Brazilian Journal of Motor Behavior

Editorial: Control of Gait and Posture: a tribute to Professor Lilian T. B. Gobbi

2023-08-12T14:22:35+00:00

This special issue aims to pay tribute to Professor Lilian Gobbi by discussing the control of gait and posture. Given her extensive dedication to comprehending gait and posture control throughout her life, this issue delves into cutting-edge studies that explore various aspects related to these topics. These aspects encompass mobility and balance performance, kinematics, kinetics, muscle activity, and brain activity analysis under both normal and adaptive conditions. Within this special issue, an array of themes associated with gait and posture control is presented through ten dedicated articles, all of which are intended to honor Professor Lilian Gobbi. Among these, five studies investigated locomotion, while three studies closely examined postural control. Furthermore, two studies took on a dual-tasking, addressing both gait and posture contexts. We would also like to extend our gratitude to the reviewers and members of the editorial board for their invaluable expertise and unwavering dedication in ensuring the utmost quality of research presented in this editorial. The editors of this Special Issue are not only pleased with the contributions made to honor Professor Lilian Gobbi, but also view these contributions as a celebration of scientific collaboration and the significant strides we have taken in advancing our understanding of gait and posture.

Effect of antiparkinsonian medication on spatiotemporal gait parameters of individuals with Parkinson’s disease: comparison between individuals with and without freezing of gait

2023-06-01T19:21:47+00:00

BACKGROUND: The gait of individuals with Parkinson’s disease (PD) tends to be slower, characterized by narrow and short steps. During the medication, the self-selected gait speed of individuals with PD increases. However, when looking individually at the spatiotemporal parameters of gait, the medication induces different and not always consistent effects. However, the effects of medication and freezing of gait during walking in individuals with PD are unknown.

AIM: To analyze the effect of antiparkinsonian medication and freezing of gait (FoG) on spatiotemporal gait parameters in individuals with PD.

METHOD: For this purpose, we compared gait parameters in individuals with FoG (freezers, n=11) and without FoG (non-freezers, n=11). Spatiotemporal gait parameters (speed, cadence, step length, step time, step width, stride length, stride time, swing phase, and double support) and clinical scales (parts II and III of the Unified Parkinson’s Disease Rating Scale, Hoehn and Yahr, Montreal Cognitive Assessment questionnaire and Mini-Test scale of Balance Assessment System) were analyzed in two experimental sessions, counterbalanced between individuals: one in the ON medication state (1h after ingestion), and another in the OFF medication state (~12h after the last ingestion). Linear mixed effects models 2-groups X 2-conditions were used.

RESULTS: We found that gait speed, stride, and step length were significantly higher in the ON than in the OFF condition for both freezers and non-freezers, and significantly lower in the freezers than in the non-freezers, regardless of the medication state.

CONCLUSION: These results indicate that medication improved gait performance equivalently in both freezers and non-freezers.

Effect of long-term locomotion and balance exercise on functional mobility considering the Parkinson’s disease subtypes: a pilot study

2023-06-17T00:58:35+00:00

BACKGROUND: Different clinical subtypes (i.e., Postural Instability and Gait Difficulty -PIGD and Tremor Dominant -TD) have been highlighted in Parkinson's disease (PD). Although physical exercise improves motor symptoms in PD, the knowledge about the effect of physical exercise considering the PD subtype is limited.

AIM: To compare the effects of long-term locomotion and balance exercise on lower limb functional strength and functional mobility in PD subtypes.

METHOD: Eight individuals PIGD and 10 TD participated in this study. All individuals participated in the interventions with exercises focused on improving locomotion and balance. 48 sessions of exercise were performed three times per week for 60 minutes each session. Functional Mobility was analyzed by the Timed Up and Go test (TUG) in a single (ST) and double-task (DT – i.e., subtraction by three). Lower limb functional strength was analyzed by the 30s sit-to-stand test. Both tests were performed at baseline (pre-test) and post-intervention (post-test). Statistical analysis was performed by two-way ANOVA, with Group (PIGD vs. TD) and Moment (pre vs. post-test) factors, with repeated measures for the second factor.

RESULTS: PIGD decreased the time to perform TUG_ST in the post-test compared to the pre-test (p=0.001). Both groups decreased the time in TUG_DT and increased the number of repetitions in sit-to-stand test in the post-test in relation to the pre-test (p<0.05).

CONCLUSION: Long-term locomotion and balance exercise programs can improve functional mobility mainly in PIGD. A possible explanation is due to the greater room for improvement of PIGD subtypes and exercise specificity.

Do motor subtypes of Parkinson’s disease impact the learning of motor tasks?

2023-07-17T13:01:40+00:00

BACKGROUND:Previous studies have demonstrated that people with Parkinson's disease (PD) can acquire postural control skills even with the degeneration of motor areas responsible for consolidation of the representation regarding the learned motor skill in long-term memory. However, these findings have not considered the PD motor subtypes – tremor-dominant (TD), and postural instability and gait difficulty (PIGD). Although there is considerable heterogeneity in motor and non-motor symptoms between TD and PIGD, no study has addressed the effect of the PD subtype on learning postural control skills.

AIM:We investigated the influence of PD motor subtypes on the learning of tasks with different postural control demands.

METHOD:Fourteen individuals with PD (7 TD, 7 PIGD) practiced four motor tasks with high postural and cognitive demands. Participants completed 13 one-hour sessions (2x/week for 7 weeks). We considered the first and last practice sessions, pre-test and post-test, respectively. Also, we conducted one-week and one-month retention tests to assess performance persistence (motor learning). We assessed motor performance through the scores achieved on each motor task.

RESULTS:Both groups demonstrated improvement in performance during the acquisition phase. However, the TD group outperformed the PIGD group in all motor tasks, despite both groups showing improvement in motor performance when comparing the results of pre-test with the post-test, and the improved performance was maintained in retention tests. The performance differences between groups are dissipated during consolidation, and they did not directly affect motor learning.

INTERPRETATION: The TD and PIGD motor subtypes learned postural control tasks with different motor and cognitive demands.

The effects of social isolation on gait parameters of older people with Parkinson’s disease

2023-06-15T01:14:23+00:00

BACKGROUND: The COVID-19 disease acquired pandemic proportions in 2020. To deal with the scenario, social isolation (SI) was adopted, which configures a lack of contact with people and places. The impediments of this measure, however, can bring risks to older people with Parkinson's disease (PD), such as impairments in gait parameters.

AIM: To verify the effects of SI on gait parameters in people with Parkinson's disease.

METHOD: Thirty-three people with PD were recruited. Gait assessment was conducted in two periods: February 2020 and March 2022 (before and after the SI, respectively). For that, participants were invited to walk on a 5.74m mat with pressure sensors under two conditions: preferred walking speed and fast walking speed. Three trials were performed for each condition. The gait parameters analyzed were Stride Length, Stride Time, Double Support Time, Stride Velocity, Stride Width, and Cadence. Statistical Analysis was performed by paired t-tests for the comparison of gait parameters between moments (pre and post-SI). RESULTS: In the preferred walking speed condition, the participants reduced their Stride Length (t₁₅ = 3.88, p = 0.001) and Stride Velocity (t₁₅ = 3.63, p = 0.002) in the post-SI period. In the fast-walking speed condition, the participants also reduced their Stride Length (t₁₅ = 3.73, p = 0.002) and Stride Velocity (t₁₅ = 2.86, p = 0.012) in the post-SI period.

INTERPRETATION: The SI period reduced the stride length and velocity of people with PD. A possible explanation is the lack of physical activity resulting from this public safety measure.

Mini-BESTest cutoff points for classifying fallers and non-fallers female older adults

2023-06-20T15:13:38+00:00

BACKGROUND: The Mini-Balance Evaluation Systems Test (Mini-BESTest) is an efficient screening tool healthcare professionals use to predict the risk of falls in older adults. However, the Mini-BESTest cutoff scores to classify fallers and non-fallers were established using men and women in the same sample. Considering the higher number and prevalence of falls in older women, it is important to know the Mini-BESTest accuracy and the cutoff score specifically for this population.

AIM: We examined the capability and accuracy of the Mini-BESTest for identifying fallers and non-fallers female older adults without neurological impairments and established the cutoff scores according to different age groups.

METHOD:Eighty-one female older adults were classified into fallers (n=40) and non-fallers (n=41) groups according to their retrospective history of falls in the last 12 months. Fallers and non-fallers were divided into three age groups according to the following ranges: 65-69 years, 70-74 years, and 75+ years. We used the receiver operating characteristic (ROC) curves to determine the relative performances of the Mini-BESTest score for classifying participants with and without a history of falls.

RESULTS: The Mini-BESTest is a good and highly accurate tool for identifying female Brazilian fallers and non-fallers. The Mini-BESTest cutoff scores established to classify fallers and non-fallers female older adults in the different age groups were 26 points for 65-69 years and 24 points for 70-74 years and 75+ years.

INTERPRETATION: The Mini-BESTest is an important tool that health professionals in clinical practice can use to estimate the risk of falls for older Brazilian women.

Fear of falling is associated with gait parameters during obstacle avoidance with different physical characteristics in older adults

2023-06-17T00:55:06+00:00

BACKGROUND: Fear of falling (FOF) is related to worse locomotor performance, is a predictor of decline in functionality, and predisposes falls in older adults. It is necessary to investigate how FOF influences locomotor parameters during walking and in obstacle avoidance in older adults.

AIM: To investigate the relationship between FOF and the locomotor variables during walking through and obstacle avoidance with different physical characteristics.

METHOD: 22 older adults participated in this study and were invited to perform three tasks: 1) Walking Through; 2) Walking with a solid obstacle and 3) Walking with a fragile obstacle.

RESULTS: Correlations were found between FOF and following variables: 1) Walking Through: step velocity (r=-0.640, p=0.003), width (r=0.641, p=0.003), double support time (r=0.523, p=0.022); 2) Solid obstacle: step velocity (r=-0.666, p=0.002), length (r=-0.758, p<0.001), foot-obstacle horizontal distance (r=-0.479, p=0.038), right stride velocity (r=-0.534, p=0.019), length (r=-0.522, p=0.022), left stride velocity (r=-0.551, p=0.014), left stride duration (r=0.561, p=0.012); 3) Fragilid obstacle: step velocity (r=-0.629, p=0.004), length (r=-0.556, p=0.014), foot-obstacle distance (r=-0.540, p=0.017), obstacle-foot distance (r=-0.492, p=0.032), right stride velocity (r=-0.583, p=0.009), length (r=-0.498, p=0.030), left stride velocity (r=-0.574, p=0.010), length (r=-0.462, p=0.047), width (r=-0.514, p=0.024), right stride duration (r=0.479, p=0.038), left stride duration (r=0.646, p=0.003).

CONCLUSION: The characteristics of the obstacle did not influence the older adults FOF during walking through and obstacle avoidance. Although they adopt predictive and reactive compensatory adaptations in an attempt to make the task safer, these adaptations actually make the task more dangerous and increase the risk of stumbling and falling.

Mini-Review: Gait and balance assessment in multiple sclerosis

2023-05-26T12:33:04+00:00

BACKGROUND: Gait and balance deficiencies are significant concerns for people with multiple sclerosis, resulting in reduced walking capacity, falls and poor quality of life. Issues caused by sensory loss and the inability to properly reweight sensory information are often reported. Even at the early stages of the disease, subclinical gait and balance impairments can be found.

AIM: In this article, we review objective measures used to assess gait and postural balance impairment in multiple sclerosis patients.

INTERPRETATION: Although scales and clinical tests are important tools for assessing postural instability and walking performance, they can be insensitive to minor disabilities in multiple sclerosis. Instrumented measurements, such as kinematics, kinetics, spatiotemporal gait parameters and center of pressure, play an important role in detecting impairment and evaluating the effects of interventions in people with mild to moderate multiple sclerosis. Thus, objective measurements may be more suitable for tracking deficits in gait and postural balance in multiple sclerosis, contributing to the early detection of disease symptoms, and therefore allowing for the planning of effective interventions to control the speed of disease progression.

Do timed up and go and five times sit to stand test outcomes correlate with trunk stability? A pilot-study

2023-05-31T11:39:10+00:00

BACKGROUND: Five Times Sit to Stand (FTSS) and Timed Up and Go (TUG) are clinical tests in which performance is evaluated through completion time, which can be thought to reflect dynamic balance. Completion time in these tests, however, can be affected not only by balance stability but also by other important components, such as legs’ muscular strength and velocity.

AIM: This investigation aimed to evaluate the correlation of completion times in these clinical tests and mediolateral (ML) balance stability measured through lower trunk accelerometry in older individuals.

METHOD: Fifteen volunteers were evaluated, aged 60-86 years (M = 69.56±5.89 years). For TUG, we evaluated the conventional version of the test (TUG_C), in addition to a dual task (TUG_DT) and a new overline (TUG_OL) version featured by increased balance demand. Balance stability during test performance was measured through ML accelerations of the lower trunk.

RESULTS: The results indicated negative time-acceleration correlations for TUG_C (r_p = -.71, r_p² =.50, p <.01) and TUG_DT (r_p = -.77, r_p² =.59, p <.01) and a positive correlation for FTSS (r_p =.73, r_p² =.53, p <.01). The TUG_OL test failed to show significant time-acceleration correlations.

CONCLUSION: Our results suggest that completion time in the FTSS test importantly reflects dynamic balance stability in older individuals. On the other hand, ML trunk acceleration when performing TUG seems to be more related to movement speed than body balance. Our results suggest that completion time can be considered a predictor of dynamic balance in the FTSS test.

Effects of smartphone use on postural control and mobility: a dual-task study

2023-06-29T01:09:20+00:00

BACKGROUND: Smartphones have become an integral part of our lives, providing a wide range of useful features. However, it is important to address the potential risks of using a smartphone while performing motor tasks.

AIM: To investigate the effects of smartphone use on postural control and mobility in young adults during standing or walking activities.

METHOD: Forty-five individuals, mean age of 22.1 ± 1.5 years, were enrolled in this study. The impact of using smartphone was assessed during a static (performed on a force platform) and a dynamic (timed up and go) test. The participants were instructed to text a message and talk on the phone while standing or walking. Multiple analyses of variance were applied to verify main effect of task. Effect sizes are reported. Significance was set at 5%.

RESULTS: Using a smartphone with a simultaneous motor task had a negative impact on both static and dynamic tests (effect size of 0.820 and 0.788, respectively). Participants were at similar risks when walking while texting messages or talking on the phone. Conversely, when standing, talking on the phone caused greater risks compared to the texting condition.

INTERPRETATION: In a sample of young adults, smartphone usage was found to affect the performance of motor tasks. The impact varied depending on whether the participants were walking or standing. Further studies should be conducted to investigate the risks associated with performing motor tasks with a smartphone among different population groups, including older individuals and subjects with physical disabilities.

Acute effect of boing balance board on postural control in older adults

2023-06-09T18:52:46+00:00

BACKGROUND: Balance training has demonstrated a positive effect on older adults. However, the specific types and durations of interventions needed to effectively address postural deficits in aging individuals remain important areas of study. It is crucial to impact their motor performance quickly to bring about changes in postural control.

AIM: This study aims to investigate the effect of an acute motor intervention using a balance board called the "Boing" on postural control in elderly individuals.

METHOD: Twenty senior women between the ages of 60 and 78 were divided into two groups: Intervention Group (IG, n=10) and Control Group (n=10). Both groups performed a pretest postural task on a force plate, including conditions with feet together, feet apart, and semi-tandem stance. Participants in the IG then underwent the motor intervention on the Boing balance board, which disturbed balance in the antero-posterior and medio-lateral directions, similar to the pretest conditions. After the intervention, a posttest was conducted for both groups using the same procedure as the pretest. One week later, a retention test was performed. Analysis of center of pressure (COP) was conducted, examining total displacement (DOT) and root mean square (RMS) in the antero-posterior and medio-lateral directions.

RESULTS: A two-way repeated measures ANOVA revealed that during the posttest phase, there were significant differences between the groups in DOT and ML RMS specifically in the semi-tandem condition. The IG group exhibited lower values.

CONCLUSION: The Boing balance board shows promise as a useful apparatus for improving postural control through acute motor intervention.

Infographic: Developmental Coordination Disorder (part I) – characteristics, diagnosis, and consequences

2023-01-30T12:16:56+00:00

Adaptation of motor control to musculoskeletal pain: Theories for the sensorimotor interactions involved

2023-03-06T12:51:00+00:00

BACKGROUND: There are reports in the literature showing that the pain alters motor control, whether in static or dynamic conditions.

VIEW OF THE PAST: Over the past decades theories have been proposed on how and in what conditions the pain affects motor control. To date, changes in movement control have been identified at both peripheral and central levels, which potentially leads to the emergence of compensatory lesions in the medium and long term.

CURRENT STATE: The current state of the art on the understanding of how pain alters movement control has enabled the emergence of preventive exercise protocols and treatment of movement disorders generated by the presence of pain.

FUTURE PERSPECTIVE: The application of new data acquisition and analysis technologies will allow the development of effective exercise protocols for pain management.

Gaze behavior data in the vitrine of human movement science: considerations on eye-tracking technique

2023-06-29T01:04:42+00:00

Background: The eyes are the main gateway of visual information input. Moving the eyes is essential to extract visual information from scenes while performing motor actions. This has helped to explain motor behavior, especially in relation to visual attention mechanisms, gaze training and learning, and the relevance of visual information in controlling actions. Thus, collecting data on gaze behavior has become important for explaining motor behavior. Aim: We present the main video-based eye-tracking techniques, briefly describing the anatomy of the eyes, explaining the operation of the eye-tracker (eye capture techniques, calibration, and data analysis), and proposing interpretations of the main variables extracted by the technique. In this way, we carry out considerations (limitations and advantages) on the eye-tracking technique that placed gaze behavior data in the vitrine of human movement science. Interpretation: Eye-tracking has become an excellent tool to assist in the analysis of human movement through gaze behavior. Mainly by combining sensory information, such as visual information, with performance during motor tasks, it is possible to infer about perception, cognition, and human behavior during the most diverse day-to-day activities. Eye-tracker systems have been employed in different majors related to motor behavior, such as medicine, commerce, and game development.