Does increased gait variability improve stability when faced with an expected balance perturbation during treadmill walking?

Nestico, Jacqueline; Novak, Alison C.; Perry, Stephen D.; Mansfield, Avril

doi:10.1016/j.gaitpost.2021.03.014

Cited by 10 publications

(11 citation statements)

References 34 publications

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“…As a consequence, the evaluation of responses to expected perturbations can allow obtaining further information on CNS behavior considering that there are still two open, opposing interpretations of movement changes. In fact, it was shown that the movement changes may be considered not only as incorrect patterns due to the perturbations, but also as exploratory behavior to avoid falls [22]. In this context, this study aimed at measuring the effects induced by expected perturbations in AP and ML directions on treadmill-based gaits of young healthy adults in terms of lower limb joint angles and inter-joint coordination.…”

Section: Introductionmentioning

confidence: 99%

Measuring Kinematic Response to Perturbed Locomotion in Young Adults

Taborri

Santuz

Brüll

et al. 2022

Sensors

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Daily life activities often require humans to perform locomotion in challenging scenarios. In this context, this study aimed at investigating the effects induced by anterior-posterior (AP) and medio-lateral (ML) perturbations on walking. Through this aim, the experimental protocol involved 12 participants who performed three tasks on a treadmill consisting of one unperturbed and two perturbed walking tests. Inertial measurement units were used to gather lower limb kinematics. Parameters related to joint angles, as the range of motion (ROM) and its variability (CoV), as well as the inter-joint coordination in terms of continuous relative phase (CRP) were computed. The AP perturbation seemed to be more challenging causing differences with respect to normal walking in both the variability of the ROM and the CRP amplitude and variability. As ML, only the ankle showed different behavior in terms of joint angle and CRP variability. In both tasks, a shortening of the stance was found. The findings should be considered when implementing perturbed rehabilitative protocols for falling reduction.

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Section: Introductionmentioning

confidence: 99%

Measuring Kinematic Response to Perturbed Locomotion in Young Adults

Taborri

Santuz

Brüll

et al. 2022

Sensors

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“…Precisely anticipating a gait disturbance requires 1) certainty about when the perturbation will occur, 2) an internal representation of the physical disturbance (e.g., location and magnitude relative to one’s own body state), and 3) enough time to develop and execute a motor command (Figure 1). When individuals lack certainty about the physical nature or specific timing of an upcoming disturbance, a cautious gait strategy may be adopted, characterized by a shorter step length and wider SW. For example, healthy young adults have been shown to exhibit cautious gait when walking while blindfolded (Hallemans et al ., 2009; Saucedo and Yang, 2017), and when they are generally aware of upcoming slip or translation perturbations but don’t know specific timing (Lawrence et al ., 2015; Nestico et al ., 2021). Yet, it remains unclear how the temporal and physical nature of upcoming perturbations contribute to cautious gait; perturbations with certain temporal and physical features, and enough temporal affordance, may allow individuals to implement a precise anticipatory strategy specific to task demands.…”

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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“…Balance perturbation methods and details : The full details of balance perturbation methods of each paper are given in Table 2 . Eight studies used a split-belt treadmill [ 8 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ], five used a single-belt treadmill [ 9 , 25 , 26 , 27 , 28 ], and six studies oscillated the treadmill during gait [ 29 , 30 , 31 , 32 , 33 , 34 ].…”

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%

“…Preferred or prescribed walking speed : Eighteen studies prescribed a fixed walking speed when subjected to perturbations [ 7 , 8 , 21 , 22 , 24 , 25 , 26 , 29 , 30 , 31 , 34 , 35 , 36 , 38 , 40 , 42 , 43 , 46 ]. 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%

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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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Does increased gait variability improve stability when faced with an expected balance perturbation during treadmill walking?

Cited by 10 publications

References 34 publications

Measuring Kinematic Response to Perturbed Locomotion in Young Adults

Measuring Kinematic Response to Perturbed Locomotion in Young Adults

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

Perturbations during Gait: A Systematic Review of Methodologies and Outcomes

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