1
|
Yamagata M, Tateuchi H, Shimizu I, Ichihashi N. Changes in kinematic synergy in older adults during walking: A two-year follow-up study. Gait Posture 2022; 96:244-250. [PMID: 35700642 DOI: 10.1016/j.gaitpost.2022.05.030] [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: 10/12/2021] [Revised: 05/19/2022] [Accepted: 05/24/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND A well-controlled center of mass (CoM) in a coordinated segmental manner is required during gait. A synergy index that quantifies the strength of the synergistic control of the body segments that control the CoM can be evaluated using uncontrolled manifold (UCM) analysis. Several studies have compared the synergy index between older and younger adults; however, contradictory results have been found regarding age-related changes in the synergy index. Moreover, no study has investigated these changes longitudinally. RESEARCH QUESTION To evaluate age-related changes in the synergy index to control the CoM during gait in a longitudinal study. METHODS Twenty-five older adults participated at a baseline visit. The gait task at the two-year follow-up was completed by 16 older adults. Participants walked on a 6-m walkway at baseline and the two-year follow-up, and kinematic data were collected. Using UCM analysis, the synergy indices controlling CoM in the mediolateral and vertical directions were evaluated at baseline and follow-up. We also evaluated the Timed Up and Go (TUG) test and the strength of the knee extensor at both periods. RESULTS We found that TUG was significantly slower at follow-up; however, no difference was found in muscle strength. The synergy index in the mediolateral direction increased significantly after two years; such increases were found in individuals with decreased gait speed. SIGNIFICANCE This study showed that changes in gait patterns, including decreasing gait speed and increasing segmental coordination, may be important for gait with appropriate postural control relative to the environment and dynamic stability of the body in individuals with low functional mobility.
Collapse
Affiliation(s)
- Momoko Yamagata
- Faculty of Rehabilitation, Kansai Medical University, 18-89 Uyama Higashimachi, Hirakata, Osaka 573-1136, Japan; Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Hiroshige Tateuchi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Itsuroh Shimizu
- Fukui General Clinic, 1-42-1 Nittazuka, Fukui-shi,Fukui 910-0067, Japan
| | - Noriaki Ichihashi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| |
Collapse
|
2
|
Zakerian SA, Masjoodi S, Makkiabadi B, Arabian A. An innovative sit-standing seat in urban buses: A new design to prevent falls and non-collision injuries. Work 2022; 72:687-696. [DOI: 10.3233/wor-210515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Due to the rapid growth of metropolises and the insufficiency of public transportation, nowadays, many people travel on these vehicles in a standing position. This position leads to discomfort and the risk of falling or non-collision incidents for the passengers. OBJECTIVE: The present study was conducted to analyze an innovative sit-standing seat to prevent falls and non-collision injuries in standing passengers. METHODS: A total of sixteen participated in this study. EMG signal and Borg scale were used to assess muscle activity and discomfort, respectively. RESULTS: The mean Borg scale score for perceived discomfort was lower in the sit-standing position than the standing position in all body organs, except for the hips. Also, in the sit-standing position compared to the standing position, the muscle activity of the soleus and medial gastrocnemius muscles was significantly lower in the constant velocity and entire phases in both legs, lower in the right leg in the acceleration phase and lower in the left leg in the deceleration phase. CONCLUSIONS: So, this seat can be used as an innovative idea to improve the ergonomic condition of standing passengers to prevent falls and non-collision injuries on transit buses.
Collapse
Affiliation(s)
- Seyed Abolfazl Zakerian
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sadegh Masjoodi
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Bahador Makkiabadi
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Ali Arabian
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| |
Collapse
|
3
|
Postural control in response to unilateral and bilateral external perturbations in older adults. Gait Posture 2022; 94:26-31. [PMID: 35227938 DOI: 10.1016/j.gaitpost.2022.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 01/11/2022] [Accepted: 02/21/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Balance is an important determinant of physical function and falls risk. The ability to withstand external perturbations is important when walking on icy or uneven surfaces, whether the perturbations are bilateral or unilateral. RESEARCH QUESTION This study sought to determine the effect of unilateral and bilateral standing perturbations on leg muscle activity in healthy older adults. METHODS Participants experienced unilateral and bilateral standing perturbations of the treadmill. Surface electromyography (EMG) from lower limb muscles was recorded unilaterally. EMG onset latency and root mean square (RMS) amplitude of the muscle bursts were calculated. RESULTS Older adults demonstrated a combined ankle/hip strategy, along with pre-activation and co-contraction of muscles in response to unilateral and bilateral stance perturbations. As well, older adults demonstrated higher levels of EMG, but no difference in the latency of burst onset, in bilateral than unilateral perturbation types. SIGNIFICANCE When the stance limb was perturbed in the bilateral condition, the older adults responded with a Gastrocs EMG burst nearly 100% of the maximum EMG. The high level of EMG used, especially in the Gastrocs, during the bilateral perturbations may reduce the safety factor for falls in older adults. Older adults responded to the different perturbation demands by modulating EMG amplitude as opposed to the onset timing of EMG.
Collapse
|
4
|
Roelker SA, Koehn RR, Caruthers EJ, Schmitt LC, Chaudhari AMW, Siston RA. Effects of age and knee osteoarthritis on the modular control of walking: A pilot study. PLoS One 2021; 16:e0261862. [PMID: 34965270 PMCID: PMC8716059 DOI: 10.1371/journal.pone.0261862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 12/12/2021] [Indexed: 11/18/2022] Open
Abstract
Background Older adults and individuals with knee osteoarthritis (KOA) often exhibit reduced locomotor function and altered muscle activity. Identifying age- and KOA-related changes to the modular control of gait may provide insight into the neurological mechanisms underlying reduced walking performance in these populations. The purpose of this pilot study was to determine if the modular control of walking differs between younger and older adults without KOA and adults with end-stage KOA. Methods Kinematic, kinetic, and electromyography data were collected from ten younger (23.5 ± 3.1 years) and ten older (63.5 ± 3.4 years) adults without KOA and ten adults with KOA (64.0 ± 4.0 years) walking at their self-selected speed. Separate non-negative matrix factorizations of 500 bootstrapped samples determined the number of modules required to reconstruct each participant’s electromyography. One-way Analysis of Variance tests assessed the effect of group on walking speed and the number of modules. Kendall rank correlations (τb) assessed the association between the number of modules and self-selected walking speed. Results The number of modules required in the younger adults (3.2 ± 0.4) was greater than in the individuals with KOA (2.3 ± 0.7; p = 0.002), though neither cohorts’ required number of modules differed significantly from the unimpaired older adults (2.7 ± 0.5; p ≥ 0.113). A significant association between module number and walking speed was observed (τb = 0.350, p = 0.021) and individuals with KOA walked significantly slower (0.095 ± 0.21 m/s) than younger adults (1.24 ± 0.15 m/s; p = 0.005). Individuals with KOA also exhibited altered module activation patterns and composition (which muscles are associated with each module) compared to unimpaired adults. Conclusion These findings suggest aging alone may not significantly alter modular control; however, the combined effects of knee osteoarthritis and aging may together impair the modular control of gait.
Collapse
Affiliation(s)
- Sarah A. Roelker
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, Massachusetts, United States of America
- Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, Ohio, United States of America
- * E-mail:
| | - Rebekah R. Koehn
- Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, Ohio, United States of America
| | - Elena J. Caruthers
- Department of Engineering, Otterbein University, Westerville, Ohio, United States of America
| | - Laura C. Schmitt
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, United States of America
- Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America
- Division of Physical Therapy, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, United States of America
| | - Ajit M. W. Chaudhari
- Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, Ohio, United States of America
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, United States of America
- Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America
- Division of Physical Therapy, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, United States of America
- Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio, United States of America
- Department of Orthopaedics, The Ohio State University, Columbus, Ohio, United States of America
| | - Robert A. Siston
- Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, Ohio, United States of America
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, United States of America
- Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America
- Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio, United States of America
- Department of Orthopaedics, The Ohio State University, Columbus, Ohio, United States of America
| |
Collapse
|
5
|
Farinelli V, Bolzoni F, Marchese SM, Esposti R, Cavallari P. A Novel Viewpoint on the Anticipatory Postural Adjustments During Gait Initiation. Front Hum Neurosci 2021; 15:709780. [PMID: 34707487 PMCID: PMC8543010 DOI: 10.3389/fnhum.2021.709780] [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: 05/14/2021] [Accepted: 08/31/2021] [Indexed: 11/16/2022] Open
Abstract
Anticipatory postural adjustments (APAs) are the coordinated muscular activities that precede the voluntary movements to counteract the associated postural perturbations. Many studies about gait initiation call APAs those activities that precede the heel-off of the leading foot, thus taking heel-off as the onset of voluntary movement. In particular, leg muscles drive the center of pressure (CoP) both laterally, to shift the body weight over the trailing foot and backward, to create a disequilibrium torque pushing forward the center of mass (CoM). However, since subjects want to propel their body rather than lift their foot, the onset of gait should be the CoM displacement, which starts with the backward CoP shift. If so, the leg muscles driving such a shift are the prime movers. Moreover, since the disequilibrium torque is mechanically equivalent to a forward force acting at the pelvis level, APAs should be required to link the body segments to the pelvis: distributing such concentrated force throughout the body would make all segments move homogeneously. In the aim of testing this hypothesis, we analyzed gait initiation in 15 right-footed healthy subjects, searching for activities in trunk muscles that precede the onset of the backward CoP shift. Subjects stood on a force plate for about 10 s and then started walking at their natural speed. A minimum of 10 trials were collected. A force plate measured the CoP position while wireless probes recorded the electromyographic activities. Recordings ascertained that at gait onset APAs develop in trunk muscles. On the right side, Rectus Abdominis and Obliquus Abdominis were activated in 11 and 13 subjects, respectively, starting on average 33 and 54 ms before the CoP shift; Erector Spinae (ES) at L2 and T3 levels was instead inhibited (9 and 7 subjects, 104 and 120 ms). On the contralateral side, the same muscles showed excitatory APAs (abdominals in 11 and 12 subjects, 27 and 82 ms; ES in 10 and 7 subjects, 75 and 32 ms). The results of this study provide a novel framework for distinguishing postural from voluntary actions, which may be relevant for the diagnosis and rehabilitation of gait disorders.
Collapse
Affiliation(s)
- Veronica Farinelli
- Human Physiology Section of the Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Francesco Bolzoni
- Human Physiology Section of the Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Silvia Maria Marchese
- Human Physiology Section of the Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Roberto Esposti
- Human Physiology Section of the Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Paolo Cavallari
- Human Physiology Section of the Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| |
Collapse
|
6
|
Latash ML. One more time about motor (and non-motor) synergies. Exp Brain Res 2021; 239:2951-2967. [PMID: 34383080 DOI: 10.1007/s00221-021-06188-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 08/03/2021] [Indexed: 11/28/2022]
Abstract
We revisit the concept of synergy based on the recently translated classical book by Nikolai Bernstein (On the construction of movements, Medgiz, Moscow 1947; Latash, Bernstein's Construction of Movements, Routledge, Abingdon 2020b) and progress in understanding the physics and neurophysiology of biological action. Two aspects of synergies are described: organizing elements into stable groups (modes) and ensuring dynamical stability of salient performance variables. The ability of the central nervous system to attenuate synergies in preparation for a quick action-anticipatory synergy adjustments-is emphasized. Recent studies have demonstrated synergies at the level of hypothetical control variables associated with spatial referent coordinates for effectors. Overall, the concept of synergies fits naturally the hierarchical scheme of control with referent coordinates with an important role played by back-coupling loops within the central nervous system and from peripheral sensory endings. Further, we review studies showing non-trivial changes in synergies with development, aging, fatigue, practice, and a variety of neurological disorders. Two aspects of impaired synergic control-impaired stability and impaired agility-are introduced. The recent generalization of the concept of synergies for non-motor domains, including perception, is discussed. We end the review with a list of unresolved and troubling issues.
Collapse
Affiliation(s)
- Mark L Latash
- Department of Kinesiology, Rec.Hall-268N, The Pennsylvania State University, University Park, PA, 16802, USA.
| |
Collapse
|
7
|
Rubega M, Formaggio E, Di Marco R, Bertuccelli M, Tortora S, Menegatti E, Cattelan M, Bonato P, Masiero S, Del Felice A. Cortical correlates in upright dynamic and static balance in the elderly. Sci Rep 2021; 11:14132. [PMID: 34238987 PMCID: PMC8266885 DOI: 10.1038/s41598-021-93556-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 06/24/2021] [Indexed: 02/06/2023] Open
Abstract
Falls are the second most frequent cause of injury in the elderly. Physiological processes associated with aging affect the elderly's ability to respond to unexpected balance perturbations, leading to increased fall risk. Every year, approximately 30% of adults, 65 years and older, experiences at least one fall. Investigating the neurophysiological mechanisms underlying the control of static and dynamic balance in the elderly is an emerging research area. The study aimed to identify cortical and muscular correlates during static and dynamic balance tests in a cohort of young and old healthy adults. We recorded cortical and muscular activity in nine elderly and eight younger healthy participants during an upright stance task in static and dynamic (core board) conditions. To simulate real-life dual-task postural control conditions, the second set of experiments incorporated an oddball visual task. We observed higher electroencephalographic (EEG) delta rhythm over the anterior cortex in the elderly and more diffused fast rhythms (i.e., alpha, beta, gamma) in younger participants during the static balance tests. When adding a visual oddball, the elderly displayed an increase in theta activation over the sensorimotor and occipital cortices. During the dynamic balance tests, the elderly showed the recruitment of sensorimotor areas and increased muscle activity level, suggesting a preferential motor strategy for postural control. This strategy was even more prominent during the oddball task. Younger participants showed reduced cortical and muscular activity compared to the elderly, with the noteworthy difference of a preferential activation of occipital areas that increased during the oddball task. These results support the hypothesis that different strategies are used by the elderly compared to younger adults during postural tasks, particularly when postural and cognitive tasks are combined. The knowledge gained in this study could inform the development of age-specific rehabilitative and assistive interventions.
Collapse
Affiliation(s)
- Maria Rubega
- Department of Neuroscience, Section of Rehabilitation, University of Padua, Padova, 35128, Italy
| | - Emanuela Formaggio
- Department of Neuroscience, Section of Rehabilitation, University of Padua, Padova, 35128, Italy
| | - Roberto Di Marco
- Department of Neuroscience, Section of Rehabilitation, University of Padua, Padova, 35128, Italy
| | - Margherita Bertuccelli
- Department of Neuroscience, Section of Rehabilitation, University of Padua, Padova, 35128, Italy
| | - Stefano Tortora
- Department of Information Engineering, University of Padua, Padova, Italy, 35131
| | - Emanuele Menegatti
- Department of Information Engineering, University of Padua, Padova, Italy, 35131
| | - Manuela Cattelan
- Department of Statistical Sciences, University of Padua, Padova, 35121, Italy
| | - Paolo Bonato
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Charlestown, Boston, MA, 02129, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, 02115, USA
| | - Stefano Masiero
- Department of Neuroscience, Section of Rehabilitation, University of Padua, Padova, 35128, Italy
- Padova Neuroscience Center, Padova, 35128, Italy
| | - Alessandra Del Felice
- Department of Neuroscience, Section of Rehabilitation, University of Padua, Padova, 35128, Italy.
- Padova Neuroscience Center, Padova, 35128, Italy.
| |
Collapse
|
8
|
Akbaş A, Marszałek W, Bacik B, Juras G. Two Aspects of Feedforward Control During a Fencing Lunge: Early and Anticipatory Postural Adjustments. Front Hum Neurosci 2021; 15:638675. [PMID: 34194305 PMCID: PMC8236721 DOI: 10.3389/fnhum.2021.638675] [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: 12/07/2020] [Accepted: 04/29/2021] [Indexed: 11/20/2022] Open
Abstract
The present study investigated whether expertise in fencing influences the onset of postural preparation during the fencing lunge and how it changes under different performance conditions. We also questioned if the onset of feedforward control can be categorized into one of the postural phases: anticipatory or early postural adjustment. Eight elite fencers and nine physical education students performed an attack with a lunge in self-paced and reaction time conditions from three different initial stance widths. The onset of the center of pressure (COP) displacement and EMG activities for the tibialis anterior (TA) of both limbs were recorded. The results show that expertise in fencing delays the onset of the activity of TA of the front leg and the onset of COP displacement during fencing lunge performance in comparison to controls. Additionally, in contrast to the control group, fencers produce typical APA patterns in the activation of TA under different performance conditions, delayed reaction time in comparison to self-initiated lunging, and constant time of APA onset under different widths of stance. According to different times and functions of TA activity and COP displacement in lunging, we propose to address them as anticipatory postural adjustment and early postural adjustment, respectively.
Collapse
Affiliation(s)
- Anna Akbaş
- Department of Human Motor Behavior, Institute of Sport Sciences, Academy of Physical Education, Katowice, Poland
| | - Wojciech Marszałek
- Department of Human Motor Behavior, Institute of Sport Sciences, Academy of Physical Education, Katowice, Poland
| | - Bogdan Bacik
- Department of Human Motor Behavior, Institute of Sport Sciences, Academy of Physical Education, Katowice, Poland
| | - Grzegorz Juras
- Department of Human Motor Behavior, Institute of Sport Sciences, Academy of Physical Education, Katowice, Poland
| |
Collapse
|
9
|
Neuromechanical response of the upper body to unexpected perturbations during gait initiation in young and older adults. Aging Clin Exp Res 2021; 33:909-919. [PMID: 32447739 DOI: 10.1007/s40520-020-01592-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 05/06/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Control of upper body motion deteriorates with ageing leading to impaired ability to preserve balance during gait, but little is known on the contribution of the upper body to preserve balance in response to unexpected perturbations during locomotor transitions, such as gait initiation. AIM To investigate differences between young and older adults in the ability to modify the trunk kinematics and muscle activity following unexpected waist lateral perturbations during gait initiation. METHODS Ten young (25 ± 2 years) and ten older adults (73 ± 5 years) initiated locomotion from stance while a lateral pull was randomly applied to the pelvis. Two force plates were used to define the feet centre-of-pressure displacement. Angular displacement of the trunk in the frontal plane was obtained through motion analysis. Surface electromyography of cervical and thoracic erector spinae muscles was recorded bilaterally. RESULTS A lower trunk lateral bending towards the stance leg side in the preparatory phase of gait initiation was observed in older participants following perturbation. Right thoracic muscle activity was increased in response to the perturbation during the initial phase of gait initiation in young (+ 68%) but not in older participants (+ 7%). CONCLUSIONS The age-related reduction in trunk movement could indicate a more rigid behaviour of the upper body employed by older compared to young individuals in response to unexpected perturbations preceding the initiation of stepping. Older adults' delayed activation of thoracic muscles could suggest impaired reactive mechanisms that may potentially lead to a fall in the early stages of the gait initiation.
Collapse
|
10
|
Rubega M, Di Marco R, Zampini M, Formaggio E, Menegatti E, Bonato P, Masiero S, Del Felice A. Muscular and cortical activation during dynamic and static balance in the elderly: A scoping review. AGING BRAIN 2021; 1:100013. [PMID: 36911521 PMCID: PMC9997172 DOI: 10.1016/j.nbas.2021.100013] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 12/28/2022] Open
Abstract
Falls due to balance impairment are a major cause of injury and disability in the elderly. The study of neurophysiological correlates during static and dynamic balance tasks is an emerging area of research that could lead to novel rehabilitation strategies and reduce fall risk. This review aims to highlight key concepts and identify gaps in the current knowledge of balance control in the elderly that could be addressed by relying on surface electromyographic (EMG) and electroencephalographic (EEG) recordings. The neurophysiological hypotheses underlying balance studies in the elderly as well as the methodologies, findings, and limitations of prior work are herein addressed. The literature shows: 1) a wide heterogeneity in the experimental procedures, protocols, and analyses; 2) a paucity of studies involving the investigation of cortical activity; 3) aging-related alterations of cortical activation during balance tasks characterized by lower cortico-muscular coherence and increased allocation of attentional control to postural tasks in the elderly; and 4) EMG patterns characterized by delayed onset after perturbations, increased levels of activity, and greater levels of muscle co-activation in the elderly compared to younger adults. EMG and EEG recordings are valuable tools to monitor muscular and cortical activity during the performance of balance tasks. However, standardized protocols and analysis techniques should be agreed upon and shared by the scientific community to provide reliable and reproducible results. This will allow researchers to gain a comprehensive knowledge on the neurophysiological changes affecting static and dynamic balance in the elderly and will inform the design of rehabilitative and preventive interventions.
Collapse
Affiliation(s)
- Maria Rubega
- Department of Neurosciences, Section of Rehabilitation, University of Padova, via Giustiniani 5, 35128 Padova, IT, Italy
| | - Roberto Di Marco
- Department of Neurosciences, Section of Rehabilitation, University of Padova, via Giustiniani 5, 35128 Padova, IT, Italy
| | - Marianna Zampini
- Department of Neurosciences, Section of Rehabilitation, University of Padova, via Giustiniani 5, 35128 Padova, IT, Italy
| | - Emanuela Formaggio
- Department of Neurosciences, Section of Rehabilitation, University of Padova, via Giustiniani 5, 35128 Padova, IT, Italy
| | - Emanuele Menegatti
- Department of Information Engineering, University of Padova, Padova, IT, Italy
| | - Paolo Bonato
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, USA
| | - Stefano Masiero
- Department of Neurosciences, Section of Rehabilitation, University of Padova, via Giustiniani 5, 35128 Padova, IT, Italy.,Padova Neuroscience Center, University of Padova, Padova, IT, Italy
| | - Alessandra Del Felice
- Department of Neurosciences, Section of Rehabilitation, University of Padova, via Giustiniani 5, 35128 Padova, IT, Italy.,Padova Neuroscience Center, University of Padova, Padova, IT, Italy
| |
Collapse
|
11
|
Freitas SMSF, de Freitas PB, Falaki A, Corson T, Lewis MM, Huang X, Latash ML. Synergic control of action in levodopa-naïve Parkinson's disease patients: II. Multi-muscle synergies stabilizing vertical posture. Exp Brain Res 2020; 238:2931-2945. [PMID: 33068173 PMCID: PMC7644647 DOI: 10.1007/s00221-020-05947-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 10/06/2020] [Indexed: 01/07/2023]
Abstract
Postural instability is a major disabling feature in Parkinson's disease (PD). We quantified the organization of leg and trunk muscles into synergies stabilizing the center of pressure (COP) coordinate within the uncontrolled manifold hypothesis in levodopa-naïve patients with PD and age-matched control subjects. The main hypothesis was that changes in the synergic control of posture are present early in the PD process even before levodopa exposure. Eleven levodopa-naïve patients with PD and 11 healthy controls performed whole-body cyclical voluntary sway tasks and a self-initiated load-release task during standing on a force plate. Surface electromyographic activity in 13 muscles on the right side of the body was analyzed to identify muscle groups with parallel scaling of activation levels (M-modes). Data were collected both before ("off-drug") and approximately 60 min after the first dose of 25/100 carbidopa/levodopa ("on-drug"). COP-stabilizing synergies were quantified for the load-release task. Levodopa-naïve patients with PD showed no COP-stabilizing synergy "off-drug", whereas controls showed posture-stabilizing multi-M-mode synergy. "On-drug", patients with PD demonstrated a significant increase in the synergy index. There were no significant drug effects on the M-mode composition, anticipatory postural adjustments, indices of motor equivalence, or indices of COP variability. The results suggest that levodopa-naïve patients with PD already show impaired posture-stabilizing multi-muscle synergies that may be used as promising behavioral biomarkers for emerging postural disorders in PD. Moreover, levodopa modified synergy metrics differently in these levodopa-naïve patients compared to a previous study of patients on chronic antiparkinsonian medications (Falaki et al. in J Electromyogr Kinesiol 33:20-26, 2017a), suggesting different neurocircuitry involvement.
Collapse
Affiliation(s)
- Sandra M S F Freitas
- Graduate Program in Physical Therapy, City University of São Paulo, São Paulo, SP, Brazil
- Department of Kinesiology, The Pennsylvania State University, Rec.Hall-267, University Park, PA, 16802, USA
- Department of Neurology, Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA, USA
| | - Paulo B de Freitas
- Department of Kinesiology, The Pennsylvania State University, Rec.Hall-267, University Park, PA, 16802, USA
- Department of Neurology, Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA, USA
- Interdisciplinary Graduate Program in Health Sciences, Cruzeiro do Sul University, São Paulo, SP, Brazil
| | - Ali Falaki
- Department of Physiology, University of Montreal, Montreal, QC, Canada
| | - Tyler Corson
- Department of Neurology, Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA, USA
| | - Mechelle M Lewis
- Department of Neurology, Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA, USA
- Department of Pharmacology, Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA, USA
| | - Xuemei Huang
- Department of Kinesiology, The Pennsylvania State University, Rec.Hall-267, University Park, PA, 16802, USA
- Department of Neurology, Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA, USA
- Department of Pharmacology, Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA, USA
- Department of Radiology, Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA, USA
- Department of Neurosurgery, Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA, USA
| | - Mark L Latash
- Department of Kinesiology, The Pennsylvania State University, Rec.Hall-267, University Park, PA, 16802, USA.
| |
Collapse
|
12
|
Age-Related Differences in Muscle Synergy Organization during Step Ascent at Different Heights and Directions. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10061987] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The aim of this study was to explore the underlying age-related differences in dynamic motor control during different step ascent conditions using muscle synergy analysis. Eleven older women (67.0 y ± 2.5) and ten young women (22.5 y ± 1.6) performed stepping in forward and lateral directions at step heights of 10, 20 and 30 cm. Surface electromyography was obtained from 10 lower limb and torso muscles. Non-negative matrix factorization was used to identify sets of (n) synergies across age groups and stepping conditions. In addition, variance accounted for (VAF) by the detected number of synergies was compared to assess complexity of motor control. Finally, correlation coefficients of muscle weightings and between-subject variability of the temporal activation patterns were calculated and compared between age groups and stepping conditions. Four synergies accounted for >85% VAF across age groups and stepping conditions. Age and step height showed a significant negative correlation with VAF during forward stepping but not lateral stepping, with lower VAF indicating higher synergy complexity. Muscle weightings showed higher similarity across step heights in older compared to young women. Neuromuscular control of young and community-dwelling older women could not be differentiated based on the number of synergies extracted. Additional analyses of synergy structure and complexity revealed subtle age- and step-height-related differences, indicating that older women rely on more complex neuromuscular control strategies.
Collapse
|
13
|
Arabian A, Masjoodi S, Makkiabadi B, Ghafari E, Torabi Nassaj E, Zakerian SA. Determination of critical time points in non-collision incidents of elderly passengers in standing position on urban bus. TRAFFIC INJURY PREVENTION 2020; 21:151-155. [PMID: 32119568 DOI: 10.1080/15389588.2020.1723793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 01/27/2020] [Accepted: 01/27/2020] [Indexed: 06/10/2023]
Abstract
Objective: Due to the reduced physical ability of elderly, the occurrence of non-collision incidents is higher for these passengers in standing position. Therefore, the purpose of the present study is to determine the critical time points of non-collision incidents using the level of leg muscle activity in elderly standing passengers on urban bus.Methods: To determine the critical time points in the occurrence of non-collision incidents, the level of muscular activity of the standing passengers was analyzed using a surface electromyography (surface EMG) device during the movement scenario of the bus. The results of assessing the leg muscle activity was analyzed in SPSS software.Results: The contraction pattern of the leg muscles in standing passengers was consistent with Newton's First Law. The results showed that the level of muscular activity decreased in the right leg muscles when changing the phase of bus motion from acceleration to constant velocity. This level of muscular activity in the left leg muscles increased when constant velocity changed to deceleration. These changes were quite significant in the medial gastrocnemius and soleus muscles (P < 0.05).Conclusions: According to these findings, it was found that the acceleration and deceleration phases, especially the starting and changing phases of bus motion, are the most critical time points in the occurrence of non-collision incidents in elderly standing passengers on urban bus.
Collapse
Affiliation(s)
- Ali Arabian
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sadegh Masjoodi
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Bahador Makkiabadi
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Ehsan Ghafari
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Ebrahim Torabi Nassaj
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Seyed Abolfazl Zakerian
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| |
Collapse
|
14
|
Cheng YS, Chien A, Lai DM, Lee YY, Cheng CH, Wang SF, Chang YJ, Wang JL, Hsu WL. Perturbation-Based Balance Training in Postoperative Individuals With Degenerative Cervical Myelopathy. Front Bioeng Biotechnol 2020; 8:108. [PMID: 32154235 PMCID: PMC7044125 DOI: 10.3389/fbioe.2020.00108] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 02/03/2020] [Indexed: 11/28/2022] Open
Abstract
Degenerative cervical myelopathy (DCM) is a common aging condition caused by spinal cord compression. Individuals with DCM often presented with residual balance and functional impairments postoperatively. Perturbation-based balance training (PBT) has been shown to have positive effects on populations with neurological disorders but has yet to be investigated in DCM. The objective of this study was therefore to evaluate the effects of PBT on balance and functional performance in postoperative individuals with DCM. Fifteen postoperative individuals with DCM (DCM group) and 14 healthy adults (healthy control group) were recruited. The DCM group received a 4-weeks PBT using a perturbation treadmill. The outcome measures included mean velocity of center of pressure (COP) during quiet standing; center of mass (COM) variance and reaction time to balance perturbation during standing with forward and backward perturbation; gait speed during level ground walking; Timed Up and Go Test (TUG) and disability questionnaire scores including Visual Analog Scale, Neck Disability Index, and Lower Extremity Function of Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire. The assessments were conducted pre- and post-training postoperatively for the DCM group but only once for the healthy control group. Significant improvements were observed in the mean velocity of COP, COM variance, reaction time, gait speed, and TUG in the DCM group. Disability questionnaire scores were not significantly different after training in DCM group. For between-group comparisons, significant differences that were observed pre-training were not observed post-training. The 4-weeks PBT is a potential rehabilitation strategy for addressing balance and functional impairment in postoperative individuals with DCM. In addition, the post-training performance in the DCM group exhibited trends comparable to those of age-matched healthy controls. Furthermore, the training regimens offer a practical reference for future studies on populations with balance disorders. Future studies complemented with neurophysiological assessments could reveal more information of the underlying mechanisms of PBT.
Collapse
Affiliation(s)
- Yi-Shan Cheng
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Division of Physical Therapy, Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Andy Chien
- Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung, Taiwan
| | - Dar-Ming Lai
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Ya-Yun Lee
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Chih-Hsiu Cheng
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shwu-Fen Wang
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Ya-Ju Chang
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jaw-Lin Wang
- Department of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
| | - Wei-Li Hsu
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan
| |
Collapse
|
15
|
Wang Y, Watanabe K, Asaka T. Effect of dance on multi-muscle synergies in older adults: a cross-sectional study. BMC Geriatr 2019; 19:340. [PMID: 31795946 PMCID: PMC6889198 DOI: 10.1186/s12877-019-1365-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 11/22/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to investigate the efficacy of dance in the experienced older dancers compared to the inexperienced older adults. We explored the effect of dance on the composition of muscle groups and multi-muscle synergies stabilizing the center of pressure (COP) displacement in preparation to take a step during support surface translation. METHODS Eight dance experienced elderly participants were asked to take a step in response to support surface perturbations. Uncontrolled manifold analysis was used to identify muscle modes (M-modes) as factors in the muscle activation space. Variance components in the M-mode space and indices of M-mode synergy stabilizing COP displacement were computed. RESULTS The reciprocal M-modes were observed more frequently in the dance group than in the control group prior to the step initiation. Dance led to higher indices of multi-muscle synergies and earlier anticipatory synergy adjustments during preparation for making a step in response to the support surface translations. CONCLUSIONS Dance appeared to be associated with adjustments in both the composition of M-modes and M-mode co-variation patterns resulting in stronger synergies stabilizing COP coordinate in older adults. The results reported here could have clinical relevance when offering a dance approach to balance training for impaired individuals.
Collapse
Affiliation(s)
- Yun Wang
- Tianjin Key Lab of Exercise Physiology and Sports Medicine, College of Social Sport and Health Sciences, Tianjin University of Sport, 16 Donghai Road, Tuanbo Xincheng Xiqu, Jinghai District, Tianjin, 301617 China
| | - Kazuhiko Watanabe
- Institute of Sports and Health Science, 3-10-31, Kagamiyama, Higashi-hiroshima, Hiroshima, 739-0046 Japan
| | - Tadayoshi Asaka
- Department of Rehabilitation Science, Faculty of Health Sciences, Hokkaido University, N12-W5, Kita-ku, Sapporo, 060-0826 Japan
| |
Collapse
|
16
|
Liew BXW, Morrison A, Hobara H, Morris S, Netto K. Not all brawn, but some brain. Strength gains after training alters kinematic motor abundance in hopping. PeerJ 2018; 6:e6010. [PMID: 30505639 PMCID: PMC6254240 DOI: 10.7717/peerj.6010] [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: 06/22/2018] [Accepted: 10/26/2018] [Indexed: 11/20/2022] Open
Abstract
Background The effects of resistance training on a muscle’s neural, architectural, and mechanical properties are well established. However, whether resistance training can positively change the coordination of multiple motor elements in the control of a well-defined lower limb motor performance objective remains unclear. Such knowledge is critical given that resistance training is an essential and ubiquitous component in gait rehabilitation. This study aimed to investigate if strength gains of the ankle and knee extensors after resistance training increases kinematic motor abundance in hopping. Methods The data presented in this study represents the pooled group results of a sub-study from a larger project investigating the effects of resistance training on load carriage running energetics. Thirty healthy adults performed self-paced unilateral hopping, and strength testing before and after six weeks of lower limb resistance training. Motion capture was used to derive the elemental variables of planar segment angles of the foot, shank, thigh, and pelvis, and the performance variable of leg length. Uncontrolled manifold analysis (UCM) was used to provide an index of motor abundance (IMA) in the synergistic coordination of segment angles in the stabilization of leg length. Bayesian Functional Data Analysis was used for statistical inference, with a non-zero crossing of the 95% Credible Interval (CrI) used as a test of significance. Results Depending on the phase of hop stance, there were significant main effects of ankle and knee strength on IMA, and a significant ankle by knee interaction effect. For example at 10% hop stance, a 1 Nm/kg increase in ankle extensor strength increased IMA by 0.37 (95% CrI [0.14–0.59]), a 1 Nm/kg increase in knee extensor strength decreased IMA by 0.29 (95% CrI [0.08–0.51]), but increased the effect of ankle strength on IMA by 0.71 (95% CrI [0.10–1.33]). At 55% hop stance, a 1 Nm/kg increase in knee extensor strength increase IMA by 0.24 (95% CrI [0.001–0.48]), but reduced the effect of ankle strength on IMA by 0.71 (95% CrI [0.13–1.32]). Discussion Resistance training not only improves strength, but also the structure of coordination in the control of a well-defined motor objective. The role of resistance training on motor abundance in gait should be investigated in patient cohorts, other gait patterns, and its translation into functional improvements.
Collapse
Affiliation(s)
- Bernard X W Liew
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Andrew Morrison
- Sport and Exercise Sciences, Faculty of Science and technology, Anglia Ruskin University, Cambridge, United Kingdom
| | - Hiroaki Hobara
- Human Informatics Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tokyo, Japan
| | - Susan Morris
- School of Physiotherapy and Exercise Sciences, Curtin University of Technology, Perth, Western Australia, Australia
| | - Kevin Netto
- School of Physiotherapy and Exercise Sciences, Curtin University of Technology, Perth, Western Australia, Australia
| |
Collapse
|
17
|
Park J, Xu D. Multi-Finger Interaction and Synergies in Finger Flexion and Extension Force Production. Front Hum Neurosci 2017; 11:318. [PMID: 28674489 PMCID: PMC5474495 DOI: 10.3389/fnhum.2017.00318] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 06/02/2017] [Indexed: 11/13/2022] Open
Abstract
The aim of this study was to discover finger interaction indices during single-finger ramp tasks and multi-finger coordination during a steady state force production in two directions, flexion, and extension. Furthermore, the indices of anticipatory adjustment of elemental variables (i.e., finger forces) prior to a quick pulse force production were quantified. It is currently unknown whether the organization and anticipatory modulation of stability properties are affected by force directions and strengths of in multi-finger actions. We expected to observe a smaller finger independency and larger indices of multi-finger coordination during extension than during flexion due to both neural and peripheral differences between the finger flexion and extension actions. We also examined the indices of the anticipatory adjustment between different force direction conditions. The anticipatory adjustment could be a neural process, which may be affected by the properties of the muscles and by the direction of the motions. The maximal voluntary contraction (MVC) force was larger for flexion than for extension, which confirmed the fact that the strength of finger flexor muscles (e.g., flexor digitorum profundus) was larger than that of finger extensor (e.g., extensor digitorum). The analysis within the uncontrolled manifold (UCM) hypothesis was used to quantify the motor synergy of elemental variables by decomposing two sources of variances across repetitive trials, which identifies the variances in the uncontrolled manifold (VUCM) and that are orthogonal to the UCM (VORT). The presence of motor synergy and its strength were quantified by the relative amount of VUCM and VORT. The strength of motor synergies at the steady state was larger in the extension condition, which suggests that the stability property (i.e., multi-finger synergies) may be a direction specific quantity. However, the results for the existence of anticipatory adjustment; however, no difference between the directional conditions suggests that feed-forward synergy adjustment (changes in the stability property) may be at least independent of the magnitude of the task-specific apparent performance variables and its direction (e.g., flexion and extension forces).
Collapse
Affiliation(s)
- Jaebum Park
- Department of Physical Education, Seoul National UniversitySeoul, South Korea.,Institute of Sport Science, Seoul National UniversitySeoul, South Korea
| | - Dayuan Xu
- Department of Physical Education, Seoul National UniversitySeoul, South Korea
| |
Collapse
|