Helping Children with Obesity "Move Well" To Move More: An Applied Clinical Review.

ABSTRACT: Children with obesity experience musculoskeletal pain and reduced physical function and well-being, which collectively impact their fitness, strength, motor skills, and even their ability to undertake simple tasks, like walking and climbing stairs. Disrupting obesity-related disability may be critical to increasing children's physical activity. Thus, barriers to movement should be considered by health practitioners to improve the efficacy of prescribed physical activity. This applied clinical review highlights key subjective and objective findings from a hypothetical case scenario, linking those findings to the research evidence, before exploring strategies to enhance movement and increase physical activity.

The effect of auditory pacing on period stability and temporal consistency in children with and without dyslexia co-existing motor dysfunction.

The primary purpose of this study was to examine the effect of auditory pacing on period stability and temporal consistency of a dual motor task in children with and without dyslexia and with varying amounts of motor deficiency. Fifty-four children were divided into groups based on dyslexia diagnosis and score on the Movement Assessment Battery for Children-Second Edition (Movement ABC-2). Participants performed a dual motor task (clapping while walking) at a self-determined pace in a pretest block, practiced 4 blocks of 4 trials with a metronome pacing signal, and finished with a posttest block without auditory pacing. Measures of period stability (interclap/interheel strike intervals across trial blocks) and temporal consistency (coefficient of variation of period with trials) were taken. The results suggest that auditory pacing may improve period stability across groups, but does not appear to impact temporal consistency. Weak support existed for a general impairment of motor function in children diagnosed with dyslexia.

The Influence of Motor Competence on Broader Aspects of Health: A Systematic Review of the Longitudinal Associations Between Motor Competence and Cognitive and Social-Emotional Outcomes.

BACKGROUND: Motor competence has important developmental associations with aspects of physical health, but there has been no synthesis of longitudinal associations with cognitive and social-emotional health. OBJECTIVES: The first aim was to present a conceptual model that positions motor competence as a mediator between physical activity and cognitive and social-emotional outcomes. The second aim was to synthesize the association of motor competence and cognitive and social-emotional development using longitudinal observational and experimental evidence, in particular to (i) identify the role of task, individual, and environmental characteristics in moderating the association between motor and cognitive and social-emotional outcomes and (ii) synthesize the strength of evidence pertaining to domain-specific relationships. METHODS: This systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO) and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for reporting systematic reviews and meta-analyses. Five electronic databases (PubMed, Web of Science, Scopus, PsycINFO, and SPORTDiscus) were systematically searched. Following study screening and risk-of-bias assessment by two authors, 49 eligible studies were identified for inclusion and grouped by study design. Evidence for domain-specific paths between motor competence and cognitive and social-emotional outcomes was synthesized by calculating the significant analyses in the hypothesized direction, divided by the total number of analyses for that path. These percentages were then collated for each domain outcome. This collated influence was classified as either no association (0-33%), written as '0', or indeterminate/inconsistent (34-59%), written as '?' If there were fewer than three studies in the domain, the strength of evidence was classified as insufficient (I). RESULTS: Of the 49 studies, 35% were able to satisfy six or more of the seven risk-of-bias criteria. Longitudinal observational evidence about domain-specific and global associations of motor competence and cognitive and social-emotional development is indeterminate. The included studies also did not provide evidence for a consistent moderating role of age and sex. Some preliminary experimental evidence does support the role of motor competence in moderating the influence of cognitively enriched physical activity on cognitive outcomes, especially working memory and social-emotional skills. However, too few studies were appropriately designed to acknowledge the moderating role of contextual mechanisms. CONCLUSIONS: Between-study heterogeneity means it was not possible to identify definitive domain- and construct-specific relationships between motor competence and cognitive and social-emotional outcomes. To further develop our understanding, it is important that researchers acknowledge the complexity of these relationships within rigorous study designs.

The Influence of Multisensory Input On Voice Perception and Production Using Immersive Virtual Reality.

OBJECTIVES: The purpose was to examine the influence of auditory vs visual vs combined audiovisual input on perception and production of one's own voice, using immersive virtual reality technology. METHODS: Thirty-one vocally healthy men and women were investigated under 18 sensory input conditions, using immersive virtual reality technology. Conditions included two auditory rooms with varying reverberation times, two visual rooms with varying volumes, and the combination of audiovisual conditions. All conditions were repeated with and without background noise. Speech tasks included counting, sustained vowel phonation, an all-voiced sentence from the Consensus Auditory-Perceptual Evaluation of Voice, and the first sentence from the Rainbow Passage, randomly ordered. Perception outcome measures were participants' self-reported perceptions of their vocal loudness, vocal effort, and vocal comfort in speech. Production outcome measures were sound pressure level (SPL) and spectral moments (spectral mean and standard deviation in Hz, skewness, and kurtosis). Statistical analyses used self-reported vocal effort, vocal loudness, and vocal comfort in percent (0 = "not at all," 100 = extremely), SPL in dB, and spectral moments in Hz. The reference level was a baseline audiovisual deprivation condition. RESULTS: Results suggested (i) increased self-perceived vocal loudness and effort, and decreased comfort, with increasing room volume, speaker-to-listener distance, audiovisual input, and background noise, and (ii) increased SPL and fluctuations in spectral moments across conditions. CONCLUSIONS: Not only auditory, but also visual and audiovisual input influenced voice perception and production in ways that have not been previously documented. Findings contribute to the basic science understanding the role of visual, audiovisual and auditory input in voice perception and production, and also to models of voice training and therapy. The findings also set the foundation for the use of virtual reality in voice and speech training, as a potentially power solution to the generalization problem.

Through the Looking Glass: A Systematic Review of Longitudinal Evidence, Providing New Insight for Motor Competence and Health.

INTRODUCTION: In 2008, a conceptual model explaining the role of motor competence (MC) in children's physical activity (PA), weight status, perceived MC and health-related fitness was published. OBJECTIVE: The purpose of the current review was to systematically compile mediation, longitudinal and experimental evidence in support of this conceptual model. METHODS: This systematic review (registered with PROSPERO on 28 April 2020) was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. Separate searches were undertaken for each pathway of interest (final search 8 November 2019) using CINAHL Complete, ERIC, Medline (OVID), PsycINFO, Web of Science Core Collection, Scopus and SportDiscus. Potential articles were initially identified through abstract and title checking (N = 585) then screened further and combined into one review (n = 152), with 43 articles identified for extraction. Studies needed to be original and peer reviewed, include typically developing children and adolescents first assessed between 2 and 18 years and objective assessment of gross MC and at least one other variable (i.e., PA, weight status, perceived MC, health-related fitness). PA included sport participation, but sport-specific samples were excluded. Longitudinal or experimental designs and cross-sectional mediated models were sought. Strength of evidence was calculated for each pathway in both directions for each domain (i.e., skill composite, object control and locomotor/coordination/stability) by dividing the proportion of studies indicating a significantly positive pathway in the hypothesised direction by the total associations examined for that pathway. Classifications were no association (0-33%), indeterminate/inconsistent (34-59%), or a positive '+' or negative ' - ' association (≥ 60%). The latter category was classified as strong evidence (i.e., ++or --) when four or more studies found an association. If the total number of studies in a domain of interest was three or fewer, this was considered insufficient evidence to make a determination. RESULTS: There was strong evidence in both directions for a negative association between MC and weight status. There was strong positive evidence for a pathway from MC to fitness and indeterminate evidence for the reverse. There was indeterminate evidence for a pathway from MC to PA and no evidence for the reverse pathway. There was insufficient evidence for the MC to perceived MC pathway. There was strong positive evidence for the fitness-mediated MC/PA pathway in both directions. There was indeterminate evidence for the perceived MC-mediated pathway from PA to MC and no evidence for the reverse. CONCLUSION: Bidirectional longitudinal associations of MC with weight status are consistent with the model authored by Stodden et al. (Quest 2008;60(2):290-306, 2008). However, to test the whole model, the field needs robust longitudinal studies across childhood and adolescence that include all variables in the model, have multiple time points and account for potential confounding factors. Furthermore, experimental studies that examine change in MC relative to change in the other constructs are needed. TRIAL REGISTRATIONS: PROSPERO ID# CRD42020155799.

Object-control skills in Hispanic preschool children enrolled in Head Start.

Fundamental movement skills are considered a building block for movement competence. However, little is known about the influence of culture and ethnicity on the development of fundamental motor skills. A total of 111 Hispanic preschool children enrolled in a Head Start program, ages 38 to 52 months, was assessed on object-control skills using Ulrich's Test of Gross Motor Development-2. About 83% of the participants scored poor (standard score < or = 5) and 17% of children scored very poor on the performance scale (standard score < or = 3) using the descriptions in the manual. In addition, both boys and girls evidenced similar deficiencies. This information has implications for exploring and implementing age-appropriate object-control skills for children with low socioeconomic status, such as these Hispanic Head Start preschoolers.

The comparison of performances of preschool children on two motor assessments.

Understanding children's motor performance on different assessments is important for researchers. The Test of Gross Motor Development-2 (TGMD-2) and the Movement Assessment Battery for Children-2 (MABC-2) are motor assessments that use either a process- or product-oriented scoring approach. However, no studies have examined how performances are related to these two types of assessment. This study compared the performance of preschool children on the TGMD-2 and the MABC-2. 32 children (M age = 4.2 yr., SD = 9) completed each test to assess whether each described motor performance similarly. Significant low to moderate Spearman's rank correlations (r2 range = .13-.40) were found between the subscales of the assessments. A related-samples Wilcoxon signed rank test was not significant between total performances on the TGMD-2 and MABC-2. From a practical standpoint, each assessment provides a similar overall description of motor competence in preschool children. However, each assessment results in scores that present different information about motor performance.

Repurposing an EMG Biofeedback Device for Gait Rehabilitation: Development, Validity and Reliability.

Gait impairment often limits physical activity and negatively impacts quality of life. EMG-Biofeedback (EMG-BFB), one of the more effective interventions for improving gait impairment, has been limited to laboratory use due to system costs and technical requirements, and has therefore not been tested on a larger scale. In our research, we aimed to develop and validate a cost-effective, commercially available EMG-BFB device for home- and community-based use. We began by repurposing mTrigger® (mTrigger LLC, Newark, DE, USA), a cost-effective, portable EMG-BFB device, for gait application. This included developing features in the cellphone app such as step feedback, success rate, muscle activity calibration, and cloud integration. Next, we tested the validity and reliability of the mTrigger device in healthy adults by comparing it to a laboratory-grade EMG system. While wearing both devices, 32 adults walked overground and on a treadmill at four speeds (0.3, 0.6, 0.9, and 1.2 m/s). Statistical analysis revealed good to excellent test-retest reliability (r > 0.89) and good to excellent agreement in the detection of steps (ICC > 0.85) at all speeds between two systems for treadmill walking. Our results indicated that mTrigger compared favorably to a laboratory-grade EMG system in the ability to assess muscular activity and to provide biofeedback during walking in healthy adults.

Reconceptualizing and Operationalizing Seefeldt's Proficiency Barrier: Applications and Future Directions.

In 1980, Seefeldt introduced the concept of a motor skill "proficiency barrier" that provides a conceptual basis for understanding the importance of a motor skill barrier as it relates to critical public health initiatives. While the intent of Seefeldt's proficiency barrier hypothesis had great potential to advance the field of motor development, the notion of a proficiency barrier was not empirically tested. Instead, this concept lay dormant for several decades. The purpose of this paper was to expand upon Seefeldt's proficiency barrier concept in greater detail by addressing the following questions: (1) what constitutes a motor proficiency barrier? (2) how do we assess/measure the existence of a proficiency barrier? and (3) how do we break through the proficiency barrier in order to maximize the likelihood of participation in health-enhancing levels of physical activity later on in life? We conclude with a future research suggestion to explore the existence of the proficiency barrier.

No Clinical Predictors of Postconcussion Musculoskeletal Injury in College Athletes.

PURPOSE: This study aimed to identify clinical predictors of postconcussion subsequent musculoskeletal (MSK) injuries. METHODS: We recruited 66 National Collegiate Athletic Association intercollegiate student-athletes with a diagnosed concussion as well as 36 National Collegiate Athletic Association student-athletes without a concussion. All participants completed a multifaceted concussion baseline consisting of 1) 22-item 0-6 self-reported symptom checklist with outcomes including both the number of symptoms endorsed (0-22) and 2) total symptom score (0-132), 3) Standard Assessment of Concussion, 4) Balance Error Scoring System, 5) Immediate Post-Concussion Assessment and Cognitive Testing, 6) clinical reaction time, and 7) the King-Devick as well as demographic and injury characteristics. The concussion participants completed the same examination acutely postconcussion, and binary logistic regression was used to identify predictors of subsequent MSK from the change scores (acute minus baseline). From the 66 concussed student-athletes, a subset 36, matched with the healthy athletes, compared the risk of subsequent MSK in the year before and year after their concussion. RESULTS: The concussion participants were 1.78 times (95% confidence interval, 1.12-2.84; P = 0.015) more likely to suffer a lower extremity MSK in the year after their concussion than the control participants. The participant demographics and injury characteristics (P = 0.318) and concussion clinical outcomes (P = 0.461) did not predict subsequent MSK. CONCLUSION: The concussion participants were 1.78 times more likely to sustain a subsequent MSK; however, no demographic, injury characteristic, or concussion assessments predicted the MSK. Thus, clinicians are not able to utilize common neurological measures or participant demographics to identify those at risk for subsequent lower extremity MSK. Injury prevention strategies should be considered for collegiate student-athletes upon premature return to participation after a concussion to reduce the subsequent MSK.

Using grasping tasks to evaluate hand force coordination in children with hemiplegic cerebral palsy.

UNLABELLED: Mackenzie SJ, Getchell N, Modlesky CM, Miller F, Jaric S. Using grasping tasks to evaluate hand force coordination in children with hemiplegic cerebral palsy. OBJECTIVE: To assess force coordination in children with hemiplegic cerebral palsy (CP) using a device that allows for testing both unimanual and bimanual manipulation tasks performed under static and dynamic conditions. DESIGN: Nonequivalent groups design. SETTING: University research laboratory for motor control. PARTICIPANTS: Six children with hemiplegic CP (age, mean +/- SD, 11.6+/-1.8 y) and 6 typically developing controls (11.6+/-1.6 y). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Children performed simple lifting and force-matching static ramp tasks by way of both unimanual and bimanual pulling using a device that measures grip force (force acting perpendicularly at the digits-device contact area) and load force (tangential force). Main outcome measures were grip/load force ratios (grip force scaling) and correlation coefficients (force coupling). RESULTS: CP subjects showed significantly higher grip/load force ratios (P<.05) and slightly lower correlation coefficients than the control group, with more pronounced differences for most tasks when using their involved hand. For subjects with CP, switching from unimanual to bimanual conditions did not bring changes in scaling or coupling for the involved hand (P>.05). CONCLUSIONS: Compared with healthy children, the impaired hand function in the hemiplegic CP pediatric population could be reflected in excessive grip force that is also decoupled from ongoing changes in load force. Therefore, the bimanual grip load device used in this study could provide a sensitive measure of grip force coordination in CP, although nonmotor deficits should be taken into account when asking children to perform more complex tasks.

Does Movement Matter? Prefrontal Cortex Activity During 2D vs. 3D Performance of the Tower of Hanoi Puzzle.

In the current study, we used functional near-infrared spectroscopy (fNIRS) to compare prefrontal cortex (PFC) activity in adults as they performed two conditions of the Tower of Hanoi (ToH) disk-transfer task that have equivalent executive function (EF) but different motor requirements. This study explored cognitive workload, here defined as the cognitive effort utilized while problem-solving by performance output. The first condition included a two-dimensional (2D) computerized ToH where participants completed trials using a computer mouse. In contrast, our second condition used a traditional, three-dimensional (3D) ToH that must be manually manipulated. Our aim was to better understand the role of the PFC in these two conditions to detect if PFC activity increases as a function of motor planning. Twenty right-handed, neurotypical adults (10M/10F, x ¯ = 24.6, SD ± 2.8 years old) participated in two blocks (one per condition) of three 1-min trials where they were asked to solve as many puzzles as possible. These data were analyzed using a mixed effects ANOVA with participants nested within blocks for 2D vs. 3D conditions, presentation order (leading block), individual participants, and regions and additional follow-up statistics. Results showed that changes in oxygenated hemoglobin, ΔHbO, were significantly higher for 3D compared to 2D condition (p = 0.0211). Presentation order and condition interacted significantly (p = 0.0015). Notably, a strong correlation between performance and ΔHbO existed between blocks 1 and 2 (r = -0.69, r 2 = 0.473, p < 0.01) when the 3D condition was initially performed, in contrast to the 2D condition where no significant correlation was seen. Findings also showed a significant decrease in ΔHbO between the first and second block (p = 0.0015) while performance increased significantly for both 3D and 2D conditions (p < 0.005). We plan to use this information in the future to narrow the potential points of impairment on the perception-cognition-action continuum in certain developmental disabilities.

Effects of Repetitive Head Impacts on a Concussion Assessment Battery.

PURPOSE: The purpose of this study was to determine the relationship between repetitive head impacts (RHI) and clinical concussion assessments across a season among collegiate football (FB) and women's soccer (WSOC) players. METHODS: Fifteen male FB and 23 WSOC players participated in this study. Participants were included if they were medically cleared for unrestricted athletic participation. Participants were tested in a university athletic training room on two occasions: preseason (PRE) and postseason (POST). The outcome measures consisted of tandem gait (TG), Standardized Assessment of Concussion, Balance Error Scoring System, King-Devick (KD), clinical reaction time, and Immediate Post-Concussion Assessment and Cognitive Testing. Repetitive head impact during the season was quantified using the Head Impact Telemetry System (Simbex, NH) for FB and the Smart Impact Monitor (SIM; Triax Technologies, Norwalk, CT) for WSOC. Independent variables included total number of impacts, average magnitude of peak linear acceleration, cumulative linear exposure, and number of impacts ≥98g. RESULTS: Results from direct-entry multiple regression analyses suggest significant associations between RHI and both visual memory (R = 0.670, F = 6.487, P = 0.002) and TG (R = 0.636, F = 3.841, P = 0.029) for WSOC and between RHI and KD (R = 0.756, F = 5.579, P = 0.013) for FB, whereby those with greater exposure performed worse. No other regression analyses within or across groups were significant. CONCLUSIONS: These data suggest that RHI do not represent clinically meaningful changes on a multifaceted and multimodal concussion assessment battery. However, there may be subtle visual/vestibular impairments as observed by the associations between RHI and visual memory/TG among WSOC, RHI, and KD among FB.

Multi-limb coordination and rhythmic variability under varying sensory availability conditions in children with DCD.

Children with Developmental Coordination Disorder (DCD) have sensory processing deficits; how do these influence the interface between sensory input and motor performance? Previously, we found that children with DCD were less able to organize and maintain a gross motor coordination task in time to an auditory cue, particularly at higher frequencies [Whitall, J., Getchell, N., McMenamin, S., Horn, C., Wilms-Floet, A., & Clark, J. (2006). Perception-action coupling in children with and without DCD: Frequency locking between task relevant auditory signals and motor responses in a dual motor task. Child: Care, Health, and Development, 32, 679-692]. In the present study, we examine the same task (clapping in-phase to marching on a platform) under conditions involving the removal of vision and hearing. Eleven children with DCD (mean=7.21, SD=0.52 years), 7 typically developing (TD) children (mean=6.95+/-0.72 years), and 10 adults performed continuous clapping while marching under four conditions: with vision and hearing, without vision, without hearing, and without both. Results showed no significant condition effects for any measure taken. The DCD group was more variable in phasing their claps and footfalls than both the adult group and the TD group. There were also significant group effects for inter-clap interval coefficient of variation and inter-footfall interval coefficient of variation, with the DCD group being the most variable for both measures. Coherence analysis between limb combinations (e.g., left arm-right arm, right arm-left leg) revealed that the adults exhibited significantly greater coherence for each combination than both of the children's groups. The TD group showed significantly greater coherence than the DCD group for every limb combination except foot-foot and left hand-right foot. Measures of approximate entropy indicated that adults differed from children both with and without DCD in the structure of the variability across a trial with adults showing more complexity. Children with DCD are able to accomplish a self-initiated gross-motor coordination task but with increased variability for most but not all measures compared to typically developing children. The availability of visual and/or auditory information does not play a significant role in stabilizing temporal coordination of this task, suggesting that these are not salient sources of information for this particular task.

Cortical activity in fine-motor tasks in children with Developmental Coordination Disorder: A preliminary fNIRS study.

Developmental Coordination Disorder (DCD) is as a neurodevelopmental condition characterized by poor motor proficiency, which impacts academic performance and activities of daily living. Several studies have determined that children with DCD activate different regions of the brain when performing motor skills in comparison to typically developing (TD) children. However, none have used Functional Near-Infrared Spectroscopy (fNIRS) to explore cortical activation in this population. With that, the goal of this preliminary study was to investigate cortical activation using fNIRS in six children with DCD and six TD children between ages of 8 and 12 years. Three fine-motor tasks were performed: Finger Tapping (FT), Curve Tracing (CT), and Paragraph Writing (PW). Tasks were presented in counterbalanced order and had a baseline of 30s. Cortical activity elicited during performance of the FT, CT, and PW tasks was measured by fNIRS, and activation areas within each group were statistically compared. Results indicated that participant groups used different focal activation areas as well as different neural networks to perform the tasks. These distinct patterns were also task-specific, with differences in the right Pre-Motor Cortex (Pre-MC) and Supplementary Motor Area (SMA) for CT, and the right Dorsolateral Prefrontal Cortex (DLPFC) and the right Pre-MC for the PW task. These results add to the body of research exploring neurological alterations in children with DCD, and establish the feasibility of using fNIRS technology with this population.

Comparing children with and without dyslexia on the Movement Assessment Battery for Children and the Test of Gross Motor Development.

Dyslexia is the most commonly occurring learning disability in the United States, characterized by difficulties with word recognition, spelling, and decoding. A growing body of literature suggests that deficits in motor skill performance exist in the dyslexic population. This study compared the performance of children with and without dyslexia on different subtests of the Test of Gross Motor Development and Movement Assessment Battery for Children and assessed whether there were developmental changes in the scores of the dyslexic group. Participants included 26 dyslexic children (19 boys and 7 girls; 9.5 yr. old, SD = 1.7) and 23 age- and sex-matched typically developing (17 boys and 6 girls; 9.9 yr. old, SD = 1.3) children as a control group. Mann-Whitney U tests indicated that the dyslexic group performed significantly lower than the control group only on the Total Balance subtest of the Movement Assessment Battery for Children. Additionally, the young dyslexic group performed significantly better on the Total Balance subtest, compared to the older dyslexic group. These results suggest that cerebellar dysfunction may account for differences in performance.

Physical Activity Levels in Children With and Without Autism Spectrum Disorder When Playing Active and Sedentary Xbox Kinect Videogames.

OBJECTIVE: We compare physical activity during bouts of sedentary videogaming (SVG), active videogaming (AVG), and paced walking in children with and without autism spectrum disorder (ASD) to determine the effectiveness of AVG in providing moderate-to-vigorous physical activity. MATERIALS AND METHOD: Participants included nine males (8-11 years old) with ASD and eight age-matched males who were typically developing. Both groups had anthropometric and motor proficiency (Movement Assessment Battery for Children II) measures taken before testing. Participants attended three randomly assigned acquisition sessions: 20 minutes of paced walking at 4.5 metabolic equivalents, AVG, and SVG. Videogaming occurred on an Xbox® Kinect. An Actical accelerometer provided activity counts (AC) and percentage of time in moderate-to-vigorous physical activity (%MVPA). These were compared using 3 × 2 repeated measures analysis of variance for each measure. RESULTS: Main effects for conditions existed for %MVPA (P < 0.0001) and AC (P < 0.0001). Post hoc Bonferroni comparisons indicated that AVG had significantly higher AC (P < 0.001) and % MVPA (P < 0.001) than SVG, but was significantly lower than paced walking (AC P < 0.001; %MVPA P < 0.01). Overall, participants spent 76.25% of their time in MVPA during AVG compared to 99.4% during paced walking and 2.31% in SVG. No main effects for groups or group by condition interaction effects were found for either measure. CONCLUSIONS: AVG may provide an appealing means by which all individuals can increase their overall physical activity levels, although AVG should not be seen as a replacement for walking or other forms of PA. Although further research is necessary, the finding that both groups performed similarly in AVG suggests that games can potentially be played without modifications or adaptations to gaming units, which may provide several advantages in terms of social/cost/ease of accessing unit.

Transitions to and from asymmetrical gait patterns.

Asymmetrical gait patterns such as the gallop provide insight into the complexity of human locomotion. The nature of spontaneous (e.g., walk-run), quasi-spontaneous (e.g., gallop-walk), and intentional (e.g., walk-gallop) transitions was analyzed in 2 ways in the present study. In Analysis 1, the authors used step-wise regression to associate 10 physical characteristics with gait transitions. Transition predictability was moderate; thigh length best predicted 3 of 6 transitions. In Analysis 2, the dynamic characteristics of transitions (order parameters, phase shifts, multistability, and critical fluctuations) were described; those characteristics existed for all transition types. The results of the analyses suggest that intentional transitions are less biomechanically predictable than are spontaneous transitions and that transitions between gait pairs (e.g., walk-gallop and gallop-walk), regardless of velocity direction, have more in common than do transitions requiring specific intention.