1.69, Δ 3.9%) compared to MF (p = 0.001, d = 1.03, Δ 2.5%). In addition, changes in parietal alpha-2 power and measures of postural sway did not correlate significantly, irrespective of the applied fatigue protocol. No significant changes were found for the other frequency bands, irrespective of the fatigue protocol and ROI under investigation. Thus, the applied PF protocol resulted in increased postural sway (CoPd and CoPv) and CoP variability accompanied by enhanced alpha-2 power in the parietal ROI while MF led to increased CoP variability and alpha-2 power in our sample of young adults. Potential underlying cortical mechanisms responsible for the greater increase in parietal alpha-2 power after PF were discussed but could not be clearly identified as cause. Therefore, further future research is needed to decipher alternative interpretations.
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Affiliation(s)
- Arnd Gebel
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany
- *Correspondence: Arnd Gebel,
| | - Aglaja Busch
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany
- University Outpatient Clinic, Sports Medicine and Sports Orthopedics, University of Potsdam, Potsdam, Germany
- Physiotherapy, Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | | | - Tibor Hortobágyi
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany
- University Medical Center Groningen, Center for Human Movement Sciences, University of Groningen, Groningen, Netherlands
- Somogy County Kaposi Mór Teaching Hospital, Kaposvár, Hungary
- Department of Sport Biology, Institute of Sport Science and Physical Education, University of Pécs, Pécs, Hungary
- Department of Kinesiology, University of Physical Education, Budapest, Hungary
| | - Urs Granacher
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany
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31
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Reed CA, DuBois CK, Hutchison KA, Huppert TJ, Monfort SM. Influence of serial subtraction tasks on transient characteristics of postural control. Hum Mov Sci 2022; 83:102950. [PMID: 35397288 PMCID: PMC11327925 DOI: 10.1016/j.humov.2022.102950] [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: 10/09/2021] [Revised: 03/15/2022] [Accepted: 03/28/2022] [Indexed: 11/17/2022]
Abstract
We sought to better understand the influence of cognitive perturbations on transient aspects of postural control. Twenty healthy, younger adults had their postural control assessed during eyes open quiet stance. Participants completed three different conditions that either had no cognitive perturbation present, an easy cognitive perturbation (i.e., serial subtraction by ones), or a more difficult cognitive perturbation (i.e., serial subtraction by sevens). All trials finished with 60 s of undisturbed eyes open quiet stance, which was the focus of the balance assessment. 95% confidence ellipse area (EA) was calculated for 5-s epochs throughout the trial. The difference in EA from the first epoch after participants started (onset) or stopped (offset) the cognitive task to the last epoch of the trial (i.e., 55-60 s after perturbation) was used to characterize transient postural control behavior. Functional near-infrared spectroscopy was also used to quantify changes in prefrontal cortex activation during the counting tasks to support interpretation of the transient balance findings. There was a significant effect of condition for transient balance characteristics following a cognitive perturbation (P < 0.001), with greater transient increases in postural sway for both difficult (Cohen's d = 0.40, P < 0.001) and easier (Cohen's d = 0.29, P = 0.013) cognitive perturbations relative to no cognitive perturbation. The onset of cognitive tasks was also associated with greater transient increases in postural sway than the offset of the cognitive tasks (Cohen's d = 0.24, P = 0.019). The functional near-infrared spectroscopy data indicated that a significant decrease in deoxygenated hemoglobin was observed for left Brodmann area 46 for both the subtraction by ones (T = -3.97; Benjamini-Hochberg significance value (q) = 0.008) and subtraction by sevens (T = -3.11; q = 0.036) conditions relative to the baseline condition. The subtraction by sevens condition was also associated with a relative increase in deoxygenated hemoglobin for the right Brodmann area 9 (T = 3.36; q = 0.026) compared to the subtraction by ones condition. In conclusion, serial subtraction can elicit transient increases in postural sway, with more difficult tasks and the onset of the cognitive-motor challenge exhibiting magnified effects. Additionally, even the cessation of a cognitive task (i.e., serial subtraction) can be associated with lingering perturbing effects on balance control.
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Affiliation(s)
- Cody A Reed
- Department of Mechanical and Industrial Engineering, Montana State University, Bozeman, MT, USA.; Sanford Orthopedics & Sports Medicine Research, Sanford Health, Sioux Falls, SD, USA
| | - Camryn K DuBois
- Department of Mechanical and Industrial Engineering, Montana State University, Bozeman, MT, USA
| | - Keith A Hutchison
- Department of Psychology, Montana State University, Bozeman, MT, USA
| | - Theodore J Huppert
- Department of Department of Electrical and Computer Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Scott M Monfort
- Department of Mechanical and Industrial Engineering, Montana State University, Bozeman, MT, USA..
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Sujatha Ravindran A, Malaya C, John I, Francisco GE, Layne C, Contreras-Vidal JL. Decoding Neural Activity Preceding Balance Loss During Standing with a Lower-limb Exoskeleton using an Interpretable Deep Learning Model. J Neural Eng 2022; 19. [PMID: 35508113 DOI: 10.1088/1741-2552/ac6ca9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 05/04/2022] [Indexed: 11/11/2022]
Abstract
Falls are a leading cause of death in adults 65 and older. Recent efforts to restore lower-limb function in these populations have seen an increase in the use of wearable robotic systems; however, fall prevention measures in these systems require early detection of balance loss to be effective. Prior studies have investigated whether kinematic variables contain information about an impending fall, but few have examined the potential of using electroencephalography (EEG) as a fall-predicting signal and how the brain responds to avoid a fall. To address this, we decoded neural activity in a balance perturbation task while wearing an exoskeleton. We acquired EEG, electromyography (EMG), and center of pressure (COP) data from 7 healthy participants during mechanical perturbations while standing. The timing of the perturbations was randomized in all trials. We found perturbation evoked potentials (PEP) components as early as 75-134 ms after the onset of the external perturbation, which preceded both the peak in EMG (∼ 180 ms) and the COP (∼ 350 ms). A convolutional neural network trained to predict balance perturbations from single-trial EEG had a mean F-score of 75.0 ± 4.3 %. Clustering GradCAM-based model explanations demonstrated that the model utilized components in the PEP and was not driven by artifacts. Additionally, dynamic functional connectivity results agreed with model explanations; the nodal connectivity measured using phase difference derivative was higher in the occipital-parietal region in the early stage of perturbations, before shifting to the parietal, motor, and back to the frontal-parietal channels. Continuous-time decoding of COP trajectories from EEG, using a gated recurrent unit model, achieved a mean Pearson's correlation coefficient of 0.7 ± 0.06. Overall, our findings suggest that EEG signals contain short-latency neural information related to an impending fall, which may be useful for developing brain-machine interface systems for fall prevention in robotic exoskeletons.
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Affiliation(s)
- Akshay Sujatha Ravindran
- Department of Electrical and Computer Engineering, University of Houston, 4800 calhoun road, E413, Cullen Engineering Building 1, University of Houston, Houston, Texas, 77204, UNITED STATES
| | - Christopher Malaya
- Health and Human Performance, University of Houston, 4800 calhoun road, Houston, Houston, Texas, 77204, UNITED STATES
| | - Isaac John
- Health and Human Performance, University of Houston, 4800 calhoun road, Houston, Houston, Texas, 77204, UNITED STATES
| | - Gerard E Francisco
- Department of Physical Medicine and Rehabilitation, The University of Texas Health Science Center at Houston, 7000 Fannin St, Houston, Texas, 77030, UNITED STATES
| | - Charles Layne
- Health and Human Performance, University of Houston, 4800 calhoun road, Houston, Houston, Texas, 77204, UNITED STATES
| | - Jose Luis Contreras-Vidal
- Electrical and Computer Engineering, University of Houston, N308 Engineering Building I, Houston, Texas, 77204-4005, UNITED STATES
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Paran I, Nachmani H, Salti M, Shelef I, Melzer I. Balance recovery stepping responses during walking were not affected by a concurrent cognitive task among older adults. BMC Geriatr 2022; 22:289. [PMID: 35387589 PMCID: PMC8988391 DOI: 10.1186/s12877-022-02969-w] [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: 12/04/2021] [Accepted: 03/17/2022] [Indexed: 11/10/2022] Open
Abstract
Background Most of older adults’ falls are related to inefficient balance recovery after an unexpected loss of balance, i.e., postural perturbation. Effective balance recovery responses are crucial to prevent falls. Due to the considerable consequences of lateral falls and the high incidence of falls when walking, this study aimed to examine the effect of a concurrent cognitive task on older adults’ balance recovery stepping abilities from unannounced lateral perturbations while walking. We also aimed to explore whether cognitive performance accuracy is affected by perturbed walking and between task trade-offs. Methods In a laboratory-based study, 20 older adults (> 70 years old) performed the following test conditions: (1) cognitive task while sitting; (2) perturbed walking; and (3) perturbed walking with a concurrent cognitive task. The cognitive task was serial numbers subtraction by seven. Single-step and multiple-step thresholds, highest perturbation achieved, 3D kinematic analysis of the first recovery step, and cognitive task performance accuracy were compared between single-task and dual-task conditions. Between task trade-offs were examined using dual-task cost (DTC). Results Single-step and multiple-step thresholds, number of recovery step trials, number of foot collision, multiple-step events and kinematic recovery step parameters were all similar in single-task and dual-task conditions. Cognitive performance was not significantly affected by dual-task conditions, however, different possible trade-offs between cognitive and postural performances were identified using DTC. Conclusions In situations where postural threat is substantial, such as unexpected balance loss during walking, balance recovery reactions were unaffected by concurrent cognitive load in older adults (i.e., posture first strategy). The study was approved by the Helsinki Ethics Committee of Soroka University Medical Center in Beer-Sheva, Israel (ClinicalTrials.gov Registration number NCT04455607, ID Numbers: Sor 396–16 CTIL; 02/07/2020). Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02969-w.
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Affiliation(s)
- Inbal Paran
- Schwartz Movement Analysis & Rehabilitation Laboratory, Department of Physical Therapy, Recanati School of Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B. 653, 84105, Beer-Sheva, Israel
| | - Hadas Nachmani
- Schwartz Movement Analysis & Rehabilitation Laboratory, Department of Physical Therapy, Recanati School of Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B. 653, 84105, Beer-Sheva, Israel
| | - Moti Salti
- Scientific Head of the Brain Imaging Research Center (BIRC), Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, 84105, Beer-Sheva, Israel.
| | - Ilan Shelef
- Diagnostic Imaging Institute, Soroka University Medical Center, Beer-Sheva, Israel
| | - Itshak Melzer
- Schwartz Movement Analysis & Rehabilitation Laboratory, Department of Physical Therapy, Recanati School of Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B. 653, 84105, Beer-Sheva, Israel.
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Lehmann N, Kuhn YA, Keller M, Aye N, Herold F, Draganski B, Taube W, Taubert M. Brain Activation During Active Balancing and Its Behavioral Relevance in Younger and Older Adults: A Functional Near-Infrared Spectroscopy (fNIRS) Study. Front Aging Neurosci 2022; 14:828474. [PMID: 35418854 PMCID: PMC8997341 DOI: 10.3389/fnagi.2022.828474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 02/28/2022] [Indexed: 12/26/2022] Open
Abstract
Age-related deterioration of balance control is widely regarded as an important phenomenon influencing quality of life and longevity, such that a more comprehensive understanding of the neural mechanisms underlying this process is warranted. Specifically, previous studies have reported that older adults typically show higher neural activity during balancing as compared to younger counterparts, but the implications of this finding on balance performance remain largely unclear. Using functional near-infrared spectroscopy (fNIRS), differences in the cortical control of balance between healthy younger (n = 27) and older (n = 35) adults were explored. More specifically, the association between cortical functional activity and balance performance across and within age groups was investigated. To this end, we measured hemodynamic responses (i.e., changes in oxygenated and deoxygenated hemoglobin) while participants balanced on an unstable device. As criterion variables for brain-behavior-correlations, we also assessed postural sway while standing on a free-swinging platform and while balancing on wobble boards with different levels of difficulty. We found that older compared to younger participants had higher activity in prefrontal and lower activity in postcentral regions. Subsequent robust regression analyses revealed that lower prefrontal brain activity was related to improved balance performance across age groups, indicating that higher activity of the prefrontal cortex during balancing reflects neural inefficiency. We also present evidence supporting that age serves as a moderator in the relationship between brain activity and balance, i.e., cortical hemodynamics generally appears to be a more important predictor of balance performance in the older than in the younger. Strikingly, we found that age differences in balance performance are mediated by balancing-induced activation of the superior frontal gyrus, thus suggesting that differential activation of this region reflects a mechanism involved in the aging process of the neural control of balance. Our study suggests that differences in functional brain activity between age groups are not a mere by-product of aging, but instead of direct behavioral relevance for balance performance. Potential implications of these findings in terms of early detection of fall-prone individuals and intervention strategies targeting balance and healthy aging are discussed.
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Affiliation(s)
- Nico Lehmann
- Department of Sport Science, Institute III, Faculty of Humanities, Otto von Guericke University, Magdeburg, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- *Correspondence: Nico Lehmann,
| | - Yves-Alain Kuhn
- Department of Neurosciences and Movement Science, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Martin Keller
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Norman Aye
- Department of Sport Science, Institute III, Faculty of Humanities, Otto von Guericke University, Magdeburg, Germany
| | - Fabian Herold
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
| | - Bogdan Draganski
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Laboratory for Research in Neuroimaging, Department of Clinical Neuroscience, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Wolfgang Taube
- Department of Neurosciences and Movement Science, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Marco Taubert
- Department of Sport Science, Institute III, Faculty of Humanities, Otto von Guericke University, Magdeburg, Germany
- Center for Behavioral Brain Science, Otto von Guericke University, Magdeburg, Germany
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35
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Khalil K, Asgher U, Ayaz Y. Novel fNIRS study on homogeneous symmetric feature-based transfer learning for brain-computer interface. Sci Rep 2022; 12:3198. [PMID: 35210460 PMCID: PMC8873341 DOI: 10.1038/s41598-022-06805-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 01/04/2022] [Indexed: 01/23/2023] Open
Abstract
The brain-computer interface (BCI) provides an alternate means of communication between the brain and external devices by recognizing the brain activities and translating them into external commands. The functional Near-Infrared Spectroscopy (fNIRS) is becoming popular as a non-invasive modality for brain activity detection. The recent trends show that deep learning has significantly enhanced the performance of the BCI systems. But the inherent bottleneck for deep learning (in the domain of BCI) is the requirement of the vast amount of training data, lengthy recalibrating time, and expensive computational resources for training deep networks. Building a high-quality, large-scale annotated dataset for deep learning-based BCI systems is exceptionally tedious, complex, and expensive. This study investigates the novel application of transfer learning for fNIRS-based BCI to solve three objective functions (concerns), i.e., the problem of insufficient training data, reduced training time, and increased accuracy. We applied symmetric homogeneous feature-based transfer learning on convolutional neural network (CNN) designed explicitly for fNIRS data collected from twenty-six (26) participants performing the n-back task. The results suggested that the proposed method achieves the maximum saturated accuracy sooner and outperformed the traditional CNN model on averaged accuracy by 25.58% in the exact duration of training time, reducing the training time, recalibrating time, and computational resources.
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Affiliation(s)
- Khurram Khalil
- National Center of Artificial Intelligence (NCAI), School of Mechanical and Manufacturing Engineering (SMME), National University of Sciences and Technology (NUST), Islamabad, 44000, Pakistan
| | - Umer Asgher
- National Center of Artificial Intelligence (NCAI), School of Mechanical and Manufacturing Engineering (SMME), National University of Sciences and Technology (NUST), Islamabad, 44000, Pakistan.,Department of Mechatronics Engineering, College of Electrical and Mechanical Engineering, National University of Sciences and Technology (NUST), Islamabad, 44000, Pakistan
| | - Yasar Ayaz
- National Center of Artificial Intelligence (NCAI), School of Mechanical and Manufacturing Engineering (SMME), National University of Sciences and Technology (NUST), Islamabad, 44000, Pakistan.
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36
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Abstract
Downward gazing is often observed when walking requires guidance. This gaze behavior is thought to promote walking stability through anticipatory stepping control. This study is part of an ongoing effort to investigate whether downward gazing also serves to enhance postural control, which can promote walking stability through a feedback/reactive mechanism. Since gaze behavior alone gives no indication as to what information is gathered and the functions it serves, we aimed to investigate the cognitive demands associated with downward gazing, as they are likely to differ between anticipatory and feedback use of visual input. To do so, we used a novel methodology to compromise walking stability in a manner that could not be resolved through modulation of stepping. Then, using interference methodology and neuroimaging, we tested for (1) interference related to dual tasking, and (2) changes in prefrontal activity. The novel methodology resulted in an increase in the time spent looking at the walking surface. Further, while some dual-task interference was observed, indicating that this gaze behavior is cognitively demanding, several gaze parameters pertaining to downward gazing and prefrontal activity correlated. These correlations revealed that a greater tendency to gaze onto the walking surface was associated with lower PFC activity, as is expected when sensory information is used through highly automatic, and useful, neural circuitry. These results, while not conclusive, do suggest that gazing onto the walking surface can be used for purposes other than anticipatory stepping control, bearing important motor-control and clinical implications.
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37
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Chen XP, Wang LJ, Chang XQ, Wang K, Wang HF, Ni M, Niu WX, Zhang M. Tai Chi and Yoga for Improving Balance on One Leg: A Neuroimaging and Biomechanics Study. Front Neurol 2021; 12:746599. [PMID: 34721273 PMCID: PMC8548460 DOI: 10.3389/fneur.2021.746599] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 09/13/2021] [Indexed: 12/26/2022] Open
Abstract
The one-leg stance is frequently used in balance training and rehabilitation programs for various balance disorders. There are some typical one-leg stance postures in Tai Chi (TC) and yoga, which are normally used for improving balance. However, the mechanism is poorly understood. Besides, the differences of one-leg stance postures between TC and yoga in training balance are still unknown. Therefore, the aim of the present study was to investigate cortical activation and rambling and trembling trajectories to elucidate the possible mechanism of improving one-leg stance balance, and compare the postural demands during one-leg stance postures between TC and yoga. Thirty-two healthy young individuals were recruited to perform two TC one-leg stance postures, i.e., right heel kick (RHK) and left lower body and stand on one leg (LSOL), two yoga postures, i.e., one-leg balance and Tree, and normal one-leg standing (OLS). Brain activation in the primary motor cortex, supplementary motor area (SMA), and dorsolateral prefrontal cortex (DLPFC) was measured using functional near-infrared spectroscopy. The center of pressure was simultaneously recorded using a force platform and decomposed into rambling and trembling components. One-way repeated-measures analysis of variance was used for the main effects. The relative concentration changes of oxygenated hemoglobin (ΔHbO) in SMA were significantly higher during RHK, LSOL, and Tree than that during OLS (p < 0.001). RHK (p < 0.001), LSOL (p = 0.003), and Tree (p = 0.006) all showed significantly larger root mean square rambling (RmRMS) than that during OLS in the medial–lateral direction. The right DLPFC activation was significantly greater during the RHK than that during the Tree (p = 0.023), OLB (p < 0.001), and OLS (p = 0.013) postures. In conclusion, the RHK, LSOL, and Tree could be used as training movements for people with impaired balance. Furthermore, the RHK in TC may provide more cognitive training in postural control than Tree and OLB in yoga. Knowledge from this study could be used and implemented in training one-leg stance balance.
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Affiliation(s)
- Xin-Peng Chen
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China.,Laboratory of Biomechanics and Rehabilitation Engineering, School of Medicine, Tongji University, Shanghai, China
| | - Le-Jun Wang
- Physical Education Department, Sport and Health Research Center, Tongji University, Shanghai, China
| | - Xiao-Qian Chang
- Laboratory of Biomechanics and Rehabilitation Engineering, School of Medicine, Tongji University, Shanghai, China
| | - Kuan Wang
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China.,Laboratory of Biomechanics and Rehabilitation Engineering, School of Medicine, Tongji University, Shanghai, China
| | - Hui-Fang Wang
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
| | - Ming Ni
- Department of Orthopaedics, Pudong New Area Peoples' Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Wen-Xin Niu
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China.,Laboratory of Biomechanics and Rehabilitation Engineering, School of Medicine, Tongji University, Shanghai, China
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
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Abstract
Magnetic resonance elastography (MRE) is an emerging noninvasive technique, an alternative to palpation for quantitative assessment of biomechanical properties of tissue. In MRE, tissue stiffness information is obtained by a 3-step process, propagating mechanical waves in the tissues, measuring the wave propagation using modified magnetic resonance (MR) pulse sequences, and generating the quantitative stiffness maps from the MR images. MRE is clinically used in patients with liver diseases, whereas its applications in other organs are still being investigated. At present, the pediatric studies are in the initial stage and preliminary results promise to provide additional information about tissue characteristics.
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Affiliation(s)
- Manjunathan Nanjappa
- Department of Radiology, The Ohio State University Wexner Medical Center, 460 West 12th Avenue, Room No 333 3rd Floor, Columbus, OH 43210, USA
| | - Arunark Kolipaka
- Department of Radiology, The Ohio State Wexner Medical Center, 395 West 12th Avenue, 4th Floor, Columbus, OH 43210, USA.
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Szabo DA, Neagu N, Teodorescu S, Panait CM, Sopa IS. Study on the Influence of Proprioceptive Control versus Visual Control on Reaction Speed, Hand Coordination, and Lower Limb Balance in Young Students 14-15 Years Old. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910356. [PMID: 34639656 PMCID: PMC8508127 DOI: 10.3390/ijerph181910356] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/26/2021] [Accepted: 09/27/2021] [Indexed: 12/02/2022]
Abstract
Currently, sports activities require a high reaction speed, coordination, and balance, highlighting the relationship between proprioceptive control, visual control, and hand–eye coordination in youth. The present research assessed the proprioceptive control, reaction speed, and lower limb balance of youth from five different schools to identify the level of physical preparation of children in this direction. This prospective study was conducted between 1 January 2020 and 29 February 2020. A total of 107 healthy children (33 females and 74 males) with appropriate medical conditions, aged between 14 and 15 years, from five Romanian schools were included in the experiment. All children were assessed for visual control and reaction speed with the ruler drop test, and for lower limb balance, the standing stork test was used. Statistical analysis included descriptive statistics, data series distribution, and comparison of means and medians using specific statistical programs. Comparison of medians highlighted significant statistical differences in the standing stork test with eyes closed and the dominant leg compared with the nondominant leg (p = 0.0057). Males were compared to females at the nondominant leg (p = 0.0179); closed eyes were compared with opened eyes for the nondominant leg (p = 0.0175 and 0.0006) for the ruler drop test comparing the dominant hand with the nondominant hand (p = 0.0212). Children who engage in sports activities better integrated sensory information in motor action execution based on reaction speed and coordination with the nondominant hand.
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Affiliation(s)
- Dan Alexandru Szabo
- Department ME1—Faculty of Medicine in English, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania
- Correspondence:
| | - Nicolae Neagu
- Department of Human Movement Sciences, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania;
| | - Silvia Teodorescu
- Department of Doctoral Studies, National University of Physical Education and Sports, 060057 Bucharest, Romania;
| | - Ciprian Marius Panait
- Department of Physical Education and Sports, National University of Physical Education and Sports, 060057 Bucharest, Romania;
| | - Ioan Sabin Sopa
- Department of Environmental Sciences, Physics, Physical Education and Sports, “Lucian Blaga” University Sibiu, 550012 Sibiu, Romania;
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40
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Behrangrad S, Zoghi M, Kidgell D, Jaberzadeh S. The Effect of a Single Session of Non-Invasive Brain Stimulation on Balance in Healthy Individuals: A Systematic Review and Best Evidence Synthesis. Brain Connect 2021; 11:695-716. [PMID: 33798002 DOI: 10.1089/brain.2020.0872] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Aim: To evaluate the effects of a single session of non-invasive brain stimulation (NIBS) on postural balance. Introduction: The NIBS has been used widely in improving balance. However, the effect of a single session of NIBS on balance in healthy individuals has not been systemically reviewed. Methods: A systematic literature review and best evidence synthesis were conducted, according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, to determine the effects of different NIBS techniques on balance function in healthy individuals. The methodological quality of included articles was assessed by the risk of bias, and the Downs and Black tool. Data were analyzed by using the best evidence synthesis. Thirty-five articles were included that used the following NIBS techniques: anodal transcranial direct current stimulation (a-tDCS), cathodal transcranial direct current stimulation (c-tDCS), continuous theta burst stimulation (cTBS), and repetitive transcranial magnetic stimulation (rTMS) on primary motor cortex (M1), supplementary motor area (SMA), dorsolateral prefrontal cortex (DLPFC), and cerebellum on balance. Results: Strong evidence showed that a-tDCS of M1, SMA improve balance in healthy participants, and the a-tDCS of DLPFC induces improvement only in dual task balance indices. Also, the findings indicate that cerebellar a-tDCS might significantly improve balance, if at least 10 min cerebellar a-tDCS with an intensity of ≥1 mA, over or maximum 1.5 cm below the inion, is used. Strong evidence showed that c-tDCS, cTBS, and rTMS are not effective on the balance. Conclusion: According to the results, the a-tDCS may be a useful technique to improve balance in healthy adults.
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Affiliation(s)
- Shabnam Behrangrad
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Maryam Zoghi
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Bundoora, Australia
| | - Dawson Kidgell
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Shapour Jaberzadeh
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
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Martelli D, Kang J, Aprigliano F, Staudinger UM, Agrawal SK. Acute Effects of a Perturbation-Based Balance Training on Cognitive Performance in Healthy Older Adults: A Pilot Study. Front Sports Act Living 2021; 3:688519. [PMID: 34485902 PMCID: PMC8415786 DOI: 10.3389/fspor.2021.688519] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/22/2021] [Indexed: 11/13/2022] Open
Abstract
Aging is accompanied by an alteration in the capacity to ambulate, react to external balance perturbations, and resolve cognitive tasks. Perturbation-based balance training has been used to induce adaptations of gait stability and reduce fall risk. The compensatory reactions generated in response to external perturbations depend on the activation of specific neural structures. This suggests that training balance recovery reactions should show acute cognitive training effects. This study aims to investigate whether exposure to repeated balance perturbations while walking can produce acute aftereffects that improve proactive and reactive strategies to control gait stability and cognitive performance in healthy older adults. It is expected that an adaptation of the recovery reactions would be associated with increased selective attention and information processing speed. Twenty-eight healthy older adults were assigned to either an Experimental (EG) or a Control Group (CG). The protocol was divided in 2 days. During the first visit, all participants completed the Symbol Digit Modalities Test (SDMT) and the Trail Making Test (TMT). During the second visit, a cable-driven robot was used to apply waist-pull perturbations while walking on a treadmill. The EG was trained with multidirectional perturbations of increasing intensity. The CG walked for a comparable amount of time with cables on, but without experiencing perturbations. Before and after the training, all participants were exposed to diagonal waist-pull perturbations. Changes in gait stability were evaluated by comparing the distance between the heel of the leading leg and the extrapolated Center of Mass (Heel-XCoM Distance-HXD) at perturbation onset (PON) and first compensatory heel strike (CHS). Finally, the cables were removed, and participants completed the SDMT and the TMT again. Results showed that only the EG adapted the gait stability (p < 0.001) in reaction to diagonal perturbations and showed improved performance in the SDMT (p < 0.001). This study provides the first evidence that a single session of perturbation-based balance training produce acute aftereffects in terms of increased cognitive performance and gait stability in healthy older adults. Future studies will include measures of functional activation of the cerebral cortex and examine whether a multi-session training will demonstrate chronic effects.
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Affiliation(s)
- Dario Martelli
- Department of Mechanical Engineering, University of Alabama, Tuscaloosa, AL, United States
| | - Jiyeon Kang
- Department of Mechanical and Aerospace Engineering, University at Buffalo, New York, NY, United States
| | | | - Ursula M. Staudinger
- The Robert N. Butler Columbia Aging Center, Columbia University, New York, NY, United States
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Sunil K. Agrawal
- Department of Mechanical Engineering, Columbia University, New York, NY, United States
- Department of Rehabilitation and Regenerative Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, United States
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42
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Bahmani M, Bahram A, Mohammadi Sanjani F, Diekfuss JA. Systematically Increased External Loads Secured Inferior to Younger and Older Adults' Center of Mass Improves Postural Control without Compromising Functional Motor Performance. J Mot Behav 2021; 54:291-303. [PMID: 34369322 DOI: 10.1080/00222895.2021.1960788] [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: 10/20/2022]
Abstract
Few studies have investigated the effect of external loads secured inferior to the center of mass (COM) on postural control and motor performance in younger and older adults. In the present study, we investigated the effect of systematically increased external loads secured inferior to the COM on young (N = 15, age [years]: M = 26.67, SD= 3.45) and older adults' (N = 15, age [years]: M = 67.4, SD= 7.69) center of pressure displacement and velocity, and also dart throwing performance in four different load conditions: 1) no load (control condition), 2) loading with 5% of body mass, 3) loading with 10% of body mass, and 4) loading with 20% of body mass. Overall, older adults had higher COP displacement and velocity in both anterior/posterior (AP) and Medio-lateral (ML) directions and poorer dart throwing scores than younger adults. Despite no significant difference in dart throwing performance for the different load conditions within each age group, loading with 10% and 20% of body mass reduced AP COP displacement relative to control for both study groups, with 20% body mass also reducing AP COP velocity relative to control for both study groups. In conclusion the present findings reveal that external loads secured inferior to older and younger adults' COM may enhance postural control without compromising motor performance. The findings were discussed in the context of fall-prevention and athletic performance.
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Affiliation(s)
- Moslem Bahmani
- Department of motor behavior, Kharazmi University, Tehran, Iran
| | - Abbas Bahram
- Department of motor behavior, Kharazmi University, Tehran, Iran
| | | | - Jed A Diekfuss
- Emory Sports Performance and Research Center, Flowery Branch, GA, USA.,Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA, USA
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43
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Shenoy Handiru V, Alivar A, Hoxha A, Saleh S, Suviseshamuthu ES, Yue GH, Allexandre D. Graph-theoretical analysis of EEG functional connectivity during balance perturbation in traumatic brain injury: A pilot study. Hum Brain Mapp 2021; 42:4427-4447. [PMID: 34312933 PMCID: PMC8410544 DOI: 10.1002/hbm.25554] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 05/08/2021] [Accepted: 05/27/2021] [Indexed: 12/13/2022] Open
Abstract
Traumatic brain injury (TBI) often results in balance impairment, increasing the risk of falls, and the chances of further injuries. However, the underlying neural mechanisms of postural control after TBI are not well understood. To this end, we conducted a pilot study to explore the neural mechanisms of unpredictable balance perturbations in 17 chronic TBI participants and 15 matched healthy controls (HC) using the EEG, MRI, and diffusion tensor imaging (DTI) data. As quantitative measures of the functional integration and segregation of the brain networks during the postural task, we computed the global graph-theoretic network measures (global efficiency and modularity) of brain functional connectivity derived from source-space EEG in different frequency bands. We observed that the TBI group showed a lower balance performance as measured by the center of pressure displacement during the task, and the Berg Balance Scale (BBS). They also showed reduced brain activation and connectivity during the balance task. Furthermore, the decrease in brain network segregation in alpha-band from baseline to task was smaller in TBI than HC. The DTI findings revealed widespread structural damage. In terms of the neural correlates, we observed a distinct role played by different frequency bands: theta-band modularity during the task was negatively correlated with the BBS in the TBI group; lower beta-band network connectivity was associated with the reduction in white matter structural integrity. Our future studies will focus on how postural training will modulate the functional brain networks in TBI.
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Affiliation(s)
- Vikram Shenoy Handiru
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, New Jersey, USA.,Department of Physical Medicine and Rehabilitation, Rutgers University New Jersey Medical School, Newark, New Jersey, USA
| | - Alaleh Alivar
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, New Jersey, USA.,Department of Physical Medicine and Rehabilitation, Rutgers University New Jersey Medical School, Newark, New Jersey, USA
| | - Armand Hoxha
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, New Jersey, USA
| | - Soha Saleh
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, New Jersey, USA.,Department of Physical Medicine and Rehabilitation, Rutgers University New Jersey Medical School, Newark, New Jersey, USA
| | - Easter S Suviseshamuthu
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, New Jersey, USA.,Department of Physical Medicine and Rehabilitation, Rutgers University New Jersey Medical School, Newark, New Jersey, USA
| | - Guang H Yue
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, New Jersey, USA.,Department of Physical Medicine and Rehabilitation, Rutgers University New Jersey Medical School, Newark, New Jersey, USA
| | - Didier Allexandre
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, New Jersey, USA.,Department of Physical Medicine and Rehabilitation, Rutgers University New Jersey Medical School, Newark, New Jersey, USA
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44
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Lehmann T, Büchel D, Mouton C, Gokeler A, Seil R, Baumeister J. Functional Cortical Connectivity Related to Postural Control in Patients Six Weeks After Anterior Cruciate Ligament Reconstruction. Front Hum Neurosci 2021; 15:655116. [PMID: 34335206 PMCID: PMC8321596 DOI: 10.3389/fnhum.2021.655116] [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: 01/18/2021] [Accepted: 06/24/2021] [Indexed: 11/13/2022] Open
Abstract
Whereas initial findings have already identified cortical patterns accompanying proprioceptive deficiencies in patients after anterior cruciate ligament reconstruction (ACLR), little is known about compensatory sensorimotor mechanisms for re-establishing postural control. Therefore, the aim of the present study was to explore leg dependent patterns of cortical contributions to postural control in patients 6 weeks following ACLR. A total of 12 patients after ACLR (25.1 ± 3.2 years, 178.1 ± 9.7 cm, 77.5 ± 14.4 kg) and another 12 gender, age, and activity matched healthy controls participated in this study. All subjects performed 10 × 30 s. single leg stances on each leg, equipped with 64-channel mobile electroencephalography (EEG). Postural stability was quantified by area of sway and sway velocity. Estimations of the weighted phase lag index were conducted as a cortical measure of functional connectivity. The findings showed significant group × leg interactions for increased functional connectivity in the anterior cruciate ligament (ACL) injured leg, predominantly including fronto-parietal [F (1, 22) = 8.41, p ≤ 0.008, η2 = 0.28], fronto-occipital [F (1, 22) = 4.43, p ≤ 0.047, η2 = 0.17], parieto-motor [F (1, 22) = 10.30, p ≤ 0.004, η2 = 0.32], occipito-motor [F (1, 22) = 5.21, p ≤ 0.032, η2 = 0.19], and occipito-parietal [F (1, 22) = 4.60, p ≤ 0.043, η2 = 0.17] intra-hemispherical connections in the contralateral hemisphere and occipito-motor [F (1, 22) = 7.33, p ≤ 0.013, η2 = 0.25] on the ipsilateral hemisphere to the injured leg. Higher functional connectivity in patients after ACLR, attained by increased emphasis of functional connections incorporating the somatosensory and visual areas, may serve as a compensatory mechanism to control postural stability of the injured leg in the early phase of rehabilitation. These preliminary results may help to develop new neurophysiological assessments for detecting functional deficiencies after ACLR in the future.
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Affiliation(s)
- Tim Lehmann
- Exercise Science and Neuroscience Unit, Department of Exercise & Health, Faculty of Science, Paderborn University, Paderborn, Germany
| | - Daniel Büchel
- Exercise Science and Neuroscience Unit, Department of Exercise & Health, Faculty of Science, Paderborn University, Paderborn, Germany
| | - Caroline Mouton
- Department of Orthopaedic Surgery, Clinique D'Eich, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg.,Luxembourg Institute of Research in Orthopaedics, Sports Medicine and Science, Luxembourg, Luxembourg
| | - Alli Gokeler
- Exercise Science and Neuroscience Unit, Department of Exercise & Health, Faculty of Science, Paderborn University, Paderborn, Germany
| | - Romain Seil
- Department of Orthopaedic Surgery, Clinique D'Eich, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg.,Luxembourg Institute of Research in Orthopaedics, Sports Medicine and Science, Luxembourg, Luxembourg.,Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - Jochen Baumeister
- Exercise Science and Neuroscience Unit, Department of Exercise & Health, Faculty of Science, Paderborn University, Paderborn, Germany
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45
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de Rond V, Orcioli-Silva D, Dijkstra BW, Orban de Xivry JJ, Pantall A, Nieuwboer A. Compromised Brain Activity With Age During a Game-Like Dynamic Balance Task: Single- vs. Dual-Task Performance. Front Aging Neurosci 2021; 13:657308. [PMID: 34290599 PMCID: PMC8287632 DOI: 10.3389/fnagi.2021.657308] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 05/31/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Postural control and cognition are affected by aging. We investigated whether cognitive distraction influenced neural activity differently in young and older adults during a game-like mediolateral weight-shifting task with a personalized task load. Methods: Seventeen healthy young and 17 older adults performed a balance game, involving hitting virtual wasps, serial subtractions and a combination of both (dual-task). A motion analysis system estimated each subject's center of mass position. Cortical activity in five regions was assessed by measuring oxygenated hemoglobin (HbO2) with a functional Near-Infrared Spectroscopy system. Results: When adding cognitive load to the game, weight-shifting speed decreased irrespective of age, but older adults reduced the wasp-hits more than young adults. Accompanying these changes, older adults decreased HbO2 in the left pre-frontal cortex (PFC) and frontal eye fields (FEF) compared to single-tasking, a finding not seen in young adults. Additionally, lower HbO2 levels were found during dual-tasking compared to the summed activation of the two single tasks in all regions except for the right PFC. These relative reductions were specific for the older age group in the left premotor cortex (PMC), the right supplementary motor area (SMA), and the left FEF. Conclusion: Older adults showed more compromised neural activity than young adults when adding a distraction to a challenging balance game. We interpret these changes as competitive downgrading of neural activity underpinning the age-related deterioration of game performance during dual-tasking. Future work needs to ascertain if older adults can train their neural flexibility to withstand balance challenges during daily life activities.
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Affiliation(s)
- Veerle de Rond
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Diego Orcioli-Silva
- Posture and Gait Studies Laboratory (LEPLO), Institute of Biosciences, São Paulo State University (UNESP), Rio Claro, Brazil
| | - Bauke Wybren Dijkstra
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Jean-Jacques Orban de Xivry
- Motor Control and Neuroplasticity Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium.,Leuven Brain Institute, Leuven, Belgium
| | - Annette Pantall
- Clinical Ageing Research Unit, Institute of Neuroscience, Newcastle University Institute of Ageing, Newcastle upon Tyne, United Kingdom
| | - Alice Nieuwboer
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.,Leuven Brain Institute, Leuven, Belgium
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46
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Tia B, Pifferi F. Oscillatory Activity in Mouse Lemur Primary Motor Cortex During Natural Locomotor Behavior. Front Syst Neurosci 2021; 15:655980. [PMID: 34220457 PMCID: PMC8249816 DOI: 10.3389/fnsys.2021.655980] [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: 01/19/2021] [Accepted: 05/17/2021] [Indexed: 11/29/2022] Open
Abstract
In arboreal environments, substrate orientation determines the biomechanical strategy for postural maintenance and locomotion. In this study, we investigated possible neuronal correlates of these mechanisms in an ancestral primate model, the gray mouse lemur. We conducted telemetric recordings of electrocorticographic activity in left primary motor cortex of two mouse lemurs moving on a branch-like small-diameter pole, fixed horizontally, or vertically. Analysis of cortical oscillations in high β (25–35 Hz) and low γ (35–50 Hz) bands showed stronger resting power on horizontal than vertical substrate, potentially illustrating sensorimotor processes for postural maintenance. Locomotion on horizontal substrate was associated with stronger event-related desynchronization than vertical substrate, which could relate to locomotor adjustments and/or derive from differences in baseline activity. Spectrograms of cortical activity showed modulation throughout individual locomotor cycles, with higher values in the first than second half cycle. However, substrate orientation did not significantly influence these variations. Overall, these results confirm that specific cortical mechanisms are solicited during arboreal locomotion, whereby mouse lemurs adjust cortical activity to substrate orientation during static posture and locomotion, and modulate this activity throughout locomotor cycles.
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47
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Fettrow T, Hupfeld K, Tays G, Clark DJ, Reuter-Lorenz PA, Seidler RD. Brain activity during walking in older adults: Implications for compensatory versus dysfunctional accounts. Neurobiol Aging 2021; 105:349-364. [PMID: 34182403 DOI: 10.1016/j.neurobiolaging.2021.05.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 05/19/2021] [Accepted: 05/23/2021] [Indexed: 11/25/2022]
Abstract
A prominent trend in the functional brain imaging literature is that older adults exhibit increased brain activity compared to young adults to perform a given task. This phenomenon has been extensively studied for cognitive tasks, with the field converging on interpretations described in two alternative accounts. One account interprets over-activation in older adults as reflecting neural dysfunction (increased brain activity - indicates poorer performance), whereas another interprets it as neural compensation (increased brain activity - supports better performance). Here we review studies that have recorded brain activity and walking measurements in older adults, and we categorize their findings as reflecting either neural dysfunction or neural compensation. Based on this synthesis, we recommend including multiple task difficulty levels in future work to help differentiate if and when compensation fails as the locomotion task becomes more difficult. Using multiple task difficulty levels with neuroimaging will lead to a more advanced understanding of how age-related changes in locomotor brain activity fit with existing accounts of brain aging and support the development of targeted neural rehabilitation techniques.
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Affiliation(s)
- Tyler Fettrow
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA.
| | - Kathleen Hupfeld
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - Grant Tays
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - David J Clark
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA; Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, USA
| | | | - Rachael D Seidler
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA; Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
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48
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Nakamura A, Suzuki Y, Milosevic M, Nomura T. Long-Lasting Event-Related Beta Synchronizations of Electroencephalographic Activity in Response to Support-Surface Perturbations During Upright Stance: A Pilot Study Associating Beta Rebound and Active Monitoring in the Intermittent Postural Control. Front Syst Neurosci 2021; 15:660434. [PMID: 34093142 PMCID: PMC8175801 DOI: 10.3389/fnsys.2021.660434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/29/2021] [Indexed: 11/13/2022] Open
Abstract
Movement related beta band cortical oscillations, including beta rebound after execution and/or suppression of movement, have drawn attention in upper extremity motor control literature. However, fewer studies focused on beta band oscillations during postural control in upright stance. In this preliminary study, we examined beta rebound and other components of electroencephalogram (EEG) activity during perturbed upright stance to investigate supraspinal contributions to postural stabilization. Particularly, we aimed to clarify the timing and duration of beta rebound within a non-sustained, but long-lasting postural recovery process that occurs more slowly compared to upper extremities. To this end, EEG signals were acquired from nine healthy young adults in response to a brief support-surface perturbation, together with the center of pressure, the center of mass and electromyogram (EMG) activities of ankle muscles. Event-related potentials (ERPs) and event-related spectral perturbations were computed from EEG data using the perturbation-onset as a triggering event. After short-latency (<0.3 s) ERPs, our results showed a decrease in high-beta band oscillations (event-related desynchronization), which was followed by a significant increase (event-related synchronization) in the same band, as well as a decrease in theta band oscillations. Unlike during upper extremity motor tasks, the beta rebound in this case was initiated before the postural recovery was completed, and sustained for as long as 3 s with small EMG responses for the first half period, followed by no excessive EMG activities for the second half period. We speculate that those novel characteristics of beta rebound might be caused by slow postural dynamics along a stable manifold of the unstable saddle-type upright equilibrium of the postural control system without active feedback control, but with active monitoring of the postural state, in the framework of the intermittent control.
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Affiliation(s)
| | | | | | - Taishin Nomura
- Department of Mechanical Science and Bioengineering, Graduate School of Engineering Science, Osaka University, Osaka, Japan
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49
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Investigating neural correlates of locomotion transition via temporal relation of EEG and EOG-recorded eye movements. Comput Biol Med 2021; 132:104350. [PMID: 33799217 DOI: 10.1016/j.compbiomed.2021.104350] [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: 11/20/2020] [Revised: 03/17/2021] [Accepted: 03/17/2021] [Indexed: 11/18/2022]
Abstract
The present study examines a temporal relation of walking behavior during locomotion transition (walking to stair ascent) to electrooculography (EOG) signals recorded from eye movement. Further, electroencephalography (EEG) signals from the occipital region of the brain are processed to understand the relative occurrence in EOG and EEG signals during the transition. The dipole sources in the occipital region with reference to EOG detection were estimated from independent components and then clustered using the k means algorithm. The dynamics of the dipoles in the occipital cluster in different frequency bands revealed significant desynchronization in the β and low γ bands, followed by resynchronization. This transitional behavior coincided with transient features suggesting possible saccadic movement of the eyes in the EOG signal. With the data from six able-bodied participants, the desynchronization in EEG from the occipital region was detected by nearly 2.2 ± 0.5s before the transition. Using preprocessing techniques on the EOG signal followed by detecting saccades from the derivative of the EOG signal, the eye movements were detected by nearly 2.5 ± 0.5s before the transition. The EOG decoded intention of transition appeared as early as 3.0 ± 1.63s before desynchronization in the EEG. A paired t-test analysis showed that the EOG-based intent decoding of transition reflects significantly earlier than occipital EEG (p < 0.00001). This study could lead to a multi-modal neural-machine interface that may produce results superior to previous attempts involving only EEG and EMG signals.
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50
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Tassignon B, Verschueren J, De Pauw K, Verhagen E, Meeusen R. Acute fatigue alters brain activity and impairs reactive balance test performance. TRANSLATIONAL SPORTS MEDICINE 2021. [DOI: 10.1002/tsm2.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Bruno Tassignon
- Faculty of Physical Education and Physiotherapy Human Physiology and Sports Physiotherapy Research Group Vrije Universiteit Brussel Brussels Belgium
| | - Jo Verschueren
- Faculty of Physical Education and Physiotherapy Human Physiology and Sports Physiotherapy Research Group Vrije Universiteit Brussel Brussels Belgium
| | - Kevin De Pauw
- Faculty of Physical Education and Physiotherapy Human Physiology and Sports Physiotherapy Research Group Vrije Universiteit Brussel Brussels Belgium
- Strategic Research Program “Exercise and the Brain in Health & Disease: The Added Value of Human‐Centred Robotics” Vrije Universiteit Brussel Brussels Belgium
- Brussels Human Robotics Research Center Brussels Belgium
| | - Evert Verhagen
- Amsterdam Collaboration on Health and Safety in Sports Department of Public and Occupational Health Amsterdam Movement Sciences Amsterdam UMCVrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Romain Meeusen
- Faculty of Physical Education and Physiotherapy Human Physiology and Sports Physiotherapy Research Group Vrije Universiteit Brussel Brussels Belgium
- Strategic Research Program “Exercise and the Brain in Health & Disease: The Added Value of Human‐Centred Robotics” Vrije Universiteit Brussel Brussels Belgium
- Brussels Human Robotics Research Center Brussels Belgium
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