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Interlimb Coordination Performance in Seated Position in Persons With Multiple Sclerosis: Reduced Amplitude Over 6 min and Higher Coordination Variability in Persons With Walking Fatigability

ABSTRACT: Background: Walking fatigability is prevalent in MS and can be measured by a percentage distance decline during a 6-min walking test. Walking is characterized by an accurate and consistent interlimb antiphase coordination pattern. A decline in coordination each minute during a 6-min walking test is observed in persons with MS (pwMS). Measuring coordination during a 6-min seated coordination task with minimized balance and strength requirements, is assumed to examine a more fundamental interlimb antiphase coordination pattern in pwMS. This research aimed to answer the following research question: How does interlimb antiphase coordination pattern change during a seated coordination task in pwMS with walking fatigability (WF), non-walking fatigability (NWF) and Healthy Controls (HC)? Methods: Thirty-five pwMS and 13 HC participated. Interlimb coordination was assessed by a seated 6-min coordination task (6MCT) with the instruction to perform antiphase lower leg movements as fast as possible. Outcomes were Phase Coordination Index (PCI) and movement parameters (amplitude, frequency). Results: Mixed models revealed a significant effect of time for the the variability of generating interlimb movements, with a difference in mean values between WF and HC. A significant group∗time interaction effect was found for movement amplitude, represented by a significant decrease in movement amplitude in the WF group from minute 1 to the end of the task. Conclusion: The higher variability in interlimb coordination and decrease in movement amplitude over time during the 6MCT in the WF group could be an indicator of decreased control of fundamental antiphase coordination pattern in pwMS with walking fatigability. Clinical Trial Registration:www.clinicaltrials.gov, identifier NCT04142853 (registration date: October 29, 2019) and NCT03938558 (registration date: May 6, 2019).

SUBMITTER: Goetschalckx M

PROVIDER: S-EPMC8564500 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Handholding can naturally occur between two walkers. When people walk side-by-side, either with or without hand contact, they often synchronize their steps. However, despite the importance of haptic interaction in general and the natural use of hand contact between humans during walking, few studies have investigated forces arising from physical interactions. Eight pairs of adult subjects participated in this study. They walked on side-by-side treadmills at 4 km/h independently and with hand contact. Only hand contact-related sensory information was available for unintentional synchronization, while visual and auditory communication was obstructed. Subjects walked at their natural cadences or following a metronome. Limb kinematics, hand contact 3D interaction forces and EMG activity of 12 upper limb muscles were recorded. Overall, unintentional step frequency locking was observed during about 40% of time in 88% of pairs walking with hand contact. On average, the amplitude of contact arm oscillations decreased while the contralateral (free) arm oscillated in the same way as during normal walking. Interestingly, EMG activity of the shoulder muscles of the contact arm did not decrease, and their synergistic pattern remained similar. The amplitude of interaction forces and of trunk oscillations was similar for synchronized and non-synchronized steps, though the synchronized steps were characterized by significantly more regular orientations of interaction forces. Our results further support the notion that gait synchronization during natural walking is common, and that it may occur through interaction forces. Conservation of the proximal muscle activity of the contact (not oscillating) arm is consistent with neural coupling between cervical and lumbosacral pattern generation circuitries ("quadrupedal" arm-leg coordination) during human gait. Overall, the findings suggest that individuals might integrate force interaction cues to communicate and coordinate steps during walking.

Project description:Interlimb coordination plays an important role in adaptive locomotion of humans and animals. This has been investigated using a split-belt treadmill, which imposes different speeds on the two sides of the body. Two types of adaptation have been identified, namely fast and slow adaptations. Fast adaptation induces asymmetric interlimb coordination soon after a change of the treadmill speed condition from same speed for both belts to different speeds. In contrast, slow adaptation slowly reduces the asymmetry after fast adaptation. It has been suggested that these adaptations are primarily achieved by the spinal reflex and cerebellar learning. However, these adaptation mechanisms remain unclear due to the complicated dynamics of locomotion. In our previous work, we developed a locomotion control system for a biped robot based on the spinal reflex and cerebellar learning. We reproduced the fast and slow adaptations observed in humans during split-belt treadmill walking of the biped robot and clarified the adaptation mechanisms from a dynamic viewpoint by focusing on the changes in the relative positions between the center of mass and foot stance induced by reflex and learning. In this study, we modified the control system for application to a quadruped robot. We demonstrate that even though the basic gait pattern of our robot is different from that of general quadrupeds (due to limitations of the robot experiment), fast and slow adaptations that are similar to those of quadrupeds appear during split-belt treadmill walking of the quadruped robot. Furthermore, we clarify these adaptation mechanisms from a dynamic viewpoint, as done in our previous work. These results will increase the understanding of how fast and slow adaptations are generated in quadrupedal locomotion on a split-belt treadmill through body dynamics and sensorimotor integration via the spinal reflex and cerebellar learning and help the development of control strategies for adaptive locomotion of quadruped robots.

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Interlimb Coordination Performance in Seated Position in Persons With Multiple Sclerosis: Reduced Amplitude Over 6 min and Higher Coordination Variability in Persons With Walking Fatigability

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