Step Asymmetry Research Articles

Serial engagement of distinct motor learning mechanisms to alter walking after stroke

This study asked if combining different motor learning mechanisms—adaptation and reinforcement—could produce immediate improvements in over ground walking after stroke. Fifteen adults with stroke engaged in three conditions: (1) reinforcement following adaptation, (2) reinforcement alone, and (3) adaptation alone. Adaptation involved split-belt treadmill walking to produce after-effects that reduce step asymmetry. Reinforcement involved the use of real-time auditory feedback about step length asymmetry. Auditory feedback was binary, signaling whether steps were asymmetric or equal, but not whether to shorten or lengthen either step. Change in step length asymmetry was the outcome assessed during over ground walking. Reinforcement following adaptation led to reductions in step length asymmetry that persisted into an immediate retention period. Importantly, it led to the desired pattern of lengthening the shorter step in a majority of participants. Reinforcement alone led to no significant change in step length asymmetry, and sometimes produced a non-optimal pattern of shortening the longer step. Our control condition of adaptation alone led to more transient reductions in step length asymmetry. These findings reveal the potential for utilizing serial delivery of adaptation and reinforcement to influence a complex movement in the real-world context of over ground walking, in people with stroke.

Enhancing hoof health and locomotion in crossbred dairy cows: impact of recycled manure solids bedding on lameness incidence and gait kinematics.

Recycled manure solids has emerged as a promising alternative for animal bedding, owing to its economic feasibility, ready availability on farms, and soft, non-abrasive nature. This research aimed to assess the impact of recycled manure solids (RMS) bedding, combined with a conditioner containing 7.5% lime and 6% sodium hydrosulphate, on dairy cow welfare and gait kinematics over three months. Hock and knee injury scores, lameness incidence, and gait kinematic parameters were evaluated for animals housed on cement flooring (Control), RMS bedding (Treatment I), and conditioner-added RMS bedding (Treatment II) on days 0, 45, and 90 of the experiment with six crossbred cows in each group. The results revealed a significant reduction (p < 0.05) in lameness scores (5-point scale) for animals in both the RMS and conditioner-added RMS groups, with scores of 1.09 ± 0.05 and 1.04 ± 0.03, respectively, compared to those on cement floors. Moreover, a noteworthy decrease (p < 0.05) in knee and hock injury scores (4-point scale) was observed in the RMS groups, indicating a potentially positive impact on joint health. Gait kinematic analysis demonstrated that animals in the RMS (1.03 ± 0.04m/s) and conditioner-added RMS (1.02 ± 0.06m/s) groups exhibited higher walking speeds and increased step angles (158.59 ± 4.82° and 149.58 ± 3.85°) compared to their cement-floor counterparts. No significant changes (p > 0.05) were observed in stride length, step asymmetry, step length, and step width. The study concluded that the conditioner incorporated recycled manure solids resulting in a substantial decrease in lameness incidence and a reduction in hock and knee injuries among dairy cows. Additionally, the improved gait kinematics observed in non-lame animals suggest that this bedding combination positively influences overall animal well-being. These findings underscore the potential of sustainable bedding practices to enhance both physical health and locomotor behaviour in dairy cattle.

Spatiotemporal Gait Differences before and after Botulinum Toxin in People with Focal Dystonia: A Pilot Study.

The impact of focal dystonia on gait has attracted little attention and remains elusive. Considering the importance of both visual and head control in gait, blepharospasm and cervical dystonia should affect gait. Improvement of cervical/eyelid control following botulinum toxin (BTX) injections would translate into gait changes. To assess gait differences in people with focal dystonia before and after BTX treatment. Ten patients with blepharospasm, 10 patients with cervical dystonia, and 20 healthy age- and gender-matched controls were included. Gait was assessed before and 1-month after BTX injections using Biodex Gait Trainer™ 3. Gait velocity, cadence, step length, step asymmetry, and variability of step length were compared between patients and controls, and between the two time-points using non-parametric statistics. At baseline, compared to controls, cervical dystonia patients showed reduced gait velocity, step length, and cadence. After BTX injections, while gait velocity and step length were significantly increased and step length variability reduced, gait parameters still differed between patients and controls. In blepharospasm patients, baseline gait velocity and step length were significantly smaller than in controls. After BTX injections, these gait parameters were significantly increased and variability decreased, so that patients no longer differed from controls. Gait differences exist between patients with focal dystonia not directly affecting the lower limbs and healthy controls. These gait abnormalities were improved differently by BTX treatment according to the type of dystonia. These disparities suggest different pathophysiological mechanisms and support the need for changes in rehabilitation routines in cervical dystonia.

Enhanced motor learning and motor savings after acute intermittent hypoxia are associated with a reduction in metabolic cost.

Breathing mild bouts of low oxygen air (i.e. acute intermittent hypoxia, AIH) has been shown to improve locomotor function in humans after a spinal cord injury. How AIH-induced gains in motor performance are achieved remains unclear. We examined the hypothesis that AIH augments motor learning and motor retention during a locomotor adaptation task. We further hypothesized that gains in motor learning and retention will be associated with reductions in net metabolic power, consistent with the acquisition of energetically favourable mechanics. Thirty healthy individuals were randomly allocated into either a control group or an AIH group. We utilized a split-belt treadmill to characterize adaptations to an unexpected belt speed perturbation of equal magnitude during an initial exposure and a second exposure. Adaptation was characterized by changes in spatiotemporal step asymmetry, anterior-posterior force asymmetry, and net metabolic power. While both groups adapted by reducing spatial asymmetry, only the AIH group achieved significant reductions in double support time asymmetry and propulsive force asymmetry during both the initial and the second exposures to the belt speed perturbation. Net metabolic power was also significantly lower in the AIH group, with significant reductions from the initial perturbation exposure to the second. These results provide the first evidence that AIH mediates improvements in both motor learning and retention. Further, our results suggest that reductions in net metabolic power continue to be optimized upon subsequent learning and are driven by more energetically favourable temporal coordination strategies. Our observation that AIH facilitates motor learning and retention can be leveraged to design rehabilitation interventions that promote functional recovery. KEY POINTS: Brief exposures to low oxygen air, known as acute intermittent hypoxia (AIH), improves locomotor function in humans after a spinal cord injury, but it remains unclear how gains in motor performance are achieved. In this study, we tested the hypothesis that AIH induces enhancements in motor learning and retention by quantifying changes in interlimb coordination, anterior-posterior force symmetry and metabolic cost during a locomotor adaptation task. We show the first evidence that AIH improves both motor learning and savings of newly learned temporal interlimb coordination strategies and force asymmetry compared to untreated individuals. We further demonstrate that AIH elicits greater reductions in metabolic cost during motor learning that continues to be optimized upon subsequent learning. Our findings suggest that AIH-induced gains in locomotor performance are facilitated by enhancements in motor learning and retention of more energetically favourable coordination strategies.

Feasibility of a Novel Therapist-Assisted Feedback System for Gait Training in Parkinson's Disease.

We tested the feasibility of one session of treadmill training using a novel physical therapist assisted system (Mobility Rehab) using wearable sensors on the upper and lower limbs of 10 people with Parkinson's disease (PD). Participants performed a 2-min walk overground before and after 15 min of treadmill training with Mobility Rehab, which included an electronic tablet (to visualize gait metrics) and five Opal sensors placed on both the wrists and feet and on the sternum area to measure gait and provide feedback on six gait metrics (foot-strike angle, trunk coronal range-of-motion (ROM), arm swing ROM, double-support duration, gait-cycle duration, and step asymmetry). The physical therapist used Mobility Rehab to select one or two gait metrics (from the six) to focus on during the treadmill training. Foot-strike angle (effect size (ES) = 0.56, 95% Confidence Interval (CI) = 0.14 to 0.97), trunk coronal RoM (ES = 1.39, 95% CI = 0.73 to 2.06), and arm swing RoM (ES = 1.64, 95% CI = 0.71 to 2.58) during overground walking showed significant and moderate-to-large ES following treadmill training with Mobility Rehab. Participants perceived moderate (60%) and excellent (30%) effects of Mobility Rehab on their gait. No adverse events were reported. One session of treadmill training with Mobility Rehab is feasible for people with mild-to-moderate PD.

The presence of a previous lower limb injury does not affect step asymmetry in elite basketball players: A prospective, longitudinal observational study

ABSTRACT This study investigates whether the presence of a previous lower limb injury influences “Lower limb asymmetry” (LLA) in elite basketball players. A prospective, longitudinal observational study was carried out with 13 players grouped based on lower limb injury history in the 3 months prior to the study (Injury = 7, non-injured = 6). A total of 68 measurements per player were collected over 3 months, using the “Inertial Measurement Unit (IMU)” device. The mean difference in, (i) % of step balance; (ii) the average of the number of impacts performed per minute during training and (iii) the player’s load was assessed. This intensive evaluation is in line with the assessment methodology proposed in the field of sports injury. Our results show no significant differences (p = 0.377) in the asymmetry of the step balance between players with/without a history of injury. However, there were differences when the player’s position was considered (p = 0.046). These findings confirm that the presence of a previous lower limb injury does not influence the asymmetry in lower limb step balance in male basketball players. For clinicians, the variables studied offer an indirect measurement of any capacity and/or deficit in the absorption of lower limb loads after an injury.

Prolonged acute intermittent hypoxia improves forelimb reach-to-grasp function in a rat model of chronic cervical spinal cord injury

Repetitive acute intermittent hypoxia (AIH – brief, episodes of low inspired oxygen) elicits spinal motor plasticity, resulting in sustained improvements of respiratory and non-respiratory motor function in both animal models and humans with chronic spinal cord injury (SCI). We previously demonstrated that 7 days of AIH combined with task-specific training improves performance on a skilled locomotor task for at least 3 weeks post-treatment in rats with incomplete SCI. Here we investigated the effect of repetitive AIH administered for 12 wks on a forelimb reach-to-grasp task in a rat model of chronic, incomplete cervical SCI. In a replicated, sham-controlled, randomized and blinded study, male Spraque-Dawley rats were subject to partial hemisection at the 3rd cervical spinal segment, and exposed to daily AIH (10, 5 min episodes of 11% inspired O2; 5 min intervals of 21% O2) or sham normoxia (continuous 21% O2) for 7 days beginning 8 weeks post-injury. Treatments were then reduced to 4 daily treatments per week, and continued for 11 weeks. Performance on 2 pre-conditioned motor tasks, single pellet reaching and horizontal ladder walking, was recorded each week for up to 12 weeks after initiating treatment; performance on spontaneous adhesive removal was also tested. SCI significantly impaired reach-to-grasp task performance 8 weeks post-injury (pre-treatment). Daily AIH improved reaching success by the first week of treatment versus sham controls, and this difference was maintained at 12 weeks (p < 0.0001). Daily AIH did not affect step asymmetry or stride length during ladder walking or adhesive removal time. Thus, prolonged AIH combined with task-specific training improved forelimb reach-to-grasp function in rats with a chronic cervical hemisection, but not off-target motor tasks. This study further supports the idea that daily AIH improves limb function when combined with task-specific training.

Inter-limb step asymmetry in closed and open skill sprint accelerations in soccer players

PurposeInter-limb differences may decrease sports performance. There is a need to understand the comparison of asymmetries between open and closed skill tasks. The study investigated inter-limb step asymmetry responses to closed and open skill acceleration sprint running tasks.Methods3D motion analysis kinematic data of step characteristics were collected from 20 male soccer players (mean ± SD: 21 ± 1.9 years, 78.7 ± 7.7 kg, 1.78 ± 0.06 m) for bilaterally located lower-limb markers during the initial 20 m of closed and open skill acceleration sprint running trials. Step velocity, step length, step frequency, flight time, contact time, and flight distance were calculated. In the closed skill conditions, players knew the final sprint distance before initiation. In the open skill conditions, players were informed of the final sprint distance (20 or 40 m) immediately after run initiation.ResultsSignificant asymmetries (0.10–10.3%, &lt;i&gt;p&lt;/i&gt; &amp;lt; 0.05) in step characteristics were observed during closed skill acceleration sprint performances. Positive correlations (&lt;i&gt;r&lt;/i&gt;: 0.51–0.77, &lt;i&gt;p&lt;/i&gt; &amp;lt; 0.05) were evidenced between asymmetry scores in the closed skill and in the open skill 20-m and 40-m conditions. Asymmetry scores were not associated with sprint performance (&lt;i&gt;r&lt;/i&gt;: from –0.13 to 0.30, &lt;i&gt;p&lt;/i&gt; &amp;gt; 0.05), suggesting that asymmetry may be functional or dysfunctional.ConclusionsSkilled soccer players can regulate step characteristic asymmetries across closed and open skill tasks. Symmetry should not be assumed when assessing open and closed skill acceleration sprint performance in soccer players. Practitioners should be aware of these asymmetries when implementing programmes.

Use-dependent plasticity explains aftereffects in visually guided locomotor learning of a novel step length asymmetry

Studies of upper extremity reaching show that use-dependent plasticity, or learning from repetition, plays an important role in shaping motor behaviors. Yet the impact of repetition on locomotor learning is unclear, despite the fact that gait is developed and practiced over millions of repetitions. To test whether repetition alone can induce storage of a novel walking pattern, we instructed two groups of young healthy subjects to learn an asymmetric walking pattern through two distinct learning paradigms. The first group learned a new pattern through an established visual distortion paradigm, which provided both sensory prediction error and repetition of movement patterns to induce walking aftereffects, and the second received veridical feedback with a target change, which provided only repetition (use-dependent plasticity) to induce aftereffects. When feedback was removed, both groups demonstrated aftereffects in the primary outcome, step asymmetry index. Surprisingly, despite the different task demands, both groups produced similar aftereffect magnitudes, which also had similar rates of decay, suggesting that the addition of sensory prediction errors did not improve storage of learning beyond that induced by the use-dependent process alone. To further characterize the use-dependent process, we conducted a second experiment to quantify aftereffect size in a third group who practiced double the asymmetry magnitude. This new group showed a proportionately greater magnitude of the use-dependent aftereffect. Together, these findings show that the primary driver of storage of a new step length asymmetry during visually guided locomotor learning is repetition, not sensory prediction error, and this effect scales with the learning magnitude.NEW & NOTEWORTHY Use-dependent plasticity, or learning from repetition, is an important process for upper extremity reaching tasks, but its contribution to walking is not well established. Here, we demonstrate the existence of a dose-dependent, use-dependent process during visually guided treadmill walking. We also show that sensory prediction errors, previously thought to drive aftereffects in similar locomotor learning paradigms, do not appear to play a significant role in visually driven learning of a novel step asymmetry during treadmill walking.

High density muscle size and muscle power are associated with both gait and sit-to-stand kinematic parameters in frail nonagenarians

Frailty is an important concept in clinical and demographic research in the elderly because of its incidence level and its relationship with adverse outcomes. Functional ability declines with advanced age, likely due to changes in muscle function. This study aimed to examine the relationship between muscle quality and muscle power with kinematics from functional tests in a population of 21 institutionalized frail nonagenarian (91.3 ± 3.1 years).Here, muscle quality was measured by segmenting areas of high- and low-density fibers with computerized tomography. In addition, muscle strength and muscle power were obtained through maximal strength and power tests using resistance exercises. Finally, functional capacity outcomes (i.e., balance, gait velocity and sit-to-stand ability), as well as kinematic parameters, were evaluated from a tri-axial sensor used during a battery of functional tests.Our results show that lower limb muscle quality, maximal strength and power output present statistically significant relationships with different kinematic parameters, especially during the sit-to-stand and gait tests (e.g. leg power and maximum power during sit-to-stand (r = 0.80) as well as quadriceps muscle mass and step asymmetry (r = -0,71). In particular, frail individuals with greater muscle quality needed less trunk range of motion to make the transition between sitting and standing, took less time to stand up, and exerted a major peak power of force.As a conclusion, a loss of muscle quality and power may lead to motor control impairments such as gait, sit-to-stand and balance that can be the cause of adverse events such as falls.

Gait Asymmetry Post-Stroke: Determining Valid and Reliable Methods Using a Single Accelerometer Located on the Trunk.

Asymmetry is a cardinal symptom of gait post-stroke that is targeted during rehabilitation. Technological developments have allowed accelerometers to be a feasible tool to provide digital gait variables. Many acceleration-derived variables are proposed to measure gait asymmetry. Despite a need for accurate calculation, no consensus exists for what is the most valid and reliable variable. Using an instrumented walkway (GaitRite) as the reference standard, this study compared the validity and reliability of multiple acceleration-derived asymmetry variables. Twenty-five post-stroke participants performed repeated walks over GaitRite whilst wearing a tri-axial accelerometer (Axivity AX3) on their lower back, on two occasions, one week apart. Harmonic ratio, autocorrelation, gait symmetry index, phase plots, acceleration, and jerk root mean square were calculated from the acceleration signals. Test–retest reliability was calculated, and concurrent validity was estimated by comparison with GaitRite. The strongest concurrent validity was obtained from step regularity from the vertical signal, which also recorded excellent test–retest reliability (Spearman’s rank correlation coefficients (rho) = 0.87 and Intraclass correlation coefficient (ICC21) = 0.98, respectively). Future research should test the responsiveness of this and other step asymmetry variables to quantify change during recovery and the effect of rehabilitative interventions for consideration as digital biomarkers to quantify gait asymmetry.

The association of leg length and offset reconstruction after total hip arthroplasty with clinical outcomes

BackgroundRestoring native hip anatomy and biomechanics is important to create a well-functioning hip arthroplasty. This study investigated the association of hip offset and leg length after hip arthroplasty with clinical outcomes, including patient reported outcome measures, the Trendelenburg Test and gait analysis. MethodsIn 77 patients undergoing primary hip arthroplasty for osteoarthritis (age mean = 65 SD = 11 years; BMI mean = 27 SD = 5 kg/m2), hip offset and leg length discrepancy were measured on anteroposterior radiographs. The Western Ontario & McMaster Universities Osteoarthritis Index, the Trendelenburg Test and gait were assessed preoperatively, and at 3 and 12 months postoperatively. An inertial measurement unit was used to derive biomechanical parameters, including spatiotemporal gait parameters and tilt angles of the pelvis. Relationships between radiographic and functional outcomes were investigated, and subgroups of patients with >15% decreased and increased femoral offset were analysed separately. FindingsPatient-reported function scores and clinical tests demonstrated a few significant, weak correlations with radiographic outcomes (Spearman's ρ range = 0.26–0.32; p < 0.05). Undercorrection of femoral offset was associated with lower patient-reported function scores and with more step irregularity as well as step asymmetry during gait. Postoperative leg length inequality was associated with increased frontal plane tilt angle of the pelvis during the Trendelenburg Test and increased sagittal plane motion of the pelvis during gait. Femoral offset subgroups demonstrated no significant differences for patient-reported function scores and outcomes of the Trendelenburg Test and gait analysis. InterpretationReduced hip offset and leg length discrepancy following hip arthroplasty seem to be marginally associated with worse clinical outcomes.

Comparison of walking quality variables between incomplete spinal cord injury patients and healthy subjects by using a footscan plantar pressure system.

The main goal of spinal cord rehabilitation is to restore walking ability and improve walking quality after spinal cord injury (SCI). The spatiotemporal parameters of walking and the parameters of plantar pressure can be obtained using a plantar pressure analysis system. Previous studies have reported step asymmetry in patients with bilateral SCI. However, the asymmetry of other parameters in patients with SCI has not been reported. This was a prospective, cross-sectional study, which included 23 patients with SCI, aged 48.1 ± 14.5 years, and 28 healthy subjects, aged 47.1 ± 9.8 years. All subjects underwent bare foot walking on a plantar pressure measurement device to measure walking speed and spatiotemporal parameters. Compared with healthy subjects, SCI patients had slower walking speed, longer stride time and stance time, larger stance phase percentage, and shorter stride length. The peak pressures under the metatarsal heads and toe were lower in SCI patients than in healthy subjects. In the heel, regional impulse and the contact area percentage in SCI patients were higher than those in healthy subjects. The symmetry indexes of stance time, step length, maximum force, impulse and contact area were increased in SCI patients, indicating a decline in symmetry. The results confirm that the gait quality, including spatiotemporal variables and plantar pressure parameters, and symmetry index were lower in SCI patients compared with healthy subjects. Plantar pressure parameters and symmetry index could be sensitive quantitative parameters to improve gait quality of SCI patients. The protocols were approved by the Clinical Research Ethics Committee of Shengjing Hospital of China Medical University (approval No. 2015PS54J) on August 13, 2015. This trial was registered in the ISRCTN Registry (ISRCTN42544587) on August 22, 2018. Protocol version: 1.0.

First and Second Step Characteristics of Amputee and Able-Bodied Sprinters.

In sprint events, the first 2 steps are used to accelerate the center of mass horizontally and vertically. Amputee athletes cannot actively generate energy with their running-specific prosthesis. It is likely that sprint acceleration mechanics, including step asymmetry, are altered compared with able-bodied athletes. To investigate spatiotemporal and kinetic variables of amputee compared with able-bodied sprinters. Kinematic and kinetic data of the first and second stance were collected from 15 able-bodied and 7 amputee sprinters (2 unilateral transfemoral, 4 unilateral transtibial, and 1 bilateral transtibial) with a motion-capture system (250Hz) and 2 force plates (1000Hz). In addition, bilateral asymmetry was quantified and compared between groups. Compared with able-bodied athletes, amputee athletes demonstrated significantly lower performance values for 5- and 10-m times. Step length, step velocity, and step frequency were decreased and contact times increased. Peak horizontal force and relative change of horizontal velocity were decreased in both stances. Peak vertical force and relative change of vertical velocity were lower for the amputee than the able-bodied group during the first stance but significantly higher during the second stance. During the first stance, able-bodied and amputee sprinters displayed a similar orientation of the ground-reaction-force vector, which became more vertically orientated in the amputee group during second stance. Amputee sprinters showed significantly greater asymmetry magnitudes for vertical force kinetics compared with able-bodietd athletes. A running-specific prosthesis does not replicate the function of the biological limb well in the early acceleration phase.

Gait of dairy cows on floors with different slipperiness.

This study assessed the slip resistance of different types of solid flooring in cattle housing using a range of technical tests and gait analysis. Dynamic and static coefficient of friction, skid resistance, and abrasiveness were tested on concrete flooring with a smooth finish, a grooved pattern, or a tamped pattern, acid-resistant mastic asphalt, soft rubber mats, and a worn slatted concrete floor. Coefficients of friction and skid resistance were tested under clean and slurry-soiled conditions. Linear kinematic variables were assessed in 40 cows with trackway measurements after the cows passed over the floors in a straight walk. All gait variables were assessed as deviations from those obtained on the slatted concrete floor, which was used as a baseline. The coefficient of friction tests divided the floors into 3 categories: concrete flooring, which had a low coefficient of friction (0.29-0.41); mastic asphalt flooring, which had medium values (0.38-0.45); and rubber mats, which had high values (0.49-0.57). The highest abrasion (g/10 m) was on the asphalt flooring (4.48), and the concrete flooring with a tamped pattern had significantly higher abrasiveness (2.77) than the other concrete floors (1.26-1.60). Lowest values on the skid-resistance tests (dry/wet) were for smooth concrete (79/35) and mastic asphalt (65/47), especially with a slurry layer on the surface. Gait analysis mainly differentiated floors with higher friction and abrasion by longer strides and better tracking. Step asymmetry was lower on floors with high skid-resistance values. The most secure cow gait, in almost every aspect, was observed on soft rubber mats. Relationships between gait variables and physical floor characteristics ranged from average to weak (partial correlations 0.54-0.16). Thus, none of the physical characteristics alone was informative enough to characterize slip resistance. With reference to gait analysis, the abrasiveness of the hard surfaces was more informative than the coefficient of friction, but the effect of pattern was better detected by skid-resistance measurements. Consequently, several physical characteristics are needed to objectively describe the slip resistance of cattle floors. Soft rubber mats gave better tracking than hard, solid floors, even with a grooved surface or a tamped pattern.

Estimation of Temporal Gait Events from a Single Accelerometer Through the Scale-Space Filtering Idea.

The purpose of this paper is to develop an accelerometry system capable of performing gait event demarcation and calculation of temporal parameters using a single waist-mounted device. Particularly, a mobile phone positioned over the L2 vertebra is used to acquire trunk accelerations during walking. Signals from the acceleration magnitude and the vertical acceleration are smoothed through different filters. Cut-off points between filtered signals as a result of convolving with varying levels of Gaussian filters and other robust features against temporal variation and noise are used to identify peaks that correspond to gait events. Five pre-frail older adults and five young healthy adults were recruited in an experiment. Cadence, step/stride time, step/stride CV, step asymmetry and percentages of the stance/swing and single/double support phases, among the two groups of different mobility were quantified by the system.

Investigation of dairy cattle ease of movement on new methyl methacrylate resin aggregate floorings.

Freestall dairy farms commonly present issues with cattle slips and falls caused by smooth flooring and manure slurry. This study examined the effect of 4 new methyl methacrylate (MMA) resin aggregate flooring types (1-4) compared with rubber (positive) and concrete (negative control) on dairy cow (n=18) ease of movement when walking on straight and right-angled corridors. Our hypothesis was that cow ease of movement when walking on the MMA surfaces would be better than when walking on traction milled concrete, and at least as good as when walking on rubber. Cattle ease of movement was measured using kinematics, accelerometers, and visual observation of gait and associated behaviors. Stride length, swing time, stance time, and hoof height were obtained from kinematic evaluation. Acceleration and asymmetry of variance were measured with accelerometers. Locomotion score and behaviors associated with lameness, such as arch back, head bob, tracking up, step asymmetry, and reluctance to bear weight were visually observed. Stride length, swing time, stance time, and the number of steps taken were the only variables affected by flooring type. Differences between flooring types for these variables were tested using a generalized linear mixed model with cow as a random effect, week as a random block factor, and flooring type as a fixed effect. Multiple comparisons with a Scheffé adjustment were done to analyze differences among flooring types. Stride length was 0.14 m longer (better) on rubber when compared with concrete, and 0.11 and 0.17 m shorter on MMA 1 and 2 compared with rubber. On MMA 3 and 4, stride length did not differ from either rubber or concrete. Swing time was 0.04 s shorter (worse) on MMA 1 than on rubber, but did not differ from any other flooring. Stance time was 0.18 s longer (worse) on MMA 2 when compared with rubber, but it did not differ from any other treatment. The number of steps was higher on MMA 4 compared with rubber (4.57 vs. 3.95 steps), but did not differ from any other treatment. Of all the MMA floors tested, MMA 3 was the only one that was consistently as good as rubber (positive control). All 4 MMA floors never differed from concrete (negative control) in any of the ease of movement variables measured. These results suggest that MMA 3 may improve cow ease of movement, compared with the other MMA floors, but more research is required to confirm these findings.

Carrying shopping bags does not alter static postural stability and gait parameters in healthy older females

Food shopping is an important aspect of maintaining independence and social interaction in older age. Carriage of shopping bags alters the body's weight distribution which, depending on load distribution, could potentially increase instability during standing and walking. The study examined the effect of carrying UK style shopping bags on static postural stability and gait in healthy older and young females. Nine older (71.0±6.0 years) and 10 young (26.7±5.2 years) females were assessed in five conditions carrying no bags, one 1.5kg bag in each hand, one 3kg bag in each hand, one 1.5kg bag in preferred hand, one 3kg bag in preferred hand. Antero-posterior and medio-lateral displacement, and 95% ellipse area from a 30s quiet standing were used for postural stability assessment. Stride length and its coefficient of variation, total double support time, step asymmetry and gait stability ratio were calculated from 1min treadmill walking at self-selected speed for gait assessment. Carrying shopping bags did not negatively affect postural stability or gait variables, in either group. Further, in older individuals, a decrease in sway velocity was found when holding bags during the postural stability assessment (p<0.05), suggesting that carriage of bags, irrespective of the load distribution, may have a stabilising effect during quiet standing. These results should help to alleviate concerns regarding safety of carrying shopping bags and help encourage shopping, both as a social and as a physical activity.

Effect of 24-h continuous rotigotine treatment on stationary and non-stationary locomotion in de novo patients with Parkinson disease in an open-label uncontrolled study.

The aim of this study was to investigate the effect of a rotigotine transdermal patch on stationary and non-stationary locomotion in de novo Parkinson disease (PD) patients in an open-label uncontrolled study. A 3-D gait analysis system was used to investigate four different locomotor tasks: steady-state linear walking, gait initiation, gait termination and 180°-turning. A series of gait variables were measured for each locomotor task. PD patients who received rotigotine treatment (4-8 mg) displayed: (1) increased step length, gait speed, cadence and arm oscillations, and reduced double support duration and step asymmetry during steady-state linear gait; (2) increased initial step length during gait initiation; (3) increased final step length and gait speed, and decreased stability index during gait termination; (4) decreased duration of turning and head-pelvis delays during 180°-turning. The main finding that emerges from the present study is that the dopamine agonist rotigotine can improve various aspects of gait in de novo PD patients.

The influence of physical training with the use of a lokomat robotic system on the walking ability of the patients with post-stroke hemiparesis

The objective of the present study was to estimate the influence of the driven gait orthosis Lokomat on the functional mobility in the post-stroke hemiparethic patients and to elucidate the mechanisms underlying the improvement of functional mobility after the treatment. The study included 141patients presenting with post-stroke hemiparesis of the mean duration 12.00 [3.0; 14.5] months. The patients of the experimental group (n = 100) completed the robot-assisted training course, those of the control group (n = 41) were given conventional gait training therapy under the guidance of a specialist in therapeutic physical training. The results of the treatment were evaluated using the following clinical scales: Fugl-Meyer assessment scale, Modified Ashworth scale and Perry mobility scale. Step symmetry, intra- and inter-joint kinematics were measured using the 3D gait videoanalysis system before and after the treatment course. The study has demonstrated a decrease of step asymmetry, the improvement of kinematic gait parameters (hip flexion/extension and hip abduction/adduction amplitudes, hip abduction/ adduction and knee flexion/extension torque amplitudes) as well as inter- and intrajoint dynamic interactions. It is concluded that these changes can be the main causes behind the enhancement of the functional mobility of walking under the influence of training with the use of the driven gait orthosis Lokomat.