Minimum toe clearance: probing the neural control of locomotion

Minimum toe clearance (MTC) occurs during a highly dynamic phase of the gait cycle and is associated with the highest risk of unintentional contact with obstacles or the ground. Age, cognitive function, attention and visual feedback affect foot clearance but how these factors interact to influence MTC control is not fully understood. We measured MTC in 121 healthy individuals aged 20-80 under four treadmill walking conditions; normal walking, lower visual field restriction and two Stroop colour/word naming tasks of two difficulty levels. Competition for cognitive and attentional resources from the Stroop task resulted in significantly lower mean MTC in older adults, with the difficult Stroop task associated with a higher frequency of extremely low MTC values and subsequently an increased modelled probability of tripping in this group. While older adults responded to visual restriction by markedly skewing MTC distributions towards higher values, this condition was also associated with frequent, extremely low MTC values. We reveal task-specific, age-dependent patterns of MTC control in healthy adults. Age-related differences are most pronounced during heavy, distracting cognitive load. Analysis of critically-low MTC values during dual-task walking may have utility in the evaluation of locomotor control and fall risk in older adults and patients with motor control deficits

Analyzing a Single Nucleotide Polymorphism (SNP) in Schizophrenia: A meta-analysis approach

Human arm swing looks and feels highly automated, yet it is increasingly apparent that higher centres, including the cortex, are involved in many aspects of locomotor control. The addition of a cognitive task increases arm swing asymmetry during walking, but the characteristics and mechanism of this asymmetry are unclear. We hypothesized that this effect is lateralized and a Stroop word-colour naming task—primarily involving left hemisphere structures—would reduce right arm swing only. We recorded gait in 83 healthy subjects aged 18–80 walking normally on a treadmill and while performing a congruent and incongruent Stroop task. The primary measure of arm swing asymmetry—an index based on both three-dimensional wrist trajectories in which positive values indicate proportionally smaller movements on the right—increased significantly under dual-task conditions in those aged 40–59 and further still in the over-60s, driven by reduced right arm flexion. Right arm swing attenuation appears to be the norm in humans performing a locomotor-cognitive dual-task, confirming a prominent role of the brain in locomotor behaviour. Women under 60 are surprisingly resistant to this effect, revealing unexpected gender differences atop the hierarchical chain of locomotor control

Cooperative hand movements: task-dependent modulation of ipsi- and contralateral cortical control

Cooperative hand movements are known to be controlled by a task-specific neural coupling associated with an involvement of the respective ipsilateral hemispheres. The aim of this study was to explore in how far this neural control applies to and is modulated during various, fine and gross, cooperative hand movements required during activities of daily living. Somatosensory evoked potentials and contralateral electromyographic reflex responses to unilateral ulnar nerve stimulation were simultaneously recorded in healthy participants during three different cooperative hand movement tasks and a resting condition. Amplitude ratio (ipsi-/contralateral) of the somatosensory evoked potentials, which is a measure for the involvement of the ipsilateral hemisphere in movement control, was higher in all three movement tasks compared to resting. This ratio was highest during the fine cooperative movement studied here. Contralateral reflex responses, as a measure for the functional coupling of the arms, were elicited following stimulation of both arms during gross cooperative movements. However, such a response could only be elicited in the dominant arm during fine movement. It is concluded that the neural coupling and thus enhancement of ipsilateral cortical control is preserved through different cooperative hand movement tasks, independently whether fine or gross motor tasks are performed. However, modulation of cortical control can be observed as ipsilateral cortical control is stronger during fine movements and functional coupling of the arms more focused to the dominant hand compared to gross cooperative tasks

Short Trail Running Race: Beyond the Classic Model for Endurance Running Performance

International audiencePURPOSE:This study aimed to examine the extent to which the classical physiological variables of endurance running performance (maximal oxygen uptake (V˙O2max), %V˙O2max at ventilatory threshold (VT), and running economy (RE)) but also muscle strength factors contribute to short trail running (TR) performance.METHODS:A homogeneous group of nine highly trained trail runners performed an official TR race (27 km) and laboratory-based sessions to determine V˙O2max, %V˙O2max at VT, level RE (RE0%) and RE on a +10% slope, maximal voluntary concentric and eccentric knee extension torques, local endurance assessed by a fatigue index (FI), and a time to exhaustion at 87.5% of the velocity associated with V˙O2max. A simple regression method and commonality analysis identifying unique and common coefficients of each independent variable were used to determine the best predictors for the TR race time (dependent variable).RESULTS:Pearson correlations showed that FI and V˙O2max had the highest correlations (r = 0.91 and r = -0.76, respectively) with TR performance. The other selected variables were not significantly correlated with TR performance. The analysis of unique and common coefficients of relative V˙O2max, %V˙O2max at VT, and RE0% provides a low prediction of TR performance (R = 0.48). However, adding FI and RE on a +10% slope (instead of RE0%) markedly improved the predictive power of the model (R = 0.98). FI and V˙O2max showed the highest unique (49.8% and 20.4% of total effect, respectively) and common (26.9% of total effect) contributions to the regression equation.CONCLUSIONS:The classic endurance running model does not allow for meaningful prediction of short TR performance. Incorporating more specific factors into TR such as local endurance and gradient-specific RE testing procedures should be considered to better characterize short TR performance

Increasing cognitive load attenuates right arm swing in healthy human walking

Human arm swing looks and feels highly automated, yet it is increasingly apparent that higher centres, including the cortex, are involved in many aspects of locomotor control. The addition of a cognitive task increases arm swing asymmetry during walking, but the characteristics and mechanism of this asymmetry are unclear. We hypothesized that this effect is lateralized and a Stroop word-colour naming task-primarily involving left hemisphere structures-would reduce right arm swing only. We recorded gait in 83 healthy subjects aged 18-80 walking normally on a treadmill and while performing a congruent and incongruent Stroop task. The primary measure of arm swing asymmetry-an index based on both three-dimensional wrist trajectories in which positive values indicate proportionally smaller movements on the right-increased significantly under dual-task conditions in those aged 40-59 and further still in the over-60s, driven by reduced right arm flexion. Right arm swing attenuation appears to be the norm in humans performing a locomotor-cognitive dual-task, confirming a prominent role of the brain in locomotor behaviour. Women under 60 are surprisingly resistant to this effect, revealing unexpected gender differences atop the hierarchical chain of locomotor control

Modulating Arm Swing Symmetry with Cognitive Load: A Window on Rhythmic Spinal Locomotor Networks in Humans?

In healthy subjects, changes in arm swing symmetry while walking are observed when a cognitive dual task is added, with a tendency toward left-dominant arm swing as cognitive load increases. We applied a modified Stroop word/color naming paradigm to investigate this effect in spinal cord injured (SCI) patients. Six patients with cervical SCI (cSCI), 6 with thoracic injuries (tSCI; all 12 patients American Spinal Injury Association [ASIA] Injury Score [AIS]D), and 12 healthy, matched controls underwent three-dimensional 3D gait analysis while walking normally at a comfortable speed (NW) and when performing an additional congruent (CS) and incongruent (IS) Stroop task. An arm swing symmetry index (ASI)-in which positive values indicate proportionally more movement on the left and vice versa-was calculated. Even in the baseline NW condition, all three subject groups showed larger arm movements on the left. In controls, ASI increased (NW, 13.7 ± 6.3; CS, 16.6 ± 6.4; IS, 19.6 ± 7.8) as the task became more demanding. A larger shift in tSCI patients (NW, 15.8 ± 6.0; CS, 23.4 ± 3.8; IS, 30.7 ± 4.4) was driven by a significant reduction in right wrist trajectory (p = 0.014), whereas cSCI patients showed a small reduction in mean ASI with high variability (NW, 14.2 ± 10.7; CS, 9.3 ± 13.5; IS, 6.0 ± 12.9). The effect of the IS task on ASI compared to baseline (NW) was significantly different between tSCI (+12.5 ± 6.3) and cSCI (-8.2 ± 6.0) patients (p = 0.011). Disruption of the long propriospinal connections coordinating arm and leg movements during walking may explain the heightened sensitivity to manipulation of cognitive load in tSCI, whereas the more robust automaticity in cSCI may be attributed to impaired supraspinal inputs in the context of preserved intraspinal pathways

Profiling walking dysfunction in multiple sclerosis: characterisation, classification and progression over time

Gait dysfunction is a common and relevant symptom in multiple sclerosis (MS). This study aimed to profile gait pathology in gait-impaired patients with MS using comprehensive 3D gait analysis and clinical walking tests. Thirty-seven patients with MS walked on the treadmill at their individual, sustainable speed while 20 healthy control subjects walked at all the different patient's paces, allowing for comparisons independent of walking velocity. Kinematic analysis revealed pronounced restrictions in knee and ankle joint excursion, increased gait variability and asymmetry along with impaired dynamic stability in patients. The most discriminative single gait parameter, differentiating patients from controls with an accuracy of 83.3% (χtest; p = 0.0001), was reduced knee range of motion. Based on hierarchical cluster and principal component analysis, three principal pathological gait patterns were identified: a spastic-paretic, an ataxia-like, and an unstable gait. Follow-up assessments after 1 year indicated deterioration of walking function, particularly in patients with spastic-paretic gait patterns. Our findings suggest that impaired knee/ankle control is common in patients with MS. Personalised gait profiles and clustering algorithms may be promising tools for stratifying patients and to inform patient-tailored exercise programs. Responsive, objective outcome measures are important for monitoring disease progression and treatment effects in MS trials

Familiarization with treadmill walking: How much is enough?

Treadmill-based gait analysis is widely used to investigate walking pathologies and quantify treatment effects on locomotion. Differential sensorimotor conditions during overground vs. treadmill walking necessitate initial familiarization to treadmill walking. Currently, there is no standardized treadmill acclimatization protocol and insufficient familiarization potentially confounds analyses. We monitored initial adaptations to treadmill walking in 40 healthy adults. Twenty-six walking parameters were assessed over 10 minutes with marker-based kinematic analysis and acclimatization profiles were generated. While 16 walking parameters demonstrated initial acclimatization followed by plateau performance, ten parameters remained stable. Distal lower limb control including ankle range of motion, toe trajectory and foot clearance underwent substantial adaptations. Moreover, intralimb coordination and gait variability also demonstrated acclimatization, while measures of symmetry and interlimb coordination did not. All parameters exhibiting a plateau after acclimatization did so within 6-7 minutes (425 strides). Older participants and those naïve to treadmill walking showed adaptations with higher amplitudes but over similar timescales. Our results suggest a minimum of 6 minutes treadmill acclimatization is required to reach a stable performance, and that this should suffice for both older and naïve healthy adults. The presented data aids in optimizing treadmill-based gait analysis and contributes to improving locomotor assessments in research and clinical settings

Effects of circadian cortisol on the development of a health habit

International audienceGiven the impact of individuals' habits on health, it is important to study how behaviors can become habitual. Cortisol has been well documented to have a role in habit formation. This study aimed to elucidate the influence of the circadian rhythm of cortisol on habit formation in a real-life setting