A 'Fingerprint' of locomotor maturation: Motor development descriptors, reference development bands and data-set.

BACKGROUND: When aiming at studying and monitoring locomotor development in childhood, innovative indexes for the characterization of motor control performance and wearable technologies have highlighted the potential of significant advances. In particular, quantitative assessment of motor performance during natural walking (NW) and tandem walking (TW) has been proposed to highlight manifestations of motor automaticity and complexity, respectively. RESEARCH QUESTION: This work aims at providing a quantitative overview of metrics characterizing locomotor maturation in a typically developing population, by analysing NW and TW. The final goal is to propose a novel graphical representation of motor development from childhood to adulthood, providing metrics for quantitative assessment with reference bands and data-set, supporting data interpretation and longitudinal assessment. METHODS: 112 typically developing participants (age groups: 6-, 7-, 8-, 9-, 10-, 15-, and 25 years) walked in NW and in TW at self-selected speed. 3D acceleration and angular velocity of lower trunk and shanks were collected. Temporal parameters, their variability, and nonlinear metrics characterizing human movement (harmonic ratio, short-term Lyapunov exponents, multiscale entropy, and recurrence quantification analysis) were calculated. Effect of age was analysed on the different parameters and a graphical polar plot was defined to represent parameters that showed age effect in at least one of the two tasks. RESULTS: Age effect was shown on temporal parameters, their variability, multiscale entropy and recurrence quantification analysis. These parameters were selected for monitoring locomotor development and presented on an ad-hoc designed polar plot showing age-group reference bands. SIGNIFICANCE: Graphic results outline locomotor differences with maturation at first glance. The patterns in NW and TW allow to characterize specific aspects of locomotor maturation, to evaluate in which area changes occur and towards which direction, depending on the task. The novel database containing participants' raw collected data is made available as additional result of the present study.

Changes of human movement complexity during maturation: quantitative assessment using multiscale entropy.

Movement complexity can be defined as the capability of using different strategies to accomplish a specific task and is expected to increase with maturation, reaching its highest level in adulthood.Multiscale Entropy (MSE) has been proposed to estimate complexity on different kinematic signals, at different time scales. When applied on trunk acceleration data during natural walking (NW) at different ages, MSE decreased from childhood to adulthood, apparently contradicting the premises. On the contrary, authors hypothesised that this decrease was dependent on the specific task analysed and resulted from the concurrent increase in gait automaticity.This work aims to test this hypothesis, applying MSE on a non-paradigmatic task (tandem walking, TW), in order to exclude aspects related to automaticity.MSE was estimated on trunk acceleration data, collected on children, adolescents, and young adults during TW and NW. As hypothesized, MSE increased significantly with age in TW and decreased in NW on the sagittal plane. Assuming the development of complexity in TW as reference, MSE in NW showed a reduction to half of the complexity of TW with maturation on the sagittal plane. These results indicate MSE as sensitive to differences in performance due to maturation and to expected changes in complexity related to the specific performed task.

Complexity of human gait pattern at different ages assessed using multiscale entropy: From development to decline.

Multiscale entropy (MSE) has been applied in biomechanics to evaluate gait stability during human gait and was found to be a promising method for evaluating fall risk in elderly and/or pathologic subjects. The hypothesis of this work is that gait complexity is a relevant parameter of gait development during life, decreasing from immature to mature gait and then increasing again during old age. In order to verify this hypothesis, MSE was applied on trunk acceleration data collected during gait of subjects of different ages: toddlers at the onset of walking, pre-scholar and scholar children, adolescents, young adults, adults and elderlies. MSE was estimated by calculating sample entropy (SEN) on raw unfiltered data of L5 acceleration along the three axes, using values of τ ranging from 1 to 6. In addition, other performance parameters (cadence, stride time variability and harmonic ratio) were evaluated. The results followed the hypothesized trend when MSE was applied on the vertical and/or anteroposterior axis of trunk acceleration: an age effect was found and adult SEN values were significantly different from children ones. From young adults to elderlies a slight increase in SEN values was shown although not statistically significant. While performance gait parameters showed adolescent gait similar to the one of adults, SEN highlighted that their gait maturation is not complete yet. In conclusion, present results suggest that the complexity of gait, evaluated on the sagittal plane, can be used as a characterizing parameter of the maturation of gait control.

Evaluation of toddler different strategies during the first six-months of independent walking: a longitudinal study.

Twenty infants (age 10-16 month) were analyzed using inertial sensors over a 6-month period after the onset of independent walking. Changes in gait temporal parameters, coordination and gait strategies were evaluated. Gait temporal parameters showed a developmental shift at 2 months of walking experience: after this period, a change in the developmental trend was present in most of the analyzed parameters. Cadence results showed that the increased velocity is more due to an increase in step length than to an increase in cadence, after the first two months of independent walking. Different gait strategies were identified during the first month of independent gait based on collected data; after one month, characteristics of the pendulum mechanism were present in each examined toddler.

Gait variability and stability measures: minimum number of strides and within-session reliability.

BACKGROUND: Several methods are proposed in the literature for the quantification of gait variability/stability from trunk accelerations. Since outputs can be influenced by implementation differences, reliability assessment and standardization of implementation parameters are still an issue. The aim of this study is to assess the minimum number of required strides and the within-session reliability of 11 variability/stability measures. METHOD: Ten healthy participants walked in a straight line at self-selected speed wearing two synchronized tri-axial Inertial Measurement Units. Five variability measures were calculated based on stride times namely Standard deviation, Coefficient of variation, Inconsistency of variance, Nonstationary index and Poincaré plot. Six stability measures were calculated based on trunk accelerations namely Maximum Floquet multipliers, Short term/long term Lyapunov exponents, Recurrence quantification analysis, Multiscale entropy, Harmonic ratio and Index of harmonicity. The required minimum number of strides and the within-session reliability for each measure were obtained based on the interquartile range/mean ratio. Measures were classified in five categories (namely excellent, good, average, poor, and very poor) based on their reliability. RESULTS: The number of strides required to obtain a reliable measure was generally larger than those conventionally used. Variability measures showed average to poor reliability, while stability measures ranged from excellent to very poor reliability. CONCLUSION: Recurrence quantification analysis and multiscale entropy of trunk accelerations showed excellent reliability and a reasonable number of required strides. Based on these results, these measures should be taken into consideration in the assessment of fall risk.

Orbital stability analysis in biomechanics: a systematic review of a nonlinear technique to detect instability of motor tasks.

Falls represent a heavy economic and clinical burden on society. The identification of individual chronic characteristics associated with falling is of fundamental importance for the clinicians; in particular, the stability of daily motor tasks is one of the main factors that the clinicians look for during assessment procedures. Various methods for the assessment of stability in human movement are present in literature, and methods coming from stability analysis of nonlinear dynamic systems applied to biomechanics recently showed promise. One of these techniques is orbital stability analysis via Floquet multipliers. This method allows to measure orbital stability of periodic nonlinear dynamic systems and it seems a promising approach for the definition of a reliable motor stability index, taking into account for the whole task cycle dynamics. Despite the premises, its use in the assessment of fall risk has been deemed controversial. The aim of this systematic review was therefore to provide a critical evaluation of the literature on the topic of applications of orbital stability analysis in biomechanics, with particular focus to methodologic aspects. Four electronic databases have been searched for articles relative to the topic; 23 articles were selected for review. Quality of the studies present in literature has been assessed with a customised quality assessment tool. Overall quality of the literature in the field was found to be high. The most critical aspect was found to be the lack of uniformity in the implementation of the analysis to biomechanical time series, particularly in the choice of state space and number of cycles to include in the analysis.

Sensitivity analysis of an energetic muscle model applied at whole body level in recumbent pedalling.

Musculoskeletal models are used in order to describe and analyse the mechanics of human movement. In order to get a complete evaluation of the human movement, energetic muscle models were developed and were shown to be promising. The aim of this work is to determine the sensitivity of muscle mechanical and energetic model estimates to changes in parameters during recumbent pedalling. Inputs of the model were electromyography and joint angles, collected experimentally on one participant. The sensitivity analysis was performed on muscle-specific tension, physiological cross-sectional area, muscle maximal force, tendon rest length and percentage of fast-twitch fibres using an integrated sensitivity ratio. Soleus, gastrocnemius, vasti, gluteus and medial hamstrings were selected for the analyses. The energetic model was found to be always less sensitive to parameter changes than the mechanical model. Tendon slack length was found to be the most critical parameter for both energetic and mechanical models even if the effect on the energetic output was smaller than on muscle force and joint moments.

A physical phantom for the calibration of three-dimensional X-ray microtomography examination.

X-ray microtomography is rapidly gaining importance as a non-destructive investigation technique, especially in the three-dimensional examination of trabecular bone. Appropriate quantitative three-dimensional parameters describing the investigated structure were introduced, such as the model-independent thickness and the structure model index. The first parameter calculates a volume-based thickness of the structure in three dimensions independent of an assumed structure type. The second parameter estimates the characteristic form of which the structure is composed, i.e. whether it is more plate-like, rod-like or even sphere-like. These parameters are now experiencing a great diffusion and are rapidly growing in importance. To measure the accuracy of these three-dimensional parameters, a physical three-dimensional phantom containing different known geometries and thicknesses, resembling those of the examined structures, is needed. Unfortunately, such particular phantoms are not commonly available and neither does a consolidated standard exist. This work describes the realization of a calibration phantom for three-dimensional X-ray microtomography examination and reports an application example using an X-ray microtomography system. The calibration phantom (external size 13 mm diameter, 23 mm height) was based on various aluminium inserts embedded in a cylinder of polymethylmethacrylate. The inserts had known geometries (wires, foils, meshes and spheres) and thicknesses (ranging from 20 microm to 1 mm). The phantom was successfully applied to an X-ray microtomography device, providing imaging of the inserted structures and calculation of three-dimensional parameters such as the model-independent thickness and the structure model index. With the indications given in the present work it is possible to design a similar phantom in a histology laboratory and to adapt it to the requested applications.