Medicine and Health Sciences Commons^™

Assessment Of Gait, Balance, And Falls In Individuals With Neurodegenerative Diseases, Lauren Tueth

WUSM Theses and Dissertations – All Programs

Neurodegenerative diseases are a group of disorders that impact the brain and lead to neuronal degeneration. This degeneration causes many different symptoms, which are often grouped into motor, cognitive, and psychiatric domains. Individuals with these disorders can experience symptoms from multiple domains at the same time, but little is known about how these distinct symptoms may impact each other.

In Chapter 2, we explored the intersection of balance and cognitive impairment in individuals with Alzheimer disease (AD). AD is traditionally discussed in the context of the dementia symptoms, but people with AD also experience motor deficits. Falls are a huge …

Spatiotemporal Gait Parameter Consistency Across Two Days Of Treadmill Walking In Stroke Survivors, Alejandro Aguirre Ramirez, Samantha N. Jeffcoat, Natalia Sanchez, Andrian Kuch

Student Scholar Symposium Abstracts and Posters

Retraining impaired gait is essential in post-stroke recovery. This project aims to determine between day variability of spatiotemporal gait measures in treadmill walking post-stroke to differentiate between changes due to the intervention and measurement errors due to between day test-retest variability. Six individuals post-stroke performed a two-minute walk test at a self-selected speed (SSS) for two consecutive days. SSS was assessed through the six-minute walk test. Reflective markers were placed on anatomical landmarks (van den Bogert et al. 2013). The heel markers were used for step detection. We calculated spatiotemporal parameters: stride length, stride time, step length, stance time, and …

Effects Of Yoga On Older Residing In Assisted Living Facilities, Anita Walters, Luke Kriley

SACAD: John Heinrichs Scholarly and Creative Activity Days

Although the number of adults aged 65 and older has been steadily increasing world-wide for the past three decades, few studies have been conducted to explore the benefits of a yoga-type exercise program for those residing in assisted living facilities. A within-subjects repeated measures quasi-experimental design was used to examine the effectiveness of standing yoga postures in improving strength, balance, and quality of life in older adults currently residing in an assisted living facility. In the single-group design the participants were pre-assessed in week one, reassessed in week 2 for test-retest reliability, attended a 30-minute exercise session three times per …

Gait Analysis Of Male Professional Boxers, Jacek Perliński, Joanna M. Bukowska, Łukasz Rydzik, Wojciech Wąsacz, Dariusz Kruczkowski, Tadeusz Ambroży, Wojciech Czarny, Jarosław Jaszczur-Nowicki

Baltic Journal of Health and Physical Activity

Introduction: Gait plays a crucial role in both daily life and sports performance. This study analyzes professional boxers’ gait, as it is essential to understand its influence on performance and injury risk. However, there is a need to comprehend the effects of boxing training on gait and the occurrence of asymmetries between limbs. Research Question: Does the gait of professional boxers exhibit significant differences between limbs, and what are the potential implications of this asymmetry? Materials and Methods: The study involved 36 professional boxers, and the Gaitway 3D Pressure treadmill was used to collect data. The analysis was performed using …

Limb Speed Perception Accuracy In Neurodegenerative Disease, Brandmeir Lynn Cheryl

Graduate Theses, Dissertations, and Problem Reports

Movement is a fundamental human activity, enabling us to engage with our surroundings. Consequently, a well-operating neuromuscular system is essential for maintaining quality of life. Motion is not only integral for the basic function of daily living, but also plays a significant role in enhancing our physical, mental, and emotional health. The importance of this system becomes abundantly clear when it is compromised, such as with neurodegenerative disease.

Alzheimer’s disease (AD), followed by Parkinson’s disease (PD) are the two most common neurodegenerative diseases that profoundly affect millions of individuals worldwide (Lamptey et al., 2022). Characterized by distinct but sometimes overlapping …

Remote Teleassessment And Telerehabilitation Of A Comprehensive Exercise Training Protocol For Older Adults: Design And Methodology Of A Usability Protocol, Savitha Subramaniam, Spyros Kitsiou, Tanvi Bhatt

Internet Journal of Allied Health Sciences and Practice

ABSTRACT

Purpose: The design, usability, safety, and feasibility of a telehealth protocol comprising teleassessment and tele rehabilitation to evaluate and improve physical and cognitive function among older adults was assessed. Methods: Healthy older adults (n=23) participated in a pre-post tele-assessment of a 4-week (3 sessions/week) telerehabilitation session. Tele-assessment was performed to evaluate balance, gait function, and cognition. Tele-rehabilitation sessions comprised of balance games, dancing, dual-tasking, yoga, and tai-chi exercises. Results: There were no adverse events reported to indicate concerns with the safety of the current telehealth protocol. Conclusion: The proposed telehealth protocol to assess and improve physical and cognitive function …

Effects Of High Heeled Gait On Knee Joint Mechanics, James Baldonado, Errin Abosolo, Harry Montoya, Zander Sadorra, Christie R. O'Hara

International Journal of Exercise Science: Conference Proceedings

Numerous women wear high heeled shoes, whether it be a professional attire, part of an outfit for a ballroom gala, or just casual day to day wear. Often, the high heel of choice in these situations is the stiletto. These shoes adversely affect natural gait and have the potential to alter joint mechanics in the knee during gait. PURPOSE: This study is designed to analyze the impacts of wearing high heels, and if it puts the user at a higher risk of a degenerative condition with repeated use. We hypothesized that all of our dependent variables would see a …

Feasibility And Outcomes Of Supplemental Gait Training By Robotic And Conventional Means In Acute Stroke Rehabilitation, Mukul Talaty, Alberto Esquenazi

Moss-Magee Rehabilitation Papers

INTRODUCTION: Practicality of implementation and dosing of supplemental gait training in an acute stroke inpatient rehabilitation setting are not well studied but can have positive impact on outcomes.

OBJECTIVES: To determine the feasibility of early, intense supplemental gait training in inpatient stroke rehabilitation, compare functional outcomes and the specific mode of delivery.

DESIGN AND SETTING: Assessor blinded, randomized controlled trial in a tertiary Inpatient Rehabilitation Facility.

PARTICIPANTS: Thirty acute post-stroke patients with unilateral hemiparesis (≥ 18 years of age with a lower limb MAS ≤ 3).

INTERVENTION: Lokomat® or conventional gait training (CGT) in addition to standard mandated therapy time. …

Effect Of Posterior Leaf Spring And Carbon Composite Ankle Foot Orthosis On Gait And Functional Mobility Of Stroke Survivors With Hemiplegia: A Randomized Clinical Trial, Zidikheri B. Msechu, Ahmad Zaheer Qureshi, Tim Drew

Internet Journal of Allied Health Sciences and Practice

Purpose: The study was carried out as a randomized clinical trial to assess the effect of posterior leaf spring ankle foot orthosis (PLS-AFO) and carbon composite ankle foot orthosis (C-AFO) on functional mobility, walking speed and satisfaction among stroke survivors with hemiplegia. Methods: Twenty-seven ambulatory stroke survivors with hemiplegia who had completed a rehabilitation program and were already using an ankle foot orthosis (AFO) were included in the study. Subjects were randomly assigned either PLS-AFO or C-AFO and assessment was done with and without their AFOs. Functional mobility, walking speed, and satisfaction were assessed using the Timed Up and …

Assessment Of Knee Flexion In Young Children With Prosthetic Knee Components Using Dynamic Time Warping, Mark Daniel Geil, Zahra Safaeepour

Faculty and Research Publications

Introduction: Analysis of human locomotion is challenged by limitations in traditional numerical and statistical methods as applied to continuous timeseries data. This challenge particularly affects understanding of how close limb prostheses are to mimicking anatomical motion. This study was the first to apply a technique called Dynamic Time Warping to measure the biomimesis of prosthetic knee motion in young children and addressed the following research questions: Is a combined dynamic time warping/root mean square analysis feasible for analyzing pediatric lower limb kinematics? When provided at an earlier age than traditional protocols dictate, can children with limb loss utilize an articulating …

Obstacle Crossing In Healthy Young And Older Individuals, Hope M. Hanson, Ashlyn M. Jendro, Abigail C. Schmitt

Health, Human Performance and Recreation Undergraduate Honors Theses

Introduction: In the United States, the average population age is rising and will continue to increase in the coming years.With an older population comes increased risk of injury associated with falls. Falls are considered a leading cause of injury and death in older individuals, and many falls are caused by body imbalance or obstacle collision due to a clearly visible stationary object (e.g., rug, chair, branch). Older adults tend to cross obstacles with increased toe clearance in order to prevent tripping, but much of what is known about obstacle crossing in older adults is limited to artificial obstacles that are …

The Effects Of Exercise Training On Gait In Adults With Down Syndrome, Anna Lois Aquino, Sandra Daugherty, Alex Palko

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Down syndrome (Ds) is a genetic disorder in which the individual carries an extra copy of chromosome 21 resulting in mental and physical disabilities and risk of major health conditions. A high prevalence of gait pattern dysfunction occurs in adults with Ds due to muscle hypotonia, ligamentous laxity, joint hypermobility, and altered development of musculoskeletal structure, which often lead to increased falls and fear of falling. The purpose of this study is to investigate the differences in kinematic and spatiotemporal gait parameters between adults with Ds and age-matched controls, as well as studying the effects of a 12-week Ds-specific …

The Psychometric Properties Of The Modified Fear Of Falling Avoidance Behavior Questionnaire In Parkinson’S Disease And Older Adults, Billy La, Arturo Aldaco, Ashley Haller

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background/purpose: The Fear of Falling Avoidance Behavior Questionnaire (FFABQ), developed in 2011 to measure fear of falling avoidance behavior, has good evidence for reliability and validity. However, a recently modified version (mFFABQ) is theorized to be easier to understand for those completing the questionnaire because the Likert responses are more logical in completing the item stem. The purpose of this study was to examine the test-retest reliability and construct validity of the mFFABQ in adults with Parkinson’s Disease (PD) and older adults aged 60-90 years. Methods: Thirty-nine participants (age 72.21 ± 9.5; 29 men, 10 women) diagnosed with PD (diagnosis …

Association Between Measures Of Cognitive Function On Physical Function In Novice Users Of A Lower Limb Prosthesis, Humberto Omana, Courtney Frengopoulos, Manuel Montero-Odasso, Michael W. Payne, Ricardo Viana, Susan W. Hunter

Physical Therapy Publications

BACKGROUND: Cognitive impairment is prevalent in people with lower limb amputations (PLLA) and is associated with adverse outcomes, such as falls and worse rehabilitation outcomes. Physical function tests are essential to examine abilities; however, no research in PLLA has clarified the magnitude of cognitive demands amongst available tests in users novice at walking with a prosthesis.

METHODS: People from inpatient prosthetic rehabilitation were recruited. Inclusion criteria were: age ≥ 50 years, unilateral transtibial amputation and able to walk independently. Gait velocity and the L Test under single-task (usual) and dual-task (walking while counting backwards) conditions assessed functional mobility. The Four …

Effect Of Repetitive Transcranial Magnetic Stimulation On Gait Function And Strength Among Patients With Spinal Cord Injury: A Meta-Analysis, Yen-Ting Chen, Yu-Chi Su, Yu-Ching Lin

Rehabilitation Practice and Science

Purpose: This meta-anaylysis investigated the efficacy of repetitive transcranial magnetic stimulation (rTMS) in the context of spinal cord injury (SCI). The study focused on assessing its impact on muscle strength and gait speed, measured through the lower extremities motor score of the American Spinal Injury Association (ASIA) and 10-Meter Walk Test scores(10MWT). Methods: The PubMed, Cochrane Library, and Embase databases were searched for articles published through Oct 2023. We enrolled only randomized controlled trials. The Cochrane Collaboration risk of bias tool was used for quality assessment. Outcomes were analyzed as standardized mean differences (SMDs) with 95% confidence intervals (CIs). We …

Premotor And Posterior Parietal Cortex Activity Is Increased For Slow, As Well As Fast Walking Poststroke: An Fnirs Study, Shannon B Lim, Sue Peters, Chieh-Ling Yang, Lara A Boyd, Teresa Liu-Ambrose, Janice J Eng

Physical Therapy Publications

Background and Purpose. The ability to change gait speeds is important for interacting with the surrounding environment. Gait speed modulation poststroke is often impaired and is related to decreased walking independence after stroke. Assessment of brain activation during walking at different speeds can provide insight into important regions for facilitating gait recovery. The purpose is to determine: (1) the symmetry of brain activation as individuals increase or decrease their gait speed, (2) the activation levels in frontal to parietal brain regions during walking at different speeds, and (3) the relationship between an individual’s stroke impairment or their ability to modulate …

Implementation Of Increased Physical Therapy Intensity For Improving Walking After Stroke: Walk 'N Watch Protocol For A Multisite Stepped-Wedge Cluster-Randomized Controlled Trial, Sue Peters, Shannon B Lim, Mark T Bayley, Krista Best, Louise A Connell, Hélène Corriveau, Sarah J Donkers, Sean P Dukelow, Tara D Klassen, Marie-Hélène Milot, Brodie M Sakakibara, Lisa Sheehy, Hubert Wong, Jennifer Yao, Janice J Eng

Physical Therapy Publications

RATIONALE: Clinical practice guidelines support structured, progressive protocols for improving walking after stroke. Yet, practice is slow to change, evidenced by the little amount of walking activity in stroke rehabilitation units. Our recent study (n = 75) found that a structured, progressive protocol integrated with typical daily physical therapy improved walking and quality-of-life measures over usual care. Research therapists progressed the intensity of exercise by using heart rate and step counters worn by the participants with stroke during therapy. To have the greatest impact, our next step is to undertake an implementation trial to change practice across stroke units where …

Cost-Effectiveness Analysis Of Overground Robotic Training Versus Conventional Locomotor Training In People With Spinal Cord Injury, Daniel Pinto, Allen W. Heinemann, Shuo-Hsiu Chang, Susan Charlifue, Edelle C. Field-Fote, Catherine L. Furbish, Arun Jayaraman, Candy Tefertiller, Heather B. Taylor, Dustin D. French

Physical Therapy Faculty Research and Publications

Background

Few, if any estimates of cost-effectiveness for locomotor training strategies following spinal cord injury (SCI) are available. The purpose of this study was to estimate the cost-effectiveness of locomotor training strategies following spinal cord injury (overground robotic locomotor training versus conventional locomotor training) by injury status (complete versus incomplete) using a practice-based cohort.

Methods

A probabilistic cost-effectiveness analysis was conducted using a prospective, practice-based cohort from four participating Spinal Cord Injury Model System sites. Conventional locomotor training strategies (conventional training) were compared to overground robotic locomotor training (overground robotic training). Conventional locomotor training included treadmill-based training with body weight …

Toward Real-Time, Robust Wearable Sensor Fall Detection Using Deep Learning Methods: A Feasibility Study, Haben Yhdego, Christopher Paolini, Michel Audette

Electrical & Computer Engineering Faculty Publications

Real-time fall detection using a wearable sensor remains a challenging problem due to high gait variability. Furthermore, finding the type of sensor to use and the optimal location of the sensors are also essential factors for real-time fall-detection systems. This work presents real-time fall-detection methods using deep learning models. Early detection of falls, followed by pneumatic protection, is one of the most effective means of ensuring the safety of the elderly. First, we developed and compared different data-segmentation techniques for sliding windows. Next, we implemented various techniques to balance the datasets because collecting fall datasets in the real-time setting has …

Higher Intensity Walking Improves Global Cognition During Inpatient Rehabilitation: A Secondary Analysis Of A Randomized Control Trial, Sue Peters, Keith R Lohse, Tara D Klassen, Teresa Liu-Ambrose, Sean P Dukelow, Mark T Bayley, Michael D Hill, Sepideh Pooyania, Jennifer Yao, Janice J Eng

Physical Therapy Publications

Cognitive deficits are common poststroke. Cognitive rehabilitation is typically used to improve cognitive deficits. It is unknown whether higher doses of exercise to promote motor recovery influence cognitive outcomes. Our recent trial, Determining Optimal Post-Stroke Exercise (DOSE), shows more than double the steps and aerobic minutes can be achieved during inpatient rehabilitation versus usual care, and translates to improved long-term walking outcomes. Thus, the secondary analysis aim was to determine the effect of the DOSE protocol on cognitive outcomes over 1-year poststroke. The DOSE protocol progressively increased step number and aerobic minutes during inpatient stroke rehabilitation over 20 sessions. The …

Does Fatigue Influence Joint-Specific Work And Ground Force Production During The First Steps Of Maximal Acceleration?, Shayne Vial, Jodie C. Wilkie, Mitchell Turner, Mark Scanlan, Anthony J. Blazevich

Research outputs 2022 to 2026

During initial acceleration, the first steps of a maximal-effort (sprint) run often determine success or failure in the capture and evasion of an opponent, and is therefore a vital factor of success in many modern sports. However, accelerative events are commonly performed after having already run considerable distances, and the associated fatigue should impair muscle force production and thus reduce acceleration. Despite this, the effects of running-induced fatigue on our ability to accelerate as well as the running technique used to achieve it have received little attention. We recorded 3-D kinematics and ground reaction forces during the first three steps …

Fatigue Does Not Increase Limb Asymmetry Or Induce Proximal Joint Power Shift In Habitual, Multi-Speed Runners, Shayne Vial, Jodie Cochrane Wilkie, Mitchell Turner, Anthony J. Blazevich

Research outputs 2022 to 2026

During prolonged jogging, joint moment and work tend to decrease in the distal (ankle) joint but increase at proximal (hip/knee) joints as performance fatigue manifests, and such adaptations might be expected to occur in sprinting. Fatigue is also thought to increase inter-limb asymmetries, which is speculated to influence injury risk. However, the effects of fatigue on sprint running gait have been incompletely studied, so these hypotheses remain untested. Using statistical parametric mapping, we compared 3-D kinematics and ground reaction force production between the dominant (DL) and non-dominant (NDL) legs of 13 soccer players during both non-fatigued and fatigued sprint running. …

More Than Energy Cost: Multiple Benefits Of The Long Achilles Tendon In Human Walking And Running, Anthony J. Blazevich, Jared R. Fletcher

Research outputs 2022 to 2026

Elastic strain energy that is stored and released from long, distal tendons such as the Achilles during locomotion allows for muscle power amplification as well as for reduction of the locomotor energy cost: as distal tendons perform mechanical work during recoil, plantar flexor muscle fibres can work over smaller length ranges, at slower shortening speeds, and at lower activation levels. Scant evidence exists that long distal tendons evolved in humans (or were retained from our more distant Hominoidea ancestors) primarily to allow high muscle–tendon power outputs, and indeed we remain relatively powerless compared to many other species. Instead, the majority …

Biomechanics Associated With Tibial Stress Fracture In Runners: A Systematic Review And Meta-Analysis, Clare E. Milner, Eric Foch, Joseph M. Gonzales, Drew Peterson

All Faculty Scholarship for the College of Education and Professional Studies

Background

Tibial stress fracture (TSF) is an overuse running injury with a long recovery period. While many running studies refer to biomechanical risk factors for TSF, only a few have compared biomechanics in runners with TSF to controls. The aim of this systematic review and meta-analysis was to evaluate biomechanics in runners with TSF compared to controls.

Methods

Electronic databases PubMed, Web of Science, SPORTDiscus, Scopus, Cochrane, and CINAHL were searched. Risk of bias was assessed and meta-analysis conducted for variables reported in 3 or more studies.

Results

The search retrieved 359 unique records, but only the 14 that compared …

Make Reading Fun: Implications Of Virtual Reality On Standing Balance And Control, Makena Savola, Belle Ponce De Leon, Amanda Duben, Wendy T. Pham, Joshua Vicente, Jacob Hinkel-Lipsker

International Journal of Exercise Science: Conference Proceedings

The recent rapid expansion of virtual reality (VR) technology is driving a widespread number of new applications, including providing immersive environments for users to learn and read through commercially-available applications. However, recent research has shown that VR causes symptoms of dizziness and motion sickness, which could disrupt users gait and balance. Thus, it is important to understand how to best mitigate these effects before VR use becomes more widespread across the lay public. PURPOSE: The purpose of this study was to determine the acute effect of VR use on gait and balance control following use, and whether aspects of virtual …

Novel Application Of A Performance Prediction Model During Altered Running Gait Strategies, Oluchi Ibe, Robert Musci, Jenevieve L. Roper

International Journal of Exercise Science: Conference Proceedings

Currently, there is limited research demonstrating that gait retraining can significantly impact running economy and subsequent running performance in distance runners with most of the research showing no or minimal change. Recently, a novel model was developed that predicts running performance based on changes in running economy but has not previously been applied when altering running gait strategies. PURPOSE: The goal of the study was to determine the effect of altering running strategy on predicted running performance in distance runners through application of this novel prediction model. METHODS: Fifteen male (n=10; Age: 22.2 ± 4.9 years; Height: 177.7 ± 7.4 …

Assessing The Validity Of A Performance Prediction Model For Use With Gait Retraining, Christian Faltas, Robert Musci, Jenevieve L. Roper

International Journal of Exercise Science: Conference Proceedings

A common strategy that athletic trainers and high-performance athletes use to manage and treat running-related injuries is gait retraining. However, the research is equivocal on how gait retraining can affect running economy and subsequent running performance in distance runners. A new prediction model was developed that predicts running performance based on oxygen consumption changes, however, it is unclear if this model is valid and can accurately be used to predict running performance as a result of gait retraining. PURPOSE: The goal of the study was to determine the validity of the performance prediction model, particularly when applied to gait …

A.R.G! Augmented Reality And Gait: Analyzing The Influence Of Cues On Gait Patterns In Augmented Reality, Gwendolyn R. Retzinger, Borna Golbarg, Rabbani R. Nzeza, Wendy T. Pham, Milad Mehrjou, Summer M. Diaz, Jacob W. Hinkel-Lipsker

International Journal of Exercise Science: Conference Proceedings

Use of Augmented Reality (AR) technology for rehabilitation has drastically increased in recent years. While theoretically AR can be used to cue gait adaptations such as changes to step length and cadence through visual and auditory cues, it is still unknown how people respond to the technology. PURPOSE: To assess the feasibility of external visual and auditory cues delivered through AR on spatiotemporal gait outcomes in a healthy, young population. METHODS: 20 healthy participants between age 18 and 35 were screened and recruited to perform randomized gait trials consisting of four different cueing conditions. The participants wore a Magic Leap …

Impact Of Latin Ballroom Dancing On Gait Biomechanics, Grace Hanks, Tyler Standifird

International Journal of Exercise Science: Conference Proceedings

Purpose: Past research has focused on biomechanical changes, kinematic differences, and injury rates among dancers compared to healthy non-dancers. This research has shown that there are differences biomechanically between dancers and healthy non-dancers which indicates that various forms of dance training has both potential short- and long-term effects on an individual (Yihong et al, 2018, Prochazkova et al, 2014, Tepla et al, 2014, Turner et al 2018). The purpose of this study is to analyze the effect of Latin ballroom dance training on gait. Methods: 24 participants, (12 Latin dancers, 12 recreationally active non-dancers; 12 males,12 females) between the …

Contributions Of Asymmetry And Instability To Transfer And Retention Following Locomotor Adaptation, Daniel L. Gregory

Doctoral Dissertations

Gait asymmetry resulting from neurological injury is more costly and less stable than healthy gait. Split-belt treadmills, which drive limbs at different speeds, lead to spatial and temporal gait asymmetries, and perturb walking balance, have been used to study locomotor adaptability and learning related to asymmetry and stability. This knowledge may be leveraged to design more effective rehabilitation protocols. In experiment 1, we asked how constraining stride-rates away from preferred during split-belt walking influences learning revealed in a retention test. We found that constraints to stride rate during asymmetric walking uncovered the capacity to leverage redundant degrees-of-freedom for walking control, …