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1.
BMC Geriatr ; 22(1): 648, 2022 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-35941561

RESUMO

BACKGROUND: Aging is associated with an increased likelihood of developing dementia, but a growing body of evidence suggests that certain modifiable risk factors may help prevent or delay dementia onset. Among these, physical activity (PA) has been linked to better cognitive performance and brain functions in healthy older adults and may contribute to preventing dementia. The current pilot study investigated changes in behavioral and brain activation patterns over a 1-year period in individuals with mild cognitive impairment (MCI) and healthy controls taking part in regular PA. METHODS: Frontal cortical response during a dual-task walking paradigm was investigated at baseline, at 6 months (T6), and at 12 months (T12) by means of a portable functional Near-Infrared Spectroscopy (fNIRS) system. The dual-task paradigm included a single cognitive task (2-back), a single motor task (walking), and a dual-task condition (2-back whilst walking). RESULTS: Both groups showed progressive improvement in cognitive performance at follow-up visits compared to baseline. Gait speed remained stable throughout the duration of the study in the control group and increased at T6 for those with MCI. A significant decrease in cortical activity was observed in both groups during the cognitive component of the dual-task at follow-up visits compared to baseline, with MCI individuals showing the greatest improvement. CONCLUSIONS: The observations of this pilot study suggest that taking part in regular PA may be especially beneficial for both cognitive performance and brain functions in older adulthood and, especially, in individuals with MCI. Our findings may serve as preliminary evidence for the use of PA as a potential intervention to prevent cognitive decline in individuals at greater risk of dementia.


Assuntos
Disfunção Cognitiva , Demência , Idoso , Encéfalo , Cognição , Demência/complicações , Marcha/fisiologia , Humanos , Projetos Piloto
2.
Biomed Res Int ; 2022: 8417089, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35937395

RESUMO

Gait stability in exercise is an inevitable and vexing problem in mechanics, artificial intelligence, sports, and rehabilitation medicine research. With the rapid development and popularization of science and technology, it becomes a reality for researchers to obtain large-scale human motion data sets in real time with higher efficiency. However, at present, the analysis of gait stability of moving joints is still based on image recognition technology, which is ten times less accurate and inefficient. In this paper, Vicon 3D motion capture system, dynamometer, and surface electromyography system were used to obtain the parameters of the lower limbs of the subjects. Using Anywhere modeling and simulation system, simulation experiments were carried out, and the reaction force data of lower limb joints under two environments were obtained. The gait characteristics of human gait were analyzed from the angle of internal and external adjustment mechanism. Combining one-way ANOVA and incremental occupancy rate, the adjustment process of gait stability is described comprehensively. The findings of this study can provide a theoretical basis for the research of lower limb con-assistive devices and can guide the design and development of bipedal anthropomorphic robots.


Assuntos
Inteligência Artificial , Transtornos Neurológicos da Marcha , Fenômenos Biomecânicos , Marcha , Transtornos Neurológicos da Marcha/reabilitação , Humanos , Extremidade Inferior
3.
Sci Prog ; 105(3): 368504221117895, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35938190

RESUMO

The aim of the prosthetic devices is to replicate the able-bodied angle-torque profile of a healthy human during locomotion. A lightweight and energy-efficient ankle joint is able to lower the actuator peak power and/or energy consumption per gait cycle, while adequately fulfilling the profile matching constraints. This study presents the design optimization of the prosthetic ankle joint containing an elastic element and actuator coupled with a rigid triangular part. The dimensions of the ankle joint triangular part were optimized to minimize actuator peak power and maximize spring energy within its elastic limits. As a result of series simulation tests, at 1.1 and 1.6 m/s walking speeds, the simulation of dorsi/plantar flexion shows up to 78.8% and 66.98% reduction in motor peak power compared to a direct drive system, respectively. Low power ankle-prosthetic device that closely matches the angle-torque profile of a healthy human's ankle, is one of the key parameters for the cost-effectiveness of lower limb prostheses.


Assuntos
Tornozelo , Membros Artificiais , Fenômenos Biomecânicos , Marcha , Humanos , Caminhada
4.
Zh Nevrol Psikhiatr Im S S Korsakova ; 122(7. Vyp. 2): 14-18, 2022.
Artigo em Russo | MEDLINE | ID: mdl-35912551

RESUMO

The most common and important consequence of multiple sclerosis (MS) is impaired walking, which limits daily activities and increases the risk of falling. This article provides an overview of the main non-pharmacological methods of medical rehabilitation of gait disorders in people with MS (aerobic and strength training, robotic technologies, orthotics and functional electrical stimulation), which have an evidence base on systematic reviews and meta-analyses. Special attention is paid to the approach to rehabilitation in people with severe disabilities. Methods for determining gait parameters using tests and high-tech devices are considered, which serve as the basis for the routine assessment of the domains of the International Classification of Functioning (ICF) and the effectiveness of interventions.


Assuntos
Transtornos Neurológicos da Marcha , Transtornos dos Movimentos , Esclerose Múltipla , Marcha , Transtornos Neurológicos da Marcha/etiologia , Humanos , Caminhada/fisiologia
6.
Sci Data ; 9(1): 473, 2022 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-35922448

RESUMO

Human gait data have traditionally been recorded in controlled laboratory environments focusing on single aspects in isolation. In contrast, the database presented here provides recordings of everyday walk scenarios in a natural urban environment, including synchronized IMU-, FSR-, and gaze data. Twenty healthy participants (five females, fifteen males, between 18 and 69 years old, 178.5 ± 7.64 cm, 72.9 ± 8.7 kg) wore a full-body Lycra suit with 17 IMU sensors, insoles with eight pressure sensing cells per foot, and a mobile eye tracker. They completed three different walk courses, where each trial consisted of several minutes of walking, including a variety of common elements such as ramps, stairs, and pavements. The data is annotated in detail to enable machine-learning-based analysis and prediction. We anticipate the data set to provide a foundation for research that considers natural everyday walk scenarios with transitional motions and the interaction between gait and gaze during walking.


Assuntos
Marcha , Caminhada , Adulto , Idoso , Bases de Dados Factuais , Feminino , , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
7.
J Neuroeng Rehabil ; 19(1): 84, 2022 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-35922846

RESUMO

OBJECTIVES: This systematic review and meta-analysis aim to summarize and analyze the available evidence of non-invasive brain stimulation/spinal cord stimulation on gait, balance and/or lower limb motor recovery in stroke patients. METHODS: The PubMed database was searched from its inception through to 31/03/2021 for randomized controlled trials investigating repetitive transcranial magnetic stimulation or transcranial/trans-spinal direct current/alternating current stimulation for improving gait, balance and/or lower limb motor function in stroke patients. RESULTS: Overall, 25 appropriate studies (including 657 stroke subjects) were found. The data indicates that non-invasive brain stimulation/spinal cord stimulation is effective in supporting recovery. However, the effects are inhomogeneous across studies: (1) transcranial/trans-spinal direct current/alternating current stimulation induce greater effects than repetitive transcranial magnetic stimulation, and (2) bilateral application of non-invasive brain stimulation is superior to unilateral stimulation. CONCLUSIONS: The current evidence encourages further research and suggests that more individualized approaches are necessary for increasing effect sizes in stroke patients.


Assuntos
Acidente Vascular Cerebral , Estimulação Magnética Transcraniana , Encéfalo/fisiologia , Marcha , Humanos , Extremidade Inferior , Acidente Vascular Cerebral/terapia , Reabilitação do Acidente Vascular Cerebral , Estimulação Transcraniana por Corrente Contínua , Estimulação Magnética Transcraniana/métodos
8.
Age Ageing ; 51(8)2022 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-35930726

RESUMO

BACKGROUND: exergaming-based interventions (EbIs) have been proposed to improve older adults' mobility and balance performance. However, the effectiveness of such interventions for older adults with Parkinson's disease (OAPD) remains unclear. METHODS: seven databases (Web of Science, Medline, Academic Search Premier, CINAHL Complete, PsycINFO, PsychARTICLE and PubMed) were searched up to 7 April 2022. We assessed mobility and balance performance between EbIs groups and control groups or traditional physical training interventions (TPTIs) groups by comparing the outcomes of the Timed Up and Go (TUG), 6-Minute Walk Test (6MWT), Berg Balance Scale (BBS), gait velocity, stride length and Functional Gait Assessment (FGA). RESULTS: we scanned 1,190 articles and meta-analysed 19 trials (sample size = 781). In general, the results revealed statistical differences between EbIs groups and TPTIs groups in the TUG [mean difference (MD) = -1.030 s; 95% confidence interval (CI) = -2.029 to -0.031; P = 0.043; high quality of evidence], 6MWT (MD = 63.483 m; 95% CI = 9.542 to 117.425; P = 0.021; moderate quality of evidence), BBS (MD = 2.129; 95% CI = -1.293 to 2.965; P < 0.001; high quality of evidence) and FGA (MD = 2.099 95% CI = -0.306 to 3.893; P = 0.022; moderate quality of evidence). No significant difference was discovered between EbIs groups and TPTIs groups in enhancing gait velocity and stride length. CONCLUSIONS: EbIs are statistically better than TPTIs in improving OAPD's performance in TUG, 6MWT, BBS and FGA, whereas only the change between EbIs and TPTIs in 6MWT can reach the value of minimal clinically important difference. Further studies are needed to better assess the effectiveness of exergaming-based interventions.


Assuntos
Doença de Parkinson , Idoso , Jogos Eletrônicos de Movimento , Marcha , Humanos , Doença de Parkinson/diagnóstico , Doença de Parkinson/terapia , Modalidades de Fisioterapia , Equilíbrio Postural , Ensaios Clínicos Controlados Aleatórios como Assunto
9.
Am J Vet Res ; 83(7)2022 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-35930785

RESUMO

OBJECTIVE: To collect kinetic gait reference data of dogs of 2 breeds in their growth period during walking and trotting gait, to describe their development, and to investigate the weight support pattern over time. ANIMALS: 8 Foxhound-Boxer-Ingelheim Labrador Retriever mixed breeds and 4 Beagles. PROCEDURES: Ground reaction force variables (GRFs), peak vertical force and vertical impulse, and temporal variables (TVs) derived therefrom; time of occurrence; and stance times were collected. Body weight distribution (BWD) was evaluated. Six measurements, each containing 1 trial in walking and 1 trial in trotting gait, were taken at age 10, 17, 26, 34, 52, and 78 weeks. The study period started July 17, 2013 and lasted until October 7, 2015. Area under the curve with respect to increase was applied. The difference of area under the curve with respect to increase values between breeds and gaits was analyzed using either the t test or the Mann-Whitney test. Generalized mixed linear models were applied. RESULTS: Significant differences in gait and breed comparisons were found. Growing dogs showed a forelimb-dominated gait. The development of GRF and TV values over the study period were described. CLINICAL RELEVANCE: Reference values for GRFs, TVs, and BWDs in growing dogs were given. A cranial shift in weight support over time was found during trotting gait. Smaller, younger dogs walked and trotted more inconsistently.


Assuntos
Análise da Marcha , Marcha , Animais , Fenômenos Biomecânicos , Cães , Membro Anterior , Membro Posterior , Cinética , Caminhada
10.
PLoS One ; 17(8): e0269061, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35925954

RESUMO

Comprehensive data sets for lower-limb kinematics and kinetics during slope walking and running are important for understanding human locomotion neuromechanics and energetics and may aid the design of wearable robots (e.g., exoskeletons and prostheses). Yet, this information is difficult to obtain and requires expensive experiments with human participants in a gait laboratory. This study thus presents an empirical mathematical model that predicts lower-limb joint kinematics and kinetics during human walking and running as a function of surface gradient and stride cycle percentage. In total, 9 males and 7 females (age: 24.56 ± 3.16 years) walked at a speed of 1.25 m/s at five surface gradients (-15%, -10%, 0%, +10%, +15%) and ran at a speed of 2.25 m/s at five different surface gradients (-10%, -5%, 0%, +5%, +10%). Joint kinematics and kinetics were calculated at each surface gradient. We then used a Fourier series to generate prediction equations for each speed's slope (3 joints x 5 surface gradients x [angle, moment, mechanical power]), where the input was the percentage in the stride cycle. Next, we modeled the change in value of each Fourier series' coefficients as a function of the surface gradient using polynomial regression. This enabled us to model lower-limb joint angle, moment, and power as functions of the slope and as stride cycle percentages. The average adjusted R2 for kinematic and kinetic equations was 0.92 ± 0.18. Lastly, we demonstrated how these equations could be used to generate secondary gait parameters (e.g., joint work) as a function of surface gradients. These equations could be used, for instance, in the design of exoskeletons for walking and running on slopes to produce trajectories for exoskeleton controllers or for educational purposes in gait studies.


Assuntos
Marcha , Caminhada , Adulto , Articulação do Tornozelo , Fenômenos Biomecânicos , Feminino , Humanos , Cinética , Extremidade Inferior , Masculino , Adulto Jovem
11.
Comput Intell Neurosci ; 2022: 2982894, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35942464

RESUMO

The study of plantar pressure has become a research consensus in the field of biomechanics. The purpose of this paper is to study some lower limb movements in the daily activities of ice and snow athletes to obtain relevant data so as to carry out gait recognition analysis research. This paper selects the average foot pressure, forefoot foot pressure, front and rear foot pressure, foot pressure, toe pressure, 2-5 toe pressure, standing with eyes closed, x- and y-axes speed, foot length, foot width, and other actions of ice and snow athletes. Therefore, correlation analysis, work analysis, and curve fitting analysis were carried out on the joint motion in a single gait cycle. The collection and application of foot pressure and foot posture information are also analyzed. According to the plantar structure, the sole is divided into four parts. The maximum pressure point and coordinates of each part, the pressure center point, the ratio of the width and height of the sole of the foot, and so on are extracted as the haptic features of the gait. The experimental data shows that it can be seen that if the plantar area is divided in advance and the weight of each area is marked, whether standing, walking, or standing with one leg closed eyes can achieve better recognition results, and the accuracy rate is all more than 90 percent. The average recognition accuracy rate using the method of dividing four regions is only about 80%, and the accuracy rate of recognition using the method of dividing eight regions is 82%. It can be seen that the features extracted by the FCM model proposed in this paper contain more information of the plantar pressure image, and the accuracy rate is higher in the classification and recognition.


Assuntos
Gelo , Neve , Atletas , Fenômenos Biomecânicos , Marcha , Humanos , Pressão , Caminhada
12.
Zhongguo Zhen Jiu ; 42(7): 726-30, 2022 Jul 12.
Artigo em Chinês | MEDLINE | ID: mdl-35793880

RESUMO

OBJECTIVE: To compare the clinical efficacy between Jiao's scalp acupuncture combined with virtual reality (VR) rehabilitation training and VR rehabilitation training alone for motor dysfunction in patients with Parkinson's disease (PD). METHODS: A total of 52 patients with PD were randomly divided into an observation group and a control group, 26 cases in each group. The patients in both groups were treated with routine basic treatment, and the patients in the control group were treated with VR rehabilitation training. The patients in the observation group were treated with Jiao's scalp acupuncture on the basis of the control group. The scalp points included the movement area, balance area and dance tremor control area. Both groups were treated once a day, 5 times a week for a total of 8 weeks. Before treatment and 4 and 8 weeks into treatment, the gait parameters (step distance, step width, step speed and step frequency), timed "up and go" test (TUGT) time and unified Parkinson's disease rating scale part Ⅲ (UPDRS-Ⅲ) score were compared between the two groups, and the clinical efficacy was evaluated. RESULTS: Four weeks into treatment, except for the step width in the control group, the gait parameters of the two groups were improved, the TUGT time was shortened, and the UPDRS-Ⅲ scores were reduced (P<0.01, P<0.05); the step distance in the observation group was better than that in the control group, and the UPDRS-Ⅲ score in the observation group was lower than that in the control group (P<0.05). Eight weeks into treatment, the gait parameters of the two groups were improved, the TUGT time was shortened, and the UPDRS-Ⅲ scores were reduced (P<0.01); the step distance and step speed in the observation group were better than those in the control group, the TUGT time in the observation group was shorter than that in the control group, and the UPDRS-Ⅲ score in the observation group was lower than that in the control group (P<0.05, P<0.01). The total effective rate was 92.3% (24/26) in the observation group, which was higher than 69.2% (18/26) in the control group (P<0.05). CONCLUSION: Jiao's scalp acupuncture combined with VR rehabilitation training could improve the gait parameters, walking ability and motor function in patients with PD. The clinical effect is better than VR rehabilitation training alone.


Assuntos
Terapia por Acupuntura , Doença de Parkinson , Realidade Virtual , Terapia por Acupuntura/efeitos adversos , Marcha , Humanos , Doença de Parkinson/terapia , Couro Cabeludo
13.
Biomed Res Int ; 2022: 1869922, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35782074

RESUMO

Proximal fibula osteotomy (PFO) is a relatively new surgery to treat medial compartment knee osteoarthritis (KOA), which can improve varum deformity and relieve knee joint pain. However, the gait alterations in KOA patients after PFO are still poorly understood. The purpose of this study was to evaluate the gait patterns change in patients of medial compartment KOA after PFO. Gait data were collected for 9 females with unilateral medial compartment KOA before and at 6 months after PFO and also for 9 healthy age-matched females. Paired t-test was used to determine the effect of PFO within the KOA group, and independent t-test were performed to compare between KOA and control groups for spatiotemporal, kinematic, and kinetic variables. The results showed that patients with KOA had significantly increased knee peak flexion angle, knee sagittal range of motion, and peak external hip adduction moment but decreased knee frontal range of motion in the affected limb after PFO. The gait symmetry was improved postoperatively confirmed by single support and swing phases, knee peak flexion angle and sagittal range of motion, peak external hip and knee adduction moments, and peak anterior and peak posterior ground reaction forces. These findings provided evidence of a biomechanical benefit and gait improvement following PFO to treat medial compartment KOA.


Assuntos
Osteoartrite do Joelho , Feminino , Fíbula/cirurgia , Marcha , Humanos , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/cirurgia , Osteotomia
14.
BMC Musculoskelet Disord ; 23(1): 663, 2022 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-35820837

RESUMO

BACKGROUND: Trimalleolar fracture is a common ankle fracture with serious complications and costly healthcare problem. Most studies used clinical assessments to evaluate the functional status of the patients. Although clinical assessments are valid, they are static and subjective. Dynamic, objective and precise evaluations such as gait analysis are needed. Ankle biomechanics studies on gait in patients with trimalleolar fractures are still rare. This study aimed to investigate the clinical outcomes and gait biomechanics in patients with trimalleolar fractures in the early postoperative period and compared to healthy controls. METHODS: This was a cross-sectional study. 12 patients with trimalleolar fractures were recruited, and 12 healthy people served as controls. All patients underwent clinical assessments: Olerud and Molander ankle score (OMAS), ankle swelling and passive range of motion (ROM) of ankle, and completed gait biomechanical analysis when weight-bearing was allowed: temporal-spatial parameters, plantar pressure distributions, and surface electromyography (sEMG). The control group only performed gait test. RESULTS: Patients had poor outcomes of clinical assessments in the short-term. During gait analysis, patients presented compromised gait patterns: shorter step length, larger step width, slower walking speed and shorter single support compared to healthy controls (P < 0.001), and patients showed asymmetrical gait. Symmetry index of step width and walking speed were mainly correlated with the difference of ankle inversion ROM between two sides (R = -0.750, P = 0.005; R = -0.700, P = 0.011). During walking, patients showed abnormal dynamic plantar pressure features (mainly in the hindfoot and forefoot regions), and the IEMG (integrated electromyography) of tibial anterior muscle (TA) and peroneal longus muscle (PL) were larger than healthy controls (P = 0.002, 0.050). CONCLUSIONS: Patients with trimalleolar fractures showed physical impairments of the ankle, and presented altered gait parameters compared to healthy subjects in the short-term. The ankle stability of patients declined, and deficits in TA and PL muscle ability might contribute to it. Restoring complete muscle functions and improving passive ankle ROM are significant to promote the recovery of a normal gait pattern.


Assuntos
Fraturas do Tornozelo , Fraturas do Tornozelo/cirurgia , Estudos Transversais , Marcha/fisiologia , Análise da Marcha , Humanos , Período Pós-Operatório
15.
Biomed Res Int ; 2022: 4043426, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35832852

RESUMO

The efficacy of the variance equality test in steady-state gait analysis is well documented; however, temporal information on where differences in variability occur during gait subtasks, especially during gait termination caused by unexpected stimulation, is poorly understood. Therefore, the purpose of the current study was to further verify the efficacy of the waveform-level variance equality test in gait subtasks by comparing temporal kinematical variability between planned gait termination (PGT) and unplanned gait termination (UGT) caused by unexpected stimulation. Thirty-two asymptomatic male subjects were recruited to participate in the study. A Vicon motion capture system was utilized to measure lower extremity kinematics during gait termination tasks with and without unexpected stimulation conditions. The F-statistic for each interval of the temporal kinematic waveform was compared to the critical value using a variance equality test to identify significant differences in the waveform. Comparative tests between two types of gait terminations found that subjects may exhibit greater kinematics variance in most lower limb joints during UGT caused by unexpected stimulation (especially at stimulus delay and reaction phases). Significant greater variances during PGT were exhibited only in the MPJ sagittal and frontal planes at the early stimulus delay phase (4-15% and 1-15%). This recorded dataset of temporal kinematic changes caused by unexpected stimuli during gait termination is essential for interpreting lower limb biomechanical function and injury prediction in relation to UGT. Given the complexity of the gait termination task, which involves both internal and external variability, the variance equality test can be used as a valuable method to compare temporal differences in the variability of biomechanical variables.


Assuntos
Análise da Marcha , Marcha , Fenômenos Biomecânicos/fisiologia , Marcha/fisiologia , Análise da Marcha/métodos , Humanos , Extremidade Inferior/fisiologia , Masculino , Movimento (Física)
16.
IEEE J Transl Eng Health Med ; 10: 2200111, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35795875

RESUMO

OBJECTIVE: To develop an objective and efficient method to automatically identify Parkinson's disease (PD) and healthy control (HC). METHODS: We design a novel model based on residual network (ResNet) architecture, named PD-ResNet, to learn the gait differences between PD and HC and between PD with different severity levels. Specifically, a polynomial elevated dimensions technique is applied to increase the dimensions of the input gait features; then, the processed data is transformed into a 3-dimensional picture as the input of PD-ResNet. The synthetic minority over-sampling technique (SMOTE), data augmentation, and early stopping technologies are adopted to improve the generalization ability. To further enhance the classification performance, a new loss function, named improved focal loss function, is developed to focus on the train of PD-ResNet on the hard samples and to discard the abnormal samples. RESULTS: The experiments on the clinical gait dataset show that our proposed model achieves excellent performance with an accuracy of 95.51%, a precision of 94.44%, a recall of 96.59%, a specificity of 94.44%, and an F1-score of 95.50%. Moreover, the accuracy, precision, recall, specificity, and F1-score for the classification of early PD and HC are 92.03%, 94.20%, 90.28%, 93.94%, and 92.20%, respectively. Furthermore, the accuracy, precision, recall, specificity, and F1-score for the classification of PD with different severity levels are 92.03%, 94.29%, 90.41%, 93.85%, and 92.31%, respectively. CONCLUSION: Our proposed method shows better performance than the traditional machine learning and deep learning methods. CLINICAL IMPACT: The experimental results show that the proposed method is clinically meaningful for the objective assessment of gait motor impairment for PD patients.


Assuntos
Doença de Parkinson , Algoritmos , Progressão da Doença , Marcha , Humanos , Aprendizado de Máquina , Doença de Parkinson/diagnóstico
17.
Sci Rep ; 12(1): 9842, 2022 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-35798755

RESUMO

Humans typically coordinate their muscles to meet movement objectives like minimizing energy expenditure. In the presence of pathology, new objectives gain importance, like reducing loading in an osteoarthritic joint, but people often do not change their muscle coordination patterns to meet these new objectives. Here we use musculoskeletal simulations to identify simple changes in coordination that can be taught using electromyographic biofeedback, achieving the therapeutic goal of reducing joint loading. Our simulations predicted that changing the relative activation of two redundant ankle plantarflexor muscles-the gastrocnemius and soleus-could reduce knee contact force during walking, but it was unclear whether humans could re-coordinate redundant muscles during a complex task like walking. Our experiments showed that after a single session of walking with biofeedback of summary measures of plantarflexor muscle activation, healthy individuals reduced the ratio of gastrocnemius-to-soleus muscle activation by 25 ± 15% (p = 0.004, paired t test, n = 10). Participants who walked with this "gastrocnemius avoidance" gait pattern reduced late-stance knee contact force by 12 ± 12% (p = 0.029, paired t test, n = 8). Simulation-informed coordination retraining could be a promising treatment for knee osteoarthritis and a powerful tool for optimizing coordination for a variety of rehabilitation and performance applications.


Assuntos
Biorretroalimentação Psicológica , Articulação do Joelho , Fenômenos Biomecânicos , Eletromiografia , Marcha/fisiologia , Humanos , Articulação do Joelho/fisiologia , Músculo Esquelético/fisiologia , Caminhada/fisiologia
18.
Artigo em Inglês | MEDLINE | ID: mdl-35805289

RESUMO

This study aimed to examine the linear and nonlinear associations between sleep duration and gait speed and the risk of developing mild cognitive impairment (MCI) in community-dwelling older adults. Participants were 233 older adults who met the study inclusion criteria. The MCI diagnosis was based on medical evaluations through a clinical interview conducted by a dementia specialist. Self-reported sleep duration was evaluated using the Pittsburgh Sleep Quality Index. The usual gait speed was calculated from the time taken to walk along a 4 m walkway. Multivariate logistic regression analysis was used to calculate the odds ratio (OR) and the 95% confidence interval (95% CI) of developing MCI in relation to sleep duration and gait speed. Generalized additive models were used to examine the dose-response relationships between sleep duration, gait speed, and the risk of developing MCI. Slower gait speed (OR: 1.84, 95%; CI: 1.00-3.13) and poor sleep duration (OR: 1.76, 95%; CI: 1.00-3.35) were associated with the risk of developing MCI, compared with their optimal status. In addition, the combination of poor sleep and slower gait was associated with a higher risk of developing MCI than optimal sleep duration and gait speed (OR: 3.13, 95%; CI: 1.93-5.14). Furthermore, gait speed and sleep duration were non-linearly associated with the risk of developing MCI. These results highlight the complex interplay and synergism between sleep duration and gait abilities on the risk of developing MCI in older adults. In addition, our results suggest that slower gait speed (<1.0 m/s) and short (<330 min) and long (>480 min) sleep duration may be linked to MCI risks through underlying pathways.


Assuntos
Disfunção Cognitiva , Velocidade de Caminhada , Idoso , Disfunção Cognitiva/complicações , Marcha/fisiologia , Humanos , Vida Independente , Sono
19.
Artigo em Inglês | MEDLINE | ID: mdl-35805532

RESUMO

Nociplastic pain has been introduced by the IASP as a third category of pain, distinct from nociceptive and neuropathic pain. Pathogenetically, it is considered to be a continuum of these two types of pain after becoming chronic. Repetitive peripheral painful stimulation causes a central sensitization with hypersensitivity of the corresponding spinal metamer or brain region. Therefore, signs of altered nociception, such as allodynia, may be found on the tissues of the related dermatome, myotome and sclerotome, and characterize nociplastic pain. This kind of pain was found in over 20% of people with multiple sclerosis (pwMS), a demyelinating autoimmune disease that affects the central nervous system. Nociplastic pain may be an amplifier of spasticity, the main pyramidal symptom that affects about 80% of pwMS. This article details the case of a 36-year-old woman with multiple sclerosis who was affected by spasticity and non-specific pain of the lower limbs, disabling on walking. Previous analgesic and muscle relaxant treatment had no benefits. The diagnosis of nociplastic pain on the cutaneous tissue of the anterolateral region of the left thigh and its treatment with intradermal normal saline injection on the painful skin area showed immediate and lasting effects on pain and spasticity, improving significantly the patient's balance and walking, as assessed by a 3D motion analysis and rating scales.


Assuntos
Esclerose Múltipla , Neuralgia , Adulto , Feminino , Marcha , Humanos , Esclerose Múltipla/complicações , Espasticidade Muscular/tratamento farmacológico , Espasticidade Muscular/etiologia , Solução Salina
20.
Artigo em Inglês | MEDLINE | ID: mdl-35805699

RESUMO

The objective of this study was to investigate the therapeutic effect of Wuqinxi Qigong vs. stretching on single- and dual-task gait, motor symptoms, and quality of life in people with mild and moderate Parkinson's disease (PD). This single-blind, randomized control trial included 40 participants with idiopathic PD who were randomized into the Wuqinxi Qigong (WQ) group or stretching group. Participants completed 12 weeks (two sessions/week) of intervention. The primary outcomes were gait parameters when performing single-task (comfortable pace) and dual-task (obstacle crossing, serial-3 subtraction and backward digit span) walking, including gait speed, stride length, and double support percentage. The secondary outcomes were ratings from the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS), results of the timed-up-and-go test (TUGT), results of the Mini-Balance Evaluation Systems Test (MiniBESTest), and responses from the 39-item Parkinson's Disease Questionnaire (PDQ-39). All measures were assessed pre- and post-intervention. The WQ group demonstrated increased gait speed (p = 0.000) during the single task, and increased stride length (p = 0.001, p = 0.021) during the single-task and serial-3 subtraction task. Double support percentage significantly decreased (p = 0.004) in the WQ group during the obstacle crossing task, and also decreased (p = 0.045) in the stretching group during the single-task. TUGT (p = 0.005), MiniBESTest (p = 0.023) and PDQ-39 (p = 0.043) in the WQ group significantly improved, and both groups showed significant improvement in MDS-UPDRS after intervention. Wuqinxi Qigong is an effective method to improve single- and dual-task gait. While both exercises improve motor symptoms, Wuqinxi Qigong results in better mobility, balance and quality of life compared to stretching alone.


Assuntos
Doença de Parkinson , Qigong , Marcha/fisiologia , Humanos , Doença de Parkinson/complicações , Equilíbrio Postural , Qigong/métodos , Qualidade de Vida , Método Simples-Cego , Estudos de Tempo e Movimento
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