The Effect of a New Generation of Ankle Foot Orthoses on Sloped Walking in Children with Hemiplegia Using the Gait Real Time Analysis Interactive Lab (GRAIL).

Cerebral palsy poses challenges in walking, necessitating ankle foot orthoses (AFOs) for stability. Gait analysis, particularly on slopes, is crucial for effective AFO assessment. The study aimed to compare the performance of commercially available AFOs with a new sports-specific AFO in children with hemiplegic cerebral palsy and to assess the effects of varying slopes on gait. Eighteen participants, aged 6-11, with hemiplegia, underwent gait analysis using GRAIL technology. Two AFO types were tested on slopes (uphill +10 deg, downhill -5 deg, level-ground). Kinematic, kinetic, and spatiotemporal parameters were analyzed. The new AFO contributed to significant changes in ankle dorsi-plantar-flexion, foot progression, and trunk and hip rotation during downhill walking. Additionally, the new AFO had varied effects on spatiotemporal gait parameters, with an increased stride length during downhill walking. Slope variations significantly influenced the kinematics and kinetics. This study provides valuable insights into AFO effectiveness and the impact of slopes on gait in hemiplegic cerebral palsy. The findings underscore the need for personalized interventions, considering environmental factors, and enhancing clinical and research approaches for improving mobility in cerebral palsy.

Wrist-Worn Sensor Validation for Heart Rate Variability and Electrodermal Activity Detection in a Stressful Driving Environment.

Wearable sensors are widely used to gather psychophysiological data in the laboratory and real-world applications. However, the accuracy of these devices should be carefully assessed. The study focused on testing the accuracy of the Empatica 4 (E4) wristband for the detection of heart rate variability (HRV) and electrodermal activity (EDA) metrics in stress-inducing conditions and growing-risk driving scenarios. Fourteen healthy subjects were recruited for the experimental campaign, where HRV and EDA were recorded over six experimental conditions (Baseline, Video Clip, Scream, No-Risk Driving, Low-Risk Driving, and High-Risk Driving) and by means of two measurement systems: the E4 device and a gold standard system. The overall quality of the E4 data was investigated; agreement and reliability were assessed by performing a Bland-Altman analysis and by computing the Spearman's correlation coefficient. HRV time-domain parameters reported high reliability levels in Baseline (r > 0.72), Video Clip (r > 0.71), and No-Risk Driving (r > 0.67), while HRV frequency domain parameters were sufficient in Baseline (r > 0.58), Video Clip (r > 0.59), No-Risk (r > 0.51), and Low-Risk Driving (r > 0.52). As for the EDA parameters, no correlation was found. Further studies could enhance the HRV and EDA quality through further optimizations of the acquisition protocol and improvement of the processing algorithms.

Is Social Training Delivered with a Head-Mounted Display Suitable for Patients with Hereditary Ataxia?

Social cognition is fundamental in everyday life to understand "others' behavior", which is a key feature of social abilities. Previous studies demonstrated the efficacy of a rehabilitative intervention in semi-immersive virtual reality (VR) controlled by whole-body motion to improve the ability of patients with cerebellar disorders to predict others' intentions (VR-SPIRIT). Patients with severe ataxia that have difficulties at multiple levels of social processing could benefit from this intervention in terms of improving their social prediction skills, but they may have difficulties in controlling VR with whole-body movements. Therefore, we implemented VR-SPIRIT on a wearable, affordable, and easy-to-use technology, such as the Oculus Quest, a head-mounted display. The aim of this work was to evaluate the usability and tolerability of this VR application. We recruited 10 patients (37.7 ± 14.8 years old, seven males) with different types of hereditary ataxia who performed a single VR-SPIRIT session using the Oculus Quest viewer. After the session, patients answered a series of questionnaires to investigate the overall usability of the system and its potential effects in terms of cyber sickness. The preliminary results demonstrated system usability and tolerability. Indeed, only three patients did not complete the session due to different problems (dizziness, nausea, and boredom). In future studies, more patients will be enrolled to assess the effectiveness of the application, paving the way for the implementation of social training that can also be delivered at home.

Context expectation influences the gait pattern biomechanics.

Beyond classical aspects related to locomotion (biomechanics), it has been hypothesized that walking pattern is influenced by a combination of distinct computations including online sensory/perceptual sampling and the processing of expectations (neuromechanics). Here, we aimed to explore the potential impact of contrasting scenarios ("risky and potentially dangerous" scenario; "safe and comfortable" scenario) on walking pattern in a group of healthy young adults. Firstly, and consistently with previous literature, we confirmed that the scenario influences gait pattern when it is recalled concurrently to participants' walking activity (motor interference). More intriguingly, our main result showed that participants' gait pattern is also influenced by the contextual scenario when it is evoked only before the start of walking activity (motor expectation). This condition was designed to test the impact of expectations (risky scenario vs. safe scenario) on gait pattern, and the stimulation that preceded walking activity served as prior. Noteworthy, we combined statistical and machine learning (Support-Vector Machine classifier) approaches to stratify distinct levels of analyses that explored the multi-facets architecture of walking. In a nutshell, our combined statistical and machine learning analyses converge in suggesting that walking before steps is not just a paradox.