Stumbling reactions during perturbed walking: Neuromuscular reflex activity and 3-D kinematics of the trunk – A pilot study

Müller, Juliane; Müller, Steffen; Engel, Tilman; Reschke, Antje; Baur, Heiner; Mayer, Frank

doi:10.1016/j.jbiomech.2015.09.041

Cited by 23 publications

(41 citation statements)

References 27 publications

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“…The recovery reactions to different perturbation magnitudes in a lateral direction in different phases of the gait cycle need also be considered. When balance is lost unexpectedly to the right or left, arm lift [25] and trunk movements [26] are used to decelerate the CoM motion and preserve balance at minor perturbation magnitudes. A recovery step is used at higher magnitudes, and the foot is placed more to the right or left (i.e., lateral stepping or cross-over stepping) than usual to preserve balance [27][28][29].…”

Section: Introductionmentioning

confidence: 99%

Characteristics of First Recovery Step Response following Unexpected Loss of Balance during Walking: A Dynamic Approach

et al. 2020

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Introduction: Many falls in older adults occur during walking and result in lateral falls. The ability to perform a recovery step after balance perturbation determines whether a fall will occur. Aim: To investigate age-related changes in first recovery step kinematics and kinematic adaptations over a wide range of lateral perturbation magnitudes while walking. Methods: Thirty-five old (78.5 ± 5 years) and 19 young adults (26.0 ± 0.8 years) walked at their preferred walking speed on a treadmill. While walking, the subjects were exposed to announced right/left perturbations in different phases of the gait cycle that were gradually increased in order to trigger a recovery stepping response. The subjects were instructed to react naturally and try to avoid falling. Kinematic analysis was performed to analyze the first recovery step parameters (e.g., step initiation, swing duration, step length, and the estimated distance of the center of mass from the base of support [dBoS]). Results: Compared with younger adults, older adults displayed a significantly lower step threshold and at lower perturbation magnitudes during the experiment. Also, they showed slower compensatory step initiation, shorter step length, and dBoS with similar step recovery times. As the perturbation magnitudes increased, older adults showed very small, yet significant, decreases in the timing of the step response, and increased their step length. Younger adults did not show changes in the timing of stepping, with a tendency toward a significant increase in step length. Conclusions: First compensatory step performance is impaired in older adults. In terms of the dynamic approach, older adults were more flexible, i.e., less automatic, while younger adults displayed more automatic behavior.

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Section: Introductionmentioning

confidence: 99%

Characteristics of First Recovery Step Response following Unexpected Loss of Balance during Walking: A Dynamic Approach

et al. 2020

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“…2). Perturbed and unperturbed steps were normalized to the RMS of the entire stride during unperturbed walking (formula unperturbed step: (RMS 200ms to 400ms after heel strike / RMS of entire unperturbed stride) * 100; formula perturbed step: (RMS 200ms after perturbation / RMS of entire unperturbed stride) * 100)[21]. Moreover, coactivation was calculated for both, normal and perturbed walking (formula: GM EMG-RMS:…”

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confidence: 99%

Differences in neuromuscular activity of ankle stabilizing muscles during postural disturbances: A gender-specific analysis

et al. 2018

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The purpose was to examine gender differences in ankle stabilizing muscle activation during postural disturbances. Seventeen participants (9 females: 27 ± 2yrs., 1.69 ± 0.1 m, 63 ± 7 kg; 8 males: 29 ± 2yrs., 1.81 ± 0.1 m; 83 ± 7 kg) were included in the study. After familiarization on a split-belt-treadmill, participants walked (1 m/s) while 15 right-sided perturbations were randomly applied 200 ms after initial heel contact. Muscle activity of M. tibialis anterior (TA), peroneus longus (PL) and gastrocnemius medialis (GM) was recorded during unperturbed and perturbed walking. The root mean square (RMS; [%]) was analyzed within 200 ms after perturbation. Co-activation was quantified as ratio of antagonist (GM)/agonist (TA) EMG-RMS during unperturbed and perturbed walking. Time to onset was calculated (ms). Data were analyzed descriptively (mean ± SD) followed by three-way-ANOVA (gender/condition/muscle; α = 0.05). Perturbed walking elicited higher EMG activity compared to normal walking for TA and PL in both genders (p < 0.000). RMS amplitude gender comparisons revealed an interaction between gender and condition (F = 4.6, p = 0.049) and, a triple interaction among gender, condition and muscle (F = 4.7, p = 0.02). Women presented significantly higher EMG-RMS [%] PL amplitude than men during perturbed walking (mean difference = 209.6%, 95% confidence interval = -367.0 to -52.2%, p < 0.000). Co-activation showed significant lower values for perturbed compared to normal walking (p < 0.000), without significant gender differences for both walking conditions. GM activated significantly earlier than TA and PL (p < 0.01) without significant differences between the muscle activation onsets of men and women (p = 0.7). The results reflect that activation strategies of the ankle encompassing muscles differ between genders. In provoked stumbling, higher PL EMG activity in women compared to men is present. Future studies should aim to elucidate if this specific behavior has any relationship with ankle injury occurrence between genders.

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“…It could be discussed that due to the knowledge of the task, as well as the low (1 kg) and middle (10 kg) lifting weight, BPP are able to use an adequate - comparable to healthy controls - activation strategy to perform the task despite pain. In contrast, frequently used quick-release experiments apply a sudden, unexpected load to either the trunk or the limbs[ 12 , 13 , 17 ]. In these studies, patients could not prepare themselves for the high loading and therefore showed altered neuromuscular activity pattern.…”

Section: Discussionmentioning

confidence: 99%

Neuromuscular trunk activation patterns in back pain patients during one-handed lifting

Mueller¹,

Engel²,

Kopinski³

et al. 2017

WJO

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AIMTo analyze neuromuscular activity patterns of the trunk in healthy controls (H) and back pain patients (BPP) during one-handed lifting of light to heavy loads.METHODSAfter assessment of back pain (graded chronic pain scale according to von Korff) all subjects (n = 43) performed a warm-up (treadmill walking). Next, subjects were instructed to lift 3 × a 20 kg weight placed in front of them (with both hand) onto a table (height: 0.75 m). Subsequently, all subjects lifted with one hand (left-side, 3 repetitions) a weight of 1 kg (light), 10 kg (middle) and 20 kg (heavy) in random order from the ground up onto the table left of them. Trunk muscle activity was assessed with a 12-lead EMG (6 ventral/6 dorsal muscles; 4000 Hz). EMG-RMS (%) was averaged over the 3 repetitions and analyzed for the whole one-handed lifting cycle, then normalized to RMS of the two-handed lifting. Additionally, the mean (normalized) EMG-RMS of four trunk areas [right/left ventral area (VR/VL); right/left dorsal area (DR/DL)] was calculated. Data were analyzed descriptively (mean ± SD) followed by student’s t-test comparing H and BPP (α = 0.05). With respect to the unequal distribution of subjects in H and BPP, a matched-group analysis was conducted. Seven healthy controls were gender- and age-matched (group Hmatched) to the 7 BPP. In addition, task failure was calculated and compared between H/Hmatched vs BPP using χ2.RESULTSSeven subjects (3m/4f; 32 ± 7 years; 171 ± 7 cm; 65 ± 11 kg) were assigned to BPP (pain grade ≥ 2) and 36 (13m/23f; 28 ± 8 years; 174 ± 10 cm; 71 ± 12 kg) to H (pain grade ≤ 1). H and BPP did not differ significantly in anthropometrics (P > 0.05). All subjects were able to lift the light and middle loads, but 57% of BPP and 22% of H were not able to lift the heavy load (all women). χ2 analysis revealed statistically significant differences in task failure between H vs BPP (P = 0.03). EMG-RMS ranged from 33% ± 10%/30% ± 9% (DL, 1 kg) to 356% ± 148%/283% ± 80% (VR, 20 kg) in H/BPP with no statistical difference between groups regardless of load (P > 0.05). However, the EMG-RMS of the VR was greatest in all lifting tasks for both groups and increased with heavier loads.CONCLUSIONHeavier loading leads to an increase (2- to 3-fold) in trunk muscle activity with comparable patterns. Heavy loading (20 kg) leads to task failure, especially in women with back pain.

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Stumbling reactions during perturbed walking: Neuromuscular reflex activity and 3-D kinematics of the trunk – A pilot study

Cited by 23 publications

References 27 publications

Characteristics of First Recovery Step Response following Unexpected Loss of Balance during Walking: A Dynamic Approach

Characteristics of First Recovery Step Response following Unexpected Loss of Balance during Walking: A Dynamic Approach

Differences in neuromuscular activity of ankle stabilizing muscles during postural disturbances: A gender-specific analysis

Neuromuscular trunk activation patterns in back pain patients during one-handed lifting

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