Metabolic cost of lateral stabilization during walking in people with incomplete spinal cord injury

Matsubara, Jesse; Wu, Meng; Gordon, Keith E.

doi:10.1016/j.gaitpost.2015.01.015

Cited by 34 publications

(28 citation statements)

References 29 publications

(42 reference statements)

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“…MoS tended to increase with BWS in the Speed-Matched condition, however this increase was not significant and may have been due to our small sample size (n = 8). In addition, step length only reduced when walking speed was decreased in the Dynamically Similar condition, but not in the Speed-Matched condition, which is consistent with other external lateral stabilization studies (Ijmker et al, 2013; Matsubara et al, 2015), but is inconsistent with previous BWS work (Threlkeld et al, 2003). …”

Section: Discussionsupporting

confidence: 55%

Body weight support impacts lateral stability during treadmill walking

Dragunas

Gordon

2016

Journal of Biomechanics

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Body weight support (BWS) systems are a common tool used in gait rehabilitation. BWS systems may alter the requirements for an individual to actively stabilize by 1) providing lateral restoring forces that reduce the requirements for the nervous system to actively stabilize and 2) decreasing the stabilizing gravitational moment in the frontal plane, which could increase the requirements to actively stabilize. The goal of the current study was to quantify the interaction between BWS and lateral stability. We hypothesized that when able-bodied people walk with BWS: 1) the lateral restoring forces provided by BWS would reduce the requirements to stabilize in the frontal plane when comparing dynamically similar gaits, and 2) increasing BWS would decrease the stabilizing gravitational moment in the frontal plane and increase the requirements to stabilize when speed is constrained. Our findings partly support these hypotheses, but indicate a complex interaction between BWS and lateral stability. With BWS, subjects significantly decreased step width variability and significantly increased step width (p < 0.05) for both the dynamically similar and speed-matched conditions. The decrease in step width variability may be attributable to a combination of lateral restoring forces decreasing the mechanical requirements to stabilize and an enhanced sense of position that could have improved locomotor control. Increases in step width when walking with high levels of BWS could have been due to decreases in the gravitational moment about the stance limb, which may challenge the control of stability in multiple planes.

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Section: Discussionsupporting

confidence: 55%

Body weight support impacts lateral stability during treadmill walking

Dragunas

Gordon

2016

Journal of Biomechanics

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“…Consistent with previous studies [10, 11, 13, 4], our results confirmed that external lateral stabilization provided medio-lateral gait stability, represented by a direct reduction of medio-lateral pelvis displacement which was accompanied by an indirect reduction of step width in stabilized condition. Consistent with Matsubara et al [22], our results confirmed that external lateral stabilization did not constrain the amplitude of anterior-posterior pelvis displacement because bilateral springs were connected to the horizontal trolley which were capable to move freely and in-phase with the displacement of the center of mass in anterior-posterior direction. However, springs fixed in anterior-posterior direction used by previous studies [23, 10, 11, 14] may provide unwanted forces and assistance in the anterior-posterior direction (see Supplementary Material; Figure.…”

Section: Discussionsupporting

confidence: 91%

How does external lateral stabilization constrain normal gait, apart from improving medio-lateral gait stability?

Mahaki

IJmker

Houdijk

et al. 2020

Preprint

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Background:The effect of external lateral stabilization on medio-lateral gait stability has been investigated previously. However, existing lateral stabilization devices not only constrains lateral motions, but also transverse and frontal pelvis rotations. This study aimed to investigate the effect of external lateral stabilization with and without constrained transverse pelvis rotation on mechanical and metabolic gait features. Methods:We undertook 2 experiments with eleven and ten young adult subjects, respectively. Experiment 2 supplemented experiment 1, as it considered several potential confounding factors in the design and set-up of experiment 1. Kinematic, kinetic, and breath-by-breath oxygen consumption data were recorded during 3 walking conditions (normal walking (Normal), lateral stabilization with (Free) and without transverse pelvis rotation (Restricted)) and at 3 speeds (0.83, 1.25, and 1.66 m/s) for each condition.Results: External lateral stabilization significantly reduced the amplitudes of the transverse and frontal pelvis rotations, medio-lateral pelvis displacement, transverse thorax rotation, arm swing, and step width.The amplitudes of free vertical moment, anterior-posterior and vertical pelvis displacements, step length, and energy cost were not significantly influenced by external lateral stabilization. The removal of transverse pelvis rotation restriction by our experimental set-up resulted in significantly higher transverse pelvis rotation, although it remained significantly less than Normal condition. In concert, concomitant gait features such as transverse thorax rotation and arm swing were not significantly influenced by our new set-up. Conclusion:Existing lateral stabilization set-ups not only constrain medio-lateral motions (i.e. mediolateral pelvis displacement), but also constrains other movements such as transverse and frontal pelvis rotations, which leads to several other gait changes such as reduced transverse thorax rotation, and arm swing. Our new setup allowed for more transverse pelvis rotation, however, this did not result in more normal pelvis rotation, arm swing, etc. Hence, to provide medio-lateral support without constraining other gait variables, more elaborate set-ups are needed. Unless such a set-up is realized the observed side effects need to be taken into account when interpreting the effects of lateral stabilization as reported in previous studies.

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“…During straight-ahead walking, to compensate for sensory and motor deficits that are known to impair balance [ 39 , 40 ], individuals with neurologic injury often depend heavily on general, passive mechanisms to provide locomotor stability (e.g. decreasing walking speed [ 41 , 42 ], increasing step width [ 14 , 43 – 45 ], and increasing double support time [ 46 , 47 ]). Older adults [ 48 , 49 ] and individuals with neurologic injury [ 50 , 51 ] may also select compensatory stepping patterns during maneuvers to enhance their passive stability (e.g.…”

Section: Discussionmentioning

confidence: 99%

General and Specific Strategies Used to Facilitate Locomotor Maneuvers

Matsubara

Gordon

2015

PLoS ONE

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People make anticipatory changes in gait patterns prior to initiating a rapid change of direction. How they prepare will change based on their knowledge of the maneuver. To investigate specific and general strategies used to facilitate locomotor maneuvers, we manipulated subjects’ ability to anticipate the direction of an upcoming lateral “lane-change” maneuver. To examine specific anticipatory adjustments, we observed the four steps immediately preceding a maneuver that subjects were instructed to perform at a known time in a known direction. We hypothesized that to facilitate a specific change of direction, subjects would proactively decrease margin of stability in the future direction of travel. Our results support this hypothesis: subjects significantly decreased lateral margin of stability by 69% on the side ipsilateral to the maneuver during only the step immediately preceding the maneuver. This gait adaptation may have improved energetic efficiency and simplified the control of the maneuver. To examine general anticipatory adjustments, we observed the two steps immediately preceding the instant when subjects received information about the direction of the maneuver. When the maneuver direction was unknown, we hypothesized that subjects would make general anticipatory adjustments that would improve their ability to actively initiate a maneuver in multiple directions. This second hypothesis was partially supported as subjects increased step width and stance phase hip flexion during these anticipatory steps. These modifications may have improved subjects’ ability to generate forces in multiple directions and maintain equilibrium during the onset and execution of the rapid maneuver. However, adapting these general anticipatory strategies likely incurred an additional energetic cost.

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Metabolic cost of lateral stabilization during walking in people with incomplete spinal cord injury

Cited by 34 publications

References 29 publications

Body weight support impacts lateral stability during treadmill walking

Body weight support impacts lateral stability during treadmill walking

How does external lateral stabilization constrain normal gait, apart from improving medio-lateral gait stability?

General and Specific Strategies Used to Facilitate Locomotor Maneuvers

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