Anticipatory and reactive responses to underfoot perturbations during gait in healthy adults and individuals with a recent mild traumatic brain injury.
Anticipatory and reactive responses to underfoot perturbations during gait in healthy adults and individuals with a recent mild traumatic brain injury.
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DOI：
10.1016/j.clinbiomech.2021.105496
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发表时间：
2021-12
期刊：
影响因子：
--
通讯作者：
Fino PC
中科院分区：
文献类型：
--
作者：
Kreter N;Rogers CL;Fino PC
轻度创伤性脑损伤后，个体通常会在平坦表面上表现出可量化的步态缺陷，但人们对他们如何在复杂表面上控制步态知之甚少。这种复杂的表面需要精确的神经运动控制来预测行走表面的微小干扰并对其做出反应，而轻度创伤性脑损伤相关的平衡缺陷可能会对这些步态调整产生不利影响。本研究调查了健康成年人 (n = 5) 和轻度脑外伤患者 (n = 5) 对预期和意外脚下扰动的预期和反应性步态调整。参与者完成了行走试验，其中机械化鞋产生随机意外或预期的脚下扰动，惯性测量装置从脚和胸骨收集运动数据。线性混合效应模型评估了分段、组及其相互作用对扰动和非扰动试验之间加速度标准化差异的影响。当意外扰动时，两组人都表现出相似的步态策略。在预期扰动之前的后期摆动阶段，与未受扰动的步态相比，患有轻度创伤性脑损伤的人表现出受扰足的横向加速度更大，躯干的横向运动更少。与同期未受干扰的步态相比，对照组参与者的脚外侧加速度较小，躯干内侧加速度没有差异。在步态周期的这一部分中，显着的组*段交互作用（p < 0.001）表明各组对扰动采取了不同的预期策略。患有轻度创伤性脑损伤的个体可能会因受伤而导致持续的神经机械缺陷而对预期的扰动采取谨慎的策略。
Following mild traumatic brain injury individuals often exhibit quantifiable gait deficits over flat surfaces, but little is known about how they control gait over complex surfaces. Such complex surfaces require precise neuromotor control to anticipate and react to small disturbances in walking surfaces, and mild traumatic brain injury-related balance deficits may adversely affect these gait adjustments. This study investigates anticipatory and reactive gait adjustments for expected and unexpected underfoot perturbations in healthy adults (n = 5) and individuals with mild traumatic brain injury (n = 5). Participants completed walking trials with random unexpected or expected underfoot perturbations from a mechanized shoe and inertial measurement units collected kinematic data from the feet and sternum. Linear mixed-effects models assessed the effects of segment, group, and their interaction on standardized difference of accelerations between perturbation and non-perturbation trials. Both groups demonstrated similar gait strategies when perturbations were unexpected. During late swing phase before expected perturbations, persons with mild traumatic brain injury exhibited greater lateral acceleration of their perturbed foot and less lateral movement of their trunk compared with unperturbed gait. Control participants exhibited less lateral foot acceleration and no difference in mediolateral trunk acceleration compared with unperturbed gait during the same period. A significant group*segment interaction (p < 0.001) during this part of the gait cycle suggests the groups adopted different anticipatory strategies for the perturbation. Individuals with mild traumatic brain injury may be adopting cautious strategies for expected perturbations due to persistent neuromechanical deficits stemming from their injury.
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