Anticipatory and reactive responses to underfoot perturbations during gait in healthy adults and individuals with a recent mild traumatic brain injury.

Autor: Kreter N; Department of Health and Kinesiology, University of Utah, 250 South 1850 East Salt Lake City, UT 84112, United States. Electronic address: nick.kreter@utah.edu., Rogers CL; Department of Biomedical Engineering, University of Utah, 36 South Wasatch Drive Salt Lake City, UT 84112, United States., Fino PC; Department of Health and Kinesiology, University of Utah, 250 South 1850 East Salt Lake City, UT 84112, United States.
Jazyk: angličtina
Zdroj: Clinical biomechanics (Bristol, Avon) [Clin Biomech (Bristol, Avon)] 2021 Dec; Vol. 90, pp. 105496. Date of Electronic Publication: 2021 Sep 27.
DOI: 10.1016/j.clinbiomech.2021.105496
Abstrakt: Background: 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.
Methods: 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.
Findings: 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.
Interpretation: Individuals with mild traumatic brain injury may be adopting cautious strategies for expected perturbations due to persistent neuromechanical deficits stemming from their injury.
(Copyright © 2021 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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