Lori Ann Vallis

Locomotor adjustments for circumvention of an obstacle in the travel path

Independent living requires the navigation of a surrounding environment which is often cluttered with obstacles. When walking around an obstacle in the travel path, safe clearance requires some degree of body-segment reorientation. While body-segmental coordination strategies have been well studied for steering tasks that require moving the body in a new walking direction, it has never been established just what coordination strategies are used in different walking tasks. To address this issue, the current study was designed to investigate the timing of body segment coordination strategies and whole-body anticipatory locomotor adjustments employed when circumventing an obstacle placed in the travel path. Six healthy adults were asked to walk at their natural pace during unobstructed walking, as well as during avoidance to the right or left of a cylindrical obstacle (OBS) located in the travel path. Data analyzed were center of mass (COM) clearance from the OBS, forward velocity, step length and width, yaw angles of the head and trunk, roll angle of the trunk, and medial-lateral COM displacement. Onset of change in these variables from unobstructed walking was calculated as the time from OBS crossing. Avoidance involved two equally used strategies: lead limb close to or away from the OBS during the crossing step. Medial-lateral COM deviations were controlled by changes in step width without changes in trunk roll. There were no differences in the onset times of body segment reorientation for path deviation. These results are in contrast to previous studies on change in travel direction where the head segment initiates the body reorientation. Contrary to a steering task, circumventing an obstacle requires a different coordination for a transient change in COM trajectory with the underlying travel-direction maintained.

Age-related modifications in steering behaviour: effects of base-of-support constraints at the turn point

This study investigated the effects of altering the base of support (BOS) at the turn point on anticipatory locomotor adjustments during voluntary changes in travel direction in healthy young and older adults. Participants were required to walk at their preferred pace along a 3-m straight travel path and continue to walk straight ahead or turn 40° to the left or right for an additional 2-m. The starting foot and occasionally the gait starting point were adjusted so that participants had to execute the turn using a cross-over step with a narrow BOS or a lead-out step with a wide BOS. Spatial and temporal gait variables, magnitudes of angular segmental movement, and timing and sequencing of body segment reorientation were similar despite executing the turn with a narrow or wide BOS. A narrow BOS during turning generated an increased step width in the step prior to the turn for both young and older adults. Age-related changes when turning included reduced step velocity and step length for older compared to young adults. Age-related changes in the timing and sequencing of body segment reorientation prior to the turn point were also observed. A reduction in walking speed and an increase in step width just prior to the turn, combined with a delay in motion of the center of mass suggests that older adults used a more cautious combined foot placement and hip strategy to execute changes in travel direction compared to young adults. The results of this study provide insight into mobility constraints during a common locomotor task in older adults.

The relationship between postural stability and virtual environment adaptation

Currently little is known about how adaptive responses to virtual environments are different between individuals who experience sickness related symptoms and those who do not. It is believed that sensory interactions between visually perceived self-motion and static inertial cues from vestibular and/or proprioceptive sensory systems contribute to the development of adaptation symptoms. The aim of this study was to evaluate the relationship between adaptation symptoms and postural stability in a virtual environment (VE) driving simulator. In addition, the role of sensory interaction was assessed using direct electrical stimulation techniques of the vestibular and cutaneous sensory systems. Posture performance was measured using centre of pressure measures of single leg stance tests during eyes open and eyes closed conditions. Correlation analysis of postural measures and symptom scores were conducted, as well as analysis of variance of posture performance between SICK and WELL individuals. Results indicate that posture stability is negatively correlated to symptom reporting. WELL individuals displayed the greatest decrease in postural stability during eyes open single leg stance following VE simulation. Application of a secondary sensory stimulation (vestibular or cutaneous) resulted in increased visual dependency for postural control following simulation. Combined, these results suggest that sensory interactions drive postural changes that are observed following VE simulation and are related to how visual information is used to control posture.

Sarcopenia and predictors of the fat free mass index in community-dwelling and assisted-living older men and women.

The purpose of this study was to assess the relationship of the fat free mass index (FFMI), an indicator of sarcopenia in older adults, to anthropometric, gait, balance, and strength measures. We hypothesized that strength, balance, and mobility measures will correlate, and could be used to predict FFMI in older adults. Thirty-three older adults (81.5±7.9 years) participated. Fat free mass (FFM) was measured using Air-Displacement Plethysmography (ADP). Anthropometric measures, maximum handgrip (MG) and quadriceps strength were quantified. Clinical tests included the Berg Balance Scale (BBS), Dynamic Gait Index (DGI), and the Timed-up and Go (TUG) test. Finally, variability measures in gait and balance were calculated. Means, standard deviations (SD), correlations and multiple linear regression statistical analyses were then performed using functional predictor variables for FFMI. In total, 54.5% males and 36.3% females in our population were classified sarcopenic. FFMI correlated only to waist circumference (Total population (Pop), R(2)=0.649 p<0.01; Sarcopenics (Sarc), R(2)=0.636, p<0.05) and maximum grip strength (Pop, R(2)=0.633, p<0.01; Sarc, R(2)=0.771, p<0.01), nullifying our hypothesis. Multiple linear regression analyses revealed waist circumference, maximum handgrip strength, greater variability of time spent in double support, and anterior-posterior balance variability predicted 70.7% of the variance within the population. Results demonstrate a successful predictor model for FFMI based on a combination of strength, circumference and gait/balance variance measures. The ability to predict FFMI based on these variables will facilitate the diagnosis of sarcopenia in older adults.

Age-related kinematic changes in late visual-cueing during obstacle circumvention

On a daily basis, we are challenged by common environmental obstacles (e.g. street posts) that require simple and often rapid modifications to our gait patterns to avoid collisions. Poor vision appears to be responsible for important reductions in postural stability during gait; and therefore, individuals with impaired vision, such as the elderly, may be at a greater risk of falling, especially under conditions where stepping avoidance strategies may be constrained by the environment. The purpose of the current study was to examine the body segment and eye-gaze reorientation strategy, role of base of support, as well as visual areas of interest attended to by healthy young (YA) and older adults (OA) when only given limited time, one stride, to prepare for an obstacle circumvention task. Six YA and six OA were asked to perform ten walking trials which required them to circumvent an obstacle in their travel path. Participants used one of two avoidance strategies, either lead leg crossing-over trail leg (narrow base of support) or lead leg stepping-out (wide base of support). Results indicate that base of support constraints did not affect segment reorientation sequence in either age group. The general segment reorientation sequence in YA was initiated by trunk yaw and head yaw, followed by gaze and finally, by M-L foot deviation. No trunk roll deviations were observed. In OA, the general segment reorientation sequence was the following: trunk yaw and trunk roll, gaze and finally, M-L foot deviation. No head yaw deviations were observed. Our findings suggest that YA utilized a foot placement strategy to perform the transient change in travel direction while OA relied on a hip strategy. In addition, YA spent more time gazing straight ahead at the obstacle and the wall, while OA spent more time looking at the ground. This strategy indicates that OA use a more cautious strategy to safely avoid the obstacle. Findings from the present work contribute further knowledge regarding locomotor adjustments during a common, and complex, everyday task in young and older adults.

Kinematics and muscular responses to a ramp descent in the ACL deficient knee

BACKGROUND AND PURPOSE Descent of a ramp has been shown to induce large anterior shear forces on the knee joint. Compensatory muscle responses observed in individuals following an anterior cruciate ligament (ACL) injury are believed to be adopted for the purpose of reducing these forces at the knee, in the absence of the mechanical restraint previously provided by the ACL. As such, examining the kinematics and muscle responses of ACL deficient individuals during ramp descent may provide further insight into strategies used by this population to compensate for anterior shear forces at the knee. METHODS Eight ACL deficient individuals were studied, in comparison to a healthy CONTROL group (N=8), during the descent of a 20 degrees ramp. Kinematics and electromyography were recorded for the injured lower limb of ACLD and matched limb of healthy control individuals. RESULTS ACLD individuals produced altered knee kinematics at heel contact only. Knee motion through stance and swing were similar to CONTROL individuals. ACLD individuals produced significantly greater vastus lateralis and gastrocnemius total muscle activity, but decreased total biceps femoris activity. No significant differences were observed for the timing of peak muscle activity or the magnitude at this point between ACLD and CONTROL. DISCUSSION AND CONCLUSION Greater total muscle activity of vastus lateralis implies that greater force contributions from this muscle were used by ACLD in comparison to CONTROL in response to the ramp. These observations reinforce that quadriceps avoidance is not used by ACLD individuals to reduce anterior shear forces at the knee joint. Rather, vastus lateralis may be used to reduce internal tibial rotation in extreme loading situations.

Proprioceptive deficits of the lower limb following anterior cruciate ligament deficiency affect whole body steering control

The role of lower limb proprioception in the steering control of locomotion is still unclear. The purpose of the current study was to determine whether steering control is altered in individuals with reduced lower limb proprioception. Anterior cruciate ligament deficiency (ACLD) results in a decrease in proprioceptive information from the injured knee joint (Barrack et al. 1989). Therefore the whole body kinematics were recorded for eight unilateral ACLD individuals and eight CONTROL individuals during the descent of a 20° incline ramp followed by either a redirection using a side or cross cutting maneuver or a continuation straight ahead. Onset of head and trunk yaw, mediolateral displacement of a weighted center of mass (COMHT) and mediolateral displacement of the swing foot were analyzed to evaluate differences in the steering control. Timing analyses revealed that ACLD individuals delayed the reorientation of body segments compared to CONTROL individuals. In addition, ACLD did not use a typical steering synergy where the head leads whole body reorientation; rather ACLD individuals reoriented the head, trunk and COMHT in the new direction at the same time. These results suggest that when lower limb proprioceptive information is reduced, the central nervous system (CNS) may delay whole body reorientation to the new travel direction, perhaps in order to integrate existing sensory information (vision, vestibular and proprioception) with the reduced information from the injured knee joint. This control strategy is maintained when visual information is present or reduced in a low light environment. Additionally, the CNS may move the head and trunk segments as, effectively, one segment to decrease the number of degrees of freedom that must be controlled and increase whole body stability during the turning task.

Sequential tapping interferes selectively with multiple-object tracking: Do finger-tapping and tracking share a common resource?

Multiple-object tracking involves simultaneously monitoring positions of a number of target items as they move among distractors. Young adults are capable of tracking only 3–5 items at once. In this study we investigated the origin of this limitation by looking for secondary tasks that interfere with tracking. We compared tracking performance (baseline condition), with performance when participants tapped three fingers in a specific order while tracking (sequential tapping) or articulated three syllables in a specific order while tracking (sequential articulation). The articulation task was used to ensure that the interference produced by sequential tapping was more than would be expected by the executive demands of carrying out any two “attention-demanding” tasks at once. Even though sequential tapping does not require vision or memorizing the positions of external items, it produced significantly more interference than did sequential articulation, as might be expected if tracking and sequential tapping shared a common (limited) resource.

Concurrent Performance of a Cognitive and Dynamic Obstacle Avoidance Task: Influence of Dual-Task Training

ABSTRACT The performance of 2 or more attention demanding tasks simultaneously is poorly understood. The purpose of the study was to investigate optimal practice strategies for performing 2 simultaneous tasks. Eighteen young adults walked and stepped over either a static or dynamic obstacle, while responding to an auditory Stroop test. Participants were randomly assigned to 1 of 3 groups: one that practiced both tasks simultaneously, practiced only the cognitive task, or received no practice. Results indicate that only the dual-task practice group showed significantly more improvement in the locomotor task through reduced variability of gait velocity, obstacle clearance, and takeoff distance. Findings demonstrate that the practice of two concurrent, attention demanding tasks results in the best performance improvement for both tasks.

Local Dynamic Joint Stability During Human Treadmill Walking in Response to Lower Limb Segmental Loading Perturbations

Our purpose was to quantify changes in local dynamic stability (LDS) of the lumbar spine, hip, knee, and ankle in response to changes in lower limb segment mass, as well as to quantify temporal adaptations to segment loading during treadmill walking. Results demonstrate that increased mass distal to a joint yields either the maintenance of, or increased stabilization of, that particular joint relative to the unloaded condition. Increased mass proximal to a particular joint resulted in joint destabilization. The hip and ankle LDS were observed to change temporally, independent of segment loading condition, suggesting adaptation to walking on a treadmill interface.