Attractive Gait Training: Applying Dynamical Systems Theory to the Improvement of Locomotor Performance Across the Lifespan

Comparison of Metabolic Power and Energy Cost of Submaximal and Sprint Running Efforts Using Different Methods in Elite Youth Soccer Players: A Novel Energetic Approach

Sprinting is a decisive action in soccer that is considerably taxing from a neuromuscular and energetic perspective. This study compared different calculation methods for the metabolic power (MP) and energy cost (EC) of sprinting using global positioning system (GPS) metrics and electromyography (EMG), with the aim of identifying potential differences in performance markers. Sixteen elite U17 male soccer players (age: 16.4 ± 0.5 years; body mass: 64.6 ± 4.4 kg; and height: 177.4 ± 4.3 cm) participated in the study and completed four different submaximal constant running efforts followed by sprinting actions while using portable GPS-IMU units and surface EMG. GPS-derived MP was determined based on GPS velocity, and the EMG-MP and EC were calculated based on individual profiles plotting the MP of the GPS and all EMG signals acquired. The goodness of fit of the linear regressions was assessed by the coefficient of determination (R2), and a repeated measures ANOVA was used to detect changes. A linear trend was found in EMG activity during submaximal speed runs (R2 = 1), but when the sprint effort was considered, the trend became exponential (R2 = 0.89). The EMG/force ratio displayed two different trends: linear up to a 30 m sprint (R2 = 0.99) and polynomial up to a 50 m sprint (R2 = 0.96). Statistically significant differences between the GPS and EMG were observed for MP splits at 0-5 m, 5-10 m, 25-30 m, 30-35 m, and 35-40 m and for EC splits at 5-10 m, 25-30 m, 30-35 m, and 35-40 m (p ≤ 0.05). Therefore, the determination of the MP and EC based on GPS technology underestimated the neuromuscular and metabolic engagement during the sprinting efforts. Thus, the EMG-derived method seems to be more accurate for calculating the MP and EC in this type of action.

Perturbation-based balance training: Principles, mechanisms and implementation in clinical practice

Since the mid-2000s, perturbation-based balance training has been gaining interest as an efficient and effective way to prevent falls in older adults. It has been suggested that this task-specific training approach may present a paradigm shift in fall prevention. In this review, we discuss key concepts and common issues and questions regarding perturbation-based balance training. In doing so, we aim to provide a comprehensive synthesis of the current evidence on the mechanisms, feasibility and efficacy of perturbation-based balance training for researchers and practitioners. We address this in two sections: "Principles and Mechanisms" and "Implementation in Practice." In the first section, definitions, task-specificity, adaptation and retention mechanisms and the dose-response relationship are discussed. In the second section, issues related to safety, anxiety, evidence in clinical populations (e.g., Parkinson's disease, stroke), technology and training devices are discussed. Perturbation-based balance training is a promising approach to fall prevention. However, several fundamental and applied aspects of the approach need to be further investigated before it can be widely implemented in clinical practice.

Ballistic strength training in adults with cerebral palsy may increase rate of force development in plantar flexors, but transition to walking remains unclear: a case series

Background

Persons with cerebral palsy (CP) walk with reduced ankle plantar flexor power compared to typically developing. In this study, we investigated whether a ballistic strength-training programme targeting ankle plantar flexors could improve muscle strength, muscle architecture and walking function in adults with CP.

Methods

Eight adults (mildly affected CP) underwent eight weeks of ballistic strength training, with two sessions per week. Before and after the intervention preferred walking speed, ankle plantar flexion rate of force development (RFD), maximal voluntary contraction (MVC), muscle thickness, pennation angle and fascicle length were measured. Data are presented for individuals, as well as for groups. Group changes were analysed using the Wilcoxon signed-rank test.

Results

Data were analysed for eight participants (five women, mean age 37.9 years; six GMFCS I and two GMFCS II). Two participants increased their walking speed, but there were no significant group changes. In terms of muscle strength, there were significant group changes for RFD at 100 ms and MVC. In the case of muscle architecture, there were no group changes.

Conclusion

In this study, we found that eight weeks of ballistic strength training improved ankle plantar flexor muscle strength but walking function and muscle architecture were unchanged. Larger studies will be needed to obtain conclusive evidence of the efficacy of this training method.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13102-022-00487-1.

Relational Behavior and ACT: A Dynamic Relationship

Acceptance and commitment therapy (ACT) and its counterpart, relational frame theory (RFT), represent emerging areas of research and professional interest for behavior analysts. We extend traditional RFT approaches by emphasizing relational framing as a dynamic pattern of behavior with implications for ACT-based strategies implemented by behavior analysts in practice and in research. We borrow from emerging approaches within affective dynamics, relational density theory, and the hyper-dimensional multilevel model to develop some immediate considerations for practitioners. We then extend an approach grounded in relational dynamics to the six core processes of the ACT hexaflex not only to influence negative affective patterns of relational behavior but also to promote greater psychological flexibility and well-being. Finally, we turn this account inward to discuss our own rigidity as a field and the necessity to engage more flexibly with our own science, ultimately to improve the lives of clients whom we serve.

Theoretical Rationale for Design of Tasks in a Virtual Reality-Based Exergame for Rehabilitation Purposes

Virtual reality games are playing a greater role in rehabilitation settings. Previously, commercial games have dominated, but increasingly, bespoke games for specific rehabilitation contexts are emerging. Choice and design of tasks for VR-games are still not always clear, however; some games are designed to motivate and engage players, not necessarily with the facilitation of specific movements as a goal. Other games are designed specifically for the facilitation of specific movements. A theoretical background for the choice of tasks seems warranted. As an example, we use a game that was designed in our lab: VR Walk. Here, the player walks on a treadmill while wearing a head-mounted display showing a custom-made virtual environment. Tasks include walking on a glass bridge across a drop, obstacle avoidance, narrowing path, walking in virtual footsteps, memory, and selection tasks, and throwing and catching objects. Each task is designed according to research and theory from movement science, exercise science, and cognitive science. In this article, we discuss how for example walking across a glass bridge gives perceptual challenges that may be suitable for certain medical conditions, such as hearing loss, when perceptual abilities are strained to compensate for the hearing loss. In another example, walking in virtual footsteps may be seen as a motor and biomechanical constraint, where the double support phase and base of support can be manipulated, making the task beneficial for falls prevention. In a third example, memory and selection tasks may challenge individuals that have cognitive impairments. We posit that these theoretical considerations may be helpful for the choice of tasks and for the design of virtual reality games.

Proof of Concept of Novel Visuo-Spatial-Motor Fall Prevention Training for Old People

Falls in the geriatric population are one of the most important causes of disabilities in this age group. Its consequences impose a great deal of economic burden on health and insurance systems. This study was conducted by a multidisciplinary team with the aim of evaluating the effect of visuo-spatial-motor training for the prevention of falls in older adults. The subjects consisted of 31 volunteers aged 60 to 92 years who were studied in three groups: (1) A group under standard physical training, (2) a group under visuo-spatial-motor interventions, and (3) a control group (without any intervention). The results of the study showed that visual-spatial motor exercises significantly reduced the risk of falls of the subjects.

Spontaneous Interpersonal Synchronization of Gait: A Systematic Review

Objective

To systematically review the existing evidence of spontaneous synchronization in human gait.

Data Sources

EBSCO, PubMed, Google Scholar, and PsycINFO were searched from inception to July 2020 using all possible combinations of (1) “spontaneous interpersonal synchronization” or “spontaneous interpersonal coordination” or “unintentional interpersonal synchronization” or “unintentional interpersonal coordination” and (2) “human movement” or “movement” or “walking” or “ambulation” or “gait.”

Study Selection

Studies had to focus on spontaneous synchronization in human gait, be published in a peer-reviewed journal, present original data (no review articles were included), and be written in English. The search yielded 137 results, and the inclusion criteria were met by 16 studies.

Data Extraction

Participant demographics, study purpose, setup, procedure, biomechanical measurement, coordination analytical technique, and findings were extracted. Our synthesis focused on the context in which this phenomenon has been studied, the role of sensory information in the emergence of spontaneous interpersonal synchronization in human gait, and the metrics used to quantify this behavior.

Data Synthesis

The included 16 articles ranged from 2007-2019 and used healthy, primarily young subjects to investigate the role of spontaneous interpersonal synchronization on gait behavior, with the majority using a side-by-side walking/running paradigm. All articles reported data supporting spontaneous interpersonal synchronization, with the strength of the synchronization depending on the sensory information available to the participants.

Conclusions

Walking alongside an intact locomotor system may provide an effective and biologically variable attractor signal for rehabilitation of gait behavior. Future research should focus on the utility of spontaneous interpersonal synchronization in clinical populations as a noninvasive method to enhance gait rehabilitation.

Muscle Synergies in Patients With Multiple Sclerosis Reveal Demand-Specific Alterations in the Modular Organization of Locomotion

For patients with multiple sclerosis (MS), deficits in gait significantly reduce the quality of life. Using the concept of muscle synergies, this study investigated the modular organization of motor control during level and inclined walking in MS patients (MSP) compared with healthy participants (HP) to identify the potential demand-specific adjustments in motor control in MSP. We hypothesized a widening of the time-dependent activation patterns (motor primitives) in MSP to increase the overlap of temporally-adjacent muscle synergies, especially during inclined walking, as a strategy to increase the robustness of motor control, thus compensating pathology-related deficits. We analyzed temporal gait parameters and muscle synergies from myoelectric signals of 13 ipsilateral leg muscles using non-negative matrix factorization. Compared with HP, MSP demonstrated a widening in the time-dependent coefficients (motor primitives), as well as altered relative muscle contribution (motor modules), in certain synergies during level and inclined walking. Moreover, inclined walking revealed a demand-specific adjustment in the modular organization in MSP, resulting in an extra synergy compared with HP. This further increased the overlap of temporally-adjacent muscle synergies to provide sufficient robustness in motor control to accomplish the more demanding motor task while coping with pathology-related motor deficits during walking.

Posterior single-stepping thresholds are prospectively related to falls in older women

BACKGROUND

Falls are a leading cause of injury in older women. Stepping thresholds quantify balance-reaction capabilities. It is unclear how such evaluations predict falls in comparison to, or as a complement to, other objective measures of gait, standing postural control, strength, and balance confidence.

AIMS

The objective of this study was to determine if stepping thresholds are prospectively related to falls in older women.

METHODS

For this prospective cohort study, 125 ambulatory, community-dwelling women, age ≥ 65 years were recruited. Using a treadmill to deliver perturbations to standing participants, we determined anteroposterior single- and multiple-stepping thresholds. Here, thresholds represent the minimum perturbation magnitudes that consistently evoke one step or multiple steps. In addition, gait kinematics, obstacle-crossing kinematics, standing sway measures, unipedal stance time, the functional reach, lower extremity isometric strength, grip strength, balance confidence, and fall history were evaluated. Falls were prospectively recorded for one year.

RESULTS

Seventy-four participants (59%) fell at least once. Posterior single-stepping thresholds were the only outcome that predicted future fall status (OR = 1.50, 95% CI 1.01-2.28; AUC = .62). A multivariate approach added postural sway with eyes closed as a second predictive variable, although predictive abilities were not meaningfully improved.

DISCUSSION

These results align with the previous evidence that reactive balance is a prospective indicator of fall risk. Unlike previous studies, strength scaled to body size did not contribute to fall prediction.

CONCLUSION

Posterior single-stepping thresholds held a significant relationship with future fall status. This relationship was independent of, and superior to that of, other measures of standing balance, gait, strength, and balance confidence.

Transient Effect at the Onset of Human Running

While training and competing as a runner, athletes often sense an unsteady feeling during the first meters on the road. This sensation, termed as transient effect, disappears after a short period as the runners approach their individual running rhythm. The foundation of this work focuses on the detection and quantification of this phenomenon. Thirty athletes ran two sessions over 60 min on a treadmill at moderate speed. Three-dimensional acceleration data were collected using two MEMS sensors attached to the lower limbs. By using the attractor method and Fourier transforms, the transient effect was isolated from noise and further components of human cyclic motion. A substantial transient effect was detected in 81% of all measured runs. On average, the transient effect lasted 5.25 min with a range of less than one minute to a maximum of 31 min. A link to performance data such as running level, experience and weekly training hours could not be found. The presented work provides the methodological basis to detect and quantify the transient effect at moderate running speeds. The acquisition of further physical or metabolic performance data could provide more detailed information about the impact of the transient effect on athletic performance.

Exercise of Dynamic Stability in the Presence of Perturbations Elicit Fast Improvements of Simulated Fall Recovery and Strength in Older Adults: A Randomized Controlled Trial

Age-related impairments of reactive motor responses to postural threats and reduced muscular capacities of the legs are key factors for the higher risk of falling in older people. It has been evidenced that a training of dynamic stability in the presence of perturbations has the potential to improve these deficits. However, the time course of training effects during such interventions is poorly understood. The purpose of this parallel-group study was to investigate the temporal adaptation dynamics of the balance recovery performance and leg strength during a dynamic stability training. Forty-two healthy older adults (65–85 years) were randomly assigned to a training (n = 27, analyzed n = 18) or control group (n = 15, n = 14). The training was conducted in a group setting for 6 weeks (3×/week, 45 min). The exercises focused on the mechanism of stability control (i.e., modulation of the base of support and segment counter-rotations around the center of mass) during standing, stepping, and jumping on unstable surfaces with a high balance intensity. Before, after 3 and after 6 weeks, the maximum plantar flexion moment and the knee extension moment were assessed. The recovery performance was evaluated by a simulated forward fall (lean-and-release test) and the margin of stability concept. The margin of stability at release decreased significantly after 3 weeks of training (34%, effect size g = 0.79), which indicates fast improvements of balance recovery performance. The margin of stability further decreased after week 6 (53%, g = 1.21), yet the difference between weeks 3 and 6 was not significant. Furthermore, the training led to significant increases in the plantar flexion moment after weeks 3 (12%, g = 0.72) and 6 (13%, g = 0.75) with no significant difference between weeks. For the knee extension moment, a significant increase was found only after week 6 (11%, g = 1.07). The control group did not show any significant changes. This study provides evidence that a challenging training of dynamic stability in the presence of perturbations can improve balance recovery performance and leg strength of older adults already after a few weeks. Therefore, short-term training interventions using this paradigm may be an effective strategy for fall prevention in the elderly population, particularly when intervention time is limited.

Fuzziness of muscle synergies in patients with multiple sclerosis indicates increased robustness of motor control during walking

Deficits during gait poses a significant threat to the quality of life in patients with Multiple Sclerosis (MS). Using the muscle synergy concept, we investigated the modular organization of the neuromuscular control during walking in MS patients compared to healthy participants (HP). We hypothesized a widening and increased fuzziness of motor primitives (e.g. increased overlap intervals) in MS patients compared to HP allowing the motor system to increase robustness during walking. We analysed temporal gait parameters, local dynamic stability and muscle synergies from myoelectric signals of 13 ipsilateral leg muscles using non-negative matrix factorization. Compared to HP, MS patients showed a significant decrease in the local dynamic stability of walking during both, preferred and fixed (0.7 m/s) speed. MS patients demonstrated changes in time-dependent activation patterns (motor primitives) and alterations of the relative muscle contribution to the specific synergies (motor modules). We specifically found a widening in three out of four motor primitives during preferred speed and in two out of four during fixed speed in MS patients compared to HP. The widening increased the fuzziness of motor control in MS patients, which allows the motor system to increase its robustness when coping with pathology-related motor deficits during walking.

Neuromuscular organisation and robustness of postural control in the presence of perturbations

Perturbation-based exercise interventions challenge balance and improve reactive motor control. Our purpose was to investigate the modular organisation during a standing balance task in both stable and unstable conditions to provide new insights into the neuromuscular control mechanisms needed to cope with perturbations. Fifteen participants performed 54 cycles of a specific task (i.e. pass from a double- to a single-leg standing) on stable ground and an unstable oscillating platform (Posturomed). Muscle synergies were extracted from the electromyographic activity of thirteen lower limb muscles. The maximum Lyapunov exponents of different body segments were calculated using kinematic data. We found two synergies functionally associated with the single- and double-leg stance in both stable and unstable conditions. Nonetheless, in the unstable condition participants needed an extra muscle synergy also functionally related to the single stance. Although a simple organisation of the neuromuscular system was sufficient to maintain the postural control in both conditions, the increased challenge in the oscillating platform was solved by adding one extra synergy. The addition of a new synergy with complementary function highlighted an increased motor output's robustness (i.e. ability to cope with errors) in the presence of perturbations.