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1.
Corticomuscular control of walking in older people and people with Parkinson's disease.
Roeder, L, Boonstra, TW, Kerr, GK
Scientific reports. 2020;(1):2980
Abstract
Changes in human gait resulting from ageing or neurodegenerative diseases are multifactorial. Here we assess the effects of age and Parkinson's disease (PD) on corticospinal activity recorded during treadmill and overground walking. Electroencephalography (EEG) from 10 electrodes and electromyography (EMG) from bilateral tibialis anterior muscles were acquired from 22 healthy young, 24 healthy older and 20 adults with PD. Event-related power, corticomuscular coherence (CMC) and inter-trial coherence were assessed for EEG from bilateral sensorimotor cortices and EMG during the double-support phase of the gait cycle. CMC and EMG power at low beta frequencies (13-21 Hz) was significantly decreased in older and PD participants compared to young people, but there was no difference between older and PD groups. Older and PD participants spent shorter time in the swing phase than young individuals. These findings indicate age-related changes in the temporal coordination of gait. The decrease in low-beta CMC suggests reduced cortical input to spinal motor neurons in older people during the double-support phase. We also observed multiple changes in electrophysiological measures at low-gamma frequencies during treadmill compared to overground walking, indicating task-dependent differences in corticospinal locomotor control. These findings may be affected by artefacts and should be interpreted with caution.
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Effects of combined aerobic and resistance exercise on central arterial stiffness and gait velocity in patients with chronic poststroke hemiparesis.
Lee, YH, Park, SH, Yoon, ES, Lee, CD, Wee, SO, Fernhall, B, Jae, SY
American journal of physical medicine & rehabilitation. 2015;(9):687-95
Abstract
OBJECTIVE The effects of combined aerobic and resistance exercise training on central arterial stiffness and gait velocity in patients with chronic poststroke hemiparesis were investigated. DESIGN Twenty-six patients with chronic poststroke hemiparesis were randomly assigned to either the combined aerobic and resistance exercise group (n = 14) or the control group (n = 12). The exercise intervention group received a combined aerobic and resistance exercise training (1 hr/day, three times/week for 16 wks), whereas the control group received usual care. Central arterial stiffness was determined by pulse wave velocity and augmentation index. Gait velocity was assessed using the 6-min walk test, 10-m walk test, and the Timed Up-and-Go test. RESULTS Patients in the exercise intervention group had greater improvement of mean pulse wave velocity (P < 0.001), augmentation index (P = 0.048), and gait velocity (6-min walk test, P < 0.001; 10-m walk test, P < 0.001) than did patients in the control group. Patients in the exercise intervention group also had greater improvements in physical fitness component (grip strength, P < 0.001; muscular strength of upper and lower limbs, P < 0.027; flexibility, P < 0.001) when compared with control patients. CONCLUSIONS The combined aerobic and resistance exercise program significantly reduced central arterial stiffness and increased gait velocity in patients with chronic poststroke hemiparesis.
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The effect of shoe type and fatigue on strike index and spatiotemporal parameters of running.
Mann, R, Malisoux, L, Urhausen, A, Statham, A, Meijer, K, Theisen, D
Gait & posture. 2015;(1):91-5
Abstract
We aimed to observe differences in running style parameters and the stride-to-stride coefficient of variation and correlative patterns using detrended fluctuation analysis (DFA) between conventional and first-time minimalistic shoe use. We also aimed to study the effect of fatigue on these parameters. 26 recreational runners were tested using a pressure insole device on a treadmill whilst wearing conventional (CONV) and minimalistic (MIN) shoes. They then performed a prolonged running bout simulating a fatiguing training session, before being tested a second time in both shoe types. Average values of strike index (initial ground contact point on the footsole expressed as a percentage of total sole length) were not significantly different between CONV [25.7±14.6% (unfatigued), 23.1±11.1% (fatigued)] and MIN [28.9±19.1% (unfatigued), 26.7±17.6% (fatigued)] (p=0.501). The fatigued state also yielded a similar strike index compared to the unfatigued state (p=0.661). An overall trend in decreased inter-stride correlative patterns of strike index was observed in MIN compared to CONV (p=0.075). No differences in contact time, flight time, stride time, duty factor, stride length and stride frequency were found between shoe types. A trend in reduced flight time (p=0.078) and therefore increased duty factor (p=0.053) was observed due to fatigue. We conclude that in recreational runners, no meaningful, acute adaptation in running style occurs as a result of first-time MIN use. Similarly, runners were able to maintain their running style after a prolonged running bout.
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Executive function processes predict mobility outcomes in older adults.
Gothe, NP, Fanning, J, Awick, E, Chung, D, Wójcicki, TR, Olson, EA, Mullen, SP, Voss, M, Erickson, KI, Kramer, AF, et al
Journal of the American Geriatrics Society. 2014;(2):285-90
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Abstract
OBJECTIVES To examine the relationship between performance on executive function measures and subsequent mobility outcomes in community-dwelling older adults. DESIGN Randomized controlled clinical trial. SETTING Champaign-Urbana, Illinois. PARTICIPANTS Community-dwelling older adults (N = 179; mean age 66.4). INTERVENTION A 12-month exercise trial with two arms: an aerobic exercise group and a stretching and strengthening group. MEASUREMENTS Established cognitive tests of executive function (flanker task, task switching, and a dual-task paradigm) and the Wisconsin card sort test. Mobility was assessed using the timed 8-foot up and go test and times to climb up and down a flight of stairs. METHODS Participants completed the cognitive tests at baseline and the mobility measures at baseline and after 12 months of the intervention. Multiple regression analyses were conducted to determine whether baseline executive function predicted postintervention functional performance after controlling for age, sex, education, cardiorespiratory fitness, and baseline mobility levels. RESULTS Selective baseline executive function measurements, particularly performance on the flanker task (β = 0.15-0.17) and the Wisconsin card sort test (β = 0.11-0.16) consistently predicted mobility outcomes at 12 months. The estimates were in the expected direction, such that better baseline performance on the executive function measures predicted better performance on the timed mobility tests independent of intervention. CONCLUSION Executive functions of inhibitory control, mental set shifting, and attentional flexibility were predictive of functional mobility. Given the literature associating mobility limitations with disability, morbidity, and mortality, these results are important for understanding the antecedents to poor mobility function that well-designed interventions to improve cognitive performance can attenuate.
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Inverse association between insulin resistance and gait speed in nondiabetic older men: results from the U.S. National Health and Nutrition Examination Survey (NHANES) 1999-2002.
Kuo, CK, Lin, LY, Yu, YH, Wu, KH, Kuo, HK
BMC geriatrics. 2009;:49
Abstract
BACKGROUND Recent studies have revealed the associations between insulin resistance (IR) and geriatric conditions such as frailty and cognitive impairment. However, little is known about the relation of IR to physical impairment and limitation in the aging process, eg. slow gait speed and poor muscle strength. The aim of this study is to determine the effect of IR in performance-based physical function, specifically gait speed and leg strength, among nondiabetic older adults. METHODS Cross-sectional data were from the population-based National Health and Nutrition Examination Survey (1999-2002). A total of 1168 nondiabetic adults (> or = 50 years) with nonmissing values in fasting measures of insulin and glucose, habitual gait speed (HGS), and leg strength were analyzed. IR was assessed by homeostasis model assessment (HOMA-IR), whereas HGS and peak leg strength by the 20-foot timed walk test and an isokinetic dynamometer, respectively. We used multiple linear regression to examine the association between IR and performance-based physical function. RESULTS IR was inversely associated with gait speed among the men. After adjusting demographics, body mass index, alcohol consumption, smoking status, chronic co-morbidities, and markers of nutrition and cardiovascular risk, each increment of 1 standard deviation in the HOMA-IR level was associated with a 0.04 m/sec decrease (p = 0.003) in the HGS in men. We did not find such association among the women. The IR-HGS association was not changed after further adjustment of leg strength. Last, HOMA-IR was not demonstrated in association with peak leg strength. CONCLUSION IR is inversely associated with HGS among older men without diabetes. The results suggest that IR, an important indicator of gait function among men, could be further investigated as an intervenable target to prevent walking limitation.
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Gait muscle activity during walking on an inclined icy surface.
Gao, C, Oksa, J, Rintamäki, H, Holmér, I
Industrial health. 2008;(1):15-22
Abstract
The objective of this study was to explain the contribution of lower extremity muscle activity to gait kinetic and kinematic adaptations for maintaining gait dynamic balance when walking on an inclined icy surface and the biomechanical mechanisms used to counteract slip risk. A two-way factorial experimental design was applied. The two independent variables were the walkway surface (ice and treadmill) and the walkway inclination (0 masculine, 6 masculine, 8 masculine). The dependent variable was the amplitude of the surface EMG of four right lower extremity muscles (tibialis anterior TA, gastrocnemius lateralis GL, rectus femoris RF, and biceps femoris BF). Twelve healthy subjects (7 males and 5 females) participated in the walking trials. A two-way ANOVA analysis showed that on the icy surface in the heel contact phase, EMG amplitudes significantly decreased in TA and RF compared to those for the treadmill surface. In the mid-stance phase, the GL muscle activity significantly decreased on ice compared to treadmill and all four muscle activities increased significantly with the inclination. During the toe off phase, GL and RF activities increased with the inclination. The mechanisms identified may be applied to develop intervention, rehabilitation and training techniques, and to improve performance in human locomotion, such as for winter sports.
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Functional roles of lower-limb joint moments while walking in water.
Miyoshi, T, Shirota, T, Yamamoto, S, Nakazawa, K, Akai, M
Clinical biomechanics (Bristol, Avon). 2005;(2):194-201
Abstract
OBJECTIVE To clarify the functional roles of lower-limb joint moments and their contribution to support and propulsion tasks while walking in water compared with that on land. DESIGN Sixteen healthy, young subjects walked on land and in water at several different speeds with and without additional loads. BACKGROUND Walking in water is a major rehabilitation therapy for patients with orthopedic disorders. However, the functional role of lower-limb joint moments while walking in water is still unclear. METHODS Kinematics, electromyographic activities in biceps femoris and gluteus maximums, and ground reaction forces were measured under the following conditions: walking on land and in water at a self-determined pace, slow walking on land, and fast walking in water with or without additional loads (8 kg). The hip, knee, and ankle joint moments were calculated by inverse dynamics. RESULTS The contribution of the walking speed increased the hip extension moment, and the additional weight increased the ankle plantar flexion and knee extension moment. CONCLUSIONS The major functional role was different in each lower-limb joint muscle. That of the muscle group in the ankle is to support the body against gravity, and that of the muscle group involved in hip extension is to contribute to propulsion. In addition, walking in water not only reduced the joint moments but also completely changed the inter-joint coordination. RELEVANCE It is of value for clinicians to be aware that the greater the viscosity of water produces a greater load on the hip joint when fast walking in water.
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Differences in the EMG pattern of leg muscle activation during locomotion in Parkinson's disease.
Albani, G, Sandrini, G, Künig, G, Martin-Soelch, C, Mauro, A, Pignatti, R, Pacchetti, C, Dietz, V, Leenders, KL
Functional neurology. 2003;(3):165-70
Abstract
In this pilot study, EMG patterns of leg muscle activation were studied in five parkinsonian patients with (B1) and five without (B2) freezing. Gastrocnemius medialis (GM) and tibialis anterior (TA) activity was analysed, by means of surface electromyography (EMG), during treadmill walking at two different belt speeds. Both groups showed reduced GM activity and an overactive TA at the lower speed compared with controls. Upon increasing the speed, the B2 patients showed a marked GM response (increment index 100%), while a moderate change was observed in the B1 group. Poor recruitment of the GM characterises parkinsonian gait in general; this pattern is much more marked in parkinsonian patients with freezing of gait, who show a loss of GM adaptation to variation of locomotion speed.
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Trajectories of leg strength and gait speed among sedentary older adults: longitudinal pattern of dose response.
Purser, JL, Pieper, CF, Poole, C, Morey, M
The journals of gerontology. Series A, Biological sciences and medical sciences. 2003;(12):M1125-34
Abstract
BACKGROUND Current theory about how an older adult's leg strength influences walking speed is based primarily on nonlinear patterns of association observed in cross-sectional data. Compared with adults with normal or high levels of leg muscle strength, weak older adults are thought to have a greater capacity for functional change in response to changes in lower extremity strength. Longitudinal data, however, have not been applied to study this putative pattern of dose response. METHODS Three repeated measures of leg strength, gait speed, and covariates were evaluated in a cohort of 134 sedentary, community-dwelling male and female participants (aged >64 years) of a randomized exercise intervention. Empirical Bayes methods were used to evaluate the association between trajectories of strength and gait speed during the course of the study. RESULTS We observed a potentially clinically important, positive linear association between strength change and gait speed change. Each additional unit increase in the monthly rate of strength change increased the rate of gait speed change by 0.29 meters/minute/month (95% CI [confidence interval] = 0.03, 0.55 m/min/mo). Absolute change in walking velocity due to strength changes in the cohort ranged from a gain of approximately 15 m/min to a loss of approximately 13 m/min over the 9-month period (changes of -18% to +20% relative to a normal walking speed of 72 m/min). CONCLUSIONS In this cohort, change in functional walking speed depended more on the rate of strength change observed than on the amount of muscle weakness present at baseline. These results have important implications for screening and intervention programs designed to change functional walking ability among sedentary older adults.
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Determination of the effectiveness of materials in attenuating high frequency shock during gait using filterbank analysis.
Gillespie, KA, Dickey, JP
Clinical biomechanics (Bristol, Avon). 2003;(1):50-9
Abstract
OBJECTIVE To develop an accurate method for quantifying the frequency content of the ground reaction force transient. DESIGN Repeated measures design comparing the impact severity during walking with different insole materials. BACKGROUND The body experiences a brief but sizeable impact upon heel strike during walking. This impact transient is believed to result in musculoskeletal injuries. It is important to accurately quantify this impact as a step towards decreasing the risk of injury. METHODS Seven subjects walked barefoot at their normal cadence across a force platform, while insole materials (Spenco, Microcel-puff, and Plastazote) were placed on the surface of the force platform. A filterbank program was developed to determine the percent root mean square in 10 Hz frequency bands from zero to 400 Hz. Analysis focused on the impact transient contained in a 20 ms window after heel contact. RESULTS The high frequency (>60 Hz) power was significantly larger in the barefoot condition compared to the insole conditions. The barefoot condition also resulted in significantly higher initial peak forces and force loading rates. CONCLUSIONS The frequency content of the ground reaction force can be effectively quantified using a filterbank approach. Shoe insole materials can reduce the initial peak force, force loading rate, and frequency content of the impact transient in walking. The frequency content of the initial ground reaction force extends up to 400 Hz in some footwear conditions. RELEVANCE The new filterbank procedure illustrates that the vertical ground reaction force in walking has a higher frequency content than previously thought. This signal requires high sampling rates to avoid aliasing, and appropriate signal processing algorithms, such as filter banks, for analysis.