scholarly journals Different Error Size During Locomotor Adaptation Affects Transfer to Overground Walking Poststroke

2018 ◽  
Vol 32 (12) ◽  
pp. 1020-1030 ◽  
Author(s):  
Carolina C. Alcântara ◽  
Charalambos C. Charalambous ◽  
Susanne M. Morton ◽  
Thiago L. Russo ◽  
Darcy S. Reisman
Keyword(s):  
Catch Trial ◽  
Step Length ◽  
Similar Amount ◽  
Adaptation Period ◽  
Overground Walking ◽  
Locomotor Adaptation ◽  
Walking Pattern ◽  
Gradual Group ◽  
Adaptation Response ◽  
Group A

Background. Studies in neurologically intact subjects suggest that the gradual presentation of small perturbations (errors) during learning results in better transfer of a newly learned walking pattern to overground walking. Whether the same result would be true after stroke is not known. Objective. To determine whether introducing gradual perturbations, during locomotor learning using a split-belt treadmill influences learning the novel walking pattern or transfer to overground walking poststroke. Methods. Twenty-six chronic stroke survivors participated and completed the following walking testing paradigm: baseline overground walking; baseline treadmill walking; split-belt treadmill/adaptation period (belts moving at different speeds); catch trial (belts at same speed); post overground walking. Subjects were randomly assigned to the Gradual group (gradual changes in treadmill belts speed during adaptation) or the Abrupt group (a single, large, abrupt change during adaptation). Step length asymmetry adaptation response on the treadmill and transfer of learning to overground walking was assessed. Results. Step length asymmetry during the catch trial was the same between groups ( P = .195) confirming that both groups learned a similar amount. The magnitude of transfer to overground walking was greater in the Gradual than in the Abrupt group ( P = .041). Conclusions. The introduction of gradual perturbations (small errors), compared with abrupt (larger errors), during a locomotor adaptation task seems to improve transfer of the newly learned walking pattern to overground walking poststroke. However, given the limited magnitude of transfer, future studies should examine other factors that could impact locomotor learning and transfer poststroke.

scholarly journals Characterization of speed adaptation while walking on an omnidirectional treadmill

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Smit Soni ◽  
Anouk Lamontagne
Keyword(s):  
Lower Limb ◽  
Muscle Activation ◽  
Low Cost ◽  
Weight Bearing ◽  
Step Length ◽  
Overground Walking ◽  
Walking Pattern ◽  
Spatiotemporal Parameters ◽  
Walking Speeds ◽  
The Impact

Abstract Background Conventional treadmills are widely used for gait retraining in rehabilitation setting. Their usefulness for training more complex locomotor tasks, however, remains limited given that they do not allow changing the speed nor the direction of walking which are essential walking adaptations for efficient and safe community ambulation. These drawbacks can be addressed by using a self-pace omnidirectional treadmill, as those recently developed by the gaming industry, which allows speed changes and locomotor movements in any direction. The extent to which these treadmills yield a walking pattern that is similar to overground walking, however, is yet to be determined. Methods The objective of this study was to compare spatiotemporal parameters, body kinematics and lower limb muscle activation of healthy young individuals walking at different speeds (slow, comfortable, fast) on a low-cost non-motorized omnidirectional treadmill with and without virtual reality (VR) vs. overground. Results Results obtained from 12 young healthy individuals (18–29 years) showed that participants achieved slower speed on the treadmill compared to overground. On the treadmill, faster walking speeds were achieved by a mere increase in cadence, as opposed to a combined increase in cadence and step length when walking overground. At matched speed, enhanced stance phase knee flexion, reduced late stance ankle plantarflexion, as well as enhanced activation amplitudes of hip extensors in late stance and hip extensors in early swing were observed. The addition of VR to treadmill walking had little or no effect of walking outcomes. Collectively, results show that the omnidirectional treadmill yields a different walking pattern and lead to different adaptations to speed compared to overground walking. We suggest that these alterations are mainly driven by the reduced shear forces between the weight bearing foot and supporting surface and a perceived threat to balance on the omnidirectional treadmill. Conclusion Since such treadmills are likely to be used for prolonged periods of time by gamers or patients undergoing physical rehabilitation, further research should aim at determining the impact of repeated exposure on gait biomechanics and lower limb musculoskeletal integrity.

scholarly journals Blocking trial-by-trial error correction does not interfere with motor learning in human walking

2016 ◽  
Vol 115 (5) ◽  
pp. 2341-2348 ◽  
Author(s):  
Andrew W. Long ◽  
Ryan T. Roemmich ◽  
Amy J. Bastian
Keyword(s):  
Error Correction ◽  
Motor Pattern ◽  
Step Length ◽  
The Other ◽  
Human Walking ◽  
Not Given ◽  
Foot Placement ◽  
Locomotor Adaptation ◽  
Walking Pattern ◽  
Environmental Demands

Movements can be learned implicitly in response to new environmental demands or explicitly through instruction and strategy. The former is often studied in an environment that perturbs movement so that people learn to correct the errors and store a new motor pattern. Here, we demonstrate in human walking that implicit learning of foot placement occurs even when an explicit strategy is used to block changes in foot placement during the learning process. We studied people learning a new walking pattern on a split-belt treadmill with and without an explicit strategy through instruction on where to step. When there is no instruction, subjects implicitly learn to place one foot in front of the other to minimize step-length asymmetry during split-belt walking, and the learned pattern is maintained when the belts are returned to the same speed, i.e., postlearning. When instruction is provided, we block expression of the new foot-placement pattern that would otherwise naturally develop from adaptation. Despite this appearance of no learning in foot placement, subjects show similar postlearning effects as those who were not given any instruction. Thus locomotor adaptation is not dependent on a change in action during learning but instead can be driven entirely by an unexpressed internal recalibration of the desired movement.

The Moving Platform Aftereffect: Limited Generalization of a Locomotor Adaptation

2004 ◽  
Vol 91 (1) ◽  
pp. 92-100 ◽  
Author(s):  
R. F. Reynolds ◽  
A. M. Bronstein
Keyword(s):  
Baseline Period ◽  
Adaptation Period ◽  
Locomotor Adaptation ◽  
Walking Pattern ◽  
After Effect ◽  
Walking Velocity ◽  
Full Knowledge ◽  
Flashing Light ◽  
Moving Platform ◽  
Insight Into

We have recently described a postural after-effect of walking onto a stationary platform previously experienced as moving, which occurs despite full knowledge that the platform will no longer move. This experiment involves an initial baseline period when the platform is kept stationary (BEFORE condition), followed by a brief adaptation period when subjects learn to walk onto the platform moving at 1.2 m/s (MOVING condition). Subjects are clearly warned that the platform will no longer move and asked to walk onto it again (AFTER condition). Despite the warning, they walk toward the platform with a velocity greater than that observed during the BEFORE condition, and a large forward sway of the trunk is observed once they have landed on the platform. This aftereffect, which disappears within three trials, represents dissociation of knowledge and action. In the current set of experiments, to gain further insight into this phenomenon, we have manipulated three variables, the context, location, and method of the walking task, between the MOVING and AFTER conditions, to determine how far the adaptation will generalize. It was found that when the gait initiation cue was changed from beeps to a flashing light, or vice versa, there was no difference in the magnitude of the aftereffect, either in terms of walking velocity or forward sway of the trunk. Changing the leg with which gait was initiated, however, reduced sway magnitude by approximately 50%. When subjects changed from forward walking to backward walking, the aftereffect was abolished. Similarly, walking in a location other than the mobile platform did not produce any aftereffect. However, in these latter two experiments, the aftereffect reappeared when subjects reverted to the walking pattern used during the MOVING condition. Hence, these results show that a change in abstract context had no influence, whereas any deviation from the way and location in which the moving platform task was originally performed profoundly reduced the size of the aftereffect. Although the moving platform aftereffect is an example of inappropriate generalization by the motor system across time, these results show that this generalization is highly limited to the method and location in which the original adaptation took place.

scholarly journals Fluid Cognitive Abilities Are Important for Learning and Retention of a New, Explicitly Learned Walking Pattern in Individuals After Stroke

2021 ◽  
pp. 154596832110010
Author(s):  
Margaret A. French ◽  
Matthew L. Cohen ◽  
Ryan T. Pohlig ◽  
Darcy S. Reisman
Keyword(s):  
Cognitive Abilities ◽  
Step Length ◽  
Cognitive Measures ◽  
Retention Models ◽  
Wechsler Memory Scale ◽  
Walking Pattern ◽  
Learning Principles ◽  
The Relationship ◽  
Sequential Regression ◽  
Neurologically Intact

Background There is significant variability in poststroke locomotor learning that is poorly understood and affects individual responses to rehabilitation interventions. Cognitive abilities relate to upper extremity motor learning in neurologically intact adults, but have not been studied in poststroke locomotor learning. Objective To understand the relationship between locomotor learning and retention and cognition after stroke. Methods Participants with chronic (>6 months) stroke participated in 3 testing sessions. During the first session, participants walked on a treadmill and learned a new walking pattern through visual feedback about their step length. During the second session, participants walked on a treadmill and 24-hour retention was assessed. Physical and cognitive tests, including the Fugl-Meyer-Lower Extremity (FM-LE), Fluid Cognition Composite Score (FCCS) from the NIH Toolbox -Cognition Battery, and Spatial Addition from the Wechsler Memory Scale-IV, were completed in the third session. Two sequential regression models were completed: one with learning and one with retention as the dependent variables. Age, physical impairment (ie, FM-LE), and cognitive measures (ie, FCCS and Spatial Addition) were the independent variables. Results Forty-nine and 34 participants were included in the learning and retention models, respectively. After accounting for age and FM-LE, cognitive measures explained a significant portion of variability in learning ( R2 = 0.17, P = .008; overall model R2 = 0.31, P = .002) and retention (Δ R2 = 0.17, P = .023; overall model R2 = 0.44, P = .002). Conclusions Cognitive abilities appear to be an important factor for understanding locomotor learning and retention after stroke. This has significant implications for incorporating locomotor learning principles into the development of personalized rehabilitation interventions after stroke.

scholarly journals Split-Belt Treadmill Adaptation Transfers to Overground Walking in Persons Poststroke

2009 ◽  
Vol 23 (7) ◽  
pp. 735-744 ◽  
Author(s):  
Darcy S. Reisman ◽  
Robert Wityk ◽  
Kenneth Silver ◽  
Amy J. Bastian
Keyword(s):  
Step Length ◽  
Overground Walking ◽  
Double Support ◽  
Context Switching ◽  
Before And After ◽  
Partial Transfer ◽  
And Gender ◽  
Double Support Time ◽  
Support Time ◽  
Control Locomotion

Background and Objective. Following stroke, subjects retain the ability to adapt interlimb symmetry on the split-belt treadmill. Critical to advancing our understanding of locomotor adaptation and its usefulness in rehabilitation is discerning whether adaptive effects observed on a treadmill transfer to walking over ground. We examined whether aftereffects following split-belt treadmill adaptation transfer to overground walking in healthy persons and those poststroke. Methods. Eleven poststroke and 11 age-matched and gender-matched healthy subjects walked over ground before and after walking on a split-belt treadmill. Adaptation and aftereffects in step length and double support time were calculated. Results. Both groups demonstrated partial transfer of the aftereffects observed on the treadmill ( P < .001) to overground walking ( P < .05), but the transfer was more robust in the subjects poststroke ( P < .05). The subjects with baseline asymmetry after stroke improved in asymmetry of step length and double limb support ( P = .06). Conclusions. The partial transfer of aftereffects to overground walking suggests that some shared neural circuits that control locomotion for different environmental contexts are adapted during split-belt treadmill walking. The larger adaptation transfer from the treadmill to overground walking in the stroke survivors may be due to difficulty adjusting their walking pattern to changing environmental demands. Such difficulties with context switching have been considered detrimental to function poststroke. However, we propose that the persistence of improved symmetry when changing context to overground walking could be used to advantage in poststroke rehabilitation.

scholarly journals A Comparison of Treadmill and Overground Walking Effects on Step Cycle Asymmetry in Young and Older Individuals

2013 ◽  
Vol 29 (2) ◽  
pp. 188-193 ◽  
Author(s):  
Hanatsu Nagano ◽  
Rezaul K. Begg ◽  
William A. Sparrow ◽  
Simon Taylor
Keyword(s):  
Older Adults ◽  
Walking Speed ◽  
Step Length ◽  
Treadmill Walking ◽  
Older Individuals ◽  
Aging Effects ◽  
Overground Walking ◽  
Time Data ◽  
Step Cycle ◽  
Step Velocity

Although lower limb strength becomes asymmetrical with age, past studies of aging effects on gait biomechanics have usually analyzed only one limb. This experiment measured how aging and treadmill surface influenced both dominant and nondominant step parameters in older (mean 74.0 y) and young participants (mean 21.9 y). Step-cycle parameters were obtained from 3-dimensional position/time data during preferred-speed walking for 40 trials along a 10 m walkway and for 10 minutes of treadmill walking. Walking speed (young 1.23 m/s, older 1.24 m/s) and step velocity for the two age groups were similar in overground walking but older adults showed significantly slower walking speed (young 1.26 m/s, older 1.05 m/s) and step velocity on the treadmill due to reduced step length and prolonged step time. Older adults had shorter step length than young adults and both groups reduced step length on the treadmill. Step velocity and length of older adults’ dominant limb was asymmetrically larger. Older adults increased the proportion of double support in step time when treadmill walking. This adaptation combined with reduced step velocity and length may preserve balance. The results suggest that bilateral analyses should be employed to accurately describe asymmetric features of gait especially for older adults.

EFFECT OF ACCUPRESSURE PEN ON DISTANCE VARIABLE IN SCIATICA PATIENTS -A RANDOMIZED CONTROL TRIAL

2021 ◽  
pp. 28-31
Author(s):  
Urja S. Vaidya ◽  
Roshani S. Patel
Keyword(s):  
Randomized Control Trial ◽  
Stride Length ◽  
Step Length ◽  
Control Group ◽  
Exclusion Criteria ◽  
Parametric Test ◽  
Group A ◽  
Randomized Control ◽  
Experimental Group ◽  
Distance Variable

Background: Sciatica is a radiating pain which is treated with manual accupressure and after a time electro accupressure came into introduction. Aim And Objective: Aim: To nd out the effectiveness of accupressure pen to improve the distance variable To nd out the effect of Objective: accupressure pen on pain and distance variable in sciatica patient To compare the experimental group to the control group On the basis of Method: inclusion and exclusion criteria 30 participants were selected. They were treated with electro accupressure pen for 3 alternative days / week for 3 weeks, after that re-assessment was taken with NPRS, Slump and Distance variables. The data was analyzed using SPSS Version Results: 21.Parametric test was used .In Group A improvement was seen Accupressure Conclusions: pen is effective to reduce pain and improve step length and stride length in Sciatica Patients

scholarly journals In vitro Comparison of Apically Extruded Debris during Root Canal Retreatment with Rotary and Reciprocating Systems

2019 ◽  
Vol 13 (1) ◽  
pp. 488-492
Author(s):  
María J. Burbano Balseca ◽  
Silvana B. Terán Ayala ◽  
Fábio D. da Costa Aznar ◽  
Adriana R. de Freitas-Aznar ◽  
Guillermo M. Aguirre Balseca ◽  
...  
Keyword(s):  
Similar Amount ◽  
Hybrid Technique ◽  
Significance Level ◽  
Sealing Material ◽  
Apical Extrusion ◽  
Root Canal Retreatment ◽  
Group A ◽  
Group B ◽  
Reciprocating Systems

Introduction: The extrusion of apical detritus during the retracting procedure is very important, as, besides eliminating materials of radicular obturation, aggressive agents and products such as the remains of dentin taken out, and microorganisms are generally located in tissue around the roots, producing undesired effects, such as inflammation, acute pain, post-operatory pain and delays in the periapical treatment. Objective: To determine the amount of apically extruded detritus using rotary and reciprocating retreatment systems. Methodology: An experimental comparative study as conducted in which 40 single-rooted human first premolars were analyzed. The instruments used were ProTaper Universal files up to F3 and sodium hypochlorite, and the sealing was made through the hybrid technique Tager. They were then kept at 37ºC and 100% of humidity for 15 days so that the sealing material would seal. For the retracting procedure, experimental tubes previously weighted were used. The sample was divided randomly into two groups of 20 pieces. Group A: ProTaper R, and group B: Reciproc. Then, the irrigating material (distilled water) was evaporated from the tubes for 12 hours in a stove at 105ºC, and the experimental tubes were weighted in an analytical precision weighing scale 10-5g. The data was analyzed through the T Student with a significance level of 5%. Results: Results indicated that groups A and B, retreatment with rotational ProTaper R and reciprocating retreatment system (Reciproc) showed a similar difference of initial and final weights, indicating similar apical extrusion of detritus. Conclusion: Both systems extruded a similar amount of detritus during the retreatment procedures.

scholarly journals Large Propulsion Demands Increase Locomotor Adaptation at the Expense of Step Length Symmetry

2019 ◽  
Vol 10 ◽  
Author(s):  
Carly J. Sombric ◽  
Jonathan S. Calvert ◽  
Gelsy Torres-Oviedo
Keyword(s):  
Step Length ◽  
Locomotor Adaptation

scholarly journals End-to-side nerve repair using fibrin glue in rats

2010 ◽  
Vol 25 (2) ◽  
pp. 158-162 ◽  
Author(s):  
Daniel Nunes e Silva ◽  
Julice Coelho ◽  
Fabrício de Oliveira Frazílio ◽  
Alexandre Nakao Odashiro ◽  
Paulo de Tarso Camillo de Carvalho ◽  
...  
Keyword(s):  
Fibrin Glue ◽  
Axonal Regeneration ◽  
Nerve Repair ◽  
Control Group ◽  
Morphometrical Analysis ◽  
Walking Pattern ◽  
Group A ◽  
Nerve Anastomosis ◽  
Group B ◽  
Control Group Group

PURPOSE: To evaluate axonal regeneration after end-to-side nerve repair with fibrin glue in rats. METHODS: Forty-five Wistar rats were divided into three groups: group A (n=15), were not submitted to surgery (control group); group B (n=15) were submitted to fibular transection without repair; and group C (n=15), were submitted to fibular transection with end-to-side nerve anastomosis using fibrin glue, in the lateral surface of an intact tibial nerve. The three groups were submitted to walking track (30 and 90 days) and posterior morphometrical analysis (90 days). RESULTS: The functional tests demonstrated that there was no difference in the walking track during the study in group A (p>0.05). The group B had walking pattern impairment in the two tests (p>0.05). The group C had walking pattern impairment in the first test, with important recovery in the second test (p<0.05). The morphometrical assessment revealed significantly higher number of regenerated mielinates axons in group C, compared to group B (p<0.05). CONCLUSION: The end-to-side nerve repair with fibrin glue shows axonal recovery, demonstrated through functional and morphometrical ways in rats.

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