Foot-placement accuracy during planned and reactive target stepping during walking in stroke survivors and healthy adults

Veen, Susanne M. van der; Hammerbeck, Ulrike; Hollands, Kristen

doi:10.1016/j.gaitpost.2020.08.114

Cited by 6 publications

(4 citation statements)

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“…Doi et al showed that better visual memory was associated with faster gait speed, especially in participants with mild cognitive impairment ( 49 ). This is in agreement with literature showing people slow down ( 15 , 50 ) and attentional costs increase ( 51–53 ) when walking to visual targets, and sway area (an often used balance measure) increases when eyes are closed ( 54 ). However, better delayed recall (after a 25-min delay) is associated with slower gait speeds.…”

Section: Discussionsupporting

confidence: 92%

“…However, during more complex (and dynamic) tasks, integration informed by all sensory inputs may be more critical to task success. When walking in cluttered terrain, where multiple obstacles complicate foot-placement ( 15 ), visual information can be leveraged in a feed-forward manner to register (1) where the foot needs to be placed safely and (2) ongoing visual monitoring of the foot to safely place the foot.…”

Section: Introductionmentioning

confidence: 99%

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Sensory functions and their relation to balance metrics: a secondary analysis of the LIMBIC-CENC multicenter cohort

van der Veen,

Perera,

Fino

et al. 2023

Front. Neurol.

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IntroductionAmong patients with traumatic brain injury (TBI), balance problems often persist alongside hearing and vision impairments that lead to poorer outcomes of functional independence. As such, the ability to regain premorbid independent gait may be dictated by the level of sensory acuity or processing decrements that are shown following TBI assessment. This study explores the relationships between standardized sensory acuity and processing outcomes to postural balance and gait speed.MethodsSecondary analysis was performed on the Long-Term Impact of Military- Relevant Brain Injury Consortium Chronic Effects of Neurotrauma Consortium LIMBIC (CENC) data set. Separate regression analyses were carried out for each of the balance assessments (via Computerized Dynamic Posturography, CDP) and walking speed.DiscussionTBI frequency was significantly related to the majority of single CDP outcomes (i.e., Conditions 2–6), while various sensory processing outcomes had task-specific influences. Hearing impairments and auditory processing decrements presented with lower CDP scores (CDP Conditions 3,5,6, and 1–3 respectively), whereas greater visual processing scores were associated with better CDP scores for Conditions 2,5, and 6. In sum, patients with TBI had similar scores on static balance tests compared to non-TBI, but when the balance task got more difficult patients with TBI scored worse on the balance tests. Additionally, stronger associations with sensory processing than sensory acuity measures may indicate that patients with TBI have increased fall risk.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Sensory functions and their relation to balance metrics: a secondary analysis of the LIMBIC-CENC multicenter cohort

van der Veen,

Perera,

Fino

et al. 2023

Front. Neurol.

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“…This study included persons with chronic stroke with different mobility function levels and was the first to report that ipsilateral lower limb targeted movement performance was also associated with gait after stroke. The sub-tasks involved in gait adaptation primarily include taking a step to properly place the foot in the environment and at the same time maintaining forward propulsion force and balance in healthy adults and persons with stroke [61,62]. Targeted movement is a fundamental ability in proper foot placement and could thus be associated with gait.…”

Section: Plos Onementioning

confidence: 99%

Ipsilateral lower limb motor performance and its association with gait after stroke

Lee,

Chen,

Tseng

et al. 2024

PLoS ONE

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Background and purpose Motor deficits of the ipsilateral lower limb could occur after stroke and may be associated with walking performance. This study aimed to determine whether the accuracy and movement path of targeted movement in the ipsilateral lower limb would be impaired in the chronic stage of stroke and whether this impairment would contribution to gait. Methods Twenty adults with chronic stroke and 20 age-matched controls went through Mini Mental Status Examination (MMSE), and a series of sensorimotor tests. The targeted movement tasks were to place the big toe ipsilateral to the lesion at an external visual target (EXT) or a proprioceptive target (PRO, contralateral big toe) with eyes open (EO) or closed (EC) in a seated position. A motion analysis system was used to obtain the data for the calculation of error distance, deviation from a straight path, and peak toe-height during the targeted movement tasks and gait velocity, step length, step width and step length symmetry of the lower limb ipsilateral to the brain lesion during walking. Results The stroke group had significantly lower MMSE and poorer visual acuity on the ipsilateral side, but did not differ in age or other sensorimotor functions when compared to the controls. For the targeted movement performance, only the deviation in PRO-EC showed significant between-group differences (p = 0.02). Toe-height in both EXT-EO and in PRO-EO was a significant predictor of step length (R2 = 0.294, p = 0.026) and step length symmetry (R2 = 0.359, p = 0.014), respectively. Discussion and conclusions The performance of ipsilateral lower limb targeted movement could be impaired after stroke and was associated with step length and its symmetry. The training of ipsilateral targeted movement with unseen proprioceptive target may be considered in stroke rehabilitation.

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“…The resulting cognitive decline and limited executive function (EF) have been related to the risk of falling and control of gait. Elderly and stroke survivors have been known to lag or slow down when walking to audio or visual cues ( 1 , 2 ), be less accurate at dual tasks (auditory Stroop-task) during walking ( 3 ), and even stop walking when talking ( 4 , 5 ). Patients with traumatic brain injury (TBI) can suffer symptoms of dizziness, nausea, and postural instability that persist for over 3 months in 40%−50% of mild TBI patients ( 6 – 11 ) and longer when caused by blast exposure (e.g., military injury and industrial accidents).…”

Section: Introductionmentioning

confidence: 99%

Executive function and relation to static balance metrics in chronic mild TBI: A LIMBIC-CENC secondary analysis

Veen

Perera²,

Manning-Franke³

et al. 2023

Front. Neurol.

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IntroductionAmong patients with traumatic brain injury (TBI), postural instability often persists chronically with negative consequences such as higher fall risk. One explanation may be reduced executive function (EF) required to effectively process, interpret and combine, sensory information. In other populations, a decline in higher cognitive functions are associated with a decline in walking and balance skills. Considering the link between EF decline and reduction in functional capacity, we investigated whether specific tests of executive function could predict balance function in a cohort of individuals with a history of chronic mild TBI (mTBI) and compared to individuals with a negative history of mTBI.MethodsSecondary analysis was performed on the local LIMBIC-CENC cohort (N = 338, 259 mTBI, mean 45 ± STD 10 age). Static balance was assessed with the sensory organization test (SOT). Hierarchical regression was used for each EF test outcome using the following blocks: (1) the number of TBIs sustained, age, and sex; (2) the separate Trail making test (TMT); (3) anti-saccade eye tracking items (error, latency, and accuracy); (4) Oddball distractor stimulus P300 and N200 at PZ and FZ response; and (5) Oddball target stimulus P300 and N200 at PZ and FZ response.ResultsThe full model with all predictors accounted for between 15.2% and 21.5% of the variability in the balance measures. The number of TBI's) showed a negative association with the SOT2 score (p = 0.002). Additionally, longer times to complete TMT part B were shown to be related to a worse SOT1 score (p = 0.038). EEG distractors had the most influence on the SOT3 score (p = 0.019). Lastly, the SOT-composite and SOT5 scores were shown to be associated with longer inhibition latencies and errors (anti-saccade latency and error, p = 0.026 and p = 0.043 respectively).ConclusionsThese findings show that integration and re-weighting of sensory input when vision is occluded or corrupted is most related to EF. This indicates that combat-exposed Veterans and Service Members have greater problems when they need to differentiate between cues when vision is not a reliable input. In sum, these findings suggest that EF could be important for interpreting sensory information to identify balance challenges in chronic mTBI.

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Foot-placement accuracy during planned and reactive target stepping during walking in stroke survivors and healthy adults

Cited by 6 publications

References 36 publications

Sensory functions and their relation to balance metrics: a secondary analysis of the LIMBIC-CENC multicenter cohort

Sensory functions and their relation to balance metrics: a secondary analysis of the LIMBIC-CENC multicenter cohort

Ipsilateral lower limb motor performance and its association with gait after stroke

Executive function and relation to static balance metrics in chronic mild TBI: A LIMBIC-CENC secondary analysis

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