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Wong AKO, Fung HJW, Pretty SP, Laing AC, Chan AH, Mathur S, Zabjek K, Giangregorio L, Cheung AM. Ankle flexor/extensor strength and muscle density are complementary determinants of balance during dual‐task engagement: The ankle quality study. JCSM CLINICAL REPORTS 2023. [DOI: 10.1002/crt2.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Affiliation(s)
- Andy K. O. Wong
- Joint Department of Medical Imaging University Health Network ON Toronto Canada
- Schroeder Arthritis Institute & Toronto General Hospital Research Institute University Health Network ON Toronto Canada
- Division of Epidemiology, Dalla Lana School of Public Health University of Toronto ON Toronto Canada
| | - Hugo J. W. Fung
- Joint Department of Medical Imaging University Health Network ON Toronto Canada
- Department of Exercise Sciences, Faculty of Kinesiology and Physical Education University of Toronto ON Toronto Canada
| | - Steven P. Pretty
- Department of Kinesiology and Health Sciences University of Waterloo ON Waterloo Canada
| | - Andrew C. Laing
- Department of Kinesiology and Health Sciences University of Waterloo ON Waterloo Canada
| | - Adrian H. Chan
- Joint Department of Medical Imaging University Health Network ON Toronto Canada
- Schroeder Arthritis Institute & Toronto General Hospital Research Institute University Health Network ON Toronto Canada
- Temerty Faculty of Medicine University of Toronto ON Toronto Canada
| | - Sunita Mathur
- School of Rehabilitation Therapy Queen's University ON Kingston Canada
| | - Karl Zabjek
- Department of Physical Therapy, Rehabilitation Sciences Institute University of Toronto ON Toronto Canada
| | - Lora Giangregorio
- Department of Kinesiology and Health Sciences University of Waterloo ON Waterloo Canada
- Schlegel‐UW Research Institute for Aging University of Waterloo ON Waterloo Canada
| | - Angela M. Cheung
- Joint Department of Medical Imaging University Health Network ON Toronto Canada
- Schroeder Arthritis Institute & Toronto General Hospital Research Institute University Health Network ON Toronto Canada
- Division of Epidemiology, Dalla Lana School of Public Health University of Toronto ON Toronto Canada
- Temerty Faculty of Medicine University of Toronto ON Toronto Canada
- Centre of Excellence in Skeletal Health Assessment University of Toronto ON Toronto Canada
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Dehmiyani A, Mehdizadeh H, Azad A, Cheraghifard M, Jamali S, Davoudi M, Shokouhyan SM, Taghizadeh G. Apathy exacerbates postural control impairments in stroke survivors: The potential effects of cognitive dual-task for improving postural control. Neuropsychologia 2022; 174:108344. [PMID: 35964781 DOI: 10.1016/j.neuropsychologia.2022.108344] [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: 11/18/2021] [Revised: 07/15/2022] [Accepted: 08/01/2022] [Indexed: 10/15/2022]
Abstract
Apathy is a stressor and debilitating common condition for both stroke survivors and their caregivers. However, its effects on the postural control of these patients have not yet been investigated. Improved postural stability through withdrawing attention from postural control by concurrent cognitive task (i.e. dual-task condition) has been reported previously, but the effect of apathy, as a confounding factor, remains unknown. This study aimed to examine the effects of apathy and dual-task condition on postural control of chronic stroke survivors from biomechanical and neurophysiological perspectives. Twenty non-apathetic stroke survivors, 20 apathetic stroke survivors, and 20 sex-, age-, weight-, and height-matched healthy subjects were assessed using different postural sway measures and electromyography activity of ankle and hip muscles while quietly standing on rigid and foam surfaces under single-task, easy dual-task, and difficult dual-task conditions. The results showed postural instability and neuromuscular stiffening of stroke survivors, particularly apathetic stroke survivors, compared with healthy controls as evidenced by significantly greater postural sway measures and increased co-contraction of ankle muscles as well as hip muscles. Notably, concurrently performing a cognitive task significantly reduced postural instability and neuromuscular stiffening in chronic stroke survivors even in those with apathy. In conclusion, apathy exacerbates postural control impairments in chronic stroke survivors promoting an inefficient conscious mode of postural control. It is recommended that distracting the attention away from postural control by performing a concurrent cognitive task can be considered an effective strategy while designing interventions for improving postural control in apathetic stroke survivors.
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Affiliation(s)
- Arian Dehmiyani
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hajar Mehdizadeh
- Department of Neurosciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Azad
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Moslem Cheraghifard
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Shamsi Jamali
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Davoudi
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran; Clinic for Orthopaedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Ghorban Taghizadeh
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
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Salihu AT, Hill KD, Jaberzadeh S. Effect of cognitive task complexity on dual task postural stability: a systematic review and meta-analysis. Exp Brain Res 2022; 240:703-731. [PMID: 35034175 DOI: 10.1007/s00221-021-06299-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 12/21/2021] [Indexed: 01/01/2023]
Abstract
The dual task experimental paradigm is used to probe the attentional requirements of postural control. However, findings of dual task postural studies have been inconsistent with many studies even reporting improvement in postural stability during dual tasking and thus raising questions about cognitive involvement in postural control. A U-shaped non-linear relationship has been hypothesized between cognitive task complexity and dual task postural stability suggesting that the inconsistent results might have arisen from the use of cognitive tasks of varying complexities. To systematically review experimental studies that compared the effect of simple and complex cognitive tasks on postural stability during dual tasking, we searched seven electronic databases for relevant studies published between 1980 to September 2020. 33 studies involving a total of 1068 participants met the review's inclusion criteria, 17 of which were included in meta-analysis (healthy young adults: 15 studies, 281 participants; Stroke patients: 2 studies, 52 participants). Narrative synthesis of the findings in studies involving healthy old adults was carried out. Our result suggests that in healthy population, cognitive task complexity may not determine whether postural stability increases or decreases during dual tasking (effect of cognitive task complexity was not statistically significant; P > 0.1), and thus the U-shaped non-linear hypothesis is not supported. Rather, differential effect of dual tasking on postural stability was observed mainly based on the age of the participants and postural task challenge, implying that the involvement of cognitive resources or higher cortical functions in the control of postural stability may largely depends on these two factors.
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Affiliation(s)
- Abubakar Tijjani Salihu
- Non-Invasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, School of Primary and Allied Health Care, Monash University, Frankston Victoria 319, P O Box 527, Melbourne, Australia.
| | - Keith D Hill
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Monash University, Frankston, Australia
| | - Shapour Jaberzadeh
- Non-Invasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, School of Primary and Allied Health Care, Monash University, Frankston Victoria 319, P O Box 527, Melbourne, Australia
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Krawczyk-Suszek M, Martowska B, Sapuła R. Analysis of the Stability of the Body in a Standing Position When Shooting at a Stationary Target-A Randomized Controlled Trial. SENSORS (BASEL, SWITZERLAND) 2022; 22:368. [PMID: 35009908 PMCID: PMC8749732 DOI: 10.3390/s22010368] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/12/2021] [Accepted: 12/29/2021] [Indexed: 06/14/2023]
Abstract
Postural stability of the body depends on many factors. One of them is physical activity. It is especially important in the case of sports or professional work, which combine mobility with the accuracy of a shot in a standing position. The smaller the body fatigue, the more accurate the shot. The aim of the study was the assessment of the impact of physical effort on the center of gravity deflection and length of the COP (center of pressure) path, as well as the reaction of ground forces in people who do not engage in systematic physical activity. The study group included 139 people (23.1 ± 5.2 yr; M: 46.8%; F: 53.2%). The test consisted of performing a static test twice, shooting at the target in a multimedia shooting range. Group X performed the Harvard test between the static tests. Group Y made no effort. The reaction parameters of the ground forces were assessed using the Zebris PDM-L Platform. In Group X performing the Harvard test, an increase in the average COP, VCOP, and 95% confidence ellipse area was noted. The path length and the average velocity of COP speed increased. There were no differences in Group Y (p > 0.05). Physical effort significantly affected the postural stability of the studied people, increasing the average parameters assessing balance when adopting static firing position.
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Affiliation(s)
- Marlena Krawczyk-Suszek
- Department of Physiotherapy, Medical College, University of Information Technology and Management in Rzeszow, 2 Sucharskiego Str., 35-225 Rzeszów, Poland;
| | - Blanka Martowska
- Department of Physiotherapy, Medical College, University of Information Technology and Management in Rzeszow, 2 Sucharskiego Str., 35-225 Rzeszów, Poland;
| | - Rafał Sapuła
- Zamosc Clinic of Rehabilitation, 22-400 Zamosc, Poland;
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Ghorbanpour Z, Taghizadeh G, Hosseini SA, Pishyareh E, Ghomsheh FT, Bakhshi E, Mehdizadeh H. Overload of anxiety on postural control impairments in chronic stroke survivors: The role of external focus and cognitive task on the automaticity of postural control. PLoS One 2021; 16:e0252131. [PMID: 34292945 PMCID: PMC8297887 DOI: 10.1371/journal.pone.0252131] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 05/10/2021] [Indexed: 11/23/2022] Open
Abstract
Background Despite the high prevalence of anxiety among chronic stroke survivors and evidence of its negative effects on postural control in healthy subjects, it is unclear whether anxiety also affects postural control in these patients. Recent evidence of improved postural control of healthy subjects by distracting the attention using an external focus (EF) or cognitive task, raises the question of whether similar benefits would be observed in stroke survivors. Thus, the current study aimed to investigate the effects of anxiety and distracting the attention on postural control of chronic stroke survivors in terms of both postural sway measures and neuromuscular regulation. Methods Postural sway measures and ankle muscle activity of chronic stroke survivors with the high and low level of anxiety (HA-stroke (n = 17), and LA-stroke (n = 17), respectively) and age-, sex-, height-, and weight-matched healthy subjects (n = 17) were assessed while standing on rigid and foam surfaces under following conditions: baseline, internal focus (IF), EF, simple and hard cognitive tasks (SC and HC, respectively). Results Stroke survivors, particularly HA-stroke participants, showed greater postural sway measures (i.e. postural instability) and enhanced co-contraction of ankle muscles (i.e. stiffening of the neuromuscular system) compared with healthy subjects. As opposed to baseline and IF conditions, postural instability and neuromuscular stiffening significantly reduced in EF condition and decreased more in cognitive task conditions, particularly HC condition. Conclusions The results suggest that anxiety enhances stroke-induced postural instability promoting improper neuromuscular control of posture with stiffening strategy, which can be alleviated by EF and cognitive tasks.
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Affiliation(s)
- Zahra Ghorbanpour
- Department of Occupational Therapy, School of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran
| | - Ghorban Taghizadeh
- Department of Occupational Therapy, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Hosseini
- Department of Occupational Therapy, School of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran
| | - Ebrahim Pishyareh
- Department of Occupational Therapy, School of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran
- * E-mail:
| | - Farhad Tabatabai Ghomsheh
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran,Iran
| | - Enayatollah Bakhshi
- Department of Biostatistics and Epidemiology, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran,Iran
| | - Hajar Mehdizadeh
- Department of Neurosciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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Standing Balance Strategies and Dual-Task Interference Are Differentially Modulated Across Various Sensory Contexts and Cognitive Tests in Individuals With Chronic Stroke. J Neurol Phys Ther 2020; 44:233-240. [PMID: 32815889 DOI: 10.1097/npt.0000000000000328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Mental tracking and verbal fluency tests have been linked to poor mobility and falls; however, no studies have examined the influence of imposing these tests on standing balance post-stroke. The purpose of this study was to investigate standing balance and cognitive performance across sensory conditions and cognitive tests post-stroke. METHODS Ninety-two participants with chronic stroke stood on dual-force platforms while performing various sensory conditions (eyes open/fixed surface, eyes closed/fixed surface, eyes open/sway-referenced surface, and eyes closed/sway-referenced surface) and cognitive tests (no cognitive test, serial subtractions, and verbal fluency). Equilibrium scores were computed based on the anterior-posterior sway angle. The number of correct verbal responses was recorded. RESULTS Performing serial subtractions during eyes closed/sway-referenced surface revealed the highest equilibrium score (64.0 ± 13.5), followed by the same sensory condition with added verbal fluency test (59.6 ± 15.1), followed by the single-task condition with no cognitive test (52.6 ± 20.9). The number of correct serial subtractions between seated (7.7 ± 3.7) and standing (7.2 ± 3.5) conditions was similar. A trend for more correct verbal fluency responses emerged when seated (8.1 ± 2.9) than the eyes open/sway-referenced surface condition (7.5 ± 2.8). Greater correct verbal fluency responses emerged when seated (8.6 ± 3.1) than the eyes closed/sway-referenced surface condition (7.8 ± 2.7). DISCUSSION AND CONCLUSIONS Standing balance enhancement (higher equilibrium score/better balance) depends on the neuropsychological process targeted and the sensory input available post-stroke. Cognitive dual-task interference emerged for the verbal fluency test during the most attention demanding sensory condition. Cognitive tests that enhance standing balance should be considered in assessments and interventions to evaluate and improve dual-tasking post-stroke.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A321).
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Vickers KL, Schultheis MT, Manning KJ. Driving after brain injury: Does dual-task modality matter? NeuroRehabilitation 2018; 42:213-222. [PMID: 29562565 DOI: 10.3233/nre-172301] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Virtual reality technology allows neuropsychologists to examine complex, real-world behaviors with high ecological validity and can provide an understanding of the impact of demanding dual-tasks on driving performance. OBJECTIVE We hypothesized that a task imposing high cognitive and physical demands (coin-sorting) would result in the greatest reduction in driving maintenance performance. METHODS Twenty participants with acquired brain injury and 28 healthy controls were included in the current study. All participants were licensed and drove regularly. Participants completed two standardized VRDS drives: (1) a baseline drive with no distractions, and (2) the same route with three, counterbalanced dual-tasks representing differing demands. RESULTS A series of 3 (Task)×2 (Group) ANOVAs revealed that the ABI group tended to go slower than the HC group in the presence of a dual-task, F (1, 111) = 6.24, p = 0.01. Importantly, the ABI group also showed greater variability in speed, F (1, 110) = 10.97, p < 0.01, and lane position, F (1, 108) = 7.81, p < 0.01, an effect driven by dual-tasks with both a cognitive and motor demand. CONCLUSIONS These results indicate that long-term driving difficulties following ABI are subtle and likely due to reduced cognitive resources.
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Affiliation(s)
- Kayci L Vickers
- Department of Psychology, Drexel University, Philadelphia, PA, USA
| | | | - Kevin J Manning
- Department of Psychology, University of Connecticut, Storrs, CT, USA
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The effects of cognitive versus motor demands on postural performance and weight bearing asymmetry in patients with stroke. Neurosci Lett 2017; 659:75-79. [PMID: 28866051 DOI: 10.1016/j.neulet.2017.08.070] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 07/12/2017] [Accepted: 08/24/2017] [Indexed: 11/21/2022]
Abstract
While several studies have investigated the interaction between postural control and secondary cognitive tasks in stroke patients, little is known about the influence of secondary motor task on postural control in these patients. The current research was designed to further examine dual-task performance by comparing the effects of cognitive versus motor dual-tasks on postural performance and weight bearing asymmetry (WBA) in stroke patients (n=23) relative to healthy, matched controls (n=22). All participants stood on dual-force plate under 5 conditions: (1) free standing; (2) simple cognitive task (easy Stroop) while standing; (3) difficult cognitive task (difficult Stroop) while standing; (4) simple motor task (holding a tray while a cylinder lying on its flat side) while standing; and (5) difficult motor task (holding a tray while a cylinder lying on its round side) while standing. The center of pressure (COP) measures was greater in stroke patients than healthy controls. Also, the WBA of the patients was greater than the controls. The COP measures increased when moving from single-task to cognitive dual-task conditions. No significant effect of motor dual-tasking was seen when moving from single-task to motor dual-task conditions. However, in contrast to cognitive dual-tasking, stroke patients and healthy controls employed different strategies during simultaneous performance of postural and motor tasks. It can be suggested that performing a motor task while standing requires greater attentional resources compared to performing a cognitive task while standing and this resulted in greater dual-task interference on motor performance in the stroke patients.
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Chang YT, Meng LF, Chang CJ, Lai PL, Lung CW, Chern JS. Effect of Postural Control Demands on Early Visual Evoked Potentials during a Subjective Visual Vertical Perception Task in Adolescents with Idiopathic Scoliosis. Front Hum Neurosci 2017; 11:326. [PMID: 28713252 PMCID: PMC5492482 DOI: 10.3389/fnhum.2017.00326] [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: 05/06/2016] [Accepted: 06/06/2017] [Indexed: 11/23/2022] Open
Abstract
Subjective visual vertical (SVV) judgment and standing stability were separately investigated among patients with adolescent idiopathic scoliosis (AIS). Although, one study has investigated the central mechanism of stability control in the AIS population, the relationships between SVV, decreased standing stability, and AIS have never been investigated. Through event-related potentials (ERPs), the present study examined the effect of postural control demands (PDs) on AIS central mechanisms related to SVV judgment and standing stability to elucidate the time-serial stability control process. Thirteen AIS subjects (AIS group) and 13 age-matched adolescents (control group) aged 12–18 years were recruited. Each subject had to complete an SVV task (i.e., the modified rod-and-frame [mRAF] test) as a stimulus, with online electroencephalogram recording being performed in the following three standing postures: feet shoulder-width apart standing, feet together standing, and tandem standing. The behavioral performance in terms of postural stability (center of pressure excursion), SVV (accuracy and reaction time), and mRAF-locked ERPs (mean amplitude and peak latency of the P1, N1, and P2 components) was then compared between the AIS and control groups. In the behavioral domain, the results revealed that only the AIS group demonstrated a significantly accelerated SVV reaction time as the PDs increased. In the cerebral domain, significantly larger P2 mean amplitudes were observed during both feet shoulder-width-apart standing and feet together standing postures compared with during tandem standing. No group differences were noted in the cerebral domain. The results indicated that (1) during the dual-task paradigm, a differential behavioral strategy of accelerated SVV reaction time was observed in the AIS group only when the PDs increased and (2) the decrease in P2 mean amplitudes with the increase in the PD levels might be direct evidence of the competition for central processing attentional resources under the dual-task postural control paradigm.
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Affiliation(s)
- Yi-Tzu Chang
- Department of Educational Psychology and Counseling, National Taiwan Normal UniversityTaipei, Taiwan.,Department of Occupational Therapy and Graduate Institute of Behavioral Science, School of Medicine, Chang Gung UniversityTaoyuan, Taiwan
| | - Ling-Fu Meng
- Department of Occupational Therapy and Graduate Institute of Behavioral Science, School of Medicine, Chang Gung UniversityTaoyuan, Taiwan.,Division of Occupational Therapy, Department of Rehabilitation, Chiayi Chang Gung Memorial HospitalChiayi, Taiwan
| | - Chun-Ju Chang
- Graduate Institute of Medical Sciences, Chang Jung Christian UniversityTainan, Taiwan.,Department of Medical Science Industry, Chang Jung Christian UniversityTainan, Taiwan
| | - Po-Liang Lai
- Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Jung UniversityTaoyuan, Taiwan
| | - Chi-Wen Lung
- Department of Creative Product Design, Asia UniversityTaichung, Taiwan
| | - Jen-Suh Chern
- Graduate Institute of Rehabilitation Counseling, National Taiwan Normal UniversityTaipei, Taiwan
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Tse CM, Carpenter MG, Liu-Ambrose T, Chisholm AE, Lam T. Attentional requirements of postural control in people with spinal cord injury: the effect of dual task. Spinal Cord 2017; 55:915-920. [DOI: 10.1038/sc.2017.42] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Revised: 03/25/2017] [Accepted: 03/28/2017] [Indexed: 11/09/2022]
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Gupta A, Hilliard RJ, Mudie KL, Clothier PJ. Does providing real-time augmented feedback affect the performance of repeated lower limb loading to exhaustion? Gait Posture 2016; 44:204-8. [PMID: 27004659 DOI: 10.1016/j.gaitpost.2015.12.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 12/02/2015] [Accepted: 12/16/2015] [Indexed: 02/02/2023]
Abstract
INTRODUCTION This study aimed to determine whether real-time augmented feedback influenced performance of single-leg hopping to volitional exhaustion. METHODS Twenty-seven healthy, male participants performed single-leg hopping (2.2 Hz) with (visual and tactile feedback for a target hop height) or without feedback on a force plate. Repeated measures ANOVA were used to determine differences in vertical stiffness (k), duration of flight (tf) and loading (tl) and vertical height displacement during flight (zf) and loading (zl). A Friedman 2-way ANOVA was performed to compare the percentage of trials between conditions that were maintained at 2.2 Hz ± 5%. Correlations were performed to determine if the effects were similar when providing tactile or visual feedback synchronously with the audible cue. RESULTS Augmented feedback resulted in maintenance of the tf, zf and zl between the start and end of the trials compared to hopping with no feedback (p<0.01). With or without feedback there was no change in tl and k from start to end. Without feedback, 21 of 27 participants maintained >70% of total hops at 2.2 ± 5% Hz and this was significantly lower (p=0.01) with tactile (13/27) and visual (15/27) feedback. There was a strong correlation between tactile and visual feedback for duration of hopping cycle (Spearman's r=0.74, p ≤ 0.01). CONCLUSION Feedback was detrimental to being able to maintain hopping cadence in some participants while other participants were able to achieve the cadence and target hop height. This indicates variability in the ability to use real-time augmented feedback effectively.
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Affiliation(s)
- Amitabh Gupta
- School of Science and Health, Western Sydney University, Australia.
| | - Ryan J Hilliard
- School of Science and Health, Western Sydney University, Australia
| | - Kurt L Mudie
- School of Science and Health, Western Sydney University, Australia
| | - Peter J Clothier
- School of Science and Health, Western Sydney University, Australia
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Motor and Visuospatial Attention and Motor Planning After Stroke: Considerations for the Rehabilitation of Standing Balance and Gait. Phys Ther 2015; 95:1423-32. [PMID: 25929533 PMCID: PMC4595814 DOI: 10.2522/ptj.20140492] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 04/19/2015] [Indexed: 01/09/2023]
Abstract
Attention and planning can be altered by stroke, which can influence motor performance. Although the influence of these factors on recovery from stroke has been explored for the upper extremity (UE), their impact on balance and gait are unknown. This perspective article presents evidence that altered motor and visuospatial attention influence motor planning of voluntary goal-directed movements poststroke, potentially affecting balance and gait. Additionally, specific strategies for rehabilitation of balance and gait poststroke in the presence of these factors are discussed. Visuospatial attention selects relevant sensory information and supports the preparation of responses to this information. Motor attentional impairments may produce difficulty with selecting appropriate motor feedback, potentially contributing to falls. An original theoretical model is presented for a network of brain regions supporting motor and visuospatial attention, as well as motor planning of voluntary movements. Stroke may influence this functional network both locally and distally, interfering with input or output of the anatomical or functional regions involved and affecting voluntary movements. Although there is limited research directly examining leg function, evidence suggests alterations in motor and visuospatial attention influence motor planning and have a direct impact on performance of gait and balance. This model warrants testing comparing healthy adults with individuals with stroke.
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Crétual A. Which biomechanical models are currently used in standing posture analysis? Neurophysiol Clin 2015; 45:285-95. [PMID: 26388359 DOI: 10.1016/j.neucli.2015.07.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 07/23/2015] [Indexed: 12/22/2022] Open
Abstract
In 1995, David Winter concluded that postural analysis of upright stance was often restricted to studying the trajectory of the center of pressure (CoP). However, postural control means regulation of the center of mass (CoM) with respect to CoP. As CoM is only accessible by using a biomechanical model of the human body, the present article proposes to determine which models are actually used in postural analysis, twenty years after Winter's observation. To do so, a selection of 252 representative articles dealing with upright posture and published during the four last years has been checked. It appears that the CoP model largely remains the most common one (accounting for nearly two thirds of the selection). Other models, CoP/CoM and segmental models (with one, two or more segments) are much less used. The choice of the model does not appear to be guided by the population studied. Conversely, while some confusion remains between postural control and the associated concepts of stability or strategy, this choice is better justified for real methodological concerns when dealing with such high-level parameters. Finally, the computation of the CoM continues to be a limitation in achieving a more complete postural analysis. This unfortunately implies that the model is chosen for technological reasons in many cases (choice being a euphemism here). Some effort still has to be made so that bioengineering developments allow us to go beyond this limit.
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Affiliation(s)
- A Crétual
- M2S lab (Mouvement Sport Santé), University Rennes 2 - ENS Rennes - UEB, avenue Robert-Schuman, campus de Ker Lann, 35170 Bruz, France; MimeTIC team, INRIA Rennes, campus universitaire de Beaulieu, 35042 Rennes, France.
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Bonato M. Unveiling residual, spontaneous recovery from subtle hemispatial neglect three years after stroke. Front Hum Neurosci 2015; 9:413. [PMID: 26283942 PMCID: PMC4519683 DOI: 10.3389/fnhum.2015.00413] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 07/03/2015] [Indexed: 11/20/2022] Open
Abstract
A common and disabling consequence of stroke is the difficulty in processing contralesional space (i.e., hemispatial neglect). According to paper-and-pencil tests, neglect remits or stabilizes in severity within a few months after a brain injury. This arbitrary temporal limit, however, is at odds with neglect’s well-known dependency on task-sensitivity. The present study tested the hypothesis that the putative early resolution of neglect might be due to the insensitivity of testing methods rather than to the lack of spontaneous recovery at later stages. A right hemisphere stroke patient was studied longitudinally for 3 years. According to paper-and-pencil tests the patient showed no symptom of hemispatial neglect 1 month post stroke. Awareness of spatially lateralized visual targets was then assessed by means of computer-based single- and dual-tasks requiring an additional top-down deployment of attention for the parallel processing of visual or auditory stimuli. Errorless performance at computer-based tasks was reached at month 12 and maintained until month 29 after stroke. A bottom-up manipulation was then implemented by reducing target diameter. Following this change, more than 50% of contralesional targets were omitted, mostly under dual-tasking. At months 40 and 41 the same task revealed a significant (but not complete) reduction in the number of contralesional omissions. Ipsilesional targets were, in contrast, still errorless detected. The coupling of a bottom-up (target change) and a top-down (dual-tasking) manipulation revealed the presence of a long-lasting spontaneous recovery from contralesional spatial awareness deficits. In contrast, neither manipulation was effective when implemented separately. After having excluded the potential confound of practice effects, it was concluded that not only the presence but also the time course of hemispatial neglect strongly depends on the degree of attentional engagement required by the task.
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Affiliation(s)
- Mario Bonato
- Department of Experimental Psychology, Ghent University Ghent, Belgium
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Jehu DA, Desponts A, Paquet N, Lajoie Y. Prioritizing attention on a reaction time task improves postural control and reaction time. Int J Neurosci 2014; 125:100-6. [DOI: 10.3109/00207454.2014.907573] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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