Relationships between dual-task related changes in stride velocity and stride time variability in healthy older adults

Dual-task related gait changes have been previously reported for healthy older adults, suggesting that gait control requires attention. Compared to balance control, the involvement of attention in the control of the rhythmic stepping mechanism, as reflected by stride time variability, is not well known. In particular, under dual-task, the relative contributions of a second, attention-demanding task and changes in walking speed remain unclear. Thus, the aims of this study were (1) to assess whether walking with a slow-selected speed or walking while performing an attention-demanding task affected stride time variability in a sample of healthy older participants, and (2) to establish whether stride time variability under dual-task conditions is related either to the decrease of walking speed or the simultaneous attention-demanding task, or to both. Forty-five healthy older participants performed four experimental conditions: (1) walking at a normal self-selected speed, (2) walking at a slow self-selected speed, (3) performing a verbal fluency task when sitting on a chair, and (4) performing the verbal fluency task while walking at self-selected walking speed. Gait parameters were recorded across 15 meters, using Physilog. Results showed a significant dual-task related decrease in mean values of stride velocity, as well as a significant increase in mean values and coefficients of variation of stride time. These dual-task related changes in stride time were explained by the simultaneous performance of the verbal fluency task, the decrease of gait speed and the variability between participants. Although a relationship exists between decreased walking speed and increased stride time variability, the dual-task related increase of stride time variability was also significantly associated with the attention-demanding task, suggesting some attentional control for the rhythmic stepping mechanism of walking in healthy older adults.     

Gait training facilitates push-off and improves gait symmetry in children with cerebral palsy

BackgroundHuman walking involves a rapid and powerful contraction of ankle plantar flexors during push-off in late stance.ObjectiveHere we investigated whether impaired push-off force contributes to gait problems in children with cerebral palsy (CP) and whether it may be improved by intensive gait training.MethodsSixteen children with CP (6–15 years) and fourteen typically developing (TD) children (4–15 years) were recruited. Foot pressure was measured by insoles and gait kinematics were recorded by 3-dimensional video analysis during treadmill and overground walking. The peak derivative of ground reaction force at push off (dPF) was calculated from the foot pressure measurements. Maximal voluntary plantar flexion (MVC) was measured while seated. Measurements were performed before and after a control period and after 4 weeks of 30 minutes daily inclined treadmill training.ResultsdPF and MVC were significantly lower in children with CP on the most affected (MA) as compared to TD children (p < .001). dPF was lower on the MA leg as compared to the less affected (LA) leg in children with CP (p < .05). Following gait training, increases in dPF (p < .001) and MVC (p < .01) were observed for the MA leg. Following gait training children with CP showed similar timing of dPF and similar stance phase duration on both legs indicating improved symmetry of gait. These effects were also shown during overground walking.ConclusionImpaired ability to voluntarily activate ankle plantar flexors and produce a rapid and powerful push-off during late stance are of importance for impaired gait function in children with CP. Intensive treadmill training may facilitate the drive to ankle plantar flexors and reduce gait asymmetry during both treadmill and overground walking.     

Comparing the effect of haptic modalities on walking balance control: Is using one or two arms better?

BackgroundAdding haptic input by lightly touching a railing or using haptic anchors may improve walking balance control. Typical use of the railing(s) and haptic anchors requires the use of one and two arms in an extended position, respectively. It is unclear whether it is arm configuration and/or the number of arms used or the addition of sensory input that affects walking balance control.Research questionThis study examined whether using one arm or two arms to add haptic input through light touch on a railing or using the haptic anchors affects walking balance control.MethodsIn this study, young adults (n = 24) walked while using (actual use) or pretending to use (pretend use) the railing(s) and haptic anchors with one or two arms. Inertial-based sensors (Mobility Lab, APDM) were used to measure stride velocity, relative time spent in double support (%DS), and peak normalized medio-lateral trunk velocity (pnMLTV).ResultsUsing two arms lead to a decrease in pnMLTV compared to using one arm and pnMLTV was lower in the actual use trials compared to the pretend use trials for the anchors only. Stride velocity and %DS did not change between trials when one or two arms were used or when participants actually or pretended to use the haptic tools. Participants walked slower when using the railing compared to the anchors.SignificanceThe importance of considering the number of arms is highlighted in the improved balance control when using two arms with either tool. The augmented sensory input adds to the stabilizing effect of arm configuration for the anchors but not the railings. These results have implications for future research and rehabilitation efforts emphasizing sensorimotor integration to improve walking balance control.     

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 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.     

Partial body weight support treadmill training speed influences paretic and non-paretic leg muscle activation,stride characteristics,and ratings of perceived exertion during acute stroke rehabilitation

BackgroundIntensive task-specific training is promoted as one approach for facilitating neural plastic brain changes and associated motor behavior gains following neurologic injury. Partial body weight support treadmill training (PBWSTT), is one task-specific approach frequently used to improve walking during the acute period of stroke recovery (<1 month post infarct). However, only limited data have been published regarding the relationship between training parameters and physiologic demands during this early recovery phase.ObjectiveTo examine the impact of four walking speeds on stride characteristics, lower extremity muscle demands (both paretic and non-paretic), Borg ratings of perceived exertion (RPE), and blood pressure.DesignA prospective, repeated measures design was used.MethodsTen inpatients post unilateral stroke participated. Following three familiarization sessions, participants engaged in PBWSTT at four predetermined speeds (0.5, 1.0, 1.5 and 2.0 mph) while bilateral electromyographic and stride characteristic data were recorded. RPE was evaluated immediately following each trial.ResultsStride length, cadence, and paretic single limb support increased with faster walking speeds (p ⩽ 0.001), while non-paretic single limb support remained nearly constant. Faster walking resulted in greater peak and mean muscle activation in the paretic medial hamstrings, vastus lateralis and medial gastrocnemius, and non-paretic medial gastrocnemius (p ⩽ 0.001). RPE also was greatest at the fastest compared to two slowest speeds (p < 0.05).ConclusionsDuring the acute phase of stroke recovery, PBWSTT at the fastest speed (2.0 mph) promoted practice of a more optimal gait pattern with greater intensity of effort as evidenced by the longer stride length, increased between-limb symmetry, greater muscle activation, and higher RPE compared to training at the slowest speeds.     

The effect of dividing attention between walking and auxiliary tasks in people with Parkinson's disease

This controlled study examined the effects of dividing attention between walking and the performance of a secondary cognitive task in people with mild to moderate Parkinson's disease (Hoehn and Yahr stages 2-3.5). Participants in the training group (n=6) received 30 min divided attention training in taking big steps while simultaneously performing serial three subtractions. Participants in the control group (n=6) received no training. Stride length, gait velocity and accurate enumeration rate were measured at baseline, immediate after training and 30 min after training under single-task (walk only or subtract only) and dual-task (walk and subtract) conditions. Data were also collected at training in the training group. Immediate improvement in stride length and gait velocity was found when instruction was given to participants to pay equal attention to gait and subtractions (p=0.001, p=0.05) compared to baseline. Short-term improvement in the gait variables was also found after training when compared to the controls (p=0.001, p=0.001). Nevertheless, there was no significant difference in the accurate enumeration rate. Based on the findings, we conclude that divided attention can be used as a strategy to improve slow and short-stepped gait under dual-task conditions. Divided attention can also be used in gait training for short term stride length and gait velocity improvement.     

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.     

Dual-task costs of texting while walking forward and backward are greater for older adults than younger adults

Cognitive-motor dual-tasking involves concurrent performance of two tasks with distinct cognitive and motor demands and is associated with increased fall risk. In this hypothesis-driven study, younger (18–30 years, n = 24) and older (60–75 years, n = 26) adults completed six walking tasks in triplicate. Participants walked forward and backward along a GAITRite mat, in isolation or while performing a verbal fluency task. Verbal fluency tasks involved verbally listing or typing on a smartphone as many words as possible within a given category (e.g., clothes). Using repeated measures MANOVA models, we examined how age, method of fluency task (verbal or texting), and direction of walking altered dual-task performance. Given that tasks like texting and backward walking require greater cognitive resources than verbal and forward walking tasks, respectively, we hypothesized older adults would show higher dual-task costs (DTCs) than younger adults across different task types and walking directions, with degree of impairment more apparent in texting dual-task trials compared to verbal dual-task trials. We also hypothesized that both age groups would have greater DTCs while walking backward than while walking forward, regardless of task.Independent of age group, velocity and stride length were reduced for texting compared to the verbal task during both forward and backward walking; cadence and velocity were reduced while walking forward compared to walking backward for the texting task; and stride length was reduced for forward walking compared to backward walking during the verbal task. Younger adults performed better than older adults on all tasks with the most pronounced differences seen in velocity and stride length during forward-texting and backward-texting. Interaction effects for velocity and stride length while walking forward indicated younger adults performed better than older adults for the texting task but similarly during the verbal task. An interaction for cadence during the verbal task indicated younger adults performed better than older adults while walking backward but similarly while walking forward.In summary, older adults experienced greater gait decrement for all dual-task conditions. The greater declines in velocity and stride length in combination with cadence being stable suggest reductions in velocity during texting were due to shorter strides rather than a reduced rate of stepping. Contrary to our hypotheses, we found greater DTCs while walking forward rather than backward, which may be due to reduced gait performance during single-task backward walking; thus, further decrements with dual-tasking are unlikely. These findings underscore the need for further research investigating fall risk potential associated with texting and walking among aging populations and how interventions targeting stride length during dual-task circumstances may improve performance.     

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.     

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.     

Expectancies of infant-feeding methods among mothers in three ethnic groups

Abstract

The psychometric characteristics and construct validity of an inventory of expectancy statements about breast- and formula-feeding were assessed to refine a measure of the predictors of breastfeeding initiation and maintenance. Respondents were a tri-ethnic sample of mostly lower income mothers within two days after delivery. Ninety-six expectancy items reflecting eight hypothesized domains in expectancies of breastfeeding (BF) and formula-feeding(FF) were submitted to maximum likelihood factor analysis. Four factors were determined: “Benefits of BF,” “Relative Advantages of FF,” “Inconveniences of FF,” and “Relative Inconveniences of BF.” All factors were significantly related to actual BF of the new infant in the expected directions using unweighted factor scores in a multiple logistic regression analysis. Predicted BF closely matched actual BF for all ethnicities combined with a total error rate for misclassification of only 14%. This match was high for Anglo- and Black-American mothers. Each of the factors was determined to be reliably estimated by the ten most highly loaded items without an appreciable loss of internal consistency. Further research must assess expectancies prior to delivery in order to assess their predictiveness of behavior. and must further clarify the meaning of the expectancy factors to facilitate intervention.     

Gait and risk of falls associated with frontal cognitive functions at different stages of Alzheimer's disease

ABSTRACT

The decline in frontal cognitive functions contributes to alterations of gait and increases the risk of falls in patients with dementia, a category which included Alzheimer's disease (AD). The objective of the present study was to compare the gait parameters and the risk of falls among patients at different stages of AD, and to relate these variables with cognitive functions. This is a cross-sectional study with 23 patients with mild and moderate AD. The Clinical Dementia Rating was used to classify the dementia severity. The kinematic parameters of gait (cadence, stride length, and stride speed) were analyzed under two conditions: (a) single task (free gait) and (b) dual task (walking and counting down). The risk of falls was evaluated using the Timed Up-and-Go test. The frontal cognitive functions were evaluated using the Frontal Assessment Battery (FAB), the Clock Drawing Test (CDT) and the Symbol Search Subtest. The patients who were at the moderate stage suffered reduced performance in their stride length and stride speed in the single task and had made more counting errors in the dual task and still had a higher fall risk. Both the mild and the moderate patients exhibited significant decreases in stride length, stride speed and cadence in the dual task. Was detected a significant correlation between CDT, FAB, and stride speed in the dual task condition. We also found a significant correlation between subtest Similarities, FAB and cadence in the dual task condition. The dual task produced changes in the kinematic parameters of gait for the mild and moderate AD patients and the gait alterations are related to frontal cognitive functions, particularly executive functions.     

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.     

The gait of visually impaired pedestrians

The stride lengths, stride durations and walking speeds of visually impaired pedestrians were recorded under two conditions: firstly accompanied by a sighted guide, secondly walking independently. The same outdoor route was used for both conditions. When accompanied subjects walked at approximately the same speed as they would have on a force platform. However, when independent they were significantly slower (p = 0.051), with smaller strides (p = 0.083) which were of a longer duration (p = 0.062). Research into the gait of visually impaired pedestrians needs to take account of the effect of route conditions and the type of mobility aid being used.     

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.     

Muscle coordination patterns in regulation of medial gastrocnemius activation during walking

The ankle plantar flexion in the late stance phase is referred to as the ankle push-off. When the ankle push-off force is enhanced, compensatory adjustments occur in the adjacent phases. The muscle control that achieves these compensatory movements remains unknown, although they are expected to be coordinately regulated across multiple muscles and phases. Muscle synergy is used as a quantification technique for muscle coordination, and this analysis enables the comparison of synchronized activity between multiple muscles. Therefore, this study aimed to elucidate the tuning of muscle synergies in muscle activation adjustment of push-off. It is hypothesized that muscle activation adjustment of push-off is performed in the muscle synergy related to ankle push-off and in the muscle synergy that activates during the adjacent push-off phase. Eleven healthy men participated, and participants manipulated the activity of the medial gastrocnemius during walking through visual feedback. Two conditions were compared as experimental conditions: increasing the muscle activity to 1.6 times that during normal walking (High) and matching it with that during normal walking (Normal). Twelve muscle activities in the trunk and lower limb and kinematic data were recorded. Muscle synergies were extracted by the non-negative matrix factorization. No significant difference was observed in the number of synergies (High: 3.5 ± 0.8, Normal: 3.7 ± 0.9, p = 0.21) and muscle synergy activation timing and duration between the High and Normal conditions (p > 0.27). However, significant differences were observed in the peak muscle activity during the late stance phase of the rectus femoris (RF), biceps femoris (BF) between conditions (RF at High: 0.32 ± 0.21, RF at Normal: 0.45 ± 0.17, p = 0.02; BF at High: 0.16 ± 0.01, BF at Normal: 0.08 ± 0.06 p = 0.02). Although the quantification of force exertion has not been conducted, the modulation of RF and BF activation could have occurred due to the attempts to help knee flexion. Muscle synergies during normal walking are therefore maintained, and slight adjustments in the amplitude of muscle activity occurred for each muscle.     

Intentional compensation for selective loading affecting human gait phases

The locomotor strategies used by 12 subjects, instructed to hold their walking speed constant, were examined under various dynamic conditions in order to determine the means by which subjects can act upon their basic locomotor synergy. The dynamic conditions were modified either by adding a load or applying an impeding force. These modifications were designed to selectively affect either the stance phase or the swing phase. The results show that (a) subjects were able to rapidly calibrate their efforts to hold their walking speed constant, (b) in all conditions, the same walking speed was achieved with the same stride lengths and durations, and (c) at the within-cycle level, a change in duration synergically affected both phases and not just the perturbed one. The above results are discussed in terms of intentionally controlled parameters. Because cadence is closely linked to walking speed, it can be used as feedback; the control of walking speed in our experiments may thus be achieved simply by increasing the exerted force until the same cadence is produced.     

Task specificity and neural adaptations after balance learning in young adults

BackgroundOnly 30 min of balance skill training can significantly improve behavioral and neuromuscular outcomes. However, it is unclear if such a rapidly acquired skill is also retained and transferred to other untrained balance tasks.Research questionWhat are the effects of a single balance training session on balance skill acquisition, retention, and transferability and on measures of neural plasticity examined by transcranial magnetic brain stimulation (TMS) and inter-muscular coherence?MethodsHealthy younger adults (n = 36, age 20.9, 18 M) were randomly assigned to: Balance training (BT); Active control (cycling training, CT) or non-active control (NC) and received a 20-min intervention. Before, immediately and ~ 7 days after the interventions, we assessed performance in the trained wobble board task, untrained static standing tasks and dynamic beam walking balance tasks. Underlying neural plasticity was assessed by tibialis anterior motor evoked potential, intracortical facilitation, short-interval intracortical inhibition and long-interval intracortical inhibition using TMS and by inter-muscular coherence.ResultsBT, but not CT (18%, d = 0.32) or NC (−1%, d = −0.02), improved balance performance in the trained, wobble board task by 207% (effect size d = 2.12). BT retained the acquired skill after a 1-week no-training period (136%, d = 1.57). No changes occurred in 4 measures of balance beam walking, in 8 measures of static balance, in 8 measures of intermuscular coherence, and in 4 TMS measures of supra-spinal plasticity (all p > 0.05).SignificanceHealthy young adults can learn a specific balance skill very rapidly but one should be aware that while such improvements were retained, the magnitude of transfer (32%, d = 0.94) to other balancing skills was statistically not significant. Additional studies are needed to determine the underlying neural mechanisms of rapid balance skill acquisition, retention, and transfer.     

Influence of cognitive and motor tasks using smartphone during gait: EMG and gait performance analysis – Dual-task study

Previous studies reported changes in spatiotemporal gait parameters during dual-task performance while walking using a smartphone compared to walking without a smartphone. However, studies that assess muscle activity while walking and simultaneously performing smartphone tasks are scarce. So, this study aimed to assess the effects of motor and cognitive tasks using a smartphone while simultaneously performing gait on muscle activity and gait spatiotemporal parameters in healthy young adults. Thirty young adults (22.83 ± 3.92 years) performed five tasks: walking without a smartphone (single-task, ST); typing on a smartphone keyboard in a sitting position (secondary motor single-task); performing a cognitive task on a smartphone in a sitting position (cognitive single-task); walking while typing on a smartphone keyboard (motor dual-task, mot-DT) and walking while performing a cognitive task on a smartphone (cognitive dual-task, cog-DT). Gait speed, stride length, stride width and cycle time were collected using an optical motion capture system coupled with two force plates. Muscle activity was recorded using surface electromyographic signals from bilateral biceps femoris, rectus femoris, tibialis anterior, gastrocnemius medialis, gastrocnemius lateralis, gluteus maximus and lumbar erector spinae. Results showed a decrease in stride length and gait speed from the single-task to cog-DT and mot-DT (p < 0.05). On the other hand, muscle activity increased in most muscles analyzed from single- to dual-task conditions (p < 0.05). In conclusion, performing a cognitive or motor task using a smartphone while walking promote a decline in spatiotemporal gait parameters performance and change muscle activity pattern compared to normal walking.