Synchronization performance affects gait variability measures during cued walking

S Jordão; N Cortes; J Gomes; R Brandão; P Santos; P Pezarat-Correia; R Oliveira; J R Vaz

doi:10.1016/j.gaitpost.2022.06.015

Synchronization performance affects gait variability measures during cued walking

Gait Posture. 2022 Jul:96:351-356. doi: 10.1016/j.gaitpost.2022.06.015. Epub 2022 Jul 3.

Authors

S Jordão¹, N Cortes², J Gomes³, R Brandão³, P Santos⁴, P Pezarat-Correia⁴, R Oliveira⁴, J R Vaz⁵

Affiliations

¹ Neuromuscular Research Lab, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal; Hospital da Ordem Terceira Chiado, Lisbon, Portugal.
² Department of Bioengineering, George Mason University, Fairfax, VA, USA; School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, UK.
³ Neuromuscular Research Lab, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.
⁴ Neuromuscular Research Lab, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal; CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.
⁵ Neuromuscular Research Lab, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal; CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal; Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz - Cooperativa de Ensino Superior, Monte da Caparica, Portugal. Electronic address: jvaz@egasmoniz.edu.pt.

PMID: 35820239
DOI: 10.1016/j.gaitpost.2022.06.015

Abstract

Background: Incorporating variability within gait rehabilitation offers a promising approach to restore functional capacity. However, it's success requires adequate synchronization, a parameter that lacks report in most of the literature regarding cued gait training.

Research question: How changes to synchronization performance during fractal-like and isochronous cueing impacts gait variability measures?

Methods: We asked twelve young male participants to walk in synchronization to two different temporally structure cueing (isochronous [ISO] and fractal [FRC]). We have also manipulated the cueing's tempo by increasing and decreasing it by 5% to manipulate synchronization, resulting in six conditions (stimuli [ISO,FRC] x tempo [SLOW, NORMAL, FAST]). The normal condition was set from an uncued trial through the participant's self-paced stride time. Synchronization performance (ASYNC) and gait variability (fractal scaling and coefficient of variation) were calculated from stride time data ( -ISIs,CV-ISIs). Repeated measures analysis of variance or Aligned Rank Transform were conducted to determine significant differences between metronome tempo and stimuli for the dependent variables RESULTS: Our results showed a FAST tempo decreases synchronization performance (ASYNC) and leads to lower -ISIs, for both ISO and FRC stimuli. This indicates that when an individual exhibits poor synchronization during cued gait training, his/her gait variability patterns will not follow the temporal structure of the presented metronome. Specifically, if the individual poorly synchronizes to the cues, the gait patterns become more random, a condition typically observed in older adults and neurological patients, which runs contrary to the hypothesis when using fractal-like metronomes.

Significance: This study provides supporting evidence that measuring synchronization performance in cued training is fundamental for a proper clinical interpretation of its effects. This is particularly relevant for the recent and ongoing clinical research using fractal-like metronomes since the expected gait patterns are dependent on the synchronization performance. Randomized control trials must incorporate synchronization performance related measures.

Keywords: Asynchronies; Complexity; Cueing; Fractals; Sensorimotor synchronization; Strideto-stride fluctuations.

MeSH terms

Aged
Cues*
Female
Fractals
Gait*
Humans
Male
Walking