Matthew A. Timmis

Obstacle crossing during locomotion: Visual exproprioceptive information is used in an online mode to update foot placement before the obstacle but not swing trajectory over it

Although gaze during adaptive gait involving obstacle crossing is typically directed two or more steps ahead, visual information of the swinging lower-limb and its relative position in the environment (termed visual exproprioception) is available in the lower visual field (lvf). This study determined exactly when lvf exproprioceptive information is utilised to control/update lead-limb swing trajectory during obstacle negotiation. 12 young participants negotiated an obstacle wearing smart-glass goggles which unpredictably occluded the lvf for certain periods during obstacle approach and crossing. Trials were also completed with lvf occluded for the entirety of the trial. When lvf was occluded throughout, foot-placement distance and toe-clearance became significantly increased; which is consistent with previous work that likewise used continuous lvf occlusion. Both variables were similarly affected by lvf occlusion from instant of penultimate-step contact, but both were unaffected when lvf was occluded from instant of final-step contact. These findings suggest that lvf (exproprioceptive) input is typically used in an online manner to control/update final foot-placement, and that without such control, uncertainty regarding foot placement causes toe-clearance to be increased. Also that lvf input is not normally exploited in an online manner to update toe-clearance during crossing: which is contrary to what previous research has suggested.

Visual Search Strategies of Soccer Players Executing a Power vs. Placement Penalty Kick

Introduction When taking a soccer penalty kick, there are two distinct kicking techniques that can be adopted; a ‘power’ penalty or a ‘placement’ penalty. The current study investigated how the type of penalty kick being taken affected the kicker’s visual search strategy and where the ball hit the goal (end ball location). Method Wearing a portable eye tracker, 12 university footballers executed 2 power and placement penalty kicks, indoors, both with and without the presence of a goalkeeper. Video cameras were used to determine initial ball velocity and end ball location. Results When taking the power penalty, the football was kicked significantly harder and more centrally in the goal compared to the placement penalty. During the power penalty, players fixated on the football for longer and more often at the goalkeeper (and by implication the middle of the goal), whereas in the placement penalty, fixated longer at the goal, specifically the edges. Findings remained consistent irrespective of goalkeeper presence. Discussion/conclusion Findings indicate differences in visual search strategy and end ball location as a function of type of penalty kick. When taking the placement penalty, players fixated and kicked the football to the edges of the goal in an attempt to direct the ball to an area that the goalkeeper would have difficulty reaching and saving. Fixating significantly longer on the football when taking the power compared to placement penalty indicates a greater importance of obtaining visual information from the football. This can be attributed to ensuring accurate foot-to-ball contact and subsequent generation of ball velocity. Aligning gaze and kicking the football centrally in the goal when executing the power compared to placement penalty may have been a strategy to reduce the risk of kicking wide of the goal altogether.

Kinematic analysis of step ascent among patients with central visual field loss

Vision is of paramount importance in regulating adaptive gait. Using three-dimensional motion analysis, the current study investigated how central visual field loss (CFL) affects step ascent. Ten patients with chronic CFL (77 ± 10 years) and 13 visual normal participants (72 ± 6 years) walked up to and ascended a single step (of varying height). Movement kinematics assessed the period immediately prior to and during step ascent. Compared to visual normal participants, patients with CFL exhibited a lower lead foot horizontal crossing velocity, increased lead limb swing time and increased head flexion (looking down at more immediate areas of the ground/step). They also took longer to initiate the step up, transfer weight to the lead foot upon landing on the upper level and increased trail limb swing time when negotiating the medium and high step height. Increased variability was also shown in a number of dependent measures. Data indicate that during step ascent, patients with CFL exhibit a cautious stepping strategy when compared to visual normal participants. This cautious strategy becomes increasingly evident when negotiating higher step heights, as shown by an increased planning time prior to entering the relatively unstable period of single support during the step up. The increased variability among CFL patients increases their likelihood of experiencing dynamic instability and falling during step ascent.

How does the extent of central visual field loss affect adaptive gait

Visual impairment is one of the most important clinical risk factors associated with falls. Currently it remains unclear whether adaptive gait is progressively affected as the extent of central visual field loss (CFL) increases, or when CFL exceeds a certain size. 10 participants (aged 22 ± 3 years) negotiated a floor based obstacle in full vision (no occlusion) and wearing custom made contact lenses which simulated 10° CFL and 20° CFL. Movement kinematics assessed the period immediately prior to and during obstacle crossing. In the 20° CFL condition, participants exhibited adaptations in gait which were consistent with being more cautious and more variable during the approach to and crossing of the obstacle, when compared to both 10° CFL and full vision conditions. Specifically, in the 20° CFL condition participants placed their lead foot further from the obstacle, lifted both their lead and trail feet higher and slower over the obstacle, and took longer to negotiate the obstacle when compared to the 10° CFL and full vision conditions. Data highlights differences in adaptive gait as a function of the extent of CFL when compared to full vision. More importantly, these adaptations were only associated with loss of the central 20° of the visual field, suggesting that gait is compromised only after central visual field loss exceeds a certain level.

Difficulties With Goals of the Dutch ICF Activity Inventory: Perceptions of Those With Retinitis Pigmentosa and of Those Who Support Them

PURPOSE To provide a comprehensive overview of the perceived difficulties with visual activities and participation by those with retinitis pigmentosa (RP), and as perceived by those who support people with RP. Further, to examine the performance of the Dutch ICF Activity Inventory (D-AI) using Rasch analysis. METHODS Three hundred fifty people with RP and 75 supporters of people with RP provided demographic information and completed the D-AI at goal level (47 goals). RESULTS Following removal of four goals, the D-AI behaved well in Rasch analysis, but with limitations to its unidimensionality. The most difficult goals for people with RP related to mobility and to work-related activities. Greater difficulty was associated with higher visual impairment registration status, use of mobility aids, and longer duration of visual impairment. For those with less severe visual loss, goals relating to communicating with people were relatively more difficult. In more severe loss, goals involving good central vision (e.g., dealing with correspondence) were relatively more difficult. The perceptions of supporters matched those of the people with RP relatively well, but with a tendency for supporters to overestimate the difficulty of goals, which related to administration and domestic chores, and to underestimate difficulty with goals relating to communication with people. CONCLUSIONS The results indicate important areas of rehabilitation to address in addition to orientation and mobility in those with RP, including work-related activities and goals involving good central vision. Both people with RP and those supporting them could benefit from help addressing difficulties with communication.

The impact of mobile phone use on where we look and how we walk when negotiating floor based obstacles

Pedestrians regularly engage with their mobile phone whilst walking. The current study investigated how mobile phone use affects where people look (visual search behaviour) and how they negotiate a floor based hazard placed along the walking path. Whilst wearing a mobile eye tracker and motion analysis sensors, participants walked up to and negotiated a surface height change whilst writing a text, reading a text, talking on the phone, or without a phone. Differences in gait and visual search behaviour were found when using a mobile phone compared to when not using a phone. Using a phone resulted in looking less frequently and for less time at the surface height change, which led to adaptations in gait by negotiating it in a manner consistent with adopting an increasingly cautious stepping strategy. When using a mobile phone, writing a text whilst walking resulted in the greatest adaptions in gait and visual search behaviour compared to reading a text and talking on a mobile phone. Findings indicate that mobile phone users were able to adapt their visual search behaviour and gait to incorporate mobile phone use in a safe manner when negotiating floor based obstacles.

Physical inactivity in relation to self-rated eyesight: cross-sectional analysis from the English Longitudinal Study of Ageing

Background To assess the cross-sectional association between self-rated eyesight and physical activity behaviour in a large general population sample of older English adults. Methods Analyses of data from the English Longitudinal Study of Ageing. Participants provided information on self-rated eyesight (categorised as: excellent/very good/good/fair–poor) and their own physical activity levels (categorised as: inactive/moderate only at least 1/week, vigorous at least 1/week). Associations between self-rated eyesight and physical activity levels were examined using logistic regression. Results A total of 6634 participants (mean age 65.0±9.2 years) were included in the analyses. In adjusted logistic regression models, those with fair–poor and good eyesight were significantly more likely to be inactive than those who reported excellent eyesight (OR 2.07, 95% CI 1.58 to 2.72; OR 1.59, 1.27 to 1.99, respectively). Conclusion In this sample of older English adults, those with self-rated fair–poor vision were over twice as likely to be physically inactive than those who reported having excellent vision. When consistent data have emerged, interventions to increase physical activity in those who have poor eyesight are needed.

Visual Search Behavior in Individuals With Retinitis Pigmentosa During Level Walking and Obstacle Crossing

Purpose Investigate the visual search strategy of individuals with retinitis pigmentosa (RP) when negotiating a floor-based obstacle compared with level walking, and compared with those with normal vision. Methods Wearing a mobile eye tracker, individuals with RP and normal vision walked along a level walkway or walked along the walkway negotiating a floor-based obstacle. In the level walking condition, tape was placed on the floor to act as an object attracting visual attention. Analysis compared where individuals looked within the environment. Results In the obstacle compared with level walking condition: (1) the RP group reduced the length of time and the number of times they looked Ahead, and increased the time and how often they looked at features on the ground (Object and Down, P < 0.05); and (2) the visual normal group reduced the time (by 19%) they looked Ahead (P = 0.076), and increased the time and how often they looked at the Object (P < 0.05). Compared with the normal vision group, in both level walking and obstacle conditions, the RP group reduced the time looking Ahead and looked for longer and more often Down (P < 0.05). Conclusions The RP group demonstrated a more active visual search pattern, looking at more areas on the ground in both level walking and obstacle crossing compared with visual normals. This gaze strategy was invariant across conditions. This is most likely due to the constricted visual field and inability to rely on inferior peripheral vision to acquire information from the floor within the environment when walking.

The anticipatory stress response to sport competition; a systematic review with meta-analysis of cortisol reactivity

Objective Athletes anticipating sport competition regularly experience distinct emotional and physiological responses as a result of the expected psychosocial and physical stress. Specifically, cortisol, an indicator of hypothalamic-pituitary-adrenal axis activation, prepares the athlete for the psychological and physiological demands of competition. The objective of this meta-analysis is to analyse the magnitude of the anticipatory cortisol response in athletes preparing to participate in sport competition and to examine the influence of gender, level of competition and data collection time. Design Systematic review with meta-analysis. Data sources Four electronic databases were searched to March 2017: PubMed, PsycINFO, SPORTDiscus and Scopus. Eligibility criteria for selecting studies (1) Athletes participating in real sport competition;(2) salivary cortisol concentration collected before competition in addition to baseline sample(s);(3) original research article published in English language. Results Data from 25 studies provided 27 effect sizes. A significant anticipatory cortisol response of g=0.85, p<0.001 was identified. Males had a stronger trend for greater cortisol reactivity (g=1.07) than females (g=0.56, p=0.07). Females and athletes competing at international level did not demonstrate a significant anticipatory stress response. There were no significant differences between level of competition, type of sport or time of competition. Meta-regression indicated that the anticipatory cortisol response is greater when assessed closer to the start of competition (Q=6.85, p=0.009). Summary/conclusion The anticipatory cortisol response before sport competition reflects moderate cortisol reactivity that prepares athletes optimally for the demands of sport competition via the influence on cognitive processes and attentional control. However, both female athletes and international competitors did not demonstrate a significant anticipatory cortisol response, possibly due to differences in appraisal of the stress of sport competition.

Emotional Health of People with Visual Impairment Caused by Retinitis Pigmentosa

Purpose To understand the emotional difficulties associated with living with the ocular condition Retinitis Pigmentosa, and to examine the functioning of a self-report instrument used to assess this construct. Methods The difficulty of goals and tasks in the emotional health domain of the Dutch ICF Activity Inventory were rated by 166 people with Retinitis Pigmentosa in a cross-sectional study. Demographic factors were also assessed. Results Responses to the 23 emotional health tasks were Rasch analysed and could be used to form either one 20 item overview scale with some multidimensionality, or three unidimensional subscales addressing feelings (4 items), communicating visual loss (5 items) and fatigue (7 items). The most difficult individual tasks related to communicating visual loss to other people, and dealing with feelings such as frustration, anxiety and stress. The use of mobility aids and female gender were associated with increased difficulty with emotional health, explaining 19% of the variance in the overview scale. Conclusions The emotional health domain of the Dutch ICF Activity Inventory is a valid tool to assess emotional difficulties arising from visual loss. Interventions to aid people with Retinitis Pigmentosa deal with emotional difficulties should particularly address communicating vision loss effectively to others and coping with negative feelings.