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Li Z, Zhu J, Liu J, Shi M, Liu P, Guo J, Hu Z, Liu S, Yang D. Using dual-task gait to recognize Alzheimer's disease and mild cognitive impairment: a cross-sectional study. Front Hum Neurosci 2023; 17:1284805. [PMID: 38188506 PMCID: PMC10770261 DOI: 10.3389/fnhum.2023.1284805] [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: 08/29/2023] [Accepted: 11/27/2023] [Indexed: 01/09/2024] Open
Abstract
Background Gait is a potential diagnostic tool for detecting mild cognitive impairment (MCI) and Alzheimer's disease (AD). Nevertheless, little attention has been paid to arm movements during walking, and there is currently no consensus on gait asymmetry. Therefore, in this study, we aimed to determine whether arm motion and gait asymmetry could be utilized for identifying MCI and AD. Methods In total, 102 middle-aged and elderly individuals were included in the final analysis and were assigned to the following three groups: AD (n = 27), MCI (n = 35), and a normal control group (n = 40). Gait and cognitive assessments were conducted for all participants. Gait detection included a single-task gait with free-speed walking and a dual-task gait with adding a cognitive task of successive minus seven to walking. Original gait parameters were collected using a wearable device featuring the MATRIX system 2.0. Gait parameters were shortened to several main gait domains through factor analysis using principal component extraction with varimax rotation. Subsequently, the extracted gait domains were used to differentiate the three groups, and the area under the receiver operating characteristic curve was calculated. Results Factor analysis of single-task gait identified five independent gait domains: rhythm symmetry, rhythm, pace asymmetry, arm motion, and variability. Factor analysis of the dual-task gait identified four gait domains: rhythm, variability, symmetry, and arm motion. During single-task walking, pace asymmetry was negatively correlated with MoCA scores and could distinguish between the AD group and the other two groups. Arm motion was not associated with MoCA scores, and did not exhibit adequate discrimination in either task. Conclusion Currently, there is no reliable evidence suggesting that arm motion can be used to recognize AD or MCI. Gait asymmetry can serve as a potential gait marker for the auxiliary diagnosis of AD but not for MCI.
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Mtibaa K, Zarrouk N, Ryu JH, Racinais S, Girard O. Mechanical asymmetries remain low-to-moderate during 30 min of self-paced treadmill running. Front Physiol 2023; 14:1289172. [PMID: 38170120 PMCID: PMC10759222 DOI: 10.3389/fphys.2023.1289172] [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: 09/05/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction: We characterized the magnitude and range of gait asymmetry during self-paced treadmill running. Methods: On an instrumented treadmill, twelve trained runners (11 males, 1 female) completed a 30-min self-paced run, during which participants were instructed to cover the most distance possible. Ground reaction force recordings at a constant velocity corresponding to 70% of their maximal aerobic velocity (13.3 ± 0.8 km.h-1) allowed for the measurement of running kinetics and kinematics, as well as the calculation of spring-mass characteristics at the beginning, middle, and end of the run (minutes 1, 14, and 29, respectively). Group mean asymmetry scores were assessed using the "symmetry angle" (SA) formulae, where scores of 0% and 100% represent perfect symmetry and perfect asymmetry, respectively. Results: There was no time effect on SA scores for any of the 13 biomechanical variables (p ≥ 0.128). Mean SA scores were <2.5% for contact time (0.8% ± 0.7%), flight time (1.4% ± 0.6%), step frequency (0.7% ± 0.3%), duty factor (0.7% ± 0.3%), duration of braking (1.3% ± 0.7%) and push-off phases (0.9% ± 0.8%), as well as peak braking (2.3% ± 1.3%) and push-off forces (1.4% ± 0.9%). Mean SA scores were ≥2.5% for peak vertical loading rate (3.1% ± 1.7%), mean vertical loading rate (3.4% ± 2.1%), peak vertical forces (2.9% ± 2.2%), as well as vertical stiffness (5.2% ± 3.5%) and leg stiffness (2.5% ± 1.5%). Conclusion: Throughout a 30-min running time trial, there were consistently low-to-moderate mechanical asymmetries for spatiotemporal variables, kinetics, and spring-mass model characteristics. This suggests that trained runners maintained relatively even strides during the self-paced treadmill run, with lower extremities behaving similarly when controlling for velocity.
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Peterson M, Prigge MBD, Floris DL, Bigler ED, Zielinski B, King JB, Lange N, Alexander AL, Lainhart JE, Nielsen JA. Reduced Lateralization of Multiple Functional Brain Networks in Autistic Males. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.12.15.571928. [PMID: 38187671 PMCID: PMC10769214 DOI: 10.1101/2023.12.15.571928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Background Autism spectrum disorder has been linked to a variety of organizational and developmental deviations in the brain. One such organizational difference involves hemispheric lateralization, which may be localized to language-relevant regions of the brain or distributed more broadly. Methods In the present study, we estimated brain hemispheric lateralization in autism based on each participant's unique functional neuroanatomy rather than relying on group-averaged data. Additionally, we explored potential relationships between the lateralization of the language network and behavioral phenotypes including verbal ability, language delay, and autism symptom severity. We hypothesized that differences in hemispheric asymmetries in autism would be limited to the language network, with the alternative hypothesis of pervasive differences in lateralization. We tested this and other hypotheses by employing a cross-sectional dataset of 118 individuals (48 autistic, 70 neurotypical). Using resting-state fMRI, we generated individual network parcellations and estimated network asymmetries using a surface area-based approach. A series of multiple regressions were then used to compare network asymmetries for eight significantly lateralized networks between groups. Results We found significant group differences in lateralization for the left-lateralized Language (d = -0.89), right-lateralized Salience/Ventral Attention-A (d = 0.55), and right-lateralized Control-B (d = 0.51) networks, with the direction of these group differences indicating less asymmetry in autistic individuals. These differences were robust across different datasets from the same participants. Furthermore, we found that language delay stratified language lateralization, with the greatest group differences in language lateralization occurring between autistic individuals with language delay and neurotypical individuals. Limitations The generalizability of our findings is restricted due to the male-only sample and greater representation of individuals with high verbal and cognitive performance. Conclusions These findings evidence a complex pattern of functional lateralization differences in autism, extending beyond the Language network to the Salience/Ventral Attention-A and Control-B networks, yet not encompassing all networks, indicating a selective divergence rather than a pervasive one. Furthermore, a differential relationship was identified between Language network lateralization and specific symptom profiles (namely, language delay) of autism.
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KolaszyŃSka O, Lorkowski J. Symmetry and asymmetry in atherosclerosis. Int J Occup Med Environ Health 2023; 36:693-703. [PMID: 37791506 PMCID: PMC10743353 DOI: 10.13075/ijomeh.1896.02171] [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: 02/24/2023] [Accepted: 08/11/2023] [Indexed: 10/05/2023] Open
Abstract
Atherosclerosis remains the main cause of death worldwide. Most important issues concerning atherosclerosis are hemodynamics and how it affects plaque prevalence and distribution, as well as the symmetry and asymmetry of vasculature and plaques. To present the symmetry in the vascular system an analysis of PubMed and MEDLINE databases was performed. As of February 21, 2023, the results were as follows: for "symmetry" AND "atherosclerosis" there were 47 results; for "symmetry" AND "atherosclerotic lesions" - 20 results; for "symmetry" AND "artery stenosis" - 82 results; for "asymmetry" AND "atherosclerosis" - 87 results. Not without meaning are preventive measures. In the light of the Fourth Industrial Revolution artificial intelligence (AI) solutions help to develop new tools outperforming already existing cardiovascular risk scales. The aim of this paper is to present a current view on symmetry within vasculature and atherosclerosis as well as present a new approach to assess individuals' cardiovascular risk in accordance with precision medicine assumptions. Symmetry and asymmetry within the human vascular system play a crucial role in understanding of arterial diseases, including atherosclerosis. Moreover, it is unavoidable to use AI in cardiovascular risk stratification. Int J Occup Med Environ Health. 2023;36(6):693-703.
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Ricciardi C, Ponsiglione AM, Recenti M, Amato F, Gislason MK, Chang M, Gargiulo P. Development of soft tissue asymmetry indicators to characterize aging and functional mobility. Front Bioeng Biotechnol 2023; 11:1282024. [PMID: 38149173 PMCID: PMC10749973 DOI: 10.3389/fbioe.2023.1282024] [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: 08/23/2023] [Accepted: 11/22/2023] [Indexed: 12/28/2023] Open
Abstract
Introduction: The aging population poses significant challenges to healthcare systems globally, necessitating a comprehensive understanding of age-related changes affecting physical function. Age-related functional decline highlights the urgency of understanding how tissue composition changes impact mobility, independence, and quality of life in older adults. Previous research has emphasized the influence of muscle quality, but the role of tissue composition asymmetry across various tissue types remains understudied. This work develops asymmetry indicators based on muscle, connective and fat tissue extracted from cross-sectional CT scans, and shows their interplay with BMI and lower extremity function among community-dwelling older adults. Methods: We used data from 3157 older adults from 71 to 98 years of age (mean: 80.06). Tissue composition asymmetry was defined by the differences between the right and left sides using CT scans and the non-Linear Trimodal Regression Analysis (NTRA) parameters. Functional mobility was measured through a 6-meter gait (Normal-GAIT and Fast-GAIT) and the Timed Up and Go (TUG) performance test. Statistical analysis included paired t-tests, polynomial fitting curves, and regression analysis to uncover relationships between tissue asymmetry, age, and functional mobility. Results: Findings revealed an increase in tissue composition asymmetry with age. Notably, muscle and connective tissue width asymmetry showed significant variation across age groups. BMI classifications and gait tasks also influenced tissue asymmetry. The Fast-GAIT task demonstrated a substantial separation in tissue asymmetry between normal and slow groups, whereas the Normal-GAIT and the TUG task did not exhibit such distinction. Muscle quality, as reflected by asymmetry indicators, appears crucial in understanding age-related changes in muscle function, while fat and connective tissue play roles in body composition and mobility. Discussion: Our study emphasizes the importance of tissue asymmetry indicators in understanding how muscle function changes with age in older individuals, demonstrating their role as risk factor and their potential employment in clinical assessment. We also identified the influence of fat and connective tissue on body composition and functional mobility. Incorporating the NTRA technology into clinical evaluations could enable personalized interventions for older adults, promoting healthier aging and maintaining physical function.
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Palazon-Cabanes A, Palazon-Cabanes B, Garcia-Medina JJ, Alvarez-Sarrion A, del-Rio-Vellosillo M. Normative Database of the Superior-Inferior Thickness Asymmetry for All Inner and Outer Macular Layers of Adults for the Posterior Pole Algorithm of the Spectralis SD-OCT. J Clin Med 2023; 12:7609. [PMID: 38137678 PMCID: PMC10743748 DOI: 10.3390/jcm12247609] [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: 11/09/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND This study aims to establish a reference for the superior-inferior hemisphere asymmetry in thickness values for all macular layers for the posterior pole algorithm (PPA) available for the Spectralis SD-OCT device. METHODS We examined 300 eyes of 300 healthy Caucasian volunteers aged 18-84 years using the PPA, composed of a grid of 64 (8 × 8) cells, to analyze the thickness asymmetries of the following automatically segmented macular layers: retinal nerve fiber layer (RNFL); ganglion cell layer (GCL); inner plexiform layer (IPL); inner nuclear layer (INL); outer plexiform layer (OPL); outer nuclear layer (ONL); retinal pigment epithelium (RPE); inner retina; outer retina; complete retina. Mean ± standard deviation and the 2.5th and 97.5th percentiles of the thickness asymmetry values were obtained for all the corresponding cells. RESULTS All the macular layers had significant superior-inferior thickness asymmetries. GCL, IPL, INL, ONL and RPE showed significantly greater thicknesses in the superior than the inferior hemisphere, whereas RNFL and OPL were thicker in the inferior hemisphere. The largest differences between hemispheres were for RNFL and ONL. CONCLUSIONS This is the first normative database of macular thickness asymmetries for the PPA and should be considered to distinguish normal from pathological values when interpreting superior-inferior macular asymmetries.
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Peterson M, Braga RM, Floris DL, Nielsen JA. Evidence for a Compensatory Relationship between Left- and Right-Lateralized Brain Networks. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.12.08.570817. [PMID: 38106130 PMCID: PMC10723397 DOI: 10.1101/2023.12.08.570817] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
The two hemispheres of the human brain are functionally asymmetric. At the network level, the language network exhibits left-hemisphere lateralization. While this asymmetry is widely replicated, the extent to which other functional networks demonstrate lateralization remains a subject of Investigation. Additionally, it is unknown how the lateralization of one functional network may affect the lateralization of other networks within individuals. We quantified lateralization for each of 17 networks by computing the relative surface area on the left and right cerebral hemispheres. After examining the ecological, convergent, and external validity and test-retest reliability of this surface area-based measure of lateralization, we addressed two hypotheses across multiple datasets (Human Connectome Project = 553, Human Connectome Project-Development = 343, Natural Scenes Dataset = 8). First, we hypothesized that networks associated with language, visuospatial attention, and executive control would show the greatest lateralization. Second, we hypothesized that relationships between lateralized networks would follow a dependent relationship such that greater left-lateralization of a network would be associated with greater right-lateralization of a different network within individuals, and that this pattern would be systematic across individuals. A language network was among the three networks identified as being significantly left-lateralized, and attention and executive control networks were among the five networks identified as being significantly right-lateralized. Next, correlation matrices, an exploratory factor analysis, and confirmatory factor analyses were used to test the second hypothesis and examine the organization of lateralized networks. We found general support for a dependent relationship between highly left- and right-lateralized networks, meaning that across subjects, greater left lateralization of a given network (such as a language network) was linked to greater right lateralization of another network (such as a ventral attention/salience network) and vice versa. These results further our understanding of brain organization at the macro-scale network level in individuals, carrying specific relevance for neurodevelopmental conditions characterized by disruptions in lateralization such as autism and schizophrenia.
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Neuhaus E, Santhosh M, Kresse A, Aylward E, Bernier R, Bookheimer S, Jeste S, Jack A, McPartland JC, Naples A, Van Horn JD, Pelphrey K, Webb SJ. Frontal EEG alpha asymmetry in youth with autism: Sex differences and social-emotional correlates. Autism Res 2023; 16:2364-2377. [PMID: 37776030 PMCID: PMC10840952 DOI: 10.1002/aur.3032] [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: 01/23/2023] [Accepted: 09/04/2023] [Indexed: 10/01/2023]
Abstract
In youth broadly, EEG frontal alpha asymmetry (FAA) associates with affective style and vulnerability to psychopathology, with relatively stronger right activity predicting risk for internalizing and externalizing behaviors. In autistic youth, FAA has been related to ASD diagnostic features and to internalizing symptoms. Among our large, rigorously characterized, sex-balanced participant group, we attempted to replicate findings suggestive of altered FAA in youth with an ASD diagnosis, examining group differences and impact of sex assigned at birth. Second, we examined relations between FAA and behavioral variables (ASD features, internalizing, and externalizing) within autistic youth, examining effects by sex. Third, we explored whether the relation between FAA, autism features, and mental health was informed by maternal depression history. In our sample, FAA did not differ by diagnosis, age, or sex. However, youth with ASD had lower total frontal alpha power than youth without ASD. For autistic females, FAA and bilateral frontal alpha power correlated with social communication features, but not with internalizing or externalizing symptoms. For autistic males, EEG markers correlated with social communication features, and with externalizing behaviors. Exploratory analyses by sex revealed further associations between youth FAA, behavioral indices, and maternal depression history. In summary, findings suggest that individual differences in FAA may correspond to social-emotional and mental health behaviors, with different patterns of association for females and males with ASD. Longitudinal consideration of individual differences across levels of analysis (e.g., biomarkers, family factors, and environmental influences) will be essential to parsing out models of risk and resilience among autistic youth.
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Cummine J, Ngo T, Nisbet K. Characterization of Cortical and Subcortical Structural Brain Asymmetry in Adults with and without Dyslexia. Brain Sci 2023; 13:1622. [PMID: 38137070 PMCID: PMC10741947 DOI: 10.3390/brainsci13121622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 10/31/2023] [Accepted: 11/16/2023] [Indexed: 12/24/2023] Open
Abstract
Multiple cortical (planum temporale, supramarginal gyrus, fusiform gyrus) and subcortical (caudate, putamen, and thalamus) regions have shown different functional lateralization patterns for skilled vs. dyslexic readers. The extent to which skilled and dyslexic adult readers show differential structural lateralization remains to be seen. Method: Participants included 72 adults (N = 41 skilled; N = 31 dyslexic) who underwent a high-resolution MRI brain scan. The grey matter volume of the cortical and subcortical structures was extracted. Results: While there were clear behavioral differences between the groups, there were no differences in any of the isolated structures (i.e., either total size or asymmetry index) and limited evidence for any brain-behavior relationships. We did find a significant cortical-cortical relationship (p = 0.006) and a subcortical-subcortical relationship (p = 0.008), but not cross-over relationships. Overall, this work provides unique information on neural structures as they relate to reading in skilled and dyslexic readers.
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Gawlikowska-Sroka A, Stocki Ł, Szczurowski J, Nowaczewska W. Topography of the infraorbital foramen in human skulls originating from different time periods. Folia Morphol (Warsz) 2023; 82:875-884. [PMID: 37957943 DOI: 10.5603/fm.97440] [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: 09/15/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND The infraorbital foramen (IOF) is present on the maxilla under the infraorbital margin. Its identification is essential in various surgical procedures. The main aim of this study was the morphometric assessment of the position of the right and left infraorbital foramina in relation to specific structural elements of the facial skeleton, their width and direction, and also the determination of the location of these foramina above maxillary teeth in examined male skulls (belonging to European populations) dated to the beginning of the 20th century and the medieval and post-medieval period. This aim concerned also the assessment of the symmetry of the examined foramina (their location and size). An additional goal was to determine differences between the cranial samples concerning the analysed traits. MATERIALS AND METHODS The six metric and two non-metric traits concerning the IOF were collected from the male cranial samples including modern skulls (n = 87), the medieval and post-medieval skulls (from 13th centuries and 15-17th centuries, respectively; n = 47) obtained from archaeological excavations in Wroclaw, and the sample of the medieval skulls (11-13th centuries, n = 100) from Sypniewo. The sex and age of the specimens were determined using the standard methodology. The appropriate statistical analysis was performed. RESULTS Significant differences were established for three traits (taken from the left and right side) in the case of modern skulls (diameter of IOF, its distance to the midline, and zygomaticomaxillary suture) and one in the case of medieval skulls from Sypniewo (distance to the midline). In all of the cranial samples IOF most frequently occurred above the first upper molar. The greater diameter of IOF and its shorter distance to the alveolar crest and nasal notch were observed in non-modern skulls compared to modern skulls. CONCLUSIONS The results of this study provide new additional data on the topography of IOF and its asymmetry, confirm the presence of both geographical and chronological differences between populations, and can be used in dental practice, and forensic odontology in the analysis of archaeological bone materials.
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Rum L, Romagnoli R, Lazich A, Sciarra T, Balletti N, Piacentini MF, Boraschi A, Bergamini E. Variability analysis of muscle activation symmetry to identify indicators of individual motor strategy: a case series on elite Paralympic powerlifters. Front Sports Act Living 2023; 5:1290964. [PMID: 38022778 PMCID: PMC10655026 DOI: 10.3389/fspor.2023.1290964] [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: 09/08/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction In Paralympic powerlifting competitions, movement execution symmetry is a technical requirement influenced by individual athlete characteristics and motor strategies. Identifying the elements associated with individual motor strategies can offer valuable insight for improving sport performance. Therefore, this case series study aimed to explore muscle activation symmetry and its intra- and inter-individual variability to determine the muscles mostly related to individual motor strategies in elite Paralympic powerlifters. Methods Bilateral electromyographic activation of the anterior deltoid (AD), pectoralis major (PM), latissimus dorsi (LD), triceps (TRI) and external oblique (EO) muscles were analysed in five elite Paralympic powerlifters while performing four sets of one-repetition maximum of Paralympic bench press. Muscle activation symmetry indexes (SI) were obtained and transformed to consider individual-independent evaluation. The coefficient of variation (CV), variance ratio (VR), and mean deviation (MD) were computed to assess inter- and intra-individual variability in electromyographic waveforms and SI. Results Both transformed and non-transformed SI indicated overall symmetric activation in DA, PM, TRI, and LD. Transformed SI revealed asymmetrical muscle activation of EO when grouping data (mean bilateral difference: 10%). Athletes exhibited low intra-individual SI variability in all analysed muscles (CV < 10%) and low inter-individual variability in DA, PM, LD, and TRI (CV < 10%; VR: 4%-11%; MD: 29%-43%). In contrast, higher inter-individual variability was observed in EO (CV: 23%; VR: 23%; MD: 72%-81%). Conclusion The highest variability and asymmetry in abdominal muscle activation among athletes emphasize the importance of personalized training approaches for targeting these muscles due to their role in individualizing motor strategies.
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Quévreux P, Haegeman B, Loreau M. Spatial heterogeneity of biomass turnover has contrasting effects on synchrony and stability in trophic metacommunities. Ecol Lett 2023; 26:1817-1828. [PMID: 37602911 DOI: 10.1111/ele.14297] [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: 02/23/2023] [Revised: 07/24/2023] [Accepted: 07/28/2023] [Indexed: 08/22/2023]
Abstract
Spatial heterogeneity is a fundamental feature of ecosystems, and ecologists have identified it as a factor promoting the stability of population dynamics. In particular, differences in interaction strengths and resource supply between patches generate an asymmetry of biomass turnover with a fast and a slow patch coupled by a mobile predator. Here, we demonstrate that asymmetry leads to opposite stability patterns in metacommunities receiving localized perturbations depending on the characteristics of the perturbed patch. Perturbing prey in the fast patch synchronizes the dynamics of prey biomass between the two patches and destabilizes predator dynamics by increasing the predator's temporal variability. Conversely, perturbing prey in the slow patch decreases the synchrony of the prey's dynamics and stabilizes predator dynamics. Our results have implications for conservation ecology and suggest reinforcing protection policies in fast patches to dampen the effects of perturbations and promote the stability of population dynamics at the regional scale.
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Krentel H, Keckstein J, Füger T, Hornung D, Theben J, Salehin D, Buchweitz O, Mueller A, Schäfer SD, Sillem M, Schweppe KW, Tchartchian G, Gilman E, De Wilde RL. Accuracy of ultrasound signs on two-dimensional transvaginal ultrasound in prediction of adenomyosis: prospective multicenter study. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2023; 62:739-746. [PMID: 36920431 DOI: 10.1002/uog.26197] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 01/09/2023] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE Two-dimensional (2D) transvaginal ultrasound (TVS) is an accessible and cost-effective diagnostic tool for the detection of adenomyosis. Different ultrasound features related to adenomyosis have been described, but the predictive value of each ultrasound sign and their combinations requires further investigation. We aimed to analyze the accuracy of 2D-TVS and describe possible combinations of ultrasound signs with a high predictive value in the diagnosis of adenomyosis. METHODS This was a prospective multicenter study of patients scheduled for laparoscopic hysterectomy who had been examined using standardized 2D-TVS at nine expert centers specializing in the diagnosis and treatment of endometriosis. 2D-TVS examination included nine typical adenomyosis ultrasound features, comprising heterogeneous myometrium, myometrial linear striations, myometrial cysts, subendometrial microcysts, asymmetrical myometrial thickening, uterine enlargement, the 'question mark sign', thickening of the junctional zone and hyperechoic myometrial spots, in order to predict or exclude the presence of adenomyosis. Ultrasound examination results were compared with histology after hysterectomy. The diagnostic reliability of the nine ultrasound signs and their combinations, and the influence of concurrent fibroids on the accuracy of the results, were analyzed. RESULTS A total of 202 patients were enrolled into the study. Histopathological examination revealed adenomyosis in 130 patients (64.4%). The accuracy of prediction of adenomyosis by 2D-TVS examination using all signs was 63.4% (positive predictive value, 71.5%; negative predictive value, 48.6%; sensitivity, 71.5%; specificity, 48.6%). Heterogeneous myometrium, myometrial cysts, subendometrial microcysts and hyperechoic myometrial spots showed the highest accuracy (55.7-62.1%) as individual ultrasound signs for the prediction of adenomyosis. The combination of the most accurate ultrasound signs (subendometrial microcysts, myometrial cysts and heterogeneous myometrium) improved the specificity of prediction (86.1%) when compared with that of these three single markers (35.2-81.7%). Uterine enlargement and asymmetry showed both low sensitivity (60.8% and 52.3%, respectively) and specificity (41.7% and 49.3%, respectively) as individual sonographic signs. CONCLUSIONS Heterogeneous myometrium, myometrial cysts, subendometrial microcysts and hyperechoic myometrial spots showed the highest accuracy for the detection of adenomyosis in this study, while uterine enlargement and asymmetry led to high false-positive and false-negative results. A combination of ultrasound features including the most accurate signs increases specificity. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Zhang Y, Chen W, Cao B, Lin L, Li J, Guo VY. Associations of handgrip weakness and asymmetry with new-onset stroke in Chinese middle-aged and older adults: a cohort study. Front Public Health 2023; 11:1251262. [PMID: 37908684 PMCID: PMC10615130 DOI: 10.3389/fpubh.2023.1251262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 08/31/2023] [Indexed: 11/02/2023] Open
Abstract
Background Weak handgrip strength (HGS) has been linked to adverse health outcomes including stroke. However, the joint associations of HGS weakness and asymmetry between limbs with stroke incidence remain underexplored. Methods This cohort study analyzed data of participants aged ≥45 years from three waves (2011, 2013, and 2015) of the China Health and Retirement Longitudinal Study. Weak HGS was defined according to the recommendation of European Working Group on Sarcopenia in Older People. Asymmetric HGS was defined if the HGS ratio of both hands was over 1.1 or below 0.9. New-onset stroke was confirmed through self-report of physician's diagnosis. Results A total of 10,966 participants without stroke at baseline were included in the analysis. During the 4 years follow-up, there were 262 (2.39%) new-onset stroke cases. Compared to individuals with non-weak and symmetric HGS, those with HGS asymmetry alone and weakness alone were associated with hazards of 1.09 (95% confidence interval [CI]: 0.80-1.48) and 1.27 (95%CI: 0.86-1.88) for new-onset stroke, respectively, while co-occurrence of both HGS asymmetry and weakness was associated with 1.80 (95%CI: 1.24-2.60) greater hazard for new-onset stroke after controlling for confounders. Such associations were consistent in older adults aged ≥60 years, but not in those aged<60 years. Conclusion Individuals with both weak and asymmetric HGS tended to have greater risk of new-onset stroke, compared to those with normal HGS, or with either weak or asymmetric HGS alone. Our finding suggested that examining HGS asymmetry alongside weakness may help to improve the risk-stratification and target prevention of stroke, particularly in the older population.
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Sokołowski A, Roy ARK, Goh SM, Hardy EG, Datta S, Cobigo Y, Brown JA, Spina S, Grinberg L, Kramer J, Rankin KP, Seeley WW, Sturm VE, Rosen HJ, Miller BL, Perry DC. Neuropsychiatric symptoms and imbalance of atrophy in behavioral variant frontotemporal dementia. Hum Brain Mapp 2023; 44:5013-5029. [PMID: 37471695 PMCID: PMC10502637 DOI: 10.1002/hbm.26428] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/25/2023] [Accepted: 07/05/2023] [Indexed: 07/22/2023] Open
Abstract
Behavioral variant frontotemporal dementia is characterized by heterogeneous frontal, insular, and anterior temporal atrophy patterns that vary along left-right and dorso-ventral axes. Little is known about how these structural imbalances impact clinical symptomatology. The goal of this study was to assess the frequency of frontotemporal asymmetry (right- or left-lateralization) and dorsality (ventral or dorsal predominance of atrophy) and to investigate their clinical correlates. Neuropsychiatric symptoms and structural images were analyzed for 250 patients with behavioral variant frontotemporal dementia. Frontotemporal atrophy was most often symmetric while left-lateralized (9%) and right-lateralized (17%) atrophy were present in a minority of patients. Atrophy was more often ventral (32%) than dorsal (3%) predominant. Patients with right-lateralized atrophy were characterized by higher severity of abnormal eating behavior and hallucinations compared to those with left-lateralized atrophy. Subsequent analyses clarified that eating behavior was associated with right atrophy to a greater extent than a lack of left atrophy, and hallucinations were driven mainly by right atrophy. Dorsality analyses showed that anxiety, euphoria, and disinhibition correlated with ventral-predominant atrophy. Agitation, irritability, and depression showed greater severity with a lack of regional atrophy, including in dorsal regions. Aberrant motor behavior and apathy were not explained by asymmetry or dorsality. This study provides additional insight into how anatomical heterogeneity influences the clinical presentation of patients with behavioral variant frontotemporal dementia. Behavioral symptoms can be associated not only with the presence or absence of focal atrophy, but also with right/left or dorsal/ventral imbalance of gray matter volume.
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Ahamed AS, G VL, Vm N, Kumar KD, Syed M. Surgical Correction of Post-traumatic Residual Deformity of the Mandible: A Case Report. Cureus 2023; 15:e46710. [PMID: 38021596 PMCID: PMC10630716 DOI: 10.7759/cureus.46710] [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] [Accepted: 10/08/2023] [Indexed: 12/01/2023] Open
Abstract
Mandibular fractures are the most common trauma cases that we often come across in our day-to-day practice of oral and maxillofacial surgery. Various factors can lead to deformities and make those cases more challenging, which includes a delay in surgical treatment, resulting in non-union or malunion of the fracture site causing occlusal disturbances and functional abnormalities in the temporomandibular joint.
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Allen-Perkins A, García-Callejas D, Bartomeus I, Godoy O. Structural asymmetry in biotic interactions as a tool to understand and predict ecological persistence. Ecol Lett 2023; 26:1647-1662. [PMID: 37515408 DOI: 10.1111/ele.14291] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 06/29/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023]
Abstract
A universal feature of ecological systems is that species do not interact with others with the same sign and strength. Yet, the consequences of this asymmetry in biotic interactions for the short- and long-term persistence of individual species and entire communities remains unclear. Here, we develop a set of metrics to evaluate how asymmetric interactions among species translate to asymmetries in their individual vulnerability to extinction under changing environmental conditions. These metrics, which solve previous limitations of how to independently quantify the size from the shape of the so-called feasibility domain, provide rigorous advances to understand simultaneously why some species and communities present more opportunities to persist than others. We further demonstrate that our shape-related metrics are useful to predict short-term changes in species' relative abundances during 7 years in a Mediterranean grassland. Our approach is designed to be applied to any ecological system regardless of the number of species and type of interactions. With it, we show that is possible to obtain both mechanistic and predictive information on ecological persistence for individual species and entire communities, paving the way for a stronger integration of theoretical and empirical research.
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Mezentseva LV. Asymmetry of Characteristics of the Right-Left Hemodynamic Balance of Microcirculation in the Temporal Skin Areas of the Head in Young Male and Female Subjects. Bull Exp Biol Med 2023; 175:734-738. [PMID: 37978150 DOI: 10.1007/s10517-023-05935-7] [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: 04/20/2023] [Indexed: 11/19/2023]
Abstract
The indices of asymmetry of microcirculation in the skin of the temporal areas of the head in young male and female subjects were studied. In 20 healthy volunteers (10 men and 10 women, age 18-19 years), synchronous measurements of the microcirculation of the skin of the symmetrical temporal areas of the head were carried out by laser Doppler flowmetry. The coefficients of asymmetry of regression relationships between perfusion changes in each side and initial perfusion values in both the same and opposite sides, the distribution function of perfusion asymmetry coefficients, and variability of perfusion in the studied areas were analyzed. The sex differences of the measured characteristics of asymmetry were revealed. In men, the distribution functions of perfusion asymmetry are pointed, with positive excesses, and in women they were flat, with negative excesses. In female subjects, the contribution of the right microcirculatory bed to the right-left hemodynamic balance was higher. These findings support the hypothesis on greater plasticity of the female brain in comparison with the male brain.
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69
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Holmes AA, Matarazzo M, Mondesire‐Crump I, Katz E, Mahajan R, Arroyo‐Gallego T. Exploring Asymmetric Fine Motor Impairment Trends in Early Parkinson's Disease via Keystroke Typing. Mov Disord Clin Pract 2023; 10:1530-1535. [PMID: 37868929 PMCID: PMC10585965 DOI: 10.1002/mdc3.13864] [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: 04/24/2023] [Revised: 07/10/2023] [Accepted: 08/06/2023] [Indexed: 10/24/2023] Open
Abstract
Background The nQiMechPD algorithm transforms natural typing data into a numerical index that characterizes motor impairment in people with Parkinson's Disease (PwPD). Objectives Use nQiMechPD to compare asymmetrical progression of PD-related impairment in dominant (D-PD) versus non-dominant side onset (ND-PD) de-novo patients. Methods Keystroke data were collected from 53 right-handed participants (15 D-PD, 13 ND-PD, 25 controls). We apply linear mixed effects modeling to evaluate participants' right, left, and both hands nQiMechPD relative change by group. Results The 6-month nQiMechPD trajectories of right (**P = 0.002) and both (*P = 0.043) hands showed a significant difference in nQiMechPD trends between D-PD and ND-PD participants. Left side trends were not significantly different between these two groups (P = 0.328). Conclusions Significant differences between D-PD and ND-PD groups were observed, likely driven by contrasting dominant hand trends. Our findings suggest disease onset side may influence motor impairment progression, medication response, and functional outcomes in PwPD.
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Michailidis Y. Relation of Jump and Change of Direction Inter-Limb Asymmetries with Fitness in Youth Male Soccer Players. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1749. [PMID: 37893467 PMCID: PMC10608550 DOI: 10.3390/medicina59101749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/21/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Asymmetries between the lower limbs were evaluated by both researchers and practitioners as they seem to be related to the occurrence of injuries and the effect on performance. The purposes of this study were to (a) detect asymmetries of the lower limbs using a unilateral jump (single-leg countermovement jump (SLCMJ)) and 505 agility test, and (b) examine asymmetry effects on fitness (acceleration, speed, squat jump, Illinois agility test), in U16 youth male soccer players. Materials and Methods: Twenty U16 soccer players performed an SLCMJ and a 505 test to calculate the asymmetry index. They also performed the above fitness tests. The difference between the lower limbs was tested using the paired samples t-test (dominant vs. non-dominant). The correlations between the asymmetries of the lower extremities with the performance indicators were tested using the Pearson's correlation test. The level of significance was set at p < 0.05. Results: The lower limbs differed significantly in the SLCMJ and 505 tests (p < 0.05). The only correlation was between the asymmetry in SLCMJ and performance in SJ (r = -0.641, p = 0.002). Asymmetries did not affect performance on most fitness tests. Conclusions: The two asymmetry tests identified asymmetries in different limbs. This indicates the variability in asymmetries and the need for specialized tests depending on the kinematic chain. The asymmetries observed should be eliminated using individualized training programs so that athletes are protected from injuries and from the possible negative impact on performance. Also, the detection of asymmetries in developmental age offers a greater time period for their elimination before the athlete enters professional sports.
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Sharpley CF, Evans ID, Bitsika V, Arnold WM, Jesulola E, Agnew LL. Frontal Alpha Asymmetry Argues for the Heterogeneity of Psychological Resilience. Brain Sci 2023; 13:1354. [PMID: 37759955 PMCID: PMC10526132 DOI: 10.3390/brainsci13091354] [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: 08/30/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 09/29/2023] Open
Abstract
Depression is associated with frontal alpha asymmetry (FAA) and Psychological Resilience (PR), although in different ways. Only cursory attention has been given to how these three constructs interact despite the possible clinical and research implications of those associations. One limitation of recent research into these associations has been conceptualising PR as a unitary construct, whereas it has been shown to be multi-component. This study investigated the underlying components of PR, their correlations with FAA, and the effect that participants' depressive status had upon those correlations in a community sample of 54 males and 46 females aged between 18 yr and 75 years. Results confirmed the overall inverse association between total PR and depression for four of the original five PR components and for one of the two components found in this sample. Similarly, there were differences between the ways that FAA and PR components were associated, depending upon the depressive status of participants. Source localisation data indicated that the PR components were not uniformly correlated with alpha activity in the same brain regions. These findings of content, efficacy, and neurophysiological differences between the five components of PR and their associations with FAA argue against consideration of PR as a unitary construct.
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Giannakou E, Fotiadou S, Gourgoulis V, Mavrommatis G, Aggelousis N. A Comparative Analysis of Symmetry Indices for Spatiotemporal Gait Features in Early Parkinson's Disease. Neurol Int 2023; 15:1129-1139. [PMID: 37755361 PMCID: PMC10535875 DOI: 10.3390/neurolint15030070] [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: 07/19/2023] [Revised: 08/19/2023] [Accepted: 09/05/2023] [Indexed: 09/28/2023] Open
Abstract
This study compared the five most commonly used equations for calculating gait symmetry in discrete variables among Parkinson's disease patients. Twelve patients (five women and seven men) performed ten consecutive gait trials on a 10 m walkway. Gait data were collected using eight optoelectronic cameras (100 fr/s). The analysis focused on various spatiotemporal parameters, including cadence, step time, stride time, single support, double support, walking speed, step length, stride length, step width, and foot angle. Five symmetry indices were calculated for each trial rather than averaging the ten recorded trials. The variability in and reliability of each symmetry equation were assessed using the coefficient of variation (CV) and intraclass correlation coefficient (ICC), respectively. Additionally, Bland-Altman plots were produced to visualize the agreement between each pair of methods for each spatiotemporal parameter. The results revealed that the symmetry ratio method exhibited lower variability and higher reliability compared with the other four indices across all spatiotemporal gait parameters. However, it was found that the reliability of a single trial was generally poor, regardless of the symmetry calculation formula used. Therefore, we recommend basing measurements of gait asymmetry in Parkinson's disease on multiple trials.
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Maciel DG, Dantas GAF, Cerqueira MS, Barboza JAM, Caldas VVDA, de Barros ACM, Varela RR, Magalhães DH, de Brito Vieira WH. Peak torque angle, acceleration time and time to peak torque as additional parameters extracted from isokinetic test in professional soccer players: a cross-sectional study. Sports Biomech 2023; 22:1108-1119. [PMID: 32673150 DOI: 10.1080/14763141.2020.1784260] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/12/2020] [Indexed: 10/23/2022]
Abstract
This study investigated additional and traditional variables from isokinetic test of thigh muscles in soccer players across different field positions. One hundred and eighty-nine athletes performed maximal concentric isokinetic knee contractions on dominant (DL) and non-dominant limb (NDL) at 60º/s and 240º/s. The additional outcomes peak torque angle (AngPT), acceleration time (AcT) and time to peak torque (TPT) and traditional outcomes Peak torque (PT), total work (TW) and power (Pw) were extracted from the exam. Goalkeepers (GK), side backs (SB), central backs (CB), central defender midfielders (CDM), central attacking midfielders (CAM) and forwards (FW) were considered. Comparisons between limbs and positions demonstrated that SB extensors of the DL presented TPT lower (p = 0.006) and AngPT higher (p = 0.011) than NDL at 60°/s. CDM extensors of the DL showed lower TPT at 60°/s (p = 0.003) and 240°/s (p = 0.024). CAM flexors of the DL showed lower TPT (p = 0.026) and AcT (p = 0.021) at 240°/s than NDL. CB, CDM and CAM extensors of the NDL showed higher PT, TW and Pw than DL (p < 0.05). In conclusion, there are muscle imbalances between limbs in SB, CDM and CAM and across different field positions.
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Baxter LC, Limback-Stokin M, Patten KJ, Arreola AC, Locke DE, Hu L, Zhou Y, Caselli RJ. Hippocampal connectivity and memory decline in cognitively intact APOE ε4 carriers. Alzheimers Dement 2023; 19:3806-3814. [PMID: 36906845 PMCID: PMC11105018 DOI: 10.1002/alz.13023] [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: 08/24/2022] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 03/13/2023]
Abstract
INTRODUCTION Resting-state functional magnetic resonance imaging (fMRI) graph theory may help detect subtle functional connectivity changes affecting memory prior to impairment. METHODS Cognitively normal apolipoprotein E (APOE) ε4 carriers/noncarriers underwent longitudinal cognitive assessment and one-time MRI. The relationship of left/right hippocampal connectivity and memory trajectory were compared between carriers/noncarriers. RESULTS Steepness of verbal memory decline correlated with decreased connectivity in the left hippocampus, only among APOE ε4 carriers. Right hippocampal metrics were not correlated with memory and there were no significant correlations in the noncarriers. Verbal memory decline correlated with left hippocampal volume loss for both carriers and noncarriers, with no other significant volumetric findings. DISCUSSION Findings support early hippocampal dysfunction in intact carriers, the AD disconnection hypothesis, and left hippocampal dysfunction earlier than the right. Combining lateralized graph theoretical metrics with a sensitive measure of memory trajectory allowed for detection of early-stage changes in APOE ε4 carriers before symptoms of mild cognitive impairment are present. HIGHLIGHTS Graph theory connectivity detects preclinical hippocampal changes in APOE ε4 carriers. The AD disconnection hypothesis was supported in unimpaired APOE ε4 carriers. Hippocampal dysfunction starts asymmetrically on the left.
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Stark NEP, Streamer J, Queen R. Patients with unilateral ankle arthritis have decreased discrete and time-series limb symmetry compared to healthy controls. J Orthop Res 2023; 41:1953-1964. [PMID: 36866826 PMCID: PMC10440243 DOI: 10.1002/jor.25541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/01/2023] [Indexed: 03/04/2023]
Abstract
Patients with ankle arthritis (AA) have side-to-side limb differences at the ankle and in spatiotemporal measures; however, the degree of symmetry between limbs has not been compared to a healthy population. The purpose of this study was to determine differences in limb symmetry during walking for discrete and time-series measures when comparing patients with unilateral AA to healthy participants. Thirty-seven AA and 37 healthy participants were age, gender, and body mass index matched. Three-dimensional gait mechanics and ground reaction force (GRF) were captured during four to seven walking trails. GRF and hip and ankle mechanics were extracted bilaterally for each trial. The Normalized Symmetry Index and Statistical Parameter Mapping were used to assess discrete and time-series symmetry, respectively. Discrete symmetry was analyzed using linear mixed-effect models to determine significant differences between groups (α = 0.05). Compared to healthy participants, patients with AA had decreased weight acceptance (p = 0.017) and propulsive (p < 0.001) GRF, ankle plantarflexion (p = 0.021), ankle dorsiflexion (p = 0.010), and ankle plantarflexion moment (p < 0.001) symmetry. Significant regions of difference were found between limbs and groups throughout the stance phase for the vertical GRF force (p < 0.001), the ankle angle during push-off (p = 0.047), the plantarflexion moment (p < 0.001), and the hip extension angle (p = 0.034) and moment (p = 0.010). Patients with AA have decreased symmetry in the vertical GRF and at the ankle and hip during the weight acceptance and propulsive portions of the stance phase. Therefore, clinicians should try a non improving symmetry focusing on changing hip and ankle mechanics during the weight acceptance and propulsive phases of gait.
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