The effects of experimentally-induced fatigue on gait parameters during obstacle crossing: A systematic review

Chardon, Matthias; Barbieri, Fábio Augusto; Penedo, Tiago; Santos, Paulo Cezar Rocha dos; Vuillerme, Nicolas

doi:10.1016/j.neubiorev.2022.104854

Cited by 8 publications

(6 citation statements)

References 54 publications

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“…Self-reported fatigue was associated with impaired ability to safely negotiate obstacles in older adults, consistent with the effect of experimentally induced fatigue: increased lower limb variability and impaired motor control 16,17 and increased trips on obstacles in relatively young firefighters 18,19,20 . The fatigue induced in this protocol from walking and stepping over obstacles for 1.29 km is likely similar to the fatigue induced from everyday activities, such as a shopping trip.…”

Section: Discussionsupporting

confidence: 65%

“…Gait parameters that have been associated with falls include: speed, step length, step width, and/or variability of these measures 12,14,15 . Exercise-induced fatigue increases lower limb variability, impairs motor control 16,17 , and increases trips on obstacles in relatively young firefighters 18,19,20 . Furthermore, the effect of exercise-induced fatigue on movement was greater in adults aged 40 and older compared to younger participants during level walking and obstacle crossing 17 .…”

Section: Introductionmentioning

confidence: 99%

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Inadvertent obstacle contacts when older adults step over obstacles: Effect of sex, self-reported fatigue, gait parameters, and prescription medications

Becker¹,

Rietdyk²

2022

BJMB

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Background: Tripping is a common cause of falls, but the factors that are associated with trip risk are understudied. Aim: To quantify inadvertent trips with a stationary, visible obstacle in older adults, and to determine how inadvertent trips are related to fatigue, sex, gait measures, and prescription medications. Methods: Forty-one subjects walked on a 6 m walkway and stepped over a visible, stationary obstacle (height: 25% of leg length) 100 times; inadvertent trips with the obstacle were documented. We also collected gait measures on a clear walkway, self-reported fatigue every 25 obstacle crossing trials, and number of prescription medications. Participants were categorized as: 0 contacts or ≥1 contact. Results: The obstacle was contacted by 15 participants (37%) in 29 trials (0.7% of all trials); 52% of contacts were with the lead limb. Self-reported fatigue increased during the obstacle crossing protocol (p<0.001). Participants in the ≥1 contact group had slower gait speed, shorter stride length, and higher gait cycle time variability (p≤0.041). They also reported higher maximum fatigue (p=0.022) and a higher number of prescription medications (p=0.019). Males and females were not different in contact frequency (p=0.93). Interpretation: Inadvertent trips were not uncommon in older adults, even with a visible, stationary obstacle. Lead limb contacts indicate that older adults will have more difficulty recovering their balance after a trip. The strong association between fatigue (induced by walking) and impaired gait is highly relevant when quantifying gait in older adults, and also when developing fall prevention programs.

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Section: Discussionsupporting

confidence: 65%

Section: Introductionmentioning

confidence: 99%

Inadvertent obstacle contacts when older adults step over obstacles: Effect of sex, self-reported fatigue, gait parameters, and prescription medications

Becker¹,

Rietdyk²

2022

BJMB

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“…While patient-related factors, such as curve characteristics related to body size, muscle power, degenerative disease, etc, would remain constant throughout an insole measurement, fatigue-related changes [ 15 ] may increasingly appear and then stay toward the later stages of a recording of a walking bout. Additionally, age, body height, body weight, BMI, and handgrip strength were shown to cause characteristic changes in the plantar pressure force curve, that would usually only change on a long-term scale [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Characteristic Changes of the Stance-Phase Plantar Pressure Curve When Walking Uphill and Downhill: Cross-Sectional Study

Wolff,

Steinheimer,

Warmerdam

et al. 2024

J Med Internet Res

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Background Monitoring of gait patterns by insoles is popular to study behavior and activity in the daily life of people and throughout the rehabilitation process of patients. Live data analyses may improve personalized prevention and treatment regimens, as well as rehabilitation. The M-shaped plantar pressure curve during the stance phase is mainly defined by the loading and unloading slope, 2 maxima, 1 minimum, as well as the force during defined periods. When monitoring gait continuously, walking uphill or downhill could affect this curve in characteristic ways. Objective For walking on a slope, typical changes in the stance phase curve measured by insoles were hypothesized. Methods In total, 40 healthy participants of both sexes were fitted with individually calibrated insoles with 16 pressure sensors each and a recording frequency of 100 Hz. Participants walked on a treadmill at 4 km/h for 1 minute in each of the following slopes: −20%, −15%, −10%, −5%, 0%, 5%, 10%, 15%, and 20%. Raw data were exported for analyses. A custom-developed data platform was used for data processing and parameter calculation, including step detection, data transformation, and normalization for time by natural cubic spline interpolation and force (proportion of body weight). To identify the time-axis positions of the desired maxima and minimum among the available extremum candidates in each step, a Gaussian filter was applied (σ=3, kernel size 7). Inconclusive extremum candidates were further processed by screening for time plausibility, maximum or minimum pool filtering, and monotony. Several parameters that describe the curve trajectory were computed for each step. The normal distribution of data was tested by the Kolmogorov-Smirnov and Shapiro-Wilk tests. Results Data were normally distributed. An analysis of variance with the gait parameters as dependent and slope as independent variables revealed significant changes related to the slope for the following parameters of the stance phase curve: the mean force during loading and unloading, the 2 maxima and the minimum, as well as the loading and unloading slope (all P<.001). A simultaneous increase in the loading slope, the first maximum and the mean loading force combined with a decrease in the mean unloading force, the second maximum, and the unloading slope is characteristic for downhill walking. The opposite represents uphill walking. The minimum had its peak at horizontal walking and values dropped when walking uphill and downhill alike. It is therefore not a suitable parameter to distinguish between uphill and downhill walking. Conclusions While patient-related factors, such as anthropometrics, injury, or disease shape the stance phase curve on a longer-term scale, walking on slopes leads to temporary and characteristic short-term changes in the curve trajectory.

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“…The study design adopted here does not allow us to differentiate between fatigue and shifting attention. Given these observations, future studies should quantify self-reported fatigue before, during, and after gait protocols to clarify the role of fatigue in locomotor research in various populations [ 38 , 78 ]. The other parameter that changed in the second block was a decrease in trail foot clearance; the decrease in clearance was not different between age groups.…”

Section: Discussionmentioning

confidence: 99%

The effect of visual sensory interference during multitask obstacle crossing in younger and older adults

Cho,

Rietdyk

2024

PLoS ONE

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When older adults step over obstacles during multitasking, their performance is impaired; the impairment results from central and/or sensory interference. The purpose was to determine if sensory interference alters performance under low levels of cognitive, temporal, and gait demand, and if the change in performance is different for younger versus older adults. Participants included 17 younger adults (20.9±1.9 years) and 14 older adults (69.7±5.4 years). The concurrent task was a single, simple reaction time (RT) task: depress button in response to light cue. The gait task was stepping over an obstacle (8 m walkway) in three conditions: (1) no sensory interference (no RT task), (2) low sensory interference (light cue on obstacle, allowed concurrent foveation of cue and obstacle), or (3) high sensory interference (light cue away from obstacle, prevented concurrent foveation of cue and obstacle). When standing, the light cue location was not relevant (no sensory interference). An interaction (sensory interference by task, p<0.01) indicated that RT was longer for high sensory interference during walking, but RT was not altered for standing, confirming that sensory interference increased RT during obstacle approach. An interaction (sensory interference by age, p<0.01) was observed for foot placement before the obstacle: With high sensory interference, younger adults placed the trail foot closer to the obstacle while older adults placed it farther back from the obstacle. The change increases the likelihood of tripping with the trail foot for younger adults, but with the lead limb for older adults. Recovery from a lead limb trip is more difficult due to shorter time for corrective actions. Overall, visual sensory interference impaired both RT and gait behavior with low levels of multitask demand. Changes in foot placement increased trip risk for both ages, but for different limbs, reducing the likelihood of balance recovery in older adults.

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The effects of experimentally-induced fatigue on gait parameters during obstacle crossing: A systematic review

Cited by 8 publications

References 54 publications

Inadvertent obstacle contacts when older adults step over obstacles: Effect of sex, self-reported fatigue, gait parameters, and prescription medications

Inadvertent obstacle contacts when older adults step over obstacles: Effect of sex, self-reported fatigue, gait parameters, and prescription medications

Characteristic Changes of the Stance-Phase Plantar Pressure Curve When Walking Uphill and Downhill: Cross-Sectional Study

The effect of visual sensory interference during multitask obstacle crossing in younger and older adults

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