Gait variability: methods, modeling and meaning

The study of gait variability, the stride-to-stride fluctuations in walking, offers a complementary way of quantifying locomotion and its changes with aging and disease as well as a means of monitoring the effects of therapeutic interventions and rehabilitation. Previous work has suggested that measures of gait variability may be more closely related to falls, a serious consequence of many gait disorders, than are measures based on the mean values of other walking parameters. The Current JNER series presents nine reports on the results of recent investigations into gait variability. One novel method for collecting unconstrained, ambulatory data is reviewed, and a primer on analysis methods is presented along with a heuristic approach to summarizing variability measures. In addition, the first studies of gait variability in animal models of neurodegenerative disease are described, as is a mathematical model of human walking that characterizes certain complex (multifractal) features of the motor control's pattern generator. Another investigation demonstrates that, whereas both healthy older controls and patients with a higher-level gait disorder walk more slowly in reduced lighting, only the latter's stride variability increases. Studies of the effects of dual tasks suggest that the regulation of the stride-to-stride fluctuations in stride width and stride time may be influenced by attention loading and may require cognitive input. Finally, a report of gait variability in over 500 subjects, probably the largest study of this kind, suggests how step width variability may relate to fall risk. Together, these studies provide new insights into the factors that regulate the stride-to-stride fluctuations in walking and pave the way for expanded research into the control of gait and the practical application of measures of gait variability in the clinical setting

Complexity measures of heart-rate variability in amyotrophic lateral sclerosis with alternative pulmonary capacities

Objective: the complexity of heart-rate variability (HRV) in amyotrophic lateral sclerosis (ALS) patients with different pulmonary capacities was evaluated. Methods: We set these according to their pulmonary capacity, and specifically forced vital capacity (FVC). We split the groups according to FVC (FVC > 50% (n = 29) and FVC < 50% (n = 28)). In ALS, the presence of an FVC below 50% is indicative of noninvasive ventilation with two pressure levels and with the absence of other respiratory symptoms. As the number of subjects per group was different, we applied the unbalanced one-way analysis of variance (uANOVA1) test after three tests of normality, and effect size by Cohen’s d to assess parameter significance. Results: with regard to chaotic global analysis, CFP4 (p < 0.001; d = 0.91), CFP5 (p = 0.0022; d = 0.85), and CFP6 (p = 0.0009; d = 0.92) were enlarged. All entropies significantly increased. Shannon (p = 0.0005; d = 0.98), Renyi (p = 0.0002; d = 1.02), Tsallis (p = 0.0004; d = 0.99), approximate (p = 0.0005; d = 0.97), and sample (p < 0.0001; d = 1.22). Detrended fluctuation analysis (DFA) (p = 0.0358) and Higuchi fractal dimension (HFD) (p = 0.15) were statistically inconsequential between the two groups. Conclusions: HRV complexity in ALS subjects with different pulmonary capacities increased via chaotic global analysis, especially CFP5 and 3 out of 5 entropies

Acute mental stress assessment via short term HRV analysis in healthy adults : a systematic review with meta-analysis

Mental stress reduces performances, on the work place and in daily life, and is one of the first causes of cognitive dysfunctions, cardiovascular disorders and depression. This study systematically reviewed existing literature investigating, in healthy subjects, the associations between acute mental stress and short term Heart Rate Variability (HRV) measures in time, frequency and non-linear domain. The goal of this study was to provide reliable information about the trends and the pivot values of HRV measures during mental stress. A systematic review and meta-analysis of the evidence was conducted, performing an exhaustive research of electronic repositories and linear researching references of papers responding to the inclusion criteria. After removing duplicates and not pertinent papers, journal papers describing well-designed studies that analyzed rigorously HRV were included if analyzed the same population of healthy subjects at rest and during mental stress. 12 papers were shortlisted, enrolling overall 758 volunteers and investigating 22 different HRV measures, 9 of which reported by at least 2 studies and therefore meta-analyzed in this review. Four measures in time and non-linear domains, associated with a normal degree of HRV variations resulted significantly depressed during stress. The power of HRV fluctuations at high frequencies was significantly depressed during stress, while the ratio between low and high frequency resulted significantly increased, suggesting a sympathetic activation and a parasympathetic withdrawal during acute mental stress. Finally, among the 15 non-linear measures extracted, only 2 were reported by at least 2 studies, therefore pooled, and only one resulted significantly depressed, suggesting a reduced chaotic behaviour during mental stress. HRV resulted significantly depressed during mental stress, showing a reduced variability and less chaotic behaviour. The pooled frequency domain measures demonstrated a significant autonomic balance shift during acute mental stress towards the sympathetic activation and the parasympathetic withdrawal. Pivot values for the pooled mean differences of HRV measures are provided. Further studies investigating HRV non-linear measures during mental stress are still required. However, the method proposed to transform and then meta-analyze the HRV measures can be applied to other fields where HRV proved to be clinically significant

Quantitative Multidimensional Stress Assessment from Facial Videos

Stress has a significant impact on the physical and mental health of an individual and is a growing concern for society, especially during the COVID-19 pandemic. Facial video-based stress evaluation from non-invasive cameras has proven to be a significantly more efficient method to evaluate stress in comparison to approaches that use questionnaires or wearable sensors. Plenty of classification models have been built for stress detection. However, most do not consider individual differences. Also, the results for such models are limited by a uni-dimensional definition of stress levels lacking a comprehensive quantitative definition of stress. The dissertation focuses on building a framework that utilizes the multilevel video frame representations from deep learning and the remote photoplethysmography signals extracted from the facial videos for stress assessment. The fusion model takes the inputs of a baseline video and a target video of the subject. The physiological features such as heart rate and heart rate variability are used with the initial stress scores generated from deep learning are used to predict the stress scores in cognitive anxiety, somatic anxiety, and self-confidence. To generate stress scores with better accuracy, the signal extraction method is improved by introducing the CWT-SNR method that uses the signal-to-noise ratio to assist the adaptive bandpass filtering in the post-processing of the signals. A study on phase space reconstruction features is performed and the results show the potential for additional accuracy improvement for the heart rate variability detection. To select the best deep learning architecture, multiple deep learning architectures are tested to build the deep learning model. Support Vector Regression is used to generate the output stress score results. Testing with the data from the UBFC-Phys dataset, the fusion model shows a strong correlation between ground truth and the predicted results

Higuchi fractal dimension applied to RR intervals in children with Attention Defi cit Hyperactivity Disorder

Background: Attention defi cit hyperactivity disorder (ADHD) is categorized by a lowered attention span, recklessness, and hyperactivity. Autonomic nervous system inequality has previously been studied using the same data by chaotic global techniques. We aim to compare the autonomic function of children with ADHD and controls by analyzing heart rate variability (HRV). Methods: 28 children with ADHD (22 boys, mean age 10.0 years ± 1.9 years) and 28 controls (15 boys, mean age 9.9 years ± 1.8 years) rested in supine position with spontaneous breathing for 20 minutes. Heart rate was recorded beat by beat. HRV analysis was performed by Higuchi Fractal Dimension technique. Results: ADHD promoted an increase in the Higuchi Fractal Dimension. The optimum value of Kmax was 10. Conclusion: ADHD signifi cantly altered cardiac autonomic modulation as measured by the Higuchi fractal dimension of HRV. It can therefore be stated that ADHD has increased the complexity of the HRV  signal through cardiac autonomic modulation

Acute effects of instructed and self-created variable rope skipping on EEG brain activity and heart rate variability

The influence of physical activity on brain and heart activity dependent on type and intensity of exercise is meanwhile widely accepted. Mainly cyclic exercises with longer duration formed the basis for showing the influence on either central nervous system or on heart metabolism. Effects of the variability of movement sequences on brain and heart have been studied only sparsely so far. This study investigated effects of three different motor learning approaches combined with a single bout of rope skipping exercises on the spontaneous electroencephalographic (EEG) brain activity, heart rate variability (HRV) and the rate of perceived exertion (RPE). Participants performed repetitive learning (RL) and two extremely variable rope skipping schedules according to the differential learning approach. Thereby one bout was characterized by instructed variable learning (DLi) and the other by self-created variable learning (DLc) in randomized order each on three consecutive days. The results show higher RPE after DLi and DLc than after RL. HRV analysis demonstrates significant changes in pre-post exercise comparison in all training approaches. No statistically significant differences between training schedules were identified. Slightly greater changes in HRV parameters were observed in both DL approaches indicating a higher activation of the sympathetic nervous system. EEG data reveals higher parietal alpha1 and temporal alpha2 power in RL compared to both DL schedules immediately post exercise. During the recovery of up to 30 minutes, RL shows higher temporal and occipital theta, temporal, parietal and occipital alpha, temporal and occipital beta and frontal beta3 power. In conclusion, already a single bout of 3 minutes of rope skipping can lead to brain states that are associated with being advantageous for cognitive learning. Combined with additional, cognitively demanding tasks in form of the DL approach, it seems to lead to an overload of the mental capacity, at least on the short term. Further research should fathom the reciprocal influence of cardiac and central-nervous strain in greater detail

Exploring Cognitive States: Methods for Detecting Physiological Temporal Fingerprints

Cognitive state detection and its relationship to observable physiologically telemetry has been utilized for many human-machine and human-cybernetic applications. This paper aims at understanding and addressing if there are unique psychophysiological patterns over time, a physiological temporal fingerprint, that is associated with specific cognitive states. This preliminary work involves commercial airline pilots completing experimental benchmark task inductions of three cognitive states: 1) Channelized Attention (CA); 2) High Workload (HW); and 3) Low Workload (LW). We approach this objective by modeling these "fingerprints" through the use of Hidden Markov Models and Entropy analysis to evaluate if the transitions over time are complex or rhythmic/predictable by nature. Our results indicate that cognitive states do have unique complexity of physiological sequences that are statistically different from other cognitive states. More specifically, CA has a significantly higher temporal psychophysiological complexity than HW and LW in EEG and ECG telemetry signals. With regards to respiration telemetry, CA has a lower temporal psychophysiological complexity than HW and LW. Through our preliminary work, addressing this unique underpinning can inform whether these underlying dynamics can be utilized to understand how humans transition between cognitive states and for improved detection of cognitive states