Trunk Compensation During Bimanual Reaching at Different Heights by Healthy and Hemiparetic Adults

The authors explored how trunk compensation and hand symmetry in stroke survivors and healthy controls were affected by the distance and height of virtual targets during a bimanual reaching task. Participants were asked to reach to 4 different virtual targets set at: 90% of their arm length at shoulder, xiphoid process, and knee height, and 50% of their arm length at xiphoid process height. For the stroke group, for all targets, the hands’ movements were more asymmetrical than those of the healthy group, with more asymmetry observed in the direction of gravity, and trunk forward displacement values were larger and more variable. The knee targets had the largest trunk displacement values; index of curvature and trunk displacement were strongly correlated with participants’ impairment scores. A strong correlation was found between the hands’ asymmetry in the anterior or posterior direction for the shoulder targets, and the impairment scores. The results suggest that target height influences the degree of trunk compensation and hand symmetry during bimanual reaching by hemiparetic participants.     

Kinematic descriptions of upper limb function using simulated tasks in activities of daily living after stroke

Assessment of upper limb function poststroke is critical for clinical management and determining the efficacy of interventions. We designed a unilateral upper limb task to simulate activities of daily living to examine how chronic stroke survivors manage reaching, grasping and handling skills simultaneously to perform the functional task using kinematic analysis. The aim of the study was to compare the motor strategies for performing a functional task between paretic and nonparetic arms. Sixteen chronic stroke survivors were instructed to control an ergonomic spoon to transfer liquid from a large bowl to a small bowl using paretic or nonparetic arm. Kinematic data were recorded using a Vicon motion capture system. Outcome measures included movement duration, relative timing, path length, joint excursions, and trial-to-trial variability. Results showed that movement duration, spoon path length, and trunk path length increased significantly when participants used paretic arm to perform the task. Participants tended to reduce shoulder and elbow excursions, and increase trunk excursions to perform the task with paretic arm and altered the relative timing of the task. Although participants used different motor strategies to perform the task with their paretic arms, we did not find the significant differences in trial-to trial variability of joint excursions between paretic and nonparetic arms. The results revealed differences in temporal and spatial aspects of motor strategies between paretic and nonparetic arms. Clinicians should explore the underlying causes of pathological movement patterns and facilitate preferred movement patterns of paretic arm.     

Regional brain electrical activity in posttraumatic stress disorder after motor vehicle accident

This study examined whether patients with posttraumatic stress disorder (PTSD) related to motor vehicle accidents (MVAs) would show an abnormal pattern of electroencephalographic (EEG) alpha asymmetries, which has been proposed for particular types of anxiety. Patients with PTSD (n = 22) or subsyndromal PTSD (n = 21), traumatized controls without PTSD (non-PTSD with MVA; n = 21), and healthy controls without MVA (n = 23) underwent measurement of EEG activity during baseline and exposure to a neutral, a positive, a negative, and an accident-related picture. Differences in brain asymmetry between groups were observed only during exposure to trauma-related material. PTSD and subsyndromal PTSD patients showed a pattern of enhanced right anterior and posterior activation, whereas non-PTSD with MVA participants showed the opposite pattern. Furthermore, posterior asymmetry in nontraumatized healthy controls varied with gender, with female participants showing a pattern of higher right posterior activation. The results support the hypothesis that symptomatic MVA survivors are characterized by a pattern of right hemisphere activation that is associated with anxious arousal and symptoms of PTSD during processing of trauma-specific information.     

Mechanisms for regulating step length while running towards and over an obstacle

The ability to run across uneven terrain with continuous stable movement is critical to the safety and efficiency of a runner. Successful step-to-step stabilization while running may be mediated by minor adjustments to a few key parameters (e.g., leg stiffness, step length, foot strike pattern). However, it is not known to what degree runners in relatively natural settings (e.g., trails, paved road, curbs) use the same strategies across multiple steps. This study investigates how three readily measurable running parameters – step length, foot placement, and foot strike pattern – are adjusted in response to encountering a typical urban obstacle – a sidewalk curb. Thirteen subjects were video-recorded as they ran at self-selected slow and fast paces. Runners targeted a specific distance before the curb for foot placement, and lengthened their step over the curb (p < 0.0001) regardless of where the step over the curb was initiated. These strategies of adaptive locomotion disrupt step cycles temporarily, and may increase locomotor cost and muscle loading, but in the end assure dynamic stability and minimize the risk of injury over the duration of a run.     

Level walking in adults with and without Developmental Coordination Disorder: An analysis of movement variability

Several studies have shown that Developmental Coordination Disorder (DCD) is a condition that continues beyond childhood. Although adults with DCD report difficulties with dynamic balance, as well as frequent tripping and bumping into objects, there have been no specific studies on walking in this population. Some previous work has focused on walking in children with DCD but variation in the tasks and measures used has led to inconsistent findings. The aim of the current study therefore was to examine the characteristics of level walking in adults with and without DCD. Fifteen adults with DCD and 15 typically developing (TD) controls walked barefoot at a natural pace up and down an 11 m walkway for one minute. Foot placement measures and velocity and acceleration of the body were recorded, as well as measures of movement variability. The adults with DCD showed similar gait patterns to the TD group in terms of step length, step width, double support time and stride time. The DCD group also showed similar velocity and acceleration to the TD group in the medio-lateral, anterior–posterior and vertical direction. However, the DCD group exhibited greater variability in all foot placement and some body movement measures. The finding that adults with DCD have a reduced ability to produce consistent movement patterns is discussed in relation to postural control limitations and compared to variability of walking measures found in elderly populations.     

Effects of approach velocity and foot-target characteristics on the visual regulation of step length.

Two questions emerge from the literature concerning the perceptual-motor processes underlying the visual regulation of step length. The first concerns the effects of velocity on the onset of visual control (VCO), when visual regulation of step length begins during goal-directed locomotion. The second concerns the effects of different obstacles such as a target or raised surface on step length regulation. In two separate experiments, participants (Experiment 1 & 2: n=12, 6 female, 6 male) walked, jogged, or sprinted towards an obstacle along a 10 m walkway, consisting of two marker-strips with alternating black and white 0.50 m markings. Each experiment consisted of three targeting or obstacle tasks with the requirement to both negotiate and continue moving (run-through) through the target. Five trials were conducted for each task and approach speed, with trials block randomised between the six participants of each gender. One 50 Hz video camera panned and filmed each trial from an elevated position, adjacent to the walkway. Video footage was digitized to deduce the gait characteristics. Results for the targeting tasks indicate a linear relationship between approach velocity and accuracy of final foot placement (r=0.89). When foot placement was highly constrained by the obstacle step length shortened during the entire approach. VCO was found to occur at an earlier tau-margin for lower approach velocities for both experiments, indicating that the optical variable 'tau' is affected by approach velocity. A three-phase kinematic profile was found for all tasks, except for the take-off board condition when sprinting. Further research is needed to determine whether this velocity affect on VCO is due to 'whole-body' approach velocity or whether it is a function of the differences between gait modes.     

Sylvian fissure and parietal anatomy in children with autism spectrum disorder

Autism spectrum disorder (ASD) is characterized by deficits in social functioning and language and communication, with restricted interests or stereotyped behaviors. Anatomical differences have been found in the parietal cortex in children with ASD, but parietal subregions and associations between Sylvian fissure (SF) and parietal anatomy have not been explored. In this study, SF length and anterior and posterior parietal volumes were measured on MRI in 30 right-handed boys with ASD and 30 right-handed typically developing boys (7-14 years), matched on age and non-verbal IQ. There was leftward SF and anterior parietal asymmetry, and rightward posterior parietal asymmetry, across groups. There were associations between SF and parietal asymmetries, with slight group differences. Typical SF asymmetry was associated with typical anterior and posterior parietal asymmetry, in both groups. In the atypical SF asymmetry group, controls had atypical parietal asymmetry, whereas in ASD there were more equal numbers of individuals with typical as atypical anterior parietal asymmetry. We did not find significant anatomical-behavioral associations. Our findings of more individuals in the ASD group having a dissociation between cortical asymmetries warrants further investigation of these subgroups and emphasizes the importance of investigating anatomical relationships in addition to group differences in individual regions.     

Age effects on the control of dynamic balance during step adjustments under temporal constraints

This study investigated the age effects on the control of dynamic balance during step adjustments under temporal constraints. Fifteen young adults and 14 older adults avoided a virtual white planar obstacle by lengthening or shortening their steps under free or constrained conditions. In the anterior–posterior direction, older adults demonstrated significantly decreased center of mass velocity at the swing foot contact under temporal constraints. Additionally, the distances between the ‘extrapolated center of mass’ position and base of support at the swing foot contact were greater in older adults than young adults. In the mediolateral direction, center of mass displacement was significantly increased in older adults compared with young adults. Consequently, older adults showed a significantly increased step width at the swing foot contact in the constraint condition. Overall, these data suggest that older adults demonstrate a conservative strategy to maintain anterior–posterior stability. By contrast, although older adults are able to modulate their step width to maintain mediolateral dynamic balance, age-related changes in mediolateral balance control under temporal constraints may increase the risk of falls in the lateral direction during obstacle negotiation.     

Common and specific gait patterns in people with varying anatomical levels of lower limb amputation and different prosthetic components

The present study’s aim was to identify the kinematic and kinetic gait patterns and to measure the energy consumption in people with amputation according to both the anatomical level of amputation and the type of prosthetic components in comparison with a control group matched for the gait speed. Fifteen subjects with unilateral transtibial amputation (TTA), forty with unilateral transfemoral amputation (TFA) (9 with mechanical, 17 with CLeg and 14 with Genium prosthesis) and forty healthy subjects were recruited. We computed the time-distance gait parameters; the range of angular motion (RoM) at hip, knee and ankle joints, and at the trunk and pelvis; the values of the 2 peaks of vertical force curve; the full width at half maximum (FWHM) and center of activity (CoA) of vertical force; the mechanical behavior in terms of energy recovery (R-step) and energy consumption. The main results were: i) both TTA and TFA show a common gait pattern characterized by a symmetric increase of step length, step width, double support duration, pelvic obliquity, trunk lateral bending and trunk rotation RoMs compared to control groups. They show also an asymmetric increase of stance duration and of Peak1 in non-amputated side and a decrease of ankle RoM in amputated side; ii) only TFA show a specific gait pattern, depending on the level of amputation, characterized by a symmetric reduction of R-step and an asymmetric decrease of stance duration, CoA and FWHM and an increase of Peak1 in the amputated side and of hip and knee RoM, CoA and FWHM in the non-amputated side; iii) people with amputation with Genium prosthesis show a longer step length and increased hip and knee RoMs compared to people with amputation with mechanical prosthesis who conversely show an increased pelvic obliquity: these are specific gait patterns depending of the type of prosthesis. In conclusion, we identified both common and specific gait patterns in people with amputation, either regardless of, or according to their level of amputation and the type of prosthetic component.     

Selective activation of lower leg muscles during maximum voluntary isometric contractions

The pronators and supinators play a key role in the medio-lateral stability of the ankle joint complex (i.e. talo-crural and subtalar joints). We hypothesized that each shank muscle has a specific activation pattern determined by its anatomical course around the axes of the subtalar and talo-crural joints. A secondary objective was to examine the effect of foot posture on these activation patterns. Forty-nine young adults (25 normal-arched feet, 24 flat-arched feet) performed maximum voluntary isometric contractions against manual resistance in four movement directions: plantarflexion (PF), dorsiflexion (DF), pronation (PRO) and supination (SUP). Electromyographic activity was recorded from tibialis posterior (TP) and peroneus longus (PL) with intramuscular electrodes, and gastrocnemius medialis (GM) and tibialis anterior (TA) with surface electrodes. When compared to their agonist function, all muscles were co-activated at significantly lower levels in their synergistic function (GM: 23% during SUP, TA: 72% during SUP; TP: 42% during PF, PL: 52% during PF) (p < 0.001). A significant interaction between foot posture and contraction type was evident for TA. During isometric contractions, the electromyographic activity of the shank muscles is geared to their biomechanical advantage according to their position relative to the subtalar and talo-crural joint axes.     

Effects of disease severity and medication state on postural control asymmetry during challenging postural tasks in individuals with Parkinson’s disease

The aim of this study was to investigate the effects of disease severity and medication state on postural control asymmetry during challenging tasks in individuals with Parkinson’s disease (PD). Nineteen people with PD and 11 neurologically healthy individuals performed three standing task conditions: bipedal standing, tandem and unipedal adapted standing; the individuals with PD performed the tasks in ON and OFF medication state. The participants with PD were distributed into 2 groups according to disease severity: unilateral group (n = 8) and bilateral group (n = 11). The two PD groups performed the evaluations both under and without the medication. Two force plates were used to analyze the posture. The symmetric index was calculated for various of center of pressure. ANOVA one-way (groups) and two-way (PD groups × medication), with repeated measures for medication, were calculated. For main effects of group, the bilateral group was more asymmetric than CG. For main effects of medication, only unipedal adapted standing presented effects of PD medication. There was PD groups × medication interaction. Under the effects of medication, the unilateral group presented lower asymmetry of RMS in anterior–posterior direction and area than the bilateral group in unipedal adapted standing. In addition, the unilateral group presented lower asymmetry of mean velocity, RMS in anterior–posterior direction and area in unipedal standing and area in tandem adapted standing after a medication dose. Postural control asymmetry during challenging postural tasks was dependent on disease severity and medication state in people with PD. The bilateral group presented higher postural control asymmetry than the control and unilateral groups in challenging postural tasks. Finally, the medication dose was able to reduce postural control asymmetry in the unilateral group during challenging postural tasks.     

The control of amplitude and direction in a bimanual coordination task

Bimanual coordination requires task-specific control of the spatial and temporal characteristics of the movements of both hands. The present study focused on the spatial relationship between hand movements when their amplitude and direction were manipulated. In the experiment in question, participants were instructed to draw two lines simultaneously. These two lines were instructed to be drawn in mirror symmetric or perpendicular directions of each other while the length was instructed to be the same or different. The coordinative quality of amplitude control was compared when the task required symmetric and asymmetric bimanual spatial coordination patterns. Results showed that the amplitude accuracy decreased when different amplitudes and/or directions had to be generated simultaneously. The coordinative quality of direction was also compared when the task required symmetric and asymmetric bimanual spatial coordination patterns. Unlike amplitude, the direction accuracy was largely independent of coordination symmetry/asymmetry of direction or amplitude. The results suggest that the coordinative quality of amplitude control does not only interfere with amplitude asymmetry, but it also interferes with direction asymmetry. Moreover, in bimanual coordination amplitude control is more vulnerable to the influence of direction control demands than vice versa.     

Overground gait training using virtual reality aimed at gait symmetry

This study investigated if training in a virtual reality (VR) environment that provides visual and audio biofeedback on foot placement can induce changes to spatial and temporal parameters of gait during overground walking. Eighteen healthy young adults walked for 23 min back and forth on an instrumented walkway in three different conditions: (i) real environment (RE), (ii) virtual environment (VE) with no biofeedback, and (iii) VE with biofeedback. Visual and audio biofeedback while stepping on virtual footprint targets appearing along a straight path encouraged participants to walk with an asymmetrical step length (SL). A repeated-measures, one-way ANOVA, followed by a pairwise comparison post-hoc analysis with Bonferroni's correction, was performed to compare the step length difference (SLD), stance phase percentage difference (SPPD), and double-support percentage difference (DSPD) between early and late phases of all walking conditions. The results demonstrate the efficacy of the VE biofeedback system for training asymmetrical gait patterns. Participants temporarily adapted an asymmetrical gait pattern immediately post-training in the VE. Induced asymmetries persisted significantly while later walking in the RE. Asymmetry was significant in the spatial parameters of gait (SLD) but not in the temporal parameters (SPPD and DSPD). This paper demonstrates a method to induce unilateral changes in spatial parameters of gait using a novel VR tool. This study provides a proof-of-concept validation that VR biofeedback training can be conducted directly overground and could potentially provide a new method for treatment of hemiplegic gait or asymmetrical walking.     

When an Object Appears Unexpectedly: Object Circumvention in Adults

Obstacles often appear unexpectedly in our pathway and these require us to make immediate adjustments. Despite how regularly we encounter such situations only few studies have considered how we adjust to unexpected obstacles in the pathway that require us to walk around them. The authors considered how adults adjust to the possibility of an obstacle appearing and then also how foot placement is adjusted to circumvent an obstacle. Fifteen healthy adults walked down an 11-m walkway, initially they were told this was a clear pathway and nothing in the environment would change (no gate), they then performed a series of trials in which a gate may (gate close) or may not (gate open) partially obstruct their pathway. The authors found that mediolateral trunk velocity and acceleration was significantly increased when there was the possibility of an obstacle but before the obstacle appeared. This demonstrates an adaptive walking strategy that seems to enable healthy young adults to successfully circumvent obstacles. The authors also categorized foot placement adjustments and found that adults favored making shorter and wider steps away from the obstacle. They suggest this combination of adjustments allows participants to maintain stability while successfully circumventing the obstacle.     

Negative affectivity and EEG asymmetry interact to predict emotional interference on attention in early school-aged children

Negative affectivity (NA) is a broad construct that has been associated with the development of psychopathologies, such as anxiety, and with exaggerated attention to threatening stimuli. EEG asymmetry reflects biological individual differences in emotional reactivity that may underlie the association between NA and attention to threat. The present study included a sample of 31 five-seven year olds (M age in months = 74.39, SD = 6.57) to test the hypothesis that greater NA, combined with greater right anterior and posterior asymmetries, predicts increased attention interference following threat stimuli. Children completed an executive attention task which presented task-irrelevant threat (angry) and non-threat (neutral) faces prior to each trial. EEG asymmetry was measured at baseline for anterior, anterior-temporal and posterior scalp regions and child NA was measured via maternal report. As predicted, children showing greater NA and greater right anterior-temporal asymmetry showed more attention interference following angry faces. Additionally, two trend-level effects emerged: children showing greater NA and greater left anterior-temporal asymmetry showed less attention interference following angry faces, and children showing greater NA and greater left posterior asymmetry showed less attention interference, but only following neutral faces. Discussion focuses on the utility of using EEG asymmetry in the study of temperament, attentional biases, and the biological processes by which temperament confers risk for psychopathology.     

Repeated Exposure to Forward Support-Surface Perturbation During Overground Walking Alters Upper-Body Kinematics and Step Parameters

Locomotion requires both proactive and reactive control strategies to maintain balance. The current study aimed to: (i) ascertain upper body postural responses following first exposure to a forward (slip) support-surface perturbation; (ii) investigate effects of repeated perturbation exposure; (iii) establish relationships between arms and other response components (trunk; center of mass control). Young adults (N = 11) completed 14 walking trials on a robotic platform; six elicited a slip response. Kinematic analyses were focused on extrapolated center of mass position (xCoM), bilateral upper- and forearm elevation velocity, trunk angular velocity, and step parameters. Results demonstrated that postural responses evoked in the first slip exposure were the largest in magnitude (e.g., reduced backward stability, altered reactive stepping, etc.) and preceded by anticipatory anterior adjustments of xCoM. In relation to the perturbed leg, the large contra- and ipsilateral arm responses observed (in first exposure) were characteristically asymmetric and scaled to the degree of peak trunk extension. With repeated exposure, xCoM anticipatory adjustments were altered and in turn, reduced posterior xCoM motion occurred following a slip (changes plateaued at second exposure). The few components of the slip response that persisted across multiple exposures did so at a lesser magnitude (e.g., step length and arms).     

Regional brain electrical asymmetries discriminate between previously depressed and healthy control subjects

Baseline resting electroencephalogram (EEG) activity was recorded from 6 normothymic depressives and 8 controls using three different reference montages. Power in all frequency bands was extracted by Fourier transformation. Significant Group X Region X Hemisphere interactions were found consistently for alpha band power only. Previously depressed subjects had less left-sided anterior and less right-sided posterior activation (i.e., more alpha activity) than did never depressed subjects. Previously depressed subjects had no history of pharmacological treatment and did not differ from controls in emotional state at the time of testing. The pattern of anterior and posterior asymmetry in the previously depressed subjects is similar to that found in acutely depressed subjects and suggests that this may be a state-independent marker for depression.     

Association of mobility capacity with the masses and amounts of intramuscular non-contractile tissue of the trunk and lower extremity muscles in community-dwelling older adults

We examined the association of mobility capacity with muscle thicknesses and echo intensities of the trunk and lower extremity muscles measured using an ultrasound imaging device in community-dwelling older adults. The participants were 57 community-dwelling older adults. Mobility capacity was assessed based on the measurement of usual and maximal walking speeds and timed up-and-go (TUG) time. Muscle thickness and echo intensity of the trunk and lower extremity muscles were measured using an ultrasound imaging device. Finally, sagittal spinal alignment was assessed based on the measurement of thoracic kyphosis, lumbar lordosis, and sacral anterior inclination angles in the standing position using a Spinal Mouse. Stepwise regression analysis showed that the tibialis anterior muscle thickness, tibialis posterior muscle echo intensity, and body weight were significant and independent factors of usual walking speed, with a coefficient of determination (R²) of 0.25. The thicknesses of the thoracic erector spinae and obliquus externus abdominis muscles were significant and independent factors of maximal walking speed (R² = 0.26). Moreover, only age was a significant and independent factor for TUG time (R² = 0.10). The results of this study suggested associations 1) between slow usual walking speed and low tibialis anterior muscle thicknesses and high echo intensity of the tibialis posterior muscle and 2) between slow maximal walking speed and low thoracic erector spinae and obliquus externus abdominis thicknesses in community-dwelling older adults.     

Leg and vertical stiffness (a)symmetry between dominant and non-dominant legs in young male runners

Biomechanical findings show that running is asymmetric in many kinetic properties. Running stiffness is a vital kinetic property of yet unknown pattern of lateralization. The aim of this study was to examine the degree and variability of lower limb dominance specific asymmetry of running in terms of leg stiffness, vertical stiffness, contact time, flight time, maximal ground reaction force during contact, vertical displacement of the center of mass, and change in leg length. Leg and vertical stiffness was estimated by the sine-wave method in 22 young males during treadmill running at 4.44 m/s. Lower limb dominance was determined by the triple-jump test. Asymmetry was expressed as dominant – non-dominant, and indexed by the absolute asymmetry index. Significant asymmetry was found only in flight time (3.98%) and in maximal ground reaction force (1.75%). The absolute asymmetry index ranged from 1.8% to 6.4%, showed high variation between subjects (0–31.6%), and differentiated among the 7 analyzed variables. Leg and vertical stiffness in treadmill running of moderate pace (4.44 m/s) should be considered symmetric.     

Sulcus topography of the parietal opercular region: an anatomic and MR study

The study describes the sulcal and gyral topography, variability, and left-right asymmetry of the parietal operculum. Eighty postmortem hemispheres as well as sagittal magnetic resonance images from 20 health volunteers (40 hemispheres) were evaluated. Four different types of parietal opercular sulcus topography were recognized. Most frequently, and conforming with the anatomic "textbook pattern", the inferior postcentral sulcus (POCS) is the sulcus anterior to the posterior ascending ramus (PAR) of the Sylvian fissure (type 1). Variations were the following: lack of a PAR (type 2), interposition of an intermediate opercular sulcus and gyrus between PAR and POCS (type 3), and direct transition of PAR into POCS with subsequent lack of a classical supramarginal gyrus (type 4). Inconstancy of the sulcal standard arrangement was especially pronounced among left hemispheres, where the patterns differed from type 1 in one third of the cases. Types 2 and 3 were significantly more frequent in left hemispheres, whereas type 4 occurred significantly more frequently in right hemispheres. Upon intraindividual left-right comparison, a remarkable 38% of the brains showed gross asymmetry of the parietal opercular sulcus patterns, characterized by a left type 2 or 3 and/or a right type 4; another 5% exhibited a reverse type of asymmetry. The findings supplement previous data on gross variability and left-right asymmetry of the posterior Sylvian fissure and its lower bank. They indicate that the Sylvian fissure is an unreliable landmark with respect to inferior parietal structures especially in left hemispheres. Individual mapping of perisylvian topography may contribute to studies on structural-functional relationship.