Playing Exergames Facilitates Central Drive to the Ankle Dorsiflexors During Gait in Older Adults; a Quasi-Experimental Investigation

Abstract

PurposeGait training might be of particular importance to reduce fall risk in older adults. In the present study we explore the hypothesis that video game-based training will increase tibialis anterior (TA) muscle EMG-EMG coherence and relates to functional measures of lower limb control.MethodsWe focus on video game-based training performed in standing position, where the subjects have to lift their toes to place their feet on different target zones in order to successfully play the game. This type of training is hypothesized leading to progressive changes in the central motor drive to TA motor neurons and, consequently, improved control of ankle dorsiflexion during gait.ResultsTwenty older adults, 79 ± 8 years old, 13 females/7 males, participated. Results showed a significant difference against 0 in the experimental ΔPOST condition in dual-task walking and beta Frequency Of Interest (p = 0.002). Walking under dual task condition showed significant change over time in minimal Toe Clearance for both the left [χ2(2) = 7.46, p = 0.024, n = 20] and right [χ2(2) = 8.87, p = 0.012, n = 20] leg. No change in lower extremity function was detectable.ConclusionOverall we conclude that the initiation of an exergame-based training in upright standing position improves neural drive to the lower extremities in older adults, effects on minimal Toe Clearance and seems an acceptable form of physical exercise for this group.

A pilot study assessing reliability and age‐related differences in corticomuscular and intramuscular coherence in ankle dorsiflexors during walking

“…focus of this involved locomotor task. Indeed, the present study explored corticospinal control of gait only during the swing phase of gait, to be in line with previous studies investigating the same gait phase (de Bruin et al, 2019;Petersen et al, 2012;van Asseldonk et al, 2014), however, it remains unclear whether different gait phases will show comparable results. Indeed, promising investigations in this direction have been reported and, in particular, the double limbs support phase of walking showed to differently modulate corticospinal control of gait (Artoni et al, 2017;Roeder et al, 2019Roeder et al, , 2018.…”

“…One of the two pairs of bipolar electrodes was placed over the left tibialis anterior (TA) muscle, while the other was over the right TA muscle. In each pair, one sensor was placed proximally (TAprox) while the other was placed distally (TAdist) with respect to the muscle belly and according to previously described anatomical landmarks (de Bruin, Patt, Ringli, & Gennaro, ; Jensen et al, , ; Spedden et al, ; van Asseldonk et al, ). The interelectrode distance (electrodes’ center‐to‐center) was set to ~ 2 cm and the distance between bipolar configurations in each leg was ∼11 cm (σ: ∼2 cm; range: ∼7 cm to ∼14 cm), to reduce the risk of cross‐talk as well as the recording of muscle activity from overlapping motor unit areas (Hansen et al, ).…”

“…The cleaned preprocessed EEG and EMG data were then segmented according to the swing phase from 650‐ms to 50‐ms before heel strike onsets in analogy to previous studies (Jensen et al, , ; Petersen et al, ; Spedden et al, ), avoiding the inclusion of any potentially remaining artifact due to the collision of the foot with the ground. Two participants (one in OLD and one in YNG, in the D1 and D2, respectively) were not considered for further analysis because the total amount of trials (i.e., heel strikes) was excessively low, and given that at least 25 trials per participant were used as minimum threshold criterion for further analysis, consistent with literature (de Bruin et al, ). On average, ~231 gait segments (σ: ∼109; range: 39–434, considering the sum of left and right heel strikes) were used for coherence estimation.…”

“…This method is widely used in literature on corticospinal control of gait (Jensen et al, , ; Petersen et al, ; Spedden et al, , ) as well as in studies on CMC using motor/low‐level force tasks (Chakarov et al, ; Kristeva, Patino, & Omlor, ; Omlor, Patino, Hepp‐Reymond, & Kristeva, ). Differently, one may opt to perform Fisher Z‐transformation and nonparametric permutations statistical testing (de Bruin et al, ; Maris, Schoffelen, & Fries, ), which is an alternative valid method to overcome the inconsistent number of segments used for the coherence analysis. However, in this study, we have chosen the first option given that it gives the possibility to exclude nonsignificant (and possibly not spurious) coherence estimates also at subject‐level and not exclusively at group‐level (as the second method would do).…”

“…In the present study, we focused on the collated FOI from 13 to 40 Hz, given that the central drive to muscles during gait has been shown to be largely present in this gathered frequency band (Barthelemy et al, ; de Bruin et al, ; Jensen et al, , ; Kitatani et al, ; Norton & Gorassini, ; Petersen et al, ; Spedden et al, ).…”