scholarly journals Stepping Asymmetry Among Individuals With Unilateral Transtibial Limb Loss Might Be Functional in Terms of Gait Stability

2014 ◽  
Vol 94 (10) ◽  
pp. 1480-1488 ◽  
Author(s):  
Laura Hak ◽  
Jaap H. van Dieën ◽  
Peter van der Wurff ◽  
Han Houdijk
Keyword(s):  
Center Of Mass ◽  
Step Length ◽  
Cross Sectional Study ◽  
Initial Contact ◽  
Cross Sectional ◽  
Transtibial Amputation ◽  
Functional Compensation ◽  
Double Support ◽  
Support Phase ◽  
Double Support Phase

BackgroundThe asymmetry in step length in prosthetic gait is often seen as a detrimental effect of the impairment; however, this asymmetry also might be a functional compensation. An advantage of a smaller step length of the nonprosthetic leg, and specifically foot forward placement (FFP), might be that it will bring the center of mass closer to the base of support of the leading foot and thus increase the backward margin of stability (BW MoS).ObjectiveThe purpose of this study was to characterize differences in step length, FFP, and the concomitant difference in BW MoS between steps of the prosthetic and nonprosthetic legs (referred to as prosthetic and nonprosthetic steps, respectively) of people after transtibial amputation.DesignThis was an observational and cross-sectional study.MethodsTen people after transtibial amputation walked for 4 minutes on a self-paced treadmill. Step length and FFP were calculated at initial contact. The size of the BW MoS was calculated for the moment of initial contact and at the end of the double-support phase of gait.ResultsStep length (5.4%) and FFP (7.9%) were shorter for the nonprosthetic step than for the prosthetic step. The BW MoS at initial contact was larger for the nonprosthetic step, but because of a significant leg × gait event interaction effect, BW MoS did not differ significantly at the end of the double-support phase.LimitationsAll participants were relatively good walkers (score of E on the Special Interest Group in Amputee Medicine [SIGAM] scale).ConclusionsThe smaller step length and FFP of the nonprosthetic step help to create a larger BW MoS at initial contact for the nonprosthetic step compared with the prosthetic step. Hence, step length asymmetry in people after transtibial amputation might be seen as a functional compensation to preserve BW MoS during the double-support phase to cope with the limited push-off power of the prosthetic ankle.

scholarly journals Implementation and Integration of Fuzzy Algorithms for Descending Stair of KMEI Humanoid Robot

2020 ◽  
pp. 372-388
Author(s):  
Wulandari Puspita Sari ◽  
R. Sanggar Dewanto ◽  
Dadet Pramadihanto
Keyword(s):  
Humanoid Robot ◽  
Fuzzy Logic Controller ◽  
Integrated Control ◽  
Step Length ◽  
Smooth Transition ◽  
Double Support ◽  
Walking Gait ◽  
Single Support Phase ◽  
Support Phase ◽  
Double Support Phase

Locomotion of humanoid robot depends on the mechanical characteristic of the robot. Walking on descending stairs with integrated control systems for the humanoid robot is proposed. The analysis of trajectory for descending stairs is calculated by the constrains of step length stair using fuzzy algorithm. The established humanoid robot on dynamically balance on this matter of zero moment point has been pretended to be consisting of single support phase and double support phase. Walking transition from single support phase to double support phase is needed for a smooth transition cycle. To accomplish the problem, integrated motion and controller are divided into two conditions: motion working on offline planning and controller working online walking gait generation. To solve the defect during locomotion of the humanoid robot, it is directly controlled by the fuzzy logic controller. This paper verified the simulation and the experiment for descending stair of KMEI humanoid robot. 

scholarly journals 3D visual cueing shortens the double support phase of the gait cycle in patients with advanced Parkinson's disease treated with DBS of the STN

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244676
Author(s):  
Kamila Poláková ◽  
Evžen Růžička ◽  
Robert Jech ◽  
David Kemlink ◽  
Jan Rusz ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Freezing Of Gait ◽  
Step Length ◽  
Double Support ◽  
Visual Cueing ◽  
Stn Dbs ◽  
Support Phase ◽  
Double Support Phase

Background Gait disturbances have emerged as some of the main therapeutic concerns in late-stage Parkinson’s disease (PD) treated with dopaminergic therapy and deep brain stimulation (DBS). External cues may help to overcome freezing of gait (FOG) and improve some of the gait parameters. Aim To evaluate the effect of 3D visual cues and STN-DBS on gait in PD group. Methods We enrolled 35 PD patients treated with DBS of nucleus subthalamicus (STN-DBS). Twenty-five patients (5 females; mean age 58.9 ±6.3) and 25 sex- and age-matched controls completed the gait examination. The gait in 10 patients deteriorated in OFF state. The severity of PD was evaluated using the Unified Parkinson's Disease Rating Scale (UPDRS) and Hoehn and Yahr (HY). The PD group filled the Falls Efficacy Scale-International (FES) and Freezing of Gait Questionnaire (FOGQ). Gait was examined using the GaitRite Analysis System, placed in the middle of the 10m marked path. The PD group was tested without dopaminergic medication with and without visual cueing together with the DBS switched ON and OFF. The setting of DBS was double-blind and performed in random order. Results The UPDRS was 21.9 ±9.5 in DBS ON state and 41.3 ±13.7 in DBS OFF state. HY was 2.5 ±0.6, FES 12.4 ±4.1 and FOGQ 9.4 ±5.7. In the DBS OFF state, PD group walked more slowly with shorter steps, had greater step length variability and longer duration of the double support phase compared to healthy controls. The walking speed and step length increased in the DBS ON state. The double support phase was reduced with 3D visual cueing and DBS; the combination of both cueing and DBS was even more effective. Conclusion Cueing with 3D visual stimuli shortens the double support phase in PD patients treated with DBS-STN. The DBS is more effective in prolonging step length and increasing gait speed. We conclude that 3D visual cueing can improve walking in patients with DBS.

Kinematic Analysis of Dance-Based Exergaming: A Cross-Sectional Study

2021 ◽  
Author(s):  
Ernest K. Ofori ◽  
Savitha Subramaniam ◽  
Shuaijie Wang ◽  
Tanvi Bhatt
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Postural Stability ◽  
Center Of Mass ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Healthy Older Adults ◽  
Age Related ◽  
Aging Populations ◽  
Cortical Pathology

Background: Recent studies demonstrate improvements in both postural stability and mobility among aging populations and those with stroke who are exposed to dance-based exergaming (DBExG). However, age-related deficits and aging with cortical pathology may lead to distinct movement adaptation patterns during DBExG, which could impact therapeutic outcomes.Aim: The aim of this study was to examine the movement kinematics (postural stability and mobility) of healthy older adults, older adults with stroke, and young adults for different paces of dance during DBExG. Method: The study included 33 particpants (11 participant from each group of healthy older adults, older adults with chronic stroke, and healthy young adults) who performed the DBExG using slow- (SP), medium- (MP), and fast-paced (FP) songs with movements in the anteroposterior (AP) and mediolateral (ML) directions. Center of mass (CoM) sway area, excursion (Ex), and peaks as well as hip, knee, and ankle joint excursions were computed. Results: Results of the study revealed that CoM sway areas and Exs were greater for healthy young adults than for older adults with stroke for the SP dance (p < 0.05) and that there were significantly more AP CoM peaks for young adults than for healthy older adults and those with stroke for the FP dance (p < 0.05). Young adults also exhibited greater hip and ankle Exs than older adults with stroke (p < 0.05) for all song paces. Similarly, knee and ankle Exs were greater for healthy older adults than for older adults with stroke for all song paces (p < 0.05). Conclusion: The quantitative evaluation and comparison of the movement patterns presented for the three groups could provide a foundation for both assessing and designing therapeutic DBExG protocols for these populations.

scholarly journals Overground Walking Decreases Alpha Activity and Entrains Eye Movements in Humans

2020 ◽  
Vol 14 ◽  
Author(s):  
Liyu Cao ◽  
Xinyu Chen ◽  
Barbara F. Haendel
Keyword(s):  
Eye Movements ◽  
Neuronal Activity ◽  
Walking Speed ◽  
Alpha Activity ◽  
Alpha Power ◽  
Electrode Impedance ◽  
Blink Rate ◽  
Double Support ◽  
Support Phase ◽  
Double Support Phase

Experiments in animal models have shown that running increases neuronal activity in early visual areas in light as well as in darkness. This suggests that visual processing is influenced by locomotion independent of visual input. Combining mobile electroencephalography, motion- and eye-tracking, we investigated the influence of overground free walking on cortical alpha activity (~10 Hz) and eye movements in healthy humans. Alpha activity has been considered a valuable marker of inhibition of sensory processing and shown to negatively correlate with neuronal firing rates. We found that walking led to a decrease in alpha activity over occipital cortex compared to standing. This decrease was present during walking in darkness as well as during light. Importantly, eye movements could not explain the change in alpha activity. Nevertheless, we found that walking and eye related movements were linked. While the blink rate increased with increasing walking speed independent of light or darkness, saccade rate was only significantly linked to walking speed in the light. Pupil size, on the other hand, was larger during darkness than during light, but only showed a modulation by walking in darkness. Analyzing the effect of walking with respect to the stride cycle, we further found that blinks and saccades preferentially occurred during the double support phase of walking. Alpha power, as shown previously, was lower during the swing phase than during the double support phase. We however could exclude the possibility that the alpha modulation was introduced by a walking movement induced change in electrode impedance. Overall, our work indicates that the human visual system is influenced by the current locomotion state of the body. This influence affects eye movement pattern as well as neuronal activity in sensory areas and might form part of an implicit strategy to optimally extract sensory information during locomotion.

scholarly journals Hallux Valgus Surgery May Produce Early Improvements in Balance Control

2013 ◽  
Vol 103 (6) ◽  
pp. 489-497 ◽  
Author(s):  
Saba Sadra ◽  
Adam Fleischer ◽  
Erin Klein ◽  
Gurtej S. Grewal ◽  
Jessica Knight ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Study Design ◽  
Balance Control ◽  
Center Of Mass ◽  
Cross Sectional Study ◽  
Static Balance ◽  
Long Term Effects ◽  
Cross Sectional ◽  
Eyes Open ◽  
Falls In Older Adults

Background: Hallux valgus (HV) is associated with poorer performance during gait and balance tasks and is an independent risk factor for falls in older adults. We sought to assess whether corrective HV surgery improves gait and balance. Methods: Using a cross-sectional study design, gait and static balance data were obtained from 40 adults: 19 patients with HV only (preoperative group), 10 patients who recently underwent successful HV surgery (postoperative group), and 11 control participants. Assessments were made in the clinic using body-worn sensors. Results: Patients in the preoperative group generally demonstrated poorer static balance control compared with the other two groups. Despite similar age and body mass index, postoperative patients exhibited 29% and 63% less center of mass sway than preoperative patients during double-and single-support balance assessments, respectively (analysis of variance P =.17 and P =.14, respectively [both eyes open condition]). Overall, gait performance was similar among the groups, except for speed during gait initiation, where lower speeds were encountered in the postoperative group compared with the preoperative group (Scheffe P = .049). Conclusions: This study provides supportive evidence regarding the benefits of corrective lower-extremity surgery on certain aspects of balance control. Patients seem to demonstrate early improvements in static balance after corrective HV surgery, whereas gait improvements may require a longer recovery time. Further research using a longitudinal study design and a larger sample size capable of assessing the long-term effects of HV surgical correction on balance and gait is probably warranted. (J Am Podiatr Med Assoc 103(6): 489–497, 2013)

Gait Assessment in College Athletes: Do Concussion History, Symptoms, Gender, and Type of Sport Matter?

2020 ◽  
pp. 1-12
Author(s):  
Emily L. Messerschmidt ◽  
Eric E. Hall ◽  
Caroline J. Ketcham ◽  
Kirtida Patel ◽  
Srikant Vallabhajosula
Keyword(s):  
Dual Task ◽  
Gait Speed ◽  
College Athletes ◽  
Step Length ◽  
Swing Phase ◽  
Testing Time ◽  
Contact Sports ◽  
Double Support ◽  
Concussion History ◽  
Support Phase

Context: Though previous research has focused on examining the effects of concussion history using a dual-task paradigm, the influence of factors like symptoms (unrelated to concussion), gender, and type of sport on gait in college athletes is unknown. Objective: To examine the effect of concussion history, symptoms, gender, and type of sport (noncontact/limited contact/contact) individually on gait among college athletes. Design: Exploratory cross-sectional study. Setting: Laboratory. Participants: In total, 98 varsity athletes (age, 18.3 [1.0] y; height, 1.79 [0.11] m; mass, 77.5 [19.2] kg; 27 with concussion history, 58 reported at least one symptom, 44 females; 8 played noncontact sports and 71 played contact sports) walked under single- and dual-task (walking while counting backward by 7) conditions. Interventions: Not applicable. Main Outcome Measures: Dual-task cost (DTC; % difference between single task and dual task) of gait speed, cadence, step length and width, percentage of swing and double-support phases, symptom score, and total symptom severity score. Independent samples t tests and 1-way analysis of variance were conducted (α value = .05). Results: Self-reported concussion history resulted in no significant differences (P > .05). Those who reported symptoms at testing time showed significantly greater DTC of step length (mean difference [MD], 2.7%; 95% confidence interval [CI], 0.3% to 5.1%; P = .012), % of swing phase (MD, 1.0%; 95% CI, −0.2 to 2.1%; P = .042), and % of double-support phase (MD, 3.9%; 95% CI, 0.2% to 7.8%; P = .019). Females demonstrated significantly higher DTC of gait speed (MD, 5.3%; 95% CI, 1.3% to 9.3%; P = .005), cadence (MD, 4.0%; 95% CI, 1.4% to 6.5%; P = .002), % of swing phase (MD, 1.2%; 95% CI, 0.1% to 2.3%; P = .019), and % of double-support phase (MD, 4.1%; 95% CI, 0.4% to 7.9%; P = .018). Noncontact sports athletes had significantly greater step width DTC than contact sports athletes (MD, 14.2%; 95% CI, 0.9% to 27.6%; P = .032). Conclusions: Reporting symptoms at testing time may influence gait under dual-task conditions. Additionally, female athletes showed more gait changes during a dual task. Sports medicine professionals should be aware that these variables, while unrelated to injury, may affect an athlete’s gait upon analysis.

scholarly journals Persons with essential tremor can adapt to new walking patterns

2019 ◽  
Vol 122 (4) ◽  
pp. 1598-1605 ◽  
Author(s):  
Jaimie A. Roper ◽  
Sarah A. Brinkerhoff ◽  
Benjamin R. Harrison ◽  
Abigail C. Schmitt ◽  
Ryan T. Roemmich ◽  
...  
Keyword(s):  
Essential Tremor ◽  
Motor Adaptation ◽  
Step Length ◽  
Cross Sectional Study ◽  
Motor Deficits ◽  
Cross Sectional ◽  
Gait Adaptation ◽  
Locomotor Adaptation ◽  
Temporal Aspects ◽  
Walking Adaptation

Essential tremor (ET) is a common movement disorder that causes motor deficits similar to those seen in cerebellar disorders. These include kinetic tremor, gait ataxia, and impaired motor adaptation. Previous studies of motor adaptation in ET have focused on reaching while the effects of ET on gait adaptation are currently unknown. The purpose of this study was to contrast locomotor adaptation in persons with and without ET. We hypothesized that persons with ET would show impaired gait adaptation. In a cross-sectional study, persons with ET ( n = 14) and healthy matched controls ( n = 12) walked on a split-belt treadmill. Participants walked with the belts moving at a 2:1 ratio, followed by overground walking to test transfer, followed by a readaptation period and finally a deadaptation period. Step length asymmetry was measured to assess the rate of adaptation, amount of transfer, and rates of readaptation and deadaptation. Spatial, temporal, and velocity contributions to step length asymmetry were analyzed during adaptation. There were no group by condition interactions in step length asymmetry or contributions to step length asymmetry. Regardless of condition, persons with ET walked slower and exhibited lower temporal ( P < 0.001) and velocity ( P = 0.001) contributions to step length asymmetry than controls. Persons with ET demonstrated a preserved ability to adapt to, store, and transfer a new walking pattern. Despite probable cerebellar involvement in ET, locomotor adaptation is an available mechanism to teach persons with ET new gait patterns. NEW & NOTEWORTHY This study is the first to investigate walking adaptation abilities of people with essential tremor. Despite evidence of cerebellar impairment in this population, people with essential tremor can adapt their walking patterns. However, people with essential tremor do not modulate the timing of their footsteps to meet walking demands. Therefore, this study is the first to report impairments in the temporal aspects of walking in people with essential tremor during both typical and locomotor learning.

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