Loss of fractal gait harmony in Parkinson’s Disease

Iosa, Marco; Morone, Giovanni; Fusco, Augusto; Marchetti, F.; Caltagirone, Carlo; Paolucci, Stefano; Peppe, Antonella

doi:10.1016/j.clinph.2015.11.016

Cited by 30 publications

(40 citation statements)

References 53 publications

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“…Our results showed that the three GRs converged towards the theoretical value of ϕ for WS > 1 m/s. This result is different from that found in patients with Parkinson’s disease, in which the alteration of GR was present even in patients with a walking speed of higher than 1 m/s [29]. Intriguingly, the GR values recorded for our patients with stroke were between those recorded at slow and comfortable speeds for healthy subjects.…”

Section: Discussioncontrasting

confidence: 99%

“…In healthy subjects, muscle activations intervene at discrete times to drive the pendular oscillations of the system for compensating for the small loss of energy. Different from patients with Parkinson’s disease, in which the alteration of GR seems related to the deficits in producing timed internal cues [29], it is conceivable that in patients with stroke, the main problem is not related to the timing of locomotor control, but to the force deficit that does not allow them to exploit the pendular mechanism of walking for generating harmonic movements. Hence, for patients with stroke, the GR alteration seems to be an effect, and not a cause, of speed reduction.…”

Section: Discussionmentioning

confidence: 99%

“…Other neurological diseases, with different etiopathology such as Parkinson’s disease or ataxia expose subjects to wider alterations in terms of gait harmony [29]. …”

Section: Discussionmentioning

confidence: 99%

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Stability and Harmony of Gait in Patients with Subacute Stroke

et al. 2016

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Stroke affects many gait features, such as gait stability, symmetry, and harmony. However, it is still unclear which of these features are directly altered by primary damage, and which are affected by the reduced walking speed. The aim of this study was to analyze the above gait features in patients with subacute stroke with respect to the values observed in age- and speed-matched healthy subjects. A wearable triaxial accelerometer and an optoelectronic device were used for assessing the upright gait stability, symmetry of trunk movements, and harmonic structure of gait phases by means of the root-mean-square (RMS) acceleration of the trunk, harmonic ratio (HR), and gait ratios (GRs), respectively. For healthy subjects, results showed that RMS acceleration increased with speed, HR peaked at a comfortable speed, and GRs tended towards the theoretical value of the golden ratio for speeds >1 m/s. At matched speed conditions, patients showed higher instabilities in the latero-lateral axis (p = 0.001) and reduced symmetry of trunk movements (p = 0.002). Different from healthy subjects, antero-posterior and latero-lateral acceleration harmonics were coupled in patients (R = 0.507, p = 0.023). Conversely, GRs were not more altered in patients than in slow-walking healthy subjects. In conclusion, patients with stroke showed some characteristics similar to those of the elderly when the latter subjects walk slowly, and some altered characteristics, such as increased latero-lateral instabilities coupled with movements performed along the antero-posterior axis.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Stability and Harmony of Gait in Patients with Subacute Stroke

et al. 2016

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“…Thus, the anterior putamen plays a role in the recovery of upper limbs, and the posterolateral putamen has an important role in the recovery of lower limbs (Alexander et al., ; Lee et al., ). In addition, globus pallidus would be an important structure for gait; it is connected with the cerebellum, the central pattern generator, and plays an inhibitory role while balancing the excitatory effect of the cerebellum in automatic movements (Iosa, Morone, et al., ). Our results revealed that globus pallidus had an influence on gait at 3 months after onset upon the VLSM analysis, and at 6 months after onset as well, upon the subtraction analysis.…”

Section: Discussionmentioning

confidence: 99%

Brain lesions affecting gait recovery in stroke patients

et al. 2017

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ObjectivesGait recovery is an important goal in stroke patients. Several studies have sought to uncover relationships between specific brain lesions and the recovery of gait, but the effects of specific brain lesions on gait remain unclear. Thus, we investigated the effects of stroke lesions on gait recovery in stroke patients.Materials and MethodsIn total, 30 subjects with stroke were assessed in a retrograde longitudinal observational study. To assess gait function, the functional ambulation category (FAC) was tested four times: initially (within 2 weeks) and 1, 3, and 6 months after the onset of the stroke. Brain lesions were analyzed via overlap, subtraction, and voxel‐based lesion symptom mapping (VLSM).ResultsAmbulation with FAC improved significantly with time. Subtraction analysis showed that involvement of the corona radiata, internal capsule, globus pallidus, and putamen were associated with poor recovery of gait throughout 6 months after onset. The caudate nucleus did influence poor recovery of gait at 6 months after onset. VLSM revealed that corona radiata, internal capsule, globus pallidus, putamen and cingulum were related with poor recovery of gait at 3 months after onset. Corona radiata, internal capsule, globus pallidus, putamen, primary motor cortex, and caudate nucleus were related with poor recovery of gait at 6 months after onset.ConclusionResults identified several important brain lesions for gait recovery in patients with stroke. These results may be useful for planning rehabilitation strategies for gait and understanding the prognosis of gait in stroke patients.

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“…Recently, the Golden ratio has been found in gait cycle (GC) as the proportion between the stance duration (the longer part of a stride) and the swing duration (the shorter part). When the stance and swing are in the golden ratio, gait phases revealed a fractal structure based on the property of autosimilarity, with the same proportionality emerging between units and consecutive subunits of gait, resembling in each part the same whole structure (Iosa et al, 2016d ) as follows:

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Section: Current Advances In Human Walking: the Golden Gaitmentioning

confidence: 99%

Golden Gait: An Optimization Theory Perspective on Human and Humanoid Walking

2017

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Human walking is a complex task which includes hundreds of muscles, bones and joints working together to deliver harmonic movements with the need of finding equilibrium between moving forward and maintaining stability. Many different computational approaches have been used to explain human walking mechanisms, from pendular model to fractal approaches. A new perspective can be gained from using the principles developed in the field of Optimization theory and in particularly the branch of Game Theory. In particular we provide a new insight into human walking showing as the trade-off between advancement and equilibrium managed during walking has the same solution of the Ultimatum game, one of the most famous paradigms of game theory, and this solution is the golden ratio. The golden ratio is an irrational number that was found in many biological and natural systems self-organized in a harmonic, asymmetric, and fractal structure. Recently, the golden ratio has also been found as the equilibrium point between two players involved into the Ultimatum Game. It has been suggested that this result can be due to the fact that the golden ratio is perceived as the fairest asymmetric solution by the two players. The golden ratio is also the most common proportion between stance and swing phase of human walking. This approach may explain the importance of harmony in human walking, and provide new perspectives for developing quantitative assessment of human walking, efficient humanoid robotic walkers, and effective neurorobots for rehabilitation.

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Loss of fractal gait harmony in Parkinson’s Disease

Cited by 30 publications

References 53 publications

Stability and Harmony of Gait in Patients with Subacute Stroke

Stability and Harmony of Gait in Patients with Subacute Stroke

Brain lesions affecting gait recovery in stroke patients

Golden Gait: An Optimization Theory Perspective on Human and Humanoid Walking

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