Chesnutt, A. N. | bioRxiv Science

bioRxiv2020

Effects of targeted assistance and perturbations on the relationship between pelvis motion and step width in people with chronic stroke

BackgroundPeople with chronic stroke (PwCS) often exhibit a weakened relationship between pelvis motion and paretic step width, a behavior important for gait stabilization. We have developed a force-field able to manipulate this relationship on a step-by-step basis. ObjectiveThe objective of this study was to investigate the effects of a single exposure to our novel force-field on the step-by-step modulation of paretic step width among PwCS, quantified by the partial correlation between mediolateral pelvis displacement at the start of a step and paretic step width (step start paretic {rho}disp). MethodsFollowing a 3-minute period of normal walking, participants were exposed to 5-minutes of either force-field assistance (n=10; pushing the swing leg toward a mechanically-appropriate step width) or perturbations (n=10; pushing the swing leg away from a mechanically-appropriate step width). This period of assistance or perturbations was followed by a 1-minute catch period to identify any after-effects, a sign of sensorimotor adaptation. ResultsWe found that assistance did not have a significant direct effect or after-effect on step start paretic {rho}disp. In contrast, perturbations directly reduced step start paretic {rho}disp (p=0.004), but were followed by an after-effect in which this metric was increased above the baseline level (p=0.02). ConclusionsThese initial results suggest that PwCS have the ability to strengthen the link between pelvis motion and paretic foot placement if exposed to a novel mechanical environment, which may benefit gait stability. Future work is needed to determine whether this effect can be extended with repeated exposure to force-field perturbations.

bioengineering↗

bioRxiv2019

Altered active control of step width in response to mediolateral leg perturbations while walking

During human walking, step width is predicted by mediolateral motion of the pelvis, a relationship that can be attributed to a combination of passive body dynamics and active sensorimotor control. The purpose of the present study was to investigate whether humans modulate the active control of step width in response to a novel mechanical environment. Participants were repeatedly exposed to a force-field that either assisted or perturbed the normal relationship between pelvis motion and step width, separated by washout periods to detect the presence of potential after-effects. As intended, force-field assistance directly strengthened the relationship between pelvis displacement and step width. This relationship remained strengthened with repeated exposure to assistance, and returned to baseline afterward, providing minimal evidence for assistance-driven changes in active control. In contrast, force-field perturbations directly weakened the relationship between pelvis motion and step width. Repeated exposure to perturbations diminished this negative direct effect, and produced larger positive after-effects once the perturbations ceased. Both of these results provide evidence of gradual changes in active control in response to perturbations. In the longer term, these methods may be useful for improving deficits in the active control of step width often observed among clinical populations with poor walking balance.

bioengineering↗