Dynamic Touch by Hand and Head During Walking: Protective Behavior for the Head?

We investigated perception of the extent of an object held in the hand or attached to the head during walking. Participants wielded an occluded, weighted rod by hand and by head and reported the perceived location of the rod end (relative to a virtual vertical line) while walking and while standing. There was an unexpected effect of body part on perceived location of the rod end. In particular, participants stood or walked so that the rod end was farther away from the vertical line when wielding with the head than wielding with the hand. It is possible that differences between the tasks and the relative costs of a collision influenced the locomotory behavior in each condition.     

Local Dynamic Stability of the Locomotion of Lower Extremity Joints and Trunk During Backward Upslope Walking

Backward slope walking was considered as a practical rehabilitation and training skill. However, its gait stability has been hardly studied, resulting in its limited application as a rehabilitation tool. In this study, the effect of walking direction and slope grade were investigated on the local dynamic stability of the motion of lower extremity joints and trunk segment during backward and forward upslope walking (BUW/FUW). The local divergence exponents (λ_S) of 16 adults were calculated during their BUW and FUW at grades of 0%, 5%, 10%, and 15%. Mean standard deviation over strides (MeanSD) was analyzed as their gait variability. Backward walking showed larger λ_S for the abduction-adduction and rotational angles of knee and ankle on inclined surface than forward walking, while λ_S for hip flexion-extension angle at steeper grades was opposite. No grade effect for any joint existed during BUW, while λ_S increased with the increasing grade during FUW. As to the trunk, walking direction did little impact on λ_S. Still, significant larger λ_S for its medial-lateral and vertical motion were found at the steeper grades during both FUW and BUW. Results indicate that during BUW, the backward direction may influence the stability of joint motions, while the trunk stability was challenged by the increasing grades. Therefore, BUW may be a training tool for the stability of both upper and lower body motion during gait.     

A novel approach to mechanical foot stimulation during human locomotion under body weight support

Input from the foot plays an essential part in perceiving support surfaces and determining kinematic events in human walking. To simulate adequate tactile pressure inputs under body weight support (BWS) conditions that represent an effective form of locomotion training, we here developed a new method of phasic mechanical foot stimulation using light-weight pneumatic insoles placed inside the shoes (under the heel and metatarsus). To test the system, we asked healthy participants to walk on a treadmill with different levels of BWS. The pressure under the stimulated areas of the feet and subjective sensations were higher at high levels of BWS and when applied to the ball and toes rather than heels. Foot stimulation did not disturb significantly the normal motor pattern, and in all participants we evoked a reliable step-synchronized triggering of stimuli for each leg separately. This approach has been performed in a general framework looking for “afferent templates” of human locomotion that could be used for functional sensory stimulation. The proposed technique can be used to imitate or partially restore surrogate contact forces under body weight support conditions.     

Becoming a person: How long-distance walking can lead to personal growth – A cultural and health-related approach

Long-distance walking is an activity that has been practiced across cultures and ages. More recently, it has been associated with notions of mental health, and it has been suggested that long-distance walking may have psychotherapeutic effects. There is still, however, a lack of clarity regarding several central questions, including what long-distance walking is, and why it may be beneficial to mental health. In this article, we provide an overview of understandings and cultural expressions of the long-distance walk, and we provide a new definition, reaching across these various understandings and expressions. Next, we discuss the different explanations given regarding the therapeutic aspects of the long-distance walk, and suggest a new approach, leaning on an existential framework. Finally, we discuss the implications that the knowledge on long-distance walking has for notions of therapeutic interventions more generally.     

Increasing walking among older people: A test of behaviour change techniques using factorial randomised N-of-1 trials

Objective: Evaluations of techniques to promote physical activity usually adopt a randomised controlled trial (RCT). Such designs inform how a technique performs on average but cannot be used for treatment of individuals. Our objective was to conduct the first N-of-1 RCTs of behaviour change techniques with older people and test the effectiveness of the techniques for increasing walking within individuals.

Design: Eight adults aged 60–87 were randomised to a 2 (goal-setting vs. active control) × 2 (self-monitoring vs. active control) factorial RCT over 62 days. The time series data were analysed for each single case using linear regressions.

Main outcome measures: Walking was objectively measured using pedometers.

Results: Compared to control days, goal-setting increased walking in 4 out of 8 individuals and self-monitoring increased walking in 7 out of 8 individuals. While the probability for self-monitoring to be effective in 7 out of 8 participants was beyond chance (p = .03), no intervention effect was significant for individual participants. Two participants had a significant but small linear decrease in walking over time.

Conclusion: We demonstrate the utility of N-of-1 trials for advancing scientific enquiry of behaviour change and in practice for increasing older people’s physical activity.     

Coping with asymmetry: How infants and adults walk with one elongated leg

The stability of a system affects how it will handle a perturbation: The system may compensate for the perturbation or not. This study examined how 14-month-old infants—notoriously unstable walkers—and adults cope with a perturbation to walking. We attached a platform to one of participants’ shoes, forcing them to walk with one elongated leg. At first, the platform shoe caused both age groups to slow down and limp, and caused infants to misstep and fall. But after a few trials, infants altered their gait to compensate for the platform shoe whereas adults did not; infants recovered symmetrical gait whereas adults continued to limp. Apparently, adult walking was stable enough to cope with the perturbation, but infants risked falling if they did not compensate. Compensation depends on the interplay of multiple factors: The availability of a compensatory response, the cost of compensation, and the stability of the system being perturbed.     

The influences of tropical climate on imagined walking time

This study investigated the effects of a Tropical Climate (TC) on actual and imagined walking times. Participants had to execute and imagine walking 3 distances with or without a 10-kg weight in either a TC or an Air Conditioning (AC) condition. The motor imagery quality was evaluated by computing the isochrony index. The results revealed that movement times were shorter for imagined walking than for actual walking and increased with the distance of the paths in both cases. By contrast, the effect of the load increased actual walking times for the 10- and 15-meter distances without affecting imagined walking times. Importantly, the isochrony index was negatively affected by the increase in load and distance and the effects of distance were amplified in a TC. These findings showed that the environmental climate in which motor imagery arises can modulate the subject’s ability to build up the temporal characteristics of simulated actions.     

Necessary condition for forward progression in ballistic walking

Ballistic walking requires an appropriate configuration of posture and velocity at toe-off to avoid backward falling. In this study, we investigated a determinant of the state of the body center of mass (COM) at the toe-off with regard to ballistic walking. We used an inverted pendulum model to represent ballistic trajectories and the necessary condition for forward progression by a simple relationship between the COM states (position and velocity) at toe-off. This condition was validated through a computer simulation of a 7-link musculoskeletal model and measurement experiments of human movements involving stepping and walking. The results of the model simulation were in good agreement with some of the results predicted by the inverted pendulum model. The measurement experiments of walking and stepping movements showed that most COM states at toe-off satisfied the condition for forward progression and the measured trajectories during single support phase were similar to the ballistic trajectories although humans are capable of walking in non-ballistic ways. These results suggested that the necessary condition for forward progression can predict the COM states at toe-off for efficient movement and for avoiding backward falling during single support phase.     

The Effect of Auditory Cueing on the Spatial and Temporal Gait Coordination in Healthy Adults

Walk ratio, defined as step length divided by cadence, indicates the coordination of gait. During free walking, deviation from the preferential walk ratio may reveal abnormalities of walking patterns. The purpose of this study was to examine the impact of rhythmic auditory cueing (metronome) on the neuromotor control of gait at different walking speeds. Forty adults (mean age 26.6 ± 6.0 years) participated in the study. Gait characteristics were collected using a computerized walkway. In the preferred walking speed, there was no significant difference in walk ratio between uncued (walk ratio = .0064 ± .0007 m/steps/min) and metronome-cued walking (walk ratio = .0064 ± .0007 m/steps/min; p = .791). A higher value of walk ratio at the slower speed was observed with metronome-cued (walk ratio = .0071 ± .0008 m/steps/min) compared to uncued walking (walk ratio = .0068 ± .0007 m/steps/min; p < .001). The walk ratio was less at faster speed with metronome-cued (walk ratio = .0060 ± .0009 m/steps/min) compared to uncued walking (walk ratio = .0062 ± .0009 m/steps/min; p = .005). In healthy adults, the metronome cues may become an attentional demanding task, and thereby disrupt the spatial and temporal integration of gait at nonpreferred speeds.     

Psychophysiological response to cognitive workload during symmetrical,asymmetrical and dual-task walking

Walking with a lower limb prosthesis comes at a high cognitive workload for amputees, possibly affecting their mobility, safety and independency. A biocooperative prosthesis which is able to reduce the cognitive workload of walking could offer a solution. Therefore, we wanted to investigate whether different levels of cognitive workload can be assessed during symmetrical, asymmetrical and dual-task walking and to identify which parameters are the most sensitive. Twenty-four healthy subjects participated in this study. Cognitive workload was assessed through psychophysiological responses, physical and cognitive performance and subjective ratings. The results showed that breathing frequency and heart rate significantly increased, and heart rate variability significantly decreased with increasing cognitive workload during walking (p < .05). Performance measures (e.g., cadence) only changed under high cognitive workload. As a result, psychophysiological measures are the most sensitive to identify changes in cognitive workload during walking. These parameters reflect the cognitive effort necessary to maintain performance during complex walking and can easily be assessed regardless of the task. This makes them excellent candidates to feed to the control loop of a biocooperative prosthesis in order to detect the cognitive workload. This information can then be used to adapt the robotic assistance to the patient’s cognitive abilities.