scholarly journals Hip proprioceptive feedback influences the control of mediolateral stability during human walking

2015 ◽  
Vol 114 (4) ◽  
pp. 2220-2229 ◽  
Author(s):  
Devin C. Roden-Reynolds ◽  
Megan H. Walker ◽  
Camille R. Wasserman ◽  
Jesse C. Dean

Active control of the mediolateral location of the feet is an important component of a stable bipedal walking pattern, although the roles of sensory feedback in this process are unclear. In the present experiments, we tested whether hip abductor proprioception influenced the control of mediolateral gait motion. Participants performed a series of quiet standing and treadmill walking trials. In some trials, 80-Hz vibration was applied intermittently over the right gluteus medius (GM) to evoke artificial proprioceptive feedback. During walking, the GM was vibrated during either right leg stance (to elicit a perception that the pelvis was closer mediolaterally to the stance foot) or swing (to elicit a perception that the swing leg was more adducted). Vibration during quiet standing evoked leftward sway in most participants (13 of 16), as expected from its predicted perceptual effects. Across the 13 participants sensitive to vibration, stance phase vibration caused the contralateral leg to be placed significantly closer to the midline (by ∼2 mm) at the end of the ongoing step. In contrast, swing phase vibration caused the vibrated leg to be placed significantly farther mediolaterally from the midline (by ∼2 mm), whereas the pelvis was held closer to the stance foot (by ∼1 mm). The estimated mediolateral margin of stability was thus decreased by stance phase vibration but increased by swing phase vibration. Although the observed effects of vibration were small, they were consistent with humans monitoring hip proprioceptive feedback while walking to maintain stable mediolateral gait motion.

1999 ◽  
Vol 13 (4) ◽  
pp. 234-244
Author(s):  
Uwe Niederberger ◽  
Wolf-Dieter Gerber

Abstract In two experiments with four and two groups of healthy subjects, a novel motor task, the voluntary abduction of the right big toe, was trained. This task cannot usually be performed without training and is therefore ideal for the study of elementary motor learning. A systematic variation of proprioceptive, tactile, visual, and EMG feedback was used. In addition to peripheral measurements such as the voluntary range of motion and EMG output during training, a three-channel EEG was recorded over Cz, C3, and C4. The movement-related brain potential during distinct periods of the training was analyzed as a central nervous parameter of the ongoing learning process. In experiment I, we randomized four groups of 12 subjects each (group P: proprioceptive feedback; group PT: proprioceptive and tactile feedback; group PTV: proprioceptive, tactile, and visual feedback; group PTEMG: proprioceptive, tactile, and EMG feedback). Best training results were reported from the PTEMG and PTV groups. The movement-preceding cortical activity, in the form of the amplitude of the readiness potential at the time of EMG onset, was greatest in these two groups. Results of experiment II revealed a similar effect, with a greater training success and a higher electrocortical activation under additional EMG feedback compared to proprioceptive feedback alone. Sensory EMG feedback as evaluated by peripheral and central nervous measurements appears to be useful in motor training and neuromuscular re-education.


2009 ◽  
Vol 89 (11) ◽  
pp. 1205-1214 ◽  
Author(s):  
Vicki Stemmons Mercer ◽  
Michael T. Gross ◽  
Subhashini Sharma ◽  
Erin Weeks

Background Step-up exercises often are suggested for strengthening the hip abductor muscles and improving balance in older adults. Little is known, however, about whether the forward or lateral version of these exercises is best for activating the hip abductor muscles. Objective The purpose of this study was to examine the electromyographic (EMG) amplitude of the gluteus medius (GM) muscles bilaterally during forward and lateral step-up exercises. Design The study design involved single-occasion repeated measures. Methods Twenty-seven community-dwelling adults (7 men and 20 women) with a mean (SD) age of 79.4 (8.0) years performed forward and lateral step-up exercises while the surface EMG activity of the GM muscles was recorded bilaterally. Pressure switches and dual forceplates were used to identify the ascent and descent phases. Subjects were instructed to lead with the right lower extremity during ascent and the left lower extremity during descent. Differences in normalized root-mean-square EMG amplitudes with exercise direction (forward versus lateral) and phase (ascent versus descent) were examined by use of separate repeated-measures analyses of variance for the right and left lower extremities. The alpha level was set at .05. Results Gluteus medius muscle EMG activity was significantly greater for lateral than for forward step-up exercises for the left lower extremity during the ascent phase and for both lower extremities during the descent phase. In addition, right GM muscle EMG activity was significantly greater during ascent than during descent for both exercise directions. Limitations Study limitations include use of a convenience sample and collection of limited information about participants. Conclusions Step-up exercises are effective in activating the GM muscle, with lateral step-up exercises requiring greater GM muscle activation than forward step-up exercises. Further study is needed to determine whether exercise programs for hip abductor muscle strengthening in older adults should preferentially include lateral over forward step-up exercises.


2014 ◽  
Vol 112 (2) ◽  
pp. 374-383 ◽  
Author(s):  
Bradford L. Rankin ◽  
Stephanie K. Buffo ◽  
Jesse C. Dean

Stability is an important concern during human walking and can limit mobility in clinical populations. Mediolateral stability can be efficiently controlled through appropriate foot placement, although the underlying neuromechanical strategy is unclear. We hypothesized that humans control mediolateral foot placement through swing leg muscle activity, basing this control on the mechanical state of the contralateral stance leg. Participants walked under Unperturbed and Perturbed conditions, in which foot placement was intermittently perturbed by moving the right leg medially or laterally during the swing phase (by ∼50–100 mm). We quantified mediolateral foot placement, electromyographic activity of frontal-plane hip muscles, and stance leg mechanical state. During Unperturbed walking, greater swing-phase gluteus medius (GM) activity was associated with more lateral foot placement. Increases in GM activity were most strongly predicted by increased mediolateral displacement between the center of mass (CoM) and the contralateral stance foot. The Perturbed walking results indicated a causal relationship between stance leg mechanics and swing-phase GM activity. Perturbations that reduced the mediolateral CoM displacement from the stance foot caused reductions in swing-phase GM activity and more medial foot placement. Conversely, increases in mediolateral CoM displacement caused increased swing-phase GM activity and more lateral foot placement. Under both Unperturbed and Perturbed conditions, humans controlled their mediolateral foot placement by modulating swing-phase muscle activity in response to the mechanical state of the contralateral leg. This strategy may be disrupted in clinical populations with a reduced ability to modulate muscle activity or sense their body's mechanical state.


2021 ◽  
pp. 036354652199967
Author(s):  
Baris Kocaoglu ◽  
Ahmet Emre Paksoy ◽  
Simone Cerciello ◽  
Matthieu Ollivier ◽  
Romain Seil ◽  
...  

Background: Endoscopic surgical repair has become a common procedure for treating patients with hip abductor tendon tears. Considering that retear rates are high after the repair of gluteus medius and minimus tendons, exploring alternative strategies to enhance structural healing is important. Purpose/Hypothesis: The purpose of this study was to evaluate the effect of adding microfracture to single-row repair (SR) on outcomes after the surgical repair of gluteus medius and minimus tendons and compare with SR and double-row repair (DR) without microfracture. We hypothesized that microfracture of the trochanteric footprint with SR would lead to superior clinical outcomes and lower clinically evident retear rates compared with SR and DR without the addition of microfracture. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 50 patients who underwent primary arthroscopic repair of hip gluteus medius and minimus tendon tears were investigated. Patients were divided into 3 groups: DR, 16 patients; SR, 14 patients; and SR with microfracture (SRM), 20 patients. Patients were evaluated with a visual analog scale (VAS) for pain as well as the Hip Outcome Score–Activities of Daily Living (HOS-ADL), Hip Outcome Score–Sport Specific (HOS-SS), and modified Harris Hip Score (mHHS) both preoperatively and at a minimum 2-year follow-up (mean, 30 months). Results: Among the SR, SRM, and DR groups, the greatest decrease in VAS scores and increase in mHHS, HOS-ADL, and HOS-SS scores were seen in the SRM group, and all the differences were significant ( P < .001 to P = .006). The abductor tendon retear rates were 31.3%, 35.7%, and 15.0% in the DR, SR, and SRM groups, respectively. Retear rates were lower in the SRM group compared with the SR and DR groups ( P = .042); however, there was no significant difference between the SR and DR groups ( P = .32) in terms of retear rates. Conclusion: Endoscopic SR with microfracture was a safe, practical, and effective technique and had the potential advantage of enhancing biological healing at the footprint. The addition of microfracturing the trochanteric footprint significantly lowered the retear rate and provided better functional outcomes than SR and DR without microfracture.


Sensors ◽  
2021 ◽  
Vol 21 (9) ◽  
pp. 3277
Author(s):  
Juan Luis Florenciano Restoy ◽  
Jordi Solé-Casals ◽  
Xantal Borràs-Boix

The objectives of this study were to determine the amplitude of movement differences and asymmetries between feet during the stance phase and to evaluate the effects of foot orthoses (FOs) on foot kinematics in the stance phase during running. In total, 40 males were recruited (age: 43.0 ± 13.8 years, weight: 72.0 ± 5.5 kg, height: 175.5 ± 7.0 cm). Participants ran on a running treadmill at 2.5 m/s using their own footwear, with and without the FOs. Two inertial sensors fixed on the instep of each of the participant’s footwear were used. Amplitude of movement along each axis, contact time and number of steps were considered in the analysis. The results indicate that the movement in the sagittal plane is symmetric, but that it is not in the frontal and transverse planes. The right foot displayed more degrees of movement amplitude than the left foot although these differences are only significant in the abduction case. When FOs are used, a decrease in amplitude of movement in the three axes is observed, except for the dorsi-plantar flexion in the left foot and both feet combined. The contact time and the total step time show a significant increase when FOs are used, but the number of steps is not altered, suggesting that FOs do not interfere in running technique. The reduction in the amplitude of movement would indicate that FOs could be used as a preventive tool. The FOs do not influence the asymmetry of the amplitude of movement observed between feet, and this risk factor is maintained. IMU devices are useful tools to detect risk factors related to running injuries. With its use, even more personalized FOs could be manufactured.


2021 ◽  
Vol 9 (4) ◽  
pp. 232596712110077
Author(s):  
Tyler J. Uppstrom ◽  
Spencer W. Sullivan ◽  
Joost A. Burger ◽  
Anil S. Ranawat ◽  
Bryan T. Kelly ◽  
...  

Background: Open repair for gluteus medius and minimus tears is a common surgical treatment for patients with lateral hip pain associated with abductor tears; however, clinically meaningful outcomes have not been described after open surgical treatment. Purpose: To define the minimal clinically important difference (MCID) in patient-reported outcome measures (PROMs) in patients undergoing open gluteus medius or minimus repair, and to identify preoperative patient characteristics predictive of achieving MCID postoperatively. Study Design: Case series; Level of evidence, 4. Methods: A retrospective review of prospectively collected data from a consecutive series of patients undergoing open abductor repair between July 2010 and April 2019 was conducted. Perioperative patient data collected included patient characteristics and preoperative and postoperative modified Harris Hip Score (mHHS) and International Hip Outcome Tool (iHOT-33) score. Paired t tests were utilized to compare preoperative and postoperative PROMs and MCID was calculated for both PROMs. Multivariate logistical regression analysis was used to assess the association between preoperative variables and the likelihood for achieving MCID. Results: A total of 47 patients were included in the study. The majority of patients were female (78.7%), with an average age of 63 ± 10.7 years. The average follow-up for both the mHHS and the iHOT-33 surveys was 37.8 ± 27.9 months (range, 10-102 months). Patients demonstrated statistically significant improvements on the mHHS and iHOT-33 postoperatively ( P < .001 for both). The MCIDs of mHHS and iHOT-33 were calculated to be 9.9 and 14.3, respectively. Overall, 82.9% of patients achieved MCID for mHHS and 84.1% of patients achieved MCID for iHOT-33 postoperatively. Multivariate logistical analysis demonstrated younger patients were less likely to achieve MCID for both outcome measures. Four patients (8.5%) suffered postoperative complications after open repair. Conclusion: This study defined MCID for mHHS and iHOT-33 for patients undergoing open repair of hip abductor tears, with a large percentage of patients (>80%) achieving meaningful outcomes for both outcome measures. There was a low complication rate. Younger patients were less likely to achieve MCID compared with older patients.


2012 ◽  
Vol 107 (11) ◽  
pp. 3050-3061 ◽  
Author(s):  
Susan K. Patrick ◽  
J. Adam Noah ◽  
Jaynie F. Yang

Human infants can crawl using several very different styles; this diversity appears at first glance to contradict our previous findings from hands-and-knees crawling, which suggested that there were strict limitations on coordination, imposed either mechanically or by the developing nervous system. To determine whether coordination was similarly restricted across crawling styles, we studied free crawling overground in 22 infants who used a number of different locomotor strategies. Despite the wide variety in the use of individual limbs and even the number of limbs used, the duration of the stance phase increased with duration of cycle, whereas the duration of the swing phase remained more constant. Additionally, all infants showed organized, rhythmic interlimb coordination. Alternating patterns (e.g., trotlike) predominated (86% of infants). Alternatively, yet much less frequently, all limbs used could work in synchrony (14% of infants). Pacelike patterns were never observed, even in infants that crawled with the belly remaining in contact with the ground so that stability was not a factor. To explore the robustness of the interlimb coordination, a perturbation that prolonged swing of the leg was imposed on 14 additional infants crawling on hands and knees overground or on the treadmill. The perturbation led to a resetting of the crawling pattern, but never to a change in the coordination of the limbs. The findings concur with those regarding other infant animals, together suggesting that the nervous system itself limits the coordination patterns available at a young age.


2000 ◽  
Vol 523 (3) ◽  
pp. 817-827 ◽  
Author(s):  
T. Sinkjær ◽  
J. B. Andersen ◽  
M. Ladouceur ◽  
L. O. D. Christensen ◽  
J. B. Nielsen

1995 ◽  
Vol 198 (7) ◽  
pp. 1589-1601 ◽  
Author(s):  
F Kuenzi ◽  
M Burrows

The hair plate proprioceptors at the thoraco-coxal joint of insect limbs provide information about the movements of the most basal joint of the legs. The ventral coxal hair plate of a middle leg consists of group of 10-15 long hairs (70 microns) and 20-30 short hairs (30 microns). The long hairs are deflected by the trochantin as the leg is swung forward during the swing phase of walking, and their sensory neurones respond phasically during an imposed deflection and tonically if the deflection is maintained. Selective stimulation of the long hairs elicits a resistance reflex that rotates the coxa posteriorly and is similar to that occurring at the transition from the swing to the stance phase of walking. The motor neurones innervating the posterior rotator and adductor coxae muscles are excited, and those to the antagonistic anterior rotator muscle are inhibited. By contrast, selective stimulation of the short hairs leads only to a weak inhibition of the anterior rotator. The excitatory effects of the long hairs are mediated, in part, by direct connections between their sensory neurones and particular motor neurones. A spike in a sensory neurone elicits a short-latency depolarising postsynaptic potential (PSP) in posterior rotator and adductor motor neurones whose amplitude is enhanced by hyperpolarising current injected into the motor neurone. When the calcium in the saline is replaced with magnesium, the amplitude of the PSP is reduced gradually, and not abruptly as would be expected if an interneurone were interposed in the pathway. Several sensory neurones from long hairs converge to excite an individual motor neurone, evoking spikes in some motor neurones. The projections of the sensory neurones overlap with some of the branches of the motor neurones in the lateral association centre of the neuropile. It is suggested that these pathways would limit the extent of the swing phase of walking and contribute to the switch to the stance phase in a negative feedback loop that relieves the excitation of the hairs by rotating the coxa backwards.


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