Changing stimulation patterns can change the broadness of contralateral masking functions for bilateral cochlear implant users

Publication date: Available online 7 March 2018
Source:Hearing Research
Author(s): Daniel H. Lee, Justin M. Aronoff
Past studies have found that contralateral masking functions are sharper than ipsilateral masking functions for cochlear implant (CI) users. This could suggest that contralateral masking effects are only sensitive to the peak of the masker stimulation for this population. To determine if that is the case, this study investigated whether using broader stimulation patterns affects the broadness of the contralateral masking function. Contralateral masking functions were measured for six bilateral CI users using both a broad and narrow masker. Results revealed that the broad masker resulted in a broader contralateral masking function. This would suggest that stimulation outside of the peak of the masker affects contralateral masking functions for CI users.



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Preclinical and clinical otoprotective applications of cell-penetrating peptide D-JNKI-1 (AM-111)

Publication date: Available online 7 March 2018
Source:Hearing Research
Author(s): Adrien A. Eshraghi, Mayank Aranke, Richard Salvi, Dalian Ding, John K.M. Coleman, Emre Ocak, Rahul Mittal, Thomas Meyer
There is a growing interest in the auditory community to develop novel prophylactic and therapeutic drugs to prevent permanent sensorineural hearing loss following acute cochlear injury. The jun-N-terminal protein kinase (JNK) pathway plays a crucial role in acute sensory hearing loss. Blocking the JNK pathway using the cell-penetrating peptide D-JNKI-1 (AM-111/brimapitide) has shown promise as both a prophylactic and therapeutic agent for acute cochlear injury. A number of pre-clinical and clinical studies have determined the impact of D-JNKI-1 on acute sensorineural hearing loss. Given the inner-ear selective therapeutic profile, local route of administration, and ability to diffuse across cellular membranes rapidly using both active and passive transport makes D-JNK-1 a promising oto-protective drug. In this review article, we discuss the application of D-JNKI-1 in various auditory disorders as well as its pharmacological properties and distribution in the cochlea.



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Changing stimulation patterns can change the broadness of contralateral masking functions for bilateral cochlear implant users

Publication date: Available online 7 March 2018
Source:Hearing Research
Author(s): Daniel H. Lee, Justin M. Aronoff
Past studies have found that contralateral masking functions are sharper than ipsilateral masking functions for cochlear implant (CI) users. This could suggest that contralateral masking effects are only sensitive to the peak of the masker stimulation for this population. To determine if that is the case, this study investigated whether using broader stimulation patterns affects the broadness of the contralateral masking function. Contralateral masking functions were measured for six bilateral CI users using both a broad and narrow masker. Results revealed that the broad masker resulted in a broader contralateral masking function. This would suggest that stimulation outside of the peak of the masker affects contralateral masking functions for CI users.



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Preclinical and clinical otoprotective applications of cell-penetrating peptide D-JNKI-1 (AM-111)

Publication date: Available online 7 March 2018
Source:Hearing Research
Author(s): Adrien A. Eshraghi, Mayank Aranke, Richard Salvi, Dalian Ding, John K.M. Coleman, Emre Ocak, Rahul Mittal, Thomas Meyer
There is a growing interest in the auditory community to develop novel prophylactic and therapeutic drugs to prevent permanent sensorineural hearing loss following acute cochlear injury. The jun-N-terminal protein kinase (JNK) pathway plays a crucial role in acute sensory hearing loss. Blocking the JNK pathway using the cell-penetrating peptide D-JNKI-1 (AM-111/brimapitide) has shown promise as both a prophylactic and therapeutic agent for acute cochlear injury. A number of pre-clinical and clinical studies have determined the impact of D-JNKI-1 on acute sensorineural hearing loss. Given the inner-ear selective therapeutic profile, local route of administration, and ability to diffuse across cellular membranes rapidly using both active and passive transport makes D-JNK-1 a promising oto-protective drug. In this review article, we discuss the application of D-JNKI-1 in various auditory disorders as well as its pharmacological properties and distribution in the cochlea.



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Changing stimulation patterns can change the broadness of contralateral masking functions for bilateral cochlear implant users

Publication date: Available online 7 March 2018
Source:Hearing Research
Author(s): Daniel H. Lee, Justin M. Aronoff
Past studies have found that contralateral masking functions are sharper than ipsilateral masking functions for cochlear implant (CI) users. This could suggest that contralateral masking effects are only sensitive to the peak of the masker stimulation for this population. To determine if that is the case, this study investigated whether using broader stimulation patterns affects the broadness of the contralateral masking function. Contralateral masking functions were measured for six bilateral CI users using both a broad and narrow masker. Results revealed that the broad masker resulted in a broader contralateral masking function. This would suggest that stimulation outside of the peak of the masker affects contralateral masking functions for CI users.



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Preclinical and clinical otoprotective applications of cell-penetrating peptide D-JNKI-1 (AM-111)

Publication date: Available online 7 March 2018
Source:Hearing Research
Author(s): Adrien A. Eshraghi, Mayank Aranke, Richard Salvi, Dalian Ding, John K.M. Coleman, Emre Ocak, Rahul Mittal, Thomas Meyer
There is a growing interest in the auditory community to develop novel prophylactic and therapeutic drugs to prevent permanent sensorineural hearing loss following acute cochlear injury. The jun-N-terminal protein kinase (JNK) pathway plays a crucial role in acute sensory hearing loss. Blocking the JNK pathway using the cell-penetrating peptide D-JNKI-1 (AM-111/brimapitide) has shown promise as both a prophylactic and therapeutic agent for acute cochlear injury. A number of pre-clinical and clinical studies have determined the impact of D-JNKI-1 on acute sensorineural hearing loss. Given the inner-ear selective therapeutic profile, local route of administration, and ability to diffuse across cellular membranes rapidly using both active and passive transport makes D-JNK-1 a promising oto-protective drug. In this review article, we discuss the application of D-JNKI-1 in various auditory disorders as well as its pharmacological properties and distribution in the cochlea.



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Vocal Acoustic and Auditory-Perceptual Characteristics During Fluctuations in Estradiol Levels During the Menstrual Cycle: A Longitudinal Study

Publication date: Available online 7 March 2018
Source:Journal of Voice
Author(s): Polyanna Arruda, Marine Raquel Diniz da Rosa, Larissa Nadjara Alves Almeida, Leandro de Araujo Pernambuco, Anna Alice Almeida
Estradiol production varies cyclically, changes in levels are hypothesized to affect the voice. The main objective of this study was to investigate vocal acoustic and auditory-perceptual characteristics during fluctuations in the levels of the hormone estradiol during the menstrual cycle. A total of 44 volunteers aged between 18 and 45 were selected. Of these, 27 women with regular menstrual cycles comprised the test group (TG) and 17 combined oral contraceptive users comprised the control group (CG). The study was performed in two phases. In phase 1, anamnesis was performed. Subsequently, the TG underwent blood sample collection for measurement of estradiol levels and voice recording for later acoustic and auditory-perceptual analysis. The CG underwent only voice recording. Phase 2 involved the same measurements as phase 1 for each group. Variables were evaluated using descriptive and inferential analysis to compare groups and phases and to determine relationships between variables. Voice changes were found during the menstrual cycle, and such changes were determined to be related to variations in estradiol levels. Impaired voice quality was observed to be associated with decreased levels of estradiol. The CG did not demonstrate significant vocal changes during phases 1 and 2. The TG showed significant increases in vocal parameters of roughness, tension, and instability during phase 2 (the period of low estradiol levels) when compared with the CG. Low estradiol levels were also found to be negatively correlated with the parameters of tension, instability, and jitter and positively correlated with fundamental voice frequency.



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New lower-limb gait biomechanical characteristics in individuals with Achilles tendinopathy: a systematic review update

Publication date: Available online 8 March 2018
Source:Gait & Posture
Author(s): I. Ogbonmwan, B.D. Kumar, B. Paton
BackgroundVariations in lower-limb biomechanics have recurrently been associated as aetiological factors for Achilles tendinopathy.ObjectiveTo update a previous systematic review examining lower-limb gait biomechanics in Achilles tendinopathy.DesignSystematic Review.Data SourcesMEDLINE, EMBASE, CINAHL PLUS, SPORTDiscus and PUBMED databases searched from inception to May 2016.Eligibility criteria for selecting studiesStudies investigating adults with Achilles tendinopathy and lower-limb gait biomechanics including kinematics, kinetics, dynamic plantar-pressures, temporospatial parameters and muscle activity.ResultsFourteen studies were identified, involving 836 participants. Three were prospective studies and 11 were case-control designs. Selection and performance bias were high for all studies except the prospective studies, reporting bias was unclear for all studies.Significant effect size reductions in gait speed (d = −0.80), stride length (d = −0.84) and step length (d = −0.80) were calculated in runners with Achilles tendinopathy.Increased effect sizes for ankle eversion (d = 1.08), time to maximum pronation (d = −1.72), calcaneal inversion (d = −1.82) and ankle and hip joint moments were also established.Significant differences in plantar pressures and timing of ground reaction forces were calculated. Individuals with Achilles tendinopathy demonstrated differences in amplitude and timing of several lower-limb muscles, notably reductions in the onset of activity (d = 2.02) and duration of activation (d = 2.11) in the Gluteus Medius of subjects with Achilles tendinopathy.ConclusionEighteen new biomechanical characteristics in individuals with Achilles tendinopathy have been established. This review highlights a topic rich in quantity, but generally weak in quality, consequently results should be interpreted cautiously. High powered prospective studies are required to determine causality.



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Biomechanical characteristics of stair ambulation in patients with knee OA: A systematic review with meta-analysis toward a better definition of clinical hallmarks

Publication date: Available online 8 March 2018
Source:Gait & Posture
Author(s): Hirotaka Iijima, Kanako Shimoura, Tomoki Aoyama, Masaki Takahashi
BackgroundStair climbing was suggested to be the first affected task in individuals with knee osteoarthritis (OA).Research questionThis review aimed to identify consistent kinematic, kinetic, and spatiotemporal alterations of stair climbing exhibited by individuals with knee OA.MethodsA literature search published until September 2017 was conducted in PubMed, PEDro, CINAHL, and Cochrane CENTRAL. Reviewer extracted data in accordance with the Cochrane Handbook. Where possible, data were combined into a meta-analysis; the pooled standardized mean differences between individuals with knee OA and healthy adults were calculated using the random-effect model.ResultsIn total, 585 potentially relevant articles were selected, of which 12 (695 participants, mean age: 58.4 years) met the inclusion criteria. Meta-analysis revealed that kinematic and kinetic alterations during stair climbing associated with knee OA were lower external knee flexion moment in conjunction with a larger trunk/hip flexion angles and smaller knee flexion/ankle dorsiflexion angles. Individuals with knee OA showed a delayed quadriceps activation during stair ascent. A lack of evidence was detected for alterations in external knee adduction moment during stair climbing. Effect estimate in each meta-analysis was judged “very low” on the GRADE approach.SignificanceNo strong conclusion can be drawn because of the low quality of evidence; however, individuals with knee OA may exhibit altered kinematics and kinetics changes in sagittal plane during stair climbing, and have delayed quadriceps muscle activity. Further studies with adequate adjustment for confounders are warranted to facilitate clinical hallmarks of the knee OA, particularly in early stages of the disease.



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Intersegmental kinematics coordination in unilateral peripheral and central origin: Effect on gait mechanism?

Publication date: Available online 7 March 2018
Source:Gait & Posture
Author(s): Laura Wallard, Sophie Boulet, Olivier Cornu, Jean-Emile Dubuc, Philippe Mahaudens, Didier Postlethwaite, Maïté Van Cauter, Christine Detrembleur
BackgroundThe gait mechanism requires an efficient intersegmental coordination in order to ensure the displacement of the body while simultaneously maintaining the postural stability. However, intersegmental coordination may be disrupted by neurological or orthopaedic involvement, this increasing the metabolic cost associated with excessive or prolonged muscle co-contraction.Research questionOur aim was to evaluate and to understand how hip OA affects lower limbs coordination during gait by using the kinematic segmental covariation law method and predict the energy expenditure.MethodsIn order to evaluate the influence of unilateral alteration of the lower limbs on the gait mechanism, three groups namely 63 hip osteoarthritis patients, 65 chronic hemiparetic stroke patients and 72 healthy subjects performed an instrumented gait analysis. The subjects had to walk barefoot for at least 3 min at a self-selected speed on a force measuring motor-driven treadmill. The biomechanical variables (kinematic, kinetic and energetical cost) were simultaneously recorded.ResultsThe comparison between the three groups was tested using a repeated measure ANOVA. All biomechanical parameters show significant differences between the 3 groups highlighting the gait alteration for the patients groups. However, the energetic cost remains normal in the hip osteoarthritis group despite of the alteration of the other variables. A multivariate analysis allowed to identify the independent variables affecting more specifically their gait mechanisms.SignificanceThis study showed the importance of quantitative functional evaluation in order to better understand the impact of hip osteoarthritis on the gait mechanism. The biomechanical analysis provides objective evidence of the altered gait mechanism and more particularly of the intersegmental coordination in these patients. This gait analysis is therefore an interesting tool in the functional evaluation of the patient to better guide the diagnosis.



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Not just a light fingertip touch: A facilitation of functional integration between body sway and visual search in older adults

Publication date: Available online 7 March 2018
Source:Gait & Posture
Author(s): Fu-Chen Chen, Chia-Hua Chu, Chien-Yu Pan, Chia-Liang Tsai
BackgroundPrior studies demonstrated that, compared to no fingertip touch (NT), a reduction in body sway resulting from the effects of light fingertip touch (LT) facilitates the performance of visual search, buttressing the concept of functional integration. However, previous findings may be confounded by different arm postures required between the NT and LT conditions. Furthermore, in older adults, how LT influences the interactions between body sway and visual search has not been established.Research questions(1) Are LT effects valid after excluding the influences of different upper limb configurations? (2) Is functional integration is feasible for older adults?MethodsTwenty-two young (age = 21.3 ± 2.0) and 22 older adults (age = 71.8 ± 4.1) were recruited. Participants performed visual inspection and visual searches under NT and LT conditions.ResultsThe older group significantly reduced AP sway (p < 0.05) in LT compared to NT conditions, of which the LT effects on postural adaptation were more remarkable in older than young adults (p<0.05). In addition, the older group significantly improved search accuracy (p<0.05) from the LT to the NT condition, and these effects were equivalent between groups.SignificanceAfter controlling for postural configurations, the results demonstrate that light fingertip touch reduces body sway and concurrently enhances visual search performance in older adults. These findings confirmed the effects of LT on postural adaptation as well as supported functional integration in older adults.



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Repeatability of spatiotemporal, plantar pressure and force parameters during treadmill walking and running

Publication date: Available online 7 March 2018
Source:Gait & Posture
Author(s): Corina Nüesch, Jan-Arie Overberg, Hermann Schwameder, Geert Pagenstert, Annegret Mündermann
BackgroundInstrumented treadmills with integrated pressure mats measure spatiotemporal, pressure and force parameters and are often used to investigate changes in gait patterns due to injury or rehabilitation.Research questionWhat is the within- and between-day repeatability of such an instrumented treadmill for spatiotemporal parameters, peak pressures and forces during walking and running?MethodsTreadmill gait and running analysis was performed at 5.0, 6.5, and 9.0 km/h in 33 healthy adults (age: 31.6 ± 7.4 years; body mass index: 23.8 ± 3.2 kg/m²) once on day 1 and twice on day 7. For all three speeds, intraclass correlation coefficents (ICC) and smallest detectable differences (SDC) corresponding to 95% limits of agreement were calculated for spatiotemporal parameters and peak pressures and forces in the heel, midfoot, and forefoot regions.ResultsAll spatiotemporal parameters and peak forces in the heel, midfoot, and forefoot regions showed a good within- and between-day repeatability (ICCs > 0.878) for all gait speeds with within-day repeatability being generally higher. For peak pressures, only the heel and forefoot regions but not the midfoot region, showed good repeatability (ICC > 0.9) at all gait speeds. SDCs ranged from 1.5 to 2.5° for foot rotation, 4.4 to 6.6 cm for stride length, 0.7 to 2.5% for length of stance phases, and 2.8 to 9.2 N/cm² for peak pressures in all foot regions. For walking, SDCs of peak forces in the heel, midfoot and forefoot regions were below 60 N, and for running below 135 N.SignificanceExcept for peak pressures in the midfoot, spatiotemporal and kinetic gait parameters during walking and running showed a good within- and between-day repeatability. Hence, the investigated treadmill is suitable to analyze gait patterns and changes in gait patterns due to interventions.



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Effect of the sagittal ankle angle at initial contact on energy dissipation in the lower extremity joints during a single-leg landing

Publication date: Available online 7 March 2018
Source:Gait & Posture
Author(s): Jinkyu Lee, Yongnam Song, Choongsoo S. Shin
BackgroundDuring landing, the ankle angle at initial contact (IC) exhibits relatively wide individual variation compared to the knee and hip angles. However, little is known about the effect of different IC ankle angles on energy dissipation.Research QuestionThe purpose of this study was to investigate the relationship between individual ankle angles at IC and energy dissipation in the lower extremity joints.MethodsTwenty-seven adults performed single-leg landings from a 0.3-m height. Kinetics and kinematics of the lower extremity joints were measured. The relationship between ankle angles at IC and negative work, range of motion, the time to peak ground reaction force, and peak loading rate were analyzed.ResultsThe ankle angle at IC was positively correlated with ankle negative work (r = 0.80, R² = 0.64, p < 0.001) and the contribution of the ankle to total (ankle, knee and hip joint) negative work (r = 0.84, R² = 0.70, p < 0.001), but the ankle angle was negatively correlated with hip negative work (r = −0.46, R² = 0.21, p = 0.01) and the contribution of the hip to total negative work (r = −0.61, R² = 0.37, p < 0.001). The knee negative work and the contribution of the knee to total negative work were not correlated with the ankle angle at IC. The ankle angle at IC was positively correlated with total negative work (r = 0.50, R² = 0.25, p < 0.01) and negatively correlated with the peak loading rate (r = −0.76, R² = 0.57, p < 0.001).SignificanceThese results indicated that landing mechanics changed as the ankle angle at IC increased, such that the ankle energy dissipation increased and redistributed the energy dissipation in the ankle and hip joints. Further, these results suggest that increased ankle energy dissipation with a higher IC plantar flexion angle may be a potential landing technique for reducing the risk of injury to the anterior cruciate ligament and hip musculature.



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New lower-limb gait biomechanical characteristics in individuals with Achilles tendinopathy: a systematic review update

Publication date: Available online 8 March 2018
Source:Gait & Posture
Author(s): I. Ogbonmwan, B.D. Kumar, B. Paton
BackgroundVariations in lower-limb biomechanics have recurrently been associated as aetiological factors for Achilles tendinopathy.ObjectiveTo update a previous systematic review examining lower-limb gait biomechanics in Achilles tendinopathy.DesignSystematic Review.Data SourcesMEDLINE, EMBASE, CINAHL PLUS, SPORTDiscus and PUBMED databases searched from inception to May 2016.Eligibility criteria for selecting studiesStudies investigating adults with Achilles tendinopathy and lower-limb gait biomechanics including kinematics, kinetics, dynamic plantar-pressures, temporospatial parameters and muscle activity.ResultsFourteen studies were identified, involving 836 participants. Three were prospective studies and 11 were case-control designs. Selection and performance bias were high for all studies except the prospective studies, reporting bias was unclear for all studies.Significant effect size reductions in gait speed (d = −0.80), stride length (d = −0.84) and step length (d = −0.80) were calculated in runners with Achilles tendinopathy.Increased effect sizes for ankle eversion (d = 1.08), time to maximum pronation (d = −1.72), calcaneal inversion (d = −1.82) and ankle and hip joint moments were also established.Significant differences in plantar pressures and timing of ground reaction forces were calculated. Individuals with Achilles tendinopathy demonstrated differences in amplitude and timing of several lower-limb muscles, notably reductions in the onset of activity (d = 2.02) and duration of activation (d = 2.11) in the Gluteus Medius of subjects with Achilles tendinopathy.ConclusionEighteen new biomechanical characteristics in individuals with Achilles tendinopathy have been established. This review highlights a topic rich in quantity, but generally weak in quality, consequently results should be interpreted cautiously. High powered prospective studies are required to determine causality.



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Biomechanical characteristics of stair ambulation in patients with knee OA: A systematic review with meta-analysis toward a better definition of clinical hallmarks

Publication date: Available online 8 March 2018
Source:Gait & Posture
Author(s): Hirotaka Iijima, Kanako Shimoura, Tomoki Aoyama, Masaki Takahashi
BackgroundStair climbing was suggested to be the first affected task in individuals with knee osteoarthritis (OA).Research questionThis review aimed to identify consistent kinematic, kinetic, and spatiotemporal alterations of stair climbing exhibited by individuals with knee OA.MethodsA literature search published until September 2017 was conducted in PubMed, PEDro, CINAHL, and Cochrane CENTRAL. Reviewer extracted data in accordance with the Cochrane Handbook. Where possible, data were combined into a meta-analysis; the pooled standardized mean differences between individuals with knee OA and healthy adults were calculated using the random-effect model.ResultsIn total, 585 potentially relevant articles were selected, of which 12 (695 participants, mean age: 58.4 years) met the inclusion criteria. Meta-analysis revealed that kinematic and kinetic alterations during stair climbing associated with knee OA were lower external knee flexion moment in conjunction with a larger trunk/hip flexion angles and smaller knee flexion/ankle dorsiflexion angles. Individuals with knee OA showed a delayed quadriceps activation during stair ascent. A lack of evidence was detected for alterations in external knee adduction moment during stair climbing. Effect estimate in each meta-analysis was judged “very low” on the GRADE approach.SignificanceNo strong conclusion can be drawn because of the low quality of evidence; however, individuals with knee OA may exhibit altered kinematics and kinetics changes in sagittal plane during stair climbing, and have delayed quadriceps muscle activity. Further studies with adequate adjustment for confounders are warranted to facilitate clinical hallmarks of the knee OA, particularly in early stages of the disease.



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Intersegmental kinematics coordination in unilateral peripheral and central origin: Effect on gait mechanism?

Publication date: Available online 7 March 2018
Source:Gait & Posture
Author(s): Laura Wallard, Sophie Boulet, Olivier Cornu, Jean-Emile Dubuc, Philippe Mahaudens, Didier Postlethwaite, Maïté Van Cauter, Christine Detrembleur
BackgroundThe gait mechanism requires an efficient intersegmental coordination in order to ensure the displacement of the body while simultaneously maintaining the postural stability. However, intersegmental coordination may be disrupted by neurological or orthopaedic involvement, this increasing the metabolic cost associated with excessive or prolonged muscle co-contraction.Research questionOur aim was to evaluate and to understand how hip OA affects lower limbs coordination during gait by using the kinematic segmental covariation law method and predict the energy expenditure.MethodsIn order to evaluate the influence of unilateral alteration of the lower limbs on the gait mechanism, three groups namely 63 hip osteoarthritis patients, 65 chronic hemiparetic stroke patients and 72 healthy subjects performed an instrumented gait analysis. The subjects had to walk barefoot for at least 3 min at a self-selected speed on a force measuring motor-driven treadmill. The biomechanical variables (kinematic, kinetic and energetical cost) were simultaneously recorded.ResultsThe comparison between the three groups was tested using a repeated measure ANOVA. All biomechanical parameters show significant differences between the 3 groups highlighting the gait alteration for the patients groups. However, the energetic cost remains normal in the hip osteoarthritis group despite of the alteration of the other variables. A multivariate analysis allowed to identify the independent variables affecting more specifically their gait mechanisms.SignificanceThis study showed the importance of quantitative functional evaluation in order to better understand the impact of hip osteoarthritis on the gait mechanism. The biomechanical analysis provides objective evidence of the altered gait mechanism and more particularly of the intersegmental coordination in these patients. This gait analysis is therefore an interesting tool in the functional evaluation of the patient to better guide the diagnosis.



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Not just a light fingertip touch: A facilitation of functional integration between body sway and visual search in older adults

Publication date: Available online 7 March 2018
Source:Gait & Posture
Author(s): Fu-Chen Chen, Chia-Hua Chu, Chien-Yu Pan, Chia-Liang Tsai
BackgroundPrior studies demonstrated that, compared to no fingertip touch (NT), a reduction in body sway resulting from the effects of light fingertip touch (LT) facilitates the performance of visual search, buttressing the concept of functional integration. However, previous findings may be confounded by different arm postures required between the NT and LT conditions. Furthermore, in older adults, how LT influences the interactions between body sway and visual search has not been established.Research questions(1) Are LT effects valid after excluding the influences of different upper limb configurations? (2) Is functional integration is feasible for older adults?MethodsTwenty-two young (age = 21.3 ± 2.0) and 22 older adults (age = 71.8 ± 4.1) were recruited. Participants performed visual inspection and visual searches under NT and LT conditions.ResultsThe older group significantly reduced AP sway (p < 0.05) in LT compared to NT conditions, of which the LT effects on postural adaptation were more remarkable in older than young adults (p<0.05). In addition, the older group significantly improved search accuracy (p<0.05) from the LT to the NT condition, and these effects were equivalent between groups.SignificanceAfter controlling for postural configurations, the results demonstrate that light fingertip touch reduces body sway and concurrently enhances visual search performance in older adults. These findings confirmed the effects of LT on postural adaptation as well as supported functional integration in older adults.



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Repeatability of spatiotemporal, plantar pressure and force parameters during treadmill walking and running

Publication date: Available online 7 March 2018
Source:Gait & Posture
Author(s): Corina Nüesch, Jan-Arie Overberg, Hermann Schwameder, Geert Pagenstert, Annegret Mündermann
BackgroundInstrumented treadmills with integrated pressure mats measure spatiotemporal, pressure and force parameters and are often used to investigate changes in gait patterns due to injury or rehabilitation.Research questionWhat is the within- and between-day repeatability of such an instrumented treadmill for spatiotemporal parameters, peak pressures and forces during walking and running?MethodsTreadmill gait and running analysis was performed at 5.0, 6.5, and 9.0 km/h in 33 healthy adults (age: 31.6 ± 7.4 years; body mass index: 23.8 ± 3.2 kg/m²) once on day 1 and twice on day 7. For all three speeds, intraclass correlation coefficents (ICC) and smallest detectable differences (SDC) corresponding to 95% limits of agreement were calculated for spatiotemporal parameters and peak pressures and forces in the heel, midfoot, and forefoot regions.ResultsAll spatiotemporal parameters and peak forces in the heel, midfoot, and forefoot regions showed a good within- and between-day repeatability (ICCs > 0.878) for all gait speeds with within-day repeatability being generally higher. For peak pressures, only the heel and forefoot regions but not the midfoot region, showed good repeatability (ICC > 0.9) at all gait speeds. SDCs ranged from 1.5 to 2.5° for foot rotation, 4.4 to 6.6 cm for stride length, 0.7 to 2.5% for length of stance phases, and 2.8 to 9.2 N/cm² for peak pressures in all foot regions. For walking, SDCs of peak forces in the heel, midfoot and forefoot regions were below 60 N, and for running below 135 N.SignificanceExcept for peak pressures in the midfoot, spatiotemporal and kinetic gait parameters during walking and running showed a good within- and between-day repeatability. Hence, the investigated treadmill is suitable to analyze gait patterns and changes in gait patterns due to interventions.



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Effect of the sagittal ankle angle at initial contact on energy dissipation in the lower extremity joints during a single-leg landing

Publication date: Available online 7 March 2018
Source:Gait & Posture
Author(s): Jinkyu Lee, Yongnam Song, Choongsoo S. Shin
BackgroundDuring landing, the ankle angle at initial contact (IC) exhibits relatively wide individual variation compared to the knee and hip angles. However, little is known about the effect of different IC ankle angles on energy dissipation.Research QuestionThe purpose of this study was to investigate the relationship between individual ankle angles at IC and energy dissipation in the lower extremity joints.MethodsTwenty-seven adults performed single-leg landings from a 0.3-m height. Kinetics and kinematics of the lower extremity joints were measured. The relationship between ankle angles at IC and negative work, range of motion, the time to peak ground reaction force, and peak loading rate were analyzed.ResultsThe ankle angle at IC was positively correlated with ankle negative work (r = 0.80, R² = 0.64, p < 0.001) and the contribution of the ankle to total (ankle, knee and hip joint) negative work (r = 0.84, R² = 0.70, p < 0.001), but the ankle angle was negatively correlated with hip negative work (r = −0.46, R² = 0.21, p = 0.01) and the contribution of the hip to total negative work (r = −0.61, R² = 0.37, p < 0.001). The knee negative work and the contribution of the knee to total negative work were not correlated with the ankle angle at IC. The ankle angle at IC was positively correlated with total negative work (r = 0.50, R² = 0.25, p < 0.01) and negatively correlated with the peak loading rate (r = −0.76, R² = 0.57, p < 0.001).SignificanceThese results indicated that landing mechanics changed as the ankle angle at IC increased, such that the ankle energy dissipation increased and redistributed the energy dissipation in the ankle and hip joints. Further, these results suggest that increased ankle energy dissipation with a higher IC plantar flexion angle may be a potential landing technique for reducing the risk of injury to the anterior cruciate ligament and hip musculature.



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New lower-limb gait biomechanical characteristics in individuals with Achilles tendinopathy: a systematic review update

Publication date: Available online 8 March 2018
Source:Gait & Posture
Author(s): I. Ogbonmwan, B.D. Kumar, B. Paton
BackgroundVariations in lower-limb biomechanics have recurrently been associated as aetiological factors for Achilles tendinopathy.ObjectiveTo update a previous systematic review examining lower-limb gait biomechanics in Achilles tendinopathy.DesignSystematic Review.Data SourcesMEDLINE, EMBASE, CINAHL PLUS, SPORTDiscus and PUBMED databases searched from inception to May 2016.Eligibility criteria for selecting studiesStudies investigating adults with Achilles tendinopathy and lower-limb gait biomechanics including kinematics, kinetics, dynamic plantar-pressures, temporospatial parameters and muscle activity.ResultsFourteen studies were identified, involving 836 participants. Three were prospective studies and 11 were case-control designs. Selection and performance bias were high for all studies except the prospective studies, reporting bias was unclear for all studies.Significant effect size reductions in gait speed (d = −0.80), stride length (d = −0.84) and step length (d = −0.80) were calculated in runners with Achilles tendinopathy.Increased effect sizes for ankle eversion (d = 1.08), time to maximum pronation (d = −1.72), calcaneal inversion (d = −1.82) and ankle and hip joint moments were also established.Significant differences in plantar pressures and timing of ground reaction forces were calculated. Individuals with Achilles tendinopathy demonstrated differences in amplitude and timing of several lower-limb muscles, notably reductions in the onset of activity (d = 2.02) and duration of activation (d = 2.11) in the Gluteus Medius of subjects with Achilles tendinopathy.ConclusionEighteen new biomechanical characteristics in individuals with Achilles tendinopathy have been established. This review highlights a topic rich in quantity, but generally weak in quality, consequently results should be interpreted cautiously. High powered prospective studies are required to determine causality.



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Biomechanical characteristics of stair ambulation in patients with knee OA: A systematic review with meta-analysis toward a better definition of clinical hallmarks

Publication date: Available online 8 March 2018
Source:Gait & Posture
Author(s): Hirotaka Iijima, Kanako Shimoura, Tomoki Aoyama, Masaki Takahashi
BackgroundStair climbing was suggested to be the first affected task in individuals with knee osteoarthritis (OA).Research questionThis review aimed to identify consistent kinematic, kinetic, and spatiotemporal alterations of stair climbing exhibited by individuals with knee OA.MethodsA literature search published until September 2017 was conducted in PubMed, PEDro, CINAHL, and Cochrane CENTRAL. Reviewer extracted data in accordance with the Cochrane Handbook. Where possible, data were combined into a meta-analysis; the pooled standardized mean differences between individuals with knee OA and healthy adults were calculated using the random-effect model.ResultsIn total, 585 potentially relevant articles were selected, of which 12 (695 participants, mean age: 58.4 years) met the inclusion criteria. Meta-analysis revealed that kinematic and kinetic alterations during stair climbing associated with knee OA were lower external knee flexion moment in conjunction with a larger trunk/hip flexion angles and smaller knee flexion/ankle dorsiflexion angles. Individuals with knee OA showed a delayed quadriceps activation during stair ascent. A lack of evidence was detected for alterations in external knee adduction moment during stair climbing. Effect estimate in each meta-analysis was judged “very low” on the GRADE approach.SignificanceNo strong conclusion can be drawn because of the low quality of evidence; however, individuals with knee OA may exhibit altered kinematics and kinetics changes in sagittal plane during stair climbing, and have delayed quadriceps muscle activity. Further studies with adequate adjustment for confounders are warranted to facilitate clinical hallmarks of the knee OA, particularly in early stages of the disease.



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Intersegmental kinematics coordination in unilateral peripheral and central origin: Effect on gait mechanism?

Publication date: Available online 7 March 2018
Source:Gait & Posture
Author(s): Laura Wallard, Sophie Boulet, Olivier Cornu, Jean-Emile Dubuc, Philippe Mahaudens, Didier Postlethwaite, Maïté Van Cauter, Christine Detrembleur
BackgroundThe gait mechanism requires an efficient intersegmental coordination in order to ensure the displacement of the body while simultaneously maintaining the postural stability. However, intersegmental coordination may be disrupted by neurological or orthopaedic involvement, this increasing the metabolic cost associated with excessive or prolonged muscle co-contraction.Research questionOur aim was to evaluate and to understand how hip OA affects lower limbs coordination during gait by using the kinematic segmental covariation law method and predict the energy expenditure.MethodsIn order to evaluate the influence of unilateral alteration of the lower limbs on the gait mechanism, three groups namely 63 hip osteoarthritis patients, 65 chronic hemiparetic stroke patients and 72 healthy subjects performed an instrumented gait analysis. The subjects had to walk barefoot for at least 3 min at a self-selected speed on a force measuring motor-driven treadmill. The biomechanical variables (kinematic, kinetic and energetical cost) were simultaneously recorded.ResultsThe comparison between the three groups was tested using a repeated measure ANOVA. All biomechanical parameters show significant differences between the 3 groups highlighting the gait alteration for the patients groups. However, the energetic cost remains normal in the hip osteoarthritis group despite of the alteration of the other variables. A multivariate analysis allowed to identify the independent variables affecting more specifically their gait mechanisms.SignificanceThis study showed the importance of quantitative functional evaluation in order to better understand the impact of hip osteoarthritis on the gait mechanism. The biomechanical analysis provides objective evidence of the altered gait mechanism and more particularly of the intersegmental coordination in these patients. This gait analysis is therefore an interesting tool in the functional evaluation of the patient to better guide the diagnosis.



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Not just a light fingertip touch: A facilitation of functional integration between body sway and visual search in older adults

Publication date: Available online 7 March 2018
Source:Gait & Posture
Author(s): Fu-Chen Chen, Chia-Hua Chu, Chien-Yu Pan, Chia-Liang Tsai
BackgroundPrior studies demonstrated that, compared to no fingertip touch (NT), a reduction in body sway resulting from the effects of light fingertip touch (LT) facilitates the performance of visual search, buttressing the concept of functional integration. However, previous findings may be confounded by different arm postures required between the NT and LT conditions. Furthermore, in older adults, how LT influences the interactions between body sway and visual search has not been established.Research questions(1) Are LT effects valid after excluding the influences of different upper limb configurations? (2) Is functional integration is feasible for older adults?MethodsTwenty-two young (age = 21.3 ± 2.0) and 22 older adults (age = 71.8 ± 4.1) were recruited. Participants performed visual inspection and visual searches under NT and LT conditions.ResultsThe older group significantly reduced AP sway (p < 0.05) in LT compared to NT conditions, of which the LT effects on postural adaptation were more remarkable in older than young adults (p<0.05). In addition, the older group significantly improved search accuracy (p<0.05) from the LT to the NT condition, and these effects were equivalent between groups.SignificanceAfter controlling for postural configurations, the results demonstrate that light fingertip touch reduces body sway and concurrently enhances visual search performance in older adults. These findings confirmed the effects of LT on postural adaptation as well as supported functional integration in older adults.



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Repeatability of spatiotemporal, plantar pressure and force parameters during treadmill walking and running

Publication date: Available online 7 March 2018
Source:Gait & Posture
Author(s): Corina Nüesch, Jan-Arie Overberg, Hermann Schwameder, Geert Pagenstert, Annegret Mündermann
BackgroundInstrumented treadmills with integrated pressure mats measure spatiotemporal, pressure and force parameters and are often used to investigate changes in gait patterns due to injury or rehabilitation.Research questionWhat is the within- and between-day repeatability of such an instrumented treadmill for spatiotemporal parameters, peak pressures and forces during walking and running?MethodsTreadmill gait and running analysis was performed at 5.0, 6.5, and 9.0 km/h in 33 healthy adults (age: 31.6 ± 7.4 years; body mass index: 23.8 ± 3.2 kg/m²) once on day 1 and twice on day 7. For all three speeds, intraclass correlation coefficents (ICC) and smallest detectable differences (SDC) corresponding to 95% limits of agreement were calculated for spatiotemporal parameters and peak pressures and forces in the heel, midfoot, and forefoot regions.ResultsAll spatiotemporal parameters and peak forces in the heel, midfoot, and forefoot regions showed a good within- and between-day repeatability (ICCs > 0.878) for all gait speeds with within-day repeatability being generally higher. For peak pressures, only the heel and forefoot regions but not the midfoot region, showed good repeatability (ICC > 0.9) at all gait speeds. SDCs ranged from 1.5 to 2.5° for foot rotation, 4.4 to 6.6 cm for stride length, 0.7 to 2.5% for length of stance phases, and 2.8 to 9.2 N/cm² for peak pressures in all foot regions. For walking, SDCs of peak forces in the heel, midfoot and forefoot regions were below 60 N, and for running below 135 N.SignificanceExcept for peak pressures in the midfoot, spatiotemporal and kinetic gait parameters during walking and running showed a good within- and between-day repeatability. Hence, the investigated treadmill is suitable to analyze gait patterns and changes in gait patterns due to interventions.



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Effect of the sagittal ankle angle at initial contact on energy dissipation in the lower extremity joints during a single-leg landing

Publication date: Available online 7 March 2018
Source:Gait & Posture
Author(s): Jinkyu Lee, Yongnam Song, Choongsoo S. Shin
BackgroundDuring landing, the ankle angle at initial contact (IC) exhibits relatively wide individual variation compared to the knee and hip angles. However, little is known about the effect of different IC ankle angles on energy dissipation.Research QuestionThe purpose of this study was to investigate the relationship between individual ankle angles at IC and energy dissipation in the lower extremity joints.MethodsTwenty-seven adults performed single-leg landings from a 0.3-m height. Kinetics and kinematics of the lower extremity joints were measured. The relationship between ankle angles at IC and negative work, range of motion, the time to peak ground reaction force, and peak loading rate were analyzed.ResultsThe ankle angle at IC was positively correlated with ankle negative work (r = 0.80, R² = 0.64, p < 0.001) and the contribution of the ankle to total (ankle, knee and hip joint) negative work (r = 0.84, R² = 0.70, p < 0.001), but the ankle angle was negatively correlated with hip negative work (r = −0.46, R² = 0.21, p = 0.01) and the contribution of the hip to total negative work (r = −0.61, R² = 0.37, p < 0.001). The knee negative work and the contribution of the knee to total negative work were not correlated with the ankle angle at IC. The ankle angle at IC was positively correlated with total negative work (r = 0.50, R² = 0.25, p < 0.01) and negatively correlated with the peak loading rate (r = −0.76, R² = 0.57, p < 0.001).SignificanceThese results indicated that landing mechanics changed as the ankle angle at IC increased, such that the ankle energy dissipation increased and redistributed the energy dissipation in the ankle and hip joints. Further, these results suggest that increased ankle energy dissipation with a higher IC plantar flexion angle may be a potential landing technique for reducing the risk of injury to the anterior cruciate ligament and hip musculature.



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