Shorter Stride Research Articles

Effects of a vibrotactile biofeedback protocol on gait performance among older adults

Abstract Purpose Gait functions decline with aging, characterized by shorter strides, reduced hip range of motion and increased cadence and variability. Wearable biofeedback devices have been shown to improve gait, such as lengthening strides in older adults. While these devices attempted to improve the entire gait by suggesting changes in one gait parameter, it was not known if this approach could change gait patterns differently among elderly people. This study explored how a smart insole providing biofeedback on swing time only could produce different gait patterns. Methods Thirteen older adults walked on a flat walkway with and without biofeedback from a smart insole to increase the swing time. Gait analyses were recorded immediately after each condition using the GaitRite and Xsens systems. The sample was then divided into Group A (n = 7) who increased their stride length and Group B (n = 6) who did not to analyze within-group gait changes. Results Baseline analysis confirmed no significant gait differences between the two groups. Upon using the biofeedback devices, all participants increased over 5% their swing time and Group A significantly increased their hip extension (18.01%), hip flexion (5.1%) and stride length (5.5%). Conversely, the device caused Group B to significantly reduce their stride length (3.6%), velocity (13%), and increased gait variability (stance time COV 112%). Conclusions Biofeedback suggesting instant modifications in one gait parameter could produce two distinct walking patterns in participants with similar walking characteristics. Caution in biofeedback device design and gait analysis should be taken as gait outcomes could vary among users.

PSII-11 Temporal variables of the four-beat stepping gaits of the Mountain Pleasure Horse

Abstract The Mountain Pleasure Horse (MPH) is the oldest gaited horse breed in North America with genetic testing finding the breed is ancestral to all other American gaited horse breeds according to the MPH Association (MPHA). Further, the breed is classified as “threatened” according to the Livestock Conservancy with only 2,670 purebred MPHs living today. To expand numbers, the registration books for the MPHA were opened in 2009; however, 5 yr later the books were closed due to negative consequences including potential changes within the gait. Therefore, to ensure the preservation of the gait of the MPH, the objective of this study was to define the temporal variables of the four-beat stepping gaits of the purebred MPH. The six horses utilized for this study were MPHA registered with permanent registration status and were verified to be purebred using blood typing and pedigree tracing with pedigrees tracing back to the foundation sires on both sides of the pedigree as identified by the MPHA. Horses were ridden by their respective trainers at a flat walk and saddle rack following MPHA judging guidelines with those strides utilized for the study being selected by representatives of the breed association. A total of 10 strides for each horse (n = 60) for each gait were selected. Student’s paired t-tests were utilized to determine differences in temporal variables between gaits with P-value set at 0.05. Comparisons were also made within gaits using student’s paired t-test to determine differences between lateral and diagonal variables. Both gaits had a lateral footfall pattern that alternated between bipedal and tripedal support. The saddle rack was performed at a faster velocity than the walk with a longer stride length and shorter stride and stance durations (Table 1). Advanced placements and bipedal support were similar between gaits with lateral and diagonal variables similar within gaits (Flat Walk Lateral-Diagonal Comparisons: Advanced Placement; P = 0.31, Bipedal Support; P = 0.08; Saddle Rack Lateral-Diagonal Comparisons: Advanced Placement; P = 0.23, Bipedal Support; P = 0.11), thus, indicating the gaits had a regular rhythm with no couplets. These variables assist in distinguishing between the gaits of the MPH and between those performed by other gaited horse breeds.

Production of Spinocerebellar Ataxia Type 3 Model Mice by Intravenous Injection of AAV-PHP.B Vectors.

We aimed to produce a mouse model of spinocerebellar ataxia type 3 (SCA3) using the mouse blood-brain barrier (BBB)-penetrating adeno-associated virus (AAV)-PHP.B. Four-to-five-week-old C57BL/6 mice received injections of high-dose (2.0 × 1011 vg/mouse) or low-dose (5.0 × 1010 vg/mouse) AAV-PHP.B encoding a SCA3 causative gene containing abnormally long 89 CAG repeats [ATXN3(Q89)] under the control of the ubiquitous chicken β-actin hybrid (CBh) promoter. Control mice received high doses of AAV-PHP.B encoding ATXN3 with non-pathogenic 15 CAG repeats [ATXN3(Q15)] or phosphate-buffered saline (PBS) alone. More than half of the mice injected with high doses of AAV-PHP.B encoding ATXN3(Q89) died within 4 weeks after the injection. No mice in other groups died during the 12-week observation period. Mice injected with low doses of AAV-PHP.B encoding ATXN3(Q89) exhibited progressive motor uncoordination starting 4 weeks and a shorter stride in footprint analysis performed at 12 weeks post-AAV injection. Immunohistochemistry showed thinning of the molecular layer and the formation of nuclear inclusions in Purkinje cells from mice injected with low doses of AAV-PHP.B encoding ATXN3(Q89). Moreover, ATXN3(Q89) expression significantly reduced the number of large projection neurons in the cerebellar nuclei to one third of that observed in mice expressing ATXN3(Q15). This AAV-based approach is superior to conventional methods in that the required number of model mice can be created simply by injecting AAV, and the expression levels of the responsible gene can be adjusted by changing the amount of AAV injected. Moreover, this method may be applied to produce SCA3 models in non-human primates.

Gait abnormalities in older adults with transthyretin cardiac amyloidosis

Background Transthyretin cardiac amyloidosis (ATTR cardiac amyloidosis) is caused by variant (ATTRv) or wild type (ATTRwt) transthyretin. While gait abnormalities have been studied in younger patients with ATTRv amyloidosis, research on gait in older adults with ATTR cardiac amyloidosis is lacking. Given ATTR cardiac amyloidosis’ association with neuropathy and orthopedic manifestations, we explore the gait in this population. Methods Twenty-eight older male ATTR cardiac amyloidosis patients and 11 healthy older male controls walked overground with and without a dual cognitive task. Gait parameters: stride width, length, velocity and stance time percentage were measured using an instrumented mat. ATTR amyloidosis patients were further categorized based on clinical and functional assessments. Results We found significant gait differences between ATTR cardiac amyloidosis patients and healthy controls; patients had more variable, slower, narrower and shorter strides, with their feet spending more time in contact with the ground as opposed to in swing. However, the observed gait differences did not correlate with clinical and functional measures of ATTR cardiac amyloidosis severity. Conclusions Our results suggest that gait analysis could be a complementary tool for characterizing ATTR cardiac amyloidosis patients and may inform clinical care as it relates to falls, management of anticoagulation, and functional independence.

Gait Analysis and Functional Knee Scores in Primary Knee Osteoarthritis and Their Correlation with Progression of the Disease in the Indian Population.

Osteoarthritis of the knee is a leading cause of disability and is a multi-factorial disease. Moreover, it is partly considered a mechanically driven disease in which higher abnormally disbursed forces play a prime role. With the progression of the disease, the gait function declines, so a comprehensive and objective evaluation of gait function would help in prognostic evaluation and management. This study included two groups: patients with primary knee osteoarthritis and a control group of healthy volunteers. Gait analysis and functional knee scores were evaluated for all the subjects. The KOOS score, temporal parameters excluding the step length, and spatial parameters excluding the stance phase percentage were evaluated for an individual as a whole. The KSS score, kinetic parameters, kinematic parameters, step length, and stance phase percentage were calculated for each knee separately. Each knee of the patient and controls was taken as 1 sample and categorized as per Kellgren-Lawrence score. An asymptomatic control group of subjects were included in group A. Symptomatic patients with KL grades 1, 2 were included in group M, and those with KL grades 3, 4 were included in group S. The kinetic and kinematic parameters and KSS score were compared among the three groups. A total of 60 subjects were included of which 40 were patients and 20 were controls. In the control group, the age ranged from 22 to 48 years with a mean age of 28.6 years. In the patient group, the mean age was 60.3 years. Patients with knee osteoarthritis were significantly obese with slower walking speed, short stride length, longer stride time, and decreased cadence compared to the asymptomatic group. There was a significant difference in spatiotemporal parameters, functional scores, and kinetic and kinematic parameters among the groups. Various spatiotemporal, kinetic, and kinematic parameters like peak knee flexion angle, abduction/adduction angle, peak knee adduction moment, range of knee flexion, peak knee flexion, and gait deviation index along with functional scores varied significantly with the progression of the disease. The online version contains supplementary material available at 10.1007/s43465-024-01103-9.

Gait Characterization in Duchenne Muscular Dystrophy (DMD) Using a Single-Sensor Accelerometer: Classical Machine Learning and Deep Learning Approaches.

Differences in gait patterns of children with Duchenne muscular dystrophy (DMD) and typically developing (TD) peers are visible to the eye, but quantifications of those differences outside of the gait laboratory have been elusive. In this work, we measured vertical, mediolateral, and anteroposterior acceleration using a waist-worn iPhone accelerometer during ambulation across a typical range of velocities. Fifteen TD and fifteen DMD children from 3 to 16 years of age underwent eight walking/running activities, including five 25 m walk/run speed-calibration tests at a slow walk to running speeds (SC-L1 to SC-L5), a 6-min walk test (6MWT), a 100 m fast walk/jog/run (100MRW), and a free walk (FW). For clinical anchoring purposes, participants completed a Northstar Ambulatory Assessment (NSAA). We extracted temporospatial gait clinical features (CFs) and applied multiple machine learning (ML) approaches to differentiate between DMD and TD children using extracted temporospatial gait CFs and raw data. Extracted temporospatial gait CFs showed reduced step length and a greater mediolateral component of total power (TP) consistent with shorter strides and Trendelenberg-like gait commonly observed in DMD. ML approaches using temporospatial gait CFs and raw data varied in effectiveness at differentiating between DMD and TD controls at different speeds, with an accuracy of up to 100%. We demonstrate that by using ML with accelerometer data from a consumer-grade smartphone, we can capture DMD-associated gait characteristics in toddlers to teens.

Age and beta amyloid deposition impact gait speed, stride length, and gait smoothness while transitioning from an even to an uneven walking surface in older adults

BackgroundCapturing a measure of movement quality during a complex walking task may indicate the earliest signs of detrimental changes to the brain due to beta amyloid (Aβ) deposition and be a potential differentiator of older adults at elevated and low risk of developing Alzheimer's disease. This study aimed to determine: 1) age-related differences in gait speed, stride length, and gait smoothness while transitioning from an even to an uneven walking surface, by comparing young adults (YA) and older adults (OA), and 2) if gait speed, stride length, and gait smoothness in OA while transitioning from an even to an uneven walking surface is influenced by the amount of Aβ deposition present in an OA's brain. MethodsParticipants included 56 OA (>70 years of age) and 29 YA (25–35 years of age). In OA, Aβ deposition in the brain was quantified by PET imaging. All participants completed a series of cognitive assessments, a functional mobility assessment, and self-report questionnaires. Then participants performed two sets of walking trials on a custom-built walkway containing a mixture of even and uneven surface sections, including three trials with a grass uneven surface and three trials with a rocks uneven surface. Gait data were recorded using a wireless inertial measurement unit system. Stride length, gait speed, and gait smoothness (i.e., log dimensionless lumbar jerk) in the anteroposterior (AP), mediolateral (ML), and vertical (VT) directions were calculated for each stride. Outcomes were retained for five stride locations immediately surrounding the surface transition. ResultsOA exhibited slower gait (Grass: p < 0.001; Rocks: p = 0.006), shorter strides (Grass: p < 0.001; Rocks: p = 0.008), and smoother gait (Grass AP: p < 0.001; Rocks AP: p = 0.002; Rocks ML: p = 0.02) than YA, but they also exhibited greater reductions in gait speed and stride length than YA while transitioning to the uneven grass and rocks surfaces. Within the OA group, those with greater Aβ deposition exhibited decreases in smoothness with age (Grass AP: p = 0.02; Rocks AP: p = 0.03; Grass ML: p = 0.04; Rocks ML: p = 0.03), while those with lower Aβ deposition exhibited increasing smoothness with age (Grass AP: p = 0.01; Rocks AP: p = 0.02; Grass ML: p = 0.08; Rocks ML: p = 0.07). Better functional mobility was associated with less smooth gait (Grass ML: p = 0.02; Rocks ML: p = 0.05) and with less variable gait smoothness (Grass and Rocks AP: both p = 0.04) in the OA group. ConclusionThese results suggest that, relative to YA, OA may be adopting more cautious, compensatory gait strategies to maintain smoothness when approaching surface transitions. However, OA with greater Aβ deposition may have limited ability to adopt compensatory gait strategies to increase the smoothness of their walking as they get older because of neuropathological changes altering the sensory integration process and causing worse dynamic balance (i.e., jerkier gait). Functional mobility, in addition to age and Aβ deposition, may be an important factor of whether or not an OA chooses to employ compensatory strategies to prioritize smoothness while walking and what type of compensatory strategy an OA chooses.

Fibrodysplasia ossificans progressiva caused by a different mutation in a stray cat

AbstractA 2‐year‐old, unneutered, female, short‐haired stray cat was referred for general examination. A physical examination revealed gait abnormalities characterised by short strides and stiffness in all limbs. Radiographs showed malformations with excessive mineralisation affecting the shoulders and stifle joints. To confirm the diagnosis of fibrodysplasia ossificans progressiva, total RNA was isolated from blood samples of the cats (one cat with fibrodysplasia ossificans progressiva and one healthy cat). A single missense mutation was found in the coding sequence of the ACVR1 gene of the cat with fibrodysplasia ossificans progressiva. In this mutation, a single base was changed from guanine to cytosine. After this base change, the amino acid tryptophan replaced the amino acid cysteine. This is the first report that indicates cats with fibrodysplasia ossificans progressiva that do not show signs similar to the characteristic findings in humans have a different mutation.

Reversible Neurotoxicity Due To Excessive Use of Ethyl Chloride

BackgroundEthyl chloride is commercially available as a DVD/VCR cleaner, and can be found as a gasoline additive and topical anesthetic. There is an emerging trend of recreational huffing to enhance sexual relations. Neurotoxicity from repeated abuse is uncommon. Case ReportA 36-year-old man with a history of intermittent ethyl chloride use for 15 years presented to the Emergency Department with an inability to walk for 4 days after frequent use for 1 week. The patient reported a rapid titration of inhalation from zero to eight cans of 4.6 oz ethyl chloride aerosol per day over a 1-week period. Initial vital signs were heart rate 88 beats/min, blood pressure 147/60 mm Hg, temperature 37.2°C (99°F), and respiratory rate 16 breaths/min. Physical examination was notable for slurred speech, ptosis, a wide-based and ataxic gait with short strides, inability to stand without support, loss of toe/finger proprioception, horizontal and vertical nystagmus, and dysmetria on coordination testing. Strength and sensation were preserved. His work-up included computed tomography and magnetic resonance imaging of the brain, cervical, thoracic, and lumbar spine that demonstrated no acute abnormalities. On hospital day 9, the patient was able to ambulate with mild difficulty. Why Should an Emergeny Physician Be Aware of This?Toxicity from excessive ethyl chloride huffing has been rarely reported. The toxicity was characterized with cerebellar findings, no attributable laboratory abnormalities, and no radiographic abnormalities on computed tomography/magnetic resonance imaging. The neurotoxicity resolved with supportive care.This case of excessive huffing of ethyl chloride presenting with neurotoxicity and ataxia further characterizes a rare complication of ethyl chloride toxicity that is gaining popularity.

Acclimatization of force production during walking in persons with Parkinson's disease

Individuals with Parkinson’s disease walk slowly, with short strides resulting in decreased mobility. Treadmill walking assessments are utilized to understand gait impairment in persons with Parkinson’s disease and treadmill-based interventions to mobility have become increasingly popular. While walking on a treadmill, there is a reported initial acclimatization period where individuals adjust to the speed and dynamics of the moving belt before producing consistent walking patterns. It is unknown how much walking time is required for individuals with Parkinson’s disease to acclimate to the treadmill. We investigated how spatiotemporal parameters and ground reaction forces changed during treadmill acclimatization. Twenty individuals with idiopathic Parkinson’s (15 Males, 5 Females) walked for a five-minute treadmill session on an instrumented treadmill while motion capture data were collected. The measures of interest included ground reaction force measures (peak propulsive force, peak braking force, propulsive impulse, and braking impulse) and spatiotemporal measures (stride length, stride time, or double support time). Analyses demonstrated significantly increased propulsive impulse (p <.001) after the first minute, with no significant difference for the remaining minutes (p ≥ 0.395). There were no significant changes in the spatiotemporal measures (P =.065). These results quantify the stabilization of ground reaction force during the treadmill acclimatization period. Based on our findings, if steady-state gait is desired, we recommend participants walk for at least two minutes before data collection. Future clinical investigations should consider ground reaction force as sensitive parameters for evaluating gait in persons with Parkinson’s disease in treadmill-based assessments or interventional therapies.

The impact of obesity on static and proactive balance and gait patterns in sarcopenic older adults: an analytical cross-sectional investigation.

Obesity is increasingly recognized as a significant factor in the susceptibility of older adults to falls and related injuries. While existing literature has established a connection between obesity and reduced postural stability during stationary stances, the direct implications of obesity on walking dynamics, particularly among the older adults with sarcopenia, are not yet comprehensively understood. Firstly, to investigate the influence of obesity on steady-state and proactive balance, as well as gait characteristics, among older adults with sarcopenic obesity (SO); and secondly, to unearth correlations between anthropometric characteristics and balance and gait parameters in the same demographic. A cohort of 42 participants was categorized into control (CG; n = 22; age = 81.1 ± 4.0 years; BMI = 24.9 ± 0.6 kg/m²) and sarcopenic obese (SOG; n = 20; age = 77.7 ± 2.9 years; BMI = 34.5 ± 3.2 kg/m²) groups based on body mass index (BMI, kg/m²). Participants were assessed for anthropometric data, body mass, fat and lean body mass percentages (%), and BMI. Steady-state balance was gauged using the Romberg Test (ROM). Proactive balance evaluations employed the Functional Reach (FRT) and Timed Up and Go (TUG) tests. The 10-m walking test elucidated spatiotemporal gait metrics, including cadence, speed, stride length, stride time, and specific bilateral spatiotemporal components (stance, swing, 1st and 2nd double support, and single support phases) expressed as percentages of the gait cycle. The time taken to complete the TUG and ROM tests was significantly shorter in the CG compared to the SOG (p < 0.05). In contrast, the FRT revealed a shorter distance achieved in the SOG compared to the CG (p < 0.05). The CG exhibited a higher gait speed compared to the SOG (p < 0.05), with shorter stride and step lengths observed in the SOG compared to the CG (p < 0.05). Regarding gait cycle phases, the support phase was longer, and the swing phase was shorter in the SOG compared to the CG group (p < 0.05). LBM (%) showed the strongest positive correlation with the ROM (r = 0.77, p < 0.001), gait speed (r = 0.85, p < 0.001), TUG (r = -0.80, p < 0.001) and FRT (r = 0.74, p < 0.001). Obesity induces added complexities for older adults with sarcopenia, particularly during the regulation of steady-state and proactive balance and gait. The percentage of lean body mass has emerged as a crucial determinant, highlighting a significant impact of reduced muscle mass on the observed alterations in static postural control and gait among older adults with SO.

Locomotory Profiles in Thoroughbreds: Peak Stride Length and Frequency in Training and Association with Race Outcomes.

Racehorses competing in short (i.e., 'sprinters'), middle- or longer-distance (i.e., 'stayers') flat races are assumed to have natural variation in locomotion; sprinters having an innately shorter stride than stayers. No study has objectively tested this theory. Here, racehorses (n = 421) were categorised as sprinters, milers or stayers based on known race distance (n = 3269 races). Stride parameters (peak length and frequency) of those racehorses were collected from prior race-pace training sessions on turf (n = 2689; 'jumpout', n = 1013), using a locomotion monitoring device. Pedigree information for all 421 racehorses was extracted to three-generations. In training, sprinters had a shorter stride of higher frequency and covered consecutive furlongs faster than stayers (p &lt; 0.001). Relatively short or longer stride did not predict race success, but stayers had greater race success than sprinters (p &lt; 0.001). Peak stride length and frequency were moderately heritable (h2 = 0.15 and 0.20, respectively). In conclusion, differences in stride were apparent between sprinters and stayers (e.g., shorter stride in sprinters) during routine training, even after accounting for their pedigree. Objective data on stride characteristics could supplement other less objectively obtained parameters to benefit trainers in the appropriate selection of races for each individual racehorse.

Variability and symmetry of gait kinematics under dual-task performance of older patients with depression

BackgroundDepression in old age is associated with an increased fall risk. Especially in cognitively challenging situations, fall-promoting gait deviations could appear due to depression- and age-related cognitive deficits.AimThis study investigates (i) whether there are differences in gait performance between depressed older patients and healthy controls and (ii) if gait patterns aggravate when performing a cognitive task whilst walking.Methods16 depressed older patients (mean age: 73.1 ± 5.8 years) and 19 healthy controls (mean age: 73.3 ± 6.1 years) were included in the study. Spatiotemporal gait parameters (speed, stride length, swing time) and minimum toe clearance were recorded using a three-dimensional motion-capture system under a single- and a dual-task condition (counting backwards).ResultsAfter Bonferroni correction, depressed older patients showed significantly slower walking speed, shorter strides and smaller minimum toe clearance, as well as greater variability in stride length than healthy controls. Under the dual-task, gait performance deteriorated compared with single-task, with slower gait speed, shorter strides, and longer swing time.DiscussionSlower walking speed and shorter steps of depressed patients may be a strategy to counteract their fall risk. Increased variability suggests a less stable gait pattern in patients, which could be a reason for their increased fall risk.ConclusionsDepression in old age has a strong effect on gait performance. Possible interventions that might prevent falls in this vulnerable group are discussed. The study was registered at Open Science Framework on May 18, 2021 (publicly accessible May 30, 2023).

57-Year-Old Man With Headache, Vomiting, and Gait Instability

57-Year-Old Man With Headache, Vomiting, and Gait Instability

Association Between Gait and Dysautonomia in Patients With De Novo Parkinson's Disease: Forward Gait Versus Backward Gait.

Studies on gait and autonomic dysfunction have been insufficient so far, particularly de novo Parkinson's disease (PD). The aim of this study was to identify the association between gait dynamics and autonomic dysfunction in patients with de novo PD. A total 38 patients with de novo PD were retrospectively included in this study. Details of patients' dysautonomia were assessed using the Scales for Outcomes in Parkinson's Disease-Autonomic Dysfunction (SCOPA-AUT). For assessment of gait, a computerized gait analysis was performed using the GAITRite system for forward gait and backward gait. High SCOPA-AUT score (PD-HSAS) group and low SCOPA-AUT score (PD-LSAS) group were identified according to their SCOPA-AUT scores. Nineteen (50%) patients with high SCOPA-AUT scores above median value (12.5) were assigned into the PD-HSAS group and others were assigned to the PD-LSAS group. Compared with the PD-LSAS group, the PD-HSAS group exhibited slower gait, shorter stride, decreased cadence, increased double support phase, decreased swing phase, and increased variability in swing time. Total SCOPA-AUT score showed significantly positive correlations with gait variability and instability but a negative correlation with gait hypokinesia. In subdomain analysis, urinary dysautonomia was highly associated with impairment of gait dynamics. All significant results were found to be more remarkable in backward gait than in forward gait. Our findings suggest that alteration in gait dynamics, especially backward gait, is highly associated with autonomic dysfunction in patients with de novo PD.

Parkinson’s disease multimodal complex treatment improves gait performance: an exploratory wearable digital device-supported study

BackgroundWearable device-based parameters (DBP) objectively describe gait and balance impairment in Parkinson’s disease (PD). We sought to investigate correlations between DBP of gait and balance and clinical scores, their respective changes throughout the inpatient multidisciplinary Parkinson’s Disease Multimodal Complex Treatment (PD-MCT), and correlations between their changes.MethodsThis exploratory observational study assessed 10 DBP and clinical scores at the start (T1) and end (T2) of a two-week PD-MCT of 25 PD in patients (mean age: 66.9 years, median HY stage: 2.5). Subjects performed four straight walking tasks under single- and dual-task conditions, and four balance tasks.ResultsAt T1, reduced gait velocity and larger sway area correlated with motor severity. Shorter strides during motor-motor dual-tasking correlated with motor complications. From T1 to T2, gait velocity improved, especially under dual-task conditions, stride length increased for motor-motor dual-tasking, and clinical scores measuring motor severity, balance, dexterity, executive functions, and motor complications changed favorably. Other gait parameters did not change significantly. Changes in motor complications, motor severity, and fear of falling correlated with changes in stride length, sway area, and measures of gait stability, respectively.ConclusionDBP of gait and balance reflect clinical scores, e.g., those of motor severity. PD-MCT significantly improves gait velocity and stride length and favorably affects additional DBP. Motor complications and fear of falling are factors that may influence the response to PD-MCT. A DBP-based assessment on admission to PD inpatient treatment could allow for more individualized therapy that can improve outcomes.Trial registration number and dateDRKS00020948 number, 30-Mar-2020, retrospectively registered.

Enlarged Perivascular Spaces in the Basal Ganglia Independently Related to Gait Disturbances in Older People With Cerebral Small Vessel Diseases.

Background and ObjectiveGait disturbances are common in older people and are associated with adverse consequences, e.g., falls and institutionalization. Enlarged perivascular spaces in the basal ganglia (BG-EPVS) are considered an magnetic resonance imaging (MRI) marker of cerebral small vessel diseases (CSVD). However, the consequences of BG-EPVS are largely unknown. Previous studies showed that other CSVD markers were related to gait disturbances. However, the relation between BG-EPVS and gait performance is unclear. Therefore, we aimed to explore the relation between BG-EPVS and gait performance in elderly individuals.MethodsWe recruited older people with CSVD in the Neurology Department of our hospital from December 1, 2020 to October 31, 2021. Participants with BG-EPVS > 20 on the unilateral side of the basal ganglia slice containing the maximum number were classified into the BG-EPVS group (n = 78), and the rest were classified into the control group (n = 164). Quantitative gait parameters and gait variability were provided by the Intelligent Device for Energy Expenditure and Activity (IDEEA; MiniSun, United States) gait analysis system. Semiquantitative gait assessment was measured with the Tinetti test. Point-biserial correlation and multivariate linear regression analysis were performed to investigate the association between BG-EPVS and gait performance.ResultsThe BG-EPVS group had a slower gait speed and cadence, shorter stride length, longer stance phase percentage, smaller pre-swing angle and footfall, and lower Tinetti gait test and balance test scores compared with those in the control group (P < 0.05). There were no statistical differences in stride length variability and stride time variability between the two groups (P > 0.05). A correlation analysis showed that BG-EPVS were negatively related to gait speed, cadence, stride length, pre-swing angle, and footfall (γrange = −0.497 to −0.237, P < 0.001) and positively related to stance phase percentage (γ = 0.269, P < 0.001). BG-EPVS was negatively related to the score of the Tinetti gait test (γ = −0.449, P < 0.001) and the balance test (γ = −0.489, P < 0.001). The multiple linear regression analysis indicated that BG-EPVS was an independent risk factor for gait disturbances and poor balance after adjusting for confounders, including other CSVD markers.ConclusionLarge numbers of BG-EPVS were independently related to gait disturbances in older people with CSVD. This finding provides information about the consequences of BG-EPVS and risk factors for gait disturbances.

Pseudoscorpions tweak quartet footfalls when hanging, reversing and simply moving forward

Open a book in a dusty library and you might be in for a shock if a pseudoscorpion jumps out. Yet these mini arachnids pose no threat, even though they are equipped with the most fearsome pair of pincers. Instead, they subdue and dine on mites, booklice and larvae, and hitch rides on larger insects over long distances. For most shorter journeys, pseudoscorpions are equipped with four pairs of legs, yet no one knew how the tiny arthropods coordinate all eight limbs while moving forward, backward and even upside-down. ‘They are capable of locomotion on many different surfaces and substrates’, says Johanna Tross from Ulm University, Germany, so she, Sarah Pfeffer and Torben Stemme (both from University of Ulm) decided to scrutinise the manoeuvres of house pseudoscorpions (Chelifer cancroides).‘Torben Stemme caught the pseudoscorpions in an old hayloft in his parents’ garden’, says Tross, who kept the arachnids alive in the lab by feeding them leaf lice. Then, she and Pfeffer measured the insect's proportions, revealing that the impressive claws were approximately 25% longer (∼3.9 mm) than the pseudoscorpions’ body length (∼3.1 mm). ‘These oversized claws fascinated us’, says Tross. And when she and Pfeffer filmed the animals scurrying around an enclosure, the pseudoscorpions preferred to hug the walls, walking at speeds of 14 m or ∼4200 body lengths per hour – the equivalent of a brisk human walk. The dashing animals also appeared to take brief pauses as they scampered along – so brief they were barely perceptible (100–200 ms) – probably to allow them to take stock of their surroundings with their sensitive claws as their vision is so poor.But what about the fine details of the pseudoscorpion's nimble footwork? This time, Pfeffer and Tross used Harald Wolf's Ulm University high-speed camera to film 65 arachnids as they walked forward and backward along an aluminium channel, as well as upside down on a piece of Perspex placed across the top of the channel. Impressively, the animals were 33% faster (∼40 mm s−1) when going backwards than when travelling forward (∼30 mm s−1), probably because the animals reverse when making a hasty exit, holding their claws wide ready to attack. And when the team analysed the creatures’ footfall patterns, it was clear that they kept four feet in contact with the ground most of the time, alternating between one quartet of limbs – the first and third on one side and the second and fourth on the other – and the opposite quartet as they scampered along. In fact, the pseudoscorpions rarely deviated from this basic footfall pattern, no matter how fast they moved, in which direction and whether they were suspended from above, unlike humans and four-legged creatures, which switch gaits from running, walking and trotting to galloping as they shift up through the gears.However, the amount of time the pseudoscorpions’ feet remained in contact with the ground, and how well coordinated they were, varied depending on where and in which direction the animals were moving. The leg quartets were the most coordinated when walking forward, while the upside-down pseudoscorpions kept their feet in contact with the surface they were suspended from almost three times longer and took shorter strides. It was also apparent that the second pair of limbs is crucial for the creatures’ stability, remaining in contact with the surface longest, especially when they are clinging upside-down.So, pseudoscorpions stick with the same basic footfall pattern, regardless of how fast or in which direction or dimension they are moving in, but tweak how long they remain in contact for stability and stickability.

Cardiovascular and locomotory parameters during training in Thoroughbred racehorses: a multi-national study

Studies assessing concurrent speed, cardiovascular physiology and biomechanical parameters in racehorses during training have been rarely reported, mostly due to a lack of available comprehensive technology. Here, using a validated device (the ‘Equimetre’™) that records all parameters simultaneously, we report the effect of increased training speed and thus intensity, from slow canter to hard gallop, on racehorse heart rate, heart rate recovery and on biomechanical parameters, such as stride length and frequency. We also demonstrate the effects of varying track surface, horse age and sex. Cohorts comprised a total of 509 Thoroughbred racehorses in-training in either Australia or France, completing a total of 1,124 and 6,016 training sessions, respectively. Horses varied by age (2-9 years old) and sex (including geldings) and were trained by either a single trainer (Australia) or two trainers (France); both using multiple training centres that varied by track surface (sand, turf or fibre). Data were analysed using Analysis of Variation (ANOVA) or linear mixed-effect models as appropriate. Racehorses increased speed predominantly by an increment in stride length, then frequency, both of which varied according to track surface (shorter stride on sand; P&lt;0.001). Cardiovascular parameters (peak, and recovery of, heart rate) increased with training intensity, but not linearly (P trend&lt;0.001). Older horses recorded lower heart rate at 15 mins after training (P=0.002), often due to lower achieved peak heart rate at most training intensities (P&lt;0.001 for the cohort in Australia). In conclusion, this immersive field study demonstrates the value of technology for recording physiological and biomechanical parameters of racehorses-in-training. The data could inform trainers, jockeys and owners on aspects of individual racehorse health, welfare and suitability for certain races.

Longitudinal relationships between disability and gait characteristics in people with MS

Longitudinal data are vital in order to understand intra individual gait changes with the progression of multiple sclerosis (MS). Therefore, the primary aim of this study was to explore the relationship between changes in disability with changes in major spatio-temporal parameters of gait in people with MS (PwMS). PwMS (n = 83) completed two gait assessments performed at separate time points (M1, M2). For each individual, the absolute difference between the Expanded Disability Status Scale (EDSS) score, key spatio-temporal parameters of gait, Falls Efficacy Scale International (FES-I), and the 12-item Multiple Sclerosis Walking Scale (MSWS-12), were calculated. The mean time difference between M1 and M2 was 2.5 (SD = 1.7) years. At M2, PwMS presented with shorter strides, a wider base of support, increased perceived mobility difficulties and fear of falling compared with M1. According to the odds ratio (OR) analysis, the odds of experiencing an increase in the EDSS score was significantly higher once the MSWS-12 score increased at M2 compared with M1 (OR = 7.930, p = 0.004). This observation was highlighted specifically in people with mild-moderate MS (OR = 12.427, p < 0.001). The increase in the EDSS score was not associated with changes in key spatio-temporal parameters of gait. The present study provides a better understanding of gait and disease progression in PwMS, highlighting the significant role of the MSWS-12.