Unplanned gait termination in individuals with multiple sclerosis

Roeing, Kathleen L.; Moon, Yaejin; Sosnoff, Jacob J.

doi:10.1016/j.gaitpost.2017.01.016

Cited by 8 publications

(11 citation statements)

References 31 publications

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“…За даними різних авторів, розсіяний склероз іноді супроводжується функціональними порушеннями постави різного ступеня вираженості. Це -несприятливе ускладнення, яке значно знижує рівень ефективності лікувально-реабілітаційних заходів у таких пацієнтів (Roeing et al, 2017). Якщо ознаки функціонального порушення постави тривають більше одного року, воно може створити всі умови для виникнення більш грізного ускладнення -сколіозу, який проявляється комплексом дегенеративно-дистрофічних змін у складових хребта (Hutchinson, 2014).…”

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Myofascial syndrome as a pathogenetic mechanism for formation of scoliosis in people with multiple sclerosis

Lysenko

2017

Regul. Mech. Biosyst.

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The purpose of this research was to conduct a comprehensive analysis of clinical changes and electroneuromyographic indices in people with multiple sclerosis in combination with various types of functional disorders of posture. The study involved 105 people with multiple sclerosis aged 26–58 who were undergoing rehabilitation at a specialized medical center. The degree of spasticity of the muscles was determined by the modified Ashworth scale. To assess the intensity and nature of pain, a neurologic examination was performed using a visual analogue scale and a McGilovsky pain questionnaire. Interference and stimulation electroneuromyography was used to characterize the functional state of the peripheral neuromotor apparatus of skeletal muscles, the results of which determined the maximum arbitrary contraction of the muscle using quantitative analysis of time, amplitude and frequency parameters, and also determined the speed of the pulse, the amplitude and duration of the F wave, latent period and polyphase M-wave, monosynaptic testing (H-reflex) was carried out. The percentage of Hmax/Mmax was calculated from the electroneuromyographic results. By the ratio between the maximum and minimum amplitude of the M-response, the number of motor units was calculated. To analyze the denervation-reinvational processes of motor units and degenerative-restorative changes in the muscle fibers, spontaneous fibrillation potentials and positive acute waves were recorded. By the stage of manifestation of pain myofascial syndrome, all patients were divided into three groups, in which the force characteristics decreased by 10.2%, 25.0% and 30.2%, respectively. It is well understood in clinic-instrumental research, that in 67.3% cases of multiple sclerosis the patient also suffers from functional scoliosis. This pathological symptom complex contributes to the creation of not only muscular, but also fascial-ligamental trigger points. They, in turn, are the source of the formation of secondary trigger loci. In terms of the degree of manifestation of subjective pain in the presence of myo-fascial syndrome, all patients were divided into three groups, and depending on the value of individual indicators, three stages of spontaneous fibrillation potentials were identified that clearly correlate with the degree of fibromyalgic syndrome and manifest specific electroneuromyographic disorders in each of these stages. The main pathogenetic mechanism that contributes to the formation of pathological bends of the spine in people with multiple sclerosis is a painful muscular-fascial syndrome. It is provoked by myofascial hypertonia and takes part in the development of cross syndromes, which is also manifested by clear changes in electroneuromyographic parameters in the form of asymmetric muscle tone. This article discusses clinical variants of the course of local muscular-tonic syndromes. Pathogenetic approaches to the prevention of posture disorders in patients with multiple sclerosis are presented here.

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Myofascial syndrome as a pathogenetic mechanism for formation of scoliosis in people with multiple sclerosis

Lysenko

2017

Regul. Mech. Biosyst.

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“…According to different control processes, GT can be divided into planned gait termination (PGT) and unplanned gait termination (UGT). PGT means to efficiently reach the expected position or nearby in term of the purpose of movement under the dual restriction of human and environment [2], [20]. The baserunning of baseball players is a good example.…”

Section: Introductionmentioning

confidence: 99%

“…The baserunning of baseball players is a good example. UGT is a stress response to unexpected stimulus, and the body stability is greatly affected when the complete stop [20]. For instance, in table tennis, athletes often stop the original moving route and move in the opposite direction to cater to the returning table tennis because the direction of the opponent's strike is unknown.…”

Section: Introductionmentioning

confidence: 99%

Do different muscle strength levels affect stability during unplanned gait termination?

Cen

Jiang

2019

Acta Bioeng Biomech

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Unplanned gait termination (UGT) widely occurs in various sports and daily life as a kind of stress response to unexpected stimulus. However, the body stability may be greatly affected when the body completely stops. The purpose of this study was to examine the association between muscle strength levels and body stability during UGT through comparing the plantar pressure. Methods: Twenty healthy participants (10 male and 10 female) with different lower limbs muscle strength and power were asked to perform planned gait termination (PGT) and unplanned gait termination (UGT) on an 8-m walkway. Related plantar pressure data including maximum pressure, maximum force, contact area and center of pressure were recorded with Footscan pressure platform. Results: Two types of gait termination have significant differences in the plantar pressure distribution. Maximum pressure and maximum force in the lateral metatarsal increased significantly during UGT, compared to PGT. At the same time, data from the current study suggested that there might be a correlation between the muscle strength levels of individual and the stability during the gait termination, especially between the muscle power and UGT, which means that the more excellent muscle power an individual has, the more stable the body is when UGT is performed. Conclusions: The findings suggest that different muscle strength levels could affect stability during unplanned gait termination.

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“…2 In order for these feedback and feedforward mechanisms to work effectively, an individual needs to be able to constantly monitor both the environment and the body accurately and efficiently. 1 Typically, dual-task prioritization results in decreased cognitive performance as opposed to motor performance. 3 The time it takes an individual to react to external stimuli is important, and as the degrees of freedom and number of environmental factors increase, reaction time (RT) slows.…”

mentioning

confidence: 99%

“…3 The time it takes an individual to react to external stimuli is important, and as the degrees of freedom and number of environmental factors increase, reaction time (RT) slows. 1,4 Participants in sport must focus not only on properly executing the required motor tasks but often must focus on concurrent cognitive tasks such as memory recall or decision making as well as avoiding obstacles and opponents while changing speed and direction. Combining gait with a dual-task paradigm presents the individual with more complex tasks that require both motor and cognitive performance as well as effective integration of feedforward and feedback mechanisms.…”

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confidence: 99%

A Proposal for Complex Gait Evaluation Using Dual-Task Gait Termination Time

Johnson¹,

Scott²,

Lynall³

2021

Journal of Sport Rehabilitation

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Context: Gait termination time (GTT) has been used to predict falls in older adults but has not been explored in the sport rehabilitation setting. The incorporation of a concurrent cognitive task as a complex measure of gait in this clinical population could lead to better health-related outcomes. Objective: To compare the effect of planned and unplanned gait termination with and without a concurrent cognitive task on reaction time (RT), gait velocity, and GTT. Design: Cross-sectional. Setting: Laboratory. Participants: Twenty young adults (females 60.0%, age 20.1 [0.9] y, height 169.5 [8.8] cm, mass 67.4 [10.8] kg). Intervention: Participants completed 6 planned and 6 unplanned gait termination trials on an instrumented gait mat with and without a cognitive task. Main Outcome Measures: The authors measured RT (s), gait velocity (m/s), GTT (s), and normalized GTT (s2/m). A 2 (motor) × 2 (cognitive) repeated-measures analysis of variance (α = .05) was used; significant interaction effects were explored using Bonferroni-corrected t tests (α < .008). Results: Participants walked more slowly during dual-task trials compared with single-task trials (F1,19 = 4.401, P = .050). Participants walked significantly more slowly with a cognitive task during planned (P < .001, mean difference = −0.184 m/s, 95% CI, −0.256 to −0.111) and unplanned (P = .001, mean difference = −0.111 m/s, 95% CI, −0.173 to −0.050) gait termination. Participants walked significantly more slowly (P < .001, mean difference = −0.142 m/s, 95% CI, −0.210 to −0.075) when performing the most difficult task, unplanned termination with a cognitive task, than when performing the least difficult task, planned termination with no cognitive task. We observed a cognitive task main effect such that adding a cognitive task increased RT (F1,19 = 16.375, P = .001, mean difference = −0.118 s, 95% CI, −0.178 to −0.057) and slowed normalized GTT (F1,19 = 5.655, P = .028, mean difference = −0.167 s2/m, 95% CI, −0.314 to −0.020). Conclusions: Overall, participants displayed more conservative gait strategies and slower RT, normalized GTT, and gait velocity as task difficulty increased. More investigation is needed to truly understand the clinical meaningfulness of these measures in athletic injuries.

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Unplanned gait termination in individuals with multiple sclerosis

Cited by 8 publications

References 31 publications

Myofascial syndrome as a pathogenetic mechanism for formation of scoliosis in people with multiple sclerosis

Myofascial syndrome as a pathogenetic mechanism for formation of scoliosis in people with multiple sclerosis

Do different muscle strength levels affect stability during unplanned gait termination?

A Proposal for Complex Gait Evaluation Using Dual-Task Gait Termination Time

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