These data provide new evidence of a potential role for KE strength asymmetries in the symptomatic fatigue and physical dysfunction of persons with MS, possibly through an effect on postural stability.
Individuals with multiple sclerosis (MS) often have poor balance control that is especially apparent during dynamic tasks such as gait initiation (GI). The purpose of this study was to investigate how balance symptoms due to MS alter spatiotemporal variables, coordination, and temporal margins within the stability boundary during gait initiation. Twelve women with MS (Expanded Disability Status Scale [EDSS] mean = 4.0, SD = 1.4) and 12 women without MS (control group) initiated gait at their preferred speed. MS participants attained a slower anterior velocity because of smaller anterior center of mass displacements and took longer to complete the initiation of gait than the control group. MS participants exhibited a smaller posterior shift in center of pressure during GI and stepped with a longer dual support time than the control group. However, these changes may be due to differences in initiation velocity. Relative timing analysis showed invariance in postural and locomotor phases of gait initiation between groups. The MS group showed different coordination between anterior-posterior and medio-lateral center of pressure components while increasing temporal margins to the posterior and lateral stability boundaries in comparison with the control group. Overall, during gait initiation at their preferred speed the MS participants adopted a functional strategy that produces lower speed and reduced proximity to the stability boundaries prior to stepping.
Locomotor respiratory coupling patterns in humans have been assessed on the basis of the interaction between different physiological and motor subsystems; these interactions have implications for movement economy. A complex and dynamical systems framework may provide more insight than entrainment into the variability and adaptability of these rhythms and their coupling. The purpose of this study was to investigate the relationship between steady state locomotor-respiratory coordination dynamics and oxygen consumption [Formula: see text] of the movement by varying walking stride frequency from preferred. Twelve male participants walked on a treadmill at a self-selected speed. Stride frequency was varied from -20 to +20% of preferred stride frequency (PSF) while respiratory airflow, gas exchange variables, and stride kinematics were recorded. Discrete relative phase and return map techniques were used to evaluate the strength, stability, and variability of both frequency and phase couplings. Analysis of [Formula: see text] during steady-state walking showed a U-shaped response (P = 0.002) with a minimum at PSF and PSF - 10%. Locomotor-respiratory frequency coupling strength was not greater (P = 0.375) at PSF than any other stride frequency condition. The dominant coupling across all conditions was 2:1 with greater occurrences at the lower stride frequencies. Variability in coupling was the greatest during PSF, indicating an exploration of coupling strategies to search for the coupling frequency strategy with the least oxygen consumption. Contrary to the belief that increased strength of frequency coupling would decrease oxygen consumption; these results conclude that it is the increased variability of frequency coupling that results in lower oxygen consumption.
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