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Mao Q, Zheng W, Shi M, Yang F. Scientometric Research and Critical Analysis of Gait and Balance in Older Adults. SENSORS (BASEL, SWITZERLAND) 2024; 24:3199. [PMID: 38794055 PMCID: PMC11125350 DOI: 10.3390/s24103199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 05/15/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024]
Abstract
Gait and balance have emerged as a critical area of research in health technology. Gait and balance studies have been affected by the researchers' slow follow-up of research advances due to the absence of visual inspection of the study literature across decades. This study uses advanced search methods to analyse the literature on gait and balance in older adults from 1993 to 2022 in the Web of Science (WoS) database to gain a better understanding of the current status and trends in the field for the first time. The study analysed 4484 academic publications including journal articles and conference proceedings on gait and balance in older adults. Bibliometric analysis methods were applied to examine the publication year, number of publications, discipline distribution, journal distribution, research institutions, application fields, test methods, analysis theories, and influencing factors in the field of gait and balance. The results indicate that the publication of relevant research documents has been steadily increasing from 1993 to 2022. The United States (US) exhibits the highest number of publications with 1742 articles. The keyword "elderly person" exhibits a strong citation burst strength of 18.04, indicating a significant focus on research related to the health of older adults. With a burst factor of 20.46, Harvard University has made impressive strides in the subject. The University of Pittsburgh displayed high research skills in the area of gait and balance with a burst factor of 7.7 and a publication count of 103. The research on gait and balance mainly focuses on physical performance evaluation approaches, and the primary study methods include experimental investigations, computational modelling, and observational studies. The field of gait and balance research is increasingly intertwined with computer science and artificial intelligence (AI), paving the way for intelligent monitoring of gait and balance in the elderly. Moving forward, the future of gait and balance research is anticipated to highlight the importance of multidisciplinary collaboration, intelligence-driven approaches, and advanced visualization techniques.
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Affiliation(s)
- Qian Mao
- School of Design, The Hong Kong Polytechnic University, Hong Kong
| | - Wei Zheng
- Department of Computer Science and Technology, Tsinghua University, Beijing 100190, China
| | - Menghan Shi
- Lancaster Imagination Lab, Lancashire, Lancaster LA1 4YD, UK
| | - Fan Yang
- Electrical and Electronic Engineering Department, The Hong Kong Polytechnic University, Hong Kong
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Stania M, Emich-Widera E, Kamieniarz-Olczak A, Kazek B, Swatowska-Wenglarczyk M, Juras G. Postural control before and after transitional locomotor tasks in children on the autism spectrum: A case-control study. Clin Biomech (Bristol, Avon) 2024; 115:106251. [PMID: 38626570 DOI: 10.1016/j.clinbiomech.2024.106251] [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: 11/09/2023] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 04/18/2024]
Abstract
BACKGROUND Instrumented measurements of postural control provide a more accurate insight into the motor development of children with autism. This study aimed to identify postural control deficits in autistic children during quiet standing before and after transient locomotor task. It was hypothesized that the parameters that characterize the trajectory of center of foot pressure (COP) displacement would be higher in autistic children compared to typically developing children. METHODS Sixteen autistic children aged 6-10 but without a comorbidity diagnosis, were enrolled in the study group. The control group comprised 16 typically developing peers. The assessment of the transitional task comprised four different conditions: unperturbed and perturbed transition, stepping up, and stepping down tasks. Analysis of the COP signal was carried out for three distinct phases, i.e., phase 1 - quiet standing before step initiation, phase 2 - transit, and phase 3 - quiet standing until measurement completion. FINDINGS The two-way ANOVA with a 2 × 4 factorial design (group × testing condition) revealed a group effect on all posturographic variables in the antero-posterior and medio-lateral directions of phase 1 and in the antero-posterior direction of phase 3. The Bonferroni post-hoc test showed the means of all those variables were significantly higher for the autistic than for typically developing children. Group allocation also had an effect on the time of transit and step length, which turned out to be significantly longer in autistic children compared to healthy peers. INTERPRETATION Autistic children show increased postural sway before and after transitional locomotor tasks compared to typically developing children. The trial was prospectively registered in the Australian and New Zealand Clinical Trials Registry (no. ACTRN12621001113842; date registered: 23.08.2021).
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Affiliation(s)
- Magdalena Stania
- Institute of Sport Sciences, Academy of Physical Education, Mikołowska 72A, 40-065 Katowice, Poland.
| | - Ewa Emich-Widera
- Department of Pediatric Neurology, Faculty of Medical Sciences, Medical University of Silesia, Medyków 18, 40-752 Katowice, Poland
| | - Anna Kamieniarz-Olczak
- Institute of Sport Sciences, Academy of Physical Education, Mikołowska 72A, 40-065 Katowice, Poland
| | - Beata Kazek
- Persevere - Child Development Support Center, Kępowa 56, 40-583 Katowice, Poland
| | | | - Grzegorz Juras
- Institute of Sport Sciences, Academy of Physical Education, Mikołowska 72A, 40-065 Katowice, Poland
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Vallageas V, Aissaoui R, Willaert I, Labbe DR. Embodying a self-avatar with a larger leg: its impacts on motor control and dynamic stability. IEEE TRANSACTIONS ON VISUALIZATION AND COMPUTER GRAPHICS 2024; 30:2066-2076. [PMID: 38437132 DOI: 10.1109/tvcg.2024.3372084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
Several studies have shown that users of immersive virtual reality can feel high levels of embodiment in self-avatars that have different morphological proportions than those of their actual bodies. Deformed and unrealistic morphological modifications are accepted by embodied users, underlying the adaptability of one's mental map of their body (body schema) in response to incoming sensory feedback. Before initiating a motor action, the brain uses the body schema to plan and sequence the necessary movements. Therefore, embodiment in a self-avatar with a different morphology, such as one with deformed proportions, could lead to changes in motor planning and execution. In this study, we aimed to measure the effects on movement planning and execution of embodying a self-avatar with an enlarged lower leg on one side. Thirty participants embodied an avatar without any deformations, and with an enlarged dominant or non-dominant leg, in randomized order. Two different levels of embodiment were induced, using synchronous or asynchronous visuotactile stimuli. In each condition, participants performed a gait initiation task. Their center of mass and center of pressure were measured, and the margin of stability (MoS) was computed from these values. Their perceived level of embodiment was also measured, using a validated questionnaire. Results show no significant changes on the biomechenical variables related to dynamic stability. Embodiment scores decreased with asynchronous stimuli, without impacting the measures related to stability. The body schema may not have been impacted by the larger virtual leg. However, deforming the self-avatar's morphology could have important implications when addressing individuals with impaired physical mobility by subtly influencing action execution during a rehabilitation protocol.
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Tseng SC, Cherry D, Ko M, Fisher SR, Furtado M, Chang SH. The effects of combined transcranial brain stimulation and a 4-week visuomotor stepping training on voluntary step initiation in persons with chronic stroke-a pilot study. Front Neurol 2024; 15:1286856. [PMID: 38450075 PMCID: PMC10915046 DOI: 10.3389/fneur.2024.1286856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 02/02/2024] [Indexed: 03/08/2024] Open
Abstract
Purpose Evidence suggests that transcranial direct current stimulation (tDCS) can enhance motor performance and learning of hand tasks in persons with chronic stroke (PCS). However, the effects of tDCS on the locomotor tasks in PCS are unclear. This pilot study aimed to: (1) determine aggregate effects of anodal tDCS combined with step training on improvements of the neural and biomechanical attributes of stepping initiation in a small cohort of persons with chronic stroke (PCS) over a 4-week training program; and (2) assess the feasibility and efficacy of this novel approach for improving voluntary stepping initiation in PCS. Methods A total of 10 PCS were randomly assigned to one of two training groups, consisting of either 12 sessions of VST paired with a-tDCS (n = 6) or sham tDCS (s-tDCS, n = 4) over 4 weeks, with step initiation (SI) tests at pre-training, post-training, 1-week and 1-month follow-ups. Primary outcomes were: baseline vertical ground reaction force (B-vGRF), response time (RT) to initiate anticipatory postural adjustment (APA), and the retention of B-VGRF and RT. Results a-tDCS paired with a 4-week VST program results in a significant increase in paretic weight loading at 1-week follow up. Furthermore, a-tDCS in combination with VST led to significantly greater retention of paretic BWB compared with the sham group at 1 week post-training. Clinical implications The preliminary findings suggest a 4-week VST results in improved paretic limb weight bearing (WB) during SI in PCS. Furthermore, VST combined with a-tDCS may lead to better retention of gait improvements (NCT04437251) (https://classic.clinicaltrials.gov/ct2/show/NCT04437251).
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Affiliation(s)
- Shih-Chiao Tseng
- Neuromechanics Laboratory, Department of Physical Therapy, University of Texas Medical Branch, Galveston, TX, United States
| | - Dana Cherry
- Neuromechanics Laboratory, Department of Physical Therapy, University of Texas Medical Branch, Galveston, TX, United States
| | - Mansoo Ko
- Neuromechanics Laboratory, Department of Physical Therapy, University of Texas Medical Branch, Galveston, TX, United States
| | - Steven R. Fisher
- Neuromechanics Laboratory, Department of Physical Therapy, University of Texas Medical Branch, Galveston, TX, United States
| | - Michael Furtado
- Department of Physical Therapy, University of North Texas Health Science Center at Fort Worth, Fort Worth, TX, United States
| | - Shuo-Hsiu Chang
- Neuromuscular Plasticity Laboratory, Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center at Houston, Houston, TX, United States
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Simonet A, Delafontaine A, Fourcade P, Yiou E. Vertical Center-of-Mass Braking and Motor Performance during Gait Initiation in Young Healthy Adults, Elderly Healthy Adults, and Patients with Parkinson's Disease: A Comparison of Force-Plate and Markerless Motion Capture Systems. SENSORS (BASEL, SWITZERLAND) 2024; 24:1302. [PMID: 38400460 PMCID: PMC10891667 DOI: 10.3390/s24041302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/12/2024] [Accepted: 02/15/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND This study tested the agreement between a markerless motion capture system and force-plate system ("gold standard") to quantify stability control and motor performance during gait initiation. METHODS Healthy adults (young and elderly) and patients with Parkinson's disease performed gait initiation series at spontaneous and maximal velocity on a system of two force-plates placed in series while being filmed by a markerless motion capture system. Signals from both systems were used to compute the peak of forward center-of-mass velocity (indicator of motor performance) and the braking index (indicator of stability control). RESULTS Descriptive statistics indicated that both systems detected between-group differences and velocity effects similarly, while a Bland-Altman plot analysis showed that mean biases of both biomechanical indicators were virtually zero in all groups and conditions. Bayes factor 01 indicated strong (braking index) and moderate (motor performance) evidence that both systems provided equivalent values. However, a trial-by-trial analysis of Bland-Altman plots revealed the possibility of differences >10% between the two systems. CONCLUSION Although non-negligible differences do occur, a markerless motion capture system appears to be as efficient as a force-plate system in detecting Parkinson's disease and velocity condition effects on the braking index and motor performance.
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Affiliation(s)
- Arnaud Simonet
- LADAPT Loiret, Centre de Soins de Suite et de Réadaptation, 45200 Amilly, France;
- CIAMS, Université Paris-Saclay, 91190 Paris, France; (A.D.); (P.F.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | - Arnaud Delafontaine
- CIAMS, Université Paris-Saclay, 91190 Paris, France; (A.D.); (P.F.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
- Département de Chirurgie Orthopédique, Université Libre de Bruxelles, 1050 Bruxelles, Belgium
| | - Paul Fourcade
- CIAMS, Université Paris-Saclay, 91190 Paris, France; (A.D.); (P.F.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | - Eric Yiou
- CIAMS, Université Paris-Saclay, 91190 Paris, France; (A.D.); (P.F.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
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Silva-Batista C, Lira J, Coelho DB, de Lima-Pardini AC, Nucci MP, Mattos ECT, Magalhaes FH, Barbosa ER, Teixeira LA, Amaro Junior E, Ugrinowitsch C, Horak FB. Mesencephalic Locomotor Region and Presynaptic Inhibition during Anticipatory Postural Adjustments in People with Parkinson's Disease. Brain Sci 2024; 14:178. [PMID: 38391752 PMCID: PMC10887111 DOI: 10.3390/brainsci14020178] [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: 01/18/2024] [Revised: 02/11/2024] [Accepted: 02/13/2024] [Indexed: 02/24/2024] Open
Abstract
Individuals with Parkinson's disease (PD) and freezing of gait (FOG) have a loss of presynaptic inhibition (PSI) during anticipatory postural adjustments (APAs) for step initiation. The mesencephalic locomotor region (MLR) has connections to the reticulospinal tract that mediates inhibitory interneurons responsible for modulating PSI and APAs. Here, we hypothesized that MLR activity during step initiation would explain the loss of PSI during APAs for step initiation in FOG (freezers). Freezers (n = 34) were assessed in the ON-medication state. We assessed the beta of blood oxygenation level-dependent signal change of areas known to initiate and pace gait (e.g., MLR) during a functional magnetic resonance imaging protocol of an APA task. In addition, we assessed the PSI of the soleus muscle during APA for step initiation, and clinical (e.g., disease duration) and behavioral (e.g., FOG severity and APA amplitude for step initiation) variables. A linear multiple regression model showed that MLR activity (R2 = 0.32, p = 0.0006) and APA amplitude (R2 = 0.13, p = 0.0097) explained together 45% of the loss of PSI during step initiation in freezers. Decreased MLR activity during a simulated APA task is related to a higher loss of PSI during APA for step initiation. Deficits in central and spinal inhibitions during APA may be related to FOG pathophysiology.
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Affiliation(s)
- Carla Silva-Batista
- Exercise Neuroscience Research Group, University of São Paulo, São Paulo 05508-070, Brazil
- Department of Neurology, Oregon Health and Science University, Portland, OR 97239, USA
| | - Jumes Lira
- Exercise Neuroscience Research Group, University of São Paulo, São Paulo 05508-070, Brazil
- School of Arts, Sciences and Humanities, University of São Paulo, São Paulo 03828-000, Brazil
- School of Physical Education and Sport, University of São Paulo, São Paulo 05508-030, Brazil
| | - Daniel Boari Coelho
- Biomedical Engineering, Federal University of ABC, São Bernardo do Campo 09210-170, Brazil
| | | | | | | | | | - Egberto Reis Barbosa
- Movement Disorders Clinic, Department of Neurology, School of Medicine, University of São Paulo, São Paulo 05508-070, Brazil
| | - Luis Augusto Teixeira
- School of Physical Education and Sport, University of São Paulo, São Paulo 05508-030, Brazil
| | - Edson Amaro Junior
- Department of Radiology, University of São Paulo, São Paulo 05508-090, Brazil
| | - Carlos Ugrinowitsch
- School of Physical Education and Sport, University of São Paulo, São Paulo 05508-030, Brazil
| | - Fay B Horak
- Department of Neurology, Oregon Health and Science University, Portland, OR 97239, USA
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De Waele S, Hallemans A, Maréchal E, Cras P, Crosiers D. Gait initiation in Parkinson's disease: comparison of timing and displacement during anticipatory postural adjustments as a function of motor severity and apathy in a large cohort. Heliyon 2024; 10:e23740. [PMID: 38230232 PMCID: PMC10789592 DOI: 10.1016/j.heliyon.2023.e23740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/14/2023] [Accepted: 12/12/2023] [Indexed: 01/18/2024] Open
Abstract
Introduction Gait initiation is preceded by three anticipatory postural adjustment (APA) phases. In Parkinson's disease (PD) generated force, displacement and timing during APA differ from healthy controls. APA might be influenced by disease status, weight or emotion. It is unknown how motor severity, disease duration or presence of apathy influences APA timing and displacement. Methods We included 99 people with PD and 50 healthy controls (HC) to perform five gait initiation trials following an auditory cue. Force plates measured timing and center of pressure (CoP) displacement during APA phases. Results Time to gait initiation (tGI) was higher in the PD group (p < 0.001, t = 2.74, 95%CI (0.008, 0.066)). The first two APA phases (APA1 and APA2a) lasted longer in PD (respectively p < 0.001, t = 3.87, 95%CI (0.091, 0.28) and p < 0.001, t = 4.1, 95%CI (0.031, 0.091)). Mean CoP displacement, variability in timing and displacement did not differ. A multiple regression model was used to determine if clinical variables were related to gait initiation parameters. tGI was predicted by age (p < 0.001) and weight (p = 0.005). The duration of APA1 was predicted by weight (p = 0.006) and APA2a by age (p < 0.001). Variability in duration of the locomotor phase (LOC) was predicted by age (p < 0.001). Conclusion tGI and initial APA phases are longer in PD than in HC. There are no significant differences in variability of timing or displacement between the two groups. Gait initiation parameters are independent of disease duration, motor severity, medication usage or apathy in PD. Our findings suggest that cueing does not speed up gait initiation but reduces variability.
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Affiliation(s)
- Ségolène De Waele
- Translational Neurosciences, Born-Bunge Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Antwerp University Hospital, Department of Neurology, Antwerp, Belgium
| | - Ann Hallemans
- Research group MOVANT (Movement Antwerp), Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Emke Maréchal
- Antwerp University Hospital, Department of Neurology, Antwerp, Belgium
- ZNA Middelheim Hospital, Department of Neurology, Antwerp, Belgium
| | - Patrick Cras
- Translational Neurosciences, Born-Bunge Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Antwerp University Hospital, Department of Neurology, Antwerp, Belgium
| | - David Crosiers
- Translational Neurosciences, Born-Bunge Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Antwerp University Hospital, Department of Neurology, Antwerp, Belgium
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Hommen JM, Batista JP, Bollheimer LC, Hildebrand F, Laurentius T, Siebers HL. Movement patterns during gait initiation in older adults with various stages of frailty: a biomechanical analysis. Eur Rev Aging Phys Act 2024; 21:1. [PMID: 38218828 PMCID: PMC10787464 DOI: 10.1186/s11556-024-00335-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 12/30/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Gait initiation is challenging for older individuals with poor physical function, particularly for those with frailty. Frailty is a geriatric syndrome associated with increased risk of illness, falls, and functional decline. This study examines whether spatial and temporal parameters of gait initiation differ between groups of older adults with different levels of frailty, and whether fear of falling, and balance ability are correlated with the height of lifting the food during gait initiation. METHODS Sixty-one individuals aged > 65 years, classified by Fried frailty phenotype, performed five self-paced gait initiation trials. Data was collected using a three-dimensional passive optical motion capture system, consisting of 10 cameras with the ability to perceive reflective markers, and two force plates. The total duration of gait initiation and the duration of its four sub-phases, the first step length, and the maximum foot clearance during the first step were derived, and compared statistically between groups. Additionally, an association analysis was conducted between foot clearance and fear of falling, and confidence in balance in older individuals. RESULTS Frail individuals had significantly longer unloading durations, and total durations of gait initiation compared to non-frail older adults. Additionally, they had shorter first step lengths compared to non-frail older adults. Pre-frail older adults also showed shorter steps compared to the non-frail group. However, there were no significant differences between groups for the maximum foot clearance during the first step. Nevertheless, the maximum foot clearance of older individuals correlated significantly with their fear of falling and confidence in balance. CONCLUSION Older adults with reduced physical function and signs of frailty mainly display longer duration of gait initiation and decreased first step length compared to non-frail older adults. The release phase is decreased as the double support phase is prolonged in frail patients. This information can guide the development of specialized exercise programs to improve mobility in this challenging motion between static and dynamic balance.
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Affiliation(s)
- Jana Maria Hommen
- Department of Cardiology, St. Vinzenz-Hospital, Cologne, Germany.
- Department of Geriatric Medicine, Uniklinik RWTH Aachen, Aachen, Germany.
| | - João P Batista
- Chair for Physiotherapy, SRH University of Health, Leverkusen, Germany
| | | | - Frank Hildebrand
- Department of Orthopedic, Trauma and Reconstructive Surgery, Uniklinik RWTH Aachen, Aachen, Germany
| | - Thea Laurentius
- Department of Geriatric Medicine, Uniklinik RWTH Aachen, Aachen, Germany
| | - Hannah Lena Siebers
- Department of Orthopedic, Trauma and Reconstructive Surgery, Uniklinik RWTH Aachen, Aachen, Germany
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Delafontaine A, Vialleron T, Barbier G, Lardon A, Barrière M, García-Escudero M, Fabeck L, Descarreaux M. Effects of Manual Therapy on Parkinson's Gait: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2024; 24:354. [PMID: 38257446 PMCID: PMC10820786 DOI: 10.3390/s24020354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 12/28/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024]
Abstract
Manual therapy (MT) is commonly used in rehabilitation to deal with motor impairments in Parkinson's disease (PD). However, is MT an efficient method to improve gait in PD? To answer the question, a systematic review of clinical controlled trials was conducted. Estimates of effect sizes (reported as standard mean difference (SMD)) with their respective 95% confidence interval (95% CI) were reported for each outcome when sufficient data were available. If data were lacking, p values were reported. The PEDro scale was used for the quality assessment. Three studies were included in the review. MT improved Dynamic Gait Index (SMD = 1.47; 95% CI: 0.62, 2.32; PEDro score: 5/10, moderate level of evidence). MT also improved gait performances in terms of stride length, velocity of arm movements, linear velocities of the shoulder and the hip (p < 0.05; PEDro score: 2/10, limited level of evidence). There was no significant difference between groups after MT for any joint's range of motion during gait (p > 0.05; PEDro score: 6/10, moderate level of evidence). There is no strong level of evidence supporting the beneficial effect of MT to improve gait in PD. Further randomized controlled trials are needed to understand the impact of MT on gait in PD.
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Affiliation(s)
- Arnaud Delafontaine
- Department of Orthopedic Surgery, Université Libre de Bruxelles, 1050 Bruxelles, Belgium;
- Department of Sciences of Physical Activity, Université Québec Trois-Rivières, Trois-Rivières, QC G9A 5H7, Canada; (M.B.); (M.D.)
| | - Thomas Vialleron
- Laboratoire Interdisciplinaire en Neurosciences, Physiologie et Psychologie: Activité Physique, Santé et Apprentissages (LINP2), UFR STAPS, Université Paris Nanterre, 92000 Nanterre, France;
| | - Gaëtan Barbier
- Institut Franco-Européen de Chiropraxie, 94200 Ivry-sur-Seine, France; (G.B.); (A.L.)
- Complexité, Innovation, Activités Motrices et Sportives (CIAMS) Laboratory, Université Paris-Saclay, CEDEX 91405 Orsay, France
- Complexité, Innovation, Activités Motrices et Sportives (CIAMS) Laboratory, Université d’Orléans, 45067 Orléans, France
| | - Arnaud Lardon
- Institut Franco-Européen de Chiropraxie, 94200 Ivry-sur-Seine, France; (G.B.); (A.L.)
| | - Mélodie Barrière
- Department of Sciences of Physical Activity, Université Québec Trois-Rivières, Trois-Rivières, QC G9A 5H7, Canada; (M.B.); (M.D.)
| | - María García-Escudero
- Faculté de Médecine et des Sciences de la Santé, Université Catholique de Valence, San Vicente Martir, 46900 Valence, Spain;
| | - Laurent Fabeck
- Department of Orthopedic Surgery, Université Libre de Bruxelles, 1050 Bruxelles, Belgium;
| | - Martin Descarreaux
- Department of Sciences of Physical Activity, Université Québec Trois-Rivières, Trois-Rivières, QC G9A 5H7, Canada; (M.B.); (M.D.)
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Yousefi M, Zivari S, Yiou E, Caderby T. Effect of Chronic Ankle Instability on the Biomechanical Organization of Gait Initiation: A Systematic Review. Brain Sci 2023; 13:1596. [PMID: 38002555 PMCID: PMC10669647 DOI: 10.3390/brainsci13111596] [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: 09/27/2023] [Revised: 11/13/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023] Open
Abstract
This systematic review was conducted to provide an overview of the effects of chronic ankle instability (CAI) on the biomechanical organization of gait initiation. Gait initiation is a classical model used in the literature to investigate postural control in healthy and pathological individuals. PubMed, ScienceDirect, Scopus, Web of Science, and Google Scholar were searched for relevant articles. Eligible studies were screened and data extracted by two independent reviewers. An evaluation of the quality of the studies was performed using the Downs and Black checklist. A total of 878 articles were found in the initial search, but only six studies met the inclusion criteria. The findings from the literature suggest that CAI affects the characteristics of gait initiation. Specifically, individuals with CAI exhibit notable differences in reaction time, the spatiotemporal parameters of anticipatory postural adjustments (APAs) and step execution, ankle-foot kinematics, and muscle activation compared to healthy controls. In particular, the observed differences in APA patterns associated with gait initiation suggest the presence of supraspinal motor control alterations in individuals with CAI. These findings may provide valuable information for the rehabilitation of these patients. However, the limited evidence available calls for caution in interpreting the results and underscores the need for further research.
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Affiliation(s)
- Mohammad Yousefi
- Faculty of Sport Sciences, University of Birjand, Birjand 9717434765, Iran; (M.Y.); (S.Z.)
| | - Shaghayegh Zivari
- Faculty of Sport Sciences, University of Birjand, Birjand 9717434765, Iran; (M.Y.); (S.Z.)
| | - Eric Yiou
- Complexité, Innovation, Activités Motrices et Sportives (CIAMS), Université Paris-Saclay, 91400 Orsay, France
- Complexité, Innovation, Activités Motrices et Sportives (CIAMS), Université d’Orléans, 45067 Orléans, France
| | - Teddy Caderby
- Laboratoire IRISSE—EA 4075, UFR des Sciences de l’Homme et de l’Environnement, Université de La Réunion, 97430 Le Tampon, La Réunion, France;
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Salamci M, Salcı Y, Topuz S, Yalçın Aİ, Acar Özen P, Tuncer A. Gait initiation in multiple sclerosis patients with and without functional loss. Mult Scler Relat Disord 2023; 79:104990. [PMID: 37708821 DOI: 10.1016/j.msard.2023.104990] [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: 03/13/2023] [Revised: 07/25/2023] [Accepted: 09/01/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Gait initiation (GI) is an important functional task related to balance and gait performance. In addition, it has predictive importance for falls and postural instability in patient with multiple sclerosis (MS). However, it is uncertain how GI is affected in patients in the early stage of MS (Expanded Disability Status Scale (EDSS) ≤3). In this study, it was aimed to investigate the anticipatory postural adjustments (APAs), posterior center of pressure (COPap) displacement, and spatiotemporal variability during GI in patients with and without functional loss in the early stage of MS. METHODS Forty-four participants (31 MS patients and 13 healthy subjects) involved in this prospective cross-sectional study were divided into three groups: Group-I: Patients without functional loss (EDSS 0 to 1.5) (n = 14), Group-II: Patients with functional loss (EDSS 2 to 3) (n = 17) and Group-III: Healthy subjects (n = 13). Electromyographic activity of the bilateral tibialis anterior (TA) and gastrocnemius medialis (GM) and COPap displacement were recorded during the postural phase of GI. Additionally, spatiotemporal parameters were recorded within the first three steps, and the coefficient of variation was calculated with 40 walks for variability. RESULTS There were significant differences in the Kruskal-Wallis tests of variables (p<0.05). Group-I demonstrated smaller APAs magnitudes in TA [stance (p = 0.01), swing (p = 0.01)], GM of swing limb (p<0.0001), and smaller COPap displacement (p<0.0001) compared to group-III. Group-II demonstrated smaller APAs magnitudes in all muscles (p<0.0001) compared to group-III and the smallest COPap displacement (p<0.0001). Group-I showed a significant increase in stride width variability compared to group-III (p = 0.01). Group-II showed a significant increase in several variabilities [first stride length (p<0.0001), second stride time (p<0.0001), first double support time (p<0.0001), stride width (p<0.0001)] compared to group-III. CONCLUSION Patients in the early stage of MS had impairment in both the postural and locomotor phases of GI with more obvious in the patients with functional loss. The results indicate that MS patients without functional loss have difficulty initiating gait. Although there is no functional loss, the patients have a risk of falls, postural instability, and gait impairment due to their inability to initiate gait effectively. As a result, rehabilitation is necessary even if there is no functional loss in patients with MS.
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Affiliation(s)
- Mustafacan Salamci
- Department of Neurological Physiotherapy and Rehabilitation, Gazi University, Ankara, Turkey.
| | - Yeliz Salcı
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Semra Topuz
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Ali İmran Yalçın
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Pınar Acar Özen
- Department of Neurology, Hacettepe University, Ankara, Turkey
| | - Aslı Tuncer
- Department of Neurology, Hacettepe University, Ankara, Turkey
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12
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Waldon KT, Stout A, Manning K, Gray L, Wilson DG, Kang GE. Dual-Task Interference Effects on Lower-Extremity Muscle Activities during Gait Initiation and Steady-State Gait among Healthy Young Individuals, Measured Using Wireless Electromyography Sensors. SENSORS (BASEL, SWITZERLAND) 2023; 23:8842. [PMID: 37960541 PMCID: PMC10647760 DOI: 10.3390/s23218842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/21/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023]
Abstract
To maintain a healthy lifestyle, adults rely on their ability to walk while simultaneously managing multiple tasks that challenge their coordination. This study investigates the impact of cognitive dual tasks on lower-limb muscle activities in 21 healthy young adults during both gait initiation and steady-state gait. We utilized wireless electromyography sensors to measure muscle activities, along with a 3D motion capture system and force plates to detect the phases of gait initiation and steady-state gait. The participants were asked to walk at their self-selected pace, and we compared single-task and dual-task conditions. We analyzed mean muscle activation and coactivation in the biceps femoris, vastus lateralis, gastrocnemius, and tibialis anterior muscles. The findings revealed that, during gait initiation with the dual-task condition, there was a decrease in mean muscle activation and an increase in mean muscle coactivation between the swing and stance limbs compared with the single-task condition. In steady-state gait, there was also a decrease in mean muscle activation in the dual-task condition compared with the single-task condition. When participants performed dual-task activities during gait initiation, early indicators of reduced balance capability were observed. Additionally, during dual-task steady-state gait, the knee stabilizer muscles exhibited signs of altered activation, contributing to balance instability.
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Affiliation(s)
- Ke’Vaughn Tarrel Waldon
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX 75080, USA (A.S.)
| | - Angeloh Stout
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX 75080, USA (A.S.)
| | - Kaitlin Manning
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX 75080, USA (A.S.)
| | - Leslie Gray
- Department of Prosthetics-Orthotics, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - David George Wilson
- Department of Prosthetics-Orthotics, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Gu Eon Kang
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX 75080, USA (A.S.)
- Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
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13
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Oku K, Tanaka S, Kida N. Dissociation of perception and motor execution of lower limb in multi-directional movements. Sci Rep 2023; 13:17237. [PMID: 37821576 PMCID: PMC10567789 DOI: 10.1038/s41598-023-44544-2] [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: 03/19/2023] [Accepted: 10/10/2023] [Indexed: 10/13/2023] Open
Abstract
Estimating the action capability is vital for humans to move their bodies successfully. Researchers have proposed reachability as an overestimation of motor abilities by judging unreachable distances as reachable. The existing literature has mainly investigated the sagittal direction, but multi-directional reachability is unexplored. This study examined the relationship between perception and motor using the reaching of the lower limbs in multiple directions. We asked 16 adults to reach targets projected onto the floor at 21 locations (seven directions and three distances) to estimate the reaching time. We found that the reaching time slowed as the direction increased toward the contralateral side, but the subjective reaching time did not change with direction. Multiple regression analysis showed that the subjective reaching time could be calculated accurately, mainly using the duration from the toe leaving the ground to movement completion. These results suggest that changes in direction may not be perceived precisely by the motor system of the lower limbs and that the subjective reaching time was strongly affected by the time after the toe left the ground. Our findings provide novel insights into the relationship between motor and perception in multiple directions, which may provide a new strategy for the maximal performance of lower-limb movement.
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Affiliation(s)
- Kyosuke Oku
- Graduate School of Human and Environmental Studies, Kyoto University, Kyoto, Japan
| | - Shinsuke Tanaka
- Graduate School of Human and Environmental Studies, Kyoto University, Kyoto, Japan
- Institute for Liberal Arts and Sciences, Kyoto University, Kyoto, Japan
| | - Noriyuki Kida
- Faculty of Arts and Sciences, Kyoto Institute of Technology, Kyoto, Japan.
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14
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Kunimura H, Oda H, Kawasaki T, Tsujinaka R, Hamada N, Fukuda S, Matsuoka M, Hiraoka K. Effect of Laterally Moving Tactile Stimuli to Sole on Anticipatory Postural Adjustment of Gait Initiation in Healthy Males. Brain Sci 2023; 13:1411. [PMID: 37891780 PMCID: PMC10604984 DOI: 10.3390/brainsci13101411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 09/29/2023] [Accepted: 10/02/2023] [Indexed: 10/29/2023] Open
Abstract
This present study examined the effect of the laterally moving tactile stimuli (LMTS) to the sole on the anticipatory postural adjustment (APA) of the gait initiation. Thirteen healthy males participated in this study. A sound cue was provided at the beginning of each trial. The participants took three steps forward from a quiet stance at their preferred time after the start cue. The LMTS were delivered to the sole after the start cue. The loci of the tactile stimuli moved from the left- to the right-most side of the sole and then moved from the right- to the left-most side of that in a stimuli cycle. The duration of one stimuli cycle was 960 ms, and this cycle was repeated 16 times in a trial. The APA did not onset at the specific direction or phase of the LMTS, indicating that they did not use any specific phase of the stimuli as a trigger for initiating the gait. The LMTS decreased the amplitude and increased the duration of the APA. Simultaneously, the LMTS increased the time between the APA onset and toe-off of the initial support leg, indicating that they moved slowly when initiating gait during the LMTS. Those findings are explained by the view that the suppression of the APA induced via the LMTS to the sole is caused by the slowing down of the gait initiation due to masking the tactile sensation of the sole.
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Affiliation(s)
- Hiroshi Kunimura
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, 3-7-30 Habikino, Habikino 583-8555, Osaka, Japan; (H.K.); (H.O.); (T.K.); (N.H.); (S.F.); (M.M.)
- Department of Physical Therapy, Todaiji Ryoiku Hospital for Children, 406-1 Zoshicho, Nara 630-8211, Nara, Japan
| | - Hitoshi Oda
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, 3-7-30 Habikino, Habikino 583-8555, Osaka, Japan; (H.K.); (H.O.); (T.K.); (N.H.); (S.F.); (M.M.)
| | - Taku Kawasaki
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, 3-7-30 Habikino, Habikino 583-8555, Osaka, Japan; (H.K.); (H.O.); (T.K.); (N.H.); (S.F.); (M.M.)
| | - Ryo Tsujinaka
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, 3-7-30 Habikino, Habikino 583-8555, Osaka, Japan;
| | - Naoki Hamada
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, 3-7-30 Habikino, Habikino 583-8555, Osaka, Japan; (H.K.); (H.O.); (T.K.); (N.H.); (S.F.); (M.M.)
| | - Shiho Fukuda
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, 3-7-30 Habikino, Habikino 583-8555, Osaka, Japan; (H.K.); (H.O.); (T.K.); (N.H.); (S.F.); (M.M.)
| | - Masakazu Matsuoka
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, 3-7-30 Habikino, Habikino 583-8555, Osaka, Japan; (H.K.); (H.O.); (T.K.); (N.H.); (S.F.); (M.M.)
| | - Koichi Hiraoka
- School of Medicine, Osaka Metropolitan University, 3-7-30 Habikino, Habikino 583-8555, Osaka, Japan
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15
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Yen YL, Ye SK, Liang JN, Lee YJ. Recognition of walking directional intention employed ground reaction forces and center of pressure during gait initiation. Gait Posture 2023; 106:23-27. [PMID: 37639961 DOI: 10.1016/j.gaitpost.2023.08.009] [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: 01/01/2023] [Revised: 08/10/2023] [Accepted: 08/18/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Movement intentions are generally classified by Electroencephalogram (EEG) and have been used in gait initiation prediction. However, it is not easy to collect EEG data and practical in reality. Alternatively, ground reaction force (GRF) and the center of pressure (COP) is produced by the contact between the foot and the ground during a specific period of walking, which are the characteristics of evaluating gait performance RESEARCH QUESTION: The study aims to use a deep learning technique to recognize the data of the COP and GRF to classify straight walking and right turn. Second, the study aims to reveal gait characteristics that could replace EEG to predict walking directional intentions METHODS: Ten healthy male adults were instructed to stand on the force platform and self-selected to perform three conditions: standstill, straight walking, and right turn. The onset of gait initiation was evaluated by muscle activation of the right tibialis anterior, and EEG and the COP displacement evaluated the onset of gait intention. Subsequently, GRF and COP would be treated as features to classify the gait intention in the Long Short-Term Memory (LSTM) model. RESULTS The results revealed that the onset of EEG and the COP displacement initiation were statistically significant differences between straight walking and right turn. For the classification, the average accuracy of the LSTM model with GRF and COP as features reached the highest one, 94.79 %, depending on the heel- or toe-off of the swing leg. The results indicated that gait intentions could be classified based on the GRF and COP. SIGNIFICANCE The machine learning technique of LSTM with gait parameters can recognize the gait intention of changing walking orientation. Our model and approach would be expected to provide advanced predictions, such as exoskeleton control or pedestrian traffic flow.
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Affiliation(s)
- Yu-Lin Yen
- Department of Industrial Engineering and Engineering Management, National Tsing-Hua University, Hsinchu, Taiwan
| | - Shao-Kang Ye
- Department of Industrial Engineering and Engineering Management, National Tsing-Hua University, Hsinchu, Taiwan
| | - Jing Nong Liang
- Department of Physical Therapy, University of Nevada Las Vegas, Las Vegas, USA
| | - Yun-Ju Lee
- Department of Industrial Engineering and Engineering Management, National Tsing-Hua University, Hsinchu, Taiwan.
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16
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Rapson R, Latour JM, Carter B, Pitsouni V, Marsden JF. The novel Next Step test is a reliable measure of anticipatory postural adjustments made by children with cerebral palsy prior to taking a step. Gait Posture 2023; 105:110-116. [PMID: 37541088 DOI: 10.1016/j.gaitpost.2023.07.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/15/2023] [Accepted: 07/27/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND Children with cerebral palsy (CP) make smaller medio-lateral anticipatory postural adjustments (APAs) than typically developing peers when stepping forward to a medial target. They are also less accurate at reaching the stepping target. The Next Step test involves the biomechanical measurement of APAs and foot placement error. These may be useful outcome measures to evaluate dynamic balance in a clinical trial. The reliability of the measures must be assessed to establish their reliability as research tools. RESEARCH QUESTION What is the inter-rater and intra-rater reliability of stepping accuracy and measures of APAs made by children prior to taking a step? METHODS Typically developing (TD) (n = 14) or children with CP (n = 16) were recruited from local clinics. Children stepped to electro-luminescent targets placed medially and laterally to each foot. Stepping responses were measured using a force plate and 3D motion analysis of markers placed on the feet and pelvis. The APA was defined as the movement of the centre of pressure (COP) and the centre of mass (COM) estimated via pelvic markers, prior to lifting the lead leg. Stepping accuracy was defined as the absolute distance between the target and end foot position. Participants undertook two data collection sessions separated by at least one week. In session one, the test was measured by rater 1 who repeated this in session two, along with another data collection by a rater 2 or rater 3, after a rest period. Where data were normally distributed, they were assessed for inter-rater and intra-rater reliability using an intra-class correlation coefficient (ICC) and Bland-Altman plots. The standard error of measurement was calculated to determine the minimum difference needed to detect true change. RESULTS There was no between-group differences in group characteristics (age, weight, height) or in stepping velocity. We found good to excellent reliability when measuring the amplitude and velocity of medio-lateral APAs (ICC range 0.73-0.89). The reliability of antero-posterior APAs was more variable (ICC range 0.08-0.92). The minimum difference to detect a true change for peak medio-lateral motion of COP ranges from 23.7 mm to 29.6 mm and for peak velocity of medio-lateral COM estimate 41-61.9 mm. Stepping accuracy was not normally distributed. SIGNIFICANCE The Next Step test is a reliable measure of dynamic balance. The peak medio-lateral motion of the COP and medio-lateral velocity of the COM estimate are reliable when measured during a constrained stepping task in ambulant children with cerebral palsy.
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Affiliation(s)
- Rachel Rapson
- School of Health Professions, Faculty of Health, University of Plymouth, PL6 8BH, United Kingdom; Torbay and South Devon NHS Trust, Torquay TQ2 7BA, United Kingdom.
| | - Jos M Latour
- School of Nursing and Midwifery, Faculty of Health, University of Plymouth, United Kingdom
| | | | - Vasiliki Pitsouni
- School of Health Professions, Faculty of Health, University of Plymouth, PL6 8BH, United Kingdom
| | - Jonathan F Marsden
- School of Health Professions, Faculty of Health, University of Plymouth, PL6 8BH, United Kingdom
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17
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Oku K, Tanaka S, Kida N. Direction and distance dependency of reaching movements of lower limb. PLoS One 2023; 18:e0290745. [PMID: 37624786 PMCID: PMC10456125 DOI: 10.1371/journal.pone.0290745] [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: 02/27/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
Efficient body movement is required in our daily lives, as it facilitates responding to the external environment and producing movements in various directions and distances. While numerous studies have reported on goal-directed movements in the frontal direction during gait initiation, there is limited research on the efficient movement of the lower limbs in multiple directions and distances. Therefore, we aimed to examine changes in the kinematics of lower-limb reaching movements to determine skilled motor ability in terms of direction and distance. Sixteen adults (10 male participants) were requested to reach targets projected on the floor in seven directions and at three distances for a total of 21 points. The reaching time slowed down for the contralateral side (right foot to left-sided target) and was caused by a slower start of the toe movement. To identify the cause of this delay, we analyzed the onset of movement at each joint and found that movement to the contralateral side starts from the hip, followed by the knee, and subsequently the toe. The time-to-peak velocity was also calculated, and the motion required to reach the target in the shortest time varied depending on direction and distance. These results suggested that movement kinematics vary with direction and distance, resulting in a slower reaching time on the contralateral side. The results of our study hold promise for potential applications in sports and rehabilitation.
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Affiliation(s)
- Kyosuke Oku
- Graduate School of Human and Environmental Studies, Kyoto University, Kyoto, Japan
- Faculty of Arts and Sciences, Kyoto Institute of Technology, Kyoto, Japan
| | - Shinsuke Tanaka
- Graduate School of Human and Environmental Studies, Kyoto University, Kyoto, Japan
- Institute for Liberal Arts and Sciences, Kyoto University, Kyoto, Japan
| | - Noriyuki Kida
- Faculty of Arts and Sciences, Kyoto Institute of Technology, Kyoto, Japan
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18
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Xie L, Cho S. Ankle Strategies for Step-Aside Movement during Straight Walking. J Clin Med 2023; 12:5215. [PMID: 37629258 PMCID: PMC10455850 DOI: 10.3390/jcm12165215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/02/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
The step-aside movement, also known as the dodging step, is a common maneuver for avoiding obstacles while walking. However, differences in neural control mechanisms and ankle strategies compared to straight walking can pose a risk of falling. This study aimed to examine the differences in tibialis anterior (TA), peroneus longus (PL), and soleus (SOL) muscle contractions, foot center of pressure (CoP) displacement, and ground reaction force (GRF) generation between step-aside movement and straight walking to understand the mechanism behind step-aside movement during walking. Twenty healthy young male participants performed straight walking and step-aside movements at comfortable walking speeds. The participants' muscle contractions, CoP displacement, and GRF were measured. The results show significant greater bilateral ankle muscle contractions during the push and loading phases of step-aside movement than during straight walking. Moreover, the CoP displacement, GRF generation mechanism, and timing differed from those observed during straight walking. These findings provide valuable insights for rehabilitation professionals in the development of clinical decisions for populations at a risk of falls and lacking gait stability.
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Affiliation(s)
| | - Sanghyun Cho
- Department of Physical Therapy, Yonsei University, Wonju 26493, Republic of Korea;
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19
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Ciatto L, Pullia M, Tavilla G, Dauccio B, Messina D, De Cola MC, Quartarone A, Cellini R, Bonanno M, Calabrò RS. Do Patients with Parkinson's Disease Benefit from Dynamic Body Weight Support? A Pilot Study on the Emerging Role of Rysen. Biomedicines 2023; 11:2148. [PMID: 37626645 PMCID: PMC10452686 DOI: 10.3390/biomedicines11082148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/27/2023] Open
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor and non-motor alterations. Typical motor symptoms include resting tremors, bradykinesia (hypokinesia or akinesia), muscular stiffness, gait alterations, and postural instability. In this context, neurorehabilitation may have a pivotal role in slowing the progression of PD, using both conventional and innovative rehabilitation approaches. Thirty patients (15 males and 15 females) affected by PD were enrolled in our study. We randomly divided the patients into two groups, an experimental group (EG) and a control group (CG). In particular, the EG performed gait and balance training using the Rysen system, which is an innovative body weight support (BWS) system, whilst the CG received conventional physiotherapy. Both groups underwent 20 sessions, five times weekly, with each session lasting about 40 min. At the end of the training sessions (T1), we found that both groups (EG and CG) achieved clinical improvements, although the EG showed better scores for post-treatment regarding global motor functioning and postural stability compared to the CG. In conclusion, our results suggest that the Rysen system, which is an innovative BWS tool, could be considered a valid device for improving postural control and global motor functions, when compared to conventional gait training, in patients affected by PD.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Mirjam Bonanno
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Via Palermo, C.da Casazza, S.S 113, 98123 Messina, Italy; (L.C.); (M.P.); (G.T.); (B.D.); (D.M.); (M.C.D.C.); (A.Q.); (R.C.); (R.S.C.)
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20
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Stania M, Pawłowski M, Marszałek W, Juras G, Słomka KJ, Król P. A preliminary investigation into the impact of shock wave therapy and sonotherapy on postural control of stepping tasks in patients with Achilles tendinopathy. Front Neurol 2023; 14:1157335. [PMID: 37332988 PMCID: PMC10272772 DOI: 10.3389/fneur.2023.1157335] [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: 02/02/2023] [Accepted: 05/11/2023] [Indexed: 06/20/2023] Open
Abstract
Objective The outcomes of physical therapy are commonly assessed with subjective scales and questionnaires. Hence, a continuous search to identify diagnostic tests that would facilitate objective assessment of symptom reduction in those patients with Achilles tendinopathy who undergo mechanotherapy. The main aim of this study was to evaluate and compare the effectiveness of shock wave and ultrasound treatments, using objective posturographic assessment during step-up and step-down initiation. Materials and methods The patients with non-insertional Achilles tendinopathy and pain lasting for more than 3 months were randomly assigned to one of the experimental groups, i.e., radial shock wave therapy (RSWT), ultrasound therapy, or placebo ultrasound. All groups also received deep friction massage as the primary therapy. The transitional locomotor task was performed with the affected and unaffected limb in random order, on two force platforms under two conditions (step-up and step-down). The recording of center of foot pressure displacements was divided into three phases: quiet standing before step-up/step-down, transit, and quiet standing until measurement completion. Pre-intervention measurements were performed and then short-term follow-ups at weeks 1 and 6 post-therapy. Results The three-way repeated measures ANOVA showed few statistically significant two-factor interactions between therapy type, time point of measurement and the type of the locomotor task. Significant increases in postural sway were observed in the entire study population throughout the follow-up period. Three-way ANOVAs revealed a group effect (shock wave vs. ultrasound) on almost all variables of the quiet standing phase prior to step-up/step-down initiation. Overall, postural stability before the step-up and step-down tasks appeared to be more efficient in patients who had undergone RSWT compared to the ultrasound group. Conclusion Objective posturographic assessment during step-up and step-down initiation did not demonstrate therapeutic superiority of any of the three therapeutic interventions used in patients with non-insertional Achilles tendinopathy.Clinical Trial Registration: The trial was prospectively registered in the Australian and New Zealand Clinical Trials Registry (no. ACTRN12617000860369; registration date: 9.06.2017).
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21
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Duan Q, Liu W, Yang J, Huang B, Shen J. Effect of Cathodal Transcranial Direct Current Stimulation for Lower Limb Subacute Stroke Rehabilitation. Neural Plast 2023; 2023:1863686. [PMID: 37274448 PMCID: PMC10239296 DOI: 10.1155/2023/1863686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 05/04/2023] [Accepted: 05/10/2023] [Indexed: 06/06/2023] Open
Abstract
Methods A pilot double-blind and randomized clinical trial. Ninety-one subjects with subacute stroke were treated with cathodal/sham stimulation tDCS based on CGR (physiotherapy 40 min/d and occupational therapy 20 min/d) once daily for 20 consecutive working days. Computer-based stratified randomization (1 : 1) was employed by considering age and sex, with concealed assignments in opaque envelopes to ensure no allocation errors after disclosure at the study's end. Patients were evaluated at T0 before treatment, T1 immediately after the posttreatment assessment, and T2 assessment one month after the end of the treatment. The primary outcome index was assessed: lower limb Fugl-Meyer motor score (FMA-LE); secondary endpoints were other gait assessment and relevant stroke scale assessment. Results Patients in the trial group performed significantly better than the control group in all primary outcome indicators assessed posttreatment T1 and at follow-up T2: FMA-LE outcome indicators between the two groups in T1 (P = 0.032; effect size 1.00, 95% CI: 0.00 to 2.00) and FMA-LE outcome indicators between the two groups in T2 (P = 0.010; effect size 2.00, 95% CI: 1.00 to 3.00). Conclusion In the current pilot study, ctDCS plus CGR was an effective treatment modality to improve lower limb motor function with subacute stroke. The effectiveness of cathodal tDCS in poststroke lower limb motor dysfunction is inconclusive. Therefore, a large randomized controlled trial is needed to verify its effectiveness.
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Affiliation(s)
- Qian Duan
- Department of Rehabilitation, The Eighth People's Hospital of Shanghai, Shanghai 200105, China
| | - Wenying Liu
- Department of Rehabilitation, The Eighth People's Hospital of Shanghai, Shanghai 200105, China
| | - Jinhui Yang
- Department of Rehabilitation, Shanxi Provincial People's Hospital, Taiyuan 030012, China
| | - Ben Huang
- Department of Rehabilitation, The Eighth People's Hospital of Shanghai, Shanghai 200105, China
| | - Jie Shen
- Department of Rehabilitation, The Eighth People's Hospital of Shanghai, Shanghai 200105, China
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22
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Rum L, Russo Y, Vannozzi G, Macaluso A. "Posture first": Interaction between posture and locomotion in people with low back pain during unexpectedly cued modification of gait initiation motor command. Hum Mov Sci 2023; 89:103094. [PMID: 37148816 DOI: 10.1016/j.humov.2023.103094] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 04/14/2023] [Accepted: 04/21/2023] [Indexed: 05/08/2023]
Abstract
The ability to adapt anticipatory postural adjustments (APAs) in response to perturbations during single-joint movements is altered in people with chronic low back pain (LBP), but a comprehensive analysis during functional motor tasks is still missing. This study aimed to compare APAs and stepping characteristics during gait initiation between people with LBP and healthy controls, both in normal (without cue occurrence) condition and when an unexpected visual cue required to switch the stepping limb. Fourteen individuals with LPB and 10 healthy controls performed gait initiation in normal and switch conditions. The postural responses were evaluated through the analysis of center of pressure, propulsive ground reaction forces, trunk and whole-body kinematics, and activation onsets of leg and back muscles. During normal gait initiation, participants with LBP exhibited similar APAs and stepping characteristics to healthy controls. In the switch condition, individuals with LBP were characterized by greater mediolateral postural stability but decreased forward body motion and propulsion before stepping. The thorax motion was associated with forward propulsion parameters in both task conditions in people with LBP but not healthy controls. No between-group differences were found in muscle activation onsets. The results suggest that postural stability is prioritized over forward locomotion in individuals with LBP. Furthermore, the condition-invariant coupling between thorax and whole-body forward propulsion in LBP suggests an adaptation in the functional use of the thorax within the postural strategy, even in poor balance conditions.
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Affiliation(s)
- Lorenzo Rum
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro De Bosis 6, 00135 Rome, Italy.
| | - Yuri Russo
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro De Bosis 6, 00135 Rome, Italy; Department of Sport and Health Sciences, University of Exeter, St Luke's Campus, Magdalen Road, Exeter EX1 2LU, UK
| | - Giuseppe Vannozzi
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro De Bosis 6, 00135 Rome, Italy
| | - Andrea Macaluso
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro De Bosis 6, 00135 Rome, Italy
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Thomas E, Rossi C, Petrigna L, Messina G, Bellafiore M, Şahin FN, Proia P, Palma A, Bianco A. Evaluation of Posturographic and Neuromuscular Parameters during Upright Stance and Hand Standing: A Pilot Study. J Funct Morphol Kinesiol 2023; 8:jfmk8020040. [PMID: 37092372 PMCID: PMC10123693 DOI: 10.3390/jfmk8020040] [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: 02/06/2023] [Revised: 03/24/2023] [Accepted: 03/28/2023] [Indexed: 04/25/2023] Open
Abstract
Upright bipedal posture is the physiological human posture; however, it is not the only possible form of human standing; indeed, an inverted position, a handstand, is required during gymnastics or other sports. Thus, this study aimed to understand the differences between the two standing strategies from a postural and neuromuscular perspective. Thirteen gymnasts with at least three years of sports experience underwent a baropodometric assessment and a surface electromyography (sEMG) examination in a standard upright bipodalic stance and during a handstand. The sEMG examination was performed on the gastrocnemius during an upright stance and on the flexor carpi radialis during the handstand. Limb weight distribution presented differences between the two vertical stances (p < 0.01). During the handstand, the weight ratio was prevalently observed on the palm of the hand for both hands with a significant difference between the front and rear aspect of the hand compared to the standing tasks (p < 0.01). Normalized sEMG amplitude showed significant differences during bipedal standing and hand standing; however, over a 5 s period, the normalized median frequency (MDF) value was similar for the two tasks. Both standing tasks presented similar postural weight managing patterns when analysed on the frontal plane, but they were different on the sagittal plane. In addition, the neuromuscular patterns during a 5 s window differ in amplitude but not for the frequency domain.
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Affiliation(s)
- Ewan Thomas
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Giovanni Pascoli 6, 90144 Palermo, Italy
| | - Carlo Rossi
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Giovanni Pascoli 6, 90144 Palermo, Italy
| | - Luca Petrigna
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123 Catania, Italy
| | - Giuseppe Messina
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Giovanni Pascoli 6, 90144 Palermo, Italy
| | - Marianna Bellafiore
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Giovanni Pascoli 6, 90144 Palermo, Italy
| | - Fatma Neşe Şahin
- Department of Coaching Education, Faculty of Sport Science, Ankara University, Ankara 06830, Türkiye
| | - Patrizia Proia
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Giovanni Pascoli 6, 90144 Palermo, Italy
| | - Antonio Palma
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Giovanni Pascoli 6, 90144 Palermo, Italy
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Giovanni Pascoli 6, 90144 Palermo, Italy
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24
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Muijres W, Arnalsteen S, Daenens C, Afschrift M, De Groote F. Accuracy-speed-stability trade-offs in a targeted stepping task are similar in young and older adults. Front Aging Neurosci 2023; 15:1130707. [PMID: 36998319 PMCID: PMC10043485 DOI: 10.3389/fnagi.2023.1130707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/24/2023] [Indexed: 03/16/2023] Open
Abstract
IntroductionStepping accuracy, speed, and stability are lower in older compared to young adults. Lower stepping performance in older adults may be due to larger accuracy-speed-stability trade-offs because of reduced ability to simultaneously fulfill these task-level goals. Our goal was to evaluate whether trade-offs are larger in older compared to young adults in a targeted stepping task. Since sensorimotor function declines with age, our secondary goal was to evaluate whether poorer sensorimotor function was associated with larger trade-offs.MethodsTwenty-five young (median 22 years old) and 25 older (median 70 years old) adults stepped into projected targets in conditions with various levels of accuracy, speed, and stability requirements. We determined trade-offs as the change in performance, i.e., foot placement error, step duration, and mediolateral center of pressure path length, between each of these conditions and a control condition. To assess age-related differences in the magnitude of trade-offs, we compared the change in performance between age groups. Associations between trade-offs and measures of sensorimotor function were tested using correlations.ResultsWe found an accuracy-speed and an accuracy-stability trade-off in both young and older adults, but trade-offs were not different between young and older adults. Inter-subject differences in sensorimotor function could not explain inter-subject differences in trade-offs.ConclusionAge-related differences in the ability to combine task-level goals do not explain why older adults stepped less accurate and less stable than young adults. However, lower stability combined with an age-independent accuracy-stability trade-off could explain lower accuracy in older adults.
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Affiliation(s)
- Wouter Muijres
- Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | | | - Cas Daenens
- Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Maarten Afschrift
- Department of Human Movement Sciences, Vrije Universiteit, Amsterdam, Netherlands
- Robotics, Automation and Mechatronics, KU Leuven, Leuven, Belgium
| | - Friedl De Groote
- Department of Movement Sciences, KU Leuven, Leuven, Belgium
- *Correspondence: Friedl De Groote,
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Rapson R, Latour JM, Carter B, Pitsouni V, Marsden JF. A cross sectional study investigating dynamic balance when stepping to targets in children with cerebral palsy compared to typically developing children. Gait Posture 2023; 101:154-159. [PMID: 36842256 DOI: 10.1016/j.gaitpost.2023.02.006] [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: 06/06/2022] [Revised: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 02/28/2023]
Abstract
BACKGROUND Children with Cerebral Palsy (CP) have altered anticipatory postural adjustments (APAs) during gait initiation. These APAs may affect dynamic balance in tasks such as stepping. RESEARCH QUESTIONS How are APAs in children with CP affected during stepping to precise targets? How do children with CP modulate APAs when stepping to medial and lateral targets? What is the association between APAs and symptom severity, movement quality and impairment profile? METHOD Children undertook a stepping task to laterally and medially placed targets with either leg, in a randomised order. Movement of the centre of pressure (COP) and markers at the pelvis and foot were measured via a force plate and 3D motion analysis. Motion of the centre of mass (COM) was estimated via pelvic markers. APAs were assessed prior to leading leg lift-off in medio-lateral and antero-posterior directions. Stepping error was calculated. Baseline characteristics of children with CP included Gross Motor Function Measure (GMFM), Quality Function Measure (QFM), leg muscle hypertonia (Tardieu test) and strength (manual dynamometry). RESULTS Sixteen ambulant children with CP (12.2 years ± 2.2) and 14 typically developing (TD) children (11.6 years ± 2.9) were assessed. In children with CP, APAs in the medio-lateral direction were 20-30% smaller. Children with CP were less able to modulate their APAs with steps to medial and laterally placed targets, than TD children. Medio-lateral COP motion was associated with movement quality assessed by QFM subsections, GMFM (correlation coefficient r = 0.66-0.80) and hip abductor strength (r = 0.75). Antero-posterior APAs were significantly smaller when stepping with the non-paretic leg in children with CP. APA size was positively related to the length of the contralateral, paretic gastrocnemius (r = 0.77). Stepping error was higher in children with CP and inversely correlated to the size of the medio-lateral APA. DISCUSSION Children with CP show smaller medio-lateral APAs especially when stepping to medially placed targets. APA size may be limited by proximal muscle strength and gastrocnemius length.
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Affiliation(s)
- Rachel Rapson
- School of Health Professions, Faculty of Health, University of Plymouth PL6 8BH, UK; Children and Family Health Devon, Torbay and South Devon NHS Foundation Trust, Devon TQ1 7AA, UK.
| | - Jos M Latour
- School of Nursing and Midwifery, Faculty of Health, University of Plymouth, PL6 8BH, UK
| | - Bernie Carter
- Edge Hill University, St Helens Rd, Ormskirk L39 4QP, UK
| | - Vasiliki Pitsouni
- School of Health Professions, Faculty of Health, University of Plymouth PL6 8BH, UK
| | - Jonathan F Marsden
- School of Health Professions, Faculty of Health, University of Plymouth PL6 8BH, UK
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Stania M, Juras G, Marszałek W, Król P. Analysis of pain intensity and postural control for assessing the efficacy of shock wave therapy and sonotherapy in Achilles tendinopathy - A randomized controlled trial. Clin Biomech (Bristol, Avon) 2023; 101:105830. [PMID: 36469960 DOI: 10.1016/j.clinbiomech.2022.105830] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 11/01/2022] [Accepted: 11/25/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND The troublesome symptoms of Achilles tendinopathy prompt patients to seek effective forms of conservative treatment. The main aim of the study was to determine the therapeutic efficacy of shock wave and ultrasound therapies for Achilles tendinopathy in reducing pain intensity. Treatment efficacy was also assessed using objective posturographic measurements. METHODS Thirty-nine patients patients were randomly allocated to one of three experimental groups that received shock wave therapy (group A), ultrasound therapy (group B) and placebo ultrasound (group C). Posturographic measurements and subjective assessment of pain intensity were taken prior to therapy and at weeks 1 and 6 of therapy completion. FINDINGS A comparison of percentage change in activity-related pain from baseline to 6 weeks post-therapy revealed a significantly greater pain reduction in group A compared to group B. The three-way ANOVA demonstated an effect of treatment type on all posturographic variables. The Bonferroni post-hoc test showed the means of all variables were significantly smaller for group A than group B. Limb condition also had an effect on the center-of-pressure trajectories in anteroposterior plane; the post-hoc test showed the mean values of the variables were significantly greater for the non-affected compared to affected limb. INTERPRETATION Shock wave therapy was significantly more effective than sonotherapy for alleviation of activity-related pain of Achilles tendinopathy. An association was also shown between shock wave therapy and more efficient postural control in patients with Achilles tendinopathy. The parameters of center-of-pressure trajectories in the sagittal plane were significantly greater for the non-affected compared to affected limb. The trial was prospectively registered in the Australian and New Zealand Clinical Trials Registry (no. ACTRN12617000860369; registration date: 9.06.2017).
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Affiliation(s)
- Magdalena Stania
- Institute of Sport Sciences, Academy of Physical Education, Mikołowska 72a, 40-065 Katowice, Poland.
| | - Grzegorz Juras
- Institute of Sport Sciences, Academy of Physical Education, Mikołowska 72a, 40-065 Katowice, Poland
| | - Wojciech Marszałek
- Institute of Sport Sciences, Academy of Physical Education, Mikołowska 72a, 40-065 Katowice, Poland
| | - Piotr Król
- Institute of Sport Sciences, Academy of Physical Education, Mikołowska 72a, 40-065 Katowice, Poland
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Xing L, Bao Y, Wang B, Shi M, Wei Y, Huang X, Dai Y, Shi H, Gai X, Luo Q, Yin Y, Qin D. Falls caused by balance disorders in the elderly with multiple systems involved: Pathogenic mechanisms and treatment strategies. Front Neurol 2023; 14:1128092. [PMID: 36908603 PMCID: PMC9996061 DOI: 10.3389/fneur.2023.1128092] [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: 12/20/2022] [Accepted: 02/07/2023] [Indexed: 02/25/2023] Open
Abstract
Falls are the main contributor to both fatal and nonfatal injuries in elderly individuals as well as significant sources of morbidity and mortality, which are mostly induced by impaired balance control. The ability to keep balance is a remarkably complex process that allows for rapid and precise changes to prevent falls with multiple systems involved, such as musculoskeletal system, the central nervous system and sensory system. However, the exact pathogenesis of falls caused by balance disorders in the elderly has eluded researchers to date. In consideration of aging phenomenon aggravation and fall risks in the elderly, there is an urgent need to explore the pathogenesis and treatments of falls caused by balance disorders in the elderly. The present review discusses the epidemiology of falls in the elderly, potential pathogenic mechanisms underlying multiple systems involved in falls caused by balance disorders, including musculoskeletal system, the central nervous system and sensory system. Meanwhile, some common treatment strategies, such as physical exercise, new equipment based on artificial intelligence, pharmacologic treatments and fall prevention education are also reviewed. To fully understand the pathogenesis and treatment of falls caused by balance disorders, a need remains for future large-scale multi-center randomized controlled trials and in-depth mechanism studies.
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Affiliation(s)
- Liwei Xing
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming Yunnan, China.,The First Clinical Medical School, Yunnan University of Chinese Medicine, Kunming Yunnan, China
| | - Yi Bao
- Department of Rehabilitation Medicine, The Affiliated Hospital of Yunnan University, Kunming Yunnan, China
| | - Binyang Wang
- Department of Rehabilitation Medicine, The Affiliated Hospital of Yunnan University, Kunming Yunnan, China
| | - Mingqin Shi
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming Yunnan, China
| | - Yuanyuan Wei
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming Yunnan, China
| | - Xiaoyi Huang
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming Yunnan, China
| | - Youwu Dai
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming Yunnan, China
| | - Hongling Shi
- Department of Rehabilitation Medicine, The Third People's Hospital of Yunnan Province, Kunming Yunnan, China
| | - Xuesong Gai
- Department of Rehabilitation Medicine, The First People's Hospital of Yunnan Province, Kunming Yunnan, China
| | - Qiu Luo
- Department of Rehabilitation Medicine, The Affiliated Hospital of Yunnan University, Kunming Yunnan, China
| | - Yong Yin
- Department of Rehabilitation Medicine, The Affiliated Hospital of Yunnan University, Kunming Yunnan, China
| | - Dongdong Qin
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming Yunnan, China
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Xie L, Cho S. Ankle strategies for step-aside movement during quiet standing. PLoS One 2023; 18:e0281400. [PMID: 36881586 PMCID: PMC9990923 DOI: 10.1371/journal.pone.0281400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 01/22/2023] [Indexed: 03/08/2023] Open
Abstract
The mediolateral ankle strategy plays a crucial role in providing ankle stability in ground obstacle-avoidance behavior. This is achieved by changing basic walking patterns according to the characteristics of the obstacle. In daily life, it is more common to use step-aside movement (i.e., dodging step) for collision avoidance rather than side-stepping (i.e., widening standing base) when encountering an approaching pedestrian or bicycle. While studies have been conducted on the mediolateral ankle strategy contribution in obstacle avoidance using side-stepping, knowledge of step-aside movement is still inadequate. Therefore, we conducted an electromyography (EMG) analysis on the tibialis anterior (TA), peroneus longus (PL), and soleus (SOL) muscles, as well as measured center of pressure (CoP) displacement, and vertical ground reaction force (vGRF) of the standing leg, in order to understand the role of ankle muscles in step-aside movement during quiet standing. Fifteen healthy young men repeated twelve step-aside movements in both left and right directions. A Bayesian one-sample t-test was used to determine the sufficient step and participant counts. Multiple linear regression analysis was used to investigate the correlation between the muscle activity and CoP displacement or vGRF. The regression coefficients (β) of the left push phase and the right loading phase were tested against zero using a Bayesian one-sample t-test to identify the correlation between independent and dependent variables. We used the one-dimensional statistical parametric mapping (SPM1d) method to analyze the differences between and within the groups of EMG data based on the continuous time series. The results showed that the PL displayed a substantial contribution to the mediolateral ankle strategy during the push phase of step-aside movement, and also contributed to maintaining ankle stability during the loading phase. This suggested that screening for PL weakness and providing appropriate interventions and/or training approaches is especially critical for populations with walking stability problems.
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Affiliation(s)
- Lingchao Xie
- Department of Physical Therapy, Yonsei University, Wonju, South Korea
| | - Sanghyun Cho
- Department of Physical Therapy, Yonsei University, Wonju, South Korea
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Palmisano C, Beccaria L, Haufe S, Volkmann J, Pezzoli G, Isaias IU. Gait Initiation Impairment in Patients with Parkinson's Disease and Freezing of Gait. Bioengineering (Basel) 2022; 9:639. [PMID: 36354550 PMCID: PMC9687939 DOI: 10.3390/bioengineering9110639] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/14/2022] [Accepted: 10/15/2022] [Indexed: 08/03/2023] Open
Abstract
Freezing of gait (FOG) is a sudden episodic inability to produce effective stepping despite the intention to walk. It typically occurs during gait initiation (GI) or modulation and may lead to falls. We studied the anticipatory postural adjustments (imbalance, unloading, and stepping phase) at GI in 23 patients with Parkinson's disease (PD) and FOG (PDF), 20 patients with PD and no previous history of FOG (PDNF), and 23 healthy controls (HCs). Patients performed the task when off dopaminergic medications. The center of pressure (CoP) displacement and velocity during imbalance showed significant impairment in both PDNF and PDF, more prominent in the latter patients. Several measurements were specifically impaired in PDF patients, especially the CoP displacement along the anteroposterior axis during unloading. The pattern of segmental center of mass (SCoM) movements did not show differences between groups. The standing postural profile preceding GI did not correlate with outcome measurements. We have shown impaired motor programming at GI in Parkinsonian patients. The more prominent deterioration of unloading in PDF patients might suggest impaired processing and integration of somatosensory information subserving GI. The unaltered temporal movement sequencing of SCoM might indicate some compensatory cerebellar mechanisms triggering time-locked models of body mechanics in PD.
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Affiliation(s)
- Chiara Palmisano
- Department of Neurology, University Hospital and Julius-Maximilian-University, 97080 Würzburg, Germany
| | - Laura Beccaria
- Department of Neurology, University Hospital and Julius-Maximilian-University, 97080 Würzburg, Germany
| | - Stefan Haufe
- Uncertainty, Inverse Modeling and Machine Learning Group, Faculty IV Electrical Engineering and Computer Science, Technical University of Berlin, 10623 Berlin, Germany
| | - Jens Volkmann
- Department of Neurology, University Hospital and Julius-Maximilian-University, 97080 Würzburg, Germany
| | - Gianni Pezzoli
- Centro Parkinson, ASST Gaetano Pini-CTO, 20122 Milano, Italy
| | - Ioannis U. Isaias
- Department of Neurology, University Hospital and Julius-Maximilian-University, 97080 Würzburg, Germany
- Centro Parkinson, ASST Gaetano Pini-CTO, 20122 Milano, Italy
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Fantozzi S, Borra D, Cortesi M, Ferrari A, Ciacci S, Chiari L, Baroncini I. Aquatic Therapy after Incomplete Spinal Cord Injury: Gait Initiation Analysis Using Inertial Sensors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811568. [PMID: 36141834 PMCID: PMC9517342 DOI: 10.3390/ijerph191811568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/05/2022] [Accepted: 09/09/2022] [Indexed: 05/16/2023]
Abstract
Populations with potential damage to somatosensory, vestibular, and visual systems or poor motor control are often studied during gait initiation. Aquatic activity has shown to benefit the functional capacity of incomplete spinal cord injury (iSCI) patients. The present study aimed to evaluate gait initiation in iSCI patients using an easy-to-use protocol employing four wearable inertial sensors. Temporal and acceleration-based anticipatory postural adjustment measures were computed and compared between dry-land and water immersion conditions in 10 iSCI patients. In the aquatic condition, an increased first step duration (median value of 1.44 s vs. 0.70 s in dry-land conditions) and decreased root mean squared accelerations for the upper trunk (0.39 m/s2 vs. 0.72 m/s2 in dry-land conditions) and lower trunk (0.41 m/s2 vs. 0.85 m/s2 in dry-land conditions) were found in the medio-lateral and antero-posterior direction, respectively. The estimation of these parameters, routinely during a therapy session, can provide important information regarding different control strategies adopted in different environments.
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Affiliation(s)
- Silvia Fantozzi
- Department of Electrical, Electronic, and Information Engineering “Guglielmo Marconi”, University of Bologna, Viale Risorgimento 2, 40136 Bologna, Italy
- Health Sciences and Technologies—Interdepartmental Centre for Industrial Research, University of Bologna, Viale Risorgimento 2, 40136 Bologna, Italy
| | - Davide Borra
- Department of Electrical, Electronic, and Information Engineering “Guglielmo Marconi”, University of Bologna, Viale Risorgimento 2, 40136 Bologna, Italy
| | - Matteo Cortesi
- Department for Life Quality Studies, University of Bologna, Via del Pilastro 8, 40126 Bologna, Italy
- Correspondence:
| | - Alberto Ferrari
- Health Sciences and Technologies—Interdepartmental Centre for Industrial Research, University of Bologna, Viale Risorgimento 2, 40136 Bologna, Italy
| | - Simone Ciacci
- Department Biomedical and Neuromotor Sciences, University of Bologna, Via del Pilastro 8, 40126 Bologna, Italy
| | - Lorenzo Chiari
- Department of Electrical, Electronic, and Information Engineering “Guglielmo Marconi”, University of Bologna, Viale Risorgimento 2, 40136 Bologna, Italy
- Health Sciences and Technologies—Interdepartmental Centre for Industrial Research, University of Bologna, Viale Risorgimento 2, 40136 Bologna, Italy
| | - Ilaria Baroncini
- Montecatone Rehabilitation Institute S.p.A., Via Montecatone 37, 40026 Imola, Italy
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Machine Learning Strategies for Low-Cost Insole-Based Prediction of Center of Gravity during Gait in Healthy Males. SENSORS 2022; 22:s22093499. [PMID: 35591188 PMCID: PMC9100257 DOI: 10.3390/s22093499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/28/2022] [Accepted: 04/28/2022] [Indexed: 02/04/2023]
Abstract
Whole-body center of gravity (CG) movements in relation to the center of pressure (COP) offer insights into the balance control strategies of the human body. Existing CG measurement methods using expensive measurement equipment fixed in a laboratory environment are not intended for continuous monitoring. The development of wireless sensing technology makes it possible to expand the measurement in daily life. The insole system is a wearable device that can evaluate human balance ability by measuring pressure distribution on the ground. In this study, a novel protocol (data preparation and model training) for estimating the 3-axis CG trajectory from vertical plantar pressures was proposed and its performance was evaluated. Input and target data were obtained through gait experiments conducted on 15 adult and 15 elderly males using a self-made insole prototype and optical motion capture system. One gait cycle was divided into four semantic phases. Features specified for each phase were extracted and the CG trajectory was predicted using a bi-directional long short-term memory (Bi-LSTM) network. The performance of the proposed CG prediction model was evaluated by a comparative study with four prediction models having no gait phase segmentation. The CG trajectory calculated with the optoelectronic system was used as a golden standard. The relative root mean square error of the proposed model on the 3-axis of anterior/posterior, medial/lateral, and proximal/distal showed the best prediction performance, with 2.12%, 12.97%, and 12.47%. Biomechanical analysis of two healthy male groups was conducted. A statistically significant difference between CG trajectories of the two groups was shown in the proposed model. Large CG sway of the medial/lateral axis trajectory and CG fall of the proximal/distal axis trajectory is shown in the old group. The protocol proposed in this study is a basic step to have gait analysis in daily life. It is expected to be utilized as a key element for clinical applications.
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32
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Osada Y, Motojima N, Kobayashi Y, Yamamoto S. Differences in mediolateral dynamic stability during gait initiation according to whether the non-paretic or paretic leg is used as the leading limb. PLoS One 2022; 17:e0267577. [PMID: 35476702 PMCID: PMC9045617 DOI: 10.1371/journal.pone.0267577] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 04/11/2022] [Indexed: 11/24/2022] Open
Abstract
We investigated mediolateral dynamic stability at first foot off and first initial contact during gait initiation according to whether the paretic or non-paretic leg was used as the leading limb. Thirty-eight individuals with stroke initiated gait with the paretic and non-paretic legs as the leading limb, and their movements were measured using a 3D motion analysis system. Margin of stability (i.e., the length between the extrapolated center of mass and lateral border of the stance foot) was used as an index of dynamic stability, with a large value indicating dynamic stability in the lateral direction. However, an excessively large margin of stability value (i.e., when the extrapolated center of mass is outside the medial border of the stance foot) indicates dynamic instability in the medial direction. Differences in the margin of stability between tasks were compared using the Wilcoxon signed-rank test. The minimum margin of stability was observed just before first foot off. When the non-paretic leg was used as the leading limb, the margin of stability tended to be excessively large at first foot off compared with when the paretic leg was used (p < 0.001). In other words, the extrapolated center of mass was outside the medial border of the paretic stance foot. In conclusion, lateral stability was achieved when using the non-paretic leading limb because the extrapolated center of mass was located outside the medial border of the stance foot. However, medial dynamic stability was lower for the non-paretic leading limb compared with the paretic leading limb.
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Affiliation(s)
- Yuji Osada
- Department of Health and Welfare Tokushima Bunri University, Tokushima, Japan
- * E-mail:
| | - Naoyuki Motojima
- Showa University School of Nursing and rehabilitation Science, Kanagawa, Japan
| | | | - Sumiko Yamamoto
- Graduate School, International University of Health & Welfare, Tokyo, Japan
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Delafontaine A, Vialleron T, Diakhaté DG, Fourcade P, Yiou E. Effects of experimentally induced cervical spine mobility alteration on the postural organisation of gait initiation. Sci Rep 2022; 12:6055. [PMID: 35410364 PMCID: PMC9001680 DOI: 10.1038/s41598-022-10101-6] [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: 07/14/2021] [Accepted: 03/28/2022] [Indexed: 11/09/2022] Open
Abstract
AbstractGait initiation (GI), the transient period between quiet standing and locomotion, is a functional task classically used in the literature to investigate postural control. This study aimed to investigate the influence of an experimentally-induced alteration of cervical spine mobility (CSM) on GI postural organisation. Fifteen healthy young adults initiated gait on a force-plate in (1) two test conditions, where participants wore a neck orthosis that passively simulated low and high levels of CSM alteration; (2) one control condition, where participants wore no orthosis; and (3) one placebo condition, where participants wore a cervical bandage that did not limit CSM. Centre-of-pressure and centre-of-mass kinematics were computed based on force-plate recordings according to Newton’s second law. Main results showed that anticipatory postural adjustments amplitude (peak backward centre-of-pressure shift and forward centre-of-mass velocity at toe-off) and motor performance (step length and forward centre-of-mass velocity at foot-contact) were altered under the condition of high CSM restriction. These effects of CSM restriction may reflect the implementation of a more cautious strategy directed to attenuate head-in-space destabilisation and ease postural control. It follows that clinicians should be aware that the prescription of a rigid neck orthosis to posturo-deficient patients could exacerbate pre-existing GI deficits.
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Events Detection of Anticipatory Postural Adjustments through a Wearable Accelerometer Sensor Is Comparable to That Measured by the Force Platform in Subjects with Parkinson's Disease. SENSORS 2022; 22:s22072668. [PMID: 35408282 PMCID: PMC9003325 DOI: 10.3390/s22072668] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 03/26/2022] [Accepted: 03/28/2022] [Indexed: 02/06/2023]
Abstract
Out-of-the-lab instrumented gait testing focuses on steady-state gait and usually does not include gait initiation (GI) measures. GI involves Anticipatory Postural Adjustments (APAs), which propel the center of mass (COM) forward and laterally before the first step. These movements are impaired in persons with Parkinson’s disease (PD), contributing to their pathological gait. The use of a simple GI testing system, outside the lab, would allow improving gait rehabilitation of PD patients. Here, we evaluated the metrological quality of using a single inertial measurement unit for APA detection as compared with the use of a gold-standard system, i.e., the force platforms. Twenty-five PD and eight elderly subjects (ELD) were asked to initiate gait in response to auditory stimuli while wearing an IMU on the trunk. Temporal parameters (APA-Onset, Time-to-Toe-Off, Time-to-Heel-Strike, APA-Duration, Swing-Duration) extracted from the accelerometric data and force platforms were significantly correlated (mean(SD), r: 0.99(0.01), slope: 0.97(0.02)) showing a good level of agreement (LOA [s]: 0.04(0.01), CV [%]: 2.9(1.7)). PD showed longer APA-Duration compared to ELD ([s] 0.81(0.17) vs. 0.59(0.09) p < 0.01). APA parameters showed moderate correlation with the MDS-UPDRS Rigidity, Characterizing-FOG questionnaire and FAB-2 planning. The single IMU-based reconstruction algorithm was effective in measuring APAs timings in PD. The current work sets the stage for future developments of tele-rehabilitation and home-based exercises.
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Theoretical discrimination index of postural instability in amyotrophic lateral sclerosis. Sci Rep 2022; 12:2430. [PMID: 35165398 PMCID: PMC8844064 DOI: 10.1038/s41598-022-06471-6] [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: 04/01/2021] [Accepted: 01/31/2022] [Indexed: 11/09/2022] Open
Abstract
AbstractTo assess the usefulness of a theoretical postural instability discrimination index (PIth) in amyotrophic lateral sclerosis (ALS). Prospective regression analyzes were performed to identify the biomechanical determinants of postural instability unrelated to lower limb motor deficits from gait initiation factors. PIth was constructed using a logit function of biomechanical determinants. Discriminatory performance and performance differences were tested. Backward displacement of the pression center (APAamplitude) and active vertical braking of the mass center (Braking-index) were the biomechanical determinants of postural instability. PIth = − 0.13 × APAamplitude − 0.12 × Braking-index + 5.67, (P < 0.0001, RSquare = 0.6119). OR (APAamplitude) and OR (Braking-index) were 0.878 and 0.887, respectively, i.e., for a decrease of 10 mm in APAamplitude or 10% in Braking-index, the postural instability risk was 11.391 or 11.274 times higher, respectively. PIth had the highest discriminatory performance (AUC 0.953) with a decision threshold value $$\ge$$
≥
0.587, a sensitivity of 90.91%, and a specificity of 83.87%, significantly increasing the sensitivity by 11.11%. PIth, as objective clinical integrator of gait initiation biomechanical processes significantly involved in dynamic postural control, was a reliable and performing discrimination index of postural instability with a significant increased sensitivity, and may be useful for a personalized approach to postural instability in ALS.
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Reddy RS, Tedla JS, Alshahrani MS, Asiri F, Kakaraparthi VN, Samuel PS, Kandakurti PK. Reliability of hip joint position sense tests using a clinically applicable measurement tool in elderly participants with unilateral hip osteoarthritis. Sci Rep 2022; 12:376. [PMID: 35013488 PMCID: PMC8748869 DOI: 10.1038/s41598-021-04288-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 12/20/2021] [Indexed: 12/14/2022] Open
Abstract
Hip joint proprioception is vital in maintaining posture and stability in elderly individuals. Examining hip joint position sense (JPS) using reliable tools is important in contemporary clinical practice. The objective of this study is to evaluate the intra-rater and inter-rater reliability of hip JPS tests using a clinically applicable measurement tool in elderly individuals with unilateral hip osteoarthritis (OA). Sixty-two individuals (mean age = 67.5 years) diagnosed with unilateral hip OA participated in this study. The JPS tests were evaluated using a digital inclinometer in hip flexion and abduction directions. The absolute difference between target and reproduced angle (repositioning error) in degrees was taken to measure JPS accuracy. The intraclass correlation coefficient (ICC (2.k), was used to assess the reliability. The Intra rater-reliability for hip JPS tests showed very good agreement in the lying position (hip flexion-ICC = 0.88–0.92; standard error of measurement (SEM) = 0.06–0.07, hip abduction-ICC = 0.89–0.91; SEM = 0.06–0.07) and good agreement in the standing position (hip flexion-ICC = 0.69–0.72; SEM = 0.07, hip abduction-ICC = 0.66–0.69; SEM = 0.06–0.08). Likewise, inter-rater reliability for hip JPS tests demonstrated very good agreement in the lying position (hip flexion-ICC = 0.87–0.89; SEM = 0.06–0.07, hip abduction-ICC = 0.87–0.91; SEM = 0.07) and good agreement in the standing position (hip flexion-ICC = 0.64–0.66; SEM = 0.08, hip abduction-ICC = 0.60–0.72; SEM = 0.06–0.09). The results support the use of hip JPS tests in clinical practice and should be incorporated in assessing and managing elderly participants with hip OA.
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Affiliation(s)
- Ravi Shankar Reddy
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia.
| | - Jaya Shanker Tedla
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Mastour Saeed Alshahrani
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Faisal Asiri
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Venkata Nagaraj Kakaraparthi
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Paul Silvian Samuel
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
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Massot C, Simoneau E, Peron D, Barbier F, Kwiatkowski A, Donze C, Leteneur S. Simplified stance limb kinetics patterns revealed during gait initiation in early stage of multiple sclerosis. Clin Biomech (Bristol, Avon) 2022; 91:105549. [PMID: 34922096 DOI: 10.1016/j.clinbiomech.2021.105549] [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: 05/11/2021] [Revised: 11/21/2021] [Accepted: 12/08/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although patients with an early stage of Multiple Sclerosis (MS) commonly complain about balance and gait impairments, their troubles remain misunderstood. The objective was to compare body kinematics and lower limb kinetics during gait initiation between patients with MS with an EDSS score ≤ 4 and healthy participants. METHODS Sixteen patients with MS with a median EDSS score of 2.5 [0-4] and disease duration of 7.4 ± 4.2 years, as well as 16 healthy participants were included, and 3-D motion analysis was performed during gait initiation to calculate spatiotemporal, kinematic and kinetic parameters. FINDINGS The center of pressure position at the beginning of the gait initiation was more anterior (p = 0.02) in patients with MS than healthy participants. The kinetic parameters of the stance limb were highly affected in patients with MS compared to healthy participants during gait initiation. The net muscular moments for each joint were significantly different during the anticipatory postural adjustment phase with smoother variations for patients with MS compared to healthy participants. INTERPRETATION Early stage MS strongly affects the motor modulation of stance limb kinetics during the anticipatory postural adjustment of gait initiation, without alteration of the execution phase. The net muscular moments are sensitive in detecting unobservable balance impairments and can be used to assess disease progression at the early stage. These results suggest that early rehabilitation programs aimed at improving motor modulation and flexibility in gait initiation should be implemented.
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Affiliation(s)
- Caroline Massot
- Service de Médecine Physique et de Réadaptation, GHICL Hôpital Saint Philibert, Lomme, France; Service de Médecine Physique et de Réadaptation, Centre Hospitalier de Saint-Amand-les-Eaux, Saint-Amand-les-Eaux, France; Univ. Polytechnique Hauts-de-France, LAMIH, CNRS, UMR 8201, F-59313 Valenciennes, France; INSA Hauts-de-France, F-59313 Valenciennes, France.
| | - Emilie Simoneau
- Univ. Polytechnique Hauts-de-France, LAMIH, CNRS, UMR 8201, F-59313 Valenciennes, France; INSA Hauts-de-France, F-59313 Valenciennes, France
| | - David Peron
- Service de Médecine Physique et de Réadaptation, Centre Hospitalier de Saint-Amand-les-Eaux, Saint-Amand-les-Eaux, France
| | - Franck Barbier
- Univ. Polytechnique Hauts-de-France, LAMIH, CNRS, UMR 8201, F-59313 Valenciennes, France; INSA Hauts-de-France, F-59313 Valenciennes, France
| | - Arnaud Kwiatkowski
- Service de Neurologie, GHICL Hôpital Saint Vincent de Paul, Lille, France
| | - Cécile Donze
- Service de Médecine Physique et de Réadaptation, GHICL Hôpital Saint Philibert, Lomme, France
| | - Sébastien Leteneur
- Univ. Polytechnique Hauts-de-France, LAMIH, CNRS, UMR 8201, F-59313 Valenciennes, France; INSA Hauts-de-France, F-59313 Valenciennes, France
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Esposti R, Marchese SM, Farinelli V, Bolzoni F, Cavallari P. Dual-Hemisphere Transcranial Direct Current Stimulation on Parietal Operculum Does Not Affect the Programming of Intra-limb Anticipatory Postural Adjustments. Front Physiol 2021; 12:789886. [PMID: 34987420 PMCID: PMC8721103 DOI: 10.3389/fphys.2021.789886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/19/2021] [Indexed: 11/18/2022] Open
Abstract
Evidence shows that the postural and focal components within the voluntary motor command are functionally unique. In 2015, we reported that the supplementary motor area (SMA) processes Anticipatory Postural Adjustments (APAs) separately from the command to focal muscles, so we are still searching for a hierarchically higher area able to process both components. Among these, the parietal operculum (PO) seemed to be a good candidate, as it is a hub integrating both sensory and motor streams. However, in 2019, we reported that transcranial Direct Current Stimulation (tDCS), applied with an active electrode on the PO contralateral to the moving segment vs. a larger reference electrode on the opposite forehead, did not affect intra-limb APAs associated to brisk flexions of the index-finger. Nevertheless, literature reports that two active electrodes of opposite polarities, one on each PO (dual-hemisphere, dh-tDCS), elicit stronger effects than the "active vs. reference" arrangement. Thus, in the present study, the same intra-limb APAs were recorded before, during and after dh-tDCS on PO. Twenty right-handed subjects were tested, 10 for each polarity: anode on the left vs. cathode on the right, and vice versa. Again, dh-tDCS was ineffective on APA amplitude and timing, as well as on prime mover recruitment and index-finger kinematics. These results confirm the conclusion that PO does not take part in intra-limb APA control. Therefore, our search for an area in which the motor command to prime mover and postural muscles are still processed together will have to address other structures.
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Affiliation(s)
- Roberto Esposti
- Human Physiology Section of the Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Silvia M. Marchese
- Human Physiology Section of the Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Veronica Farinelli
- Human Physiology Section of the Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Francesco Bolzoni
- Human Physiology Section of the Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Paolo Cavallari
- Human Physiology Section of the Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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Pallavi P, Ranjan S, Patel N, Lahiri U. Wearable Technology for Evaluation of Risk of Falls. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:7108-7111. [PMID: 34892739 DOI: 10.1109/embc46164.2021.9629940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
One's risk of fall can be quantified in terms of variability in one's gait, reflecting a loss of automatic rhythm of one's gait. In gait analysis, variability is commonly understood in terms of the fluctuation in the kinematic, kinetic, spatio-temporal, or physiological information. Here, we have focused on the estimation of knee joint angle (kinematic variable) synchronized with some of the kinetic and spatio-temporal gait parameters while an individual walked overground. Our system consisted of a pair of shoes with instrumented insoles and knee flexion/extension recorder unit having bend sensors. In addition, we have used the Coefficient of Variation for estimating the variability in the knee flexion/extension angle while walking overground as an indicator of the risk of fall. A study with healthy individuals (young and old) walking overground on pathways having 00 and 1800 turning angles indicated the feasibility of our wearable system to compute the variability in knee flexion/extension angle as an indicator of the risk of fall.
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Characterization of Anticipatory Postural Adjustments in Lateral Stepping: Impact of Footwear and Lower Limb Preference. SENSORS 2021; 21:s21248244. [PMID: 34960335 PMCID: PMC8706929 DOI: 10.3390/s21248244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 11/26/2021] [Accepted: 12/07/2021] [Indexed: 11/17/2022]
Abstract
Lateral stepping is a motor task that is widely used in everyday life to modify the base of support, change direction, and avoid obstacles. Anticipatory Postural Adjustments (APAs) are often analyzed to describe postural preparation prior to forward stepping, however, little is known about lateral stepping. The aim of the study is to characterize APAs preceding lateral steps and to investigate how these are affected by footwear and lower limb preference. Twenty-two healthy young participants performed a lateral step using both their preferred and non-preferred leg in both barefoot and shod conditions. APA spatiotemporal parameters (size, duration, and speed) along both the anteroposterior and mediolateral axes were obtained through force plate data. APAs preceding lateral stepping showed typical patterns both along the anteroposterior and mediolateral axis. RM-ANOVA highlighted a significant effect of footwear only on medio-lateral APAs amplitude (p = 0.008) and velocity (p = 0.037). No differences were found for the limb preference. APAs in lateral stepping presented consistent features in the sagittal component, regardless of limb/shoe factors. Interestingly, the study observed that footwear induced an increase in the medio-lateral APAs size and velocity, highlighting the importance of including this factor when studying lateral stepping.
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Optoelectronic Study of Gait Kinematics in Sagittal Spinopelvic Imbalance. World Neurosurg 2021; 158:e956-e963. [PMID: 34863937 DOI: 10.1016/j.wneu.2021.11.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 11/26/2021] [Accepted: 11/27/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Degenerative processes induce loss of lumbar lordosis and anterior sagittal imbalance (ASI). Optoelectronic study provides kinematic analysis of movement and can also detect ASI. The aim of the present study was to assess gait kinematic modifications induced by ASI. METHODS Thirty-five healthy male volunteers were subjected to reversible ASI induced by wearing a kyphotic thermoformed thoracolumbar corset. The deformation was assessed by C7 tilt on EOS (EOS Imaging, Paris, France) full-spine views. Ten optoelectronic gait recordings were made with corset and 10 without. Gait kinematic parameters (stride length, walking speed, rhythm), gait balance parameters (center of mass braking index, stride width, double support time) and spinal sagittal balance parameters (C7T10S1, C7´S1' and spinal angles) were averaged. Adjusted analysis distinguished direct ASI impact from locomotor factors. RESULTS The corset-induced ASI produced +15° change in C7 tilt (P < 0.0001), -7.4° in C7T10S1 (P < 0.0001), +66.2 mm in C7´S1' (P < 0.0001), and +13.1° in spinal angle (P < 0.0001). Radiographic and optoelectronic data correlated significantly. Stride length (P < 0.0001) and rhythm (P = 0.0003) were significantly reduced, contributing to a reduction in walking speed (P < 0.0001), and strongly influencing double support time (β = -0.38; 95% confidence interval [CI]: -0.69; -0.06). Center of mass braking index was significantly reduced (P < 0.0001) and significantly influenced by ASI (β = -0.51; 95% CI: -0.78; -0.28). Stride width was significantly increased by ASI (P < 0.0001), independently of rhythm and stride length. CONCLUSIONS ASI induced by a kyphotic corset was detectable on the optoelectronic system, leading to significant changes in gait kinematics. Locomotor parameters were significantly reduced. Balance parameters were significantly and directly altered by ASI.
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Zhao G, Grimmer M, Seyfarth A. The mechanisms and mechanical energy of human gait initiation from the lower-limb joint level perspective. Sci Rep 2021; 11:22473. [PMID: 34795327 PMCID: PMC8602421 DOI: 10.1038/s41598-021-01694-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 11/02/2021] [Indexed: 11/09/2022] Open
Abstract
This study aims to improve our understanding of gait initiation mechanisms and the lower-limb joint mechanical energy contributions. Healthy subjects were instructed to initiate gait on an instrumented track to reach three self-selected target velocities: slow, normal and fast. Lower-limb joint kinematics and kinetics of the first five strides were analyzed. The results show that the initial lateral weight shift is achieved by hip abduction torque on the lifting leg (leading limb). Before the take-off of the leading limb, the forward body movement is initiated by decreasing ankle plantarflexion torque, which results in an inverted pendulum-like passive forward fall. The hip flexion/extension joint has the greatest positive mechanical energy output in the first stride of the leading limb, while the ankle joint contributes the most positive mechanical energy in the first stride of the trailing limb (stance leg). Our results indicate a strong correlation between control of the frontal plane and the sagittal plane joints during gait initiation. The identified mechanisms and the related data can be used as a guideline for improving gait initiation with wearable robots such as exoskeletons and prostheses.
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Affiliation(s)
- Guoping Zhao
- Lauflabor Locomotion Laboratory, Centre for Cognitive Science, Technical University of Darmstadt, 64289, Darmstadt, Germany.
| | - Martin Grimmer
- Lauflabor Locomotion Laboratory, Centre for Cognitive Science, Technical University of Darmstadt, 64289, Darmstadt, Germany
| | - Andre Seyfarth
- Lauflabor Locomotion Laboratory, Centre for Cognitive Science, Technical University of Darmstadt, 64289, Darmstadt, Germany
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Farinelli V, Bolzoni F, Marchese SM, Esposti R, Cavallari P. A Novel Viewpoint on the Anticipatory Postural Adjustments During Gait Initiation. Front Hum Neurosci 2021; 15:709780. [PMID: 34707487 PMCID: PMC8543010 DOI: 10.3389/fnhum.2021.709780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/31/2021] [Indexed: 11/16/2022] Open
Abstract
Anticipatory postural adjustments (APAs) are the coordinated muscular activities that precede the voluntary movements to counteract the associated postural perturbations. Many studies about gait initiation call APAs those activities that precede the heel-off of the leading foot, thus taking heel-off as the onset of voluntary movement. In particular, leg muscles drive the center of pressure (CoP) both laterally, to shift the body weight over the trailing foot and backward, to create a disequilibrium torque pushing forward the center of mass (CoM). However, since subjects want to propel their body rather than lift their foot, the onset of gait should be the CoM displacement, which starts with the backward CoP shift. If so, the leg muscles driving such a shift are the prime movers. Moreover, since the disequilibrium torque is mechanically equivalent to a forward force acting at the pelvis level, APAs should be required to link the body segments to the pelvis: distributing such concentrated force throughout the body would make all segments move homogeneously. In the aim of testing this hypothesis, we analyzed gait initiation in 15 right-footed healthy subjects, searching for activities in trunk muscles that precede the onset of the backward CoP shift. Subjects stood on a force plate for about 10 s and then started walking at their natural speed. A minimum of 10 trials were collected. A force plate measured the CoP position while wireless probes recorded the electromyographic activities. Recordings ascertained that at gait onset APAs develop in trunk muscles. On the right side, Rectus Abdominis and Obliquus Abdominis were activated in 11 and 13 subjects, respectively, starting on average 33 and 54 ms before the CoP shift; Erector Spinae (ES) at L2 and T3 levels was instead inhibited (9 and 7 subjects, 104 and 120 ms). On the contralateral side, the same muscles showed excitatory APAs (abdominals in 11 and 12 subjects, 27 and 82 ms; ES in 10 and 7 subjects, 75 and 32 ms). The results of this study provide a novel framework for distinguishing postural from voluntary actions, which may be relevant for the diagnosis and rehabilitation of gait disorders.
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Affiliation(s)
- Veronica Farinelli
- Human Physiology Section of the Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Francesco Bolzoni
- Human Physiology Section of the Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Silvia Maria Marchese
- Human Physiology Section of the Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Roberto Esposti
- Human Physiology Section of the Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Paolo Cavallari
- Human Physiology Section of the Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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Akbaş A, Marszałek W, Bacik B, Juras G. Influence of base of support on early postural adjustments and fencing lunge performance. Sports Biomech 2021:1-13. [PMID: 34641774 DOI: 10.1080/14763141.2021.1987510] [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: 04/27/2021] [Accepted: 09/24/2021] [Indexed: 10/20/2022]
Abstract
The aim of the study was to examine whether the width of the base of support (BOS) has an influence on early postural adjustments (EPA) and armed upper limb and COM kinematics during lunging. Eight elite female fencers participated in the study. The displacement of the centre of foot pressure (COP) and kinematics of centre of mass (COM) were recorded using force platforms. The kinematics of the wrist of the armed upper limb were obtained using a 3D accelerometer. The results show that EPA were characterised by a very small COP displacement (about 0.6 to 1.2 cm). The COP amplitude showed a tendency to decrease with an increase in BOS width under reaction time conditions. In contrast, a greater BOS width was associated with a significant increase in COM acceleration at foot-off and peak COM acceleration during lunging also under reaction time instructions. The kinematics of the wrist were not influenced by BOS. The results show that in elite fencers, the upper limb movement is dissociated from the whole body movement. We suppose that a small COP amplitude is a postural skill which is integrated into the lunging skill and might influence the acceleration of COM.
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Affiliation(s)
- Anna Akbaş
- Department of Human Motor Behavior, Institute of Sport Sciences, Academy of Physical Education, Katowice, Poland
| | - Wojciech Marszałek
- Department of Human Motor Behavior, Institute of Sport Sciences, Academy of Physical Education, Katowice, Poland
| | - Bogdan Bacik
- Department of Human Motor Behavior, Institute of Sport Sciences, Academy of Physical Education, Katowice, Poland
| | - Grzegorz Juras
- Department of Human Motor Behavior, Institute of Sport Sciences, Academy of Physical Education, Katowice, Poland
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Delval A, Bayot M, Lapoulvereyrie R, Defebvre L, Vermersch P, Tard C. Role of the peripheral nervous system for an appropriate postural preparation during gait initiation in patients with a chronic inflammatory demyelinating polyneuropathy: A pilot study. Gait Posture 2021; 90:29-35. [PMID: 34371225 DOI: 10.1016/j.gaitpost.2021.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 07/29/2021] [Accepted: 08/02/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Gait initiation is an automatized motor program that is preceded by anticipatory postural adjustments (APAs). During attentional tasks, these APAs can be modulated, producing multiple APAs. However, the role of the peripheral nervous system in the regulation of these APAs is unknown. RESEARCH QUESTION The objective of our study was to investigate whether APAs are also regulated by peripheral nervous afferents. METHODS We assessed 21 patients suffering from chronic inflammatory demyelinating neuropathy and 20 healthy controls. Participants initiated gait with the right or left leg either freely (in the standard condition) or according to a visual trigger (i.e., the select condition). Kinetic and kinematic parameters of APAs and step initiation were recorded. RESULTS The select condition was related to a higher rate of multiple APAs compared to the standard condition, and was more attention-consuming in both groups. The group with a neuropathy showed longer APAs than the control group, associated with a longer time to recover from multiple APAs. Consequently, the step execution time was delayed in patients with a peripheral neuropathy. SIGNIFICANCE The impairment of the peripheral nervous system is therefore responsible for an alteration of the mechanisms underlying the recovery from multiple APAs during gait initiation. Our results are in favor of a role of proprioceptive afferents in the early peripheral regulation of motor errors. Further study on gait initiation in peripheral nervous disease could be helpful to better explore sensory-motor coupling in tasks requiring balance control.
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Affiliation(s)
- Arnaud Delval
- Univ. Lille, Inserm U1172- Lille Neurosciences Cognition, CHU Lille, F-59000, Lille, France.
| | - Madli Bayot
- Univ. Lille, Inserm U1172- Lille Neurosciences Cognition, CHU Lille, F-59000, Lille, France
| | | | - Luc Defebvre
- Univ. Lille, Inserm U1172- Lille Neurosciences Cognition, CHU Lille, F-59000, Lille, France
| | - Patrick Vermersch
- Univ. Lille, Inserm U1172- Lille Neurosciences Cognition, CHU Lille, F-59000, Lille, France
| | - Céline Tard
- Univ. Lille, Inserm U1172- Lille Neurosciences Cognition, CHU Lille, F-59000, Lille, France
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Vialleron T, Delafontaine A, Millerioux I, Memari S, Fourcade P, Yiou E. Acute effects of short-term stretching of the triceps surae on ankle mobility and gait initiation in patients with Parkinson's disease. Clin Biomech (Bristol, Avon) 2021; 89:105449. [PMID: 34418858 DOI: 10.1016/j.clinbiomech.2021.105449] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 05/17/2021] [Accepted: 08/10/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Ankle mobility is known to be of uttermost importance to generate propulsive forces and control balance during gait initiation. Impaired mobility of the postural chain occurs with normal ageing and is exacerbated in patients with Parkinson's disease. This study questions whether short-term stretching session applied to the triceps surae improves ankle mobility and, consequently, dynamical postural control in patients with Parkinson's disease performing gait initiation. METHOD Nineteen patients with Parkinson's disease participated in this study and were randomly assigned to an "intervention group" or a "sham group". In the intervention group, patients were exposed to a 4 × 60 seconds triceps surae stretching. In the sham group, they were exposed to forearm stretching. Additionally, ten age-matched healthy elderly, who were not exposed to any stretching-treatment, were assigned to a "control group". Participants performed series of gait initiation on a force-plate before and after their treatment. FINDINGS Ankle mobility was improved in the intervention group after triceps surae stretching. The forward velocity of the center-of-mass at heel-off and motor performance related-parameters (progression velocity, center-of-mass velocity at foot-contact and swing phase duration) were also improved in the intervention group, with large effect sizes (d ≥ 0.8). None of the stability parameters were modified by the treatments. INTERPRETATION Short-term triceps surae stretching is an efficient method to increase ankle mobility and improve the capacity to generate forward propulsive forces in patients with Parkinson's disease. These findings are congruent with the "posturo-kinetics capacity" theory according to which dynamical postural control depends on postural chain mobility.
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Affiliation(s)
- Thomas Vialleron
- CIAMS laboratory, Université Paris-Saclay, 91405 Orsay Cedex, France; CIAMS laboratory, Université d'Orléans, 45067 Orléans, France
| | - Arnaud Delafontaine
- CIAMS laboratory, Université Paris-Saclay, 91405 Orsay Cedex, France; CIAMS laboratory, Université d'Orléans, 45067 Orléans, France
| | - Isis Millerioux
- CIAMS laboratory, Université Paris-Saclay, 91405 Orsay Cedex, France; CIAMS laboratory, Université d'Orléans, 45067 Orléans, France
| | - Sahel Memari
- CIAMS laboratory, Université Paris-Saclay, 91405 Orsay Cedex, France; CIAMS laboratory, Université d'Orléans, 45067 Orléans, France
| | - Paul Fourcade
- CIAMS laboratory, Université Paris-Saclay, 91405 Orsay Cedex, France; CIAMS laboratory, Université d'Orléans, 45067 Orléans, France
| | - Eric Yiou
- CIAMS laboratory, Université Paris-Saclay, 91405 Orsay Cedex, France; CIAMS laboratory, Université d'Orléans, 45067 Orléans, France.
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Yamada H, Shinya M. Variability in the Center of Mass State During Initiation of Accurate Forward Step Aimed at Targets of Different Sizes. Front Sports Act Living 2021; 3:691307. [PMID: 34490423 PMCID: PMC8416920 DOI: 10.3389/fspor.2021.691307] [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: 07/21/2021] [Indexed: 11/13/2022] Open
Abstract
Motor control for forward step initiation begins with anticipatory postural adjustments (APAs). During APAs, the central nervous system controls the center of pressure (CoP) to generate an appropriate center of mass (CoM) position and velocity for various task requirements. In this study, we investigated the effect of required stepping accuracy on the CoM and CoP parameters during APA for a step initiation task. Sixteen healthy young participants stepped forward onto the targets on the ground as soon as and as fast as possible in response to visual stimuli. Two target sizes (small: 2 cm square and large: 10 cm square) and two target distances (short: 20% and long: 40% of the body height) were tested. CoP displacement during the APA and the CoM position, velocity, and extrapolated CoM at the timing of the takeoff of the lead leg were compared among the conditions. In the small condition, comparing with the large condition, the CoM position was set closer to the stance limb side during the APA, which was confirmed by the location of the extrapolated center of mass at the instance of the takeoff of the lead leg [small: 0.09 ± 0.01 m, large: 0.06 ± 0.01 m, mean and standard deviation, F (1, 15) = 96.46, p < 0.001, η2 = 0.87]. The variability in the mediolateral extrapolated center of mass location was smaller in the small target condition than large target condition when the target distance was long [small: 0.010 ± 0.002 m, large: 0.013 ± 0.004 m, t(15) = 3.8, p = 0.002, d = 0.96]. These findings showed that in the step initiation task, the CoM state and its variability were task-relevantly determined during the APA in accordance with the required stepping accuracy.
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Affiliation(s)
- Hiroki Yamada
- Graduate School of Humanities and Social Sciences, Hiroshima University, Hiroshima, Japan
| | - Masahiro Shinya
- Graduate School of Humanities and Social Sciences, Hiroshima University, Hiroshima, Japan
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Hwang M, Flanagan A, Graf A, Kruger KM, Scullion N, Tayne S, Altiok H. Gait Characteristics in Youth With Transverse Myelitis. Top Spinal Cord Inj Rehabil 2021; 27:38-48. [PMID: 34456545 DOI: 10.46292/sci20-00048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background Transverse myelitis (TM) in childhood is a rare disorder characterized by the presence of spinal cord inflammation. Gait difficulty in children with TM is common; however, there is a paucity of literature regarding quantitative assessment of gait in children and adolescents with TM. Objectives To characterize gait patterns in a cohort of ambulatory children with TM and age-matched, typically developing peers in order to better understand the functional mobility of patients diagnosed with childhood TM. Methods This was a retrospective study of 26 ambulatory pediatric patients with a confirmed diagnosis of TM who had undergone three-dimensional, instrumented gait analysis (3D-IGA) at 3 years of age or older. A group of 38 typically developing children served as a control group. Results Gait in children with TM was characterized by moderate kinematic deviations as measured by the Gait Deviation Index (GDI) and a crouched gait pattern (p < .001), increased anterior pelvic tilt (p < .001), decreased motion at the knees (p < .001), and a wider base of support (foot progression angle, p < .001). The TM group had a slower walking speed (p < .001), shorter strides (p < .001), and an increased stance phase compared to controls. Conclusion Our study results showed moderate kinematic deviations quantified by the GDI. Overall, the gait pattern in the TM population tested had greater hip and knee flexion with wider foot progression angle. Identification of gait characteristics in children with TM is the first step in predicting changes in gait pattern as they mature over time, which may ultimately allow for targeted intervention to maintain their ambulatory function.
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Affiliation(s)
- Miriam Hwang
- Shriners Hospitals for Children, Chicago, Illinois
| | - Ann Flanagan
- Shriners Hospitals for Children, Chicago, Illinois
| | - Adam Graf
- Shriners Hospitals for Children, Chicago, Illinois
| | - Karen M Kruger
- Shriners Hospitals for Children, Chicago, Illinois.,Marquette University, Milwaukee, Wisconsin
| | | | | | - Haluk Altiok
- Shriners Hospitals for Children, Chicago, Illinois
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Lencioni T, Anastasi D, Carpinella I, Castagna A, Crippa A, Gervasoni E, Marzegan A, Rabuffetti M, Pelosin E, Cattaneo D, Ferrarin M. Strategies for maintaining dynamic balance in persons with neurological disorders during overground walking. Proc Inst Mech Eng H 2021; 235:1079-1087. [PMID: 34112028 DOI: 10.1177/09544119211023624] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Maintaining a stable gait requires a dynamic balance control, that can be altered in persons with Multiple Sclerosis (MS), Stroke (ST), and Parkinson's disease (PD). The understanding of the strategy for Center of Mass (CoM) positioning adopted by patients during walking is important to be able to program treatments aimed at improving gait control and preventing falls. Forty-four persons with a mild-to-moderate neurological disorder (20 with MS, 14 with ST, 10 with PD) underwent clinical examination and gait analysis. Ten Healthy Subjects (HS) walking at matched speed provided the normative data. Dynamic balance was assessed using the margin of stability (MoS). It was calculated as the distance between the extrapolated Center of Pressure and the extrapolated CoM at mid-stance. The MoS values for lower limbs were calculated in patients and compared with speed-matched values of HS. Persons with neurological disorder showed increased MoS in the medio-lateral direction with respect to HS. Within-group comparison analysis showed a symmetry between lower limbs in HS (Mean (95%CI) [mm], dominant vs non-dominant limb, 43.3 (31.9-54.6) vs 42.9 (28.8-56.9)) and PD (less affected vs more affected limb, 71.1 (59.8-82.5) vs 72.5 (58.5-86.6)), while a significant asymmetry was found in MS (54.4 (46.4-62.4) vs 81.1 (71.2-91.1)) and ST (52.1 (42.6-61.7) vs 74.7 (62.8-86.6)) participants. The history of falls was comparable among PD, MS, and ST groups, and the MoS in the frontal plane showed a strong correlation with these records. Objective assessment of MoS revealed pathology-specific strategies showing different impacts in MS, ST, and PD on the ability to control CoM information to manage the balance between limbs during gait. MoS evaluation will provide useful information to address a tailored rehabilitation program and to monitor disease progression.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Elisa Pelosin
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Genoa, Italy.,Ospedale Policlinico San Martino-IRCCS, Genoa, Italy
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Grabowiecki M, Rum L, Laudani L, Vannozzi G. Biomechanical characteristics of handstand walking initiation. Gait Posture 2021; 86:311-318. [PMID: 33839425 DOI: 10.1016/j.gaitpost.2021.03.036] [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: 10/07/2020] [Revised: 02/26/2021] [Accepted: 03/30/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The initiation in human locomotion is defined as the transition between upright stance and steady-state gait. While past literature abundantly investigated the initiation in bipedal gait, the initiation of handstand walking remains unexplored. RESEARCH QUESTION The current study aims to characterise the centre of pressure (CoP) and centre of mass (CoM) trajectory of handstand walking initiation as well as the spatiotemporal and kinematic parameters and balance strategy of this task. Also, the study examined the CoP trajectory similarity within- and between-participants using a coefficient of multiple correlation analysis. METHODS Nineteen gymnasts took part in this study. Handstand walking initiation trials were recorded using force plates and a stereophotogrammetric system. CoM and CoP trajectories were analysed during the Baseline, Preparation and Execution phases of the motor task. RESULTS We found that to successfully perform the handstand walking initiation, a shift of the CoM forward and towards the stance hand is required as a result of a lateral and posterior CoP shift. All participants performed a similar CoP pattern in the mediolateral direction, whereas two anteroposterior CoP displacement strategies were identified across participants based on different timing execution of posterior CoP shift. While CoP and CoM kinematic differences were identified during the Preparation Phase due to the adopted strategy, no significant difference was found in the Execution Phase for the spatiotemporal and kinematic characteristics. SIGNIFICANCE A better understanding of the required CoP/CoM patterns and balance control provides the basis for further neuromechanics research on the topic and could contribute to individualise training protocols to improve the learning of the task.
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Affiliation(s)
- Michal Grabowiecki
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy; Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cyncoed Campus, Cyncoed Road, CF23 6XD, Cardiff, UK
| | - Lorenzo Rum
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Luca Laudani
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cyncoed Campus, Cyncoed Road, CF23 6XD, Cardiff, UK
| | - Giuseppe Vannozzi
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy.
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