Are there attentional demands associated with haptic modalities while walking in young,healthy adults?

Study designA prospective, observational study.ObjectivesTo assess the attentional demands of using haptic modalities during walking using a multi-task paradigm in young, healthy adults.SettingBiomechanics of Balance and Movement (BBAM) Lab, University of Saskatchewan.MethodsTwenty-two (12 male) young, healthy adults performed walking trials with and without a verbal reaction time (VRT) task, as well as with and without the use of haptic anchors and light touch on a railing. Walking performance was evaluated using normalized stride velocity and step width, and dynamic stability was evaluated using step width variability and medial-lateral margin of stability (ML MOS) and its variability.ResultsThere were no significant differences in VRT when walking with and without added haptic input and no interactions between the added VRT task and added haptic input. Step width increased and variability of the ML MOS increased during trials with the VRT task compared to trials without the VRT task. The ML MOS decreased when using both haptic tools with a greater decrease when using light touch on the railing compared to when using the haptic anchors. Normalized stride velocity and step width decreased when using light touch on the railing only.ConclusionBoth haptic tools affected stability during walking. Using the railing to add haptic input had a greater effect on walking stability and was the only haptic tool to affect walking performance. Attentional demands should be considered in future research and applications of adding haptic input during walking.     

Side by side treadmill walking reduces gait asymmetry induced by unilateral ankle weight

Asymmetric gait is a hallmark of many neurological and musculoskeletal conditions. This behavior is often the result of a decrease in the stability of interlimb coordination, and synchronization to external signals such as auditory cuing or another walking individual may be helpful for altering abnormal movement patterns. The purpose of this study was to investigate the interaction between interlimb coordination and unintentional, interpersonal synchronization of gait in healthy individuals in response to unilateral ankle loading. Fifty participants completed four trials while walking on a motorized treadmill: (1) by themselves, (2) with a partner on an adjacent treadmill, (3) by themselves with additional weight applied unilaterally to their right ankle, and (4) with both a partner and unilateral weight. As expected, the addition of unilateral weight increased asymmetry according to several spatiotemporal measures of gait, but the presence of a partner on an adjacent treadmill significantly reduced this effect. Further, the amount of unintentional, interpersonal synchronization among pairings was relatively unaffected by the addition of ankle weight to one of the partners. All pairings realized a beneficial effect on asymmetrical gait but this effect was greater for pairings that consistently synchronized unintentionally. These results suggest that side by side walking might be an effective approach for influencing bilateral coordination of gait and may hold insight for understanding gait asymmetry and interlimb movement variability.     

Self-Optimization of Walking in Nondisabled Children and Children With Spastic Hemiplegic Cerebral Palsy

Children voluntarily adopt a frequency and movement pattern for walking. The force-driven harmonic oscillator (FDHO) model was used in this study for accurate prediction of the preferred walking frequency of nondisabled children and children with spastic hemiplegic cerebral palsy. Four potential optimality criteria with which the preferred walking pattern was forced to comply were examined: minimization of physiological costs, maximization of mechanical energy conservation, minimization of asymmetry in lower limb movements and minimization of variability of interlimb and intralimb coordination. Age and gender-matched nondisabled children (n = 6) and children with spastic hemiplegic cerebral palsy (n = 6) were tested under six frequency conditions of walking at a constant speed on a treadmill. For the nondisabled children, the results indicated that their preferred walking frequency could be accurately predicted by the FDHO model. They freely adopted a walking pattern that minimized physiological costs, asymmetry, and variability of inter- and intralimb coordination. For the children with spastic hemiplegic cerebral palsy, the prediction of preferred overground walking frequency required that the FDHO model be modified to account for muscle mass and leg length discrepancies between limbs and increased stiffness. Most of the children achieved the same optimality goals as the nondisabled when walking at the preferred frequency. However, the children were found to use different mechanisms to attain these goals: for example, a steeper increase observed in physiological cost at higher frequencies; a lowered center of gravity of the body, which allowed for angular symmetry; and greater variability of between-joint coordination in the nonaffected limb and less variability in the affected limb.     

Gradual increase of perturbation load induces a longer retention of locomotor adaptation in children with cerebral palsy

The goal of this study is to determine whether the size and the variability of error have an impact on the retention of locomotor adaptation in children with cerebral palsy (CP). Eleven children with CP, aged 7–16 years old, were recruited to participate in this study. Three types of force perturbations (i.e., abrupt, gradual and noisy loads) were applied to the right leg above the ankle starting from late stance to mid-swing in three test sessions while the subject walked on a treadmill. Spatial-temporal gait parameters were recorded using a custom designed 3D position sensor during treadmill walking. We observed that children with CP adapted to the resistance force perturbation and showed an aftereffect consisting of increased step length after load release. Further, we observed a longer retention of the aftereffect for the condition with a gradual load than that with an abrupt load. Results from this study suggested that the size of error might have an impact on the retention of motor adaptation in children with CP with a longer retention of motor adaptation for the condition with a small size of error than that with a large error. In addition, enhanced variability of error seems facilitate motor learning during treadmill training. Results from this study may be used for the development of force perturbation based training paradigms for improving walking function in children with CP.     

Sensorimotor synchronization during gait is altered by the addition of variability to an external cue

Sensorimotor synchronization has been used in the rehabilitation of gait, yet much remains unknown regarding the optimal use of this technique. The purpose of this study was to test the hypothesis that adding small amounts of variability to the motion of a vertically oscillating treadmill would affect the behavior of healthy walkers. Sixteen young adults walked on a treadmill and pneumatically actuated platform for one control trial (no oscillation) and eight trials in which the walking surface oscillated in the vertical direction under different conditions of variability. During the oscillation trials, the mean frequency of oscillation was equal to the preferred step frequency of the participant, but each individual cycle period was allowed to vary within a pre-determined range from 0% (no variability) to ±25% (high variability) of the mean cycle period. The amount of variance of each cycle period within each condition was drawn randomly from a white noise generator. Synchronization was improved when a small amount of noise was added to the platform motion but synchronization significantly decreased at higher levels of noise. Coefficient of variation of stride duration was relatively unchanged at lower levels of variability, but increased significantly at higher levels of variability. Statistical persistence of stride duration was significantly reduced during all trials with vertical oscillation relative to normal walking, but was not significantly altered by variability in the treadmill oscillation. These results suggest that the addition of a small amount of random variability to the cycle period of an oscillator may enhance sensorimotor synchronization of gait to an external signal. These data may have implications for the use of synchronization in a therapeutic setting.     

Stability and variability may respond differently to changes in walking speed

In gait research it has often been assumed that variability and stability are negatively correlated, where increases in variability are assumed to equate with increases in instability. The purpose of this paper is to illustrate that variability does not always equate with stability. To proof this point, a method was developed to directly assess stability and variability during the application of a visual perturbation at different walking speeds. Walking variability was measured by using the average standard deviation of the knee joint angle across the gait cycle. Walking stability was measured by the recovery time of the knee joint angle trajectory from the distortion induced by a visual perturbation that was delivered at the beginning of the stance phase. Five participants were required to walk at six different velocities on a treadmill (0.67, 0.80, 0.94, 1.07, 1.21, and 1.34 m/s). The coefficients of intraclass correlations for the experiment were 83% and 80% for the calculated stability and variability, respectively. The calculated stabilities were not sensitive to changes in walking speed (p>0.98). The calculated variability however decreased with increases in walking speed (p=0.004). No significant correlation between variability and stability was observed (r=-0.002). We suggest that gait stability is independent of variability during locomotion and should thus be measured independently.     

Effects of passive interpersonal light touch during walking on postural control responses: An exploratory study

The effects of passive interpersonal light touch (PILT) on postural stability can be observed through improved postural coordination through haptic feedback from the contact provider to the contact receiver while walking. It is unclear, however, whether PILT affects the contact receiver's detailed physical responses, such as muscle activity, body sway, and joint movements. In this study, surface electromyography and an inertial measurement unit were used simultaneously to explore changes in walking speed and control responses induced by PILT. We evaluated fourteen healthy participants for their walking speed and physical responses under two walking conditions: no-touch (NT) and PILT. As a physical response during walking, we measured muscle activity (rectus femoris, semitendinosus, tibialis anterior, and soleus muscles), body sway (pelvis and neck), and joint angles (direction of hip, knee, and ankle joint movements). In PILT condition, fingertip contact force was measured while the contact provider touched the third level of the recipient's lumbar spine. In comparison with the NT condition, PILT condition increased walking speed and decreased body sway on neck position. There were significant correlations between walking speed and neck sway regarding NT and PILT change values. Passive haptic information to the contact receiver may assist in the smooth shift of the center of gravity position during gait through interpersonal postural coordination. These findings suggest that PILT may provide an efficient and stable gait.     

Simulated Visual Field Loss Does Not Alter Turning Coordination in Healthy Young Adults

Turning, while walking, is an important component of adaptive locomotion. Current hypotheses regarding the motor control of body segment coordination during turning suggest heavy influence of visual information. The authors aimed to examine whether visual field impairment (central loss or peripheral loss) affects body segment coordination during walking turns in healthy young adults. No significant differences in the onset time of segments or intersegment coordination were observed because of visual field occlusion. These results suggest that healthy young adults can use visual information obtained from central and peripheral visual fields interchangeably, pointing to flexibility of visuomotor control in healthy young adults. Further study in populations with chronic visual impairment and those with turning difficulties are warranted.     

Cognitive performance is improved while walking: Differences in cognitive–sensorimotor couplings between children and young adults

We investigated how 9-year-olds and young adults performed a working memory task under different difficulty conditions while walking on a treadmill. Stride-length and stride-time variability tended to decrease with cognitive load in young adults, whereas children showed an increase in walking variability when cognitive load was very high. Participants in both age groups improved their cognitive performance when walking at their preferred speed as opposed to sitting or walking at a fixed, non-preferred speed. We conclude that the interaction of walking and cognitive performance is influenced by sharing resources between two tasks, and that performance improvements in cognition may be caused by an exercise-induced activation of resources.     

Effects of familiar and unfamiliar asynchronous music on treadmill walking endurance

To assess effects of familiarity of music on treadmill endurance, 15 female undergraduates in sports science performed an incremental treadmill walking task on three separate occasions while listening to Familiar Music, Unfamiliar Music, and White Noise. A repeated-measures analysis of variance indicated that participants walked for significantly longer when accompanied by Familiar and Unfamiliar Music in comparison to White Noise (p<.01). Although participants rated Familiar Music as significantly more motivating than Unfamiliar music (p<.05), no significant differences were found between the two music conditions for treadmill endurance. Heart rates did not appear to be influenced by music during treadmill walking or on completion of the task.     

Changes in step time variability,not changes in step length and width,are associated with lower-trunk sway during dual-task gait in older adults

Individuals are exposed to repetitive dual-task-like situations in daily life, particularly while walking, and falls among community-dwelling older adults typically occur in such situations. Thus, understanding how individuals adapt their walking-related motion under dual-task conditions is of clinical importance. The present study was conducted to investigate the association between dual-task-related changes (DT-changes) in lower-limb gait parameters and DT-changes in lower-trunk sway. We hypothesized that DT-changes in both spatial- and temporal-lower-limb gait parameters would be associated with DT-changes in lower-trunk sway. Participants were older adults aged > 60 years who lived independently in communities (n = 43, 73.7 [6.1] years old), and younger adults (n = 28, 22.7 [5.1] years old). Participants were asked to walk while performing an additional cognitive task, or with no additional task. During walking, lower-limb gait parameters (step time, step length and width) and lower-trunk sway were measured using a photoelectric cell system and inertial sensors. In older adults, DT-changes in step time variability was significantly associated with DT-changes in lower-trunk sway (standard beta = 0.683, p = 0.003), and DT-changes in lower-trunk sway variability (standard beta = 0.493, p = 0.029). In younger adults, DT-changes in step width were significantly associated with DT-changes in lower-trunk sway (standard beta = 0.395, p = 0.041). The current results partially supported our hypotheses. The association between DT-changes in lower limb and DT-changes in lower-trunk sway varied according to age group.     

How do children coordinate simultaneous upper and lower extremity tasks? The development of dual motor task coordination

When performing simultaneous clapping with walking or galloping, adults adopt coupled, consistent and stable dual motor task coordination; do developmental trends in this coordination exist? In this study, we measured and compared coupling characteristics, consistency across trials and variability of phasing in 4-, 6-, 8-, and 10-year-olds (n=44) as they also performed the same dual motor task. For walk/clap, children adopted specific coupling patterns like adults by 8 years and with the same consistency by 10 years. Across age, children became less variable in clap and step movements separately and as coupled together. In the gallop/clap, children did not resemble adults in coupling patterns by 10 years but all measures were becoming more consistent across age. We discuss dual motor task coordination as a function of age and task complexity using a "dynamic" perspective within a developmental context.     

Interlimb coordination in prosthetic walking: effects of asymmetry and walking velocity

The present study focuses on interlimb coordination in walking with an above-knee prosthesis using concepts and tools of dynamical systems theory (DST). Prosthetic walkers are an interesting group to investigate from this theory because their locomotory system is inherently asymmetric, while, according to DST, coordinative stability may be expected to be reduced as a function of the asymmetry of the oscillating components. Furthermore, previous work on locomotion motivated from DST has shown that the stability of interlimb coordination increases with walking velocity, leading to the additional expectation that the anticipated destabilizing effect of the prosthesis-induced asymmetry may be diminished at higher walking velocities. To examine these expectations, an experiment was conducted aimed at comparing interlimb coordination during treadmill walking between seven participants with an above-knee prosthesis and seven controls across a range of walking velocities. The observed gait patterns were analyzed in terms of standard gait measures (i.e., absolute and relative swing, stance and step times) and interlimb coordination measures (i.e., relative phase and frequency locking). As expected, the asymmetry brought about by the prosthesis led to a decrease in the stability of the coordination between the legs as compared to the control group, while coordinative stability increased with increasing walking velocity in both groups in the absence of a significant interaction. In addition, the 2:1 frequency coordination between arm and leg movements that is generally observed in healthy walkers at low walking velocities was absent in the prosthetic walkers. Collectively, these results suggest that both stability and adaptability of coordination are reduced in prosthetic walkers but may be enhanced by training them to walk at higher velocities.     

The effect of instruction to synchronize over step frequency while walking with auditory cues on a treadmill

Walking to a pacing stimulus has proven useful in motor rehabilitation, and it has been suggested that spontaneous synchronization could be preferable to intentional synchronization. But it is still unclear if the paced walking effect can occur spontaneously, or if intentionality plays a role. The aim of this work is to analyze the effect of sound pacing on gait with and without instruction to synchronize, and with different rhythmic auditory cues, while walking on a treadmill.Firstly, the baseline step frequency while walking on a treadmill was determined for all participants, followed by experimental sessions with both music and footstep sound cues. Participants were split into two groups, with one being instructed to synchronize their gait to the auditory stimuli, and the other being simply told to walk. Individual auditory cues were generated for each participant: for each trial, cues were provided at the participant’s baseline walking frequency, at 5% and 10% above baseline, and at 5% and 10% below baseline.This study’s major finding was the role of intention on synchronization, given that only the instructed group synchronized their gait with the auditory cues. No differences were found between the effects of step or music stimuli on step frequency.In conclusion, without intention or cues that direct the individual’s attention, spontaneous gait synchronization does not occur during treadmill walking.     

Comparison of the trunk-pelvis and lower extremities sagittal plane inter-segmental coordination and variability during walking in persons with and without chronic low back pain

Inter-segmental coordination can be influenced by chronic low back pain (CLBP). The sagittal plane lower extremities inter-segmental coordination pattern and variability, in conjunction with the pelvis and trunk, were assessed in subjects with and without non-specific CLBP during free-speed walking. Kinematic data were collected from 10 non-specific CLBP and 10 non-CLBP control volunteers while the subjects were walking at their preferred speed. Sagittal plane time-normalized segmental angles and velocities were used to calculate continuous relative phase for each data point. Mean absolute relative phase (MARP) and deviation phase (DP) were derived to quantify the trunk-pelvis and bilateral pelvis-thigh, thigh-shank and shank-foot coordination pattern and variability over the stance and swing phases of gait. Mann-Whitney U test was employed to compare the means of DP and MARP values between two groups (same side comparison). Statistical analysis revealed more in-phase/less variable trunk-pelvis coordination in the CLBP group (P < 0.05). CLBP group demonstrated less variable right or left pelvis-thigh coordination pattern (P < 0.05). Moreover, the left thigh-shank and left shank-foot MARP values in the CLBP group, were more in-phase than left MARP values in the non-CLBP control group during the swing phase (P < 0.05). In conclusion, the sagittal plane lower extremities, pelvis and trunk coordination pattern and variability could be generally affected by CLBP during walking. These changes can be possible compensatory strategies of the motor control system which can be considered in the CLBP subjects.     

Exploring gait adaptations to perturbed and conventional treadmill training in Parkinson’s disease: Time-course,sustainability, and transfer

BackgroundGait impairment is a major motor symptom in Parkinson’s disease (PD), and treadmill training is an effective non-pharmacological treatment option.Research questionIn this study, the time course, sustainability and transferability of gait adaptations to treadmill training with and without additional postural perturbations were investigated.Methods38 PD patients (Hoehn & Yahr 1–3.5) were randomly allocated to eight weeks of treadmill training, performed twice-weekly for 40 min either with (perturbation treadmill training [PTT], n = 18) or without (conventional treadmill training [CTT], n = 20) additional perturbations to the treadmill surface. Spatiotemporal gait parameters were assessed during treadmill walking on a weekly basis (T0–T8), and after three months follow-up (T9). Additional overground gait analyses were performed at T0 and T8 to investigate transfer effects.ResultsTreadmill gait variability reduced linearly over the course of 8 weeks in both groups (p < .001; Cohen’s d (range): −0.53 to −0.84). Only the PTT group significantly improved in other gait parameters (stride length/time, stance-/swing time), with stride time showing a significant between-group interaction effect (Cohen’s d = 0.33; p = .05). Additional between-group interactions indicated more sustained improvements in stance (Cohen’s d = 0.85; p = .02) and swing time variability in the PTT group (Cohen’s d = 0.82; p = .03) at T9. Overground gait improvements at T8 existed only in stance (d = -0.73; p = .04) and swing time (d = 0.73; p = .04).DiscussionTreadmill stride-to-stride variability reduced substantially and linearly, but transfer to overground walking was limited. Adding postural perturbations tended to increase efficacy and sustainability of several gait parameters. However, since between-group effects were small, more work is necessary to support these findings.     

Effects of velocity and limb loading on the coordination between limb movements during walking

The authors investigated the effects of velocity (increasing from 0.5 to 5.0 km/hr in steps of 0.5 km/hr) and limb loading on the coordination between arm and leg movements during treadmill walking in 7 participants. Both the consistency of the individual limb movements and the stability of their coordination increased with increasing velocity; the frequency coordination between arm and leg movements was 2:1 at the lower velocities and 1:1 at the higher velocities. The mass manipulation affected the individual limb movements but not their coordination, indicating that a stable walking pattern was preserved. The results differed qualitatively from those obtained in studies on bimanual interlimb coordination, implying that the dynamical principles identified therein are not readily applicable to locomotion.     

Investigating the social behavioral dynamics and differentiation of skill in a martial arts technique

Coordinating interpersonal motor activity is crucial in martial arts, where managing spatiotemporal parameters is emphasized to produce effective techniques. Modeling arm movements in an Aikido technique as coupled oscillators, we investigated whether more-skilled participants would adapt to the perturbation of weighted arms in different and predictable ways compared to less-skilled participants. Thirty-four participants ranging from complete novice to veterans of more than twenty years were asked to perform an Aikido exercise with a repeated attack and response, resulting in a period of steady-state coordination, followed by a take down. We used mean relative phase and its variability to measure the steady-state dynamics of both the inter- and intrapersonal coordination. Our findings suggest that interpersonal coordination of less-skilled participants is disrupted in highly predictable ways based on oscillatory dynamics; however, more-skilled participants overcome these natural dynamics to maintain critical performance variables. Interestingly, the more-skilled participants exhibited more variability in their intrapersonal dynamics while meeting these interpersonal demands. This work lends insight to the development of skill in competitive social motor activities.     

Visual and haptic feedback contribute to tuning and online control during object manipulation

The authors employed a virtual environment to investigate how humans use haptic and visual feedback in a simple, rhythmic object-manipulation task. The authors hypothesized that feedback would help participants identify the appropriate resonant frequency and perform online control adjustments. The 1st test was whether sensory feedback is needed at all; the 2nd was whether the motor system combines visual and haptic feedback to improve performance. Task performance was quantified in terms of work performed on the virtual inertia, ability to identify the correct rhythm, and variability of movement. Strict feedforward control was found to be ineffective for this task, even when participants had previous knowledge of the rhythm. Participants (N = 11) performed far better when feedback was available (11 times more work, 2.2 times more precise frequency, 30% less variability; p < .05 for all 3 performance measures). Using sensory feedback, participants were able to rapidly identify 4 different spring-inertia systems without foreknowledge of the corresponding resonant frequencies. They performed over 20% more work with 24% less variability when provided with both visual and haptic feedback than they did with either feedback channel alone (p < .05), providing evidence that they integrated online sensory channels. Whereas feedforward control alone led to poor performance, feedback control led to fast tuning or calibration of control according to the resonant frequency of the object, and to better control of the rhythmic movement itself.     

Coordination of symmetrical and asymmetrical human gait

Most human gait forms assume symmetrical, alternating patterns of interlimb coordination (e.g., crawling, walking, running). Human galloping is a notable exception. In contrast to extensive information on galloping in animals, little is known about this gait in humans. Therefore, kinematic and topographical analyses of running and galloping were undertaken to investigate the manner in which the lower limbs are uncoupled to produce this asymmetrical gait. Seven adult females were filmed while running and galloping at their preferred speed. Analysis of the gaits revealed differences in the following: (a) preferred speed, (b) coupling between upper- and lower-limb girdles, and (c) point of foot fall (end-point trajectories). In contrast to clear differences in interlimb coordination, intralimb coordination was remarkably similar across gaits, although when galloping was adopted, the rear leg did show more variable change than the front leg.