Gait variability in the context of a deterministic dynamical system may be quantified using nonlinear time series analyses that characterize the complexity of the system. Pathological gait exhibits altered gait variability. It can be either too periodic and predictable, or too random and disordered, as is the case with aging. While gait therapies often focus on restoration of linear measures such as gait speed or stride length, we propose that the goal of gait therapy should be to restore optimal gait variability, which exhibits chaotic fluctuations and is the balance between predictability and complexity. In this context, our purpose was to investigate how listening to different auditory stimuli affects gait variability. Twenty-seven young and 27 elderly subjects walked on a treadmill for 5 min while listening to white noise, a chaotic rhythm, a metronome, and with no auditory stimulus. Stride length, step width, and stride intervals were calculated for all conditions. Detrended Fluctuation Analysis was then performed on these time series. A quadratic trend analysis determined that an idealized inverted-U shape described the relationship between gait variability and the structure of the auditory stimuli for the elderly group, but not for the young group. This proof-of-concept study shows that the gait of older adults may be manipulated using auditory stimuli. Future work will investigate which structures of auditory stimuli lead to improvements in functional status in older adults.
Feedback based balance control requires the integration of visual, proprioceptive and vestibular input to detect the body’s movement within the environment. When the accuracy of sensory signals is compromised, the system reorganizes the relative contributions through a process of sensory recalibration, for upright postural stability to be maintained. Whereas this process has been studied extensively in standing using the Sensory Organization Test (SOT), less is known about these processes in more dynamic tasks such as locomotion. In the present study, ten healthy young adults performed the six conditions of the traditional SOT to quantify standing postural control when exposed to sensory conflict. The same subjects performed these six conditions using a novel experimental paradigm, the Locomotor SOT (LSOT), to study dynamic postural control during walking under similar types of sensory conflict. To quantify postural control during walking, the net Center of Pressure (netCOP) sway variability was used. This corresponds to the performance index of the center of pressure (COP) trajectory, which is used to quantify postural control during standing. Our results indicate that dynamic balance control during locomotion in healthy individuals is affected by the systematic manipulation of multisensory inputs. The sway variability patterns observed during locomotion reflect similar balance performance with standing posture, indicating that similar feedback processes may be involved. However, the contribution of visual input is significantly increased during locomotion, compared to standing in similar sensory conflict conditions. The increased visual gain in the LSOT conditions reflects the importance of visual input for the control of locomotion. Since balance perturbations tend to occur in dynamic tasks and in response to environmental constraints not present during the SOT, the LSOT may provide additional information for clinical evaluation on healthy and deficient sensory processing.
Music is often played in the operating room to increase the surgeon's concentration and to mask noise. It could have a beneficial effect on surgical performance. Ten participants with limited experience with the da Vinci robotic surgical system were recruited to perform two surgical tasks: suture tying and mesh alignment when classical, jazz, hip-hop, and Jamaican music were presented. Kinematics of the instrument tips of the surgical robot and surface electromyography of the subjects were recorded. Results revealed that a significant music effect was found for both tasks with decreased time to task completion (P = .005) and total travel distance (P = .021) as well as reduced muscle activations ( P = .016) and increased median muscle frequency (P = .034). Subjects improved their performance significantly when they listened to either hip-hop or Jamaican music. In conclusion, music with high rhythmicity has a beneficial effect on robotic surgical performance. Musical environment may benefit surgical training and make acquisition of surgical skills more efficient.
The performance of a robot-assisted surgical task was negatively affected by secondary tasks. However, residents with more surgical experience demonstrated a larger attention capacity for multitasking. Therefore, understanding how medical trainees respond to the distractive secondary tasks while performing robot-assisted surgical task is important in developing a surgical training programme based on the concept of attention.
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