Gait attentional load at different walking speeds

In-vivo 3-dimensional spine and lower body gait symmetry analysis in healthy individuals

Background

Numerous research studies have delved into the biomechanics of walking, focusing on the spine and lower extremities. However, understanding the symmetry of walking in individuals without health issues poses a challenge, as those with normal mobility may exhibit uneven movement patterns due to inherent functional differences between their left and right limbs. The goal of this study is to examine the three-dimensional kinematics of gait symmetry in the spine and lower body during both typical and brisk overground walking in healthy individuals. The analysis will utilize statistical methods and symmetry index approaches. Furthermore, the research aims to investigate whether factors such as gender and walking speed influence gait symmetry.

Methods

Sixty young adults in good health, comprising 30 males and 30 females, underwent motion capture recordings while engaging in both normal and fast overground walking. The analysis focused on interlimb comparisons and corresponding assessments of side-specific spine and pelvis motions.

Results

Statistical Parametric Mapping (SPM) predominantly revealed gait symmetries between corresponding left and right motions in the spine, pelvis, hip, knee, and ankle during both normal and fast overground walking. Notably, both genders exhibited asymmetric pelvis left-right obliquity, with women and men showing an average degree of asymmetry between sides of 0.9 ± 0.1° and 1.5 ± 0.1°, respectively. Furthermore, the analysis suggested that neither sex nor walking speed appeared to exert influence on the 3D kinematic symmetry of the spine, pelvis, and lower body in healthy individuals during gait. While the maximum normalized symmetry index (SInorm) values for the lower thorax, upper lumbar, lower lumbar, pelvis, hip, knee, and ankle displayed significant differences between sexes and walking speeds for specific motions, no interaction between sex and walking speed was observed.

Significance

The findings underscore the potential disparities in data interpretations between the two approaches. While SPM discerns temporal variations in movement, these results offer valuable insights that may enhance our comprehension of gait symmetry in healthy individuals, surpassing the limitations of straightforward discrete parameters like the maximum SInorm. The information gleaned from this study could serve as reference indicators for diagnosing and evaluating abnormal gait function.

Biomechanical investigation of tasks concerning manual materials handling using response surface methodology

In typical manual material handling, the variations in walking pattern are decided by various factors, such as load being handled, frequency of handling, walking surface, etc. Traditional gait analysis protocols commonly evaluate individual factor within specified ranges associated with particular activities or pathologies. However, existing literature underscores the concurrent impact of multiple factors on gait. This study identifies five pivotal factors-walking speed, surface slope, load carried, carrying method, and footwear-as contributors to gait alterations. To address risk factors in manual material handling activities, we propose a unique design-of-experiment-based approach for multi-task gait analysis. Unraveling the relationship between manual handling attributes and human gait holds paramount importance in formulating effective intervention strategies. We optimized the five input factors across a cohort of 15 healthy male participants by employing a face-centered central composite design experimentation. A total of 29 input factor combinations were tested, yielding a comprehensive dataset encompassing 18 kinematic gait parameters (such as cadence, step length etc., measured using inertial measurement system), the isolated impacts of factors, and the interplay of two-factor interactions with corresponding responses. The results illuminate the optimal scenarios of input factors that enhance individual gait performance-these include wearing appropriate footwear, employing a backpack for load carriage, and maintaining a moderate walking pace on a medium slope with minimal load. The study identifies walking speed and load magnitude as primary influencers of gait mechanics, followed by the chosen carrying method. In consequence, the insights gained advocate for the refinement of manual material handling tasks based on the outcomes, effectively mitigating the risk of musculoskeletal disorders by suggesting the interventions for posture correction.

Continuous peripersonal tracking accuracy is limited by the speed and phase of locomotion

Recent evidence suggests that perceptual and cognitive functions are codetermined by rhythmic bodily states. Prior investigations have focused on the cardiac and respiratory rhythms, both of which are also known to synchronise with locomotion-arguably our most common and natural of voluntary behaviours. Compared to the cardiorespiratory rhythms, walking is easier to voluntarily control, enabling a test of how natural and voluntary rhythmic action may affect sensory function. Here we show that the speed and phase of human locomotion constrains sensorimotor performance. We used a continuous visuo-motor tracking task in a wireless, body-tracking virtual environment, and found that the accuracy and reaction time of continuous reaching movements were decreased at slower walking speeds, and rhythmically modulated according to the phases of the step-cycle. Decreased accuracy when walking at slow speeds suggests an advantage for interlimb coordination at normal walking speeds, in contrast to previous research on dual-task walking and reach-to-grasp movements. Phasic modulations of reach precision within the step-cycle also suggest that the upper limbs are affected by the ballistic demands of motor-preparation during natural locomotion. Together these results show that the natural phases of human locomotion impose constraints on sensorimotor function and demonstrate the value of examining dynamic and natural behaviour in contrast to the traditional and static methods of psychological science.

The Effect of Cognitive Task, Gait Speed, and Age on Cognitive-Motor Interference during Walking

Dual-tasking can cause cognitive-motor interference (CMI) and affect task performance. This study investigated the effects of age, gait speed, and type of cognitive task on CMI during gait. Ten younger and 10 older adults walked on a pressure-sensitive GAITRite walkway which recorded gait speed and step length. Participants walked at a slow, preferred, or fast speed while simultaneously completing four cognitive tasks: visuomotor reaction time (VMRT), serial subtraction (SS), word list generation (WLG), and visual Stroop (VS). Each combination of task and speed was repeated for two trials. Tasks were also performed while standing. Motor and cognitive costs were calculated with the formula: ((single-dual)/single × 100). Higher costs indicate a larger reduction in performance from single to dual-task. Motor costs were higher for WLG and SS than VMRT and VS and higher in older adults (p < 0.05). Cognitive costs were higher for SS than WLG (p = 0.001). At faster speeds, dual-task costs increased for WLG and SS, although decreased for VMRT. CMI was highest for working memory, language, and problem-solving tasks, which was reduced by slow walking. Aging increased CMI, although both ages were affected similarly by task and speed. Dual-task assessments could include challenging CMI conditions to improve the prediction of motor and cognitive status.

Walking speed and dual task input modality impact performance on a self-paced treadmill

Interference between a walking task (target speeds on a self-paced treadmill) and dual visual and tactile-visual response time task was investigated. Ambulatory dual-task scenarios reveal how attention is divided between walking and additional tasks, but the impact of walking speed and dual-task modality on gait characteristics and dual-task performance is unclear. The purpose of this study was to evaluate the effect of visual and tactile-visual dual-task on gait performance. Participants (n=15) targeted four speeds (0.5, 1.0, 1.3, and 1.5 m/s) on a self-paced treadmill with a visual speed indicator (a green region centered at the target speed). Participants completed the same speed profile on the treadmill without (Self-Paced) and with a response time dual task (Self-Paced with Dual Task) requiring finger-tap responses to go/no-go cues. Six gait characteristics were calculated: proportion of time in the desired speed green region (GTP), speed ratio (ratio of mean to target speed), time to green region after target speed change (NRT), normalized stride width (NSW), normalized stride length (NSL), and stride time (ST). Both stride length and width were normalized by participant leg length. Lower GTP and greater speed ratio at slower speeds during dual tasking indicate speed-dependent changes in gait characteristics. Changes in NSL and ST were more affected by speed than dual task. These findings support that when speed is a parameter that is tracked, participants do not universally decrease speed in the presence of a dual task. These findings can support the decisions made when designing new wearable technologies that support navigation, communication, and mobility.

Reliability, responsiveness, and validity of slow walking speed in community dwelling older adults

BACKGROUND

Independent ambulation requires adaptability. Self-selected and maximum walking speeds are often both assessed to demonstrate the ability to adapt speed to different tasks and environments. However, purposefully walking at a slow speed (slowWS) could also be an appropriate adaptation in certain situations but has rarely been investigated.

RESEARCH QUESTION

The purpose of this study was to assess the reliability, responsiveness, and concurrent validity of slowWS in community-dwelling older adults.

METHODS

This was an observational, cross-sectional study of 110 community-dwelling older adults. Test-retest and inter-rater reliabilities of slowWS were assessed with intra-class correlation coefficients. Standard error of measurement (SEM) and minimal detectable change (MDC₉₅) were calculated to determine responsiveness. Concurrent validity was assessed with Spearman rank-order correlations between slowWS and a battery of tests previously shown to be related to walking speed.

RESULTS

Walking speed measurement for slowWS was shown to have excellent test-retest and interrater reliability (ICCs values of 0.971-0.997). Standard error of measurement value was small (0.015 m/sec) and MDC₉₅ was 0.04 m/sec. SlowWS was not found to significantly correlate to any other study variable.

SIGNIFICANCE

Walking speed, whether self-selected, maximum, or slow, can be measured reliably with a stopwatch and specific verbal commands. While slowWS could be beneficial for certain tasks or environments, walking slowly was not associated with age, sex, comorbidity, or measures of cognition, depression, strength, balance, disability, or life-space in this sample.

Spine and lower body symmetry during treadmill walking in healthy individuals-In-vivo 3-dimensional kinematic analysis

Although it is relevant to understand spine and lower body motions in healthy individuals for a variety of applications, such as clinical diagnosis, implant design, and the analysis of treatment outcomes, proper assessment and characterization of normative gait symmetry in healthy individuals remains unclear. The purpose of this study was to investigate the in vivo 3-dimensional (3D) spine and lower body gait symmetry kinematics during treadmill walking in healthy individuals. Sixty healthy young adults (30 males and 30 females) were evaluated during normal and fast treadmill walking using a motion capture system approach. Statistical parametric mapping and the normalized symmetry index approaches were used to determine spine, pelvis, and lower body asymmetries during treadmill walking. The spine and pelvis angular motions associated with the left and right lower limb motions, as well as the left and right lower extremity joint angles were compared for normal and fast treadmill walking. The lower lumbar left-right rotation (5.74±0.04°) and hip internal rotation (5.33±0.18°) presented the largest degrees of asymmetry during normal treadmill. Upper lumbar left-right lateral flexion (1.48±0.14°) and knee flexion (2.98±0.13°) indicated the largest asymmetries and during fast treadmill walking. Few asymmetry patterns were similar between normal and fast treadmill walking, whereas others appeared either only during normal or fast treadmill walking in this cohort of participants. These findings could provide insights into better understanding gait asymmetry in healthy individuals, and use them as reference indicators in diagnosing and evaluating abnormal gait function.

The range of visual detection of ground-level cues during distracted walking: Effect of cue contrast and walking speed

Walking while distracted by a smartphone has been a major safety concern for pedestrians. Visual and cognitive attention paid to the smartphone while walking with the head tilted downward would affect the ability to perceive walkway hazards and elevate risks for pedestrian accidents associated with physical contact with obstacles. A laboratory experiment was conducted to evaluate the performance of detecting ground-level visual cues during texting while walking. Forty young smartphone users performed walking trials at faster, preferred, and slower speeds for the dual-task walking on a treadmill and detected approaching cues of three contrast levels. Detection distance was quantified from the location of cue detection to the participants to assess the effects of walking speed and cue contrast on detection performance. Results show that detection distance varied from 1.7 m to 2.9 m for Low to High contrast cues and from 2.3 m to 2.5 m for Slower to Faster walking speeds, and the effects of contrast and speed were statistically significant (p < 0.05). Study findings suggest that higher contrast fixtures or in-ground signals and slower walking would help smartphone users perceive walkway hazards and in-ground safety signals earlier during their distracted walking.

Association of Muscle Mass, Muscle Strength, and Muscle Function with Gait Ability Assessed Using Inertial Measurement Unit Sensors in Older Women

Aging-related muscle atrophy is associated with decreased muscle mass (MM), muscle strength (MS), and muscle function (MF) and may cause motor control, balance, and gait pattern impairments. This study determined associations of three speed-based gait variables with loss of MM, MS, and MF in older women. Overall, 432 older women aged ≥65 performed appendicular skeletal muscle, handgrip strength, and five times sit-to-stand test to evaluate MM, MS, and MF. A gait test was performed at three speeds by modifying the preferred walking speed (PWS; slower walking speed (SWS); faster-walking speed (FWS)) on a straight 19 m walkway. Stride length (SL) at PWS was significantly associated with MM. FWS and coefficient of variance (CV) of double support phase (DSP) and DSP at PWS showed significant associations with MS. CV of step time and stride time at SWS, FWS, and single support phase (SSP) at PWS showed significant associations with MF. SL at PWS, DSP at FWS, CV of DSP at PWS, stride time at SWS, and CV of SSP at PWS showed significant associations with composite MM, MS, and MF variables. Our study indicated that gait tasks under continuous and various speed conditions are useful for evaluating MM, MS, and MF.

Assessing the Cognitive Demand of Hand Controlled Exoskeleton Walking

Individuals with spinal cord injury have motor and sensory deficits leading to ambulatory problems. Our current research is focused on developing innovative control mechanisms for wearable robotic exoskeletons to provide such users with complete control of their gait while allowing them to perform other activities (such as conversing, etc.). In this study, we evaluated the cognitive load due to using the user's hand movement to control the gait of a robot using a dual-task paradigm. The results show that there was no difference in symmetry and duty cycle between with and without a competing cognitive task, and the number of cognitive responses was similar to healthy controls walking on the treadmill. There was also no difference in obstacle navigation with and without the cognitive task. Results of this study suggest that using our control mechanisms is intuitive, easy to learn, and requires cognitive attention that is similar to normal human walking. Clinical Relevance-Initial evidence to understand the effects of the novel control mechanism on cognitive load over that of typical walking.

Prescheduled Interleaving of Processing Reduces Interference in Motor-Cognitive Dual Tasks

Continuous motor tasks like walking have the potential to allow a dynamic allocation of processing resources when interrupted by intermittent cognitive tasks. The degree to which a successful interleaving of processing streams of both tasks is possible may depend on the temporal regularity of events. Fifteen subjects participated in an experiment where we systematically manipulated the regularity of stimulus onsets in a 2-back task relative to the step cycle. We tested three conditions where stimulus onset was always synchronous to a defined event in the stride (right heel strike, left heel strike, and midway between two heel strikes) and two conditions where the temporal location of the stimulus shifted from stride to stride. In order to test for potential effects of task difficulty, we also manipulated walking speed. We measured reaction times, accuracy of the reactions and several measures describing motor performance. There was no sign of task interference in these measures when stimuli always appeared at the same relative location within the step cycle. However, we observed prolonged reaction times when the stimulus came up earlier than expected. Surprisingly, in the other non-regular regime, where the stimulus appeared later than expected, reaction times were fastest. We interpret this result in the light of a prescheduled allocation of processing resources that is linked to the cyclic profile of processing requirements of the motor task.

Altered prefrontal cortex responses in older adults with subjective memory complaints and dementia during dual-task gait: An fNIRS study

People with cognitive impairments show deficits during physical performances such as gait, in particular during cognitively challenging conditions (i.e. dual-task gait [DTG]). However, it is unclear if people at risk of dementia, such as those with subjective memory complaints (SMC), also display gait and central deficits associated with DTG. In this study, we investigated the effects of single- and dual-task gait (STG and DTG), on left prefrontal cortex (PFC) activation in elderly people with subjective memory complaints (SMC) and Dementia. A total of 58 older adults (aged 65-94 years; 26 Healthy; 23 SMC; 9 Dementia) were recruited. Gait spatiotemporal characteristics (i.e. stride velocity and length) were assessed using an instrumented walkway during STG and DTG. Single-channel functional near-infrared spectroscopy over the left PFC was used to measure changes in oxyhaemoglobin (O₂ Hb) during gait. Stride velocity and length during STG (all p < .05) and DTG (all p < .000) were significantly impaired in people with Dementia compared to Healthy and SMC individuals. No differences were observed between Healthy and SMC. For STG, a greater increase in O₂ Hb (p < .05) was observed in those with Dementia compared to the Healthy and SMC, while no differences were observed between Healthy and SMC. A significant increase and decline in O₂ Hb was observed during DTG in the SMC and Dementia groups, respectively, compared to Healthy. Our findings indicate an altered pattern of cerebral haemodynamic response of the left PFC in DTG in people with SMC and Dementia, which may suggest that central changes precede functional impairments in people with SMC.

The Effects of Mobile Texting and Walking Speed on Gait Characteristics of Normal Weight and Obese Adults

The aim of this study was to examine how usage of mobile devices while simultaneously walking affects walking characteristics and texting performance of normal weight (NW) and obese (OB) individuals. Thirty-two OB (body mass index [BMI] = 34.4) and NW (BMI = 22.7) adults performed two 60-s walking trials at three-step frequencies along a rectangular walkway in two conditions (No Texting and Texting). Dual-task cost as well as unadjusted spatial and temporal gait characteristics were measured. Dual-task costs for the gait parameters as well as texting performance were not different between the groups, except for the lateral step variability showing a larger variability at the preferred frequency in OB individuals. For the unadjusted variables, OB exhibited longer double support, longer stance time, and lower turn velocity compared with NW. Overall, the results highlight a similar dual-task cost for the OB individuals compared with the NW individuals, in spite of underlying differences in gait mechanics.

Gait Characteristics under Imposed Challenge Speed Conditions in Patients with Parkinson's Disease During Overground Walking

Evaluating gait stability at slower or faster speeds and self-preferred speeds based on continuous steps may assist in determining the severity of motor symptoms in Parkinson's disease (PD) patients. This study aimed to investigate the gait ability at imposed speed conditions in PD patients during overground walking. Overall, 74 PD patients and 52 age-matched healthy controls were recruited. Levodopa was administered to patients in the PD group, and all participants completed imposed slower, preferred, and faster speed walking tests along a straight 15-m walkway wearing shoe-type inertial measurement units. Reliability of the slower and faster conditions between the estimated and measured speeds indicated excellent agreement for PD patients and controls. PD patients demonstrated higher gait asymmetry (GA) and coefficient of variance (CV) for stride length and stance phase than the controls at slower speeds and higher CVs for phases for single support, double support, and stance. CV of the double support phase could distinguish between PD patients and controls at faster speeds. The GA and CVs of stride length and phase-related variables were associated with motor symptoms in PD patients. Speed conditions should be considered during gait analysis. Gait variability could evaluate the severity of motor symptoms in PD patients.

The feasibility of using virtual reality to induce mobility-related anxiety during turning

The fear of falling, or mobility-related anxiety, profoundly affects gait, but is challenging to study without risk to participants.

PURPOSE

To determine the efficacy of using virtual reality (VR) to manipulate illusions of height and consequently, elevated mobility-related anxiety when turning. Moreover, we examined if mobility-related anxiety effects decline across time in VR environments as participants habituate.

METHODS

Altogether, 10 healthy participants (five women, mean (standard deviation) age = 28.5 (8.5) years) turned at self-selected and fast speeds on a 2.2 m walkway under two simulated environments: (1) ground elevation; and (2) high elevation (15 m above ground). Peak turning velocity was recorded using inertial sensors and participants rated their cognitive (i.e., worry) and somatic (i.e., tension) anxiety, confidence, and mental effort.

RESULTS

A significant Height × Speed × Trial interaction (p =  0.013) was detected for peak turning velocity. On average, the virtual height illusion decreased peak turning velocity, especially at fast speeds. At low elevation, participants decreased speed across trials, but not significantly (p =  0.381), but at high elevation, they significantly increased speed across trials (p =  0.001). At self-selected speeds, no effects were revealed (all p >  0.188) and only effects for Height were observed for fast speeds (p <  0.001). After turning at high elevation, participants reported greater cognitive (p =  0.008) and somatic anxiety (p =  0.007), reduced confidence (p = 0.021), and greater mental effort (p <  0.001) compared to the low elevation.

CONCLUSION

VR can safely induce mobility-related anxiety during dynamic motor tasks, and habituation effects from repeated exposure should be carefully considered in experimental designs and analysis.

Cognitive performance during gait is worsened by overground but enhanced by treadmill walking

PURPOSE

Walking is an attention-demanding task that affects and is affected by cognitive performance. Since treadmill walking (TW) assists gait automaticity, we have hypothesized that TW affects cognitive performance to a smaller extent than overground walking (OW).

METHODS

Thirty young adults were recruited. Each subject walked overground over a 20-meter straight hallway at three different speeds (slow, normal and fast). Each task was repeated 3 times under Single Task (OW-ST) and Dual Task (OW-DT) condition, in a randomized sequence. DT was a serial subtraction by 7 starting from a different number (> 100) in each trial. Afterwards, each subject walked on the treadmill at the same three speeds as during OW-ST, while performing the dual task (TW-DT). The correct cognitive response (CCR), calculated from the number of correct responses and mistakes, was compared between rest, OW-DT and TW-DT. Dual-task cost (DTC) was calculated for speed and for CCR.

RESULTS

Backward counting diminished normal and fast OW-DT speed by about 15 %. Slow OW-DT speed was not significantly reduced. In turn, OW affected the cognitive performance. DTC for speed during OW-DT increased during normal and fast speed. CCR significantly decreased, more at slower OW-DT speed. Conversely, CCR was not worsened by TW-DT. CCR did not decline at slow TW-DT speed and improved significantly from slow and normal to fast speeds. DTC for CCR resulted smaller in TW-DT than OW-DT.

CONCLUSIONS

Decline in the cognitive performance during OW-DT is more prominent at slow speed, in keeping with higher demand of attentional resources for this unusual locomotor behaviour. Conversely, motorized TW improves the cognitive performance likely because it reduces the attentional cost of walking. Gait training by TW might improve automaticity in patients with movement disorders.

Effects of tai chi on postural control during dual-task stair negotiation in knee osteoarthritis: a randomised controlled trial protocol

INTRODUCTION

Stair ascent and descent require complex integration between sensory and motor systems; individuals with knee osteoarthritis (KOA) have an elevated risk for falls and fall injuries, which may be in part due to poor dynamic postural control during locomotion. Tai chi exercise has been shown to reduce fall risks in the ageing population and is recommended as one of the non-pharmocological therapies for people with KOA. However, neuromuscular mechanisms underlying the benefits of tai chi for persons with KOA are not clearly understood. Postural control deficits in performing a primary motor task may be more pronounced when required to simultaneously attend to a cognitive task. This single-blind, parallel design randomised controlled trial (RCT) aims to evaluate the effects of a 12-week tai chi programme versus balance and postural control training on neuromechanical characteristics during dual-task stair negotiation.

METHODS AND ANALYSIS

Sixty-six participants with KOA will be randomised into either tai chi or balance and postural control training, each at 60 min per session, twice weekly for 12 weeks. Assessed at baseline and 12 weeks (ie, postintervention), the primary outcomes are attention cost and dynamic postural stability during dual-task stair negotiation. Secondary outcomes include balance and proprioception, foot clearances, self-reported symptoms and function. A telephone follow-up to assess symptoms and function will be conducted at 20 weeks. The findings will help determine whether tai chi is beneficial on dynamic stability and in reducing fall risks in older adults with KOA patients in community.

ETHICS AND DISSEMINATION

Ethics approval was obtained from the Ethics Committee of the Affiliated Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine (#2018KY-006-1). Study findings will be disseminated through presentations at scientific conferences or publications in peer-reviewed journals.

TRIAL REGISTRATION NUMBER

ChiCTR1800018028.

Effects of tandem walk and cognitive and motor dual- tasks on gait speed in individuals with chronic idiopathic neck pain: a preliminary study

Introduction: Gait impairment has been associated with neck pain. It is relevant to understand the possible influence of narrow-based walk and an attention-demanding secondary task on gait performance in neck pain.Purpose: To investigate the effects of tandem walk and cognitive and motor dual-tasks on gait speed in persons with chronic idiopathic neck pain (CINP) compared with controls.Methods: A cross-sectional study. Thirty participants with CINP and 30 asymptomatic controls participated in the study. Gait speed was assessed using a timed 10-m walk test at a comfortable pace under four conditions: (1) comfortable walk (as reference); (2) tandem walk (single task); (3) cognitive dual-task walking; and (4) motor dual-task walking. Dual-task interference was calculated.Results: There was no difference in comfortable gait speed between groups (p= 0.40). The CINP group had slower gait speed during the tandem walk than controls (p= 0.02). The dual-task interference on gait speed was not different between groups (p = 0.67 for cognitive, p = 0.93 for motor).Conclusion: Participants with CINP had impaired gait stability during tandem walk. An attention-demanding secondary task did not influence gait speed in individuals with CINP compared to controls. The study suggests that tandem walk could be considered as an assessment tool and part of rehabilitation for neck pain.

Using Music-Based Cadence Entrainment to Manipulate Walking Intensity

BACKGROUND

While previous studies indicate an auditory metronome can entrain cadence (in steps per minute), music may also evoke prescribed cadences and metabolic intensities.

PURPOSE

To determine how modulating the tempo of a single commercial song influences adults' ability to entrain foot strikes while walking and how this entrainment affects metabolic intensity.

METHODS

Twenty healthy adults (10 men and 10 women; mean [SD]: age 23.7 [2.7] y, height 172.8 [9.0] cm, mass 71.5 [16.2] kg) walked overground on a large circular pathway for six 5-min conditions; 3 self-selected speeds (slow, normal, and fast); and 3 trials listening to a song with its tempo modulated to 80, 100, and 125 beats per minute. During music trials, participants were instructed to synchronize their step timing with the music tempo. Cadence was measured via direct observation, and metabolic intensity (metabolic equivalents) was assessed using indirect calorimetry.

RESULTS

Participants entrained their cadences to the music tempos (mean absolute percentage error = 5.3% [5.8%]). Entraining to a music tempo of 100 beats per minute yielded ≥3 metabolic equivalents in 90% of participants. Trials with music entrainment exhibited greater metabolic intensity compared with self-paced trials (repeated-measures analysis of variance, F1,19 = 8.05, P = .01).

CONCLUSION

This study demonstrates the potential for using music to evoke predictable metabolic intensities.

The effect of gait speed and gait phase to the allocation of attention during dual task gait

[Purpose] The purpose of this study was to determine the change of allocation of attention caused by a difference in gait phase and gait speed. We also determined the relationship between attentional demand and gait automaticity change caused by the gait speed alteration. [Subjects and Methods] Ten male participated. Participants were instructed to perform the probe reaction time (RT) task during treadmill walking in four different gait speed conditions (60%, 80%, 100%, and 120% of preferred speed). Walking ratio in each gait speed conditions were calculated, and RTs and walking ratios were compared in each gait speed condition and in the single-support and double-support gait phase. [Results] RTs were significantly delayed with decline of gait speed. Walking ratio was significantly decreased in proportion of decrement of gait speed. There was no difference of gait phase between single-support and double-support phase. [Conclusion] This study showed that relationship between attentional load and deficit of gait automaticity. While gait phase didn't influence attentional demand, and this result showed the characteristics of treadmill gait.

Comparable Cerebral Oxygenation Patterns in Younger and Older Adults during Dual-Task Walking with Increasing Load

The neuroimaging literature on dual-task gait clearly demonstrates increased prefrontal cortex (PFC) involvement when performing a cognitive task while walking. However, findings from direct comparisons of the cerebral oxygenation patterns of younger (YA) and older (OA) adults during dual-task walking are mixed and it is unclear how YA and OA respond to increasing cognitive load (difficulty) while walking. This functional near infra-red (fNIRS) study examined cerebral oxygenation of YA and OA during self-paced dual-task treadmill walking at two different levels of cognitive load (auditory n-back). Changes in accuracy (%) as well as oxygenated (HbO) and deoxygenated (HbR) hemoglobin were examined. For the HbO and HbR measures, eight regions of interest (ROIs) were assessed: the anterior and posterior dorsolateral and ventrolateral PFC (aDLPFC, pDLPFC, aVLPFC, pVLPFC) in each hemisphere. Nineteen YA (M = 21.83 years) and 14 OA (M = 66.85 years) walked at a self-selected pace while performing auditory 1-back and 2-back tasks. Walking alone (single motor: SM) and performing the cognitive tasks alone (single cognitive: SC) were compared to dual-task walking (DT = SM + SC). In the behavioural data, participants were more accurate in the lowest level of load (1-back) compared to the highest (2-back; p < 0.001). YA were more accurate than OA overall (p = 0.009), and particularly in the 2-back task (p = 0.048). In the fNIRS data, both younger and older adults had task effects (SM < DT) in specific ROIs for ΔHbO (three YA, one OA) and ΔHbR (seven YA, eight OA). After controlling for walk speed differences, direct comparisons between YA and OA did not reveal significant age differences, but did reveal a difficulty effect in HbO in the left aDLPFC (p = 0.028) and significant task effects (SM < DT) in HbR for six of the eight ROIs. Findings suggest that YA and OA respond similarly to manipulations of cognitive load when walking on a treadmill at a self-selected pace.

Cognition and gait in older people

Cognitive difficulties and gait abnormalities both increase with age. We review normal and pathologic changes in both gait and cognition in older adults. Gait performance in older individuals is linked to specific cognitive changes, in particular in executive function. Structural and functional assays highlight the shared anatomic control of cognitive and gait function, mostly in the prefrontal cortices. Cognitive impairment can be used to predict incident gait difficulties. Changes in gait, especially decreased gait velocity, may be a harbinger of impending cognitive decline. The combination of slow gait and cognitive complaints (the Motoric Cognitive Risk syndrome) is a powerful new clinical tool to identify those at high risk of developing dementia and therefore may be used to target interventions. Evidence is limited, but cognitive training and targeted physical activity may be useful to mitigate or prevent gait and cognitive decline with age.

Challenging the motor control of walking: Gait variability during slower and faster pace walking conditions in younger and older adults

BACKGROUND

Gait variability is a measure of motor control of gait. Little is known about age-related changes in the motor control of gait (gait variability) during challenging walking conditions, such as slower and faster pace walking.

OBJECTIVE

The purpose of this study was to examine the impact of challenging walking conditions (slower and faster speeds) on gait variability in younger and older adults.

DESIGN

This study was a cross-sectional, observational design.

METHODS

Forty younger (mean age=26.6±6.0years) and 111 community-dwelling older adults (mean age=77.3±6.0years), independent in ambulation, were studied. Gait characteristics were collected using a computerized walkway (GaitMat II™). Step length, step width, step time, swing time, stance time and double support time variability were derived as the standard deviation of all steps across the 4 passes.

RESULTS

Compared to younger, older adults had a significant change in their gait variability from usual to slower in step width (-0.006±0.003), step time (0.028±0.006), swing time (0.023±0.004), stance time (0.042±0.008), and double support time (0.024±0.005). Changes in gait variability from usual to faster were not significantly different between younger and older adults.

LIMITATION

Gait variability was examined during self-selected over-ground walking, where subjects directed to walk "slower", "usual" and "faster".

CONCLUSIONS

Walking slowly is more challenging to the motor control of gait and may be more sensitive to age-related declines in gait than usual and faster speed walks.

Does providing real-time augmented feedback affect the performance of repeated lower limb loading to exhaustion?

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.