Temporal Variability in Stride Kinematics during the Application of TENS: A Machine Learning Analysis.

INTRODUCTION: The purpose of our report was to use a Random Forest classification approach to predict the association between transcutaneous electrical nerve stimulation (TENS) and walking kinematics at the stride level when middle-aged and older adults performed the 6-min test of walking endurance. METHODS: Data from 41 participants (aged 64.6 ± 9.7 years) acquired in two previously published studies were analyzed with a Random Forest algorithm that focused on upper and lower limb, lumbar, and trunk kinematics. The four most predictive kinematic features were identified and utilized in separate models to distinguish between three walking conditions: burst TENS, continuous TENS, and control. SHAP analysis and linear mixed models were used to characterize the differences among these conditions. RESULTS: Modulation of four key kinematic features - toe-out angle, toe-off angle, and lumbar range of motion (ROM) in coronal and sagittal planes - accurately predicted walking conditions for the burst (82% accuracy) and continuous (77% accuracy) TENS conditions compared with control. Linear mixed models detected a significant difference in lumbar sagittal ROM between the TENS conditions. SHAP analysis revealed that burst TENS was positively associated with greater lumbar coronal ROM, smaller toe-off angle, and less lumbar sagittal ROM. Conversely, continuous TENS was associated with less lumbar coronal ROM and greater lumbar sagittal ROM. CONCLUSIONS: Our approach identified four kinematic features at the stride level that could distinguish between the three walking conditions. These distinctions were not evident in average values across strides.

Influence of transcutaneous electrical nerve stimulation on the distance walked by older adults during the 6-min test of walking endurance.

The purpose of our study was to compare the influence of two types of transcutaneous electrical nerve stimulation (TENS) on the performance of older adults on the 6-min test of walking endurance and on the ability to maintain balance during upright standing. Twenty-six healthy older adults (72 ± 5.4 yrs) performed tests of motor function while TENS was applied to the tibialis anterior and rectus femoris muscles of each leg. Linear mixed models were used to compare the influence of TENS on walking distance in a 6-min test of walking endurance and on sway-area rate in tests of standing balance. There was a significant decrease in the distances walked in each minute of the 6-min walk test for both the Continuous and Burst TENS modes compared with Baseline (p < 0.01 and p < 0.001, respectively). The influence of TENS on walking distance was associated with several significant effects on the mean and coefficient of variation for stride length and stride frequency between the first and last minute of the test and between the two TENS modes and the Baseline values. In contrast, there was no significant effect of TENS on sway-area rate in any balance test, which indicates that the supplementary sensory feedback compromised walking performance of older adults but not the ability to maintain balance during upright standing.

Practice-Induced Changes in Manual Dexterity of Older Adults Depend on Initial Pegboard Time.

INTRODUCTION: The purpose of our study was to determine the influence of practice on the pegboard times and peg-manipulation phases of older adults who were classified as having either slow or fast initial pegboard times. METHODS: Participants ( n = 26, 70 ± 6.6 yr) completed two evaluation sessions and six practice sessions in which they performed 25 trials (5 blocks of 5 trials) of the grooved pegboard test. All practice sessions were supervised, and the time to complete each trial was recorded. In each evaluation session, the pegboard was mounted on a force transducer so that the downward force applied to the board could be measured. RESULTS: Participants were stratified into two groups based on the initial time to complete the grooved pegboard test: a fast group (68.1 ± 6.0 s) and a slow group (89.6 ± 9.2 s). Both groups exhibited the classic two-phase profile (acquisition + consolidation) for learning a de novo motor skill. Despite the similar learning profile for the two groups, there were differences between groups in the phases of the peg-manipulation cycle that became faster with practice. The fast group seemed to reduce trajectory variability when transporting the peg, whereas the slow group seemed to exhibit both a decrease in trajectory variability and greater precision when inserting pegs into the holes. CONCLUSIONS: The changes underlying practice-induced decreases in grooved pegboard time differed for older adults who initially had either a fast or a slow pegboard time.