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Lateef S, Lanza MB, Gray VL. Does the rate of hip abductor and adductor muscle activation during weight transfer influence voluntary lateral stepping in chronic stroke? J Electromyogr Kinesiol 2025; 82:103003. [PMID: 40184848 DOI: 10.1016/j.jelekin.2025.103003] [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: 07/11/2024] [Revised: 10/09/2024] [Accepted: 03/25/2025] [Indexed: 04/07/2025] Open
Abstract
People with chronic stroke (PwCS) suffer from impaired lateral weight transfer, resulting in a loss of balance. The primary purpose of this study was to examine how stroke impairs the rate of hip abductor-adductor muscle activation during weight transfer compared to controls, and whether this influences subsequent stepping performance. The secondary purpose was to determine how stroke affects bilateral coordinated hip abductor-adductor muscle activity between the step and stance legs. 20 PwCS (61.6 ± 7.4 years, 4F/16 M) and 10 healthy controls (64.8 ± 8.9 years, 5F/5M) were included. Participants took a voluntary lateral step, as quickly as possible, in response to a light cue. Bilateral Adductor Longus (ADD) and Gluteus Medius (GM) rate of muscle activation (RoA) were measured using electromyography, and spatiotemporal step characteristics were measured using motion capture. Paretic (p < 0.01) and non-paretic (p < 0.01) stance and step legs had a reduced GM and ADD RoA during weight transfer compared to controls. Reduced stance and step GM and ADD RoA were associated with longer weight transfer and step initiation times (rs = - 0.47 to - 0.63, p < 0.001). PwCS had a lack of bilateral coordinated GM and ADD activity (p > 0.05). Post-stroke reductions in GM and ADD RoA contribute to altered step characteristics.
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Affiliation(s)
- Shabnam Lateef
- Department of Physical Therapy & Rehabilitation Science, University of Maryland, Baltimore, USA
| | - Marcel Bahia Lanza
- Department of Physical Therapy & Rehabilitation Science, University of Maryland, Baltimore, USA
| | - Vicki L Gray
- Department of Physical Therapy & Rehabilitation Science, University of Maryland, Baltimore, USA.
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Storniolo JL, Farinelli V, Esposti R, Cavallari P. Impact of muscle fatigue on anticipatory postural adjustments during gait initiation. Front Physiol 2025; 15:1520578. [PMID: 39872415 PMCID: PMC11770096 DOI: 10.3389/fphys.2024.1520578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2024] [Accepted: 12/09/2024] [Indexed: 01/30/2025] Open
Abstract
Introduction Prolonged or strenuous exercise leads to a temporary decrease in muscle function and performance, which interferes with activity of both prime movers and postural muscles. This effect of fatigue has been reported both for single segment movements and for locomotion. However, little is known regarding the effects of fatigue on anticipatory postural adjustments (APAs) during gait initiation, a task in which the control of focal movement should be strictly coupled to a feedforward control of posture. Methods We studied APAs during gait initiation in 16 healthy well-trained adult males, searching for muscle activities that precede the backward shift of the Center of Pressure (CoP). Participants stood on a force plate for about 10 s and then started walking at their natural speed. APAs were evaluated before and after a 1 min exhausting sequence of countermovement jumps. An optoelectronic system captured the heel-off events while a force plate measured the CoP position and vertical ground reaction force. Wireless probes recorded the electromyogram of trunk and leg muscles from both sides. Results It was observed that muscle fatigue delayed excitatory and inhibitory APAs, of about 40 and 80 ms, respectively, and a parallel delay was induced on prime movers; moreover, velocity and amplitude of backward CoP shift were reduced. Regarding APAs sign and occurrence, most of the participants showed bilateral inhibition in dorsal muscles and excitation in the ventral ones, displaying a forward "diving" strategy that was almost unaffected by fatigue. However, after fatigue, three of the "diving" participants switched to a "turning" strategy, i.e., they displayed a reciprocal activation/inhibition pattern in the dorsal muscles, compatible with a trunk rotation. Discussion The "turning" strategy has been previously described in untrained individuals and in a toes-amputee mountain climber, who showed a "diving" approach to gait initiation when wearing his prosthetic shoes and switched to the "turning" approach when barefoot. Altogether, these results support the idea that one and the same person may develop a repertoire of postural strategies among which the central nervous system will choose, according to the personal fitness and the constraints in which the action is performed.
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Affiliation(s)
- Jorge L. Storniolo
- Human Physiology Section of the Department of Pathophysiology and Transplantation, Università Degli Studi, Milano, Italy
- Laboratorio Sperimentale di Fisiopatologia Neuromotoria, IRCCS Istituto Auxologico Italiano, Meda, Italy
| | - Veronica Farinelli
- Human Physiology Section of the Department of Pathophysiology and Transplantation, Università Degli Studi, Milano, Italy
| | - Roberto Esposti
- Human Physiology Section of the Department of Pathophysiology and Transplantation, Università Degli Studi, Milano, Italy
| | - Paolo Cavallari
- Human Physiology Section of the Department of Pathophysiology and Transplantation, Università Degli Studi, Milano, Italy
- Laboratorio Sperimentale di Fisiopatologia Neuromotoria, IRCCS Istituto Auxologico Italiano, Meda, Italy
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Mortezanejad M, Ebrahimabadi Z, Rahimi A, Maleki A, Baghban AA, Ehsani F. Postural adjustment and muscle activity during each phase of gait initiation in chronic ankle instability: an observational study. BMC Sports Sci Med Rehabil 2024; 16:248. [PMID: 39695841 DOI: 10.1186/s13102-024-01033-x] [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: 06/09/2024] [Accepted: 12/04/2024] [Indexed: 12/20/2024]
Abstract
BACKGROUND Gait initiation (GI) can be divided into three sections according to the center of pressure (COP) trace (S1, S2, and S3). Almost all studies do not separate each phase of the GI profile in postural control assessment and muscular investigation, whereas differences in the COP and muscles are found in each phase of the GI profile in people with gait problems. METHODS Twenty individuals with CAI and twenty healthy controls were included in the present study. A force plate synchronized with Qualisys motion analysis, MEGAWIN electromyography, and a pair of auditory cues were used for data capture. The participants carried out five trials of GI with the affected leg (dominant leg). The peak and mean COP excursions; the mean and maximum velocities of COP excursion during S1, S2,, S3, and the total phases in the mediolateral (ML) and anterior‒posterior (AP) directions; the root mean square (RMS); and the onset activity of the Tibialis Anterior (TA) and Soleus (SOL) muscles for both legs were used for statistical analysis. Independent t tests and Mann‒Whitney U tests were used for statistical analysis on the basis of a significance level of ≤ 0.05. RESULTS Compared with those of healthy controls, independent t tests revealed a significant decrease in the peak COP excursion in the AP direction during S2 (P = 0.021) and in the mean velocity of COP excursion in the AP direction during S1 (P = 0.044) in the CAI group. Additionally, there was a significant increase in the duration of S1 in the GI profile (P = 0.045) in the CAI group compared with the healthy control group. There was no significant difference in the other COP variables, TA or SOL RMS or onset activity for either leg during S1, S2, or S3 between the two groups (P > 0.065). CONCLUSION Individuals with CAI exhibit increased stiffness in the AP direction in the injured ankle. This leads to a reduction in the velocity and peak of COP excursion, as well as an increase in the time required for postural control adjustment. These findings highlight the challenges individuals with CAI may face in meeting postural demands when trying to unload the affected foot. ETHICAL CODE IR.SBMU.RETECH.REC.1402.095, 2023-5-28.
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Affiliation(s)
- Marzieh Mortezanejad
- Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Zahra Ebrahimabadi
- Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Abbas Rahimi
- Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Maleki
- Biomedical Engineering Department, Semnan University, Semnan, Iran
| | - Alireza Akbarzadeh Baghban
- Proteomics Research Center, Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Ehsani
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
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Mortezanejad M, Daryabor A, Ebrahimabadi Z, Rahimi A, Yousefi M, Ehsani F, Maleki A. Kinetic changes of gait initiation in individuals with chronic ankle instability: A systematic review. Health Sci Rep 2024; 7:e70143. [PMID: 39479288 PMCID: PMC11522363 DOI: 10.1002/hsr2.70143] [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: 10/31/2023] [Revised: 09/03/2024] [Accepted: 09/26/2024] [Indexed: 11/02/2024] Open
Abstract
Background and Aims Gait initiation (GI) in individuals with chronic ankle instability (CAI) has shown differences in the center of pressure (COP) and muscular measures compared to healthy controls. Some studies reported that these alterations appeared when GI was with the affected leg, while others indicated that they occurred when GI was with the non-affected leg. This systematic review aimed to understand kinetic and muscular differences between individuals with CAI, healthy controls, and the affected and non-affected legs of individuals with CAI. Methods PubMed, Science Direct, Web of Science, Google Scholar, and Scopus databases (1990-2023) were searched using the Population, Exposure, Comparator, and Outcome measure. The PRISMA guidelines were followed. The outcome measures were the peak and rate of COP displacement in the medial-lateral and anterior-posterior directions, and resultant plane during phases 1, 2, and 3 of COP trace during GI and the duration of each phase. The other measures included the onset time of the tibialis anterior and soleus muscle activity between individuals with CAI, healthy controls, and the affected and non-affected legs of the individuals with CAI. The studies' quality assessment was conducted based on the Strengthening the Reporting of Observational Studies in Epidemiology checklist. Results Five studies were included in the final evaluation. The results of included studies showed, individuals with CAI spent less time during phases 1 and 2, as well as a shorter peak of COP displacement in the lateral direction during phase 1 compared to healthy controls, regardless of whether the GI was with the affected or non-affected leg. Conclusion Individuals with CAI have probably adopted a strategy involving adjusting the peak of COP displacement to manage internal sway while in a single-leg stance. Overall, there was no comprehensive conclusion about differences between the two legs in individuals with CAI.
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Affiliation(s)
- Marzieh Mortezanejad
- Physiotherapy Research CenterSchool of Rehabilitation, Shahid Beheshti University of Medical SciencesTehranIran
- Neuromuscular Rehabilitation Research CenterSemnan University of Medical SciencesSemnanIran
| | - Aliyeh Daryabor
- Physiotherapy Research CenterDepartment of Orthotics and Prosthetics, School of Rehabilitation, Shahid Beheshti University of Medical SciencesTehranIran
| | - Zahra Ebrahimabadi
- Physiotherapy Research CenterSchool of Rehabilitation, Shahid Beheshti University of Medical SciencesTehranIran
| | - Abbas Rahimi
- Department of PhysiotherapySchool of Rehabilitation, Shahid Beheshti University of Medical SciencesTehranIran
| | - Mohammad Yousefi
- Physiotherapy Research CenterSchool of Rehabilitation, Shahid Beheshti University of Medical SciencesTehranIran
- Sport Biomechanics, Faculty of Sport Sciences, University of BirjandBirjandIran
| | - Fatemeh Ehsani
- Neuromuscular Rehabilitation Research CenterSemnan University of Medical SciencesSemnanIran
| | - Ali Maleki
- Biomedical Engineering DepartmentSemnan UniversitySemnanIran
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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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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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Billen LS, Corneil BD, Weerdesteyn V. Evidence for an Intricate Relationship Between Express Visuomotor Responses, Postural Control and Rapid Step Initiation in the Lower Limbs. Neuroscience 2023; 531:60-74. [PMID: 37709004 DOI: 10.1016/j.neuroscience.2023.07.025] [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: 04/18/2023] [Revised: 07/18/2023] [Accepted: 07/21/2023] [Indexed: 09/16/2023]
Abstract
Recent work has described express visuomotor responses (EVRs) on the upper limb. EVRs are directionally-tuned bursts of muscle activity that occur within 100 ms of visual stimulus appearance, facilitating rapid reaching. Rapid stepping responses are also important in daily life, and while there is evidence of EVR expression on lower limbs, it is unknown whether lower-limb EVRs are influenced by increased postural demands. Here, we investigate the interaction between stepping-related EVRs and anticipatory postural adjustments (APAs) that typically precede step initiation. 16 healthy young subjects rapidly stepped towards visual targets presented in front of the left or right foot. We recorded bilateral surface EMG of gluteus medius (GM), a muscle involved in both APAs and stepping, and bilateral ground reaction forces. Two conditions were introduced: an anterolateral or anteromedial stepping condition with reduced or increased postural demands, respectively. In the anterolateral stepping condition, EVRs were robustly and strongly present in stance-side GM, and ground reaction forces revealed strongly decreased expression of APAs. Larger EVRs preceded shorter RTs, consistent with EVRs facilitating step initiation. In contrast, in the anteromedial stepping condition, EVRs were largely absent, and ground reaction forces revealed the consistent expression of APAs. When occasionally present, EVRs in the anteromedial stepping condition preceded larger APAs and longer RTs. Thus, while EVRs in lower limbs can facilitate rapid stepping, their expression is normally suppressed when postural stability is low. Failing to appropriately suppress EVRs in such situations disrupts postural stability, necessitating larger compensatory APAs and leading to longer stepping RTs.
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Affiliation(s)
- Lucas S Billen
- Department of Rehabilitation - Donders Institute for Brain, Cognition & Behavior, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Brian D Corneil
- Department of Physiology & Pharmacology, Western University, London, Canada; Robarts Research Institute, London, Canada
| | - Vivian Weerdesteyn
- Department of Rehabilitation - Donders Institute for Brain, Cognition & Behavior, Radboud University Medical Center, Nijmegen, The Netherlands; Sint Maartenskliniek Research, Nijmegen, The Netherlands
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Sozzi S, Ghai S, Schieppati M. The 'Postural Rhythm' of the Ground Reaction Force during Upright Stance and Its Conversion to Body Sway-The Effect of Vision, Support Surface and Adaptation to Repeated Trials. Brain Sci 2023; 13:978. [PMID: 37508910 PMCID: PMC10377030 DOI: 10.3390/brainsci13070978] [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: 05/11/2023] [Revised: 06/12/2023] [Accepted: 06/18/2023] [Indexed: 07/30/2023] Open
Abstract
The ground reaction force (GRF) recorded by a platform when a person stands upright lies at the interface between the neural networks controlling stance and the body sway deduced from centre of pressure (CoP) displacement. It can be decomposed into vertical (VGRF) and horizontal (HGRF) vectors. Few studies have addressed the modulation of the GRFs by the sensory conditions and their relationship with body sway. We reconsidered the features of the GRFs oscillations in healthy young subjects (n = 24) standing for 90 s, with the aim of characterising the possible effects of vision, support surface and adaptation to repeated trials, and the correspondence between HGRF and CoP time-series. We compared the frequency spectra of these variables with eyes open or closed on solid support surface (EOS, ECS) and on foam (EOF, ECF). All stance trials were repeated in a sequence of eight. Conditions were randomised across different days. The oscillations of the VGRF, HGRF and CoP differed between each other, as per the dominant frequency of their spectra (around 4 Hz, 0.8 Hz and <0.4 Hz, respectively) featuring a low-pass filter effect from VGRF to HGRF to CoP. GRF frequencies hardly changed as a function of the experimental conditions, including adaptation. CoP frequencies diminished to <0.2 Hz when vision was available on hard support surface. Amplitudes of both GRFs and CoP oscillations decreased in the order ECF > EOF > ECS ≈ EOS. Adaptation had no effect except in ECF condition. Specific rhythms of the GRFs do not transfer to the CoP frequency, whereas the magnitude of the forces acting on the ground ultimately determines body sway. The discrepancies in the time-series of the HGRF and CoP oscillations confirm that the body's oscillation mode cannot be dictated by the inverted pendulum model in any experimental conditions. The findings emphasise the robustness of the VGRF "postural rhythm" and its correspondence with the cortical theta rhythm, shed new insight on current principles of balance control and on understanding of upright stance in healthy and elderly people as well as on injury prevention and rehabilitation.
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Affiliation(s)
| | - Shashank Ghai
- Department of Political, Historical, Religious and Cultural Studies, Karlstad University, 65188 Karlstad, Sweden
- Centre for Societal Risk Research, Karlstad University, 65188 Karlstad, Sweden
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Marchese SM, Esposti R, Farinelli V, Ciaccio C, De Laurentiis A, D’Arrigo S, Cavallari P. Pediatric Slow-Progressive, but Not Non-Progressive Cerebellar Ataxia Delays Intra-Limb Anticipatory Postural Adjustments in the Upper Arm. Brain Sci 2023; 13:brainsci13040620. [PMID: 37190585 DOI: 10.3390/brainsci13040620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/01/2023] [Accepted: 04/04/2023] [Indexed: 04/08/2023] Open
Abstract
We recently investigated the role of the cerebellum during development, reporting that children with genetic slow-progressive ataxia (SlowP) show worse postural control during quiet stance and gait initiation compared to healthy children (H). Instead, children with genetic non-progressive ataxia (NonP) recalled the behavior of H. This may derive from compensatory networks, which are hindered by disease progression in SlowP while free to develop in NonP. In the aim of extending our findings to intra-limb postural control, we recorded, in 10 NonP, 10 SlowP and 10 H young patients, Anticipatory Postural Adjustments (APAs) in the proximal muscles of the upper-limb and preceding brisk index finger flexions. No significant differences in APA timing occurred between NonP and H, while APAs in SlowP were delayed. Indeed, the excitatory APA in Triceps Brachii was always present but significantly delayed with respect to both H and NonP. Moreover, the inhibitory APAs in the Biceps Brachii and Anterior Deltoid, which are normally followed by a late excitation, could not be detected in most SlowP children, as if inhibition was delayed to the extent where there was overlap with a late excitation. In conclusion, disease progression seems to be detrimental for intra-limb posture, supporting the idea that inter- and intra-limb postures seemingly share the same control mechanism.
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Affiliation(s)
- Silvia Maria Marchese
- Human Physiology Section of the DePT, Università degli Studi di Milano, 20133 Milan, Italy
| | - Roberto Esposti
- Human Physiology Section of the DePT, Università degli Studi di Milano, 20133 Milan, Italy
| | - Veronica Farinelli
- Human Physiology Section of the DePT, Università degli Studi di Milano, 20133 Milan, Italy
| | - Claudia Ciaccio
- Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, 20133 Milan, Italy
| | - Arianna De Laurentiis
- Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, 20133 Milan, Italy
| | - Stefano D’Arrigo
- Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico “Carlo Besta”, 20133 Milan, Italy
| | - Paolo Cavallari
- Human Physiology Section of the DePT, Università degli Studi di Milano, 20133 Milan, Italy
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Inal B, Ozengin N, Bakar Y, Ankaralı H, Ozturk Y. Examination of posture and balance in children with primary monosymptomatic nocturnal enuresis. J Pediatr Rehabil Med 2023; 16:529-537. [PMID: 36641693 DOI: 10.3233/prm-210105] [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] [Indexed: 01/12/2023] Open
Abstract
PURPOSE This study aimed to examine symptom severity, posture, and balance of children with primary monosymptomatic nocturnal enuresis (PMNE) and compare to a healthy control group. METHODS Thirty-five children with PMNE and 34 healthy children were included in this study. Physical and sociodemographic characteristics of the children were recorded. Symptom severity was assessed with a Vancouver Non-Neurogenic Lower Urinary Tract Dysfunction/Dysfunctional Elimination Syndrome Questionnaire (NLUTD/DES), a four-day bladder diary and a seven-day bowel diary. Standing postural alignment was assessed with the Spinal Mouse device, and the sensory integration of static balance and dynamic standing balance was assessed with the Biodex Balance System SD. RESULTS Compared to healthy controls, children with PMNE demonstrated increased symptom severity (p = 0.001), increased upright lumbar lordosis (p = 0.018) and sacral-hip angles (p = 0.029), decreased static balance in the sensory condition of unstable surface with eyes closed (p = 0.001), and decreased mediolateral dynamic balance (p = 0.049). CONCLUSION Children with PMNE demonstrate altered postural alignment, static and dynamic postural instability, and greater symptom severity on the Vancouver NLUTD/DES than age-matched controls.
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Affiliation(s)
- Busra Inal
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bolu Abant İzzet Baysal University, Bolu, Turkey
| | - Nuriye Ozengin
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bolu Abant İzzet Baysal University, Bolu, Turkey
| | - Yesim Bakar
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Bakircay University, Izmir, Turkey
| | - Handan Ankaralı
- Department of Biostatistics and Medical Informatics, Medical Faculty, Istanbul Medeniyet University, Istanbul, Turkey
| | - Yusuf Ozturk
- Department of Child and Adolescent Psychiatry, Medical Faculty, Bolu Abant İzzet Baysal University, Bolu, Turkey
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12
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Watanabe R, Higuchi T. Anticipatory action planning for stepping onto competing potential targets. Front Hum Neurosci 2022; 16:875249. [PMID: 36072888 PMCID: PMC9441706 DOI: 10.3389/fnhum.2022.875249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 08/02/2022] [Indexed: 12/05/2022] Open
Abstract
The brain plans an anticipatory action for performing tasks successfully and effortlessly even if there are multiple possible options. There is increasing evidence that, when multiple actions are possible, the brain considers two factors when planning an anticipatory action-the probabilistic value and the action cost for each potential action. When the action involves maintaining upright balance, such as standing, stepping, or walking, the action cost for maintaining postural stability could be considered dominantly. We addressed this issue by using a "go-before-you-know" task to step onto a target on the floor. In this task, two potential targets were located on the medial or lateral side of the stepping foot, and the true target was cued only after participants shifted their loads to leave that foot. Participants initiated their stepping actions without knowing which of the potential targets would be the true one. The results showed that, for the majority of participants, lateral displacements of the center of pressure (COP) with two potential targets were similar to those when a single target exists on the individual's medial side. Given that mediolateral postural stability became more destabilized with stepping onto the medial target than stepping onto the lateral target, they were likely to plan their mediolateral components of the postural adjustments for the worst-case scenario (i.e., falling). Additionally, posterior COP movements with two potential targets became smaller than those with a single target, suggesting an effort to create extra time to determine the true target and to adjust the swing foot. Based on these findings, we concluded that action costs for maintaining postural stability were considered dominantly for planning an anticipatory action to accomplish a stepping task successfully while ensuring upright balance.
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Affiliation(s)
- Ryo Watanabe
- Department of Health Promotion Sciences, Tokyo Metropolitan University, Tokyo, Japan
- Research Fellow, Japan Society for the Promotion of Science, Tokyo, Japan
| | - Takahiro Higuchi
- Department of Health Promotion Sciences, Tokyo Metropolitan University, Tokyo, Japan
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13
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Russo Y, Stuart S, Silva-Batista C, Brumbach B, Vannozzi G, Mancini M. Does visual cueing improve gait initiation in people with Parkinson's disease? Hum Mov Sci 2022; 84:102970. [PMID: 35738211 DOI: 10.1016/j.humov.2022.102970] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/04/2022] [Accepted: 06/05/2022] [Indexed: 11/04/2022]
Abstract
Anticipatory postural adjustments (APAs) prior to gait initiation are impaired in people with Parkinson's disease (PD), particularly in those who report Freezing of Gait (FOG). External cues can improve gait parameters in people with PD, but the effects of visual cues on gait initiation are poorly known. The study aimed to (i) assess differences, during gait initiation, between people with PD with (FOG+) and without FOG (FOG-) and healthy controls (HC), (ii) explore the effect of disease severity on gait initiation and (iii) investigate the acute effect of visual cueing on gait initiation and straight-ahead gait. Twenty FOG- and twenty FOG+, and eighteen HC participated in this study. Participants were asked to perform self-initiated gait with and without visual cues presented as transverse taped lines on the floor. Gait initiation and gait were characterized with wireless inertial measurement units. Results showed that FOG+ had smaller APAs than HC and FOG-; although no differences were detected between FOG+ and FOG- when taking into account disease severity. Significant correlations between MDS-UPDRS III scores and gait initiation/straight-ahead gait variables confirmed that differences between FOG+ and FOG- were driven by disease severity. In gait initiation, visual cues elicited different behaviors in people with and without PD. Particularly, people with PD showed smaller and longer APAs, whereas HC showed longer first step durations, compared to baseline. However, the adopted visual cues improved gait speed and stride length in all individuals. These results suggest that people with PD, despite the presence of FOG, utilize different motor strategies, compared to HC, to adapt to the new biomechanical requirements of gait initiation dictated by the visual cues.
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Affiliation(s)
- Yuri Russo
- Department of Movement, Human and Health Sciences, University of Roma Foro Italico, Roma, Italy; Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - Samuel Stuart
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA; Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
| | - Carla Silva-Batista
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA; Exercise Neuroscience Research Group, University of Sao Paulo, Sao Paulo, Brazil
| | - Barbara Brumbach
- Biostatistics and Design Program, Oregon Health & Science University, Portland, OR, USA
| | - Giuseppe Vannozzi
- Department of Movement, Human and Health Sciences, University of Roma Foro Italico, Roma, Italy
| | - Martina Mancini
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA.
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14
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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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15
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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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16
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Kimijanová J, Bzdúšková D, Hirjaková Z, Hlavačka F. Age-Related Changes of the Anticipatory Postural Adjustments During Gait Initiation Preceded by Vibration of Lower Leg Muscles. Front Hum Neurosci 2021; 15:771446. [PMID: 34744671 PMCID: PMC8566353 DOI: 10.3389/fnhum.2021.771446] [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: 09/06/2021] [Accepted: 09/27/2021] [Indexed: 11/13/2022] Open
Abstract
Gait initiation (GI) challenges the balance control system, especially in the elderly. To date, however, there is no consensus about the age effect on the anticipatory postural adjustments (APAs). There is also a lack of research on APAs in older adults after proprioceptive perturbation in the sagittal plane. This study aimed to compare the ability of young and older participants to generate APAs in response to the vibratory-induced perturbation delivered immediately before GI. Twenty-two young and 22 older adults performed a series of GI trials: (1) without previous vibration; (2) preceded by the vibration of triceps surae muscles; and (3) preceded by the vibration of tibialis anterior muscles. The APAs magnitude, velocity, time-to-peak, and duration were extracted from the center of pressure displacement in the sagittal plane. Young participants significantly modified their APAs during GI, whereas older adults did not markedly change their APAs when the body vertical was shifted neither backward nor forward. Significant age-related declines in APAs were observed also regardless of the altered proprioception.The results show that young adults actively responded to the altered proprioception from lower leg muscles and sensitively scaled APAs according to the actual position of the body verticality. Contrary, older adults were unable to adjust their postural responses indicating that the challenging transition from standing to walking probably requires higher reliance on the visual input. The understanding of age-related differences in APAs may help to design training programs for the elderly specifically targeted to improve balance control in different sensory conditions, particularly during gait initiation.
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Affiliation(s)
- Jana Kimijanová
- Department of Behavioral Neuroscience, Institute of Normal and Pathological Physiology, Centre of Experimental Medicine, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Diana Bzdúšková
- Department of Behavioral Neuroscience, Institute of Normal and Pathological Physiology, Centre of Experimental Medicine, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Zuzana Hirjaková
- Department of Behavioral Neuroscience, Institute of Normal and Pathological Physiology, Centre of Experimental Medicine, Slovak Academy of Sciences, Bratislava, Slovakia
| | - František Hlavačka
- Department of Behavioral Neuroscience, Institute of Normal and Pathological Physiology, Centre of Experimental Medicine, Slovak Academy of Sciences, Bratislava, Slovakia
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17
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Akbaş A, Marszałek W, Bacik B, Juras G. Two Aspects of Feedforward Control During a Fencing Lunge: Early and Anticipatory Postural Adjustments. Front Hum Neurosci 2021; 15:638675. [PMID: 34194305 PMCID: PMC8236721 DOI: 10.3389/fnhum.2021.638675] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 04/29/2021] [Indexed: 11/20/2022] Open
Abstract
The present study investigated whether expertise in fencing influences the onset of postural preparation during the fencing lunge and how it changes under different performance conditions. We also questioned if the onset of feedforward control can be categorized into one of the postural phases: anticipatory or early postural adjustment. Eight elite fencers and nine physical education students performed an attack with a lunge in self-paced and reaction time conditions from three different initial stance widths. The onset of the center of pressure (COP) displacement and EMG activities for the tibialis anterior (TA) of both limbs were recorded. The results show that expertise in fencing delays the onset of the activity of TA of the front leg and the onset of COP displacement during fencing lunge performance in comparison to controls. Additionally, in contrast to the control group, fencers produce typical APA patterns in the activation of TA under different performance conditions, delayed reaction time in comparison to self-initiated lunging, and constant time of APA onset under different widths of stance. According to different times and functions of TA activity and COP displacement in lunging, we propose to address them as anticipatory postural adjustment and early postural adjustment, respectively.
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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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18
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Vieira MF, Rodrigues FB, de Oliveira Assis A, de Mendonça Mesquita E, Lemes TS, De Villa GAG, Baptista RR, de Oliveira Andrade A, Lobo da Costa PH. Effects of additional load at different heights on gait initiation: A statistical parametric mapping of center of pressure and center of mass behavior. PLoS One 2021; 16:e0242892. [PMID: 34115751 PMCID: PMC8195414 DOI: 10.1371/journal.pone.0242892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 05/23/2021] [Indexed: 11/19/2022] Open
Abstract
The purpose of this study was to investigate the effects of different vertical positions of an asymmetrical load on the anticipatory postural adjustments phase of gait initiation. Sixty-eight college students (32 males, 36 females; age: 23.65 ± 3.21 years old; weight: 69.98 ± 8.15 kg; height: 1.74 ± 0.08 m) were enrolled in the study. Ground reaction forces and moments were collected using two force platforms. The participants completed three trials under each of the following random conditions: no-load (NL), waist uniformly distributed load (WUD), shoulder uniformly distributed load (SUD), waist stance foot load (WST), shoulder stance foot load (SST), waist swing foot load (WSW), and shoulder swing foot load (SSW). The paired Hotelling's T-square test was used to compare the experimental conditions. The center of pressure (COP) time series were significantly different for the SUD vs. NL, SST vs. NL, WST vs. NL, and WSW vs. NL comparisons. Significant differences in COP time series were observed for all comparisons between waist vs. shoulder conditions. Overall, these differences were greater when the load was positioned at the shoulders. For the center of mass (COM) time series, significant differences were found for the WUD vs. NL and WSW vs. NL conditions. However, no differences were observed with the load positioned at the shoulders. In conclusion, only asymmetrical loading at the waist produced significant differences, and the higher the extra load, the greater the effects on COP behavior. By contrast, only minor changes were observed in COM behavior, suggesting that the changes in COP (the controller) behavior are adjustments to maintain the COM (controlled object) unaltered.
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Affiliation(s)
- Marcus Fraga Vieira
- Bioengineering and Biomechanics Laboratory, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Fábio Barbosa Rodrigues
- Bioengineering and Biomechanics Laboratory, Federal University of Goiás, Goiânia, Goiás, Brazil
- State University of Goiás – Unidade Trindade-GO, Brazil
| | | | | | - Thiago Santana Lemes
- Bioengineering and Biomechanics Laboratory, Federal University of Goiás, Goiânia, Goiás, Brazil
| | | | | | - Adriano de Oliveira Andrade
- Centre for Innovation and Technology Assessment in Health (NIATS), Federal University of Uberlândia, Uberlândia, Brazil
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19
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Russo Y, Vannozzi G. Anticipatory postural adjustments in forward and backward single stepping: Task variability and effects of footwear. J Biomech 2021; 122:110442. [PMID: 33901937 DOI: 10.1016/j.jbiomech.2021.110442] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 11/25/2022]
Abstract
A single step is usually preceded by the so-named anticipatory postural adjustments (APAs). These are normally described through the observation of the trajectory of the center of pressure (CoP). Even though, external factors such as stepping direction and footwear are known to modify APAs, quantitative investigations regarding their relevant effects are understudied in the literature. Therefore, this study aims at characterizing APAs patterns prior to forward and backward stepping when performed either in barefoot or shod condition and explores their variability. Twenty-eight young healthy volunteers participated in the study. CoP trajectories were recorded using a force plate and relevant spatio-temporal parameters extracted (i.e. duration, amplitude, and mean speed). Results showed distinct effects of both direction of the step and footwear on APAs: the first mainly induces variations of APAs along the anteroposterior direction, whereas the latter in the mediolateral direction. In addition, variability indices exhibited lower values for the APAs along the mediolateral axis which was affected by neither footwear nor direction of the step. This study extends previous literature by revealing significant direction X footwear interactions on APAs. Furthermore, regardless of these factors, the medio-lateral strategy is still well preserved, highlighting the prioritization of balance control over motor performance. In conclusion, both direction and footwear have a major effect on postural preparation therefore both factors should be included when evaluating APAs in real-life condition.
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Affiliation(s)
- Yuri Russo
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System (BOHNES), Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Giuseppe Vannozzi
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System (BOHNES), Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy.
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20
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Bayot M, Delval A, Moreau C, Defebvre L, Hansen C, Maetzler W, Schlenstedt C. Initial center of pressure position prior to anticipatory postural adjustments during gait initiation in people with Parkinson's disease with freezing of gait. Parkinsonism Relat Disord 2021; 84:8-14. [PMID: 33517030 DOI: 10.1016/j.parkreldis.2021.01.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/08/2021] [Accepted: 01/11/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Freezing of gait (FOG) in Parkinson's disease (PD) is associated with an altered posture during quiet stance as well as an impaired preparation and execution of the gait initiation process. We aimed to investigate whether an altered initial posture impacts anticipatory postural adjustments (APAs) and first-step execution during gait initiation in people with PD with FOG (PD + FOG). METHODS Twenty-seven PD+FOG, 30 PD patients without FOG and 27 age-matched healthy controls performed self-generated gait initiation. Initial mean center of pressure (COP) position prior to APA onset, characteristics of APAs and features of first-step execution were investigated. RESULTS Contrarily to controls, PD patients showed a COP that was initially positioned more towards the stance leg (p = 0.007). Moreover, significantly smaller backward COP shift, longer duration of swing-foot unloading phase, and lower first-step length and velocity characterized PD+FOG compared to controls. While size and duration of backward COP shift during APA and lateral COP shift during the unloading phase were main predictors of first-step length and velocity in all groups, the medio-lateral shift of the initial COP position in PD+FOG was a main predictor of first-step execution (β = -0.191, p = 0.001 for velocity). CONCLUSION In PD+FOG, the more the COP was initially positioned towards the stance foot, the slower and shorter the first step. The initial medio-lateral COP position may be a compensatory strategy to address postural instability of PD+FOG. A specific training regarding postural control prior to gait preparation and execution could improve functional mobility in PD+FOG.
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Affiliation(s)
- Madli Bayot
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, F-59000, Lille, France
| | - Arnaud Delval
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, F-59000, Lille, France
| | - Caroline Moreau
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, F-59000, Lille, France
| | - Luc Defebvre
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, F-59000, Lille, France
| | - Clint Hansen
- Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany
| | - Walter Maetzler
- Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany
| | - Christian Schlenstedt
- Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany.
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21
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Caderby T, Caron N, Verkindt C, Bonazzi B, Dalleau G, Peyrot N. Obesity-related alterations in anticipatory postural mechanisms associated with gait initiation. Exp Brain Res 2020; 238:2557-2567. [DOI: 10.1007/s00221-020-05914-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 08/26/2020] [Indexed: 02/08/2023]
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Inaba Y, Suzuki T, Yoshioka S, Fukashiro S. Directional Control Mechanisms in Multidirectional Step Initiating Tasks. Front Hum Neurosci 2020; 14:178. [PMID: 32792926 PMCID: PMC7385377 DOI: 10.3389/fnhum.2020.00178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 04/21/2020] [Indexed: 11/13/2022] Open
Abstract
Typical anticipatory postural adjustments (APAs) in forward gait or step initiation tasks to prepare for possible disturbances caused by prime voluntary movements and to accelerate the body forward have been previously reported. However, it is not clear how wide the variations in step directions are differentiated and controlled in non-forward step initiation tasks during the APA phase. The main goal of this study is to explain the directional control mechanisms by investigating the APA of step initiation tasks in forward, diagonal, lateral, and posterior directions. The center of pressure (COP) trajectories and related muscle (soleus, tibialis anterior, and gluteus medius of both lower limbs) activities during the APA of step initiation tasks in nine different directions were analyzed in six healthy young males. Posterior shifts of COP during APA decreased as the direction became more lateral (0° to 90°). For posterior step initiations, COP moved anteriorly from the initial position to accelerate the center of mass of the whole body (COM) backward. Lateral shifts of COP toward the stepping foot during APA decreased as the stepping direction became more lateral (from 0° to 45° and from 180° to 113°) while it plateaued to about zero in the direction from 45° to 113°. Both anteroposterior and lateral displacements of COP in APA were nonlinearly modulated to each direction, but they were linearly related to the anteroposterior and mediolateral component of the velocities of COM at the take-off of the stance foot. Thus, the scaling of APA, reflected in the anteroposterior and lateral displacements of COP and the temporal sequence of selected muscle activities, was based on the anteroposterior and mediolateral components of the take-off velocity of COM that ultimately controls the direction of steps.
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Affiliation(s)
- Yuki Inaba
- Department of Sport Science, Japan Institute of Sports Sciences, Japan High Performance Sport Center, Tokyo, Japan
| | - Takahito Suzuki
- Graduate School of Human Sciences, Kanagawa University, Kanagawa, Japan.,Japan Society for the Promotion of Science (JSPS), Tokyo, Japan
| | | | - Senshi Fukashiro
- Department of Life Sciences, The University of Tokyo, Tokyo, Japan
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23
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Schlenstedt C, Peterson DS, Mancini M. The effect of tactile feedback on gait initiation in people with Parkinson's disease: A pilot study. Gait Posture 2020; 80:240-245. [PMID: 32559642 DOI: 10.1016/j.gaitpost.2020.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 05/29/2020] [Accepted: 06/01/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Gait initiation and turning are common triggers for Freezing of Gait (FOG) in people with Parkinson's disease (PD). Recently, it has been shown that closed-loop tactile feedback (CLTF) can be effective to improve turning performance in people with FOG. RESEARCH QUESTION Does CLTF change the preparation and execution of the first step during gait initiation? METHODS People (n = 36) with PD with FOG (PD + FOG) (n = 18) and without FOG (PD-FOG) (n = 18) were included in the study and performed self-initiated gait with or without CLTF under single and dual task conditions. Anticipatory postural adjustments (APAs) and step kinematics were quantified with inertial measurement units (IMUs). Muscle activity of the right and left tensor fasciae latae (TFL) was measured via EMG recordings. RESULTS PD + FOG and PD-FOG did not differ in age, gender and disease duration and severity (p > 0.05). PD + FOG performed smaller APAs (F = 4.559, p = 0.04) with a higher amount of TFL co-contraction (F = 6.034, p = 0.02) compared to PD-FOG. CLTF had no effect on APAs but led to an increase in first step duration (F = 7.921, p = 0.008). CONCLUSIONS PD + FOG had smaller APAs and higher left and right TFL co-contraction during gait initiation. CLTF did not impact preparation of the first step but led to a slower execution of the first step. We speculate that, similarly to findings from turning, CLTF might result in the participant attending more closely to the first step compared to without CLTF. Whether increased attention on gait initiation is beneficial in diminishing FOG should be investigated in more detail.
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Affiliation(s)
- Christian Schlenstedt
- Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany
| | | | - Martina Mancini
- Balance Disorders Laboratory, Oregon Health & Science University, Portland, OR, USA.
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da Silva Soares F, Moreira VMPS, Alves LV, Dionisio VC. What is the influence of severity levels of knee osteoarthritis on gait initiation? Clin Biomech (Bristol, Avon) 2020; 74:51-57. [PMID: 32145669 DOI: 10.1016/j.clinbiomech.2020.02.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 02/07/2020] [Accepted: 02/13/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The anticipatory postural adjustments required for gait initiation have not yet been investigated in older adults with different levels of severity of knee osteoarthritis. This study aimed to evaluate the anticipatory postural adjustments adopted by older adults with different severity levels of knee osteoarthritis during gait initiation. METHODS Sixty-seven older adults with knee osteoarthritis (mild, moderate, and severe levels) and 11 healthy older adults control were evaluated bilaterally with a force plate to analyze gait initiation. The center of pressure trajectory during gait initiation was divided into four phases: three anticipatory postural adjustments, and a locomotor phase. The length, duration, and velocity of each phase were calculated. FINDINGS The results showed that during the right and left limbs swing forward, the severe and moderate knee osteoarthritis groups presented a significant reduction in the length of anticipatory postural adjustment phases, locomotion, duration, and velocity (P < 0.05). The severe knee osteoarthritis group presented a significantly higher body mass index (P < 0.003) than the other groups. However, just the healthy group presented a correlation between body mass index and anticipatory postural adjustments. INTERPRETATION Our results demonstrated that older adults with severe and moderate levels of knee osteoarthritis adopt longer lasting and slower anticipatory postural adjustment phases, lower locomotion, and lower center of pressure displacement during gait initiation, suggesting that this population has adaptive strategy in performing gait initiation, which is significantly changed by the knee osteoarthritis severity level.
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Affiliation(s)
- Fabiana da Silva Soares
- Doctor Program in Health Sciences, Faculty of Medicine, Federal University of Uberlândia, Uberlândia, Brazil.
| | | | - Luiza Vinhal Alves
- Physical Therapy Course, Federal University of Uberlandia, Uberlândia, Brazil
| | - Valdeci Carlos Dionisio
- Physical Therapy Course, Federal University of Uberlandia, Uberlândia, Brazil; Doctor Program in Health Sciences, Faculty of Medicine, Federal University of Uberlândia, Uberlândia, Brazil.
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A new paradigm to study the influence of attentional load on cortical activity for motor preparation of step initiation. Exp Brain Res 2020; 238:643-656. [DOI: 10.1007/s00221-020-05739-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 01/23/2020] [Indexed: 12/25/2022]
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Influence of Swing-Foot Strike Pattern on Balance Control Mechanisms during Gait Initiation over an Obstacle to Be Cleared. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app10010244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Gait initiation (GI) over an obstacle to be cleared is a functional task that is highly challenging for the balance control system. Two swing-foot strike patterns were identified during this task—the rearfoot strike (RFS), where the heel strikes the ground first, and the forefoot strike (FFS), where the toe strikes the ground first. This study investigated the effect of the swing-foot strike pattern on the postural organisation of GI over an obstacle to be cleared. Participants performed a series of obstacle clearance tasks with the instruction to strike the ground with either an FFS or RFS pattern. Results showed that anticipatory postural adjustments in the frontal plane were smaller in FFS than in RFS, while stability was increased in FFS. The vertical braking of the centre of mass (COM) during GI swing phase was attenuated in FFS compared to RFS, leading to greater downward centre of mass velocity at foot contact in FFS. In addition, the collision forces acting on the foot were smaller in FFS than in RFS, as were the slope of these forces and the slope of the C7 vertebra acceleration at foot contact. Overall, these results suggest an interdependent relationship between balance control mechanisms and foot strike pattern for optimal stability control.
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Massot C, Guyot MA, Donze C, Simoneau E, Gillet C, Leteneur S. Ankle dysfunction in multiple sclerosis and the effects on walking. Disabil Rehabil 2019; 43:2454-2463. [PMID: 31854195 DOI: 10.1080/09638288.2019.1702726] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE Even in the early stage of the disease, for patients suffering from multiple sclerosis (MS), the most common and reported biomechanical alterations in the lower limb are located at the ankle joint. However, the effects of these impairments on gait deterioration should be discussed. MATERIALS AND METHODS This review was written according to the PRISMA guidelines. The search focussed on biomechanical changes (kinetic, kinematic, and electromyographic data) at the ankle during gait in MS patients. The search was performed in the databases: Pubmed, Web of Science, and Cochrane Library. RESULTS Eleven studies were included. The reduction in the ankle range of motion (RoM) induced by increased cocontractions of the tibialis anterior and triceps surae muscles could be a compensatory strategy to improve body-weight support and balance during the stance phase. CONCLUSIONS Future rehabilitation programmes should consider the control of weight support at the ankle during gait training.Implications for rehabilitationThe ankle supports and stabilises the body during the stance phase of gait.The reduced ankle range of motion in multiple sclerosis (MS), even at an early stage of the disease, is due to cocontractions of tibialis anterior and triceps surae and could be a compensatory strategy to be more stable.Rehabilitation programmes for MS patients should focus on the control of body segments motion during the weight transfer above the ankle.
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Affiliation(s)
- Caroline Massot
- Service de Médecine Physique et de Réadaptation, Hôpital Saint Philibert, Lomme, France
| | - Marc-Alexandre Guyot
- Service de Médecine Physique et de Réadaptation, Hôpital Saint Philibert, Lomme, France
| | - Cécile Donze
- Service de Médecine Physique et de Réadaptation, Hôpital Saint Philibert, Lomme, France
| | - Emilie Simoneau
- Université Lille Nord de France, Lille, France.,UPHF, LAMIH, Valenciennes, France.,CNRS, UMR, Valenciennes, France
| | - Christophe Gillet
- Université Lille Nord de France, Lille, France.,UPHF, LAMIH, Valenciennes, France.,CNRS, UMR, Valenciennes, France
| | - Sébastien Leteneur
- Université Lille Nord de France, Lille, France.,UPHF, LAMIH, Valenciennes, France.,CNRS, UMR, Valenciennes, France
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Characteristics of medial-lateral postural control while exposed to the external perturbation in step initiation. Sci Rep 2019; 9:16817. [PMID: 31727992 PMCID: PMC6856082 DOI: 10.1038/s41598-019-53379-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 10/30/2019] [Indexed: 11/20/2022] Open
Abstract
Controllability of posture in the medial-lateral direction is critical for balance maintenance, particularly in step initiation. The objective of the current study was to examine the effects of external perturbation and landing orientation on medial-lateral control stability in step initiation. Eleven young healthy participants stood on the force platform and waited for the instruction of taking a step while experiencing a pendulum perturbation applied at the lateral side of the right shoulder. Eight experimental conditions were conducted by two levels of step side (right or left), two levels of perturbation (with or without), and two levels of landing orientation (forward or diagonal). The center of pressure (COP), pelvic movements, and muscle activities were recorded and analyzed as the onset of COP and pelvic movement, the COP displacement, and cocontraction and reciprocal muscle activation pattern. The temporal events of COP and pelvic movement were not significantly different in all experimental conditions. However, COP and pelvic movement were significantly later in the diagonal condition. Most of the segments showed reciprocal muscle activation patterns in relation to the perturbation released time. Subsequently, all segments showed cocontraction muscle activation patterns, which was significantly affected by step side, perturbation, and orientation. The results suggest that how the CNS initiated a step was identical with the COP then pelvic movement. The outcome highlights the importance of external perturbation and foot landing orientation effects on postural adjustments, which may provide a different approach to help step initiation.
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Coppens MJM, Staring WHA, Nonnekes J, Geurts ACH, Weerdesteyn V. Offline effects of transcranial direct current stimulation on reaction times of lower extremity movements in people after stroke: a pilot cross-over study. J Neuroeng Rehabil 2019; 16:136. [PMID: 31699109 PMCID: PMC6839051 DOI: 10.1186/s12984-019-0604-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 10/02/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that has shown promise for rehabilitation after stroke. Ipsilesional anodal tDCS (a-tDCS) over the motor cortex increases corticospinal excitability, while contralesional cathodal tDCS (c-tDCS) restores interhemispheric balance, both resulting in offline improved reaction times of delayed voluntary upper-extremity movements. We aimed to investigate whether tDCS would also have a beneficial effect on delayed leg motor responses after stroke. In addition, we identified whether variability in tDCS effects was associated with the level of leg motor function. METHODS In a cross-over design, 13 people with chronic stroke completed three 15-min sessions of anodal, cathodal and sham stimulation over the primary motor cortex on separate days in an order balanced across participants. Directly after stimulation, participants performed a comprehensive set of lower-extremity tasks involving the paretic tibialis anterior (TA): voluntary ankle-dorsiflexion, gait initiation, and backward balance perturbation. For all tasks, TA onset latencies were determined. In addition, leg motor function was determined by the Fugl-Meyer Assessment - leg score (FMA-L). Repeated measures ANOVA was used to reveal tDCS effects on reaction times. Pearson correlation coefficients were used to establish the relation between tDCS effects and leg motor function. RESULTS For all tasks, TA reaction times did not differ across tDCS sessions. For gait initiation and backward balance perturbation, differences between sham and active stimulation (a-tDCS or c-tDCS) did not correlate with leg motor function. Yet, for ankle dorsiflexion, individual reaction time differences between c-tDCS and sham were strongly associated with FMA-L, with more severely impaired patients exhibiting slower paretic reaction times following c-tDCS. CONCLUSION We found no evidence for offline tDCS-induced benefits. Interestingly, we found that c-tDCS may have unfavorable effects on voluntary control of the paretic leg in severely impaired patients with chronic stroke. This finding points at potential vicarious control from the unaffected hemisphere to the paretic leg. The absence of tDCS-induced effects on gait and balance, two functionally relevant tasks, shows that such motor behavior is inadequately stimulated by currently used tDCS applications. TRIAL REGISTRATION The study is registered in the Netherlands Trial Register (NL5684; April 13th, 2016).
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Affiliation(s)
- Milou J M Coppens
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands.
| | - Wouter H A Staring
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Jorik Nonnekes
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Alexander C H Geurts
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Vivian Weerdesteyn
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands
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Delafontaine A, Vialleron T, Fischer M, Laffaye G, Chèze L, Artico R, Genêt F, Fourcade PC, Yiou E. Acute Effects of Whole-Body Vibration on the Postural Organization of Gait Initiation in Young Adults and Elderly: A Randomized Sham Intervention Study. Front Neurol 2019; 10:1023. [PMID: 31616369 PMCID: PMC6768974 DOI: 10.3389/fneur.2019.01023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 09/09/2019] [Indexed: 11/13/2022] Open
Abstract
Whole-body vibration (WBV) is a training method that exposes the entire body to mechanical oscillations while standing erect or seated on a vibrating platform. This method is nowadays commonly used by clinicians to improve specific motor outcomes in various sub-populations such as elderly and young healthy adults, either sedentary or well-trained. The present study investigated the effects of acute WBV application on the balance control mechanisms during gait initiation (GI) in young healthy adults and elderly. It was hypothesized that the balance control mechanisms at play during gait initiation may compensate each other in case one or several components are perturbed following acute WBV application, so that postural stability and/or motor performance can be maintained or even improved. It is further hypothesized that this capacity of adaptation is altered with aging. Main results showed that the effects of acute WBV application on the GI postural organization depended on the age of participants. Specifically, a positive effect was observed on dynamic stability in the young adults, while no effect was observed in the elderly. An increased stance leg stiffness was also observed in the young adults only. The positive effect of WBV on dynamic stability was ascribed to an increase in the mediolateral amplitude of "anticipatory postural adjustments" following WBV application, which did overcompensate the potentially destabilizing effect of the increased stance leg stiffness. In elderly, no such anticipatory (nor corrective) postural adaptation was required since acute WBV application did not elicit any change in the stance leg stiffness. These results suggest that WBV application may be effective in improving dynamic stability but at the condition that participants are able to develop adaptive changes in balance control mechanisms, as did the young adults. Globally, these findings are thus in agreement with the hypothesis that balance control mechanisms are interdependent within the postural system, i.e., they may compensate each other in case one component (here the leg stiffness) is perturbed.
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Affiliation(s)
- Arnaud Delafontaine
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France.,ENKRE, Saint-Maurice, France
| | - Thomas Vialleron
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France
| | - Matthieu Fischer
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France
| | - Guillaume Laffaye
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France
| | | | - Romain Artico
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France.,ENKRE, Saint-Maurice, France
| | - François Genêt
- UMR End:icap équipe 3, UFR des Sciences de la Santé Simone Veil, UVSQ, Montigny le Bretonneux, France
| | - Paul Christian Fourcade
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France
| | - Eric Yiou
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France
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Delafontaine A, Vialleron T, Hussein T, Yiou E, Honeine JL, Colnaghi S. Anticipatory Postural Adjustments During Gait Initiation in Stroke Patients. Front Neurol 2019; 10:352. [PMID: 31057474 PMCID: PMC6478808 DOI: 10.3389/fneur.2019.00352] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 03/22/2019] [Indexed: 12/03/2022] Open
Abstract
Prior to gait initiation (GI), anticipatory postural adjustments (GI-APA) are activated in order to reorganize posture, favorably for gait. In healthy subjects, the center of pressure (CoP) is displaced backward during GI-APA, bilaterally by reducing soleus activities and activating the tibialis anterior (TA) muscles, and laterally in the direction of the leading leg, by activating hip abductors. In post-stroke hemiparetic patients, TA, soleus and hip abductor activities are impaired on the paretic side. Reduction in non-affected triceps surae activity can also be observed. These may result in a decreased ability to execute GI-APA and to generate propulsion forces during step execution. A systematic review was conducted to provide an overview of the reorganization which occurs in GI-APA following stroke as well as of the most effective strategies for tailoring gait-rehabilitation to these patients. Sixteen articles were included, providing gait data from a total of 220 patients. Stroke patients show a decrease in the TA activity associated with difficulties in silencing soleus muscle activity of the paretic leg, a decreased CoP shift, lower propulsive anterior forces and a longer preparatory phase. Regarding possible gait-rehabilitation strategies, the selected studies show that initiating gait with the paretic leg provides poor balance. The use of the non-paretic as the leading leg can be a useful exercise to stimulate the paretic postural muscles.
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Affiliation(s)
- Arnaud Delafontaine
- CIAMS, Université Paris-Sud, Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France
| | - Thomas Vialleron
- CIAMS, Université Paris-Sud, Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France
| | | | - Eric Yiou
- CIAMS, Université Paris-Sud, Université Paris-Saclay, Orsay, France.,CIAMS, Université d'Orléans, Orléans, France
| | | | - Silvia Colnaghi
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.,Laboratory of Neuro-otology and Neuro-ophthalmology, IRCCS Mondino Foundation, Pavia, Italy
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Lee YJ. Changes in the symmetry of external perturbations affect patterns of muscle activity during gait initiation. Gait Posture 2019; 67:57-64. [PMID: 30286317 DOI: 10.1016/j.gaitpost.2018.09.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 08/10/2018] [Accepted: 09/24/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Gait initiation is associated with changes in the steady state and experiencing an external perturbation during initiation of gait could further threaten balance stability. RESEARCH QUESTION The aim of the study was to investigate if changes in the symmetry of the perturbations affect patterns of muscle activity during gait initiation. METHODS Eleven young health participants were instructed to stand on the force platform and wait for the instruction of taking a right step, left step or stand still while experiencing a pendulum perturbation applied to the back of both shoulders (symmetric), back of the right shoulder (asymmetric) or no perturbations. Bilateral electromyographic activity (EMG) of dorsal and ventral muscles, moments of the pendulum release and perturbation impact, center of pressure (COP) displacements and pelvic movements were recorded and analyzed before and after the onset of the perturbation. RESULTS Taking the right/left step in presence of symmetric perturbation did not affect the temporal sequence of COP and pelvic movements. The onset of COP and pelvic movement occurred before the perturbation impact at the shoulder levels. The factors of step and perturbation did not significantly affect integrals of bilateral muscles at the pendulum release. After the pendulum release, ventral and dorsal EMG integrals of the trunk, thigh, and shank segments increased or decreased corresponding to the swing and stance leg. Changes in muscle activities were also associated with the symmetric or asymmetric perturbations before and after the perturbation impact. SIGNIFICANCE The outcome of the study provides information about strategies used to coordinate the activity of muscles while body perturbations are induced during gait initiation.
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Affiliation(s)
- Yun-Ju Lee
- Department of Industrial Engineering and Engineering Management (R924), College of Engineering, National Tsing Hua University, No. 101, Sec. 2, Kuang-Fu Rd., Hsinchu City, 30013, Taiwan.
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Hirjaková Z, Šuttová K, Kimijanová J, Bzdúšková D, Hlavačka F. Postural changes during quiet stance and gait initiation in slightly obese adults. Physiol Res 2018; 67:985-992. [PMID: 30204472 DOI: 10.33549/physiolres.933870] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The study is aimed to examine balance control of slightly obese young adults during quiet stance and during gait initiation with and without crossing an obstacle. Forty-four young subjects were divided in two groups: control (BMI<25 kg/m(2)) and slightly obese (BMI from 25 to 35 kg/m(2)). Center of foot pressure (CoP) and kinematics of fifth lumbar vertebra (L5) were evaluated using a force plate and a motion capture system. During quiet stance with eyes open slightly obese group showed increased mean amplitude and velocity of CoP in anterior-posterior direction compared to normal weight subjects. During unloading phase of gait initiation significantly greater and faster lateral CoP shift was observed in slightly obese group compared to normal weight peers. Presence of an obstacle increased amplitude and velocity of the lateral CoP shift similarly in both groups. No BMI-related differences were found on L5 segment during gait initiation, which may indicate that postural control was already successfully performed in feet (CoP). We have shown that increased CoP parameters values and thus increased postural instability during quiet stance and during unloading phase of gait initiation is present not only in morbidly obese, but already in slightly obese subjects.
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Affiliation(s)
- Z Hirjaková
- Centre of Experimental Medicine Slovak Academy of Sciences, Institute of Normal and Pathological Physiology, Bratislava, Slovakia.
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Bolzoni F, Esposti R, Marchese SM, Pozzi NG, Ramirez-Pasos UE, Isaias IU, Cavallari P. Disrupt of Intra-Limb APA Pattern in Parkinsonian Patients Performing Index-Finger Flexion. Front Physiol 2018; 9:1745. [PMID: 30559682 PMCID: PMC6287199 DOI: 10.3389/fphys.2018.01745] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 11/20/2018] [Indexed: 01/08/2023] Open
Abstract
Voluntary movements induce postural perturbations which are counteracted by anticipatory postural adjustments (APAs). These actions are known to build up long fixation chains toward available support points (inter-limb APAs), so as to grant whole body equilibrium. Moreover, recent studies highlighted that APAs also build-up short fixation chains, within the same limb where a distal segment is moved (intra-limb APAs), aimed at stabilizing the proximal segments. The neural structures generating intra-limb APAs still need investigations; the present study aims to compare focal movement kinematics and intra-limb APA latencies and pattern between healthy subjects and parkinsonian patients, assuming the latter as a model of basal ganglia dysfunction. Intra-limb APAs that stabilize the arm when the index-finger is briskly flexed were recorded in 13 parkinsonian patients and in 10 age-matched healthy subjects. Index-finger movement was smaller in parkinsonian patients vs. healthy subjects (p = 0.01) and more delayed with respect to the onset of the prime mover flexor digitorum superficialis (FDS, p < 0.0001). In agreement with the literature, in all healthy subjects the FDS activation was preceded by an inhibitory intra-limb APA in biceps brachii (BB) and anterior deltoid (AD), and almost simultaneous to an excitatory intra-limb APA in triceps brachii (TB). In parkinsonian patients, no significant differences were found for TB and AD intra-limb APA timings, however only four patients showed an inhibitory intra-limb APA in BB, while other four did not show any BB intra-limb APAs and five actually developed a BB excitation. The frequency of occurrence of normal sign, lacking, and inverted BB APAs was different in healthy vs. parkinsonian participants (p = 0.0016). The observed alterations in index-finger kinematics and intra-limb APA pattern in parkinsonian patients suggest that basal ganglia, in addition to shaping the focal movement, may also contribute to intra-limb APA control.
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Affiliation(s)
- Francesco Bolzoni
- 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
| | - Silvia M Marchese
- Human Physiology Section of the Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Nicoló G Pozzi
- Department of Neurology, University Hospital and Julius Maximilians University Würzburg, Würzburg, Germany
| | - Uri E Ramirez-Pasos
- Department of Neurology, University Hospital and Julius Maximilians University Würzburg, Würzburg, Germany
| | - Ioannis U Isaias
- Department of Neurology, University Hospital and Julius Maximilians University Würzburg, Würzburg, Germany
| | - Paolo Cavallari
- Human Physiology Section of the Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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Effect of auditory stimulus on executive function and execution time during cognitively demanding stepping task in patients with Parkinson's disease. Neurosci Lett 2018; 674:101-105. [PMID: 29559418 DOI: 10.1016/j.neulet.2018.03.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 03/05/2018] [Accepted: 03/16/2018] [Indexed: 11/23/2022]
Abstract
Start hesitation in patients with Parkinson's disease (PD) occurs predominantly during distractive and conflictual situations. The aim of this study was to investigate how differently an auditory stimulus (AS) influences execution function and execution time during a cognitively demanding stepping task in PD patients as compared to healthy controls. PD patients and healthy controls stepped forward in response to a visual imperative stimulus of an arrow. We applied a Simon task that comprised congruent and incongruent conditions. Direction and location of the arrow matched in the congruent condition, while they didn't in the incongruent condition. AS were randomly and simultaneously presented with the visual stimulus. An error in the direction of an anticipatory postural adjustment (APA), termed an APA error, and temporal parameters (reaction onset of APA and APA duration) were analyzed. As a result, the AS increased the APA error rate in the control group regardless of the condition, but they did not influence it in the PD group. The AS also speeded the reaction onset in both groups regardless of the condition. The APA duration was prolonged by the AS for the control group, while it was unaffected by the AS for the PD group in both conditions. These findings indicate that AS could facilitate a step initiation, conceivably by facilitating a stimulus identification process and increasing attentional control of stepping behavior, without influencing a decision-making process even in a cognitively demanding condition in patients with PD.
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Delafontaine A, Fourcade P, Honeine JL, Ditcharles S, Yiou E. Postural adaptations to unilateral knee joint hypomobility induced by orthosis wear during gait initiation. Sci Rep 2018; 8:830. [PMID: 29339773 PMCID: PMC5770397 DOI: 10.1038/s41598-018-19151-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 11/13/2017] [Indexed: 12/22/2022] Open
Abstract
Balance control and whole-body progression during gait initiation (GI) involve knee-joint mobility. Single knee-joint hypomobility often occurs with aging, orthopedics or neurological conditions. The goal of the present study was to investigate the capacity of the CNS to adapt GI organization to single knee-joint hypomobility induced by the wear of an orthosis. Twenty-seven healthy adults performed a GI series on a force-plate in the following conditions: without orthosis ("control"), with knee orthosis over the swing leg ("orth-swing") and with the orthosis over the contralateral stance leg ("orth-stance"). In orth-swing, amplitude of mediolateral anticipatory postural adjustments (APAs) and step width were larger, execution phase duration longer, and anteroposterior APAs smaller than in control. In orth-stance, mediolateral APAs duration was longer, step width larger, and amplitude of anteroposterior APAs smaller than in control. Consequently, step length and progression velocity (which relate to the "motor performance") were reduced whereas stability was enhanced compared to control. Vertical force impact at foot-contact did not change across conditions, despite a smaller step length in orthosis conditions compared to control. These results show that the application of a local mechanical constraint induced profound changes in the global GI organization, altering motor performance but ensuring greater stability.
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Affiliation(s)
- A Delafontaine
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, 91405, Orsay, France.
- CIAMS, Université d'Orléans, 45067, Orléans, France.
| | - P Fourcade
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, 91405, Orsay, France
- CIAMS, Université d'Orléans, 45067, Orléans, France
| | - J L Honeine
- CSAM Laboratory, Department of Public Health, University of Pavia, Pavia, Italy
| | - S Ditcharles
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, 91405, Orsay, France
- CIAMS, Université d'Orléans, 45067, Orléans, France
| | - E Yiou
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, 91405, Orsay, France
- CIAMS, Université d'Orléans, 45067, Orléans, France
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Yiou E, Caderby T, Delafontaine A, Fourcade P, Honeine JL. Balance control during gait initiation: State-of-the-art and research perspectives. World J Orthop 2017; 8:815-828. [PMID: 29184756 PMCID: PMC5696609 DOI: 10.5312/wjo.v8.i11.815] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 08/30/2017] [Accepted: 09/13/2017] [Indexed: 02/06/2023] Open
Abstract
It is well known that balance control is affected by aging, neurological and orthopedic conditions. Poor balance control during gait and postural maintenance are associated with disability, falls and increased mortality. Gait initiation - the transient period between the quiet standing posture and steady state walking - is a functional task that is classically used in the literature to investigate how the central nervous system (CNS) controls balance during a whole-body movement involving change in the base of support dimensions and center of mass progression. Understanding how the CNS in able-bodied subjects exerts this control during such a challenging task is a pre-requisite to identifying motor disorders in populations with specific impairments of the postural system. It may also provide clinicians with objective measures to assess the efficiency of rehabilitation programs and better target interventions according to individual impairments. The present review thus proposes a state-of-the-art analysis on: (1) the balance control mechanisms in play during gait initiation in able bodied subjects and in the case of some frail populations; and (2) the biomechanical parameters used in the literature to quantify dynamic stability during gait initiation. Balance control mechanisms reviewed in this article included anticipatory postural adjustments, stance leg stiffness, foot placement, lateral ankle strategy, swing foot strike pattern and vertical center of mass braking. Based on this review, the following viewpoints were put forward: (1) dynamic stability during gait initiation may share a principle of homeostatic regulation similar to most physiological variables, where separate mechanisms need to be coordinated to ensure stabilization of vital variables, and consequently; and (2) rehabilitation interventions which focus on separate or isolated components of posture, balance, or gait may limit the effectiveness of current clinical practices.
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Affiliation(s)
- Eric Yiou
- Laboratoire CIAMS, Université Paris-Sud, Université Paris-Saclay, Orsay 91405, France
- Laboratoire CIAMS, Université d’Orléans, Orléans 45067, France
| | - Teddy Caderby
- Laboratoire IRISSE, UFR des Sciences de l’Homme et de l’Environnement, Université de la Réunion, Ile de la Réunion 97430, France
| | - Arnaud Delafontaine
- Laboratoire CIAMS, Université Paris-Sud, Université Paris-Saclay, Orsay 91405, France
- Laboratoire CIAMS, Université d’Orléans, Orléans 45067, France
- Ecole Nationale de Kinésithérapie et Rééducation, Saint Maurice 75012, France
| | - Paul Fourcade
- Laboratoire CIAMS, Université Paris-Sud, Université Paris-Saclay, Orsay 91405, France
- Laboratoire CIAMS, Université d’Orléans, Orléans 45067, France
| | - Jean-Louis Honeine
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia 27100, Italy
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Delafontaine A, Fourcade P, Honeine JL, Ditcharles S, Yiou E. Postural adaptations to unilateral knee joint hypomobility induced by orthosis wear during gait initiation. Comput Methods Biomech Biomed Engin 2017; 20:53-54. [DOI: 10.1080/10255842.2017.1382857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- A. Delafontaine
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, 91405 Orsay, France
- CIAMS, Université d'Orléans, 45067 Orléans, France
| | - P. Fourcade
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, 91405 Orsay, France
- CIAMS, Université d'Orléans, 45067 Orléans, France
| | - J. L. Honeine
- CSAM Laboratory, Department of Public Health, University of Pavia, Italy
| | - S. Ditcharles
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, 91405 Orsay, France
- CIAMS, Université d'Orléans, 45067 Orléans, France
| | - E. Yiou
- CIAMS, Univ. Paris-Sud., Université Paris-Saclay, 91405 Orsay, France
- CIAMS, Université d'Orléans, 45067 Orléans, France
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Lu C, Amundsen Huffmaster SL, Harvey JC, MacKinnon CD. Anticipatory postural adjustment patterns during gait initiation across the adult lifespan. Gait Posture 2017; 57:182-187. [PMID: 28651215 PMCID: PMC5546309 DOI: 10.1016/j.gaitpost.2017.06.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 05/19/2017] [Accepted: 06/15/2017] [Indexed: 02/02/2023]
Abstract
Gait initiation involves a complex sequence of anticipatory postural adjustments (APAs) during the transition from steady state standing to forward locomotion. APAs have four core components that function to accelerate the center of mass forwards and towards the initial single-support stance limb. These components include loading of the initial step leg, unloading of the initial stance leg, and excursion of the center of pressure in the posterior and lateral (towards the stepping leg) directions. This study examined the incidence, magnitude, and timing of these components and how they change across the lifespan (ages 20-79). 157 individuals performed five trials of self-paced, non-cued gait initiation on an instrumented walkway. At least one component of the APA was absent in 24% of all trials. The component most commonly absent was loading of the initial step leg (absent in 10% of all trials in isolation, absent in 10% of trials in conjunction with another missing component). Trials missing all four components were rare (1%) and were observed in both younger and older adults. There was no significant difference across decades in the incidence of trials without an APA, the number or type of APA components absent, or the magnitude or timing of the APA components. These data demonstrate that one or more components of the APA sequence are commonly absent in the general population and the spatiotemporal profile of the APA does not markedly change with ageing.
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Affiliation(s)
- Chiahao Lu
- Movement Disorders Laboratory, Department of Neurology, University of Minnesota, 516, 717 Delaware St. SE, Minneapolis, MN 55414, USA.
| | - Sommer L Amundsen Huffmaster
- Movement Disorders Laboratory, Department of Neurology, University of Minnesota, 516, 717 Delaware St. SE, Minneapolis, MN 55414, USA
| | - Jack C Harvey
- Movement Disorders Laboratory, Department of Neurology, University of Minnesota, 516, 717 Delaware St. SE, Minneapolis, MN 55414, USA
| | - Colum D MacKinnon
- Movement Disorders Laboratory, Department of Neurology, University of Minnesota, 516, 717 Delaware St. SE, Minneapolis, MN 55414, USA
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Ditcharles S, Yiou E, Delafontaine A, Hamaoui A. Short-Term Effects of Thoracic Spine Manipulation on the Biomechanical Organisation of Gait Initiation: A Randomized Pilot Study. Front Hum Neurosci 2017; 11:343. [PMID: 28713254 PMCID: PMC5491951 DOI: 10.3389/fnhum.2017.00343] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Accepted: 06/13/2017] [Indexed: 12/22/2022] Open
Abstract
Speed performance during gait initiation is known to be dependent on the capacity of the central nervous system to generate efficient anticipatory postural adjustments (APA). According to the posturo-kinetic capacity (PKC) concept, any factor enhancing postural chain mobility and especially spine mobility, may facilitate the development of APA and thus speed performance. "Spinal Manipulative Therapy High-Velocity, Low-Amplitude" (SMT-HVLA) is a healing technique applied to the spine which is routinely used by healthcare practitioners to improve spine mobility. As such, it may have a positive effect on the PKC and therefore facilitate gait initiation. The present study aimed to investigate the short-term effect of thoracic SMT-HVLA on spine mobility, APA and speed performance during gait initiation. Healthy young adults (n = 22) performed a series of gait initiation trials on a force plate before ("pre-manipulation" condition) and after ("post-manipulation" condition) a sham manipulation or an HVLA manipulation applied to the ninth thoracic vertebrae (T9). Participants were randomly assigned to the sham (n = 11) or the HVLA group (n = 11).The spine range of motion (ROM) was assessed in each participant immediately after the sham or HVLA manipulations using inclinometers. The results showed that the maximal thoracic flexion increased in the HVLA group after the manipulation, which was not the case in the sham group. In the HVLA group, results further showed that each of the following gait initiation variables reached a significantly lower mean value in the post-manipulation condition as compared to the pre-manipulation condition: APA duration, peak of anticipatory backward center of pressure displacement, center of gravity velocity at foot-off, mechanical efficiency of APA, peak of center of gravity velocity and step length. In contrast, for the sham group, results showed that none of the gait initiation variables significantly differed between the pre- and post-manipulation conditions. It is concluded that HVLA manipulation applied to T9 has an immediate beneficial effect on spine mobility but a detrimental effect on APA development and speed performance during gait initiation. We suggest that a neural effect induced by SMT-HVLA, possibly mediated by a transient alteration in the early sensory-motor integration, might have masked the potential mechanical benefits associated with increased spine mobility.
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Affiliation(s)
- Sébastien Ditcharles
- CIAMS, Université Paris-Sud, Université Paris-SaclayOrsay, France.,CIAMS, Université d'OrléansOrléans, France.,Ecole Nationale de Kinésithérapie et Rééducation (ENKRE)Saint-Maurice, France
| | - Eric Yiou
- CIAMS, Université Paris-Sud, Université Paris-SaclayOrsay, France.,CIAMS, Université d'OrléansOrléans, France
| | - Arnaud Delafontaine
- CIAMS, Université Paris-Sud, Université Paris-SaclayOrsay, France.,CIAMS, Université d'OrléansOrléans, France.,Ecole Nationale de Kinésithérapie et Rééducation (ENKRE)Saint-Maurice, France
| | - Alain Hamaoui
- Laboratoire de Physiologie de la Posture et du Mouvement (PoM Lab), Université JF ChampollionAlbi, France.,Laboratoire Activité Physique, Performance et Santé (MEPS), Université de Pau et des Pays de l'Adour (UPPA)Tarbes, France
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Lee YJ, Liang JN, Chen B, Ganesan M, Aruin AS. Standing on wedges modifies side-specific postural control in the presence of lateral external perturbations. J Electromyogr Kinesiol 2017; 36:16-24. [PMID: 28662461 DOI: 10.1016/j.jelekin.2017.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 06/13/2017] [Accepted: 06/15/2017] [Indexed: 12/26/2022] Open
Abstract
Standing on wedges changes the position in the ankle joints and affects postural stability in the medial-lateral direction. The objective of the study was to investigate the role of wedges and external lateral perturbations on anticipatory (APA) and compensatory postural adjustments (CPA). Ten healthy young participants were exposed to perturbations applied to the lateral part of their right shoulder when standing on a planar surface, on a medial or lateral wedges. Bilateral electromyographic activity of dorsal and ventral postural muscles and the center of pressure (COP) displacement were recorded and analyzed during the APA and CPA phases. When exposed to the lateral perturbation, reciprocal activation of shank muscles was seen on the side of the perturbation while co-contraction of shank muscles was seen on the contralateral side during the APA and CPA phases. Standing on a wedge was associated with decreased magnitudes of co-contraction and reciprocal activation of shank muscles. The COP displacements were smaller in the APA phase and larger in the CPA phase while standing on wedges compared to standing on the planar surface. The outcome of the study provides a basis for future investigations of incorporating wedges in balance re-training paradigms for the elderly or individuals with neurological impairment.
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Affiliation(s)
- Yun-Ju Lee
- Department of Industrial Engineering and Engineering Management, National Tshing-Hua University, Hsinchu, Taiwan; Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, USA.
| | - Jing-Nong Liang
- Department of Physical Therapy, University of Nevada, Las Vegas, NV, USA
| | - Bing Chen
- PhD Program in Rehabilitation Science, College of Applied Health Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Mohan Ganesan
- Department of Physical Therapy, Clarke University, Dubuque, IA, USA
| | - Alexander S Aruin
- Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, USA
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Buckley TA, Oldham JR, Munkasy BA, Evans KM. Decreased Anticipatory Postural Adjustments During Gait Initiation Acutely Postconcussion. Arch Phys Med Rehabil 2017; 98:1962-1968. [PMID: 28583462 DOI: 10.1016/j.apmr.2017.05.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 04/27/2017] [Accepted: 05/01/2017] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To investigate anticipatory postural adjustments (APAs) during the transitional movement task of gait initiation (GI) in individuals acutely after a concussion. DESIGN Cohort study. SETTING University research center. PARTICIPANTS A population-based sample of participants (N=84) divided into 2 equal groups of acutely postconcussion and healthy student athletes. INTERVENTION Participants were tested on 2 occasions: a preinjury baseline test and then the concussion group was retested acutely postconcussion and the healthy student athlete group again at a similar time. All participants completed 5 trials of GI on 4 forceplates. MAIN OUTCOME MEASURES The dependent variables were the displacement and velocity of the center of pressure (COP) during the APA phase and initial step kinematics. Comparisons were made with a 2 (group) × 2 (time) repeated-measures analysis of variance. RESULTS There was a significant interaction for COP posterior displacement (P<.001) and lateral displacement (P<.001). Posteriorly, post hoc testing identified a significant reduction in the concussion group (pretest: 5.7±1.6cm; posttest: 2.6±2.1cm; P<.001), but no difference in the healthy student athlete group (pretest: 4.0±1.6cm; posttest: 4.0±2.5cm; P=.921). Laterally, post hoc testing identified a significant reduction in the concussion group (pretest: 5.8±2.1cm; posttest: 3.8±1.8cm; P<.001), but no difference in the healthy student athlete group (pretest: 5.0±2.5cm; posttest: 5.2±2.4cm; P=.485). CONCLUSIONS The results of this study suggest difficulty in the planning and execution of GI acutely postconcussion, and posterior APA displacement and velocity are highly effective measures of impaired postural control. Finally, the APA phase is linked to the supplementary motor area, which suggests a supraspinal contribution to postconcussion impaired postural control.
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Affiliation(s)
- Thomas A Buckley
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE; Interdisciplinary Program in Biomechanics and Movement Science, University of Delaware, Newark, DE.
| | - Jessie R Oldham
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE
| | - Barry A Munkasy
- School of Health and Kinesiology, Georgia Southern University, Statesboro, GA
| | - Kelsey M Evans
- The Brody School of Medicine, East Carolina University, Greenville, NC
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Delafontaine A, Gagey O, Colnaghi S, Do MC, Honeine JL. Rigid Ankle Foot Orthosis Deteriorates Mediolateral Balance Control and Vertical Braking during Gait Initiation. Front Hum Neurosci 2017; 11:214. [PMID: 28503144 PMCID: PMC5408009 DOI: 10.3389/fnhum.2017.00214] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 04/11/2017] [Indexed: 12/16/2022] Open
Abstract
Rigid ankle-foot orthoses (AFO) are commonly used for impeding foot drop during the swing phase of gait. They also reduce pain and improve gait kinematics in patients with weakness or loss of integrity of ankle-foot complex structures due to various pathological conditions. However, this comes at the price of constraining ankle joint mobility, which might affect propulsive force generation and balance control. The present study examined the effects of wearing an AFO on biomechanical variables and electromyographic activity of tibialis anterior (TA) and soleus muscles during gait initiation (GI). Nineteen healthy adults participated in the study. They initiated gait at a self-paced speed with no ankle constraint as well as wearing an AFO on the stance leg, or bilaterally. Constraining the stance leg ankle decreased TA activity ipsilaterally during the anticipatory postural adjustment (APA) of GI, and ipsilateral soleus activity during step execution. In the sagittal plane, the decrease in the stance leg TA activity reduced the backward displacement of the center of pressure (CoP) resulting in a reduction of the forward velocity of the center of mass (CoM) measured at foot contact (FC). In the frontal plane, wearing the AFO reduced the displacement of the CoP in the direction of the swing leg during the APA phase. The mediolateral velocity of the CoM increased during single-stance prompting a larger step width to recover balance. During step execution, the CoM vertical downward velocity is normally reduced in order to lessen the impact of the swing leg with the floor and facilitates the rise of the CoM that occurs during the subsequent double-support phase. The reduction in stance leg soleus activity caused by constraining the ankle weakened the vertical braking of the CoM during step execution. This caused the absolute instantaneous vertical velocity of the CoM at FC to be greater in the constrained conditions with respect to the control condition. From a rehabilitation perspective, passively- or actively-powered assistive AFOs could correct for the reduction in muscle activity and enhance balance control during GI of patients.
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Affiliation(s)
- Arnaud Delafontaine
- CIAMS, Université Paris-Sud Université Paris-Saclay, Orsay, France; CIAMS, Université d'OrléansOrléans, France
| | - Olivier Gagey
- CIAMS, Université Paris-Sud Université Paris-Saclay, Orsay, France; CIAMS, Université d'OrléansOrléans, France.,Service de Chirurgie Orthopédique, C.H.U Kremlin BicêtreKremlin Bicêtre, France
| | - Silvia Colnaghi
- CSAM Laboratory, Department of Public Health, University of PaviaPavia, Italy
| | - Manh-Cuong Do
- CIAMS, Université Paris-Sud Université Paris-Saclay, Orsay, France; CIAMS, Université d'OrléansOrléans, France
| | - Jean-Louis Honeine
- CSAM Laboratory, Department of Public Health, University of PaviaPavia, Italy
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The Alteration of Neuromuscular Control Strategies During Gait Initiation in Individuals with Chronic Ankle Instability. IRANIAN RED CRESCENT MEDICAL JOURNAL 2017. [DOI: 10.5812/ircmj.44534] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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