The objective of this study was to examine the association between cognitive ability and gait initiation performance in older adults. Global and specific cognitive functions and spatiotemporal gait parameters during gait initiation were assessed in 60 older adults. Multivariate linear regression was conducted to determine the association between cognitive functions and gait initiation parameters. Results showed that global cognitive function was not associated with any of the spatiotemporal parameters. Poorer performance on measures of executive function and language ability were associated with shorter step length, narrower step width, and longer step time. In addition, poorer performance on test of visuospatial ability was associated with longer step time. In conclusion, specific but not global cognitive functions were associated with gait initiation performance. Clinical gait examination should incorporate gait initiation and cognitive assessments. Rehabilitation strategies aimed at improving cognition and gait initiation performance may be beneficial for preventing falls.
Sirinun Boripuntakul and Somporn Sungkarat
Roya Khanmohammadi, Saeed Talebian, Mohammad Reza Hadian, Gholamreza Olyaei, and Hossein Bagheri
The purpose of study was to demonstrate age-related changes during gait initiation (GI). Therefore, displacement, velocity, total power, mean and median frequency of COP trajectories were measured during phases of GI in anteroposterior (AP) and mediolateral (ML) directions. The older group demonstrated the slower and lesser displacement in comparison with the younger group during anticipatory phase in AP direction and during locomotor phase in AP and ML directions. In addition, the median and mean frequency were greater in the older relative to the younger group during anticipatory phase in AP direction, while these were lesser in older than younger group during locomotor phase in AP and ML directions. Moreover, total power was greater among older than younger adults during the anticipatory phase in ML direction and during all phases in AP direction. This study suggests that COP-related parameters extracted from time and frequency domains have the ability to demonstrate age-related changes.
Andresa R. Marinho-Buzelli, Ana Maria Forti Barela, Jose Angelo Barela, Melissa Leandro Celestino, Milos R. Popovic, and Mary Verrier
Aquatic therapies are used to restore step initiation in people with locomotor disabilities. However, there is lack of evidence of underlining mechanisms of gait initiation in water. We investigated center of pressure (CoP), vertical and anterior-posterior impulse forces, and kinematics of the first step performed in water in comparison with overground walking. The peaks of anticipatory postural adjustment (APA) and the sections of CoP trajectories were longer in water than on land. Impulse forces were increased in water compared with land. Range of motion (ROM) of ankle joint increased in water while knee joint ROM did not change. We suggest that the aquatic environment may facilitate gait initiation training by allowing a longer step execution with greater stimuli and imposed resistance for the phases of gait initiation.
Andreia S.P. Sousa, Augusta Silva, and Rubim Santos
This study aims to compare 2 methods of assessing the postural phase of gait initiation, in regard to intrasession reliability, in healthy and poststroke subjects. As a secondary aim, this study aims to analyze anticipatory postural adjustments during gait initiation based on the center of pressure (CoP) displacements in poststroke participants. The CoP signal was acquired during gait initiation in 15 poststroke subjects and 23 healthy controls. Postural phase was identified through a baseline-based method and a maximal displacement-based method. In both healthy and poststroke participants, higher intraclass correlation coefficient and lower coefficient of variation values were obtained with the baseline-based method when compared with the maximal displacement-based method. Poststroke participants presented decreased CoP displacement backward and toward the first swing limb compared with controls when the baseline-based method was used. With the maximal displacement based method, there were differences between groups only regarding backward CoP displacement. Postural phase duration in medial-lateral direction was also increased in poststroke participants when using the maximal displacement based method. The findings obtained indicate that the baseline-based method is more reliable detecting the onset of gait initiation in both groups, while the maximal displacement-based method presents greater sensitivity for poststroke participants.
Jebb G. Remelius, Joseph Hamill, Jane Kent-Braun, and Richard E.A. Van Emmerik
Individuals with multiple sclerosis (MS) often have poor balance control that is especially apparent during dynamic tasks such as gait initiation (GI). The purpose of this study was to investigate how balance symptoms due to MS alter spatiotemporal variables, coordination, and temporal margins within the stability boundary during gait initiation. Twelve women with MS (Expanded Disability Status Scale [EDSS] mean = 4.0, SD = 1.4) and 12 women without MS (control group) initiated gait at their preferred speed. MS participants attained a slower anterior velocity because of smaller anterior center of mass displacements and took longer to complete the initiation of gait than the control group. MS participants exhibited a smaller posterior shift in center of pressure during GI and stepped with a longer dual support time than the control group. However, these changes may be due to differences in initiation velocity. Relative timing analysis showed invariance in postural and locomotor phases of gait initiation between groups. The MS group showed different coordination between anterior-posterior and medio-lateral center of pressure components while increasing temporal margins to the posterior and lateral stability boundaries in comparison with the control group. Overall, during gait initiation at their preferred speed the MS participants adopted a functional strategy that produces lower speed and reduced proximity to the stability boundaries prior to stepping.
Aisha Chen, Sandhya Selvaraj, Vennila Krishnan, and Shadnaz Asgari
Gait initiation is the transition between the quasi-static state of standing and the dynamic state of walking. 1 – 6 This transitional period is broken down into 2 main phases: the postural phase and the execution phase. In the postural phase, the anticipatory postural adjustments (APAs) for
Wen-Hao Hsu, Evelyn J. Park, Daniel L. Miranda, Hani M. Sallum, Conor J. Walsh, and Eugene C. Goldfield
the gait cycle ( Bauby & Kuo, 2000 ; O’Connor & Kuo, 2009 ). In this way, the adult may not only regulate the degrees of freedom of oscillation of the child’s body center of mass (CoM) and center of pressure (CoP), but may also promote gait initiation by allowing the child to transform the AP body
Erik A. Wikstrom and Robert B. Anderson
The purpose of this investigation was to determine if stereotypical patterns of gait initiation are altered in those with posttraumatic ankle osteoarthritis. Ten subjects, five with unilateral ankle osteoarthritis and five uninjured controls, participated. Subjects completed the SF-36 and Ankle Osteoarthritis Scale to quantify self-reported disability as well as 10 dual-limb static stance trials and 10 gait initiation trials with each leg. Center of pressure outcomes were calculated for static balance trials while the peak center of pressure excursions were calculated for each phase of gait initiation. The results indicate greater self-reported disability (P < .05) and worse static postural control (P < .05) in the ankle osteoarthritis group. Nonstereotypical patterns were also observed during the first and third phases of gait initiation in those with ankle osteoarthritis. The results of this pilot study suggest that supraspinal motor control mechanisms may have changed in those with posttraumatic ankle osteoarthritis.
Bradley Fawver, Garrett F. Beatty, Kelly M. Naugle, Chris J. Hass, and Christopher M. Janelle
Emotional states influence whole-body movements during quiet standing, gait initiation, and steady state gait. A notable gap exists, however, in understanding how emotions affect postural changes during the period preceding the execution of planned whole-body movements. The impact of emotion-induced postural reactions on forthcoming posturomotor movements remains unknown. We sought to determine the influence of emotional reactions on center of pressure (COP) displacement before the initiation of forward gait. Participants (N = 23, 14 females) stood on a force plate and initiated forward gait at the offset of an emotional image (representing five discrete categories: attack, sad faces, erotica, happy faces, and neutral objects). COP displacement in the anteroposterior direction was quantified for a 2 second period during image presentation. Following picture onset, participants produced a posterior postural response to all image types. The greatest posterior displacement was occasioned in response to attack or threat stimuli compared with happy faces and erotica images. Results suggest the impact of emotional states on gait behavior begins during the motor planning period before the preparatory phase of gait initiation, and manifests in center of pressure displacement alterations.
Srikant Vallabhajosula, Beverly L. Roberts, and Chris J. Hass
Tai Chi intervention has been shown to be beneficial for balance improvement. The current study examined the effectiveness of Tai Chi to improve the dynamic postural control among older adults with mobility disability. Six sedentary older adults with mobility disability participated in a 16-week Tai Chi intervention consisting of one hour sessions three times a week. Dynamic postural control was assessed pre- and post intervention as participants initiated gait in four stepping conditions: forward; 45° medially, with the stepping leg crossing over the other leg; 45° and 90° laterally. The center of pressure (CoP) displacement, velocity, and its maximum separation distance from the center of mass in the anteroposterior, mediolateral, and resultant directions were analyzed. Results showed that in the postural phase, Tai Chi increased the CoP mediolateral excursions in the medial (13%) and forward (28%) conditions, and resultant CoP center of mass distance in the medial (9%) and forward (19%) conditions. In the locomotion phase, the CoP mediolateral displacement and velocity significantly increased after the Tai Chi intervention (both by > 100% in the two lateral conditions). These results suggest that through alteration in CoP movement characteristics, Tai Chi intervention might improve the dynamic postural control during gait initiation among older adults.