Falling accidents are costly due to their prevalence in the workplace. Slipping has been known to be the main cause of falling. Understanding the motor response used to regain balance after slipping is crucial to developing intervention strategies for effective recovery. Interestingly, studies on spinalized animals and studies on animals subjected to electrical microstimulation have provided major evidence that the Central Nervous System (CNS) uses motor primitives, such as muscle synergies, to control motor tasks. Muscle synergies are thought to be a critical mechanism used by the CNS to control complex motor tasks by reducing the dimensional complexity of the system. Even though synergies have demonstrated potential for indicating how the body responds to balance perturbations by accounting for majority of the data set's variability, this concept has not been applied to slipping. To address this gap, data from 11 healthy young adults were collected and analyzed during both unperturbed walking and slipping. Applying an iterative non-negative matrix decomposition technique, four muscle synergies and the corresponding time-series activation coefficients were extracted. The synergies and the activation coefficients were then compared between baseline walking and slipping to determine shared vs. task-specific synergies. Correlation analyses found that among four synergies, two synergies were shared between normal walking and slipping. However, the other two synergies were task-specific. Both limbs were contributing to each of the four synergies, suggesting substantial inter-limb coordination during gait and slip. These findings stay consistent with previous unilateral studies that reported similar synergies between unperturbed and perturbed walking. Activation coefficients corresponding to the two shared synergies were similar between normal walking and slipping for the first 200 ms after heel contact and differed later in stance, suggesting the activation of muscle synergies in response to a slip. A muscle synergy approach would reveal the used sub-tasks during slipping, facilitating identification of impaired sub-tasks, and potentially leading to a purposeful rehabilitation based on damaged sub-functions.

Falls impose significant negative impacts to the US population and economy. A significant number of falls may be prevented via appropriate slip-responses since a strong relation exists between slips and falls. More importantly, as severe slips are more prone to result in a fall, identifying severe slippers along with the responsible factors for their adverse motor control and severe slipping should be the highest priority in fall prevention process. Previous studies have suggested that muscle synergies may be building blocks of the central nervous system in controlling motor tasks. Muscle synergies observed during slipping (‘post-slip-initiation synergies’ or ‘just briefly,’ ‘slipping muscle synergies’), may represent the fundamental blocks of the neural control during slipping. Hence, studying the differences in slipping muscle synergies of mild and severe slippers can potentially reveal the differences in their neural control and subsequently, indicate the responsible factors for the adverse post-slip response in severe slippers. Even though the slipping muscle synergies have been investigated before, it still remains unclear on how the slip severity is associated with the slipping muscle synergies. More importantly, muscle synergies can be interpreted not only as neural blocks but also as physical sub-tasks of the main motor task. Hence, studying the differences of slipping synergies of mild and severe slippers would reveal the discrepancies in sub-tasks of their post-slip response. These discrepancies help pinpoint the malfunctioning sub-function associated with inadequate motor response seen in severe slippers. Twenty healthy subjects were recruited and underwent an unexpected slip (to extract their slipping synergies). Subjects were classified into mild and severe slippers based on their Peak Heel Speed. An independent t-test revealed several significant inter-group differences for muscle synergies of mild and severe slippers indicating differences in their neural control of slipping. A forward dynamic simulation was utilized to reveal the functionality of each synergy. Decomposition of slipping into sub-tasks (synergies), and finding the malfunctioning sub-task in severe slippers is important as it results in a novel targeted motor-rehabilitation technique that only aims to re-establish the impaired sub-task responsible for the adverse motor-response in severe slippers.

Falls cause negative impacts on society and the economy. Slipping is a common initiating event for falling. Yet, individuals differ in their ability to recover from slips. Persons experiencing mild slips can accommodate the perturbation without falling, whereas severe slipping is associated with inadequate or slow pre-or post-slip control that make these individuals more prone to fall. Knowing the discrepancies between mild and severe slippers in kinematic and kinetic variables improves understanding of adverse control responsible for severe slipping. This study examined differences across these participants with respect to center of mass (COM) height, sagittal angular momentum (H), upper body kinematics, and the duration of single/double phase. Possible causality of such relationships was also studied by observing the time-lead of the deviations. Twenty healthy young adults performed walking trials in dry and slippery conditions. They were classified into mild and severe slippers based on their heel slipping speed. No inter-group differences were observed in the upper extremity kinematics. It was found that mild and severe slippers do not differ in the studied variables during normal gait; however, they do show significant differences through slipping. Compared to mild slippers, sever slippers lowered their COM height following a slip, presented higher H, and shortened their single support phase (p-value<0.05 for all). Based on the time-lead observed in H over all other variables suggests that failure to control angular momentum may influence slip severity.

Slipping is frequently responsible for falling injuries. Preventing slips, and more importantly severe slips, is of importance in fall prevention. Our previous study characterized mild slipping and severe slipping by the analysis of muscle synergies. Significant discrepancies in motor control of slipping have been observed between mild and severe slippers. We are further interested in whether differences exist in baseline motor control patterns between persons who experience mild and severe slips when exposed to a slippery contaminant. This study investigated walking with a muscle synergy approach to detect if walking muscle synergies differ between groups experiencing different slip severities. Twenty healthy young adults (eight mild slippers and 12 severe slippers) participated in this study and their muscle synergies of walking were extracted. Muscle synergy analysis showed that mild slippers had a higher contribution of hamstring and quadriceps during walking while severe slippers had increased contribution of the tibialis group. This study provides novel information that may contribute to identifying diagnostic techniques for identifying persons or populations with a high risk of fall based on their walking patterns.

1Falls vastly affect the economy and the society with their high cost, injuries, and mortalities. 2 Slipping is the main trigger for falling. Yet, individuals differ in their ability to recover from slips. 3

Background: Adult Degenerative Scoliosis (ADS) is a common musculoskeletal problem that commonly affects the elderly. ADS patients often suffer from low back pain and consequently have reduced mobility. Surgical alignment is one of the possible treatments in ADS patients. Due to the highly variant nature of the ADS, tracking and comparing the improvements following surgery can be challenging. Muscle synergy theory suggests that the central nervous system may use a few groups of coactive muscles (i.e., synergies) to achieve a motor task. Methods: In this study, we propose to use muscle synergy approach to determine the recovery from the ADS following surgery. More specifically, two metrics are proposed: i) the number of the required muscle synergies for a motor task and ii) an entropy-inspired measure (EnIM). Entropy is a measure of uncertainty in the data and has been shown to be sensitive to detect functional mobility enhancement. We hypothesize that the number of muscle synergies required for walking increases following surgery. We also hypothesize that EnIM associated with the muscle synergies decreases following surgery. Results: The results showed that the patients required a significantly higher number of walking muscle synergies following a surgery. Also, EnIM decreased significantly in ADS patients following surgical procedures, showing a more deterministic control. Conclusions: A muscle synergy approach in tracking the improvements in motor skills could be advantageous as it considers all of the involved muscles together, bypassing the potential subject-dependent differences. Trial registration: Western Institutional Review Board, #20151780. Participants were recruited from the ClinicalTrials.gov (registration no.: NCT02761265)

Slipping is frequently responsible for falling injuries. Preventing slips, and more importantly severe slips, is of importance in fall prevention. Our previous study characterized mild slipping and severe slipping by the analysis of muscle synergies. Significant discrepancies in motor control of slipping have been observed between mild and severe slippers. We are further interested in whether differences exist in baseline motor control patterns between persons who experience mild and severe slips when exposed to a slippery contaminant. This study investigated walking with a muscle synergy approach to detect if walking muscle synergies differ between groups experiencing different slip severities. Twenty healthy young adults (8 mild slippers and 12 severe slippers) participated in this study and their muscle synergies of walking were extracted. Muscle synergy analysis showed that mild slippers had a higher contribution of hamstring and quadriceps during walking while severe slippers had increased contribution of tibialis group. This study provides novel information that may contribute to identifying diagnostic techniques for identifying persons or populations with a high risk of fall based on their walking patterns.

No abstract