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.     

Optimization characteristics of walking with and without a load on the trunk of the body

Previous work showed that subjects naturally adopt a walking speed which optimizes energy cost of locomotion and stability of stride; however, no studies have examined whether these criteria are affected by carrying an external load. The purpose of this study was to compare optimization characteristics during loaded or unloaded walking. Energy cost and stride characteristics were measured for 10 subjects with and without a load on the trunk of the body of 10% of the body weight during 4 sessions. The first 2 sessions represent free walking at 2.5, 3, 3.5, 4, 4.5, and 5 km x hr.(-1). The last sessions represent free vs forced walking at constant speed (preferred frequency and +/- 10 PF and +/-20% of preferred frequency). Results show an effect of load on energy cost of walking but no effect on the optimal speed for stability. Furthermore, when carrying a load the subject does not adopt systematically the speed that minimizes physiological cost. Our findings suggest the necessity to consider this effect to prevent gait disturbance and maintain the health benefits of walking.     

The force-driven harmonic oscillator model for energy-efficient locomotion in individuals with transtibial amputation

The force-driven harmonic oscillator (FDHO) model states that the driving force is minimum at the resonant period of an oscillator. By manipulating prosthetic mass, this study explored the compromise of resonant periods between the two legs in persons with unilateral traumatic transtibial amputation (TTA) at self-selected walking velocity (SSWV), with an aim to better understand the energy minimization mechanisms of walking. It was hypothesized that (1) SSWV was the most energy-efficient walking velocity (MEWV), (2) the stride period at SSWV (Ts) is a compromise between the resonant periods of the normal leg (Tn) and the prosthetic leg (Tp) when they are dissimilar. Eight subjects completed multiple-speed treadmill walking tests (at 53, 67, 80, 93, and 107 m/min) according to three mass conditions (60%, 80%, and 100% of the normal leg below-knee mass) in a random order. Oxygen consumption and stride period were measured, and SSWV was empirically determined. The MEWV, the speed with minimum energy expenditure per distance traveled, was derived from quadratic regression, and its stride period (Tm) was estimated. A theoretical compromise period (Tv) between Tn and Tp was predicted by a virtual single pendulum system based on Huygens' Law. Across different mass conditions, comparisons were made among: Ts, Tm, Tv, Tn, and Tp. Results showed that: (1) Ts was significantly different from Tm; (2) Ts was greater than both Tn and Tp; (3) no significant difference was found between Tm and Tn. Implications for amputee rehabilitation in terms of thigh muscle training and prosthesis development were discussed.     

The impact of speed and time on gait dynamics

To determine the effects of speed on gait previous studies have examined young adults walking at different speeds; however, the small number of strides may have influenced the results. The aim of this study was to investigate the immediate and long-term impact of continuous slow walking on the mean, variability and structure of stride-to-stride measures. Fourteen young adults walked at a constant pace on a treadmill at three speeds (preferred walking speed (PWS), 90% and 80% PWS) for 30 min each. Spatiotemporal gait parameters were computed over six successive 5-min intervals. Walking slower significantly decreased stride length, while stride period and width increased. Additionally, stride period and width variability increased. Signal regularity of stride width increased and decreased in stride period. Persistence of stride period and width increased significantly at slower speeds. While several measures changed during 30 min of walking, only stride period variability and signal regularity revealed a significant speed and time interaction. Healthy young adults walking at slower than preferred speeds demonstrated greater persistence and signal regularity of stride period while spatiotemporal changes such as increased stride width and period variability arose. These results suggest that different control processes are involved in adapting to the slower speeds.     

Biomechanical and energetic determinants of technique selection in classical cross-country skiing

Classical cross-country skiing can be performed using three main techniques: diagonal stride (DS), double poling (DP), and double poling with kick (DK). Similar to other forms of human and animal gait, it is currently unclear whether technique selection occurs to minimize metabolic cost or to keep some mechanical factors below a given threshold. The aim of this study was to find the determinants of technique selection. Ten male athletes roller skied on a treadmill at different slopes (from 0° to 7° at 10 km/h) and speeds (from 6 to 18 km/h at 2°). The technique preferred by skiers was gathered for every proposed condition. Biomechanical parameters and metabolic cost were then measured for each condition and technique. Skiers preferred DP for skiing on the flat and they transitioned to DK and then to DS with increasing slope steepness, when increasing speed all skiers preferred DP. Data suggested that selections mainly occur to remain below a threshold of poling force. Second, critically low values of leg thrust time may limit the use of leg-based techniques at high speeds. A small role has been identified for the metabolic cost of locomotion, which determined the selection of DP for flat skiing.     

Energetic Cost and Stability during Human Walking at the Preferred Stride Frequency

The possibility that preferred modes of locomotion emerge from dynamical and optimality constraints and the energetic and dynamical constraints on preferred and predicted walking frequency are explored in this article. Participants were required to walk on a treadmill at their preferred frequency, at a frequency predicted as the resonance of a hybrid pendulum-spring model of the legs, and at frequencies ±15%, ±25%, ±35% of the predicted frequency. Walking at the preferred and predicted frequencies resulted in minimal metabolic costs and maximal stability of the head and joint actions. Mechanical energy conservation was constant across conditions. The head was more stable than the joints. The joints appeared to be in service of the head in maintaining a stable trajectory. The major findings of this study suggest a complementary relationship between energetic (physiological) and stability constraints in the adoption of a preferred frequency of walking. Multiple subsystems may be involved in constraining observed macroscopic behavior in intact biological systems. The approach and results of the study imply that a useful tack in understanding how dynamical control structures arise is to study the potential criteria that serve to act as constraints on skilled movement patterns in unimpaired and impaired populations.     

The effect of shoe and floor characteristics on walking kinematics

It is common sense that walking on sand poses challenges to postural control. However, there are no studies quantifying the kinematics of sand walking compared to other types of postural perturbations such as unstable shoes. The aim of the study was to investigate differences in walking kinematics during walking on solid ground, in unstable shoes and on unstable surfaces. Nineteen healthy young adults (23.5 ± 1.5 years) performed three different walking tasks: 1) walking at preferred speed while wearing regular shoes; 2) Walking at preferred speed wearing Masai Barefoot Technology shoes and 3) barefoot walking at preferred speed on a large sand grave. Full-body kinematics were recorded during all conditions using an inertial motion capture system. Basic gait parameters (walking speed, stride length and duration), relative vertical center-of-mass position (rvCOM), and ankle, knee and hip joint angles in the sagittal plane were compared across the tasks through statistical parametric mapping over the course of full walking cycles. Participants presented similar walking speed, as well as stride length and duration across different conditions (p > 0.05). However, walking on sand reduced the rvCOM (p < 0.05), while also requiring greater ankle plantarflexion during stance phase (p < 0.05), as well as greater knee and hip flexion during leg swing and initial contact when compared to the other conditions (p < 0.05). It was concluded that walking on sand substantially changes walking kinematics, and may cause greater postural instability than unstable shoes. Therefore, walking on sand can be an alternative to improve postural control in patients undergoing walking rehabilitation.     

Energetic Cost and Stability During Human Walking at the Preferred Stride Velocity

The possibility that preferred modes of locomotion emerge from dynamical and optimality constraints and the energetic and dynamical constraints on preferred and predicted walking frequency are explored in this article. Participants were required to walk on a treadmill at their preferred frequency, at a frequency predicted as the resonance of a hybrid pendulum-spring model of the legs, and at frequencies +/-15%, +/-25%, +/-35% of the predicted frequency. Walking at the preferred and predicted frequencies resulted in minimal metabolic costs and maximal stability of the head and joint actions. Mechanical energy conservation was constant across conditions. The head was more stable than the joints. The joints appeared to be in service of the head in maintaining a stable trajectory. The major findings of this study suggest a complementary relationship between energetic (physiological) and stability constraints in the adoption of a preferred frequency of walking. Multiple subsystems may be involved in constraining observed macroscopic behavior in intact biological systems. The approach and results of the study imply that a useful tack in understanding how dynamical control structures arise is to study the potential criteria that serve to act as constraints on skilled movement patterns in unimpaired and impaired populations.     

Influence of anterior load carriage on lumbar muscle activation while walking in stable and unstable shoes

Load carriage can be harmful for workers, and alternative interventions to reduce back pain while walking and carrying loads are necessary. Unstable shoes have been used to improve balance and reduce back pain, but it is unknown whether walking wearing unstable shoes while carrying loads anteriorly causes excessive trunk extensors muscle activation. The aim of this study was to investigate the effects of different shoe types and anterior load carriage on gait kinematics and lumbar electromyographic (EMG) activity. Fourteen adults that predominantly walk or stand during the work day were asked to walk with and without carrying 10% of body mass anteriorly while wearing regular walking shoes (REG) and unstable shoes (MBT). The effects of shoe type, load carriage, and shoe × load interactions on the longissimus thoracis (LT) and iliocostalis lumborum (IC) EMG, stride duration, and stride frequency were assessed. MBT shoes induced a significant increase in LT (44.4 ± 35%) and IC EMG (33.0 ± 32%, p < .005), while load carriage increased LT (58.5 ± 41%) and IC EMG (55.1 ± 32%, p < .001). No significant shoe × load interaction was found (p>.05). However, walking wearing MBT shoes while carrying loads induced a 46 ± 40% higher EMG activity compared to walking wearing MBT shoes without load carriage. No effects of shoes or load carriage were found on stride duration and stride frequency. It was concluded that walking wearing MBT shoes and carrying 10% of total body mass induced greater activation of trunk extensors muscle compared to these factors in isolation, such a combination may not influence gait patterns.     

Examining the impact of distraction on tic suppression in children and adolescents with Tourette syndrome

Tourette syndrome (TS) is characterized by motor and/or vocal tics. Tics are thought to be temporarily suppressible, and it is believed that suppression requires significant attentional resources. The aim of the current study was to examine the impact of an attention-demanding distraction task on tic suppression. A secondary aim was to examine whether performance on that task decreased during concomitant periods of suppression. Nine children with TS, ages 9-15, participated in the study. An alternating treatment design was used to compare three conditions, free-to-tic baseline (BL), reinforced tic suppression (SUP) and reinforced tic suppression plus a distraction task (SUP + DIS). Tic frequencies were significantly higher during BL conditions than both SUP and SUP + DIS conditions, and tic frequencies during SUP and SUP + DIS did not differ. Accuracy on the distraction task decreased during SUP + DIS as compared to BL. Results suggest that contextual distractions may not negatively impact tic frequencies. In addition, accuracy on an attention-demanding task may be impacted if a child is simultaneously suppressing.     

Investigating the efficacy of a tactile feedback system to increase the gait speed of older adults

The objective of this study was to determine (1) if a novel haptic feedback system could increase the walking speed of older adults while it is being employed during overground walking and (2) whether the frequency at which this feedback was presented would have a differential impact on the ability of users to change walking speed while it was present. Given that peak thigh extension has been found to be a biomechanical surrogate for stride length, and consequently gait speed, vibrotactile haptic feedback was provided to the participants' thighs as a cue to increase peak thigh extension while the effect on gait speed was monitored. Ten healthy community-dwelling older adults (68.4 ± 4.1 years) participated. Participants' peak thigh extension, cadence, normalized stride length and velocity, along with their coefficients of variation (COV) were compared across baseline normal and fast walking (with no feedback) and three different frequency of feedback conditions. The findings indicated that, compared to self-selected normal and fast walking speeds, peak thigh extension was significantly increased when feedback was present and after it was withdrawn in a post-test. An increase in thigh extension led to an increase in stride length and, consequently, an increase in stride velocity compared to normal speed. There were no significant differences in the gait parameters as a function of feedback frequency during its application. In conclusion, while present, the haptic feedback system increased thigh extension and walking speed in older adults regardless of the feedback frequency and when the feedback was withdrawn, participants could maintain an increase in those parameters.     

Cost of transport at preferred walking speeds are minimized while walking on moderately steep incline surfaces

Research has shown that preferred walking speed results in a minimization of the cost of transport on flat surfaces. However, it has also been shown that over non-smooth surfaces other variables, such as stability, are necessary for task completion increasing the cost of transport. The purpose of this research was to investigate the effect of incline walking on the cost of transport, assessing the effect of raising the center of mass as a potential variable affecting preferred walking speed, such that the cost of transport is no longer minimized. 12 healthy, college-aged male participants completed walking trials on a treadmill at inclines of 0%, 5%, 10%, 15%, and 20% at three different continuous speeds (1mph, 2mph and 3mph) and a preferred walking speed for 4–5 min. Cost of transport was calculated using the oxygen consumption collected during the last minute of each stage. Up to 20% incline, the cost of transport was lowest on each incline for the preferred walking speed trials. On inclines greater than 20%, many participants were unable to complete the task with respiratory exchange ratios less than 1.0. We conclude that inclines up to 20% do not induce an alternative challenge affecting the established relationship that humans prefer to walk at speeds that minimize the cost of transport despite the increased need to raise the center of mass.     

Intellectual ability in young men separated temporarily from their parents in childhood

We examined the effects of early life stress (ELS) on intellectual ability in 2,725 20-year-old male participants, of whom 321 were separated temporarily (mean 1.7 years) from both their parents during World War II, at an average age of 4.3 years. Intellectual ability was tested when entering compulsory military service. The separated men had − 0.28 (95% CI − 0.39, − 0.16), − 0.13 (95% CI − 0.25, − 0.01), − 0.18 (95% CI − 0.29, − 0.06), and − 0.19 (95% CI − 0.30, − 0.07) SD units lower verbal, visuospatial, arithmetic, and composite score of intellectual ability, respectively, compared to non-separated. Participants who were separated for more than a year and between two and four years had the lowest ability scores. ELS showed most consistent associations with verbal ability, but were not limited to it. Children beyond infancy and before their school-age may be the most vulnerable to the adverse effects of the ELS.     

Bodyweight support alters the relationship between preferred walking speed and cost of transport

Humans tend to select a preferred walking speed (PWS) that minimizes the metabolic energy consumed per distance traveled, i.e. the Cost of Transport (CoT). The aims of this study were to: 1. compare PWS overground vs. on a treadmill at 100 and 50% of body weight, and 2. explore whether with body weight support, PWS corresponds to the speed that minimizes CoT. Fifteen healthy adults walked overground and on a lower body positive pressure treadmill with and without bodyweight support. Walking speeds (m^.s⁻¹) were recorded for each condition. Rate of energy expenditure (J^.kg^−1.min⁻¹) and CoT (J^.kg^−1.m⁻¹) were then determined from 5-min walking trials with 50% bodyweight support at PWS and ± 30% of the self-selected walking speed for that condition. PWS did not differ across conditions. With 50% body weight support, for each 30% increase in walking speed, rates of metabolic energy expenditure increased ∼15% while CoT decreased by ∼14%. Thus, with 50% body weight support, PWS did not correspond with the speed that minimized CoT. Bodyweight support decreases cost of maintaining an upright body but does not decrease the metabolic demand of limb advancement, contributing to the linear yet not proportional changes in rates of energy expenditure and CoT. We conclude that bodyweight support via an AlterG® treadmill disconnects the association between PWS and minimum CoT. These findings have implications for clinical populations (e.g., obese, elderly) who may benefit from walking on a bodyweight supporting treadmill but may select speeds incompatible with their physical activity goals.     

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.     

Domestic cat walking parallels human constrained optimization: Optimization strategies and the comparison of normal and sensory deficient individuals

To evaluate how fundamental gait parameters used in walking (stride length, frequency, speed) are selected by cats we compared stride characteristics selected when walking on a solid surface to those selected when they were constrained to specific stride lengths using a pedestal walkway. Humans spontaneously select substantially different stride length–stride frequency–speed relationships in walking when each of these parameters is constrained, as in walking to a metronome beat (frequency constrained), evenly spaced floor markers (stride length constrained) or on a treadmill (speed constrained). In humans such adjustments largely provide energetic economy under the prescribed walking conditions. Cats show a similar shift in gait parameter selection between conditions as observed in humans. This suggests that cats (and by extension, quadrupedal mammals) also select gait parameters to optimize walking cost-effectiveness. Cats with a profound peripheral sensory deficit (from pyridoxine overdose) appeared to parallel the optimization seen in healthy cats, but without the same level of precision. Recent studies in humans suggest that gait optimization may proceed in two stages – a fast perception-based stage that provides the initial gait selection strategy which is then fine-tuned by feedback. The sensory deficit cats appeared unable to accomplish the feedback-dependent aspect of this process.     

The combined influence of body weight support and running direction on self-selected movement patterns

We investigated metabolic costs, muscle activity, and perceptual responses during forward and backward running at matched speeds at different body weight support (BWS) conditions. Participants ran forward and backward on a lower body positive pressure treadmill at 0%BWS, 20%BWS, and 50%BWS conditions. We measured oxygen uptake, carbon dioxide production, heart rate, muscle activity, and stride frequency. Additionally, we calculated metabolic cost of transport. Furthermore, we used rating of perceived exertion and feeling scale to investigate perceptual responses. Feeling scale during running was higher with increasing BWS (0–50%BWS), regardless of running direction (p < 0.05). Oxygen uptake, heart rate, and metabolic cost of transport were influenced by the interaction of running direction and BWS (p < 0.01). For example, metabolic cost of transport during backward running was greater than when running forward only when running at 0%BWS (i.e., 4.4 ± 1.1 and 5.8 ± 1.4 J/kg/m for forward and backward running, respectively: p < 0.001). However, rectus femoris muscle activity, stride frequency, and rating of perceived exertion during backward running were averages of 113.5%, 11.3%, and 2.8 rankings greater than when running forward, respectively, regardless of BWS (p < 0.001). We interpret our observations to indicate that environment (in the context of effective body weight) is a critical factor that determines self-selected movement patterns during forward and backward running.     

Human walk-to-run transition in the context of the behaviour of complex systems

This study had two main aims: 1) to investigate if the walk-to-run (WR-) transition occurs when the speed of locomotion is kept constant below the WR-transition speed (speed clamp) and the stride rate is increased monotonously using a metronome and 2) to investigate if diversion of attention and awareness from the locomotion process influences the position of the WR-transition in stride rate, stride length, and locomotion speed (SrSlLs) space.Eighteen healthy individuals (13 men and 5 women) were recruited (age: 23.9 ± 1.5 years, height: 1.77 ± 0.10 m and body mass: 77.3 ± 12.8 kg). Stride-by-stride stride rates, stride lengths, locomotion speeds, and duty factors were determined on a treadmill in 4 different tests: 1) reference WR-transition, 2) preferred walking speed, 3) dual-task test including arithmetic calculations and 4) four speed clamp bouts with different initial velocities.Walk-to-run transitions were elicited in all participants in the speed clamp bouts. When the stride rate ramp was clamped at preferred walking speed the WR-transition stride rate was not significantly different from the WR-transition stride rate during the reference test (t = 2.2, p = 0.312). However, in the SrSlLs space the speed clamp WR-transitions all deviated from the position of the reference WR-transition. Additionally, it was demonstrated that intensive attentional diversion using a dual-task paradigm had very little influence on the position of the WR-transition in the SrSlLs space.It is argued that these observations can be explained in the context of the behavior of complex systems.     

Learning and career specialty preferences of medical school applicants

The present research examined relationships among medical school applicants’ preferred approaches to learning, methods of instruction, and specialty areas (n = 912). Based on confidential responses to a progressive series of paired comparisons, applicants’ preferences for lecture (L), self-study (SS), group discussion (GD), and computers (C) were assessed across three dimensions: (1) comfort; (2) effectiveness; and (3) interest. Using cluster analysis to generate four instructional “profiles,” participants’ comparative preferences for self-study/lecture versus group discussion/computers (+SS, L/−GD, C) were positively associated with interests in surgery and neurology, whereas opposing preferences (+GD, C/−L, SS) corresponded with the practice of family medicine. Using a matriculant subset (N = 160), analyses indicated that these relationships remained after controlling for sex and psychological type.     

Prior and future withdrawal and performance: A meta-analysis of their relations in panel studies

While consensus exists among researchers that withdrawal and performance are related, the ordering of these constructs in proposed models frequently varies based on the theoretical focus of the study. Specifically, several extant well-being theories predict employee withdrawal will affect future performance while several turnover theories predict employee performance will affect future withdrawal. This study systematically addresses these complementary theories by conducting a meta-analysis of panel studies measuring both withdrawal and performance at two or more time periods. After accounting for sampling and measurement error, meta-analytic regression results indicate that performance is significantly negatively related to future withdrawal (ρ = − .19) even after accounting for prior withdrawal (β = − .03). However, the relationship between withdrawal and future performance (ρ = − .20) disappeared after accounting for prior performance (β = .00), although burnout did predict future performance even after accounting for prior performance (β = − .07).