Melissa Scott-Pandorf

Peripheral arterial disease affects kinematics during walking

OBJECTIVE Claudication is the most common manifestation of peripheral arterial disease (PAD) producing significant ambulatory compromise. The purpose of this study was to use advanced biomechanical analysis to characterize the kinematic ambulatory pattern of claudicating patients. We hypothesized that compared with control subjects, claudicating patients have altered kinematic gait patterns that can be fully characterized utilizing advanced biomechanical analysis. METHODS The study examined fourteen PAD patients (age: 58 +/- 3.4 years; weight: 80.99 +/- 15.64 kg) with clinically diagnosed femoro-popliteal occlusive disease (Ankle Brachial Index (ABI): 0.56 +/- 0.03, range 0.45 to 0.65) and five healthy controls (age: 53 +/- 3.4 years; weight: 87.38 +/- 12.75 kg; ABI >or= 1). Kinematic parameters (hip, knee, and ankle joint angles in the sagittal plane) were evaluated during gait in patients before and after the onset of claudication pain and compared with healthy controls. Joint angles were calculated during stance time. Dependent variables were assessed (maximum and minimum flexion and extension angles and ranges of motion) and mean ensemble curves were generated. Time to occurrence of the discrete variables was also identified. RESULTS Significantly greater ankle plantar flexion in early stance and ankle range of motion during stance was observed in PAD patients (P < .05). Time to maximum ankle plantar flexion was shorter and time to maximum ankle dorsiflexion was longer in PAD patients (P < .05). These differences were noted when comparing PAD patients prior to and after the onset of claudication with healthy controls. The analysis of the kinematic parameters of the knee and the hip joints revealed no significant differences between PAD patients and controls. CONCLUSION PAD patients with claudication demonstrate significant gait alterations in the ankle joint that are present prior to the onset of claudication pain. In contrast, the joint motion of the hip and knee did not differ in PAD patients when compared with controls. Further research is needed to verify our findings and assess the impact of more proximal disease in PAD patients as well as the effect of revascularization on joint kinematics.

Optic flow improves adaptability of spatiotemporal characteristics during split-belt locomotor adaptation with tactile stimulation

Human locomotor adaptation requires feedback and feed-forward control processes to maintain an appropriate walking pattern. Adaptation may require the use of visual and proprioceptive input to decode altered movement dynamics and generate an appropriate response. After a person transfers from an extreme sensory environment and back, as astronauts do when they return from spaceflight, the prolonged period required for re-adaptation can pose a significant burden. In our previous paper, we showed that plantar tactile vibration during a split-belt adaptation task did not interfere with the treadmill adaptation however, larger overground transfer effects with a slower decay resulted. Such effects, in the absence of visual feedback (of motion) and perturbation of tactile feedback, are believed to be due to a higher proprioceptive gain because, in the absence of relevant external dynamic cues such as optic flow, reliance on body-based cues is enhanced during gait tasks through multisensory integration. In this study, we therefore investigated the effect of optic flow on tactile-stimulated split-belt adaptation as a paradigm to facilitate the sensorimotor adaptation process. Twenty healthy young adults, separated into two matched groups, participated in the study. All participants performed an overground walking trial followed by a split-belt treadmill adaptation protocol. The tactile group (TC) received vibratory plantar tactile stimulation only, whereas the virtual reality and tactile group (VRT) received an additional concurrent visual stimulation: a moving virtual corridor, inducing perceived self-motion. A post-treadmill overground trial was performed to determine adaptation transfer. Interlimb coordination of spatiotemporal and kinetic variables was quantified using symmetry indices and analyzed using repeated-measures ANOVA. Marked changes of step length characteristics were observed in both groups during split-belt adaptation. Stance and swing time symmetries were similar in the two groups, suggesting that temporal parameters are not modified by optic flow. However, whereas the TC group displayed significant stance time asymmetries during the post-treadmill session, such aftereffects were absent in the VRT group. The results indicated that the enhanced transfer resulting from exposure to plantar cutaneous vibration during adaptation was alleviated by optic flow information. The presence of visual self-motion information may have reduced proprioceptive gain during learning. Thus, during overground walking, the learned proprioceptive split-belt pattern is more rapidly overridden by visual input due to its increased relative gain. The results suggest that when visual stimulation is provided during adaptive training, the system acquires the novel movement dynamics while maintaining the ability to flexibly adapt to different environments.

Analysis of Skeletal Muscle Metrics as Predictors of Functional Task Performance: 2895

Performance Jeffrey W. Ryder, Roxanne E. Buxton, Elizabeth Redd, Melissa Scott-Pandorf, Kyle J. Hackney, James Fiedler, Robert J. Ploutz-Snyder, Jacob J. Bloomberg Lori L. Ploutz-Snyder, FACSM. Universities Space Research Association, Houston, TX, University of Houston, Houston, TX, Wyle Integrated Science and Engineering Group, Houston, TX, Syracuse University, Syracuse, NY, NASA Johnson Space Center, Houston, TX PURPOSE: The ability to predict task performance using physiological performance metrics is vital to ensure that astronauts can execute their jobs safely and effectively. This investigation used a weighted suit to evaluate task performance at various ratios of strength, power, and endurance to body weight. METHODS: Twenty subjects completed muscle performance tests and functional tasks representative of those that would be required of astronauts during planetary exploration (see table for specific tests/tasks). Subjects performed functional tasks while wearing a weighted suit with additional loads ranging from 0-120% of initial body weight. Performance metrics were time to completion for all tasks except hatch opening, which consisted of total work. Task performance metrics were plotted against muscle metrics normalized to “body weight” (subject weight + external load; BW) for each trial. Fractional polynomial regression was used to model the relationship between muscle and task performance. RESULTS: The R values for normalized muscle performance versus task performance are presented in the table below. Supine Seat Egress and Walk Object Pick Up and Carry Ladder Treadmill Hatch Opening

Squat Ground Reaction Force on a Horizontal Squat Device, Free Weights, and Smith Machine

Bed rest is an analog to spaceflight and advancement of exercise countermeasures is dependent on the development of exercise equipment that closely mimic actual upright exercise. The Horizontal Squat Device (HSD) was developed to allow a supine exerciser to perform squats that mimic upright squat exercise. PURPOSE: To compare vertical ground reaction force (GRFv) on the HSD with Free Weight (FW) or Smith Machine (SM) during squat exercise. METHODS: Subjects (3F, 3M) performed sets of squat exercise with increasing loads up to 1-repetition (rep) maximum. GRF data were collected and compared with previous GRF data for squat exercise performed with FW & SM. Loads on the HSD were adjusted to magnitudes comparable with FW & SM by subtracting the subject s body weight (BW). Peak GRFv for 45-, 55-, 64-, & 73-kg loads above BW were calculated. Percent (%) difference between HSD and the two upright conditions were computed. Effect size was calculated for the 45-kg load. RESULTS: Most subjects were unable to lift >45 kg on the HSD; however, 1 subject completed all loads. Anecdotal evidence suggested that most subjects shoulders or back failed before their legs. The mean % difference are shown. In the 45-kg condition, effect sizes were 0.37 & 0.83 (p>0.05) for HSD vs. FW and HSD vs. SM, respectively, indicating no differences between exercise modes. CONCLUSION: When BW was added to the target load, results indicated that vertical forces were similar to those in FW and SM exercise. The exercise prescription for the HSD should include a total external resistance equivalent to goal load plus subject BW. The HSD may be used as an analog to upright exercise in bed rest studies, but because most subjects were unable to lift >45 kg, it may be necessary to prescribe higher reps and lower loads to better target the leg musculature