Vertical stiffness and lower limb inter-joint coordination in older versus younger runners.

Older runners (OR) are increasing their participation in races. Aging may impact the adopted running pattern. Hence, the analysis of stiffness and the inter-joint lower limb coordination in the sagittal plane could contribute to investigating this impact. This study aimed to compare the vertical stiffness (Kvert) and the inter-joint lower limb coordination in the sagittal plane between younger runners (YR) and OR. This cross-sectional study recruited 15 YR males and 15 OR males. The pelvis and lower limb motions were assessed while running on a treadmill at self-selected (range OR: 1.94-3.75 m.s-1, YR: 2.08-4.17 m.s-1) and fixed speeds (3.33 m.s-1). Hip-ankle, knee-ankle, and hip-knee coupling angle (CA) and its variability (CAV) were extracted using the vector coding method. Mann-Whitney U tests compared Kvert between groups at each running speed. Watson's U2 tests compared the mean CA between groups in three intervals of the contact phase at each running speed. Statistical Parametric Mapping independent t-test compared the CAV curve between groups at each running speed. OR showed greater Kvert than YR at both speeds. Hip-ankle CA pattern differed between groups during the early stance at both speed conditions. OR showed in-phase, distal dominancy in hip-ankle CA, whereas YR showed anti-phase, proximal dominancy. Knee-ankle CA was distinct only at self-selected speed, in which OR showed in-phase, proximal dominancy, while YR exhibited anti-phase, proximal dominancy. CAV did not differ between groups. The findings showed that OR adopted a stiffer pattern characterized by distinct inter-joint lower limb CA, at early stance, during self-selected and fixed speeds.

Load Carriage During Walking Increases Dynamic Stiffness at Distal Lower Limb Joints.

The addition of a load during walking requires changes in the movement pattern. The investigation of the dynamic joint stiffness behavior may help to understand the lower limb joints' contribution to these changes. This study aimed to investigate the dynamic stiffness of lower limb joints in response to the increased load carried while walking. Thirteen participants walked in two conditions: unloaded (an empty backpack) and loaded (the same backpack plus added mass corresponding to 30% of body mass). Dynamic stiffness was calculated as the linear slope of the regression line on the moment-angle curve during the power absorption phases of the ankle, knee, and hip in the sagittal plane. The results showed that ankle (P = .002) and knee (P < .001) increased their dynamic stiffness during loaded walking compared with unloaded, but no difference was observed at the hip (P = .332). The dynamic stiffness changes were different among joints (P < .001): ankle and knee changes were not different (P < .992), but they had a greater change than hip (P < .001). The nonuniform increases in lower limb joint dynamic stiffness suggest that the ankle and knee are critical joints to deal with the extra loading.

Effects of a single-session stance-slip perturbation training program on reducing risk of slip-related falls.

The purpose of this pilot study was to establish the efficacy and feasibility of a single-session treadmill-based stance-slip perturbation program on preventing slip-related falls while walking over the ground among young adults. Two groups (training vs. control) of healthy young participants were respectively exposed to a treadmill-based stance-slip perturbation training protocol and a placebo training protocol. Post training, both groups experienced an unexpected overground gait-slip. Our results indicated that 28.6% of individuals in the training group and 55.0% of controls fell when responding to the overground slip. In comparison with the control group, the training group exhibited better control over the compensatory step and dynamic stability at the instant immediately prior to recovery touchdown. The improved dynamic stability control in the training group likely resulted from the enhanced capability of harnessing the slip kinematics of the base of support. Dynamic stability did not display any significant group-associated difference at slipping foot touchdown and recovery foot liftoff. This implies that a stance-slip perturbation training protocol with eight slips may not provide enough and very task-specific incentive to the Central Nervous System to form the capability of sufficiently modifying regular gait pattern after an unexpected gait slip. However, given its ease of use, stance-perturbation could be a practical option to train individuals in clinical settings as a simple push or pull could exert a perturbation to a standing individual. The findings from this study provide information for developing future studies based on large-scale samples.

Varying negative work assistance at the ankle with a soft exosuit during loaded walking.

BACKGROUND: Only very recently, studies have shown that it is possible to reduce the metabolic rate of unloaded and loaded walking using robotic ankle exoskeletons. Some studies obtained this result by means of high positive work assistance while others combined negative and positive work assistance. There is no consensus about the isolated contribution of negative work assistance. Therefore, the aim of the present study is to examine the effect of varying negative work assistance at the ankle joint while maintaining a fixed level of positive work assistance with a multi-articular soft exosuit. METHODS: We tested eight participants during walking at 1.5 ms-1 with a 23-kg backpack. Participants wore a version of the exosuit that assisted plantarflexion via Bowden cables tethered to an off-board actuation platform. In four active conditions we provided different rates of exosuit bilateral ankle negative work assistance ranging from 0.015 to 0.037 W kg-1 and a fixed rate of positive work assistance of 0.19 W kg-1. RESULTS: All active conditions significantly reduced metabolic rate by 11 to 15% compared to a reference condition, where the participants wore the exosuit but no assistance was provided. We found no significant effect of negative work assistance. However, there was a trend (p = .08) toward greater reduction in metabolic rate with increasing negative work assistance, which could be explained by observed reductions in biological ankle and hip joint power and moment. CONCLUSIONS: The non-significant trend of increasing negative work assistance with increasing reductions in metabolic rate motivates the value in further studies on the relative effects of negative and positive work assistance. There may be benefit in varying negative work over a greater range or in isolation from positive work assistance.

Effects of visual deprivation on stability among young and older adults during treadmill walking.

The purposes of this study were 1) to investigate the effect of visual deprivation on stability during treadmill walking in older and young adults, and 2) to examine if such an effect differs between age groups. Under the protection of a safety harness, 10 young (23.20±2.44years) and six older adults (67.83±2.48years) participants performed two 90-s walking trials (one with eyes open or EO and the other with eyes closed or EC) at their self-selected treadmill walking speeds determined during EO walking. The step length, step width, foot landing angle, the duration of stance phase, and cadence were calculated from the foot kinematics collected for each participant. The variability (i.e., the standard deviation) of step length, step width, foot landing angle, and the duration of stance phase was also calculated to quantify the stability during walking. Our results revealed that both young and older adults took a cautious gait pattern during EC walking, as evidenced by the shorter step length, smaller foot landing angle and shortened stance phase compared to EO walking. Under both visual conditions, older adults exhibited shorter step length and smaller foot landing angle than their young counterparts. No age-related differences were observed for the measurements of variability (i.e., the quantification of stability) while the variability measurement of all four variables was higher during EC walking than during EO walking for both age groups. Findings from this study could provide insights into the mechanisms of how visual information affects stability during gait.

Constraining eye movement in individuals with Parkinson's disease during walking turns.

Walking and turning is a movement that places individuals with Parkinson's disease (PD) at increased risk for fall-related injury. However, turning is an essential movement in activities of daily living, making up to 45 % of the total steps taken in a given day. Hypotheses regarding how turning is controlled suggest an essential role of anticipatory eye movements to provide feedforward information for body coordination. However, little research has investigated control of turning in individuals with PD with specific consideration for eye movements. The purpose of this study was to examine eye movement behavior and body segment coordination in individuals with PD during walking turns. Three experimental groups, a group of individuals with PD, a group of healthy young adults (YAC), and a group of healthy older adults (OAC), performed walking and turning tasks under two visual conditions: free gaze and fixed gaze. Whole-body motion capture and eye tracking characterized body segment coordination and eye movement behavior during walking trials. Statistical analysis revealed significant main effects of group (PD, YAC, and OAC) and visual condition (free and fixed gaze) on timing of segment rotation and horizontal eye movement. Within group comparisons, revealed timing of eye and head movement was significantly different between the free and fixed gaze conditions for YAC (p < 0.001) and OAC (p < 0.05), but not for the PD group (p > 0.05). In addition, while intersegment timings (reflecting segment coordination) were significantly different for YAC and OAC during free gaze (p < 0.05), they were not significantly different in PD. These results suggest individuals with PD do not make anticipatory eye and head movements ahead of turning and that this may result in altered segment coordination during turning. As such, eye movements may be an important addition to training programs for those with PD, possibly promoting better coordination during turning and potentially reducing the risk of falls.

Simulated visual field loss does not alter turning coordination in healthy young adults.

Turning, while walking, is an important component of adaptive locomotion. Current hypotheses regarding the motor control of body segment coordination during turning suggest heavy influence of visual information. The authors aimed to examine whether visual field impairment (central loss or peripheral loss) affects body segment coordination during walking turns in healthy young adults. No significant differences in the onset time of segments or intersegment coordination were observed because of visual field occlusion. These results suggest that healthy young adults can use visual information obtained from central and peripheral visual fields interchangeably, pointing to flexibility of visuomotor control in healthy young adults. Further study in populations with chronic visual impairment and those with turning difficulties are warranted.

Constraining eye movement when redirecting walking trajectories alters turning control in healthy young adults.

Humans use a specific steering synergy, where the eyes and head lead rotation to the new direction, when executing a turn or change in direction. Increasing evidence suggests that eye movement is critical for turning control and that when the eyes are constrained, or participants have difficulties making eye movements, steering control is disrupted. The purpose of the current study was to extend previous research regarding eye movements and steering control to a functional walking and turning task. This study investigated eye, head, trunk, and pelvis kinematics of healthy young adults during a 90° redirection of walking trajectory under two visual conditions: Free Gaze (the eyes were allowed to move naturally in the environment), and Fixed Gaze (participants were required to fixate the eyes on a target in front). Results revealed significant differences in eye, head, and trunk coordination between Free Gaze and Fixed Gaze conditions (p < 0.001). During Free Gaze, the eyes led reorientation followed by the head and trunk. Intersegment timings between the eyes, head, and trunk were significantly different (p < 0.05). In contrast, during Fixed Gaze, the segments moved together with no significant differences between segment onset times. In addition, the sequence of segment rotation during Fixed Gaze suggested a bottom-up postural perturbation control strategy in place of top-down steering control seen in Free Gaze. The results of this study support the hypothesis that eye movement is critical for the release of the steering synergy for turning control.