Anticipatory and reactive responses to underfoot perturbations during gait in healthy adults and individuals with a recent mild traumatic brain injury

Kreter, Nicholas; Rogers, Claire L.; Fino, Peter C.

doi:10.1016/j.clinbiomech.2021.105496

Cited by 5 publications

(10 citation statements)

References 23 publications

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“…We previously reported results in which healthy young adults completed walking tasks with underfoot eversion perturbations similar to stepping on a small rock that were either unexpected (no warning) or expected (warning tone approximately 600 ms before the perturbation) (Kreter, Rogers and Fino, 2021). When perturbations were unexpected, participants exhibited no kinematic differences relative to their normal walking pattern.…”

Section: Introductionmentioning

confidence: 99%

The effects of physical and temporal certainty on locomotion with discrete underfoot perturbations

Kreter

Lybbert

Gordon

et al. 2022

Preprint

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Background: Ambulation over complex terrain requires active control of foot placement to maintain a normal kinematic relationship between the center of mass and base of support. Recent investigations have suggested that foot placement location may be selected to anticipate shifts to the underfoot center of pressure. However, it is unclear whether temporal affordance and physical certainty contribute to the selection of a perturbation-specific anticipatory strategy. This study investigates anticipatory and reactive locomotor strategies for repeated underfoot perturbations with varying levels of temporal certainty, temporal affordance, and physical certainty. Methods: Thirteen healthy adults walked with random underfoot perturbations from a mechanized shoe. Temporal certainty was challenged by presenting the perturbations with or without warning. Temporal affordance was challenged by adjusting the timing of a warning tone before the perturbation. Physical certainty was challenged with conditions that included only eversion perturbations, only inversion perturbations, or both eversion and inversion perturbations. Linear-mixed effects models assessed the effect of each condition on the percent change of margin of stability and step width, respectively. Results: For temporally uncertain perturbations and perturbations with one stride or less of affordance, we observed few changes to step width or margin of stability. As affordance increased to two strides, participants adopted a wider step width in anticipation of the perturbation (p = 0.001). Physical certainty had little effect on gait for the step of the perturbation, but participants recovered normal gait sooner when the physical nature of the perturbation was predictable (p < 0.001). Discussion: Despite having information about the timing and magnitude of upcoming perturbations, individuals do not develop perturbation-specific feedforward strategies but instead rely on feedback control to recover normal gait after a perturbation. However, physical certainty appears to improve the efficiency of the feedback controller and allows individuals to recover normal gait sooner.

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Section: Introductionmentioning

confidence: 99%

The effects of physical and temporal certainty on locomotion with discrete underfoot perturbations

Kreter

Lybbert

Gordon

et al. 2022

Preprint

Self Cite

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“…One device applied vibrations to the hip abductor muscles [ 39 ]. One study used an oscillating pendulum system worn on participants’ backs [ 40 ], one study applied a mechanised block to the foot [ 41 ], and one study applied a narrow treadmill-based stepping task while participants were executing a cognitive task [ 42 ].…”

Section: Resultsmentioning

confidence: 99%

“…One study perturbed participants at 40% of stance phase [ 39 ], and another study perturbed participants at 10, 15, 20, and 30% of the gait cycle [ 24 ]. Three studies did not specify when within the gait cycle perturbations were applied [ 32 , 41 , 47 ].…”

Section: Resultsmentioning

confidence: 99%

“…Twelve studies allowed participants to walk at their preferred walking speed when perturbed [ 9 , 18 , 19 , 20 , 23 , 27 , 28 , 32 , 33 , 39 , 44 , 45 ]. Three studies did not report if gait speed was prescribed or self-selected [ 37 , 41 , 47 ].…”

Section: Resultsmentioning

confidence: 99%

“…Summary of Spatiotemporal : Eight studies reported the duration of gait phases [ 18 , 19 , 20 , 22 , 25 , 36 , 38 , 41 ]. Conflicting findings were reported in most spatiotemporal variables.…”

Section: Resultsmentioning

confidence: 99%

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Perturbations during Gait: A Systematic Review of Methodologies and Outcomes

Taylor

Walsh

Hawkins

et al. 2022

Sensors

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Background: Despite extensive literature regarding laboratory-based balance perturbations, there is no up-to-date systematic review of methods. This systematic review aimed to assess current perturbation methods and outcome variables used to report participant biomechanical responses during walking. Methods: Web of Science, CINAHL, and PubMed online databases were searched, for records from 2015, the last search was on 30th of May 2022. Studies were included where participants were 18+ years, with or without clinical conditions, conducted in non-hospital settings. Reviews were excluded. Participant descriptive, perturbation method, outcome variables and results were extracted and summarised. Bias was assessed using the Appraisal tool for Cross-sectional Studies risk of bias assessment tool. Qualitative analysis was performed as the review aimed to investigate methods used to apply perturbations. Results: 644 records were identified and 33 studies were included, totaling 779 participants. The most frequent method of balance perturbation during gait was by means of a treadmill translation. The most frequent outcome variable collected was participant step width, closely followed by step length. Most studies reported at least one spatiotemporal outcome variable. All included studies showed some risk of bias, generally related to reporting of sampling approaches. Large variations in perturbation type, duration and intensity and outcome variables were reported. Conclusions: This review shows the wide variety of published laboratory perturbation methods. Moreover, it demonstrates the significant impact on outcome measures of a study based on the type of perturbation used. Registration: PROSPERO ID: CRD42020211876.

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Acute and Longitudinal Effects of Sport-related Concussion on Reactive Balance

Monoli,

Morris,

Crofts

et al. 2024

Preprint

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Postural instability is a common observation after concussions, with balance assessments playing a crucial role in clinical evaluations. Widely used post-concussion balance tests focus primarily on static and dynamic balance, excluding the critical aspect of reactive balance. This study investigated the acute and longitudinal effects of concussion on reactive balance in collegiate athletes. The assessments were conducted at pre-season baseline and 4 post-concussion timepoints: acute, pre-return-to-play, post-return-to-play, and six months post-concussion. The instrumented-modified Push and Release test measured reactive balance. Longitudinal effects of concussions on time to stability and step latency metrics were investigated applying Generalized Estimating Equations. Acutely after concussion, athletes demonstrated impaired reactive balance, indicated by longer times to stability, in dual-task conditions (p= 0.004). These acute impairments were transient and recovered over time. Exploratory analyses revealed that athletes who sustained their first lifetime concussion exhibited both acute (p = 0.037) and longitudinal (p = 0.004 at post-return-to-play) impairments in single- and dual-task compared to controls with no lifetime concussion. This comprehensive evaluation provides insights into the multifaceted nature of post-concussion impairments and emphasizes the importance of considering cognitive demand and history of concussions in assessing athletes' balance.

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Anticipatory and reactive responses to underfoot perturbations during gait in healthy adults and individuals with a recent mild traumatic brain injury

Cited by 5 publications

References 23 publications

The effects of physical and temporal certainty on locomotion with discrete underfoot perturbations

The effects of physical and temporal certainty on locomotion with discrete underfoot perturbations

Perturbations during Gait: A Systematic Review of Methodologies and Outcomes

Acute and Longitudinal Effects of Sport-related Concussion on Reactive Balance

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