Precision Errors and Monitoring Time Interval in Pediatric Muscle Imaging and Neuromuscular Performance Assessment.

OBJECTIVES: To determine precision errors and monitoring time intervals in imaged muscle properties and neuromuscular performance, and to explore growth-related factors associated with precision errors in children. METHODS: We included 35 children (mean age 10.5yrs) in the precision study cohort and 40 children (10.7yrs) in the follow-up study cohort. We assessed forearm and lower leg muscle properties (area, density) with peripheral quantitative computed tomography. We measured neuromuscular performance via maximal pushup, grip force, countermovement and standing long jump force, power, and impulse along with long jump length. We calculated precision errors (root-mean-squared coefficient of variation) from the precision cohort and monitoring time intervals using annual changes from the follow-up cohort. We explored associations between precision errors (coefficient of variation) and maturity, time interval (between repeated measures), and anthropometric changes using Spearman's rank correlation (p<0.05). RESULTS: Muscle measures exhibited precision errors of 1.3-14%. Monitoring time intervals were 1-2.6yrs, except muscle density (>43yrs). We identified only one association between precision errors and maturity (maximal pushup force: rho=-0.349; p=0.046). CONCLUSIONS: Imaging muscle properties and neuromuscular performance measures had precision errors of 1-14% and appeared suitable for follow-up on ~2yr scales (except muscle density). Maximal pushup force appeared more repeatable in mature children.

Fall arrest strategy training improves upper body response time compared to standard fall prevention exercise in older women: A randomized trial.

INTRODUCTION: Exercise can decrease fall risk in older adults but less is known about training to reduce injury risk in the event a fall is unavoidable. The purpose of this study was to compare standard fall prevention exercises to novel Fall Arrest Strategy Training (FAST); exercises designed to improve upper body capacity to reduce fall-injury risk in older women. METHOD: Forty women (mean age 74.5 years) participated in either Standard (n = 19) or FAST (n = 21) twice per week for 12 weeks. Both interventions included lower body strength, balance, walking practice, agility and education. FAST added exercises designed to enhance forward landing and descent control such as upper body strengthening, speed and practice of landing and descent on outstretched hands. RESULTS: Both FAST and Standard significantly improved strength, mobility, balance, and fall risk factors from pre to post-intervention. There was a significant time by group interaction effect for upper body response time where FAST improved but Standard did not (p = 0.038). DISCUSSION: FAST resulted in similar gains in factors that reduce fall risk as a standard fall prevention program; with the additional benefit of improving speed of arm protective responses; a factor that may help enhance landing position and reduce injury risks such as head impact during a forward fall.

The effects of light touch on gait and dynamic balance during normal and tandem walking in individuals with an incomplete spinal cord injury.

STUDY DESIGN: Prospective cross-sectional study OBJECTIVES: To investigate the effect of adding haptic input during walking in individuals with incomplete spinal cord injury (iSCI). SETTING: Research laboratory. METHODS: Participants with iSCI and age- and sex-matched able-bodied (AB) individuals walked normally (SCI n = 18, AB n = 17) and in tandem (SCI n = 12, AB n = 17). Haptic input was added through light touch on a railing. Step parameters, and mediolateral and anterior-posterior margins of stability (means and standard deviations) were calculated. Surface electromyography data were collected bilaterally from the tibialis anterior (TA), soleus (SOL), and gluteus medius (GMED) and integrated over a stride. Repeated measures ANOVAs examined within- and between-group differences (α = 0.05). Cutaneous and proprioceptive sensation of individuals with iSCI were correlated to changes in outcome measures that were affected by haptic input. RESULTS: When walking normally, adding haptic input decreased stride velocity, step width, stride length, MOSML, MOSML_SD, MOSAP, and MOSAP_SD, and increased GMED activity on the limb opposite the railing. During tandem walking, haptic input had no effect; however, individuals with iSCI had a larger step width SD and MOSML_SD compared with the AB group. Sensory abilities of individuals with iSCI were not correlated to any of the outcome measures that significantly changed with added haptic input. CONCLUSIONS: Added haptic input improved balance control during normal but not in tandem walking. Sensory abilities did not impact the use of added haptic input during walking.

A 7-min video training intervention improves worker short-term radiation safety behavior during small animal diagnostic radiography.

Although manual restraint for small animal diagnostic radiography is common, worker protection is often not optimized, particularly for hands and eyes. Radiation safety training videos generally include hours of material on content other than personal protective equipment (PPE), have limited content, if any, on reducing dose to the lens of the eye, and are presented at the level of veterinary professionals. The objectives of this prospective, observational study were to develop a short, open access video training intervention at the layperson level, focused on proper use of PPE, and to test the effectiveness of the training video in changing behavior of workers. The use of PPE, optimal head position, and body position relative to the source of scattered radiation were compared before and after the video training was completed by workers. Results of unconditional and multivariable analyses were similar. In final multivariable analysis, workers wore gloves correctly more frequently (odds ratio [OR] = 2.09; 95% confidence interval [CI], 1.68-2.59; P < .001) and wore eyewear more frequently (OR = 1.85; 95% CI, 1.23-2.78; P = .003) after completing the training intervention. Workers also had an optimal head position more frequently (OR = 1.27; 95% CI, 1.03-1.58; P = .03) and stood straight or leaned back more frequently (OR = 1.85; 95% CI, 1.48-2.23; P < .001) after completing the training. The video training developed in this study is an effective tool that can be incorporated into a radiation protection program to improve worker radiation safety behaviors during manual restraint for small animal diagnostic radiography.

Adding Light Touch While Walking in Older Adults: Biomechanical and Neuromotor Effects.

Adding haptic input may improve balance control and help prevent falls in older adults. This study examined the effects of added haptic input via light touch on a railing while walking. Participants (N = 53, 75.9 ± 7.9 years) walked normally or in tandem (heel to toe) with and without haptic input. During normal walking, adding haptic input resulted in a more cautious and variable gait pattern, reduced variability of center of mass acceleration and margin of stability, and increased muscle activity. During tandem walking, haptic input had minimal effect on step parameters, decreased lower limb muscle activity, and increased cocontraction at the ankle closest to the railing. Age was correlated with step width variability, stride length variability, stride velocity, variability of medial-lateral center of mass acceleration, and margin of stability for tandem walking. This complex picture of sensorimotor integration in older adults warrants further exploration into added haptic input during walking.

Physical Therapists' Use of Evaluation Measures to Inform the Prescription of Ankle-Foot Orthoses for Children with Cerebral Palsy.

Aims: To examine how physical therapists (PTs) use evaluation measures to guide prescription and re-assessment of ankle-foot orthoses (AFOs) for children with CP. Methods: PTs in Canada who work with children with CP were invited to complete an online survey. Survey questions examined PT evaluation and interpretation of findings at initial AFO prescription and re-assessment. Closed-ended responses were analyzed using descriptive statistics, and a conventional content analysis examined responses to open-ended questions. Results: Sixty responses from ten provinces were analyzed. Three themes emerged from the open-ended responses, which were supported by closed-ended responses. (1) Focus on impairment-level measures. Although evaluation primarily involved observational, non-standardized measures of impairments and gait pattern, most respondents also considered participation-level constructs. (2) Lack of confidence/knowledge. Respondents reported a moderate level of confidence concerning decision-making about AFO type and characteristics. 3) Inconsistent practices between therapists, possibly reflecting the paucity of available evidence or individualization of the prescription. Conclusions: Non-standardized, observational assessment methods, and impairment-level constructs appear to guide AFO prescription decisions. Integrating current knowledge into practice, developing best practice guidelines, and developing standardized tools to assess the effects of AFOs on participation may promote confidence, consistency, and improved outcomes.

The Feasibility and Validity of Body-Worn Sensors to Supplement Timed Walking Tests for Children with Neurological Conditions.

AIMS: The 10-meter walk test (10 mWT) and Timed Up and Go (TUG) are assessments of speed/time with a ceiling effect in pediatric populations. This study aimed to (1) determine whether collecting spatiotemporal data with inertial sensors (Mobility Lab, APDM Inc.) during these tests improves their discriminative validity, and (2) evaluate the clinical feasibility of Mobility Lab. METHODS: Fifteen children with spina bifida (SB) or cerebral palsy (CP) (7.9 ± 3.1 years old) and fifteen age- and sex-matched typically-developing (TD) children completed the 10 mWT and TUG wearing Mobility Lab. Spatiotemporal data were compared between groups. Mobility Lab's potential to distinguish children with SB/CP from TD children was examined using conditional logistic regression. Feasibility was evaluated through participant adherence and a clinical utility scale. RESULTS: For the 10 mWT, group differences (p < 0.01) were found in horizontal and frontal trunk range of motion, horizontal trunk velocity, and swing asymmetry. Children with SB/CP took significantly longer to turn during the TUG. These five variables together distinguished the two groups (p = 0.006). 78% of participants with SB/CP completed the testing protocol. Mobility Lab scored 4/10 on the clinical utility scale. CONCLUSIONS: Instrumenting the 10 mWT and TUG improves the tests' ability to discriminate between children with SB/CP and TD children.

Cross-education after high-frequency versus low-frequency volume-matched handgrip training.

INTRODUCTION: Cross-education training programs cause interlimb asymmetry of strength and hypertrophy. We examined the cross-education effects from a high-frequency (HF) versus a low-frequency (LF) volume-matched handgrip training program on interlimb asymmetry. METHODS: Right-handed participants completed either HF (n = 10; 2 × 6 repetitions 10 times per week) or LF (n = 9; 5 × 8 repetitions 3 times per week) training. Testing occurred twice before and once after 4 weeks of right-handed isometric handgrip training totaling 120 weekly repetitions. Measures were maximal isometric handgrip and wrist flexion torque, muscle thickness, and muscle activation (electromyography; EMG). RESULTS: Grip strength was greater in both limbs posttraining, pooled across groups (P < 0.001). Trained limb muscle thickness increased in both groups (P < 0.05; untrained, P = 0.897). EMG and wrist flexion torque did not change (all P > 0.103). DISCUSSION: Both LF and HF induced cross-education of grip strength to the untrained limb, but HF did not reduce asymmetry. These findings have implications for injury rehabilitation. Muscle Nerve 56: 689-695, 2017.

Different haptic tools reduce trunk velocity in the frontal plane during walking, but haptic anchors have advantages over lightly touching a railing.

There are different ways to add haptic input during walking which may affect walking balance. This study compared the use of two different haptic tools (rigid railing and haptic anchors) and investigated whether any effects on walking were the result of the added sensory input and/or the posture generated when using those tools. Data from 28 young healthy adults were collected using the Mobility Lab inertial sensor system (APDM, Oregon, USA). Participants walked with and without both haptic tools and while pretending to use both haptic tools (placebo trials), with eyes opened and eyes closed. Using the tools or pretending to use both tools decreased normalized stride velocity (p < .001-0.008) and peak medial-lateral (ML) trunk velocity (p < .001-0.001). Normalized stride velocity was slower when actually using the railing compared to placebo railing trials (p = .006). Using the anchors resulted in lower peak ML trunk velocity than the railing (p = .002). The anchors had lower peak ML trunk velocity than placebo anchors (p < .001), but there was no difference between railing and placebo railing (p > .999). These findings highlight a difference in the type of tool used to add haptic input and suggest that changes in balance control strategy resulting from using the railing are based on arm placement, where it is the posture combined with added sensory input that affects balance control strategies with the haptic anchors. These findings provide a strong framework for additional research to be conducted on the effects of haptic input on walking in populations known to have decreased walking balance.

Female Age-Related Differences in Biomechanics and Muscle Activity During Descents on the Outstretched Arms.

The purposes of this study were to examine female age differences in: (1) upper extremity (UE) and trunk muscle activity, elbow joint moment, loading force, and UE energy absorption during a controlled forward body descent; and (2) UE muscle strength. Twenty young (mean 24.8 ± 3.4 years) and 20 older (68.4 ± 5.7 years) women were assessed via dynamometry for isometric, concentric, and eccentric UE strength and performed forward descents on force plates at three body lean angles (60°, 45°, and 30° from horizontal). Significant differences (p < .05) were found for muscle strength, biomechanics, and muscle activity. Concentric UE strength averaged 15% lower in older women. At 30° body lean, older women absorbed less energy. Older women had greater biceps brachii activation and less external oblique activation at all body lean angles. Age differences in muscle strength, activation, and energy absorption may contribute to fall-related injury risk.

Creatine supplementation does not alter neuromuscular recovery after eccentric exercise.

INTRODUCTION: The purpose of this study was to investigate the effects of creatine (CR) supplementation on recovery after eccentric exercise (ECC). METHODS: Fourteen men were assigned randomly to ingest 0.3 g/kg of CR or placebo (PL) before and during recovery (48 hours) from 6 sets of 8 repetitions of ECC. Maximal voluntary contraction (MVC), voluntary activation (VA), muscle thickness (MT), electromyography (EMG), contractile properties, and soreness were assessed. RESULTS: MVC, evoked twitch torque, and rate of torque development decreased for both groups immediately after ECC and recovered at 48 hours. MT increased and remained elevated at 48 hours for both groups. Soreness increased similarly for both groups. EMG activation was higher for CR versus PL only at 48 hours. There were no group differences for torque, total work, or fatigue index during ECC. CONCLUSIONS: CR supplementation before and during recovery from ECC had no effect on strength, voluntary activation, or indicators of muscle damage. Muscle Nerve 54: 487-495, 2016.

The effect of adding core stability training to a standard balance exercise program on sit to stand performance in older adults: a pilot study.

This study compared sit to stand (STS) performance between older adults in a nine-week training program focusing on core stability exercises to enhance balance and postural control (EB) versus standard balance (SB) exercises. Repetitions in 30 s (STSreps) and kinematic performance (vertical and horizontal momentum, and margin of stability) were measured pre and postintervention in 23 older adults with at least one fall risk factor. Although both groups combined improved STSreps (P = .001) and vertical momentum (.008), a significant between-group difference was observed for completers only (MANCOVA of posttest group differences, with pretest scores as covariates; P = .04). EB demonstrated a greater but nonsignificant improvement in vertical momentum (P = .095). In conclusion, core stability training added to SB did not result in STS reps improvement. Compliance may modify these results and future larger sample studies should evaluate the impact of core stability training on STS biomechanics.

Velocity-specific strength recovery after a second bout of eccentric exercise.

A bout of eccentric exercise (ECC) has the protective effect of reducing muscle damage during a subsequent bout of ECC known as the "repeated bout effect" (RBE). The purpose of this study was to determine if the RBE is greater when both bouts of ECC are performed using the same vs. different velocity of contraction. Thirty-one right-handed participants were randomly assigned to perform an initial bout of either fast (3.14 rad·s [180°·s]) or slow (0.52 rad·s [30°·s]) maximal isokinetic ECCs of the elbow flexors. Three weeks later, the participants completed another bout of ECC at the same velocity (n = 16), or at a different velocity (n = 15). Indirect muscle damage markers were measured before, immediately after, and at 24, 48, and 72 hours postexercise. Measures included maximal voluntary isometric contraction (MVC) strength (dynamometer), muscle thickness (MT; ultrasound), delayed onset muscle soreness (DOMS; visual analog scale), biceps and triceps muscle activation amplitude (electromyography), voluntary activation (interpolated twitch), and twitch torque. After the repeated bout, MVC strength recovered faster compared with the same time points after the initial bout for only the same velocity group (p = 0.017), with no differences for all the other variables. Irrespective of velocity, MT and DOMS were reduced after the repeated bout compared with that of the initial bout at 24, 48, and 72 hours with a corresponding increase in TT at 72 hours (p < 0.05). Faster recovery of isometric strength associated with a repeated bout of ECC was evident when the velocity was matched between bouts, suggesting that specificity effects contribute to the RBE. The current findings support the idea of multiple mechanisms contributing to the RBE.

Spatiotemporal walking performance in different settings: effects of walking speed and sex.

Background: Understanding the factors that influence walking is important as quantitative walking assessments have potential to inform health risk assessments. Wearable technology innovation has enabled quantitative walking assessments to be conducted in different settings. Understanding how different settings influence quantitative walking performance is required to better utilize the health-related potential of quantitative walking assessments. Research question: How does spatiotemporal walking performance differ during walking in different settings at different speeds for young adults? Methods: Forty-two young adults [21 male (23 ± 4 years), 21 female (24 ± 5 years)] walked in two laboratory settings (overground, treadmill) and three non-laboratory settings (hallway, indoor open, outdoor pathway) at three self-selected speeds (slow, preferred, fast) following verbal instructions. Six walking trials of each condition (10 m in laboratory overground, 20 m in other settings) were completed. Participants wore 17 inertial sensors (Xsens Awinda, Movella, Henderson, NV) and spatiotemporal parameters were computed from sensor-derived kinematics. Setting × speed × sex repeated measures analysis of variance were used for statistical analysis. Results: Regardless of the speed condition, participants walked faster overground when compared to while on the treadmill and walked faster in the indoor open and outdoor pathway settings when compared to the laboratory overground setting. At slow speeds, participants also walked faster in the hallway when compared to the laboratory overground setting. Females had greater cadence when compared to males, independent of settings and speed conditions. Significance: Particularly at slow speeds, spatiotemporal walking performance was different between the settings, suggesting that setting characteristics such as walkway boundary definition may significantly influence spatiotemporal walking performance.

Walking balance control in different settings: Effects of walking speed and biological sex.

BACKGROUND: Previous research has suggested that spatiotemporal step parameters differ between settings; however, it remains unclear how different settings influence walking balance control. RESEARCH QUESTION: How do settings and sex influence walking balance control during walking at different speeds for young adults? METHODS: Forty-two adults (21 male (23 ± 4 years), 21 female (24 ± 5 years)) completed overground walking trials in four settings: laboratory (10 m), hallway, indoor open, and outdoor pathway (all 20 m) at three self-selected speeds (slow, preferred, fast) following verbal instructions. Participants wore 17 inertial sensors (Xsens Awinda, Movella, Henderson, NV) to capture total body kinematics. The number of included strides was matched across all conditions, with six strides included in each condition for all participants. Medial-lateral and anterior-posterior total body angular momentum range over each stride was calculated (HML range and HAP range). Setting × speed × sex mixed factorial analysis of variance with repeated measures on setting and speed were used for statistical analysis (α =.05). RESULTS: Significant setting × speed interactions (p <.001) were present for both outcomes. HML range was greater in the laboratory and hallway compared to the indoor open and outdoor pathway settings for slow walking speed only. HAP range was lower in the outdoor pathway compared to all indoor settings at slow and preferred walking speeds. Differences in HAP range between settings was more pronounced at the slow speed condition. Across setting and speed conditions, HML range was greater for males compared to females. SIGNIFICANCE: Young adults may alter their balance control strategy depending on the setting (laboratory, indoor open and outdoor pathway), particularly at slow speeds. Researchers and clinicians are cautioned not to assume walking in laboratory settings reflects walking in all settings nor that males and females can be examined as a single group.

Bone and muscle differences in children and adolescents with type 1 diabetes: The mediating role of physical activity.

Children with type 1 diabetes (T1D) experience an increased risk of fracture, which may be related to altered bone development. We aimed to assess differences in bone, muscle and physical activity (PA), and explore if better muscle and PA measures would mitigate bone differences between children and adolescents with T1D and typically developing peers (TDP). We matched 56 children and adolescents with T1D (mean age 11.9 yrs) and 56 TDP (11.5 yrs) by sex and maturity from 171 participants with T1D and 66 TDP (6-17 yrs). We assessed the distal radius and tibia with high-resolution peripheral quantitative computed tomography (HR-pQCT), and the radius and tibia shaft bone and muscle with pQCT. We also measured muscle function from force-related measures in neuromuscular performance tests (push-up, grip test, countermovement and long jump). We compared PA based on questionnaire scores and accelerometers between groups. Bone, muscle, and neuromuscular performance measures were compared using MANOVA. We used mediation to explore the role of PA and muscle in bone differences. Children and adolescents with T1D had 6-10 % lower trabecular density, bone volume fraction, thickness and number at both distal radius and tibia, and 11 % higher trabecular separation at the distal radius than TDP. They also had 3-16 % higher cortical and tissue mineral density, and cortical thickness at the distal radius, 5-7 % higher cortical density and 1-3 % higher muscle density at both shaft sites compared to TDP. PA mediated the between-group difference in trabecular number (indirect effect -0.04) at the distal radius. Children and adolescents with T1D had lower trabecular bone density and deficits in trabecular micro-architecture, but higher cortical bone density and thickness at the radius and tibia compared to TDP. They engaged in less PA but had comparable muscle measures to those of TDP. PA participation may assist in mitigating deficit in trabecular number observed in children and adolescents with T1D.

Quantification of training load in Canadian football: application of session-RPE in collision-based team sports.

The session-rating of perceived exertion (Session-RPE) method for quantifying internal training load (TL) has proven to be a highly valuable and accurate monitoring tool in numerous team sports. However, the influence of frequent impact during Canadian football on the validity of this subjective rating tool remains unclear. The aim of this study was to validate Session-RPE application to a prolonged, intermittent, high-intensity collision-based team sport through correlation of internal TL data collected using 2 criterion heart rate-based measures known as Polar Training-Impulse (TRIMP) and Edwards' TL. Twenty male participants (age = 22.0 ± 1.4 years) from the competitive roster of the University of Saskatchewan Canadian football team were recruited. Session-RPE, Polar TRIMP, and Edwards' TL data were collected daily over the 2011 Canadian Interuniversity Sport pre-competitive and competitive season (11 weeks; 713 total practice sessions). On average, each player contributed 36 sessions of data to the analysis. Statistically significant correlations (p < 0.01) between Session-RPE with Polar TRIMP (r = 0.65-0.91) and with Edwards' TL (r = 0.69-0.91) were found for all individual players. This study provides confirmation that Session-RPE is an inexpensive and simple tool, which is highly practical and accurately measures an individual's response (internal TL) to the Canadian football practice. Furthermore, when considering the number of individuals involved worldwide in collision-based team sports, this tool has the potential to impact a large proportion of the global sporting community.

The effect of acute equine temporomandibular joint inflammation on response to rein-tension and kinematics.

Background: Although the temporomandibular joint (TMJ) is the major contact point between the reins in the riders' hand, the bit in the mouth, and the rest of the horse under saddle, the role of inflammation of this joint on equine locomotion and rein tension is unknown. Objective: To determine the effect of acute TMJ inflammation on rein-tension and horse movement when horses were long-reined on a treadmill. Study design: A randomized, controlled, cross-over design. Methods: Five horses were trained by one clinician to walk and trot on a treadmill wearing long-reining equipment instrumented with a rein-tension device and reflective optical tracking markers. Subjective assessment of horse's dominant side, and movement, were determined without rein-tension (free walk and trot); and with rein-tension (long-reined walk and trot). Continuous rein-force data from both sides were collected over ~60s from each trial. Movement was recorded using a 12-camera optical motion capture system. One randomly assigned TMJ was subsequently injected with lipopolysaccharide and the treadmill tests repeated by investigators blinded to treatment side. A second, identical assessment was performed 10 days later with the opposite TMJ being the target of intervention. Results: All horses showed reduced rein-tension on the injected (inflamed) side. Increased rein-tension was required on the non-injected side at trot, to maintain them in the correct position on the treadmill post-injection. The only kinematic variable to show any significant change due to rein tension or TMJ inflammation during the walk or trot was an increase in forward head tilt in the presence of rein tension in the trot after injection. Main limitations: Low number of horses and investigation of response to acute inflammation only. Conclusion: TMJ inflammation changed, subjectively and objectively, the response to rein-input, but the horses did not become lame.

Is it a Macho Thing? Older Adults' Perceptions of Gender Differences inFall Prevention Class Participation.

Perceptions that women are in greater need of fall prevention might impact their participation in programs. This study aimed to understand gender differences in motivating factors and experiences in a fall prevention program. Thirty-four adults (18 men and 16 women) aged 60 years or older participated in focus groups after 12 weeks of fall prevention exercises and education. Six main themes emerged. It might be a macho thing represented an overarching theme of why men might not participate in fall prevention as readily as women. Personal experience as a motivator, Get my balance back, and Challenges/Successes were common themes for men and women. Both genders realized the benefits of the program; however, men emphasized the importance of personal outcomes (Being part of something bigger), whereas women highlighted group outcomes (Socialization). These findings can guide the future messaging and marketing of fall prevention programs for older adults.

Don't get tripped up: Haptic modalities alter gait characteristics during obstacle crossing.

The attentional capacity required of haptic modalities while obstacle crossing may limit their effectiveness. Therefore, this study examined the attentional demands of haptic modalities during obstacle crossing. Nineteen healthy young adults walked across a 10 m laboratory floor within two modality blocks using either: 1) light touch on a railing, or 2) pulling haptic anchors. Randomly dispersed within these blocks were trials without added haptic input and verbal reaction time (VRT) tasks. VRT was compared across the three walking conditions. Gait characteristics, obstacle crossing stability, and obstacle toe clearance were compared across the three walking conditions (normal walking, light touch walking, anchored walking) and 2 VRT conditions (absence vs. presence). VRTs did not differ according to walking conditions (p > .05). Step length variability for the normal walking condition was significantly greater than for both the light touch and anchored walking conditions (p = .026). Toe clearance for the trail leg was less during light touch than normal walking (p = .020). The presence of the VRT resulted in greater toe clearance for both lead (p = .018) and trail limbs (F(2,34) = 8.053, p = .011). Neither haptic modality required significantly increased attentional demand; however, light touch walking results in less obstacle toe clearance. Haptic modalities likely provide greater benefit than risk to users during obstacle crossing.