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Vickery-Howe DM, Drain JR, Clarke AC, Dascombe BJ, Hoolihan B, Middleton KJ. The effect of weapon handling during load carriage across a range of military-relevant walking speeds. ERGONOMICS 2024:1-13. [PMID: 39264271 DOI: 10.1080/00140139.2024.2400125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 08/28/2024] [Indexed: 09/13/2024]
Abstract
This study investigated the effects of weapon handling on the physiological responses and walking-gait kinematics during load carriage. Seventeen soldiers completed four twelve-minute bouts of treadmill walking at incremental speeds (3.5, 5.5, 6.5 km.h-1 and self-selected) carrying 23.2-kg of additional load, while either handling a weapon or not handling a weapon. Physiological, perceptual and biomechanical outcomes were measured throughout each trial. A weapon-by-speed interaction (p < .05) was observed for hip flexion-extension during loading response and mid-swing. Weapon handling elevated (p < .05) cardiorespiratory responses at 6.5 km.h-1. Main effects (p < .05) of weapon handling were observed for ventilation, oxygen pulse, effort perception, stride length and knee flexion-extension during toe-off. No main effects of weapon handling were observed for any other biomechanical measures. These findings demonstrate that physiological and biomechanical responses to weapon handling are likely walking-speed dependent.Practitioner summary: Weapon handling is an important part of many load-carriage tasks but is rarely investigated. Physiological and biomechanical responses were assessed at incremental speeds during load carriage. Despite similar biomechanics, there was greater physiological demands at faster walking speeds, suggesting an increased contribution from isometric muscle contractions for weapon stabilisation.
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Affiliation(s)
- Danielle M Vickery-Howe
- Sport Performance and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Jace R Drain
- Human and Decision Sciences Division, Defence Science and Technology Group, Fishermans Bend, Australia
| | - Anthea C Clarke
- Sport Performance and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Ben J Dascombe
- School of Health Sciences, Western Sydney University, Campbelltown, Australia
- Applied Sport Science and Exercise Testing Laboratory, School of Life and Environmental Sciences, University of Newcastle, Ourimbah, Australia
| | - Brooke Hoolihan
- Applied Sport Science and Exercise Testing Laboratory, School of Life and Environmental Sciences, University of Newcastle, Ourimbah, Australia
| | - Kane J Middleton
- Sport Performance and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
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Song C, Wang L, Ding J, Xu C, Yang H, Mao Y. Effect of Upper Limb Repetitive Facilitative Exercise on Gait of Stroke Patients based on Artificial Intelligence and Computer Vision Evaluation. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2024; 24:301-309. [PMID: 39219328 PMCID: PMC11367173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Accepted: 04/29/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVE This study aims to assess how enhancing upper limb function on the affected side of stroke influences the gait of the lower limb. METHODS Forty eligible stroke patients were randomly assigned to either a control group or a treatment group, with 20 patients in each group. Both groups underwent dynamic evaluation using artificial intelligence and computer vision before treatment. This evaluation focused on analyzing the range of motion of the shoulder and elbow during the gait cycle, as well as various gait parameters (such as step length, step speed, and percentage of stance phase) on the affected side. Following evaluation, the control group received routine rehabilitation treatment. RESULTS The results indicated that there was no significant difference between the two groups before treatment. However, following treatment, there was a notable improvement in the motion of the shoulder and elbow joints on the affected side among patients in the treatment group (p<0.05), whereas the control group showed only slight improvement, which was not statistically significant (p>0.05). CONCLUSION The improvement in upper limb function on the affected side also appears to positively influence gait recovery. However, it's important to note that the observation period was relatively short. Further studies are needed to confirm whether this effect is sustained over the long term.
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Affiliation(s)
- Caiping Song
- Department of Rehabilitation, the First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, Zhejiang, China
| | - Lingcong Wang
- Department of Rehabilitation, the First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, Zhejiang, China
| | - Jianhui Ding
- Beijing Fushu Health Technology Co., LTD, Beijing, China
| | - Cui Xu
- Department of Rehabilitation, the First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, Zhejiang, China
| | - Hang Yang
- Department of Rehabilitation, the First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, Zhejiang, China
| | - Yajun Mao
- Department of Rehabilitation, the First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, Zhejiang, China
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Dunn JA, Gomez NG, Wong B, Sinclair SK, Henninger HB, Foreman KB, Bachus KN. Transhumeral prosthesis use affects upper body kinematics and kinetics. Gait Posture 2024; 112:59-66. [PMID: 38744022 DOI: 10.1016/j.gaitpost.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 05/03/2024] [Accepted: 05/08/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Transhumeral (TH) limb loss leads to loss of body mass and reduced shoulder range of motion. Despite most owning a prosthesis, prosthesis abandonment is common. The consequence of TH limb loss and prosthesis use and disuse during gait may be compensation in the upper body, contributing to back pain or injury. Understanding the impact of not wearing a TH prosthesis on upper body asymmetries and spatial-temporal aspects of gait will inform how TH prosthesis use and disuse affects the body. RESEARCH QUESTION Does TH limb loss alter upper body asymmetries and spatial-temporal parameters during gait when wearing and not wearing a prosthesis compared to able-bodied controls? METHODS Eight male TH limb loss participants and eight male control participants completed three gait trials at self-selected speeds. The TH limb loss group performed trials with and without their prosthesis. Arm swing, trunk angular displacement, trunk-pelvis moment, and spatial-temporal aspects were compared using non-parametric statistical analyses. RESULTS Both TH walking conditions showed greater arm swing in the intact limb compared to the residual (p≤0.001), resulting in increased asymmetry compared to the control group (p≤0.001). Without the prosthesis, there was less trunk flexion and lateral flexion compared to the control group (p≤0.001). Maximum moments between the trunk and pelvis were higher in the TH group than the control group (p≤0.05). Spatial-temporal parameters of gait did not differ between the control group and either TH limb loss condition. SIGNIFICANCE Prosthesis use affects upper body kinematics and kinetics, but does not significantly impact spatial-temporal aspects of gait, suggesting these are compensatory actions. Wearing a prosthesis helps achieve more normative upper body kinematics and kinetics than not wearing a prosthesis, which may help limit back pain. These findings emphasize the importance of encouraging at least passive use of prostheses for individuals with TH limb loss.
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Affiliation(s)
- Julia A Dunn
- Department of Biomedical Engineering University of Utah, 36 S Wasatch Dr, Salt Lake City, UT 84112, USA; Department of Orthopaedics University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
| | - Nicholas G Gomez
- Department of Physical Therapy and Athletic Training University of Utah, 520 Wakara Way, Salt Lake City, UT 84108, USA; College of Health, Human Services & Nursing California State University, 1000 E. Victoria Street, Carson, CA 90747, USA
| | - Bob Wong
- College of Nursing University of Utah, 10 2000 E, Salt Lake City, UT 84112, USA
| | - Sarina K Sinclair
- Department of Orthopaedics University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA; Department of Veterans Affairs, 500 Foothill Boulevard, Salt Lake City, UT 84148, USA
| | - Heath B Henninger
- Department of Biomedical Engineering University of Utah, 36 S Wasatch Dr, Salt Lake City, UT 84112, USA; Department of Orthopaedics University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
| | - K Bo Foreman
- Department of Orthopaedics University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA; Department of Physical Therapy and Athletic Training University of Utah, 520 Wakara Way, Salt Lake City, UT 84108, USA
| | - Kent N Bachus
- Department of Biomedical Engineering University of Utah, 36 S Wasatch Dr, Salt Lake City, UT 84112, USA; Department of Orthopaedics University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA; Department of Veterans Affairs, 500 Foothill Boulevard, Salt Lake City, UT 84148, USA.
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Arellano CJ, Vega D. Exploring How the Arms Can Help the Legs in Facilitating Gait Rehabilitation. Adv Biol (Weinh) 2024; 8:e2300661. [PMID: 38519429 DOI: 10.1002/adbi.202300661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 02/26/2024] [Indexed: 03/24/2024]
Abstract
Inspired by the ideas from the fields of gait rehabilitation, neuroscience, and locomotion biomechanics and energetics, a body of work is reviewed that has led to propose a conceptual framework for novel "self-assistive" walking devices that could further promote walking recovery from incomplete spinal cord injuries. The underlying rationale is based on a neural coupling mechanism that governs the coordinated movements of the arms and legs during walking, and that the excitability of these neural pathways can be exploited by actively engaging the arms during locomotor training. Self-assistive treadmill walking rehabilitation devices are envisioned as an approach that would allow an individual to actively use their arms to help the legs during walking. It is hoped that the conceptual framework inspires the design and use of self-assistive walking devices that are tailored to assist individuals with an incomplete spinal cord injury to regain their functional walking ability.
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Affiliation(s)
- Christopher J Arellano
- Department of Orthopaedic Surgery, University of Arizona, Tucson, AZ, 85724, USA
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, 85721, USA
| | - Daisey Vega
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, 85721, USA
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Radosavovic I, Xiao T, Zhang B, Darrell T, Malik J, Sreenath K. Real-world humanoid locomotion with reinforcement learning. Sci Robot 2024; 9:eadi9579. [PMID: 38630806 DOI: 10.1126/scirobotics.adi9579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 03/26/2024] [Indexed: 04/19/2024]
Abstract
Humanoid robots that can autonomously operate in diverse environments have the potential to help address labor shortages in factories, assist elderly at home, and colonize new planets. Although classical controllers for humanoid robots have shown impressive results in a number of settings, they are challenging to generalize and adapt to new environments. Here, we present a fully learning-based approach for real-world humanoid locomotion. Our controller is a causal transformer that takes the history of proprioceptive observations and actions as input and predicts the next action. We hypothesized that the observation-action history contains useful information about the world that a powerful transformer model can use to adapt its behavior in context, without updating its weights. We trained our model with large-scale model-free reinforcement learning on an ensemble of randomized environments in simulation and deployed it to the real-world zero-shot. Our controller could walk over various outdoor terrains, was robust to external disturbances, and could adapt in context.
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Affiliation(s)
| | - Tete Xiao
- University of California, Berkeley CA, USA
| | - Bike Zhang
- University of California, Berkeley CA, USA
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Vanderlelie L, Bosich S, O'Grady H, Azizi K, Lally J, Micks S, Sandhu S, Whyte B, Kho ME. Arm cycle ergometry in critically ill patients: A systematic review. Aust Crit Care 2024:S1036-7314(24)00024-9. [PMID: 38580486 DOI: 10.1016/j.aucc.2024.01.008] [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: 09/30/2023] [Revised: 12/14/2023] [Accepted: 01/21/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Intensive care unit (ICU) survivors face functional limitations due to ICU-acquired weakness. Arm cycle ergometry (ACE) introduced in the ICU may improve physical function. To our knowledge, there is limited evidence on the effectiveness of ACE and physical function outcomes in critically ill patients. OBJECTIVE The objective of this systematic review was to examine the impact of ICU-based ACE on physical function, safety, and other clinical outcomes. REVIEW METHOD USED Systematic Review. DATA SOURCES A search of seven databases was conducted from the inception to January 1, 2023: Medline Ahead of Print, Ovid MEDLINE(R), Allied and Complementary Medicine Database (AMED), Embase, Cochrane Central, Physiotherapy Evidence Database, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). REVIEW METHODS We included two arm studies of critically ill adults admitted to the ICU who received ACE and any comparator for our primary outcome, physical function. Our secondary outcomes included severe events. We included safety studies with or without a comparator group. Screening, data abstraction, and risk-of-bias assessments were completed independently, in duplicate. We used the Grading of Recommendations, Assessment, Development, and Evaluation approach to assess the overall certainty of evidence. RESULTS We screened 651 citations and included eight studies that enrolled 183 patients. Due to heterogeneity, meta-analysis was not performed. For our primary outcome, one randomised controlled trial found significant improvements in physical function, measured by the Barthel Index with ACE, whereas a nonrandomised study showed no difference. Out of the six studies reporting safety, none reported any severe safety events. The overall certainty of evidence was very low. CONCLUSION ACE initiated in the ICU is a likely safe intervention. Based on the limited ACE studies and heterogeneity between studies, further research with more rigorous studies evaluating important outcomes for patients is needed.
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Affiliation(s)
- Lauren Vanderlelie
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada.
| | - Sandra Bosich
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Heather O'Grady
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Karim Azizi
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Jasdeep Lally
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Sarah Micks
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Saheb Sandhu
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Bailey Whyte
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Michelle E Kho
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada; St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.
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Moon SJ, Han SY, Park DH. The Effects of Proprioceptive Neuromuscular Facilitation Pattern Kinesio Taping on Arm Swing, Balance, and Gait Parameters among Chronic Stroke Patients: A Randomized Controlled Trial. Life (Basel) 2024; 14:242. [PMID: 38398751 PMCID: PMC10890237 DOI: 10.3390/life14020242] [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: 01/02/2024] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
(1) Background: This study aimed to investigate the effects of proprioceptive neuromuscular facilitation pattern kinesio taping on arm swing, balance, and gait parameters among chronic stroke patients. (2) Methods: Twenty-eight participants were randomized into proprioceptive neuromuscular facilitation pattern kinesio taping during gait training (n = 14) and gait training (n = 14) groups. The proprioceptive neuromuscular facilitation pattern kinesio taping during gait training group employed proprioceptive neuromuscular facilitation pattern kinesio taping during 15 min treadmill-based gait training five times a week for four weeks, while the gait training group underwent the same gait training without proprioceptive neuromuscular facilitation pattern kinesio taping. Arm swing angle was measured using the Image J program, static balance was assessed with an AMTI force plate, dynamic balance was evaluated through the Timed Up and Go test, and gait parameters were recorded using the GAITRite system and the Dynamic Gait Index. (3) Results: After 4 weeks of training, the proprioceptive neuromuscular facilitation pattern kinesio taping during gait training group exhibited significant improvements in all variables compared to the baseline (p < 0.05), whereas the gait training group did not show statistically significant differences in any variables (p > 0.05). (4) Conclusions: This study demonstrates the effectiveness of proprioceptive neuromuscular facilitation pattern kinesio taping during gait training in enhancing arm swing angle, balance, and gait parameters.
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Affiliation(s)
| | | | - Dong-Hwan Park
- Department of Physical Therapy, Graduate School, College of Health Science, Kyungnam University, Changwon-si 51767, Republic of Korea; (S.-J.M.); (S.-Y.H.)
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Espinoza-Araneda J, Caparrós-Manosalva C, Caballero PM, da Cunha MJ, Marchese RR, Pagnussat AS. Arm swing asymmetry in people with Parkinson's disease and its relationship with gait: A systematic review and meta-analysis. Braz J Phys Ther 2023; 27:100559. [PMID: 37980716 PMCID: PMC10695845 DOI: 10.1016/j.bjpt.2023.100559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 10/16/2023] [Accepted: 10/25/2023] [Indexed: 11/21/2023] Open
Abstract
BACKGROUND Individuals with Parkinson's disease present arm swing alterations that can adversely affect their locomotion. OBJECTIVE To identify differences in arm swing asymmetry (ASA) between individuals with Parkinson's disease (PD) and healthy individuals and to investigate the relationship between ASA, temporal-spatial gait parameters, and disease progression. METHODS A literature search was conducted in PubMed, Scopus, ProQuest, Web of Science, and EBSCOhost up to February 2023. Cross-sectional studies evaluating parameters of arm swing (AS) and ASA were included. Methodological quality was assessed using the Critical Appraisal Checklist, and the quality of the evidence was measured with a modified Grading of Recommendations Assessment, Development, and Evaluation. RESULTS Fourteen studies were included in the systematic review (1130 participants). Irrespective of the medication phase (ON or OFF) and the type of walk test employed, the meta-analysis showed moderate-quality evidence that individuals with PD have increased ASA amplitude (SMD = 0.84; 95% CI: 0.69, 0.99; I²= 0%).Very low-quality evidence suggests higher ASA velocity (SMD=0.64; 95% CI: 0.24, 1.05; I²=59%) and lower AS amplitude on both the most affected (ES = -1.99, 95% CI: -3.04, -0.94, I2: 91%) and the least affected sides (ES = -0.75, 95% CI: -1.05, -0.44; I²=66%). Meta-regression indicated that ASA is inversely related to disease duration (Z: -2.4892, P< 0.05) and motor symptoms progression (Z: -2.1336, P< 0.05). CONCLUSIONS Regardless of the medication phase and the type of walk test employed, individuals with PD exhibited greater ASA and decreased AS amplitude than healthy individuals. ASA decreases as the disease progresses and symptoms worsen.
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Affiliation(s)
- Jessica Espinoza-Araneda
- Rehabilitation Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil; Department of Human Movement Sciences, Faculty of Health Sciences, University of Talca, Talca, Chile
| | - Cristian Caparrós-Manosalva
- Rehabilitation Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil; Department of Human Movement Sciences, Faculty of Health Sciences, University of Talca, Talca, Chile
| | - Paula M Caballero
- Department of Human Movement Sciences, Faculty of Health Sciences, University of Talca, Talca, Chile
| | - Maira J da Cunha
- Rehabilitation Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil; Movement Analysis and Neurological Rehabilitation Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre, UFCSPA, Porto Alegre, RS, Brazil
| | - Ritchele R Marchese
- Rehabilitation Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil; Movement Analysis and Neurological Rehabilitation Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre, UFCSPA, Porto Alegre, RS, Brazil
| | - Aline S Pagnussat
- Rehabilitation Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil; Movement Analysis and Neurological Rehabilitation Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre, UFCSPA, Porto Alegre, RS, Brazil.
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Pimentel RE, Sawicki GS, Franz JR. Simulations suggest walking with reduced propulsive force would not mitigate the energetic consequences of lower tendon stiffness. PLoS One 2023; 18:e0293331. [PMID: 37883368 PMCID: PMC10602298 DOI: 10.1371/journal.pone.0293331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023] Open
Abstract
Aging elicits numerous effects that impact both musculoskeletal structure and walking function. Tendon stiffness (kT) and push-off propulsive force (FP) both impact the metabolic cost of walking and are diminished by age, yet their interaction has not been studied. We combined experimental and computational approaches to investigate whether age-related changes in function (adopting smaller FP) may be adopted to mitigate the metabolic consequences arising from changes in structure (reduced kT). We recruited 12 young adults and asked them to walk on a force-sensing treadmill while prompting them to change FP (±20% & ±40% of typical) using targeted biofeedback. In models driven by experimental data from each of those conditions, we altered the kT of personalized musculoskeletal models across a physiological range (2-8% strain) and simulated individual-muscle metabolic costs for each kT and FP combination. We found that kT and FP independently affect walking metabolic cost, increasing with higher kT or as participants deviated from their typical FP. Our results show no evidence for an interaction between kT and FP in younger adults walking at fixed speeds. We also reveal complex individual muscle responses to the kT and FP landscape. For example, although total metabolic cost increased by 5% on average with combined reductions in kT and FP, the triceps surae muscles experienced a 7% local cost reduction on average. Our simulations suggest that reducing FP during walking would not mitigate the metabolic consequences of lower kT. Wearable devices and rehabilitative strategies can focus on either kT or FP to reduce age-related increases in walking metabolic cost.
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Affiliation(s)
- Richard E. Pimentel
- Joint Department of Biomedical Engineering, UNC Chapel Hill and NC State University, Chapel Hill, North Carolina, United States of America
| | - Gregory S. Sawicki
- Georgia Institute of Technology, George W. Woodruff School of Mechanical Engineering, Atlanta, Georgia, United States of America
- Georgia Institute of Technology, School of Biological Sciences, Atlanta, Georgia, United States of America
| | - Jason R. Franz
- Joint Department of Biomedical Engineering, UNC Chapel Hill and NC State University, Chapel Hill, North Carolina, United States of America
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Ho JSW, Ko KSY, Law SW, Man GCW. The effectiveness of robotic-assisted upper limb rehabilitation to improve upper limb function in patients with cervical spinal cord injuries: a systematic literature review. Front Neurol 2023; 14:1126755. [PMID: 37621855 PMCID: PMC10445651 DOI: 10.3389/fneur.2023.1126755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 07/26/2023] [Indexed: 08/26/2023] Open
Abstract
Background Spinal Cord Injury (SCI) damages corticospinal tracts and descending motor pathways responsible for transmitting signals from the brain to the spinal cord, leading to temporary or permanent changes in sensation, motor function, strength, and body function below the site of injury. Cervical SCI (cSCI), which leads to tetraplegia, causes severe functional upper limb (UL) impairments that increase falls risk, limits independence, and leads to difficulties with activities of daily living (ADLs). Robotic therapy (RT) has been developed in recent decades as a new treatment approach for people with cervical spinal cord injuries (cSCI). The present review aimed to explore current available evidence and studies regarding the effectiveness of RT for individuals with cSCI in improving UL function, identify current research gaps and future research directions. Method This review was conducted by searching PubMed, CINAHL, Medline, Embase, and APA PsycInfo for relevant studies published from January 2010 to January 2022. Selected studies were analyzed with a focus on the patients' self-perception of limited UL function and level of independence in activities of daily living. In addition, the JBI Critical Appraisal checklist was used to assess study quality. Results A total of 7 articles involving 87 patients (74 males and 13 females) were included in the analysis, with four studies utilizing exoskeleton and three studies utilizing end-effector robotic devices, respectively. The quality of these studies varied between JBI Critical Appraisal scores of 4 to 8. Several studies lacked blinding and a control group which affected internal validity. Nevertheless, four out of seven studies demonstrated statistically significant improvements in outcome measurements on UL function and strength after RT. Conclusion This review provided mixed evidence regarding the effectiveness of RT as a promising intervention approach to improve upper limb function in participants with cSCI. Although RT was shown to be safe, feasible, and reduces active therapist time, further research on the long-term effects of UL RT is still needed. Nevertheless, this review serves as a useful reference for researchers to further develop exoskeletons with practical and plausible applications toward geriatric orthopaedics.
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Yu X, Wang HJ, Zhen QX, Zhang QR, Yan HJ, Zhen Y, An X, Xi JN, Qie SY, Fang BY. Added forearm weights for gait pattern normalization in patients with Parkinson's disease. J Clin Neurosci 2023; 114:17-24. [PMID: 37276741 DOI: 10.1016/j.jocn.2023.05.025] [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: 03/30/2023] [Revised: 05/11/2023] [Accepted: 05/29/2023] [Indexed: 06/07/2023]
Abstract
Patients with Parkinson's Disease presented gait impairment. Applying additional weights to enhancing sensory input may improve gait impairment. We assumed that gait impairment could be improved when patients walked with additional forearm weights, and the gait improvement was associated with clinical characteristic of Parkinson's Disease. Thirty patients with Parkinson's Disease and 30 age-sex matched controls were recruited. Spatiotemporal and joint kinematics parameters were evaluated by a three-dimensional motion capture system in normal walking and walking with sandbags, respectively. The comparisons of spatiotemporal parameters were analyzed using t-test or nonparametric tests. The comparison of joint kinematic data was analyzed using statistical parametric mapping. The correlation between motor symptom and gait parameters changes was analyzed using Pearson's correlation analysis. During normal walking, patients showed deteriorated gait compared with controls. After applying weights to forearms patients increased cadence (p = 0.004), speed (p < 0.001) and step length (p = 0.048), and decreased stride time (p = 0.003). The hip angles significantly increased during 5%-23% and 87%-100% of gait cycle, while knee angles during 9%-25% and 88%-98% of the gait cycle, and ankle angles in 92%-100% of gait cycle. The gait parameters of patients with forearm-loading showed no significant difference compared with healthy subjects walking normally. The change of gait parameters correlated positively with the axial and tremor severity while correlated negatively with the rigidity sub-score. Patients with tremor dominant subtype also showed greater improvement of speed and step time compared with patients with postural instability/gait difficulty subtype. Applying added weights bilaterally to the forearms of patients can normalize gait patterns. Notably, patients with higher scores on axial and tremor and lower rigidity scores gained more benefits.
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Affiliation(s)
- Xin Yu
- Beijing Rehabilitation Medical College, Capital Medical University, Beijing, China
| | - Hu-Jun Wang
- Rehabilitation Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Qiao-Xia Zhen
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Qiao-Rong Zhang
- Rehabilitation Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Hong-Jiao Yan
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Yi Zhen
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Xia An
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Jia-Ning Xi
- Department of Respiratory Rehabilitation Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Shu-Yan Qie
- Rehabilitation Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China.
| | - Bo-Yan Fang
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China.
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Vucic S, Stanley Chen KH, Kiernan MC, Hallett M, Benninger DH, Di Lazzaro V, Rossini PM, Benussi A, Berardelli A, Currà A, Krieg SM, Lefaucheur JP, Long Lo Y, Macdonell RA, Massimini M, Rosanova M, Picht T, Stinear CM, Paulus W, Ugawa Y, Ziemann U, Chen R. Clinical diagnostic utility of transcranial magnetic stimulation in neurological disorders. Updated report of an IFCN committee. Clin Neurophysiol 2023; 150:131-175. [PMID: 37068329 PMCID: PMC10192339 DOI: 10.1016/j.clinph.2023.03.010] [Citation(s) in RCA: 55] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/28/2023] [Accepted: 03/09/2023] [Indexed: 03/31/2023]
Abstract
The review provides a comprehensive update (previous report: Chen R, Cros D, Curra A, Di Lazzaro V, Lefaucheur JP, Magistris MR, et al. The clinical diagnostic utility of transcranial magnetic stimulation: report of an IFCN committee. Clin Neurophysiol 2008;119(3):504-32) on clinical diagnostic utility of transcranial magnetic stimulation (TMS) in neurological diseases. Most TMS measures rely on stimulation of motor cortex and recording of motor evoked potentials. Paired-pulse TMS techniques, incorporating conventional amplitude-based and threshold tracking, have established clinical utility in neurodegenerative, movement, episodic (epilepsy, migraines), chronic pain and functional diseases. Cortical hyperexcitability has emerged as a diagnostic aid in amyotrophic lateral sclerosis. Single-pulse TMS measures are of utility in stroke, and myelopathy even in the absence of radiological changes. Short-latency afferent inhibition, related to central cholinergic transmission, is reduced in Alzheimer's disease. The triple stimulation technique (TST) may enhance diagnostic utility of conventional TMS measures to detect upper motor neuron involvement. The recording of motor evoked potentials can be used to perform functional mapping of the motor cortex or in preoperative assessment of eloquent brain regions before surgical resection of brain tumors. TMS exhibits utility in assessing lumbosacral/cervical nerve root function, especially in demyelinating neuropathies, and may be of utility in localizing the site of facial nerve palsies. TMS measures also have high sensitivity in detecting subclinical corticospinal lesions in multiple sclerosis. Abnormalities in central motor conduction time or TST correlate with motor impairment and disability in MS. Cerebellar stimulation may detect lesions in the cerebellum or cerebello-dentato-thalamo-motor cortical pathways. Combining TMS with electroencephalography, provides a novel method to measure parameters altered in neurological disorders, including cortical excitability, effective connectivity, and response complexity.
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Affiliation(s)
- Steve Vucic
- Brain, Nerve Research Center, The University of Sydney, Sydney, Australia.
| | - Kai-Hsiang Stanley Chen
- Department of Neurology, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Matthew C Kiernan
- Brain and Mind Centre, The University of Sydney; and Department of Neurology, Royal Prince Alfred Hospital, Australia
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health, Bethesda, Maryland, United States
| | - David H Benninger
- Department of Neurology, University Hospital of Lausanne (CHUV), Switzerland
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, University Campus Bio-Medico of Rome, Rome, Italy
| | - Paolo M Rossini
- Department of Neurosci & Neurorehab IRCCS San Raffaele-Rome, Italy
| | - Alberto Benussi
- Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Alfredo Berardelli
- IRCCS Neuromed, Pozzilli; Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Antonio Currà
- Department of Medico-Surgical Sciences and Biotechnologies, Alfredo Fiorini Hospital, Sapienza University of Rome, Terracina, LT, Italy
| | - Sandro M Krieg
- Department of Neurosurgery, Technical University Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany
| | - Jean-Pascal Lefaucheur
- Univ Paris Est Creteil, EA4391, ENT, Créteil, France; Clinical Neurophysiology Unit, Henri Mondor Hospital, AP-HP, Créteil, France
| | - Yew Long Lo
- Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Singapore, and Duke-NUS Medical School, Singapore
| | | | - Marcello Massimini
- Dipartimento di Scienze Biomediche e Cliniche, Università degli Studi di Milano, Milan, Italy; Istituto Di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Mario Rosanova
- Department of Biomedical and Clinical Sciences University of Milan, Milan, Italy
| | - Thomas Picht
- Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Cluster of Excellence: "Matters of Activity. Image Space Material," Humboldt University, Berlin Simulation and Training Center (BeST), Charité-Universitätsmedizin Berlin, Germany
| | - Cathy M Stinear
- Department of Medicine Waipapa Taumata Rau, University of Auckland, Auckland, Aotearoa, New Zealand
| | - Walter Paulus
- Department of Neurology, Ludwig-Maximilians-Universität München, München, Germany
| | - Yoshikazu Ugawa
- Department of Human Neurophysiology, School of Medicine, Fukushima Medical University, Japan
| | - Ulf Ziemann
- Department of Neurology and Stroke, Eberhard Karls University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany; Hertie Institute for Clinical Brain Research, Eberhard Karls University of Tübingen, Otfried-Müller-Straße 27, 72076 Tübingen, Germany
| | - Robert Chen
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital-UHN, Division of Neurology-University of Toronto, Toronto Canada
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13
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Negishi T, Ogihara N. Functional significance of vertical free moment for generation of human bipedal walking. Sci Rep 2023; 13:6894. [PMID: 37106093 PMCID: PMC10140179 DOI: 10.1038/s41598-023-34153-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 04/25/2023] [Indexed: 04/29/2023] Open
Abstract
In human bipedal walking, the plantar surface of the foot is in contact with the floor surface, so that a vertical free moment (VFM), a torque about a vertical axis acting at the centre-of-pressure due to friction between the foot and the ground, is generated and applied to the foot. The present study investigated the functional significance of the VFM in the mechanics and evolution of human bipedal walking by analysing kinematics and kinetics of human walking when the VFM is selectively eliminated using point-contact shoes. When the VFM was selectively eliminated during walking, the thorax and pelvis axially rotated in-phase, as opposed to normal out-of-phase rotation. The amplitudes of the axial rotation also significantly increased, indicating that the VFM greatly contributes to stable and efficient bipedal walking. However, such changes in the trunk movement occurred only when arm swing was restricted, suggesting that the VFM is critical only when arm swing is restrained. Therefore, the human plantigrade foot capable of generating large VFM is possibly adaptive for bipedal walking with carrying food, corroborating with the so-called provisioning hypothesis that food carrying in the early hominins is a selective pressure for the evolution of human bipedalism.
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Affiliation(s)
- Takuo Negishi
- Department of Biological Sciences, Graduate School of Science, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Naomichi Ogihara
- Department of Biological Sciences, Graduate School of Science, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
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14
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Martins VF, Gomeñuka NA, Correale L, Martinez FG, Buzzachera CF, Gonçalves AK, Peyré-Tartaruga LA. Effects of aging on arm coordination at different walking speeds. Gait Posture 2023; 103:6-11. [PMID: 37075555 DOI: 10.1016/j.gaitpost.2023.04.012] [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: 10/26/2022] [Revised: 03/19/2023] [Accepted: 04/13/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND Previous work has shown that the mean continuous relative phase and coordination variability of lower limbs are modified in older adults when walking. RESEARCH QUESTION Here, we propose to understand the extent to which such control mechanisms for upper limbs are present during gait. Specifically, we seek to understand if aging and gait speed constraints influence the interjoint control of upper limbs during walking. METHODS This observational study evaluated thirty-three participants, divided into older (n = 20, age 66.4 ± 4.3 years; mass: 77.2 ± 14.2 kg; height: 165 ± 9.20 cm) and young adults (n = 13, age 29.5 ± 4.7 years; mass 75.5 ± 9.6 kg; height: 172 ± 6.24 cm) were asked to walk at 0.28, 0.83, 1.38 m.s-1 on a level treadmill while their segmental movements were simultaneously registered with 3D motion capture system. We calculated the mean continuous relative phase and coordination variability (continuous relative phase variability) in elbow-shoulder and shoulder-hip pairs, and a generalized estimating equation was used to test the main and interaction effects of age and speed. RESULTS Older adults had a reduced continuous relative phase (more in-phase coordination) of upper limbs at whole stance for elbow-shoulder, at loading response for shoulder-hip, at mid-stance and terminal stance for elbow-shoulder and shoulder-hip in comparison to young adults at different speeds (p < 0.05). The coordination variability of upper limbs was greater (higher continuous relative phase variability) in older than young adults at 0.28 and 1.38 m.s-1. SIGNIFICANCE These findings substantiate the altered motor control role of upper limbs in gait aging, suggesting that lower self-selected speed may be related to the reduced ability to control arm movement during the intermediate phases of gait.
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Affiliation(s)
- Valéria Feijó Martins
- LaBiodin Biodynamics Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Luca Correale
- Department of Public Health, Experimental Medicine and Forensic Sciences, University of Pavia, Pavia, Italy
| | - Flávia Gomes Martinez
- LaBiodin Biodynamics Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Cosme Franklim Buzzachera
- Department of Public Health, Experimental Medicine and Forensic Sciences, University of Pavia, Pavia, Italy
| | - Andréa Kruger Gonçalves
- LaBiodin Biodynamics Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Leonardo Alexandre Peyré-Tartaruga
- LaBiodin Biodynamics Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
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15
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Brinkerhoff SA, Murrah WM, Roper JA. The relationship between gait speed and mediolateral stability depends on a person's preferred speed. Sci Rep 2023; 13:6056. [PMID: 37055464 PMCID: PMC10102176 DOI: 10.1038/s41598-023-32948-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 04/05/2023] [Indexed: 04/15/2023] Open
Abstract
Mediolateral stability during walking requires active control and is complex. Step width, a proxy for stability, follows a curvilinear relationship as gait speeds increase. However, despite the complexity of maintenance for stability, no study has yet investigated the variation across individuals of the relationship between speed and step width. The purpose of this study was to determine if variation between adults affects the estimation of the relationship between speed and step width. Participants walked on a pressurized walkway 72 times. Gait speed and step width were measured within each trial. Mixed effects models assessed the relationship between gait speed and step width, and the variability in the relationship across participants. The relationship between speed and step width followed a reverse J-curve on average, but the relationship was moderated by participants' preferred speed. Step width response as speed increases is not homogenous in adults. This finding suggests that "appropriate" stability moderation (tested across a range of speeds) differs as a function of an individual's preferred speed. Mediolateral stability is complex, and further research to elucidate individual factors contributing to variation is needed.
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Affiliation(s)
| | - William M Murrah
- Department of Educational Foundations, Leadership, and Technology, Auburn University, Auburn, AL, USA
| | - Jaimie A Roper
- School of Kinesiology, Auburn University, Auburn, AL, USA.
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16
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Courter RJ, Alvarez E, Enoka RM, Ahmed AA. Metabolic costs of walking and arm reaching in persons with mild multiple sclerosis. J Neurophysiol 2023; 129:819-832. [PMID: 36883754 PMCID: PMC10085565 DOI: 10.1152/jn.00373.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 02/06/2023] [Accepted: 02/28/2023] [Indexed: 03/09/2023] Open
Abstract
Movement slowness is a common and disruptive symptom of multiple sclerosis (MS). A potential cause is that individuals with MS slow down to conserve energy as a behavioral adjustment to heightened metabolic costs of movement. To investigate this prospect, we measured the metabolic costs of both walking and seated arm reaching at five speeds in persons with mild MS (pwMS; n = 13; 46.0 ± 7.7 yr) and sex- and age-matched controls (HCs; n = 13; 45.8 ± 7.8 yr). Notably, the cohort of pwMS was highly mobile and no individuals required a cane or aid when walking. We found that the net metabolic power of walking was approximately 20% higher for pwMS across all speeds (P = 0.0185). In contrast, we found no differences in the gross power of reaching between pwMS and HCs (P = 0.492). Collectively, our results suggest that abnormal slowness of movement in MS-particularly reaching-is not the consequence of heightened effort costs and that other sensorimotor mechanisms are playing a considerable role in slowing.NEW & NOTEWORTHY Individuals with multiple sclerosis (MS) often move more slowly than those without the disease. A possible cause is that movements in MS are more energetically expensive and slowing is an adaptation to conserve metabolic resources. Here, we find that while walking is more costly for persons with MS, arm-reaching movements are not. These results bring into question the driving force of movement slowness in MS and implicate other motor-related networks contributing to slowing.
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Affiliation(s)
- Robert J Courter
- Department of Integrative Physiology, University of Colorado, Boulder, Colorado, United States
- Department of Mechanical Engineering, University of Colorado, Colorado, Boulder, United States
| | - Enrique Alvarez
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Roger M Enoka
- Department of Integrative Physiology, University of Colorado, Boulder, Colorado, United States
| | - Alaa A Ahmed
- Department of Mechanical Engineering, University of Colorado, Colorado, Boulder, United States
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17
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Luecha T, Takesue S, Yeoh WL, Loh PY, Muraki S. Backward Walking Styles and Impact on Spatiotemporal Gait Characteristics. Healthcare (Basel) 2022; 10:healthcare10122487. [PMID: 36554011 PMCID: PMC9777745 DOI: 10.3390/healthcare10122487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/26/2022] [Accepted: 12/04/2022] [Indexed: 12/13/2022] Open
Abstract
Forward walking (FW) is a common balance assessment tool. However, its sensitivity is limited by the ceiling effect. Reverse gait, such as backward walking (BW), has been reported to have more advantages than FW for balance assessment. Three factors related to postural instability (i.e., increased speeds, restricted arm swing, and reduced visual feedback) during BW were investigated to determine BW conditions that have the potential to predict falls. Three-dimensional analyses were used to analyze seven walking conditions. FW and BW at self-selected and fast speeds were analyzed to identify the effects of speed. Walking with normal arm swings, crossed arms, and abducted arms during BW was tested to determine the effects of arm position. BW with closed and open eyes was compared to investigate the effects of visual feedback. BW had a significantly shorter step length than FW at high speeds. When the arms were abducted, the stance phase (%) was significantly lower compared to when arms were crossed during BW. Moreover, BW with closed eyes revealed significantly higher mediolateral center of mass (COM) displacements than with open eyes. We observed that BW with fast speeds, a crossed arm position, and closed eyes has the potential to help assess fall risk because it requires higher balance ability through spatiotemporal and COM adjustment.
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Affiliation(s)
- Teerapapa Luecha
- Department of Human Sciences, Graduate School of Design, Kyushu University, Fukuoka 815-8540, Japan
- Correspondence:
| | - Shin Takesue
- Department of Human Sciences, Graduate School of Design, Kyushu University, Fukuoka 815-8540, Japan
| | - Wen Liang Yeoh
- Faculty of Sciences and Engineering, Saga University, Saga 840-8502, Japan
| | - Ping Yeap Loh
- Department of Life Design and Science, Faculty of Design, Kyushu University, Fukuoka 815-8540, Japan
| | - Satoshi Muraki
- Department of Life Design and Science, Faculty of Design, Kyushu University, Fukuoka 815-8540, Japan
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18
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McDonald KA, Cusumano JP, Hieronymi A, Rubenson J. Humans trade off whole-body energy cost to avoid overburdening muscles while walking. Proc Biol Sci 2022; 289:20221189. [PMID: 36285498 PMCID: PMC9597406 DOI: 10.1098/rspb.2022.1189] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/29/2022] [Indexed: 07/22/2023] Open
Abstract
Metabolic cost minimization is thought to underscore the neural control of locomotion. Yet, avoiding high muscle activation, a cause of fatigue, often outperforms energy minimization in computational predictions of human gait. Discerning the relative importance of these criteria in human walking has proved elusive, in part, because they have not been empirically decoupled. Here, we explicitly decouple whole-body metabolic cost and 'fatigue-like' muscle activation costs (estimated from electromyography) by pitting them against one another using two distinct gait tasks. When experiencing these competing costs, participants (n = 10) chose the task that avoided overburdening muscles (fatigue avoidance) at the expense of higher metabolic power (p < 0.05). Muscle volume-normalized activation more closely models energy use and was also minimized by the participants' decision (p < 0.05), demonstrating that muscle activation was, at best, an inaccurate signal for metabolic energy. Energy minimization was only observed when there was no adverse effect on muscle activation costs. By decoupling whole-body metabolic and muscle activation costs, we provide among the first empirical evidence of humans embracing non-energetic optimality in favour of a clearly defined neuromuscular objective. This finding indicates that local muscle fatigue and effort may well be key factors dictating human walking behaviour and its evolution.
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Affiliation(s)
- Kirsty A. McDonald
- School of Health Sciences, University of New South Wales, Sydney, New South Wales 2052, Australia
- School of Human Sciences, The University of Western Australia, Crawley, Perth, Western Australia 6009, Australia
- Biomechanics Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802, USA
| | - Joseph P. Cusumano
- Department of Engineering Science and Mechanics, The Pennsylvania State University, University Park, PA 16802, USA
| | - Andrew Hieronymi
- School of Visual Arts, The Pennsylvania State University, University Park, PA 16802, USA
| | - Jonas Rubenson
- School of Human Sciences, The University of Western Australia, Crawley, Perth, Western Australia 6009, Australia
- Biomechanics Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802, USA
- Integrative and Biomedical Physiology, Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA 16802, USA
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19
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Gomez NG, Foreman KB, Hunt M, Merryweather AS. Regulation of whole-body and segmental angular momentum in persons with Parkinson's disease on an irregular surface. Clin Biomech (Bristol, Avon) 2022; 99:105766. [PMID: 36156430 DOI: 10.1016/j.clinbiomech.2022.105766] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 09/09/2022] [Accepted: 09/12/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Persons with Parkinson's disease have impaired motor control that increases their chance of falling when walking, especially on difficult terrains. This study investigated how persons with Parkinson's disease regulate their dynamic balance on a regular and an irregular surface. METHODS Nine participants with Parkinson's disease and nine healthy, age-matched control participants ambulated on both a regular and an irregular surface. Whole-body and segmental angular momenta were calculated using three-dimensional motion capture data. Major modes of variability between health groups on the two surfaces were investigated using principal component analysis, while differences within each health group between surfaces was investigated using statistical parametric mapping t-tests. FINDINGS Between groups, the Parkinson participants had greater sagittal, frontal, and transverse whole-body angular momentum on both surfaces, primarily following heel-strike, and the magnitude difference on the irregular surface was greater than on the regular surface. The greatest between group segmental differences on the irregular compared to the regular surface were the legs in the sagittal plane and the head/trunk/pelvis in the transverse plane, with the Parkinson group having greater magnitudes. The within-group comparison found the Parkinson participants had poorer regulation of whole-body angular momentum in the sagittal plane, while the healthy participants showed no consistent differences between surfaces. INTERPRETATION On an irregular surface, persons with Parkinson's disease exhibit poor control of dynamic balance in the frontal and sagittal planes. These results emphasize the need for weight transfer techniques and training in both the sagittal and frontal planes to maximize balance and reduce fall risk.
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Affiliation(s)
- Nicholas G Gomez
- Department of Mechanical Engineering, University of Utah, Salt Lake City, UT, USA.
| | - K Bo Foreman
- Department of Physical Therapy, University of Utah, Salt Lake City, UT, USA.
| | - MaryEllen Hunt
- Department of Mechanical Engineering, University of Utah, Salt Lake City, UT, USA
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20
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Ferraris C, Amprimo G, Masi G, Vismara L, Cremascoli R, Sinagra S, Pettiti G, Mauro A, Priano L. Evaluation of Arm Swing Features and Asymmetry during Gait in Parkinson's Disease Using the Azure Kinect Sensor. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22166282. [PMID: 36016043 PMCID: PMC9412494 DOI: 10.3390/s22166282] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/13/2022] [Accepted: 08/19/2022] [Indexed: 05/27/2023]
Abstract
Arm swinging is a typical feature of human walking: Continuous and rhythmic movement of the upper limbs is important to ensure postural stability and walking efficiency. However, several factors can interfere with arm swings, making walking more risky and unstable: These include aging, neurological diseases, hemiplegia, and other comorbidities that affect motor control and coordination. Objective assessment of arm swings during walking could play a role in preventing adverse consequences, allowing appropriate treatments and rehabilitation protocols to be activated for recovery and improvement. This paper presents a system for gait analysis based on Microsoft Azure Kinect DK sensor and its body-tracking algorithm: It allows noninvasive full-body tracking, thus enabling simultaneous analysis of different aspects of walking, including arm swing characteristics. Sixteen subjects with Parkinson's disease and 13 healthy controls were recruited with the aim of evaluating differences in arm swing features and correlating them with traditional gait parameters. Preliminary results show significant differences between the two groups and a strong correlation between the parameters. The study thus highlights the ability of the proposed system to quantify arm swing features, thus offering a simple tool to provide a more comprehensive gait assessment.
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Affiliation(s)
- Claudia Ferraris
- Institute of Electronics, Computer and Telecommunication Engineering, National Research Council, Corso Duca degli Abruzzi 24, 10129 Torino, Italy
| | - Gianluca Amprimo
- Institute of Electronics, Computer and Telecommunication Engineering, National Research Council, Corso Duca degli Abruzzi 24, 10129 Torino, Italy
- Department of Control and Computer Engineering, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Torino, Italy
| | - Giulia Masi
- Department of Neurosciences, University of Turin, Via Cherasco 15, 10100 Torino, Italy
| | - Luca Vismara
- Istituto Auxologico Italiano, IRCCS, Department of Neurology and Neurorehabilitation, S. Giuseppe Hospital, Strada Luigi Cadorna 90, 28824 Piancavallo, Italy
| | - Riccardo Cremascoli
- Department of Neurosciences, University of Turin, Via Cherasco 15, 10100 Torino, Italy
- Istituto Auxologico Italiano, IRCCS, Department of Neurology and Neurorehabilitation, S. Giuseppe Hospital, Strada Luigi Cadorna 90, 28824 Piancavallo, Italy
| | - Serena Sinagra
- Istituto Auxologico Italiano, IRCCS, Department of Neurology and Neurorehabilitation, S. Giuseppe Hospital, Strada Luigi Cadorna 90, 28824 Piancavallo, Italy
| | - Giuseppe Pettiti
- Institute of Electronics, Computer and Telecommunication Engineering, National Research Council, Corso Duca degli Abruzzi 24, 10129 Torino, Italy
| | - Alessandro Mauro
- Department of Neurosciences, University of Turin, Via Cherasco 15, 10100 Torino, Italy
- Istituto Auxologico Italiano, IRCCS, Department of Neurology and Neurorehabilitation, S. Giuseppe Hospital, Strada Luigi Cadorna 90, 28824 Piancavallo, Italy
| | - Lorenzo Priano
- Department of Neurosciences, University of Turin, Via Cherasco 15, 10100 Torino, Italy
- Istituto Auxologico Italiano, IRCCS, Department of Neurology and Neurorehabilitation, S. Giuseppe Hospital, Strada Luigi Cadorna 90, 28824 Piancavallo, Italy
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21
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Xu S, Yang Z, Wang D, Zhang S, Lu J, Lin J, Ning G. Enhanced assessment of human dynamic stability by eliminating the effect of body height: modeling and experiment study. Comput Methods Biomech Biomed Engin 2022:1-11. [PMID: 35903012 DOI: 10.1080/10255842.2022.2104606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Margin of stability (MOS) is one of the essential indices for evaluating dynamic stability. However, there are indications that MOS was affected by body height and its application in identifying factors on dynamic stability other than body height is restricted. An inverted pendulum model was used to simulate human walking and investigate the relevance between MOS and body height. Eventually, a height-independent index in dynamic stability assessment (named as Angled Margin of Stability, AMOS) was proposed. For testing, fifteen healthy young volunteers performed walking trials with normal arm swing, holding arms, and anti-normal arm swing. Kinematic parameters were recorded using a gait analysis system with a Microsoft Kinect V2.0 and instrumented walkway. Both simulation and test results show that MOS had a significant correlation with height during walking with normal arm swing, while AMOS had no such significant correlation. Walking with normal arm swing produced significantly larger AMOS than holding arms and anti-normal arm swing. However, no significant difference showed up in MOS between normal arm swing and holding arms. The results suggest that AMOS is not affected by body height and has the potential to identify the variations in dynamic stability caused by physiological factors other than body height.
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Affiliation(s)
- Shengqian Xu
- Department of Biomedical Engineering, Key Laboratory of Biomedical Engineering of MOE, Zhejiang University, Hangzhou, China
| | - Zhihao Yang
- Department of Biomedical Engineering, Key Laboratory of Biomedical Engineering of MOE, Zhejiang University, Hangzhou, China
| | - Daoyuan Wang
- Department of Biomedical Engineering, Key Laboratory of Biomedical Engineering of MOE, Zhejiang University, Hangzhou, China
| | - Shengyu Zhang
- Department of Biomedical Engineering, Key Laboratory of Biomedical Engineering of MOE, Zhejiang University, Hangzhou, China
| | - Jianwei Lu
- Department of Orthopedics, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Jian Lin
- Department of Rehabilitation, Zhejiang Hospital, Hangzhou, China
| | - Gangmin Ning
- Department of Biomedical Engineering, Key Laboratory of Biomedical Engineering of MOE, Zhejiang University, Hangzhou, China.,Zhejiang Lab, Hangzhou, China
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22
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Seyfarth A, Zhao G, Jörntell H. Whole Body Coordination for Self-Assistance in Locomotion. Front Neurorobot 2022; 16:883641. [PMID: 35747075 PMCID: PMC9211759 DOI: 10.3389/fnbot.2022.883641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 05/12/2022] [Indexed: 12/03/2022] Open
Abstract
The dynamics of the human body can be described by the accelerations and masses of the different body parts (e.g., legs, arm, trunk). These body parts can exhibit specific coordination patterns with each other. In human walking, we found that the swing leg cooperates with the upper body and the stance leg in different ways (e.g., in-phase and out-of-phase in vertical and horizontal directions, respectively). Such patterns of self-assistance found in human locomotion could be of advantage in robotics design, in the design of any assistive device for patients with movement impairments. It can also shed light on several unexplained infrastructural features of the CNS motor control. Self-assistance means that distributed parts of the body contribute to an overlay of functions that are required to solve the underlying motor task. To draw advantage of self-assisting effects, precise and balanced spatiotemporal patterns of muscle activation are necessary. We show that the necessary neural connectivity infrastructure to achieve such muscle control exists in abundance in the spinocerebellar circuitry. We discuss how these connectivity patterns of the spinal interneurons appear to be present already perinatally but also likely are learned. We also discuss the importance of these insights into whole body locomotion for the successful design of future assistive devices and the sense of control that they could ideally confer to the user.
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Affiliation(s)
- André Seyfarth
- Lauflabor Locomotion Laboratory, Institute of Sport Science and Centre for Cognitive Science, Technische Universität Darmstadt, Darmstadt, Germany
- *Correspondence: André Seyfarth
| | - Guoping Zhao
- Lauflabor Locomotion Laboratory, Institute of Sport Science and Centre for Cognitive Science, Technische Universität Darmstadt, Darmstadt, Germany
| | - Henrik Jörntell
- Neural Basis of Sensorimotor Control, Department of Experimental Medical Science, Lund University, Lund, Sweden
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Beam width and arm position but not cognitive task affect walking balance in older adults. Sci Rep 2022; 12:6854. [PMID: 35477729 PMCID: PMC9046185 DOI: 10.1038/s41598-022-10848-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 04/11/2022] [Indexed: 11/08/2022] Open
Abstract
Detection of changes in dynamic balance could help identify older adults at fall risk. Walking on a narrow beam with its width, cognitive load, and arm position manipulated could be an alternative to current tests. Therefore, we examined additive and interactive effects of beam width, cognitive task (CT), and arm position on dynamic balance during beam walking in older adults. Twenty older adults (69 ± 4y) walked on 6, 8, and 10-cm wide beams (2-cm high, 4-m-long), with and without CT, with three arm positions (free, crossed, akimbo). We determined cognitive errors, distance walked, step speed, root mean square (RMS) of center of mass (COM) displacement and trunk acceleration in the frontal plane. Beam width decrease progressively reduced distance walked and increased trunk acceleration RMS. Step speed decreased on the narrowest beam and with CT. Arm crossing decreased distance walked and step speed. COM displacement RMS and cognitive errors were not affected by any manipulation. In conclusion, distance walked indicated that beam width and arm position, but less so CT, affected dynamic balance, implying that beam walking has the potential to become a test of fall risk. Stability measurements suggested effective trunk adjustments to control COM position and keep dynamic balance during the task.
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Mohammadzada F, Zipser CM, Easthope CA, Halliday DM, Conway BA, Curt A, Schubert M. Mind your step: Target walking task reveals gait disturbance in individuals with incomplete spinal cord injury. J Neuroeng Rehabil 2022; 19:36. [PMID: 35337335 PMCID: PMC8957135 DOI: 10.1186/s12984-022-01013-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 03/15/2022] [Indexed: 11/23/2022] Open
Abstract
Background Walking over obstacles requires precise foot placement while maintaining balance control of the center of mass (CoM) and the flexibility to adapt the gait patterns. Most individuals with incomplete spinal cord injury (iSCI) are capable of overground walking on level ground; however, gait stability and adaptation may be compromised. CoM control was investigated during a challenging target walking (TW) task in individuals with iSCI compared to healthy controls. The hypothesis was that individuals with iSCI, when challenged with TW, show a lack of gait pattern adaptability which is reflected by an impaired adaptation of CoM movement compared to healthy controls. Methods A single-center controlled diagnostic clinical trial with thirteen participants with iSCI (0.3–24 years post injury; one subacute and twelve chronic) and twelve healthy controls was conducted where foot and pelvis kinematics were acquired during two conditions: normal treadmill walking (NW) and visually guided target walking (TW) with handrail support, during which participants stepped onto projected virtual targets synchronized with the moving treadmill surface. Approximated CoM was calculated from pelvis markers and used to calculate CoM trajectory length and mean CoM Euclidean distance TW-NW (primary outcome). Nonparametric statistics, including spearman rank correlations, were performed to evaluate the relationship between clinical parameter, outdoor mobility score, performance, and CoM parameters (secondary outcome). Results Healthy controls adapted to TW by decreasing anterior–posterior and vertical CoM trajectory length (p < 0.001), whereas participants with iSCI reduced CoM trajectory length only in the vertical direction (p = 0.002). Mean CoM Euclidean distance TW-NW correlated with participants’ neurological level of injury (R = 0.76, p = 0.002) and CoM trajectory length (during TW) correlated with outdoor mobility score (R = − 0.64, p = 0.026). Conclusions This study demonstrated that reduction of CoM movement is a common strategy to cope with TW challenge in controls, but it is impaired in individuals with iSCI. In the iSCI group, the ability to cope with gait challenges worsened the more rostral the level of injury. Thus, the TW task could be used as a gait challenge paradigm in ambulatory iSCI individuals. Trial registration Registry number/ ClinicalTrials.gov Identifier: NCT03343132, date of registration 2017/11/17. Supplementary Information The online version contains supplementary material available at 10.1186/s12984-022-01013-7.
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Affiliation(s)
- Freschta Mohammadzada
- Spinal Cord Injury Center, Neurophysiology, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland.
| | - Carl Moritz Zipser
- Spinal Cord Injury Center, Neurophysiology, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland
| | - Chris A Easthope
- Spinal Cord Injury Center, Neurophysiology, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland.,Cereneo Foundation, Center for Interdisciplinary Research, 6354, Vitznau, Switzerland
| | - David M Halliday
- Department of Electronic Engineering, University of York, York, YO10 5DD, UK.,York Biomedical Research Institute, University of York, York, UK
| | - Bernard A Conway
- Biomedical Engineering, University of Strathclyde, Glasgow, G4 0NW, UK
| | - Armin Curt
- Spinal Cord Injury Center, Neurophysiology, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland
| | - Martin Schubert
- Spinal Cord Injury Center, Neurophysiology, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland
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Bahrilli T, Topuz S. Does immobilization of the shoulder in different positions affect gait? Gait Posture 2022; 91:254-259. [PMID: 34775228 DOI: 10.1016/j.gaitpost.2021.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 09/21/2021] [Accepted: 10/15/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The shoulder joint is immobilized in various positions after injury or reconstructive operative intervention. It is not clear how these immobilization positions in the shoulder joint affect gait. RESEARCH QUESTION Does the immobilized shoulder joint in different positions following shoulder surgery or injury affect gait? METHODS A total of 38 healthy individuals with a mean age of 25.94 years and BMI of 25.66 kg/m2, underwent gait analysis in 4 different immobilized positions and normal gait. Gait parameters were evaluated using the GAITRite electronic walkway, and to determine symmetry, the bilateral spatiotemporal gait parameters were calculated using the Symmetry Index. Repeated-measures one way analysis of variance was used to compare the walking parameters in different positions. RESULTS Velocity, step length and stride length were significantly decreased, and step width and single support time were increased in some immobilized positions (p < 0.05). Differences in asymmetry were determined in the gait parameters of the immobilized positions but not significantly. When the shoulder was immobilized in abduction, step width asymmetry tended to increase but it was not significant. SIGNIFICANCE This cross-sectional simulation study may be important in demonstrating the clinical changes of gait in injuries, pathologies, and postoperative rehabilitation that require the immobilization of the shoulder joint. It could be recommended that arm swing is included in gait rehabilitation, gait and balance training can be provided to patients after shoulder immobilization.
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Affiliation(s)
| | - Semra Topuz
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
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26
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Kellaher GK, Baudendistel ST, Roemmich RT, Terza MJ, Hass CJ. Persons with Parkinson's disease show impaired interlimb coordination during backward walking. Parkinsonism Relat Disord 2022; 94:25-29. [PMID: 34871827 PMCID: PMC9284669 DOI: 10.1016/j.parkreldis.2021.11.029] [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: 05/22/2020] [Revised: 11/16/2021] [Accepted: 11/26/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Although there is growing literature supporting the implementation of backward walking as a potential rehabilitation tool, moving backwards may precipitate falls for persons with Parkinson's disease. We sought to better understand interlimb coordination during backward walking in comparison to forward walking in persons with Parkinson's disease and healthy controls. METHODS We assessed coordination using point estimate of relative phase at each participant's preferred walking speed. RESULTS Persons with Parkinson's disease demonstrated impaired interlimb coordination between the more affected arm and each leg compared to controls, which worsened during backward walking. CONCLUSION For those with Parkinson's disease, inability to output smooth coordinated movement of the more affected shoulder may impair coordination during forward and, especially, backward walking. Our findings provide new information about backward walking that can allow clinicians to make safer, more effective therapeutic recommendations for persons with Parkinson's disease.
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Affiliation(s)
- Grace K. Kellaher
- Department of Kinesiology & Applied Physiology, University of Delaware, STAR Campus, 540 S College Ave, Newark, Delaware, 19713,Department of Applied Physiology and Kinesiology, University of Florida, 1864 Stadium Road, Gainesville, Florida, 32611
| | - Sidney T. Baudendistel
- Department of Applied Physiology and Kinesiology, University of Florida, 1864 Stadium Road, Gainesville, Florida, 32611
| | - Ryan T. Roemmich
- Center for Movement Studies, Kennedy Krieger Institute, 707 N Broadway, Baltimore, Maryland, 21205,Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, 600 N Wolfe Street, Baltimore, Maryland, 21287
| | - Matthew J. Terza
- Department of Applied Physiology and Kinesiology, University of Florida, 1864 Stadium Road, Gainesville, Florida, 32611
| | - Chris J. Hass
- Department of Applied Physiology and Kinesiology, University of Florida, 1864 Stadium Road, Gainesville, Florida, 32611
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Mezher C, Siragy T, Nantel J. Increased Arm Swing and Rocky Surfaces Reduces Postural Control in Healthy Young Adults. Front Bioeng Biotechnol 2021; 9:645581. [PMID: 34926413 PMCID: PMC8675128 DOI: 10.3389/fbioe.2021.645581] [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: 12/23/2020] [Accepted: 11/08/2021] [Indexed: 11/16/2022] Open
Abstract
Fall-induced injuries can stem from a disruption in the postural control system and place a financial burden on the healthcare system. Most gait research focused on lower extremities and neglected the contribution of arm swing, which have been shown to affect the movement of the center of mass when walking. This study evaluated the effect of arm swing on postural control and stability during regular and rocky surface walking. Fifteen healthy young adults (age = 23.4 ± 2.8) walked on these two surfaces with three arm motions (normal, held, and active) using the CAREN Extended-System (Motek Medical, Amsterdam, NL). Mean, standard deviation and maximal values of trunk linear and angular velocity were calculated in all three axes. Moreover, step length, time and width mean and coefficient of variation as well as margin of stability mean and standard deviation were calculated. Active arm swing increased trunk linear and angular velocity variability and peak values compared to normal and held arm conditions. Active arm swing also increased participants’ step length and step time, as well as the variability of margin of stability. Similarly, rocky surface walking increased trunk kinematics variability and peak values compared to regular surface walking. Furthermore, rocky surface increased the average step width while reducing the average step time. Though this surface type increased the coefficient of variation of all spatiotemporal parameters, rocky surface also led to increased margin of stability mean and variation. The spatiotemporal adaptations showed the use of “cautious” gait to mitigate the destabilizing effects of both the active arm swing and rocky surface walking and, ultimately, maintain dynamic stability.
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Affiliation(s)
- Cezar Mezher
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Tarique Siragy
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Julie Nantel
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
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Abstract
Due to huge demand in engineering, vibration control technology and related studies have always been at the frontiers of research. Although traditional vibration control methods are stable and reliable, they have obvious shortcomings. Through evolution and natural selection, certain body-parts of animals in the natural world have been cleverly constructed and well designed. This provides a steady stream of inspiration for the design of vibration control equipment. The prime objective of this review is to highlight recent advances in the bionic design of vibration control devices. Current bionic vibration control devices were classified, and their bionic principles were briefly described. One kind was the bionic device based on the brain structure of the woodpecker, which is mostly used to reduce vibration at high frequencies. Another kind of bionic device was based on animal leg structure and showed outstanding performance in low frequency vibration reduction. Finally, we briefly listed the problems that need to be solved in current bionic vibration control technology and gave recommendations for future research direction.
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Maiti B, Rawson KS, Tanenbaum AB, Koller JM, Snyder AZ, Campbell MC, Earhart GM, Perlmutter JS. Functional Connectivity of Vermis Correlates with Future Gait Impairments in Parkinson's Disease. Mov Disord 2021; 36:2559-2568. [PMID: 34109682 PMCID: PMC8595492 DOI: 10.1002/mds.28684] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/20/2021] [Accepted: 05/18/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Dysfunction of cerebellar vermis contributes to gait abnormalities in multiple conditions and may play a key role in gait impairment in Parkinson's disease (PD). OBJECTIVE The purpose of this study was to investigate whether altered resting-state functional connectivity of the vermis relates to subsequent impairment of specific domains of gait in PD. METHODS We conducted morphometric and resting-state functional connectivity MRI analyses contrasting 45 PD and 32 age-matched healthy participants. Quantitative gait measures were acquired with a GAITRite walkway at varying intervals after functional connectivity data acquisition. RESULTS At baseline, PD participants had significantly altered functional connectivity between vermis and sensorimotor cortex compared with controls. Altered vermal functional connectivity with bilateral paracentral lobules correlated with subsequent measures of variability in stride length, step time, and single support time after controlling for confounding variables including the interval between imaging and gait measures. Similarly, altered functional connectivity between vermis and left sensorimotor cortex correlated with mean stride length and its variability. Vermis volume did not relate to any gait measure. PD participants did not differ from controls in vermis volume or cortical thickness at the site of significant regional clusters. Only altered lobule V:sensorimotor cortex functional connectivity correlated with subsequent gait measures in exploratory analyses involving all the other cerebellar lobules. CONCLUSIONS These results demonstrate that abnormal vermal functional connectivity with sensorimotor cortex, in the absence of relevant vermal or cortical atrophy, correlates with subsequent gait impairment in PD. Our data reflect the potential of vermal functional connectivity as a novel imaging biomarker of gait impairment in PD. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Baijayanta Maiti
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
| | - Kerri S. Rawson
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO
| | - Aaron B. Tanenbaum
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
| | - Jonathan M. Koller
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Abraham Z. Snyder
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
- Department of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Meghan C. Campbell
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
- Department of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Gammon M. Earhart
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO
- Department of Neuroscience, Washington University School of Medicine, St. Louis, MO
| | - Joel S. Perlmutter
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO
- Department of Radiology, Washington University School of Medicine, St. Louis, MO
- Department of Neuroscience, Washington University School of Medicine, St. Louis, MO
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO
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Bennett HJ, Jones T, Valenzuela KA, Haegele JA. Inter and intra-limb coordination variability during walking in adolescents with autism spectrum disorder. Clin Biomech (Bristol, Avon) 2021; 89:105474. [PMID: 34500337 DOI: 10.1016/j.clinbiomech.2021.105474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 07/23/2021] [Accepted: 08/27/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Autism spectrum disorder, a neurodevelopmental disorder, is difficult to characterize from a gait biomechanics perspective, possibly due to increased inter and intra-individual variability. Previous research illustrates increased gait variability in young children with autism, but assessments in older adolescents or at varying speeds are unavailable. The purpose of this study was to determine if adolescents with autism demonstrate increased intra-limb and inter-limb coordination variability during walking compared to age, sex, and body mass index matched controls. METHODS Seventeen adolescents with autism (age 13-18 years) and seventeen matched controls performed walking at two matched speeds: self-selected of adolescents with autism and at 1.3 m/s. Modified vector coding was used to determine the patterns of movement for foot-shank, left/right thigh, and contralateral thigh-arm coupling. Coordination variability, a measure of cycle-to-cycle variability, was determined across the full stride. Mixed-model analyses of variance were used to determine if group by speed interactions and/or main effects existed for coordination variability. FINDINGS A significant interaction existed for foot-shank variability (p = 0.039). Adolescents with autism had greater variability at self-selected speeds (p = 0.018), but not at 1.3 m/s (p = 0.593) compared to controls. Thigh-thigh coordination was greater for adolescents with ASD compared to controls at both speeds (p = 0.021). Variability was decreased at 1.3 m/s for both foot-shank (p = 0.016) and thigh-thigh (p = 0.021) coupling. INTERPRETATION This study illustrates that adolescents with autism perform walking with increased coordination variability at both proximal and distal segments. Thus, it is likely intra-individual variability drives the disparity of movement patterns in this population.
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Affiliation(s)
- Hunter J Bennett
- Center for Movement, Health and Disability & Department of Human Movement Sciences, Old Dominion University, Norfolk, VA 23529, USA.
| | - Taylor Jones
- Center for Movement, Health and Disability & Department of Human Movement Sciences, Old Dominion University, Norfolk, VA 23529, USA.
| | - Kevin A Valenzuela
- Department of Kinesiology, HHS2-203, California State University Long Beach, Long Beach, CA 90840, USA.
| | - Justin A Haegele
- Center for Movement, Health and Disability & Department of Human Movement Sciences, Old Dominion University, Norfolk, VA 23529, USA.
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Liu L, Cooper JL, Ballard DH. Computational Modeling: Human Dynamic Model. Front Neurorobot 2021; 15:723428. [PMID: 34630065 PMCID: PMC8500180 DOI: 10.3389/fnbot.2021.723428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Abstract
Improvements in quantitative measurements of human physical activity are proving extraordinarily useful for studying the underlying musculoskeletal system. Dynamic models of human movement support clinical efforts to analyze, rehabilitate injuries. They are also used in biomechanics to understand and diagnose motor pathologies, find new motor strategies that decrease the risk of injury, and predict potential problems from a particular procedure. In addition, they provide valuable constraints for understanding neural circuits. This paper describes a physics-based movement analysis method for analyzing and simulating bipedal humanoid movements. The model includes the major body segments and joints to report human movements' energetic components. Its 48 degrees of freedom strike a balance between very detailed models that include muscle models and straightforward two-dimensional models. It has sufficient accuracy to analyze and synthesize movements captured in real-time interactive applications, such as psychophysics experiments using virtual reality or human-in-the-loop teleoperation of a simulated robotic system. The dynamic model is fast and robust while still providing results sufficiently accurate to be used to animate a humanoid character. It can also estimate internal joint forces used during a movement to create effort-contingent stimuli and support controlled experiments to measure the dynamics generating human behaviors systematically. The paper describes the innovative features that allow the model to integrate its dynamic equations accurately and illustrates its performance and accuracy with demonstrations. The model has a two-foot stance ability, capable of generating results comparable with an experiment done with subjects, and illustrates the uncontrolled manifold concept. Additionally, the model's facility to capture large energetic databases opens new possibilities for theorizing as to human movement function. The model is freely available.
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Affiliation(s)
- Lijia Liu
- Department of Computer Science, The University of Texas at Austin, Austin, TX, United States
| | - Joseph L. Cooper
- Department of Computer Science, The University of Texas at Austin, Austin, TX, United States
- Google Inc., Mountain View, CA, United States
| | - Dana H. Ballard
- Department of Computer Science, The University of Texas at Austin, Austin, TX, United States
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Weersink JB, Maurits NM, de Jong BM. Amble Gait EEG Points at Complementary Cortical Networks Underlying Stereotypic Multi-Limb Co-ordination. Front Hum Neurosci 2021; 15:691482. [PMID: 34413729 PMCID: PMC8370810 DOI: 10.3389/fnhum.2021.691482] [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: 04/06/2021] [Accepted: 07/16/2021] [Indexed: 11/15/2022] Open
Abstract
Background Walking is characterized by stable antiphase relations between upper and lower limb movements. Such bilateral rhythmic movement patterns are neuronally generated at levels of the spinal cord and brain stem, that are strongly interconnected with cortical circuitries, including the Supplementary Motor Area (SMA). Objective To explore cerebral activity associated with multi-limb phase relations in human gait by manipulating mutual attunement of the upper and lower limb antiphase patterns. Methods Cortical activity and gait were assessed by ambulant EEG, accelerometers and videorecordings in 35 healthy participants walking normally and 19 healthy participants walking in amble gait, where upper limbs moved in-phase with the lower limbs. Power changes across the EEG frequency spectrum were assessed by Event Related Spectral Perturbation analysis and gait analysis was performed. Results Amble gait was associated with enhanced Event Related Desynchronization (ERD) prior to and during especially the left swing phase and reduced Event Related Synchronization (ERS) at final swing phases. ERD enhancement was most pronounced over the putative right premotor, right primary motor and right parietal cortex, indicating involvement of higher-order organization and somatosensory guidance in the production of this more complex gait pattern, with an apparent right hemisphere dominance. The diminished within-step ERD/ERS pattern in amble gait, also over the SMA, suggests that this gait pattern is more stride driven instead of step driven. Conclusion Increased four-limb phase complexity recruits distributed networks upstream of the primary motor cortex, primarily lateralized in the right hemisphere. Similar parietal-premotor involvement has been described to compensate impaired SMA function in Parkinson’s disease bimanual antiphase movement, indicating a role as cortical support regions.
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Affiliation(s)
- Joyce B Weersink
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Natasha M Maurits
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Bauke M de Jong
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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33
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Magnani RM, Bruijn SM, van Dieën JH, Forbes PA. Stabilization demands of walking modulate the vestibular contributions to gait. Sci Rep 2021; 11:13736. [PMID: 34215780 PMCID: PMC8253745 DOI: 10.1038/s41598-021-93037-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 06/04/2021] [Indexed: 12/26/2022] Open
Abstract
Stable walking relies critically on motor responses to signals of head motion provided by the vestibular system, which are phase-dependent and modulated differently within each muscle. It is unclear, however, whether these vestibular contributions also vary according to the stability of the walking task. Here we investigate how vestibular signals influence muscles relevant for gait stability (medial gastrocnemius, gluteus medius and erector spinae)-as well as their net effect on ground reaction forces-while humans walked normally, with mediolateral stabilization, wide and narrow steps. We estimated local dynamic stability of trunk kinematics together with coherence of electrical vestibular stimulation (EVS) with muscle activity and mediolateral ground reaction forces. Walking with external stabilization increased local dynamic stability and decreased coherence between EVS and all muscles/forces compared to normal walking. Wide-base walking also decreased vestibulomotor coherence, though local dynamic stability did not differ. Conversely, narrow-base walking increased local dynamic stability, but produced muscle-specific increases and decreases in coherence that resulted in a net increase in vestibulomotor coherence with ground reaction forces. Overall, our results show that while vestibular contributions may vary with gait stability, they more critically depend on the stabilization demands (i.e. control effort) needed to maintain a stable walking pattern.
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Affiliation(s)
- Rina M Magnani
- Department of Physiotherapy, School of Physical Education and Physical Therapy, State University of Goiás, Goiânia, GO, Brazil
| | - Sjoerd M Bruijn
- Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Institute Brain and Behavior Amsterdam, Amsterdam, The Netherlands
| | - Jaap H van Dieën
- Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Patrick A Forbes
- Department of Neuroscience, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
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34
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Das Gupta S, Bobbert M, Faber H, Kistemaker D. Metabolic cost in healthy fit older adults and young adults during overground and treadmill walking. Eur J Appl Physiol 2021; 121:2787-2797. [PMID: 34155525 PMCID: PMC8416847 DOI: 10.1007/s00421-021-04740-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 06/08/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to determine whether net metabolic cost of walking is affected by age per se. METHODS We selected 10 healthy, active older adults (mean age 75 years) and 10 young adults (mean age 26 years), and determined their preferred overground walking speed. On the same day, in a morning and afternoon session, we had them walk at that speed overground and on a treadmill while we measured oxygen consumption rate. From the latter we subtracted the rate in sitting and calculated net metabolic cost. RESULTS Anthropometrics were not different between the groups nor was preferred walking speed (1.27 m s-1 both groups). There was no difference in net metabolic cost of overground walking between older and young adults (e.g., in the morning 2.64 and 2.56 J kg-1 m-1, respectively, p > 0.05). In the morning session, net metabolic cost of walking was higher on the treadmill than overground in our older adults by 0.6 J kg-1 m-1 (p < 0.05), but not in young adults. CONCLUSION First, there is no effect of age per se on metabolic cost of overground walking. Second, older adults tend to have higher metabolic cost of walking on a treadmill than walking overground at preferred speed, and adaptation may take a long time. The commonly reported age-related elevation of metabolic cost of walking may be due to confounding factors causing preferred walking speed to be lower in older adults, and/or due to older adults reacting differently to treadmill walking than young adults.
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Affiliation(s)
- Sauvik Das Gupta
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Human Movement Biomechanics Research Group, Department of Movement Sciences, Biomedical Sciences Group, KU Leuven, Leuven, Belgium
| | - Maarten Bobbert
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Herre Faber
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Faculty of Health, Nutrition and Sports, The Hague University for Professional Education, The Hague, The Netherlands
| | - Dinant Kistemaker
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.
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Rurak BK, Rodrigues JP, Power BD, Drummond PD, Vallence AM. Reduced Cerebellar Brain Inhibition Measured Using Dual-Site TMS in Older Than in Younger Adults. THE CEREBELLUM 2021; 21:23-38. [PMID: 33880658 DOI: 10.1007/s12311-021-01267-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/06/2021] [Indexed: 12/30/2022]
Abstract
Dual-site transcranial magnetic stimulation (TMS) can be used to measure the cerebellar inhibitory influence on the primary motor cortex, known as cerebellar brain inhibition (CBI), which is thought to be important for motor control. The aim of this study was to determine whether age-related differences in CBI (measured at rest) were associated with an age-related decline in bilateral motor control measured using the Purdue Pegboard task, the Four Square Step Test, and a 10-m walk. In addition, we examined test re-test reliability of CBI measured using dual-site TMS with a figure-of-eight coil in two sessions. There were three novel findings. First, CBI was less in older than in younger adults, which is likely underpinned by an age-related loss of Purkinje cells. Second, greater CBI was associated with faster 10-m walking performance in older adults, but slower 10-m walking performance in younger adults. Third, moderate intraclass correlation coefficients (ICCs: 0.53) were found for CBI in younger adults; poor ICCs were found for CBI (ICC: 0.40) in older adults. Together, these results have important implications for the use of dual-site TMS to increase our understanding of age- and disease-related changes in cortical motor networks, and the role of functional connectivity in motor control.
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Affiliation(s)
- B K Rurak
- Discipline of Psychology, College of Science, Health, Engineering, and Education, Murdoch University, Perth, Australia. .,Centre for Healthy Ageing, Health Futures Institute, Murdoch University, 90 South Street, Perth, WA, 6150, Australia.
| | | | - B D Power
- Hollywood Private Hospital, Perth, WA, Australia.,School of Medicine Fremantle, University of Notre Dame Australia, Perth, WA, Australia
| | - P D Drummond
- Discipline of Psychology, College of Science, Health, Engineering, and Education, Murdoch University, Perth, Australia.,Centre for Healthy Ageing, Health Futures Institute, Murdoch University, 90 South Street, Perth, WA, 6150, Australia
| | - A M Vallence
- Discipline of Psychology, College of Science, Health, Engineering, and Education, Murdoch University, Perth, Australia.,Centre for Healthy Ageing, Health Futures Institute, Murdoch University, 90 South Street, Perth, WA, 6150, Australia.,Centre for Molecular Medicine and Innovative Therapeutics, Health Futures Institute, Murdoch University, Perth, WA, Australia
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Pieper NL, Baudendistel ST, Hass CJ, Diaz GB, Krupenevich RL, Franz JR. The metabolic and mechanical consequences of altered propulsive force generation in walking. J Biomech 2021; 122:110447. [PMID: 33933865 DOI: 10.1016/j.jbiomech.2021.110447] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 02/27/2021] [Accepted: 04/09/2021] [Indexed: 10/21/2022]
Abstract
Older adults walk with greater metabolic energy consumption than younger for reasons that are not well understood. We suspect that a distal-to-proximal redistribution of leg muscle demand, from muscles spanning the ankle to those spanning the hip, contributes to greater metabolic energy costs. Recently, we found that when younger adults using biofeedback target smaller than normal peak propulsive forces (FP), they do so via a similar redistribution of leg muscle demand during walking. This alludes to an experimental paradigm that emulates characteristics of elderly gait independent of other age-related changes relevant to metabolic energy cost. Thus, our purpose was to quantify the metabolic and limb- and joint-level mechanical energy costs associated with modulating propulsive forces during walking in younger adults. Walking with larger FP increased net metabolic power by 47% (main effect, p = 0.001), which was accompanied by small by relatively uniform increases in hip, knee, and ankle joint power and which correlated with total joint power (R2 = 0.151, p = 0.019). Walking with smaller FP increased net metabolic power by 58% (main effect, p < 0.001), which was accompanied by higher step frequencies and increased total joint power due to disproportionate increases in hip joint power. Increases in hip joint power when targeting smaller than normal FP accounted for more than 65% of the variance in the measured changes in net metabolic power. Our findings suggest that walking with a diminished push-off exacts a metabolic penalty because of higher step frequencies and more total limb work due to an increased demand on proximal leg muscles.
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Affiliation(s)
- Noah L Pieper
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC, USA
| | - Sidney T Baudendistel
- Department of Applied Physiology & Kinesiology, University of Florida, Gainesville, FL, USA
| | - Chris J Hass
- Department of Applied Physiology & Kinesiology, University of Florida, Gainesville, FL, USA
| | - Gabriela B Diaz
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC, USA
| | - Rebecca L Krupenevich
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC, USA
| | - Jason R Franz
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC, USA.
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Theunissen K, Plasqui G, Boonen A, Brauwers B, Timmermans A, Meyns P, Meijer K, Feys P. The Relationship Between Walking Speed and the Energetic Cost of Walking in Persons With Multiple Sclerosis and Healthy Controls: A Systematic Review. Neurorehabil Neural Repair 2021; 35:486-500. [PMID: 33847188 PMCID: PMC8135251 DOI: 10.1177/15459683211005028] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Persons with multiple sclerosis (pwMS) experience walking impairments, characterized by decreased walking speeds. In healthy subjects, the self-selected walking speed is the energetically most optimal. In pwMS, the energetically most optimal walking speed remains underexposed. Therefore, this review aimed to determine the relationship between walking speed and energetic cost of walking (Cw) in pwMS, compared with healthy subjects, thereby assessing the walking speed with the lowest energetic cost. As it is unclear whether the Cw in pwMS differs between overground and treadmill walking, as reported in healthy subjects, a second review aim was to compare both conditions. METHOD PubMed and Web of Science were systematically searched. Studies assessing pwMS, reporting walking speed (converted to meters per second), and reporting oxygen consumption were included. Study quality was assessed with a modified National Heart, Lung and Blood Institute checklist. The relationship between Cw and walking speed was calculated with a second-order polynomial function and compared between groups and conditions. RESULTS Twenty-nine studies were included (n = 1535 pwMS) of which 8 included healthy subjects (n = 179 healthy subjects). PwMS showed a similar energetically most optimal walking speed of 1.44 m/s with a Cw of 0.16, compared with 0.14 mL O2/kg/m in healthy subjects. The most optimal walking speed in treadmill was 1.48 m/s, compared with 1.28 m/s in overground walking with a similar Cw. CONCLUSION Overall, the Cw is elevated in pwMS but with a similar energetically most optimal walking speed, compared with healthy subjects. Treadmill walking showed a similar most optimal Cw but a higher speed, compared with overground walking.
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Affiliation(s)
- Kyra Theunissen
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, The Netherlands.,Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre, and Care and Public Health Research Institute, The Netherlands.,Rehabilitation Research Center, REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Belgium
| | - Guy Plasqui
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, The Netherlands
| | - Annelies Boonen
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre, and Care and Public Health Research Institute, The Netherlands
| | - Bente Brauwers
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, The Netherlands
| | - Annick Timmermans
- Rehabilitation Research Center, REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Belgium
| | - Pieter Meyns
- Rehabilitation Research Center, REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Belgium
| | - Kenneth Meijer
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, The Netherlands
| | - Peter Feys
- Rehabilitation Research Center, REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Belgium.,Universitair MS Centrum, Belgium
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Mahaki M, IJmker T, Houdijk H, Bruijn SM. How does external lateral stabilization constrain normal gait, apart from improving medio-lateral gait stability? ROYAL SOCIETY OPEN SCIENCE 2021; 8:202088. [PMID: 33959361 PMCID: PMC8074891 DOI: 10.1098/rsos.202088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/02/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The effect of external lateral stabilization on medio-lateral gait stability has been investigated previously. However, existing lateral stabilization devices not only constrain lateral motions but also transverse and frontal pelvis rotations. This study aimed to investigate the effect of external lateral stabilization with and without constrained transverse pelvis rotation on mechanical and metabolic gait features. METHODS We undertook two experiments with 11 and 10 young adult subjects, respectively. Kinematic, kinetic and breath-by-breath oxygen consumption data were recorded during three walking conditions (normal walking (Normal), lateral stabilization with (Free) and without transverse pelvis rotation (Restricted)) and at three speeds (0.83, 1.25 and 1.66 m s-1) for each condition. In the second experiment, we reduced the weight of the frame, and allowed for longer habituation time to the stabilized conditions. RESULTS External lateral stabilization significantly reduced the amplitudes of the transverse and frontal pelvis rotations, in addition to medio-lateral, anterior-posterior, and vertical pelvis displacements, transverse thorax rotation, arm swing, step length and step width. The amplitudes of free vertical moment, anterior-posterior drift over a trial, and energy cost were not significantly influenced by external lateral stabilization. The removal of pelvic rotation restrictions by our experimental set-ups resulted in normal frontal pelvis rotation in Experiment 1 and significantly higher transverse pelvis rotation in Experiment 2, although transverse pelvis rotation still remained significantly less than in the Normal condition. Step length increased with the increased transverse pelvis rotation. CONCLUSION Existing lateral stabilization set-ups not only constrain medio-lateral motions (i.e. medio-lateral pelvis displacement) but also constrain other movements such as transverse and frontal pelvis rotations, which leads to several other gait changes such as reduced transverse thorax rotation, and arm swing. Our new set-ups allowed for normal frontal pelvis rotation and more transverse pelvis rotation (yet less than normal). However, this did not result in more normal thorax rotation and arm swing. Hence, to provide medio-lateral support without constraining other gait variables, more elaborate set-ups are needed.
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Affiliation(s)
- Mohammadreza Mahaki
- Department of Sport Biomechanics, Faculty of Physical Education and Sport Sciences, Kharazmi University, Tehran, Iran
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, van der Boechorststraat 9, Amsterdam, NL-1081 BT, The Netherlands
| | - Trienke IJmker
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, van der Boechorststraat 9, Amsterdam, NL-1081 BT, The Netherlands
| | - Han Houdijk
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, van der Boechorststraat 9, Amsterdam, NL-1081 BT, The Netherlands
- Center for Human Movement Sciences, University Medical Centre Groningen, University Groningen, The Netherlands
| | - Sjoerd Matthijs Bruijn
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, van der Boechorststraat 9, Amsterdam, NL-1081 BT, The Netherlands
- Orthopaedic Biomechanics Laboratory, Fujian Medical University, Quanzhou, Fujian, People's Republic of China
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Pimentel RE, Pieper NL, Clark WH, Franz JR. Muscle metabolic energy costs while modifying propulsive force generation during walking. Comput Methods Biomech Biomed Engin 2021; 24:1552-1565. [PMID: 33749464 DOI: 10.1080/10255842.2021.1900134] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We pose that an age-related increase in the metabolic cost of walking arises in part from a redistribution of joint power where muscles spanning the hip compensate for insufficient ankle push-off and smaller peak propulsive forces (FP). Young adults elicit a similar redistribution when walking with smaller FP via biofeedback. We used targeted FP biofeedback and musculoskeletal models to estimate the metabolic costs of operating lower limb muscles in young adults walking across a range of FP. Our simulations support the theory of distal-to-proximal redistribution of joint power as a determinant of increased metabolic cost in older adults during walking.
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Affiliation(s)
- Richard E Pimentel
- Joint Department of Biomedical Engineering, UNC Chapel Hill and NC State University, Chapel Hill, NC, USA
| | - Noah L Pieper
- Joint Department of Biomedical Engineering, UNC Chapel Hill and NC State University, Chapel Hill, NC, USA
| | - William H Clark
- Joint Department of Biomedical Engineering, UNC Chapel Hill and NC State University, Chapel Hill, NC, USA
| | - Jason R Franz
- Joint Department of Biomedical Engineering, UNC Chapel Hill and NC State University, Chapel Hill, NC, USA
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Weersink JB, de Jong BM, Halliday DM, Maurits NM. Intermuscular coherence analysis in older adults reveals that gait-related arm swing drives lower limb muscles via subcortical and cortical pathways. J Physiol 2021; 599:2283-2298. [PMID: 33687081 PMCID: PMC8252748 DOI: 10.1113/jp281094] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 02/26/2021] [Indexed: 12/11/2022] Open
Abstract
KEY POINTS Gait-related arm swing in humans supports efficient lower limb muscle activation, indicating a neural coupling between the upper and lower limbs during gait. Intermuscular coherence analyses of gait-related electromyography from upper and lower limbs in 20 healthy participants identified significant coherence in alpha and beta/gamma bands indicating that upper and lower limbs share common subcortical and cortical drivers that coordinate the rhythmic four-limb gait pattern. Additional directed connectivity analyses revealed that upper limb muscles drive and shape lower limb muscle activity during gait via subcortical and cortical pathways and to a lesser extent vice versa. The results provide a neural underpinning that arm swing may serve as an effective rehabilitation therapy concerning impaired gait in neurological diseases. ABSTRACT Human gait benefits from arm swing, as it enhances efficient lower limb muscle activation in healthy participants as well as patients suffering from neurological impairment. The underlying neuronal mechanisms of such coupling between upper and lower limbs remain poorly understood. The aim of the present study was to examine this coupling by intermuscular coherence analysis during gait. Additionally, directed connectivity analysis of this coupling enabled assessment of whether gait-related arm swing indeed drives lower limb muscles. To that end, electromyography recordings were obtained from four lower limb muscles and two upper limb muscles bilaterally, during gait, of 20 healthy participants (mean (SD) age 67 (6.8) years). Intermuscular coherence analysis revealed functional coupling between upper and lower limb muscles in the alpha and beta/gamma band during muscle specific periods of the gait cycle. These effects in the alpha and beta/gamma bands indicate involvement of subcortical and cortical sources, respectively, that commonly drive the rhythmic four-limb gait pattern in an efficiently coordinated fashion. Directed connectivity analysis revealed that upper limb muscles drive and shape lower limb muscle activity during gait via subcortical and cortical pathways and to a lesser extent vice versa. This indicates that gait-related arm swing reflects the recruitment of neuronal support for optimizing the cyclic movement pattern of the lower limbs. These findings thus provide a neural underpinning for arm swing to potentially serve as an effective rehabilitation therapy concerning impaired gait in neurological diseases.
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Affiliation(s)
- Joyce B Weersink
- Department of Neurology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, POB 30.001, Groningen, The Netherlands
| | - Bauke M de Jong
- Department of Neurology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, POB 30.001, Groningen, The Netherlands
| | - David M Halliday
- Department of Electronic Engineering & York Biomedical Research Institute, University of York, York, YO10 5DD, UK
| | - Natasha M Maurits
- Department of Neurology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, POB 30.001, Groningen, The Netherlands
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Houdijk H, Blokland IJ, Nazier SA, Castenmiller SV, van den Heuvel I, IJmker T. Effects of Handrail and Cane Support on Energy Cost of Walking in People With Different Levels and Causes of Lower Limb Amputation. Arch Phys Med Rehabil 2021; 102:1340-1346.e3. [PMID: 33684364 DOI: 10.1016/j.apmr.2021.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 01/11/2021] [Accepted: 02/02/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The energy cost of walking with a lower limb prosthesis is higher than able-bodied walking and depends on both cause and level of amputation. This increase might partly be related to problems with balance control. In this study we investigated to what extent energy cost can be reduced by providing support through a handrail or cane and how this depends on level and cause of amputation. DESIGN Quasi-experimental study. SETTING Rehabilitation gait laboratory. PARTICIPANTS Twenty-six people with a lower limb amputation were included: 9 with vascular and 17 with nonvascular causes, 16 at transtibial, and 10 at transfemoral or knee disarticulation level (N=26). INTERVENTIONS Participants walked on a treadmill with and without handrail support and overground with and without a cane. MAIN OUTCOME MEASURES Energy cost was assessed using respirometry. RESULTS On the treadmill, handrail support resulted in a 6% reduction in energy cost on average. This effect was attributed to an 11% reduction in those with an amputation attributable to vascular causes, whereas the nonvascular group did not show a significant difference. No interaction with level of amputation was found. Overground, no main effect of cane support was found, although an interaction effect with cause of amputation demonstrated a small nonsignificant decrease in energy cost (3%) in the vascular group and a significant increase (6%) in the nonvascular group when walking with a cane. The effect of support was positively correlated with self-selected walking speed. CONCLUSIONS This study demonstrates that providing external support can contribute to a reduction in energy cost in people with an amputation due to vascular causes with reduced walking ability while walking in the more challenging condition of the treadmill. Although it is speculated that this effect might be related to problems with balance control, this will need further investigation.
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Affiliation(s)
- Han Houdijk
- Amsterdam Movement Science, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands; University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands.
| | - Ilse J Blokland
- Amsterdam Movement Science, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands
| | - Suci A Nazier
- Amsterdam Movement Science, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Poltekkes Kemenkes Jakarta 1, Jakarta School Prosthetics and Orthotics (JSPO), Jakarta, Indonesia
| | - Saskia V Castenmiller
- Amsterdam Movement Science, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Iris van den Heuvel
- Amsterdam Movement Science, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Trienke IJmker
- Amsterdam Movement Science, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Ó' Reilly D. Slow walking synergies reveal a functional role for arm swing asymmetry in healthy adults: A principal component analysis with relation to mechanical work. Gait Posture 2021; 85:126-130. [PMID: 33549966 DOI: 10.1016/j.gaitpost.2021.01.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 01/20/2021] [Accepted: 01/22/2021] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The purpose of this study was to reveal a functional role for arm-swing asymmetry during gait in healthy adults. To this end, the primary aim was to investigate the role of neuromuscular control on the asymmetry of propulsive and collision joint work at either end of the double-support phase (WDS) in the context of sidedness. The secondary aim was to investigate the effect of neuromuscular control on propulsive and collision joint work at either end of the single-support phase (WSS) in the context of arm-swing asymmetry. METHODS Slow -walking trials of 25 participants were analysed using principal component analysis to generate movement synergies (PMk). Independent variables included the tightness of neuromuscular control (N1) formulated from the first PMk and the directional Arm-swing asymmetry index (dASI). Dependent variables included the difference between double-support collision and propulsive joint work (WDS) and a ratio consisting of the difference between single-support collision and propulsive work of both sides (WSS). A linear mixed-effects model was utilized for aim 1 while a multiple linear regression analysis was undertaken for aim 2. RESULTS Healthy adult gait was accompanied by a left-side dominant arm-swing on average. For aim 1, N1 demonstrated a significant negative effect on WDS while sidedness had a negative direct effect and positive indirect effect through N1 on WDS. The most notable finding was the interaction between dASI and N1 which demonstrated a highly significant positive effect on WSS. INTERPRETATION Evidence was put forward that arm-swing asymmetry during gait is related to footedness among healthy adults. Future studies should look to formally confirm this finding.
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Affiliation(s)
- David Ó' Reilly
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Co. Cork, Ireland; Faculty of Biological Sciences, School of Biomedical Sciences, University of Leeds, Leeds, United Kingdom.
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Daily acute intermittent hypoxia combined with walking practice enhances walking performance but not intralimb motor coordination in persons with chronic incomplete spinal cord injury. Exp Neurol 2021; 340:113669. [PMID: 33647273 DOI: 10.1016/j.expneurol.2021.113669] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/14/2021] [Accepted: 02/25/2021] [Indexed: 12/15/2022]
Abstract
Persons living with incomplete spinal cord injuries (SCI) often struggle to regain independent walking due to deficits in walking mechanics. They often dedicate many weeks of gait training before benefits to emerge, with additional training needed for benefits to persist. Recent studies in humans with SCI found that daily bouts of breathing low oxygen (acute intermittent hypoxia, AIH) prior to locomotor training elicited persistent (weeks) improvement in overground walking speed and endurance. AIH-induced improvements in overground walking may result from changes in control strategies that also enhance intralimb coordination; however, this possibility remains untested. Here, we examined the extent to which daily AIH combined with walking practice (AIH + WALK) improved overground walking performance and intralimb motor coordination in persons with chronic, incomplete SCI. METHODS We recruited 11 persons with chronic (> 1 year), incomplete SCI to participate in a randomized, double-blind, balanced, crossover study. Participants first received either daily (5 consecutive days) AIH (15, 90-s episodes of 10.0% O2 with 60s intervals at 20.9% O2) or SHAM (15, 90s episodes at 20.9% O2 with 60s intervals at 20.9% O2) followed by 30-min of overground walking practice. They received the second treatment after a minimum 2-week washout period. We quantified overground walking performance, in terms of speed and endurance, using the 10-Meter Walk Test (10MWT) and 6-Minute Walk Test (6MWT), respectively. We quantified intralimb motor coordination using kinematic variability measures of foot trajectory (i.e., endpoint variability, EV) and of inter-joint coupling between the hip and knee, as well as between the knee and ankle joints (i.e., angular coefficient of correspondence, ACC). We compared the changes in walking performance relative to baseline (BL) between daily AIH + WALK and daily SHAM+WALK on treatment day 5 (T5), 1-week follow-up (F1), and 2-weeks follow-up (F2). We also compared these changes between participants who used bilateral walking aids (N = 5) and those who did not. To assess the effects of daily AIH + WALK on intralimb coordination, we compared potential treatment-induced changes in EV and ACC relative to BL at F1 and F2. RESULTS Participants improved overground walking performance (speed and endurance) after daily AIH + WALK, but not SHAM+WALK. Following daily AIH + WALK, participants decreased their 10MWT time at T5 by 28% (95% CI 0.2-10.1 s, p = 0.04), F1 by 28% (95% CI 1.1-13.5 s, p = 0.01), and F2 by 27% (95% CI 1.4-13.9 s, p = 0.01) relative to BL. The greatest decreases in the 10MWT occurred in participants who used bilateral walking aids (p < 0.05). We also found daily AIH + WALK resulted in an increase in 6MWT distance at T5 by 22% (95% CI 13.3-72.6 m, p = 0.001), F1 by 21% (95% CI 13.1-72.5 m, p = 0.001), and F2 by 16% (95% CI 2.9-62.2 m, p = 0.02). However, measures of EV and ACC during self-selected walking conditions did not change following daily AIH + WALK (all p-values >0.50). CONCLUSIONS Consistent with prior studies, daily AIH + WALK triggered improvements in walking speed and endurance that persisted for weeks after treatment. Greatest improvements in speed occurred in participants who used bilateral walking aids. No change in EV and ACC may suggest that intralimb motor coordination was not a significant gait training priority during daily AIH + WALK.
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de Oliveira CHY, José A, de Camargo AA, Feltrim MIZ, Athanazio RA, Rached SZ, Stelmalch R, Corso SD. Exercise-induced desaturation in subjects with non-cystic fibrosis bronchiectasis: laboratory-based tests versus field-based exercise tests. J Bras Pneumol 2021; 47:e20200134. [PMID: 33656157 PMCID: PMC8332849 DOI: 10.36416/1806-3756/e20200134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 10/20/2020] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To investigate the validity of field walking tests to identify exercise-induced hypoxemia and to compare cardiorespiratory responses and perceived effort between laboratory-based and field-based exercise tests in subjects with bronchiectasis. METHODS This was a cross-sectional study involving 72 non-oxygen-dependent participants (28 men; mean age = 48.3 ± 14.5 years; and mean FEV1 = 54.1 ± 23.4% of the predicted value). The participants underwent cardiopulmonary exercise testing (CPET) on a treadmill and constant work-rate exercise testing (CWRET) on the same day (1 h apart). In another visit, they underwent incremental shuttle walk testing (ISWT) and endurance shuttle walk testing (ESWT; 1 h apart). Desaturation was defined as a reduction in SpO2 ≥ 4% from rest to peak exercise. RESULTS CPET results were compared with ISWT results, as were CWRET results with ESWT results. There was no difference in the magnitude of desaturation between CPET and ISWT (-7.7 ± 6.3% vs. -6.6 ± 5.6%; p = 0.10) and between CWRET and ESWT (-6.8 ± 5.8% vs. -7.2 ± 6.3%; p = 0.50). The incremental tests showed an agreement in the magnitude of desaturation in the desaturation and no desaturation groups (42 and 14 participants, respectively; p < 0.01), as did the endurance tests (39 and 16 participants; p < 0.01). The magnitude of desaturation was similar among the participants who did or did not reach at least 85% of the maximum predicted HR. CONCLUSIONS Field exercise tests showed good precision to detect desaturation. Field tests might be an alternative to laboratory tests when the clinical question is to investigate exercise-induced desaturation in subjects with bronchiectasis.
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Affiliation(s)
| | - Anderson José
- . Programa de Pós-Graduação em Ciências de Reabilitação e Desempenho Físico-Funcional, Universidade Federal de Juiz de Fora, Juiz de Fora (MG) Brasil
| | - Anderson Alves de Camargo
- . Programa de Pós-Graduação em Ciências de Reabilitação, Universidade Nove de Julho, São Paulo (SP) Brasil
| | - Maria Ignez Zanetti Feltrim
- . Serviço de Fisioterapia, Instituto do Coração - InCor - Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Rodrigo Abensur Athanazio
- . Divisão de Pneumologia, Instituto do Coração - InCor - Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Samia Zahi Rached
- . Divisão de Pneumologia, Instituto do Coração - InCor - Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Rafael Stelmalch
- . Divisão de Pneumologia, Instituto do Coração - InCor - Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Simone Dal Corso
- . Programa de Pós-Graduação em Ciências de Reabilitação, Universidade Nove de Julho, São Paulo (SP) Brasil
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Thomas SA, Vega D, Arellano CJ. Do humans exploit the metabolic and mechanical benefits of arm swing across slow to fast walking speeds? J Biomech 2020; 115:110181. [PMID: 33383459 DOI: 10.1016/j.jbiomech.2020.110181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 10/22/2020] [Accepted: 12/11/2020] [Indexed: 10/22/2022]
Abstract
Humans naturally select conditions to minimize their net cost of transport (COT) during walking. One way to do this is by exploiting the mechanical benefit of arm swing which reduces whole-body rotation about the vertical axis and thus, minimizes the free vertical moment (FVM) that the foot applies to the ground. Humans appear to exploit these benefits of arm swing at speeds that are considered optimal, but we sought to determine if these benefits are conserved across slow to fast walking speeds. If true, arm swing may be a key feature that helps to minimize the net COT regardless of one's walking speed. We hypothesized that at all speeds, walking with arm swing would be less costly compared to walking without arm swing. As a secondary aim, we also explored if reductions in the peak FVM could explain the metabolic benefits of arm swing. Twenty-one young, healthy subjects walked with and without arm swing at speeds ranging from 0.50 to 2.00 m/s while we recorded metabolic, kinematic and kinetic data. At slow speeds (≤1.00 m/s), net COT was similar when walking with or without arm swing (p > 0.05). However, at intermediate and fast speeds (≥1.00 m/s), arm swing reduced the net COT by ~7-13% (all p's < 0.05). Additionally, peak FVM magnitudes decreased with arm swing, suggesting that it may partially explain the metabolic benefit of arm swing. Overall, we find that arm swing provides a net metabolic benefit during walking, but this benefit is constrained to intermediate and fast walking speeds.
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Affiliation(s)
- Shernice A Thomas
- Center for Neuromotor and Biomechanics Research, University of Houston, Houston, TX, USA; Department of Health and Human Performance, University of Houston, Houston, TX, USA
| | - Daisey Vega
- Center for Neuromotor and Biomechanics Research, University of Houston, Houston, TX, USA; Department of Health and Human Performance, University of Houston, Houston, TX, USA
| | - Christopher J Arellano
- Center for Neuromotor and Biomechanics Research, University of Houston, Houston, TX, USA; Department of Health and Human Performance, University of Houston, Houston, TX, USA.
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The Effects of Mobile Texting and Walking Speed on Gait Characteristics of Normal Weight and Obese Adults. Motor Control 2020; 24:588-604. [PMID: 32916659 DOI: 10.1123/mc.2020-0006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 05/27/2020] [Accepted: 06/17/2020] [Indexed: 11/18/2022]
Abstract
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.
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Haarman CJW, Hekman EEG, Haalboom MFH, van der Kooij H, Rietman JS. A New Shoulder Orthosis to Dynamically Support Glenohumeral Subluxation. IEEE Trans Biomed Eng 2020; 68:1142-1153. [PMID: 32881681 DOI: 10.1109/tbme.2020.3021521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE In this paper we presented a novel shoulder subluxation support that aims to reduce the stress on the passive structures around the shoulder of patients with glenohumeral subluxation and glenohumeral-related shoulder pain. The device applies a force to the upper arm without impeding the functional range of motion of the arm. Our design contains a mechanism that statically balances the arm with two elastic bands. METHODS A technical evaluation study was conducted to assess the performance of the orthosis. Additionally, two patients evaluated the orthosis. RESULTS The results of the technical validation confirm the working of the balancing mechanism. The pilot study demonstrated that the shoulder support increased the feeling of stability of the shoulder joint and, to a lesser extent, decreased shoulder pain. Furthermore, both patients reported that the orthosis did not impede their range of motion. CONCLUSION In this research we developed a shoulder orthosis based on two statically balanced springs that support the shoulder of patients with glenohumeral subluxation that have residual shoulder muscle force. Compared to existing shoulder supports, our design does not impede the range of motion of the arm, and continues to provide a stabilizing force to the shoulder, even if the arm is moved away from the neutral position. Tests with two participants showed promising results. SIGNIFICANCE The device presented in this work could have a significant impact on the shoulder function which may improve rehabilitation outcome and improve the quality of life of patients suffering from glenohumeral subluxation and shoulder pain.
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Bicycling Exercise Helps Maintain a Youthful Metabolic Cost of Walking in Older Adults. J Aging Phys Act 2020; 29:36-42. [PMID: 32723930 DOI: 10.1123/japa.2019-0327] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 03/29/2020] [Accepted: 04/29/2020] [Indexed: 11/18/2022]
Abstract
The decline of walking performance is a key determinant of morbidity among older adults. Healthy older adults have been shown to have a 15-20% lower walking economy compared with young adults. However, older adults who run for exercise have a higher walking economy compared with older adults who walk for exercise. Yet, it remains unclear if other aerobic exercises yield similar improvements on walking economy. The purpose of this study was to determine if regular bicycling exercise affects walking economy in older adults. We measured metabolic rate while 33 older adult "bicyclists" or "walkers" and 16 young adults walked on a level treadmill at four speeds between (0.75-1.75 m/s). Across the range of speeds, older bicyclists had a 9-17% greater walking economy compared with older walkers (p = .009). In conclusion, bicycling exercise mitigates the age-related deterioration of walking economy, whereas walking for exercise has a minimal effect on improving walking economy.
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Park SJ, Oh S. Changes in Gait Performance in Stroke Patients after Taping with Scapular Setting Exercise. Healthcare (Basel) 2020; 8:healthcare8020128. [PMID: 32397219 PMCID: PMC7349882 DOI: 10.3390/healthcare8020128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 11/20/2022] Open
Abstract
The purpose of this study was to investigate the effects of combined taping with scapular setting exercise on the gait performance of stroke patients. Twenty stroke patients were randomly allocated to two groups: the taping with scapular setting exercise (TSSE) group (n = 10) and scapular setting exercise (SSE) group (n = 10). Intervention was performed for one week, and pre- and postintervention results for TSSE and SSE were compared. Outcomes were determined using the inertia measurement unit, which can measure spatiotemporal gait parameters, and using the timed up-and-go test. Two-way repeated analysis was used to compare pre- and postintervention results. In the TSSE group, intervention significantly improved cadence, gait speed, stride length, step length, gait cycle, swing phase duration, double support duration, and timed up-and-go test results more than in the SSE group. TSSE was found to improve all spatiotemporal gait parameters examined; thus, we recommend TSSE be considered as an intervention to improve gait parameters in stroke patients.
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Affiliation(s)
- Shin Jun Park
- Department of Physical Therapy, Gangdong University, 278, Daehak-gil, Gamgok-myeon, Eumseong-gun, Chungcheongbuk-do 27600, Korea;
| | - Seunghue Oh
- Department of Physical Therapy, Graduate School, Dankook University, 119, Dandae-ro, Dongnam-gu, Cheonan-si, Chungnam 330-714, Korea
- Correspondence: ; Tel.: +82-41-550-6103
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Cornwell T, Woodward J, Wu M, Jackson B, Souza P, Siegel J, Dhar S, Gordon KE. Walking With Ears: Altered Auditory Feedback Impacts Gait Step Length in Older Adults. Front Sports Act Living 2020; 2:38. [PMID: 33345030 PMCID: PMC7739652 DOI: 10.3389/fspor.2020.00038] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 03/20/2020] [Indexed: 11/13/2022] Open
Abstract
Auditory feedback may provide the nervous system with valuable temporal (e. g., footstep sounds) and spatial (e.g., external reference sounds) information that can assist in the control of upright walking. As such, hearing loss may directly contribute to declines in mobility among older adults. Our purpose was to examine the impact of auditory feedback on the control of walking in older adults. Twenty older adults (65-86 years) with no diagnosed hearing loss walked on a treadmill for three sound conditions: Baseline, Ear Plugs, and White Noise. We hypothesized that in response to reduced temporal auditory feedback during the Ear Plugs and White Noise conditions, participants would adapt shorter and faster steps that are traditionally believed to increase mechanical stability. This hypothesis was not supported. Interestingly, we observed increases in step length (p = 0.047) and step time (p = 0.026) during the Ear Plugs condition vs. Baseline. Taking longer steps during the Ear Plugs condition may have increased ground reaction forces, thus allowing participants to sense footsteps via an occlusion effect. As a follow-up, we performed a Pearson's correlation relating the step length increase during the Ear Plugs condition to participants' scores on a clinical walking balance test, the Functional Gait Assessment. We found a moderate negative relationship (rho = -0.44, p = 0.055), indicating that participants with worse balance made the greatest increases in step length during the Ear Plugs condition. This trend suggests that participants may have actively sought auditory feedback with longer steps, sacrificing a more mechanically stable stepping pattern. We also hypothesized that reduced spatial localization feedback during the Ear Plugs and White Noise conditions would decrease control of center of mass (COM) dynamics, resulting in an increase in lateral COM excursion, lateral margin of stability, and maximum Lyapunov exponent. However, we found no main effects of auditory feedback on these metrics (p = 0.580, p = 0.896, and p = 0.056, respectively). Overall, these results suggest that during a steady-state walking task, healthy older adults can maintain walking control without auditory feedback. However, increases in step length observed during the Ear Plugs condition suggest that temporal auditory cues provide locomotor feedback that becomes increasingly valuable as balance deteriorates with age.
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Affiliation(s)
- Tara Cornwell
- Northwestern University, Biomedical Engineering, Evanston, IL, United States.,Northwestern University, Physical Therapy and Human Movement Sciences, Chicago, IL, United States
| | | | - Mengnan/Mary Wu
- Northwestern University, Physical Therapy and Human Movement Sciences, Chicago, IL, United States
| | - Brennan Jackson
- Northwestern University, Biomedical Engineering, Evanston, IL, United States
| | - Pamela Souza
- Northwestern University, Communication Sciences and Disorders, Evanston, IL, United States
| | - Jonathan Siegel
- Northwestern University, Communication Sciences and Disorders, Evanston, IL, United States
| | - Sumitrajit Dhar
- Northwestern University, Communication Sciences and Disorders, Evanston, IL, United States
| | - Keith E Gordon
- Northwestern University, Physical Therapy and Human Movement Sciences, Chicago, IL, United States.,Edward Hines Jr. VA Hospital, Research Service, Hines, IL, United States
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