Kinesiology Commons^™

Peripheral Artery Disease Affects The Function Of The Legs Of Claudicating Patients In A Diffuse Manner Irrespective Of The Segment Of The Arterial Tree Primarily Involved, Todd Leutzinger, Panagiotis Koutakis, Matthew A. Fuglestad, Hafizur Rahman, Holly Despiegelaere, Mahdi Hassan, Molly Schieber, Jason Johanning, Nick Stergiou, G. Matthew Longo, George P. Casale, Sara A. Myers, Iraklis Pipinos

Journal Articles

Different levels of arterial occlusive disease (aortoiliac, femoropopliteal, multi-level disease) can produce claudication symptoms in different leg muscle groups (buttocks, thighs, calves) in patients with peripheral artery disease (PAD). We tested the hypothesis that different locations of occlusive disease uniquely affect the muscles of PAD legs and produce distinctive patterns in the way claudicating patients walk. Ninety-seven PAD patients and 35 healthy controls were recruited. PAD patients were categorized to aortoiliac, femoropopliteal and multi-level disease groups using computerized tomographic angiography. Subjects performed walking trials both pain-free and during claudication pain and joint kinematics, kinetics, and spatiotemporal parameters were calculated to …

Filtering Affects The Calculation Of The Largest Lyapunov Exponent, Peter C. Raffalt, Ben Senderling, Nicholas Stergiou

Journal Articles

The calculation of the largest Lyapunov exponent (LyE) requires the reconstruction of the time series in an N-dimensional state space. For this, the time delay (Tau) and embedding dimension (EmD) are estimated using the Average Mutual Information and False Nearest Neighbor algorithms. However, the estimation of these variables (LyE, Tau, EmD) could be compromised by prior filtering of the time series evaluated. Therefore, we investigated the effect of filtering kinematic marker data on the calculation of Tau, EmD and LyE using several different computational codes. Kinematic marker data were recorded from 37 subjects during treadmill walking and filtered using a …

Step Width Variability As A Discriminator Of Age-Related Gait Changes, Andreas Skiadopoulos, Emily E. Moore, Harlan Sayles, Kendra K. Schmid, Nicholas Stergiou

Journal Articles

Background

There is scientific evidence that older adults aged 65 and over walk with increased step width variability which has been associated with risk of falling. However, there are presently no threshold levels that define the optimal reference range of step width variability. Thus, the purpose of our study was to estimate the optimal reference range for identifying older adults with normative and excessive step width variability.

Methods

We searched systematically the BMC, Cochrane Library, EBSCO, Frontiers, IEEE, PubMed, Scopus, SpringerLink, Web of Science, Wiley, and PROQUEST databases until September 2018, and included the studies that measured step width variability …

Auditory And Visual External Cues Have Different Effects On Spatial But Similar Effects On Temporal Measures Of Gait Variability, Joao R. Vaz, Troy Rand, Jessica Fujan-Hansen, Mukul Mukherjee, Nicholas Stergiou

Journal Articles

Walking synchronized to external cues is a common practice in clinical settings. Several research studies showed that this popular gait rehabilitation tool alters gait variability. There is also recent evidence which suggests that alterations in the temporal structure of the external cues could restore gait variability at healthy levels. It is unknown, however, if such alterations produce similar effects if the cueing modalities used are different; visual or auditory. The modality could affect gait variability differentially, since there is evidence that auditory cues mostly act in the temporal domain of gait, while visual cues act in the spatial domain of …

Modular Footwear That Partially Offsets Downhill Or Uphill Grades Minimizes The Metabolic Cost Of Human Walking, Prokopios Antonellis, Cory M. Frederick, Arash Mohammadzadeh Gonabadi, Philippe Malcolm

Journal Articles

Walking on different grades becomes challenging on energetic and muscular levels compared to level walking. While it is not possible to eliminate the cost of raising or lowering the centre of mass (COM), it could be possible to minimize the cost of distal joints with shoes that offset downhill or uphill grades. We investigated the effects of shoe outsole geometry in 10 participants walking at 1 m s−1 on downhill, level and uphill grades. Level shoes minimized metabolic rate during level walking (Psecond-order effect < 0.001). However, shoes that entirely offset the (overall) treadmill grade did not minimize the metabolic rate of walking on grades: shoes with a +3° (upward) inclination minimized metabolic rate during downhill walking on a −6° grade, and shoes with a −3° (downward) inclination minimized metabolic rate during uphill walking on a +6° grade (P interaction effect = 0.023). Shoe inclination influenced (distal) ankle joint parameters, including soleus muscle activity, ankle moment and work rate, whereas treadmill grade influenced (whole-body) ground reaction force and COM work rate as well as (distal) ankle joint parameters including tibialis anterior and plantarflexor muscle activity, ankle moment and work rate. Similar modular footwear could be used to minimize joint loads or assist with walking on rolling terrain.

Selection Procedures For The Largest Lyapunov Exponent In Gait Biomechanics, Peter C. Raffalt, Jenny A. Kent, Shane R. Wurdeman, Nicholas Stergiou

Journal Articles

The present study was aimed at investigating the effectiveness of the Wolf et al. (LyE_W) and Rosenstein et al. largest Lyapunov Exponent (LyE_R) algorithms to differentiate data sets with distinctly different temporal structures. The three-dimensional displacement of the sacrum was recorded from healthy subjects during walking and running at two speeds; one low speed close to the preferred walking speed and one high speed close to the preferred running speed. LyE_R and LyE_W were calculated using four different time series normalization procedures. The performance of the algorithms were evaluated based on their ability to return relative low values for slow …

On The Choice Of Multiscale Entropy Algorithm For Quantification Of Complexity In Gait Data, Peter C. Raffalt, William Denton, Jennifer M. Yentes

Journal Articles

The present study aimed at identifying a suitable multiscale entropy (MSE) algorithm for assessment of complexity in a stride-to-stride time interval time series. Five different algorithms were included (the original MSE, refine composite multiscale entropy (RCMSE), multiscale fuzzy entropy, generalized multiscale entropy and intrinsic mode entropy) and applied to twenty iterations of white noise, pink noise, or a sine wave with added white noise. Based on their ability to differentiate the level of complexity in the three different generated signal types, and their sensitivity and parameter consistency, MSE and RCMSE were deemed most appropriate. These two algorithms were applied to …

Exoskeleton Assistance Symmetry Matters: Unilateral Assistance Reduces Metabolic Cost, But Relatively Less Than Bilateral Assistance, Philippe Malcolm, Samuel Galle, Pieter Van Den Berghe, Dirk De Clercq

Journal Articles

Background: Many gait impairments are characterized by asymmetry and result in reduced mobility. Exoskeletons could be useful for restoring gait symmetry by assisting only one leg. However, we still have limited understanding of the effects of unilateral exoskeleton assistance. Our aim was to compare the effects of unilateral and bilateral assistance using a within-subject study design.

Methods: Eleven participants walked in different exoskeleton conditions. In the Unilateral conditions, only one leg was assisted. In Bilateral Matched Total Work, half of the assistance from the Unilateral conditions was applied to both legs such that the bilateral sum was equal …

Bi-Articular Knee-Ankle-Foot Exoskeleton Produces Higher Metabolic Cost Reduction Than Weight-Matched Mono-Articular Exoskeleton, Philippe Malcolm, Samuel Galle, Dirk De Clercq

Journal Articles

The bi-articular m. gastrocnemius and the mono-articular m. soleus have different and complementary functions during walking. Several groups are starting to use these biological functions as inspiration to design prostheses with bi-articular actuation components to replace the function of the m. gastrocnemius. Simulation studies indicate that a bi-articular configuration and spring that mimic the m. gastrocnemius could be beneficial for orthoses or exoskeletons. Our aim was to test the effect of a bi-articular and spring configuration that mimics the m. gastrocnemius and compare this to a no- spring and mono-articular configuration. We tested nine participants during walking with knee-ankle-foot exoskeletons …

Introducing Statistical Persistence Decay – A Quantification Of Stride-To-Stride Time Interval Dependency In Human Gait, P. C. Raffalt, J. M. Yentes

Journal Articles

Stride-to-stride time intervals during human walking are characterised by predictability and statistical persistence quantified by sample entropy (SaEn) and detrended fluctuation analysis (DFA) which indicates a time dependency in the gait pattern. However, neither analyses quantify time dependency in a physical or physiological interpretable time scale. Recently, entropic half-life (ENT½) has been introduced as a measure of the time dependency on an interpretable time scale. A novel measure of time dependency, based on DFA, statistical persistence decay (SPD), was introduced. The present study applied SaEn, DFA, ENT½, and SPD in known theoretical signals (periodic, chaotic, and random) and stride-to-stride time …

Dynamic Balance Changes Within Three Weeks Of Fitting A New Prosthetic Foot Component, Jenny A. Kent, Nicholas Stergiou, Shane R. Wurdeman

Journal Articles

Balance during walking is of high importance to prosthesis users and may affect walking during baseline observation and evaluation. The aim of this study was to determine whether changes in walking balance occurred during an adaptation period following the fitting of a new prosthetic component.

Margin of stability in the medial-lateral direction (MOSML) and an anterior instability margin (AIM) were used to quantify the dynamic balance of 21 unilateral transtibial amputees during overground walking. Participants trialled two prosthetic feet presenting contrasting movement/balance constraints; a Higher Activity foot similar to that of their own prosthesis, and a Lower Activity foot. Participants …

Hallux Valgus Surgery Affects Kinematic Parameters During Gait, Jitka Klugarova, Miroslav Janura, Zdenek Svoboda, Zdenek Sos, Nicholas Stergiou, Miloslav Klugar

Journal Articles

Background

The aim of our study was to compare spatiotemporal parameters and lower limb and pelvis kinematics during the walking in patients with hallux valgus before and after surgery and in relation to a control group.

Methods

Seventeen females with hallux valgus, who underwent first metatarsal osteotomy, constituted our experimental group. The control group consisted of thirteen females. Kinematic data during walking were obtained using the Vicon MX system.

Findings

Our results showed that hallux valgus before surgery affects spatiotemporal parameters and lower limb and pelvis kinematics during walking. Hallux valgus surgery further increased the differences that were present before …

Gait Kinematics And Kinetics Are Affected More By Peripheral Arterial Disease Than By Age, Sara A. Myers, Bryon Applequist, Jessie M. Huisinga, Iraklis Pipinos, Jason M. Johanning

Journal Articles

—Peripheral arterial disease (PAD) produces abnormal gait and disproportionately affects older individuals. The current study investigated PAD gait biomechanics in younger (<65 yr) and older (>/=65 yr) subjects. The study included 61 patients with PAD (31 younger, age: 57.4 +/– 5.3 yr, and 30 older, age: 71.9 +/– 5.2 yr) and 52 nondisabled age-matched control subjects. Patients with PAD were tested during pain-free walking and compared with control subjects. Joint kinematics and kinetics (torques) were compared using a 2 x 2 analysis of variance (groups: patients with PAD vs control subjects, age: younger vs older). Patients with PAD had significantly increased ankle and …

The Influence Of Push-Off Timing In A Robotic Ankle-Foot Prosthesis On The Energetics And Mechanics Of Walking, Philippe Malcolm, Robert E. Quesada, Joshua M. Caputo, Steven H. Collins

Journal Articles

Background

Robotic ankle-foot prostheses that provide net positive push-off work can reduce the metabolic rate of walking for individuals with amputation, but benefits might be sensitive to push-off timing. Simple walking models suggest that preemptive push-off reduces center-of-mass work, possibly reducing metabolic rate. Studies with bilateral exoskeletons have found that push-off beginning before leading leg contact minimizes metabolic rate, but timing was not varied independently from push-off work, and the effects of push-off timing on biomechanics were not measured. Most lower-limb amputations are unilateral, which could also affect optimal timing. The goal of this study was to vary the timing …

Locomotor Sensory Organization Test: A Novel Paradigm For The Assessment Of Sensory Contributions In Gait, Jung Hung Chien, Diderik-Jan Eikema, Mukul Mukherjee, Nicholas Stergiou

Journal Articles

Feedback based balance control requires the integration of visual, proprioceptive and vestibular input to detect the body’s movement within the environment. When the accuracy of sensory signals is compromised, the system reorganizes the relative contributions through a process of sensory recalibration, for upright postural stability to be maintained. Whereas this process has been studied extensively in standing using the Sensory Organization Test (SOT), less is known about these processes in more dynamic tasks such as locomotion. In the present study, ten healthy young adults performed the six conditions of the traditional SOT to quantify standing postural control when exposed to …

Locomotor Sensory Organization Test: A Novel Paradigm For The Assessment Of Sensory Contributions In Gait, Jung Hung Chien, Diderik Jan Anthony Eikema, Mukul Mukherjee, Nikolaos Stergiou

Journal Articles

Feedback based balance control requires the integration of visual, proprioceptive and vestibular input to detect the body’s movement within the environment. When the accuracy of sensory signals is compromised, the system reorganizes the relative contributions through a process of sensory recalibration, for upright postural stability to be maintained. Whereas this process has been studied extensively in standing using the Sensory Organization Test (SOT), less is known about these processes in more dynamic tasks such as locomotion. In the present study, ten healthy young adults performed the six conditions of the traditional SOT to quantify standing postural control when exposed to …

Adaptation And Prosthesis Effects On Stride-To-Stride Fluctuations In Amputee Gait, Shane R. Wurdeman, Sara A. Myers, Adam L. Jacobsen, Nikolaos Stergiou

Journal Articles

Twenty-four individuals with transtibial amputation were recruited to a randomized, crossover design study to examine stride-to-stride fluctuations of lower limb joint flexion/extension time series using the largest Lyapunov exponent (λ). Each individual wore a “more appropriate” and a “less appropriate” prosthesis design based on the subject's previous functional classification for a three week adaptation period. Results showed decreased λ for the sound ankle compared to the prosthetic ankle (F_1,23 = 13.897, p = 0.001) and a decreased λ for the “more appropriate” prosthesis (F_1,23 = 4.849, p = 0.038). There was also a significant effect for the time …

Gait Variablility Is Altered In Older Adults When Listening To Auditory Stimuli With Differing Temporal Structures, Jeffrey P. Kaipust, Denise Mcgrath, Mukul Mukherjee, Nikolaos Stergiou

Journal Articles

Gait variability in the context of a deterministic dynamical system may be quantified using nonlinear time series analyses that characterize the complexity of the system. Pathological gait exhibits altered gait variability. It can be either too periodic and predictable, or too random and disordered, as it is the case with aging. While gait therapies often focus on restoration of linear measures such as gait speed or stride length, we propose that the goal of gait therapy should be to restore optimal gait variability, which exhibits chaotic fluctuations and is the balance between predictability and complexity. In this context, our purpose …

Executive Function Orchestrates Regulation Of Task-Relevant Gait Fluctuations, Leslie M. Decker, Fabien Cignetti, Nikolaos Stergiou

Journal Articles

Humans apply a minimum intervention principle to regulate treadmill walking, rapidly correcting fluctuations in the task-relevant variable (step speed: SS) while ignoring fluctuations in the task-irrelevant variables (step time: ST; step length: SL). We examined whether the regulation of fluctuations in SS and not in ST and SL depends on high-level, executive function, processes. Young adults walked on a treadmill without a cognitive requirement and while performing the cognitive task of dichotic listening. SS fluctuations became less anti-persistent when performing dichotic listening, meaning that taxing executive function impaired the ability to rapidly correct speed deviations on subsequent steps. Conversely, performing …

Sensitivity Of The Wolf’S And Rostein’S Algorithms To Evaluate Local Dynamic Stability From Small Gait Data Sets, Fabien Cignetti, Leslie M. Decker, Nikolaos Stergiou

Journal Articles

The Wolf’s (W-algorithm) and Rosenstein’s (R-algorithm) algorithms have been used to quantify local dynamic stability (largest Lyapunov exponent, λ ₁) in gait, with prevalence of the latter one that is considered more suitable for small data sets. However, such a claim has never been investigated. To address it, the λ ₁ of the Lorenz attractor was estimated using small data sets and varied delays and embedding dimensions. Overall, the λ ₁ estimates from the R-algorithm got closer to the theoretical exponent than those from the W-algorithm. The W-algorithm also overestimated λ _{1 …}

Frontal Joint Dynamics When Initiating Stair Ascent From A Walk Versus A Stand, Srikant Vallabhajosula, Jenna M. Yentes, Nikolaos Stergiou

Journal Articles

Ascending stairs is a challenging activity of daily living for many populations. Frontal plane joint dynamics are critical to understand the mechanisms involved in stair ascension as they contribute to both propulsion and medio-lateral stability. However, previous research is limited to understanding these dynamics while initiating stair ascent from a stand. We investigated if initiating stair ascent from a walk with a comfortable self-selected speed could affect the frontal plane lower-extremity joint moments and powers as compared to initiating stair ascent from a stand and if this difference would exist at consecutive ipsilateral steps on the stairs. Kinematics data using …

New Insights Into Anterior Cruciate Ligament Deficiency And Reconstruction Through The Assessment Of Knee Kinematic Variability In Terms Of Nonlinear Dynamics, Leslie M. Decker, Constantina O. Moraiti, Nikolaos Stergiou, Anastasios D. Georgoulis

Journal Articles

Purpose

Injuries to the anterior cruciate ligament (ACL) occur frequently, particularly in young adult athletes, and represent the majority of the lesions of knee ligaments. Recent investigations suggest that the assessment of kinematic variability using measures of nonlinear dynamics can provide with important insights with respect to physiological and pathological states. The purpose of the present article was to critically review and synthesize the literature addressing ACL deficiency and reconstruction from a nonlinear dynamics standpoint.

Methods

A literature search was carried out in the main medical databases for studies published between 1990 and 2010.

Results

Seven studies investigated knee kinematic …

Gait Variability Of Patients With Intermittent Claudication Is Similar Before And After The Onset Of Claudication Pain, Sara A. Myers, Iraklis Pipinos, Jason Johanning, Nikolaos Stergiou

Journal Articles

Background

Recent research demonstrated that intermittent claudication patients have increased gait variability prior to the onset of claudication. However, it is unknown if these patients experience additional gait adaptations after the onset of claudication. Thus, we sought to determine how gait variability is affected by claudication in an effort to contribute to improved clinical management.

Methods

Twenty-six intermittent claudication patients and 20 controls walked on a treadmill at self-selected speed; intermittent claudication patients were tested before (pain free) and after (pain) the onset of claudication. Variability of the ankle, knee, and hip joint angles was assessed using the largest Lyapunov …

A Novel Approach To Measure Variability In The Anterior Cruciate Ligament Deficient Knee During Walking: The Use Of The Approximate Entropy In Orthopaedics, Anastasios D. Georgoulis, Constantina O. Moraiti, Stavros Ristanis, Nikolaos Stergiou

Journal Articles

Objective. The evaluation of variability of biological rhythmic activities through measures such as Approximate Entropy (ApEn) has provided important information regarding pathology in disciplines such as cardiology and neurology. This research lead to the “loss of complexity hypothesis” where decreased variability is associated with loss of healthy flexibility rendering the system more rigid and unable to adapt to stresses. ApEn as a measure of variability and complexity, correlates well with pathology while, in some cases, it is predictive of subsequent clinical changes. The study of human gait could benefit from the application of ApEn since it is also a …

An Artificial Neural Network That Utilizes Hip Joint Actuations To Control Bifurcations And Chaos In A Passive Dynamic Bipedal Walking Model, Max J. Kurz, Nikolaos Stergiou

Journal Articles

Chaos is a central feature of human locomotion and has been suggested to be a window to the control mechanisms of locomotion. In this investigation, we explored how the principles of chaos can be used to control locomotion with a passive dynamic bipedal walking model that has a chaotic gait pattern. Our control scheme was based on the scientific evidence that slight perturbations to the unstable manifolds of points in a chaotic system will promote the transition to new stable behaviors embedded in the rich chaotic attractor. Here we demonstrate that hip joint actuations during the swing phase can provide …

The Effect Of Anterior Cruciate Ligament Recontruction On Lower Extremity Relative Phase Dynamics During Walking And Running, Max J. Kurz, Nikolaos Stergiou, Ugo H. Buzzi, Anastasios D. Georgoulis

Journal Articles

The purpose of this investigation was to use relative phase dynamics to evaluate gait in individuals with a reconstructed anterior cruciate ligament (ACL) during walking and running. Relative phase dynamics can describe the coordination strategies between the interacting segments at the lower extremity. Ten subjects who had undergone ACL reconstruction using the central third of their patellar tendon and ten healthy controls walked and ran on a treadmill at a self-selected pace. Relative phase dynamics were calculated for the foot–shank and shank–thigh coordinative relation- ships. Statistical differences between the groups were noted for the foot– shank relationship (p<0.05) during both walking and running and for the shank–thigh relationship (p<0.05) during walking. Our results indicate that current ACL reconstructive techniques may result in altered relative phase dynamics. These changes in relative phase dynamics could be related to a loss of sensory information about joint position and velocity that is typically provided by the intact ACL. Additionally, relative phase adaptations could be a learned response from the early stages of postsurgical rehabilitation. Relative phase dynamics provide quantitative information about the dynamic status of the ACL-reconstructed knee that cannot be gained from the conventional time-series evaluation of gait analysis data. Relative phase dynamics measures should supplement the conventional gait analysis measures that are used today for the clinical evaluation of the functional dynamic stability of the reconstructed knee. The examination of relative phase dynamics could be clinically important for the quantification of new ACL surgical interventions and of patient performance at various stages of rehabilitation. Further research should incorporate relative phase dynamics to understand the influence of ACL reconstruction on coordination and functional patient outcomes.

Three-Dimensional Tibiofemoral Kinematics Of The Anterior Cruciate Ligament-Deficient And Reconstructed Knee During Walking, Anastasios D. Georgoulis, Anastasios Papadonikolakis, Christos D. Papageorgiou, Argyris Mitsou, Nikolaos Stergiou

Journal Articles

Background: It is possible that gait abnormalities may play a role in the pathogenesis of meniscal or chondral injury as well as osteoarthritis of the knee in patients with anterior cruciate ligament deficiency.

Hypothesis: The three-dimensional kinematics of anterior cruciate ligament-deficient knees are changed even during low-stress activities, such as walking, but can be restored by reconstruction.

Study Design: Case control study.

Methods: Using a three-dimensional optoelectronic gait analysis system, we examined 13 patients with anterior cruciate ligament-deficient knees, 21 patients with anterior cruciate ligament-reconstructed knees, and 10 control subjects with uninjured knees during walking.

Results: Normal patterns of knee …

Frequency Domain Characteristics Of Ground Reaction Forces During Walking Of Young And Elderly Females, Nikolaos Stergiou, Giannis Giakas, Jennifer E. Byrne, Valerie Pomeroy

Journal Articles

Objective. To examine the frequency domain characteristics of the ground reaction forces of young and elderly females during free walking.

Design. Independent t-tests were used to examine the frequency content of all three components of the ground reaction force.

Background. Frequency domain analysis has the potential to assist in identifying changes in gait that may be masked in the time domain. No research has been done to identify changes in gait due to age-related impairments in the frequency domain.

Methods. Ten young and ten elderly females walked at a prescribed speed while ground reaction forces were collected via a …

Comparison Of Gait Patterns Between Young And Elderly Women: An Examination Of Coordination, Jennifer E. Byrne, Nikolaos Stergiou, Daniel Blanke, Jeremy J. Houser, Max J. Kurz, Patricia A. Hageman

Journal Articles

This study investigated intralimb coordination during walking in Young and Elderly women using the theoretical model of dynamical systems. Twenty females, ten Young (M age = 24.6 yrs, SD = 3.2 yrs), and ten Elderly (M age = 73.7 yrs, SD = 4.9 yrs), were videotaped during free speed gait and gait perturbed by an ankle weight. Two parameters, one describing the phasing relationship between segments (mean absolute relative phase) and the other the variability of this relationship (deviation in phase), were calculated from the kinematics. Two-way ANOVA (age and weight) with repeated measures on weight indicated that during the …