Pattern Of Inter-joint Coordination Research Articles

Analysis of inter-joint coordination during the sit-to-stand and stand-to-sit tasks in stroke patients with hemiplegia

BackgroundInter-joint coordination is an important factor affecting postural stability, and its variability increases after fatigue. This study aimed to investigate the coordination pattern of lower limb joints during the sit-to-stand (Si-St) and stand-to-sit (St-Si) tasks in stroke patients and explore the influence of duration on inter-joint coordination.MethodsThirteen stroke hemiplegia patients (five with left paretic and eight right paretic) and thirteen age-matched healthy subjects were recruited. The Si-St and St-Si tasks were performed while each subject’s joint kinematics were recorded using a three-dimensional motion capture system. Sagittal joint angles of the bilateral hip, knee and ankle joints as well as the movement duration were extracted. The angle-angle diagrams for the hip-knee, hip-ankle and knee-ankle joint were plotted to assess the inter-joint coordination. The inter-joint coordination was quantified using geometric characteristics of the angle-angle diagrams, including perimeter, area and dimensionless ratio. The coefficient of variation (CV) was performed to compare variability of the coordination parameters.ResultsThere were no significant differences in the perimeter, area and dimensionless ratio values of the bilateral hip-knee, hip-ankle and knee-ankle inter-joints during Si-St and St-Si tasks in the stroke group. The perimeter values of bilateral hip-knee and knee-ankle inter-joints in the stroke group were lower (P<0.05) than in the healthy group during Si-St and St-Si tasks. Although no significant bilateral differences were found, the inter-joint coordination in stroke patients decreased with the increased movement duration of both Si-St and St-Si tasks. Additionally, the CV of the hip-knee inter-joint area during the Si-St task in the stroke group was less than (P<0.05) that in the healthy group.ConclusionStroke patients exhibit different inter-joint coordination patterns than healthy controls during the Si-St and St-Si tasks. The duration affects joint coordination, and inter-joint coordination is limited on the hemiplegic side joint pairs, which may lead to inconsistency in the rhythm of the left and right leg inter-joint movements and increase the risk of falls. These findings provide new insights into motor control rehabilitation strategies and may help planning targeted interventions for stoke patients with hemiplegia.

Lower limbs inter-joint coordination and variability during typical Tai Chi movement in older female adults.

Purpose: This study aimed to investigate the lower limb inter-joint coordination and variability during Tai Chi movements compared with normal walking in older adults. Methods: A total of 30 female Tai Chi practitioners (70.9 ± 5.2years) were recruited in this study. Herein, each participant performed three trials of the normal walking and Tai Chi movements. The lower limb kinematics data were collected with Vicon 3D motion capture system. The continuous relative phase (CRP) includes both spatial and temporal information of two adjacent joints, which was calculated to assess the inter-joint coordination of lower limbs. Coordination amplitude and coordination variability were assessed with mean absolute relative phase (MARP) and deviation phase (DP). MANOVOA was used to analyze inter-joint coordination parameters between different movements. Results: The CRP values of hip-knee and knee-ankle segments in the sagittal plane of the Tai Chi movements changed frequently. The MARP values of the hip-knee (p < 0.001) and knee-ankle segments (p = 0.032) as well as the DP values of the hip-knee segment (p < 0.001) were significantly lower in Tai Chi than in normal walking. Conclusion: More consistent and stable inter-joint coordination patterns of Tai Chi movements found in this study may be one of the critical factors that Tai Chi could be a suitable coordinated exercise for older adults.

Application of the Coupling Angle to Investigate Upper Limb Interjoint Coordination After Stroke

ObjectiveInterjoint coordination after stroke is affected, which limits the use of the upper limb. Current methods to determine interjoint coordination lack the ability to visualize and quantify the movement. Therefore we investigated if the coupling angle can be used to visualize and interpret upper limb interjoint coordination following a stroke. MethodsSeven chronic stroke patients trained six weeks with an assistive home-training system (MERLIN). Kinematic outcomes, i.e. elbow and shoulder range of motion, movement duration, and angle-angle plots were determined in a retrieving task. Interjoint coordination between elbow flexion and shoulder abduction angles was expressed as the coupling angle phases and the number of phase transitions: proximal/distal joint leading phase, in-phase and anti-phase. Comparisons were made within sides: pre-test versus post-test, and between sides: most-affected (MA) versus least-affected (LA). ResultsSmaller elbow flexion angles were found PreMA versus PreLA, and smaller shoulder abduction angles in PostMA versus PostLA. A general coordination pattern was revealed on the LA side, but not on the MA side. A trend showed less phase transitions at the MA side after training, suggesting a smoother movement. Quantification of the movement phases indicated more involvement of the shoulder joint involvement in the MA side during pre-test. After training, these differences were not apparent, which might reveal an increased independent control of the elbow joint. ConclusionsThe coupling angle and the movement phases provide a promising tool to investigate post-stroke interjoint coordination patterns. SignificanceA new visualisation of the interjoint coordination may benefit rehabilitation of stroke survivors. RegistrationThis trial was registered at the Netherlands Trial Register (NL7535) https://www.trialregister.nl/trial/7535.

Sequential focus of attention instructions influenced motor performance of volleyball setting despite direction of focus but dependent on motor expertise of the player

ABSTRACTPrevious studies have shown the advantage of external over internal focus of attention (FOA) for motor learning and performance. However, such a FOA effect is inconsistent when factors such as motor expertise, individual preference, and performance measurement are considered. For complex motor skills like volleyball setting, sequential FOA instructions (S-FOA) are often given to facilitate skill acquisition and performance, but it remains unknown whether internal and external FOA instructions would impact motor performance of skilled and novice players differently. Thirty-two novice (n = 16) and skilled (n = 16) female volleyball players were asked to perform a simulated volleyball setting task without (control) and with S-FOA (internal or external). Both movement outcomes and inter-joint coordination of flexion and extension were analysed using linear models and time-series analysis. The results supported previous literature on motor expertise showing that skilled players outperformed novice players with superior movement outcomes due to their ability to maintain an intermediate coordination pattern and functional variability of inter-joint coordination prior to ball contact. Despite direction of focus, S-FOA degraded the mean setting accuracy of skilled players without impacting their mean inter-joint coordination pattern and it also failed to influence the performance of novice players. Although S-FOA failed to impact the mean inter-joint coordination patterns of all participants, they allowed individuals to develop idiosyncratic coordination patterns for setting. S-FOA significantly reduced the variability of inter-joint coordination before and after ball contact for all players, however, it was considered detrimental for skilled players but beneficial for novice players.HighlightsSuperior setting performance is associated with the ability to adopt an intermediate inter-joint coordination pattern with a functional variability prior to ball contactDespite direction of focus, the effects of sequential focus of attention (SFOA) instructions on inter-joint coordination pattern of players are idiosyncraticThe SFOA-induced reduction of variability of inter-joint coordination before and after ball contact is considered detrimental for skilled players but beneficial for novice players

Lower limb inter-joint coordination patterns are associated with walking experience in toddlers according to limb and stance periods

Walking experience is crucial for inter-joint coordination during gait acquisition. Toddlers show asymmetrical lower limb function during early locomotion for transferring body weight (regulatory limb) and steering the direction of walking (impulse limb). This study aimed to investigate the association between coordination patterns and walking experience, and between coordination variability and walking experience according to healthy toddlers’ lower limb function and stance periods. Typically developing toddlers (n = 22; 17.27 ± 3.13 months) were distributed into two groups: up to (LWE) and greater than (GWE) three months of walking experience. The lower limbs were classified as regulatory or impulse limb and analyzed during the onset (SO), mid (MS), and late (LS) stance intervals. Hip-ankle, knee-ankle, and hip-knee coupling angle (CA) and its variability (CAV) were assessed. A relationship was found between inter-joint coordination pattern and groups, which was distinct according to stance period and lower limb function: (a) hip-ankle CA: at SO for both limbs, MS for the regulatory limb, and LS for the impulse limb; (b) knee-ankle CA: at SO for both limbs and MS for the regulatory limb; (c) hip-knee CA: at SO for both limbs, at MS for the regulatory limb, and LS for the impulse limb. These findings were linked to differences observed in distal joints between groups, mainly at the ankle during stance onset. The CAV was negatively associated with walking experience only in the regulatory limb in the following variables: hip-ankle at MS, knee-ankle at SO, and hip-knee at LS. Findings showed different functional roles of the lower limbs in dealing with the demands of balance and propulsion during early walking.

Interjoint Coordination in Kicking a Moving Target: A Comparison Between Elite and Nonelite Taekwondo Players.

Patterns of interjoint coordination in the kicking legs of taekwondo players were investigated to understand movement pattern variability as a functional property of skill level. Elite and nonelite players performed roundhouse kicks against a custom-built moving target fitted with an accelerometer, and movements were recorded by motion capture. Average foot segment velocities of 13.6 and 11.4m/s were recorded for elite and nonelite players, respectively (P < .05), corresponding to target accelerations of 87.5 and 70.8g (P < .05). Gradient values derived from piecewise linear regression of continuous relative phase curves established the comparative incoordination of nonelite taekwondo players in the form of an overshoot behavior during the crucial period leading to target impact (P < .05). This overshoot was apparent in both knee-hip and ankle-knee continuous relative phase curves. Elite players generated greater limb speed and impact force through more effective limb segment coordination. The combination of continuous relative phase and piecewise linear regression techniques allowed identification of alternate joint control approaches in the 2 groups.

Effects of Attentional Control on Gait and Inter-Joint Coordination During Dual-Task Walking.

In the process of walking, attentional resources are flexibly allocated to deal with varying environmental constraints correlated with attentional control (AC). A dual-task paradigm was used to investigate the effects of AC on gait and inter-joint coordination. Fifty students volunteered to participate in this study. Based on the reaction time (RT) in the Stroop task, the top 15 participants were assigned to the High Attentional Control (HAC) group, while the last 15 participants were assigned to the Low Attentional Control (LAC) group. The participants in the two groups were randomly asked to perform three tasks: (i) single 2-back working memory task (ST 2-back); (ii) single walking task (ST walking); and (iii) dual task (DT). Cognitive outcomes and gait spatiotemporal parameters were measured. Continuous relative phase (CRP), derived from phase angles of two adjacent joints, was used to assess inter-joint coordination. The LAC group exhibited significant task effects regarding RT, correct rate (CR), step width, gait cycle, step time, forefoot contact times, heel-forefoot times, hip-knee mean absolute relative phase (MARP), and deviation phase (DP) in the stance and swing phases (p < 0.05). In the HAC group, significant task effects were only detected in RT and foot progression angle of the left foot (p < 0.05). Under the three task conditions, the LAC group exhibited a higher CR in ST, longer heel contact times, and longer heel-forefoot times when compared with the LAC group (p < 0.05). Compared with the LAC group, the HAC group exhibited significantly smaller (closer to zero) MARP and weaker hip-knee DP values in the swing phase across all gait conditions (p < 0.05). In the stance phase, the HAC group had smaller MARP (closer to zero) values when compared with the LAC group (p < 0.05). In conclusion, the ability to maintain gait control and modulate inter-joint coordination patterns in young adults is affected by the level of attentional control in accommodating gait disturbances. AC is correlated with the performance of motor control, which theoretically supports the competitive selection of athletes and fall prevention strategies for a specific population.

Common kinematic synergies of various human locomotor behaviours.

Humans show a variety of locomotor behaviours in daily living, varying in locomotor modes and interaction styles with the external environment. However, how this excellent motor ability is formed, whether there are some invariants underlying various locomotor behaviours and simplifying their generation, and what factors contribute to the invariants remain unclear. Here, we find three common kinematic synergies that form the six joint motions of one lower limb during walking, running, hopping and sitting-down-standing-up (movement variance accounted for greater than 90%), through identifying the coordination characteristics of 36 lower limb motor tasks in diverse environments. This finding supports the notion that humans simplify the generation of various motor behaviours through re-using several basic motor modules, rather than developing entirely new modules for each behaviour. Moreover, a potential link is also found between these synergies and the unique biomechanical characteristics of the human musculoskeletal system (muscular-articular connective architecture and bone shape), and the patterns of inter-joint coordination are consistent with the energy-saving mechanism in locomotion by using biarticular muscles as efficient mechanical energy transducers between joints. Altogether, our work helps understand the formation mechanisms of human locomotion from a holistic viewpoint and evokes inspirations for the development of artificial limbs imitating human motor ability.

Lower Limb Inter-Joint Coordination of Unilateral Transfemoral Amputees: Implications for Adaptation Control

The gait of transfemoral amputees can be made smoother by adjusting the inter-joint coordination of both lower limbs. In this study, we compared the inter-joint coordination of the amputated and non-amputated limbs of unilateral amputees to able-bodied controls. Eight amputees and eight able-bodied control participants were recruited. Walking speed, stance–swing time ratio, joint angle, joint angular velocity, and inter-joint coordination parameters—including continuous relative phase (CRP) and decomposition index (DI)—of the lower-limb joint pairs in stance and swing phases were investigated. Similarity of the CRP between groups was evaluated using cross-correlation measures and root-mean-square, and the variability of the CRP was examined by deviation phase (DP). There were significant differences between the amputated limbs and controls in CRP of hip–knee and knee–ankle in stance and swing, DP of knee–ankle and hip–ankle in stance, and DI of hip–knee in swing. For the non-amputated limbs, there were significant differences in CRP and DP of knee–ankle, and DI of hip–knee in swing compared to controls. The amputees utilized unique inter-joint coordination patterns for both limbs—particularly the hip joint—to compensate for the support-capability impairment due to limb salvage and ensure foot placement accuracy.

Study of Postural Stability Features by Using Kinect Depth Sensors to Assess Body Joint Coordination Patterns.

A stable posture requires the coordination of multiple joints of the body. This coordination of the multiple joints of the human body to maintain a stable posture is a subject of research. The number of degrees of freedom (DOFs) of the human motor system is considerably larger than the DOFs required for posture balance. The manner of managing this redundancy by the central nervous system remains unclear. To understand this phenomenon, in this study, three local inter-joint coordination pattern (IJCP) features were introduced to characterize the strength, changing velocity, and complexity of the inter-joint couplings by computing the correlation coefficients between joint velocity signal pairs. In addition, for quantifying the complexity of IJCPs from a global perspective, another set of IJCP features was introduced by performing principal component analysis on all joint velocity signals. A Microsoft Kinect depth sensor was used to acquire the motion of 15 joints of the body. The efficacy of the proposed features was tested using the captured motions of two age groups (18–24 and 65–73 years) when standing still. With regard to the redundant DOFs of the joints of the body, the experimental results suggested that an inter-joint coordination strategy intermediate to that of the two extreme coordination modes of total joint dependence and independence is used by the body. In addition, comparative statistical results of the proposed features proved that aging increases the coupling strength, decreases the changing velocity, and reduces the complexity of the IJCPs. These results also suggested that with aging, the balance strategy tends to be more joint dependent. Because of the simplicity of the proposed features and the affordability of the easy-to-use Kinect depth sensor, such an assembly can be used to collect large amounts of data to explore the potential of the proposed features in assessing the performance of the human balance control system.

Quantifying foot inter-joint coordination and variability after wearing variable stiffness foot insoles during the stance phase of running

Although foot orthotics with different stiffness is widely used for the treatment of lower extremity abnormalities and injuries, but their effect on foot coordination and variability is unclear. The purpose of present study was to investigate the effect of different stiffness of shoe orthosis on foot inter-joint coordination pattern and variability during the stance phase of running. Fifteen healthy active men volunteered to participate in this study. Coordination pattern and variability were calculated from kinematics raw data using a Continuous Relative Phase method while running with different stiffness insoles inserted in a sandal. A repeated measure of ANOVA test was performed to test the hypothesis (p < 0.05). a part of the results showed that running with hard, soft, and semi-hard increased about %95, %179, and %220 of continue relative phase inversion: eversion of the ankle and tarsometatarsal joint in first 25% of stance phase compared to no insole condition (p < 0.001). Generally, the findings show that insole stiffness may affect lower extremity mechanics by changing foot inter-joint coordination and variability. Thus, insole stiffness should be considered when specialists use the orthotic devices for treatment.

Footwear Alters Lower Extremity Coordination Variability

Footwear has been shown to have a significant effect on numerous kinematic and kinetic variables during walking and running. While footwear mass is an indisputably important influence on gait patterns, we suspected that the amount of outsole material on most footwear would likely diminish or delay the integration of tactile feedback in motor control strategies during gait. Thus, we designed this study to investigate the influence of footwear and augmented tactile feedback on lower extremity coordination patterns during walking. A secondary purpose of the study was to examine gender differences in response to altered footwear conditions. Forty-eight participants (24 male and 24 females) walked during four standardized footwear conditions (barefoot, shod, barefoot with augmented tactile feedback, and shod with augmented tactile feedback), and we collected three-dimensional kinematic data and calculated continuous relative phase values for two adjacent lower extremity joints to determine interjoint coordination patterns. We used deviation phase and the mean of the continuous relative phase to compare motor coordination patterns across conditions. We found significant footwear and gender effects for spatiotemporal variables but only significant footwear effects for motor coordination patterns. Females displayed a significantly higher cadence and shorter height-normalized stride length as compared to males. Participants displayed significantly greater thigh-shank coordination variability in the shod, as compared to the unshod, conditions. Thus, footwear results in a diminished or delayed tactile feedback that alters neuromuscular control strategies during walking.

Inter-joint coordination patterns differ between younger and older runners

Older runners are at greater risk of certain running-related injuries. Previous work demonstrated that aging influences running biomechanics, and suggest a compensatory relation between changes in the proximal and distal joints. Previous comparisons of interjoint coordination strategies between young and older runners could potentially have missed relevant differences by averaging coordination measures across time. ObjectiveTo compare coordination strategies between male runners under the age of 30 to those over the age of 60. MethodsTwelve young (22 ± 3 yrs, 1.80 ± 0.07 m, 78.0 ± 12.1 kg) and 12 older (63 ± 3 yrs, 1.78 ± 0.06 m, 73.2 ± 15.8 kg) male runners ran at 3.35 m/s on an instrumented treadmill. Ankle frontal plane, tibial transverse plane, knee sagittal plane, and hip frontal plane motion were measured. Inter-joint coordination was calculated using a modified vector coding technique. Coordination patterns and variability time series were compared between groups throughout stance using ANOVA for circular data. ResultsAt the ankle, older runners use in-phase propulsion (inversion, tibia external rotation) pattern following midstance (46–47% stance) while young runners are still in an in-phase collapse pattern (eversion, tibia external rotation). In coordination of the knee and hip, older runners maintained an in-phase collapse pattern (knee flexion, hip adduction) approaching midstance (35–37% stance), while younger runners use an out of phase strategy (knee extension, hip adduction). In coordination of the ankle and hip in the frontal plane, older runners again maintained an in phase collapse pattern up to midstance (34–39% stance), while younger runners used an out of phase strategy (ankle inversion, hip adduction). Variability was similar between age groups. ConclusionOlder runners appear to display altered coordination patterns during mid-stance, which may indicate protective biomechanical adaptations. These changes may also have implications for performance in older runners.

Inter-joint coordination changes during and after muscle fatigue

People produce multi-joint movements by organizing many degrees of freedom into a few major covarying relationships, indicating a high level of inter-joint coordination. These relationships can be identified using data decomposition analyses (e.g. principal components analysis, non-negative matrix factorization). The purpose of this study was to determine how movement coordination changes during muscle fatigue by analyzing the covariance structure of multi-joint movements. Sixteen (16) healthy adults completed a continuous, timed ratcheting task with the right arm for three 1-min intervals before, during, and after an intermittent shoulder fatigue protocol. Joint angles from the right arm and trunk were tracked for subsequent principal components analysis. Principal component waveforms were constructed from the original joint angles, and changes in the waveforms during fatigue were assessed using cross-correlations. The variance explained by the first four principal components reached a maximum of 90.5% in the second minute of the pre-test and decreased to a minimum of 86.0% in the last minute of fatigue (p = .033). In the last minute of the post-test, explained variance (87.1%) did not differ from any other pre, fatigue, or post-test time point (p > .23). These results suggest that inter-joint coordination decreased during fatigue. Changes in the movement patterns and principal component waveforms suggest that subjects adopted a more rigid movement strategy when fatigued. However, the rigid movement strategy was not observed during the post-test. The results suggest that people adopted a new pattern of inter-joint coordination while using novel kinematics.

Changes in interjoint coordination pattern in anterior cruciate ligament reconstructed knee during stair walking

Changes in interjoint coordination pattern in anterior cruciate ligament reconstructed knee during stair walking

Difference between male and female workers lifting the same relative load when palletizing boxes

A few biomechanical studies have contrasted the work techniques of female and male workers during manual material handling (MMH). A recent study showed that female workers differed from males mostly in the strategy they used to lift 15-kg boxes from the ground, especially regarding task duration, knee and back postures and interjoint coordination. However, the lifting technique difference observed in females compared to males was perhaps due to a strength differences. The objective of this study was to test whether female workers would repeat the same lifting technique with a load adjusted to their overall strength (females: 10 kg; males: 15 kg), which can be considered a “relative load” since the overall back strength of females is 2/3 that of males. The task for the participants consisted in transferring boxes from one pallet to another. A dynamic 3D linked segment model was used to estimate the net moments at L5/S1, and different kinematic variables were considered. The results showed that the biomechanics of the lifting techniques used by males and females were similar in terms of task duration and cumulative loading, but different in terms of interjoint coordination pattern. The sequential interjoint coordination pattern previously seen in females with an absolute load (15 kg) was still present with the relative load, suggesting the influence of factors more intrinsically linked to sex. Considering that the female coordination pattern likely stretched posterior passive tissues when lifting boxes from the ground, potentially leading to higher risk of injury, the reason for this sex effect must be identified so that preventive interventions can be proposed.

Lower Limb Interjoint Postural Coordination One Year after First-Time Lateral Ankle Sprain.

Longitudinal analyses of participants with a history of lateral ankle sprain are lacking. This investigation combined measures of lower limb interjoint coordination and stabilometry to evaluate static unipedal stance with the eyes open (condition 1) and closed (condition 2) in a group of participants with chronic ankle instability (CAI) compared to lateral ankle sprain "copers" (both recruited 12 months after sustaining an acute first-time lateral ankle sprain) and a group of noninjured controls. Twenty-eight participants with CAI, 42 lateral ankle sprain "copers," and 20 noninjured controls completed three 20-s single-limb stance trials in conditions 1 and 2. An adjusted coefficient of multiple determination statistic was used to compare stance limb three-dimensional kinematic data for similarity to establish patterns of interjoint coordination. The fractal dimension of the stance limb center of pressure path was also calculated. Between-group analyses revealed that participants with CAI displayed notable increases in ankle-hip linked coordination compared with both lateral ankle sprain "copers" (-0.52 (1.05) vs 0.28 (0.9), P = 0.007) and controls (-0.52 (1.05) vs 0.63 (0.64), P = 0.006) in condition 1 and compared with controls only (0.62 (1.92) vs 0.1 (1.0) P = 0.002) in condition 2. Participants with CAI also exhibited a decrease in the fractal dimension of the center-of-pressure path during condition 2 compared with both controls and lateral ankle sprain "copers." Participants with CAI present with a hip-dominant strategy of eyes-open and eyes-closed static unipedal stance. This coincided with reduced complexity of the stance limb center of pressure path in the eyes-closed condition.

Inter-joint coordination strategies during unilateral stance following first-time, acute lateral ankle sprain: A brief report

BackgroundThis investigation combined measures of inter-joint coordination and stabilometry to evaluate eyes-open (condition 1) and eyes-closed (condition 2) static unilateral stance performance in a group of participants with an acute, first-time lateral ankle sprain injury in comparison to a control group. MethodsSixty-six participants with an acute first-time lateral ankle sprain and 19 non-injured controls completed three 20-second unilateral stance task trials in conditions 1 and 2. An adjusted coefficient of multiple determination statistic was used to compare stance limb 3-D kinematic data for similarity in the aim of establishing patterns of inter-joint coordination for these groups. FindingsBetween-group analyses revealed significant differences in stance limb inter-joint coordination strategies for conditions 1 and 2. Injured participants displayed increases in ankle-hip linked coordination compared to controls in condition 1 (sagittal/frontal plane: 0.12 [0.09] vs 0.06 [0.04]; η2=.16) and condition 2 (sagittal/frontal plane: 0.18 [0.13] vs 0.08 [0.06]; η2=0.37). InterpretationParticipants with acute first-time lateral ankle sprain exhibit a hip-dominant coordination strategy for static unilateral stance compared to non-injured controls.

Effect of Concussion on Inter-joint Coordination During Divided-Attention Gait

This study investigates the effect of concussion on the inter-joint coordination of the lower extremities during walking. Gait analyses were performed on 15 young adults who had suffered a concussion and 15 matched controls while walking on level ground with and without a concurrent cognitive task. The continuous relative phase (CRP), derived from phase planes of two adjacent joints, was used to assess the inter-joint coordination. Variability of coordination was assessed using the average value of all standard deviations calculated for each data point over the stance or swing phases from all CRP curves, namely the deviation phase. The results show that subjects who had had a concussion achieved a level of performance on the concurrent cognitive task similar to that of their matched controls, but had altered gait performance. The temporal–spatial gait control and the kinematic control of each individual joint were found to be altered immediately following a concussion. Patterns of the inter-joint coordination were similar to those of normal individuals. However, greater variability of inter-joint coordination patterns was found in swing phase hip–knee coordination. Examination of the inter-joint coordination could explain the observed deviations in gait performance and joint motion of individuals who had suffered a concussion.

Arm–Trunk Coordination for Beyond-the-Reach Movements in Adults With Stroke

Background. By involving additional degrees of freedom, the nervous system may preserve hand trajectories when making pointing movements with or without trunk displacement. Previous studies indicate that the potential contribution of trunk movement to hand displacement for movements made within arm reach is neutralized by appropriate compensatory shoulder and elbow rotations. For beyond-the-reach movements, compensatory coordination is attenuated after the hand peak velocity, allowing trunk movement to contribute to hand displacement. Objective. To investigate if the timing and spatial coordination of arm and trunk movements during beyond-the-reach movements is preserved in stroke. Methods. Eleven healthy control subjects and 11 individuals with mild-to-moderate chronic unilateral hemiparesis participated. Arm and trunk kinematics during 60 target reaches to an ipsilaterally placed target were recorded. In 30% of randomly chosen trials, trunk movement was unexpectedly prevented (blocked-trunk trials) by an electromagnetic device, resulting in divergence of the hand trajectory from that in free-trunk trials. Hand trajectories and elbow–shoulder interjoint coordination were compared between trials. Results. In stroke participants, hand trajectory divergence occurred at a shorter movement extent and interjoint coordination patterns diverged at a relatively greater distance compared to controls. Thus, arm movements in stroke participants only partially compensated trunk displacement resulting in the trunk movement contributing to arm movement earlier and to a larger extent during reaching. Conclusion. Individuals with mild-to-moderate stroke have deficits in timing and spatial coordination of arm and trunk movements during different parts of a reaching movement. This deficit may be targeted in therapy to improve upper limb function.