Changes to balance dynamics following a high-intensity run are associated with future injury occurrence in recreational runners.

Background: Fatigue is associated with increased injury risk along with changes in balance control and task performance. Musculoskeletal injury rates in runners are high and often result from an inability to adapt to the demands of exercise and a breakdown in the interaction among different biological systems. This study aimed to investigate whether changes in balance dynamics during a single-leg squat task following a high-intensity run could distinguish groups of recreational runners who did and did not sustain a running-related injury within 6 months. Methods: Thirty-one healthy recreational runners completed 60 s of single-leg squat before and after a high-intensity run. Six months after the assessment, this cohort was separated into two groups of 13 matched individuals with one group reporting injury within this period and the other not. Task performance was assessed by the number of repetitions, cycle time, amplitude, and speed. To evaluate balance dynamics, the regularity and temporal correlation structure of the center of mass (CoM) displacements in the transverse plane was analyzed. The interaction between groups (injury, non-injured) and time (pre, post) was assessed through a two-way ANOVA. Additionally, a one-way ANOVA investigated the percent change difference of each group across time. Results: The injured group presented more regular (reduced entropy; 15.6%) and diffusive (increased short-term persistence correlation; 5.6%) CoM displacements after a high-intensity run. No changes were observed in the non-injured group. The within-subject percent change was more sensitive in demonstrating the effects of fatigue and distinguishing the groups, compared to group absolute values. No differences were observed in task performance. Discussion: Runners who were injured in the future demonstrate changes in balance dynamics compared to runners who remain injury-free after fatigue. The single-leg squat test adopted appears to be a potential screening protocol that provides valuable information about balance dynamics for identifying a diminished ability to respond to training and exercise.

Inconsistent attentional contexts impair relearning following gradual visuomotor adaptation.

One of the brain's primary functions is to promote actions in dynamic, distracting environments. Because distractions divert attention from our primary goals, we must learn to maintain accurate actions under sensory and cognitive distractions. Visuomotor adaptation is a learning process that restores performance when sensorimotor capacities or environmental conditions are abruptly or gradually altered. Prior work showed that learning to counteract an abrupt perturbation under a particular single- or dual-task setting (i.e., attentional context) was associated with better recall under the same conditions. This suggested that the attentional context was encoded during adaptation and used as a recall cue. The current study investigated whether the attentional context (i.e., single vs. dual task) also affected adaptation and recall to a gradual perturbation, which limited awareness of movement errors. During adaptation, participants moved a cursor to a target while learning to counteract a visuomotor rotation that increased from 0° to 45° by 0.3° each trial, with or without performing a secondary task. Relearning was impaired when the attentional context was different between adaptation and recall (experiment 1), even when the exposure to the attentional context was limited to the early or late half of adaptation (experiment 2). Changing the secondary task did not affect relearning, indicating that the attentional context, rather than specific stimuli or tasks, was associated with better recall performance (experiment 3). These findings highlight the importance of cognitive factors, such as attention, in visuomotor adaptation and have implications for learning and rehabilitation paradigms.NEW & NOTEWORTHY Adaptation acquired under single- or dual-task setting, which created an undivided or divided attentional context, respectively, was impaired when relearning occurred under different conditions (i.e., shifting from a dual to single task). Changes to the attentional context impaired relearning when the initial adaptation was to a gradual perturbation. Explicit awareness of the perturbation was not necessary for this effect to be robust, nor was the effect attributable to changes in the secondary task requirements.

Task-specific adaptations of postural sway in sitting infants.

When engaging in manual or visual tasks while sitting, infants modify their postural sway based on concurrent task demands. It remains unclear whether these modulations are sensitive to differences in concurrent task demands (holding a toy vs. looking at a toy being held by someone else), and whether the properties of the support surface impact these adaptations. We investigated infants' ability to modify postural sway when holding a toy or visually attending to a toy someone else was holding while sitting on different support surfaces. Twenty-six independently sitting infants sat on solid and compliant surfaces placed on a force plate while looking at or holding a toy. Measures of postural sway were calculated from the center of pressure data. Visually attending to a toy was associated with less sway and lower sway velocity than when holding a toy. Surprisingly, surface compliance did not affect sway and there were no interaction effects. Whereas sway modulations may facilitate infants' performance on both manual and visual concurrent tasks, the visual task placed more constraints on the postural system leading to greater adaptations in postural sway. These findings provide insights into how infants are allocating attention and coordinating perceptual-motor information in developing sitting skills.

The Effect of Holding an Object on Postural Stability and Suprapostural Task Performance.

Holding an object has been found to reduce postural sway during quiet standing. However, people normally stand to accomplish suprapostural goals, such as fitting a key into a lock. Postural control should therefore be assessed by examining postural outcomes in the context of suprapostural task performance. This study assessed whether holding an object increased standing postural stability and improved the performance of a concurrent precision manual task. A total of 15 young adults performed a precision manual task with their dominant hand while holding or not holding an object in their nondominant hand. Postural stability was assessed using measures of postural sway and time to boundary. Suprapostural task performance was assessed as an error count. Holding did not influence postural sway or suprapostural task performance. Discrepancies among previous studies coupled with the present findings suggest that the effects of holding an object on standing posture are highly sensitive to the experimental context. The authors provide several explanations for their findings and discuss the limitations of previous suggestions that holding an object may have clinical relevance for balance-compromised populations.

Association between stride time fractality and gait adaptability during unperturbed and asymmetric walking.

Human locomotion is an inherently complex activity that requires the coordination and control of neurophysiological and biomechanical degrees of freedom across various spatiotemporal scales. Locomotor patterns must constantly be altered in the face of changing environmental or task demands, such as heterogeneous terrains or obstacles. Variability in stride times occurring at short time scales (e.g., 5-10 strides) is statistically correlated to larger fluctuations occurring over longer time scales (e.g., 50-100 strides). This relationship, known as fractal dynamics, is thought to represent the adaptive capacity of the locomotor system. However, this has not been tested empirically. Thus, the purpose of this study was to determine if stride time fractality during steady state walking associated with the ability of individuals to adapt their gait patterns when locomotor speed and symmetry are altered. Fifteen healthy adults walked on a split-belt treadmill at preferred speed, half of preferred speed, and with one leg at preferred speed and the other at half speed (2:1 ratio asymmetric walking). The asymmetric belt speed condition induced gait asymmetries that required adaptation of locomotor patterns. The slow speed manipulation was chosen in order to determine the impact of gait speed on stride time fractal dynamics. Detrended fluctuation analysis was used to quantify the correlation structure, i.e., fractality, of stride times. Cross-correlation analysis was used to measure the deviation from intended anti-phasing between legs as a measure of gait adaptation. Results revealed no association between unperturbed walking fractal dynamics and gait adaptability performance. However, there was a quadratic relationship between perturbed, asymmetric walking fractal dynamics and adaptive performance during split-belt walking, whereby individuals who exhibited fractal scaling exponents that deviated from 1/f performed the poorest. Compared to steady state preferred walking speed, fractal dynamics increased closer to 1/f when participants were exposed to asymmetric walking. These findings suggest there may not be a relationship between unperturbed preferred or slow speed walking fractal dynamics and gait adaptability. However, the emergent relationship between asymmetric walking fractal dynamics and limb phase adaptation may represent a functional reorganization of the locomotor system (i.e., improved interactivity between degrees of freedom within the system) to be better suited to attenuate externally generated perturbations at various spatiotemporal scales.

An active balance board system with real-time control of stiffness and time-delay to assess mechanisms of postural stability.

Increased time-delay in the neuromuscular system caused by neurological disorders, concussions, or advancing age is an important factor contributing to balance loss (Chagdes et al., 2013, 2016a,b). We present the design and fabrication of an active balance board system that allows for a systematic study of stiffness and time-delay induced instabilities in standing posture. Although current commercial balance boards allow for variable stiffness, they do not allow for manipulation of time-delay. Having two controllable parameters can more accurately determine the cause of balance deficiencies, and allows us to induce instabilities even in healthy populations. An inverted pendulum model of human posture on such an active balance board predicts that reduced board rotational stiffness destabilizes upright posture through board tipping, and limit cycle oscillations about the upright position emerge as feedback time-delay is increased. We validate these two mechanisms of instability on the designed balance board, showing that rotational stiffness and board time-delay induced the predicted postural instabilities in healthy, young adults. Although current commercial balance boards utilize control of rotational stiffness, real-time control of both stiffness and time-delay on an active balance board is a novel and innovative manipulation to reveal balance deficiencies and potentially improve individualized balance training by targeting multiple dimensions contributing to standing balance.

The efficacy of the Microsoft KinectTM to assess human bimanual coordination.

The Microsoft Kinect has been used in studies examining posture and gait. Despite the advantages of portability and low cost, this device has not been used to assess interlimb coordination. Fundamental insights into movement control, variability, health, and functional status can be gained by examining coordination patterns. In this study, we investigated the efficacy of the Microsoft Kinect to capture bimanual coordination relative to a research-grade motion capture system. Twenty-four healthy adults performed coordinated hand movements in two patterns (in-phase and antiphase) at eight movement frequencies (1.00-3.33 Hz). Continuous relative phase (CRP) and discrete relative phase (DRP) were used to quantify the means (mCRP and mDRP) and variability (sdCRP and sdDRP) of coordination patterns. Between-device agreement was assessed using Bland-Altman bias with 95 % limits of agreement, concordance correlation coefficients (absolute agreement), and Pearson correlation coefficients (relative agreement). Modest-to-excellent relative and absolute agreements were found for mCRP in all conditions. However, mDRP showed poor agreement for the in-phase pattern at low frequencies, due to large between-device differences in a subset of participants. By contrast, poor absolute agreement was observed for both sdCRP and sdDRP, while relative agreement ranged from poor to excellent. Overall, the Kinect captures the macroscopic patterns of bimanual coordination better than coordination variability.