The purpose of this study was to identify the rate of abnormal single-task and dual-task gait performance following concussion compared to uninjured controls using previously established normative reference values. The authors examined athletes with a concussion (n = 54; mean age = 20.3 [1.1] y, 46% female, tested 2.9 [1.5] d postinjury), and healthy controls were tested during their preseason baseline examination (n = 60; mean age = 18.9 [0.7] y, 37% female). Participants completed an instrumented single-/dual-task gait evaluation. Outcome variables included average walking speed, cadence, and step length. A significantly greater number of those with concussion walked with abnormal dual-task gait speed compared with the control group (56% vs 30%, P = .01). After adjusting for potential confounding variables (age, concussion history, symptom severity, and sleep), concussion was associated with lower dual-task gait speed (β = −0.150; 95% confidence interval [CI] = −0.252 to −0.047), cadence (β = −8.179; 95% CI = −14.49 to −1.871), and stride length (β = −0.109; 95% CI = −0.204 to −0.014). Although group analyses indicated that those with a concussion performed worse on single-task and dual-task gait compared with controls, a higher rate of abnormal gait was detected for the concussion group compared with the control group for dual-task gait speed only. Dual-task gait speed, therefore, may be considered as a measure to compare against normative values to detect postconcussion impairments.
David R. Howell, Thomas A. Buckley, Brant Berkstresser, Francis Wang and William P. Meehan III
Patricia M. Kelshaw, Trenton E. Gould, Mark Jesunathadas, Nelson Cortes, Amanda Caswell, Elizabeth D. Edwards and Shane V. Caswell
Girls’ lacrosse participation and head injury rates have increased within the past decade. In response, optional headgear was implemented following the recently developed ASTM International lacrosse headgear performance standards. It remains unknown how lacrosse headgear responds to blunt impacts after use. Our purpose was to compare the peak linear acceleration between girls’ lacrosse headgear conditions (pristine and used) during blunt impacts. Pristine headgear (n = 10) were tested in their original condition and used headgear (n = 10) were worn for an entire competitive season. A Cadex Monorail Impactor impacted all headgear following ASTM standards (F1446-15b, F2220-15, and F3137-15) in the required testing locations. A 2 × 7 repeated-measures analysis of variance compared peak linear acceleration among headgear conditions and impact locations with a simple effects analysis planned comparison. There was no difference between headgear conditions for peak linear acceleration (pristine: 47.12 [13.92] g; used: 46.62 [14.84] g; F = 2.11, P > .05). A main effect for impact location (F = 983.52, P < .01), and an interaction effect of condition and impact location (F = 12.79, P < .01) were observed. All headgear, regardless of condition, met the ASTM performance standard. This suggests that headgear performance may not degrade subsequent to a single season of high school girls’ lacrosse.
Susana Meireles, Neil D. Reeves, Richard K. Jones, Colin R. Smith, Darryl G. Thelen and Ilse Jonkers
Medial knee loading during stair negotiation in individuals with medial knee osteoarthritis has only been reported in terms of joint moments, which may underestimate the knee loading. This study assessed knee contact forces (KCF) and contact pressures during different stair negotiation strategies. Motion analysis was performed in 5 individuals with medial knee osteoarthritis (52.8 [11.0] y) and 8 healthy subjects (51.0 [13.4] y) while ascending and descending a staircase. KCF and contact pressures were calculated using a multibody knee model while performing step-over-step at controlled and self-selected speed, and step-by-step strategies. At controlled speed, individuals with osteoarthritis showed decreased peak KCF during stair ascent but not during stair descent. Osteoarthritis patients showed higher trunk rotations in frontal and sagittal planes than controls. At lower self-selected speed, patients also presented reduced medial KCF during stair descent. While performing step-by-step, medial contact pressures decreased in osteoarthritis patients during stair descent. Osteoarthritis patients reduced their speed and increased trunk flexion and lean angles to reduce KCF during stair ascent. These trunk changes were less safe during stair descent where a reduced speed was more effective. Individuals should be recommended to use step-over-step during stair ascent and step-by-step during stair descent to reduce medial KCF.
Breanna E. Studenka and Kodey Myers
Children with autism spectrum disorder (ASD) exhibit impairment in helping someone else with a motor action, which may arise from impairment in selecting and preparing motor responses. Five children with ASD and five typically developing children performed a cooperative motor planning task that required them to reach for, lift, and hand an object (hammer or stick) to a researcher. The response, movement, and grasp time were measured. Children with ASD grasped the object longer on trials where they helped, indicating that the action was planned in sequence versus as a whole (i.e., prior to the onset of movement). The hammer object elicited a quicker response than the stick, suggesting the facilitation of planning by tools with inherent action properties. Finally, the increased helping of children with ASD was not mirrored by changes in the response, movement, or grasp time.
Jocelyn F. Hafer, Mark S. Miller, Jane A. Kent and Katherine A. Boyer
Older females experience higher rates of disability than males, potentially due to sex-specific differences in gait and muscle function. The authors evaluated the effects of age and physical activity (PA) on gait mechanics and knee extensor muscle function in males and females. Three groups of 20 individuals (each 10 females) participated: young (21–35 y) and highly and less active older (55–70 y) adults. Knee extensor strength and joint mechanics during preferred speed gait were collected before and after 30 minutes of walking. Age by sex and PA by sex interactions indicated older and less active older females had lower concentric knee extensor muscle power and larger hip extension moments than males. After 30 minutes of walking, older less active adults had larger decreases in knee extensor power than their highly active older counterparts, and older adults of both sexes had decreases in ankle dorsiflexion moments while young adults did not. These results suggest that older, particularly less active, adults are susceptible to knee extensor muscle fatigue from moderate activity. For older adults, high levels of PA may be necessary to preserve gait mechanics in response to a bout of exercise. This new information may be important for targeting interventions in at-risk older adults.
Paula R. Mesquita, Silvia G.R. Neri, Ricardo M. Lima, Eliane F. Manfio and Ana C. de David
Although previous reports have provided normative plantar pressure data for walking in children, evaluation during running is lacking. This study aimed to compare foot loading patterns during running and walking in children aged 4–10 years. Furthermore, the relationship between running baropodometric parameters and anthropometric measures was investigated. Foot loading of 120 volunteers was evaluated during running and walking using an Emed AT-4 pressure platform. Analyses were performed for 5 anatomical regions (rearfoot, midfoot, forefoot, hallux, and lesser toes). Higher peak pressure and maximum force values were seen under most foot regions during running in comparison with walking, whereas relative contact area tended to increase only in the midfoot. Data for running indicated that aging explained less than 23% of the variance of plantar loads and contact area. Running foot loads were more associated with height, body mass, and foot length. This study’s data described plantar loads under the feet of children were greater during running. Aging was associated with little increase in running plantar loads and larger contact areas. Results may be useful as reference to characterize foot loading during running and in the development of orthoses in clinical applications or products such as sport shoes for children.
Yuko Kuramatsu, Yuji Yamamoto and Shin-Ichi Izumi
This study investigated the sensorimotor strategies for dynamic balance control in individuals with stroke by restricting sensory input that might influence task accomplishment. Sit-to-stand movements were performed with restricted vision by participants with hemiparesis and healthy controls. The authors evaluated the variability in the position of participants’ center of mass and velocity, and the center-of-pressure position, in each orthogonal direction at the lift-off point. When vision was restricted, the variability in the mediolateral center-of-pressure position decreased significantly in individuals with hemiparesis, but not in healthy controls. Participants with hemiparesis adopted strategies that explicitly differed from those used by healthy individuals. Variability may be decreased in the direction that most requires accuracy. Individuals with hemiparesis have been reported to have asymmetrical balance deficits, and that meant they had to prioritize mediolateral motion control to prevent falling. This study suggests that individuals with hemiparesis adopt strategies appropriate to their characteristics.
Fatemeh Azadinia, Ismail Ebrahimi-Takamjani, Mojtaba Kamyab, Morteza Asgari and Mohamad Parnianpour
The characteristics of postural sway were assessed in quiet standing under three different postural task conditions in 14 patients with nonspecific chronic low back pain and 12 healthy subjects using linear and nonlinear center of pressure parameters. The linear parameters consisted of area, the mean total velocity, sway amplitude, the SD of velocity, and the phase plane portrait. The nonlinear parameters included the Lyapunov exponent, sample entropy, and the correlation dimension. The results showed that the amount of postural sway was higher in the patients with low back pain compared with the healthy subjects. Assessing the nonlinear parameters of the center of pressure showed a lower sample entropy and a higher correlation dimension in the patients with low back pain compared with the healthy subjects. The results of this study demonstrate the greater regularity and higher dimensionality of the center of pressure fluctuations in patients with nonspecific chronic low back pain, which suggests that these patients adopt different postural control strategies to maintain an upright stance.
Christopher A. DiCesare, Scott Bonnette, Gregory D. Myer and Adam W. Kiefer
Biomechanical analysis can effectively identify factors associated with task performance and injury risk, but often does not account for the interaction among the components that underlie task execution. Uncontrolled manifold (UCM) analyses were applied to data from 38 female, adolescent athletes performing single-leg drop landings and were used to differentiate successful and unsuccessful task performance by examining the frontal plane joint variance within the UCM (V UCM) that stabilized the horizontal center of mass position (V UCM) and within the orthogonal subspace (V ORT). The UCM revealed stronger coordination, indicated by the V UCM/V ORT ratio, in the successful condition. This may inform future research examining reduced motor coordination in failed movement tasks and its relation to injury risk and allow for targeted interventions that consider coordination processes rather than joint-specific outcomes.
Grace C. Bellinger, Kristen A. Pickett and Andrea H. Mason
Reaching and grasping are often completed while walking, yet the interlimb coordination required for such a combined task is not fully understood. Previous studies have produced contradictory evidence regarding preference for support of the lower limb ipsilateral or contralateral to the upper limb when performing a reaching task. This coordinative aspect of the combined task provides insight into whether the two tasks are mutually modified or if the reach is superimposed upon normal arm swinging. Collectively, 18 right-handed young adults walked slower, took shorter steps, and spent more time in double support during the combined task compared with walking alone. The peak grasp aperture was larger in walking reach-to-grasp trials compared with standing trials. There was not a strong trend for lower limb support preferences at the reach initiation or object contact. The participants could begin walking with either foot and demonstrated variability of preferred gait initiation patterns. There was a range of interlimb coordination patterns, none of which could be generalized to all young adults. The variability with which healthy right-handed young adults execute a combined walking reach-to-grasp task suggests that the cyclical (walking) and discrete (prehension) motor tasks may have separate motor control mechanisms, as proposed in the two primitives theory.