Mediolateral damping of an overhead body weight support system assists stability during treadmill walking

Bannwart, Mathias; Bayer, Steve; Ignasiak, Niklas König; Bolliger, Marc; Rauter, Georg; Easthope, Chris

doi:10.1186/s12984-020-00735-w

Cited by 4 publications

(5 citation statements)

References 106 publications

(140 reference statements)

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“…The times of heel strike (HS) and toe off were calculated from the zero-crossing of heel and toe marker velocity ( Zeni et al, 2008 ). Approximated center of mass (CoM) was defined as the midpoint between left posterior spina iliac to right anterior spina iliac and left anterior spina iliac to right posterior spina iliac ( Havens et al, 2018 ; Bannwart et al, 2020 ).…”

Section: Methodsmentioning

confidence: 99%

Intramuscular coherence during challenging walking in incomplete spinal cord injury: Reduced high-frequency coherence reflects impaired supra-spinal control

Zipser-Mohammadzada

Conway

Halliday

et al. 2022

Front. Hum. Neurosci.

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Individuals regaining reliable day-to-day walking function after incomplete spinal cord injury (iSCI) report persisting unsteadiness when confronted with walking challenges. However, quantifiable measures of walking capacity lack the sensitivity to reveal underlying impairments of supra-spinal locomotor control. This study investigates the relationship between intramuscular coherence and corticospinal dynamic balance control during a visually guided Target walking treadmill task. In thirteen individuals with iSCI and 24 controls, intramuscular coherence and cumulant densities were estimated from pairs of Tibialis anterior surface EMG recordings during normal treadmill walking and a Target walking task. The approximate center of mass was calculated from pelvis markers. Spearman rank correlations were performed to evaluate the relationship between intramuscular coherence, clinical parameters, and center of mass parameters. In controls, we found that the Target walking task results in increased high-frequency (21–44 Hz) intramuscular coherence, which negatively related to changes in the center of mass movement, whereas this modulation was largely reduced in individuals with iSCI. The impaired modulation of high-frequency intramuscular coherence during the Target walking task correlated with neurophysiological and functional readouts, such as motor-evoked potential amplitude and outdoor mobility score, as well as center of mass trajectory length. The Target walking effect, the difference between Target and Normal walking intramuscular coherence, was significantly higher in controls than in individuals with iSCI [F(1.0,35.0) = 13.042, p < 0.001]. Intramuscular coherence obtained during challenging walking in individuals with iSCI may provide information on corticospinal gait control. The relationships between biomechanics, clinical scores, and neurophysiology suggest that intramuscular coherence assessed during challenging tasks may be meaningful for understanding impaired supra-spinal control in individuals with iSCI.

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Section: Methodsmentioning

confidence: 99%

Intramuscular coherence during challenging walking in incomplete spinal cord injury: Reduced high-frequency coherence reflects impaired supra-spinal control

Zipser-Mohammadzada

Conway

Halliday

et al. 2022

Front. Hum. Neurosci.

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“…Time of HS and TO were calculated by zero crossing in heel and toe marker velocity, respectively [ 26 ]. An approximated CoM was calculated by taking the midpoint between left posterior spina iliac to right anterior spina iliac and left anterior spina iliac to right posterior spina iliac [ 27 , 28 ]. We did not use the full-body marker set and segment weights for CoM calculation because the harness prevented reliable placement of the torso markers, and the approximated CoM model is well understood in its limitations [ 27 , 29 , 30 ].…”

Section: Methodsmentioning

confidence: 99%

Mind your step: Target walking task reveals gait disturbance in individuals with incomplete spinal cord injury

Mohammadzada

Zipser

Easthope

et al. 2022

J NeuroEngineering Rehabil

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Background Walking over obstacles requires precise foot placement while maintaining balance control of the center of mass (CoM) and the flexibility to adapt the gait patterns. Most individuals with incomplete spinal cord injury (iSCI) are capable of overground walking on level ground; however, gait stability and adaptation may be compromised. CoM control was investigated during a challenging target walking (TW) task in individuals with iSCI compared to healthy controls. The hypothesis was that individuals with iSCI, when challenged with TW, show a lack of gait pattern adaptability which is reflected by an impaired adaptation of CoM movement compared to healthy controls. Methods A single-center controlled diagnostic clinical trial with thirteen participants with iSCI (0.3–24 years post injury; one subacute and twelve chronic) and twelve healthy controls was conducted where foot and pelvis kinematics were acquired during two conditions: normal treadmill walking (NW) and visually guided target walking (TW) with handrail support, during which participants stepped onto projected virtual targets synchronized with the moving treadmill surface. Approximated CoM was calculated from pelvis markers and used to calculate CoM trajectory length and mean CoM Euclidean distance TW-NW (primary outcome). Nonparametric statistics, including spearman rank correlations, were performed to evaluate the relationship between clinical parameter, outdoor mobility score, performance, and CoM parameters (secondary outcome). Results Healthy controls adapted to TW by decreasing anterior–posterior and vertical CoM trajectory length (p < 0.001), whereas participants with iSCI reduced CoM trajectory length only in the vertical direction (p = 0.002). Mean CoM Euclidean distance TW-NW correlated with participants’ neurological level of injury (R = 0.76, p = 0.002) and CoM trajectory length (during TW) correlated with outdoor mobility score (R = − 0.64, p = 0.026). Conclusions This study demonstrated that reduction of CoM movement is a common strategy to cope with TW challenge in controls, but it is impaired in individuals with iSCI. In the iSCI group, the ability to cope with gait challenges worsened the more rostral the level of injury. Thus, the TW task could be used as a gait challenge paradigm in ambulatory iSCI individuals. Trial registration Registry number/ ClinicalTrials.gov Identifier: NCT03343132, date of registration 2017/11/17.

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“…Preregistration of protocols and outcome measures was present in three studies [ 54 – 56 ]. Original data was made publicly available in seven studies [ 16 , 54 , 56 – 60 ], whereas seven studies mentioned data to be readily available upon request [ 61 – 67 ].…”

Section: Resultsmentioning

confidence: 99%

“…From the included papers, eight involved trunk manipulation, describing five interventions. In non-impaired subjects, the most frequently used intervention was conventional body weight support (T1), which showed limited evidence for the improvement of gait stability [ 59 , 61 , 69 – 71 ]. Indicative evidence was provided in a single study applying both body weight support (BWS) and medio-lateral (ML) damping (T2) [ 61 ].…”

Section: Resultsmentioning

confidence: 99%

“…In non-impaired subjects, the most frequently used intervention was conventional body weight support (T1), which showed limited evidence for the improvement of gait stability [ 59 , 61 , 69 – 71 ]. Indicative evidence was provided in a single study applying both body weight support (BWS) and medio-lateral (ML) damping (T2) [ 61 ]. Two studies provided indicative evidence for improving gait stability by applying torques to the trunk (T3) [ 57 , 72 ].…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Direct biomechanical manipulation of human gait stability: A systematic review

Sterke,

Jabeen,

Baines

et al. 2024

PLoS ONE

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People fall more often when their gait stability is reduced. Gait stability can be directly manipulated by exerting forces or moments onto a person, ranging from simple walking sticks to complex wearable robotics. A systematic review of the literature was performed to determine: What is the level of evidence for different types of mechanical manipulations on improving gait stability? The study was registered at PROSPERO (CRD42020180631). Databases Embase, Medline All, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, and Google Scholar were searched. The final search was conducted on the 1st of December, 2022. The included studies contained mechanical devices that influence gait stability for both impaired and non-impaired subjects. Studies performed with prosthetic devices, passive orthoses, and analysing post-training effects were excluded. An adapted NIH quality assessment tool was used to assess the study quality and risk of bias. Studies were grouped based on the type of device, point of application, and direction of forces and moments. For each device type, a best-evidence synthesis was performed to quantify the level of evidence based on the type of validity of the reported outcome measures and the study quality assessment score. Impaired and non-impaired study participants were considered separately. From a total of 4701 papers, 53 were included in our analysis. For impaired subjects, indicative evidence was found for medio-lateral pelvis stabilisation for improving gait stability, while limited evidence was found for hip joint assistance and canes. For non-impaired subjects, moderate evidence was found for medio-lateral pelvis stabilisation and limited evidence for body weight support. For all other device types, either indicative or insufficient evidence was found for improving gait stability. Our findings also highlight the lack of consensus on outcome measures amongst studies of devices focused on manipulating gait.

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Mediolateral damping of an overhead body weight support system assists stability during treadmill walking

Cited by 4 publications

References 106 publications

Intramuscular coherence during challenging walking in incomplete spinal cord injury: Reduced high-frequency coherence reflects impaired supra-spinal control

Intramuscular coherence during challenging walking in incomplete spinal cord injury: Reduced high-frequency coherence reflects impaired supra-spinal control

Mind your step: Target walking task reveals gait disturbance in individuals with incomplete spinal cord injury

Direct biomechanical manipulation of human gait stability: A systematic review

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