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Background: Individuals with visual impairment (VI) have often been observed to walk slower than individuals with unimpaired vision. These observations might be confounded by typical low levels of physical activity and greater sedentary behavior in individuals with VI than the overall population., Research Question: Here, we compared gait and balance measures between individuals with VI who participate in disability sports, and activity level matched sighted individuals., Methods: We assessed static balance, anthropometry, self-selected walking speed, locomotion rehabilitation index, and lower limb muscular endurance; and applied physical activity level and fear of falling questionnaires., Results: Individuals with VI who participate in disability sports, self-selected a similar walking speed (1.29 ± 0.26 m/s) as active sighted individuals (1.39 ± 0.21 m/s). Locomotor rehabilitation index and muscular endurance of lower limbs were also similar between groups. Individuals with VI presented lower static balance (42.0 ± 17.0s) than the sighted control group (45.0 ± 0s) when the controls were tested with their eyes open. However, no difference was found when the controls were tested with their eyes closed (30.3 ± 17.0s). Furthermore, individuals with VI showed a greater fear of falling., Significance: In conclusion, individuals with VI who participate in disability sports, as goalball and football, walk with similar self-selected walking speeds as active sighted individuals, but have slightly worse static balance and fear of falling., (Copyright © 2018 Elsevier B.V. All rights reserved.)

The wide variation in muscle fibre type distribution across individuals, along with the very different energy consumption rates in slow versus fast muscle fibres, suggests that muscle fibre typology contributes to inter‐individual differences in metabolic rate during exercise. However, this has been hard to demonstrate due to the gap between a single muscle fibre and full‐body exercises. We investigated the isolated effect of triceps surae muscle contraction velocity on whole‐body metabolic rate during cyclic contractions in individuals a priori selected for their predominantly slow (n = 11) or fast (n = 10) muscle fibre typology by means of proton magnetic resonance spectroscopy (1H‐MRS). Subsequently, we examined their whole‐body metabolic rate during walking and running at 2 m/s, exercises with comparable metabolic rates but distinct triceps surae muscle force and velocity demands (walking: low force, high velocity; running: high force, low velocity). Increasing triceps surae contraction velocity during cyclic contractions elevated net whole‐body metabolic rate for both typology groups. However, the slow group consumed substantially less net metabolic energy at the slowest contraction velocity, but the metabolic difference between groups diminished at faster velocities. Consistent with the more economic force production during slow contractions, the slow group exhibited lower metabolic rates than the fast group while running, whereas metabolic rates were similar during walking. These findings provide important insights into the influence of muscle fibre typology on whole‐body metabolic rate and emphasize the importance of considering muscle mechanical demands to understand muscle fibre typology related differences in whole‐body metabolic rates. Key points: Muscle fibre typology is often suggested to affect whole‐body metabolic rate, yet convincing in vivo evidence is lacking.Using isolated plantar flexor muscle contractions in individuals a priori selected for their predominantly slow or fast muscle fibre typology, we demonstrated that having predominantly slow muscle fibres provides a metabolic advantage during slow muscle contractions, but this benefit disappeared at faster contractions.We extended these results to full‐body exercises, where we demonstrated that higher proportions of slow fibres associated with better economy during running but not when walking.These findings provide important insights into the influence of muscle fibre typology on whole‐body metabolic rate and emphasize the importance of considering muscle mechanical demands to understand muscle fibre typology related differences in whole‐body metabolic rate. [ABSTRACT FROM AUTHOR]

• Highly cushioned, carbon-plate running shoes have revolutionized marathon running. • They reduce the energetic cost of level running by 4% and enhance performance. • We find that such shoes reduce the metabolic cost of uphill and downhill running by ∼3%. • These super-shoes likely improve performance in both flat and hilly marathons. Compared to conventional racing shoes, Nike Vaporfly 4% running shoes reduce the metabolic cost of level treadmill running by 4%. The reduction is attributed to their lightweight, highly compliant, and resilient midsole foam and a midsole-embedded curved carbon-fiber plate. We investigated whether these shoes also could reduce the metabolic cost of moderate uphill (+3°) and downhill (–3°) grades. We tested the null hypothesis that, compared to conventional racing shoes, highly cushioned shoes with carbon-fiber plates would impart the same ∼4% metabolic power (W/kg) savings during uphill and downhill running as they do during level running. After familiarization, 16 competitive male runners performed six 5-min trials (2 shoes × 3 grades) in 2 Nike marathon racing-shoe models (Streak 6 and Vaporfly 4%) on a level, uphill (+3°), and downhill (–3°) treadmill at 13 km/h (3.61 m/s). We measured submaximal oxygen uptake and carbon dioxide production during Minutes 4–5 and calculated metabolic power (W/kg) for each shoe model and grade combination. Compared to the conventional shoes (Streak 6), the metabolic power in the Vaporfly 4% shoes was 3.83% (level), 2.82% (uphill), and 2.70% (downhill) less (all p < 0.001). The percent of change in metabolic power for uphill running was less compared to level running (p = 0.04; effect size (ES) = 0.561) but was not statistically different between downhill and level running (p = 0.17; ES = 0.356). On a running course with uphill and downhill sections, the metabolic savings and hence performance enhancement provided by Vaporfly 4% shoes would likely be slightly less overall, compared to the savings on a perfectly level race course. [Display omitted] [ABSTRACT FROM AUTHOR]

Training, footwear, nutrition, and racing strategies (i.e., drafting) have all been shown to reduce the metabolic cost of distance running (i.e., improve running economy). However, how these improvements in running economy (RE) quantitatively translate into faster running performance is less established. Here, we quantify how metabolic savings translate into faster running performance, considering both the inherent rate of oxygen uptake-velocity relation and the additional cost of overcoming air resistance when running overground. We collate and compare five existing equations for oxygen uptake-velocity relations across wide velocity ranges. Because the oxygen uptake vs. velocity relation is non-linear, for velocities slower than ∼3 m/s, the predicted percent improvement in velocity is slightly greater than the percent improvement in RE. For velocities faster than ∼3 m/s, the predicted percent improvement in velocity is less than the percent improvements in RE. At 5.5 m/s, i.e., world-class marathon pace, the predicted percent improvement in velocity is ∼2/3rds of the percent improvement in RE. For example, at 2:04 marathon pace, a 3% improvement in RE translates to a 1.97% faster velocity or 2:01:36, almost exactly equal to the recently set world record. [ABSTRACT FROM AUTHOR]

Optimization of gait rehabilitation using split-belt treadmills critically depends on our understanding of the roles of somatosensory perception and sensorimotor recalibration in perceiving gait asymmetry and adapting to split-belt walking. Recent evidence justifies the hypothesis that perception of gait asymmetry is based mainly on detection of temporal mismatches between afferent inputs at the spinal level. [ABSTRACT FROM AUTHOR]

To walk efficiently and stably on different surfaces under various constrained conditions, humans need to adapt their gait pattern substantially. Although the mechanisms behind locomotor adaptation are still not fully understood, the cerebellum is thought to play an important role. In this study we aimed to address the specific localization of cerebellar involvement in split-belt adaptation by comparing performance in patients with stable focal lesions after cerebellar tumor resection and in healthy controls. We observed that changes in symmetry of those parameters that were most closely related to interlimb coordination (such as step length and relative double stance time) were similar between healthy controls and cerebellar patients during and after split-belt walking. In contrast, relative stance times (proportions of stance in the gait cycle) were more asymmetric for the patient group than for the control group during the early phase of the post-split-belt condition. Patients who walked with more asymmetric relative stance times were more likely to demonstrate lesions in vermal lobules VI and Crus II. These results confirm that deficits in gait adaptation vary with ataxia severity and between patients with different types of cerebellar damage. [ABSTRACT FROM AUTHOR]

Gait adaptation is essential for humans to walk according to the different demands of the environment. Although locomotor adaptation has been studied in different contexts and in various patient populations, the mechanisms behind locomotor adaptation are still not fully understood. The aim of the present study was to test two opposing hypotheses about the control of split-belt walking, one based on avoidance of limping and the other on avoiding limb excursion asymmetry. We assessed how well cerebellar patients with focal lesions and healthy control participants could sense differences between belt speeds during split-belt treadmill walking and correlated this to split-belt adaptation parameters. The ability to perceive differences between belt speeds was similar between the cerebellar patients and the healthy controls. After combining all participants, we observed a significant inverse correlation between stance time symmetry and limb excursion symmetry during the early phase of split-belt walking. Participants who were better able to perceive belt speed differences (e.g., they had a lower threshold and hence were able to detect a smaller speed difference) walked with the smallest asymmetry in stance time and the largest asymmetry in limb excursion. Our data support the hypothesis that humans aim to minimize (temporal) limping rather than (spatial) limb excursion asymmetry when using their perception of belt speed differences in the early phase of adaptation to split-belt walking. [ABSTRACT FROM AUTHOR]

Modulation of cutaneous reflexes is important in the neural control of walking, yet knowledge about underlying neural pathways is still incomplete. Recent studies have suggested that the cerebellum is involved. Here we evaluated the possible roles of the cerebellum in cutaneous reflex modulation and in attenuation of self-induced reflexes. First we checked whether leg muscle activity during walking was similar in patients with focal cerebellar lesions and in healthy control subjects. We then recorded cutaneous reflex activity in leg muscles during walking. Additionally, we compared reflexes after standard (computer triggered) stimuli with reflexes after self-induced stimuli for both groups. Biceps femoris and gastrocnemius medialis muscle activity was increased in the patient group compared with the control subjects, suggesting a coactivation strategy to reduce instability of gait. Cutaneous reflex modulation was similar between healthy control subjects and cerebellar patients, but the latter appeared less able to attenuate reflexes to self-induced stimuli. This suggests that the cerebellum is not primarily involved in cutaneous reflex modulation but that it could act in attenuation of self-induced reflex responses. The latter role in locomotion would be consistent with the common view that the cerebellum predicts sensory consequences of movement. [ABSTRACT FROM AUTHOR]

The evident ataxic characteristics of gait in patients with cerebellar damage suggest that the cerebellum plays an important role in the neural control of gait. Ataxic features, such as increased gait variability and increased step width, are often related to gait stability. However, the link between these measures and gait stability is not straightforward. Therefore, to gain more insights into relations between gait stability, gait variability and gait ataxia, we quantified gait stability using the short-term maximum Lyapunov exponent. This is a more valid measure of gait stability, derived from dynamical systems theory. Eighteen patients with focal cerebellar lesions after tumor resection walked on an instrumented treadmill at 1.0 m/s for 3 min. The patients displayed relatively mild functional deficits (ICARS = 6.9 ± 6.4, range 0–20) and had a lower overground walking speed as compared to healthy controls (1.12 m/s versus 1.31 m/s). During treadmill walking, the short-term maximum Lyapunov exponent was higher in cerebellar patients, indicating reduced gait stability. Furthermore, step width was increased in the patient group while other spatio-temporal gait parameters were similar. Patients with the largest lesions in the vermis displayed the least stable gait pattern. These observations imply that the short-term maximum Lyapunov exponent is a sensitive measure of gait deficits in mildly ataxic cerebellar patients. [ABSTRACT FROM AUTHOR]

Motor adaptations not only recalibrate movement execution but also can lead to altered movement perception in multiple sensory domains. Vazquez, Statton, Busgang, and Bastian (J Neurophysiol 114: 3255-3267, 2015) recently showed that splitbelt walking affects perception of leg speed during walking, but not perceptions of leg position during standing and walking or perception of contact force during stepping. Considering their findings within the broader scope of sensorimotor recalibration in other tasks, we suggest that sensorimotor recalibrations are task specific and can be multisensory. [ABSTRACT FROM AUTHOR]

Backward locomotion is used increasingly in sports and rehabilitation. However, it is unclear whether training effects of backward walking (BW)/backward running (BR) can be transferred simply to forward walking (FW)/forward running (FR). This touches on the question whether the same neural substrate can generate FW and BW. The available evidence suggests that BW uses the same rhythm circuitry but additionally requires specialized control circuits. [ABSTRACT FROM AUTHOR]

Purpose: Runners naturally adopt a stride frequency closely corresponding with the stride frequency that minimizes energy consumption. Although the concept of self-optimization is well recognized, we lack mechanistic insight into the association between stride frequency and energy consumption. Altering stride frequency affects lower extremity joint power; however, these alterations are different between joints, possibly with counteracting effects on the energy consumption during ground contact and swing. Here, we investigated the effects of changing stride frequency from a joint-level perspective. Methods: Seventeen experienced runners performed six running trials at five different stride frequencies (preferred stride frequency (PSF) twice, PSF ± 8%, PSF ± 15%) at 12 km⋅h-1. During each trial, we measured metabolic energy consumption and muscle activation, and collected kinematic and kinetic data, which allowed us to calculate average positive joint power using inverse dynamics. Results: With decreasing stride frequency, average positive ankle and knee power during ground contact increased (P < 0.01), whereas average positive hip power during leg swing decreased (P <0.01). Average soleus muscle activation during ground contact also decreased with increasing stride frequency (P < 0.01). In addition, the relative contribution of positive ankle power to the total positive joint power during ground contact decreased (P = 0.01) with decreasing stride frequency, whereas the relative contribution of the hip during the full stride increased (P < 0.01) with increasing stride frequency. Conclusions: Our results provide evidence for the hypothesis that the optimal stride frequency represents a trade-off between minimizing the energy consumption during ground contact, associated with higher stride frequencies, without excessively increasing the cost of leg swing or reducing the time available to produce the necessary forces. [ABSTRACT FROM AUTHOR]

Footwear interventions are a potential avenue to correct walking asymmetry in neurologic populations, such as stroke. However, the motor learning mechanisms that underlie the changes in walking imposed by asymmetric footwear are unclear. The objectives of this study were to examine symmetry changes during and after an asymmetric shoe height intervention in (1) vertical impulse and (2) spatiotemporal gait parameters and (3) joint kinematics, in healthy young adults Eleven healthy young adults (3 males, 8 females; 21.2 ± 3.1 years old) participated in this study. Participants walked on an instrumented treadmill at 1.3 m/s for four conditions: (1) a 5-minute familiarization with equal shoe height, (2) a 5-minute baseline with equal shoe height, (3) a 10-minute intervention, where participants walked with asymmetric shoe height with a 10 mm shoe insert in one shoe, and (4) a 10-minute post-intervention, where participants walked with equal shoe height. Asymmetry in kinetics and kinematics were used to identify changes during intervention and aftereffects, a hallmark of feedforward adaptation Participants did not alter vertical impulse asymmetry (p = 0.667) nor stance time asymmetry (p = 0.228). During the intervention, step time asymmetry (p = 0.003) and double support asymmetry (p < 0.001) were greater compared to baseline. Leg joint asymmetry during stance (Ankle plantarflexion: p < 0.001; Knee flexion: p < 0.001; Hip extension: p = 0.011) was greater during the intervention compared to baseline. However, changes in spatiotemporal gait variables and joint mechanics did not demonstrate aftereffects. Our results show that healthy human adults change gait kinematics, but not weight-bearing symmetry with asymmetrical footwear. This suggests that healthy humans prioritize maintaining vertical impulse by changing their kinematics. Further, the changes in gait kinematics are short-lived, suggesting feedback-based control, and a lack of feedforward motor adaptations • Kinetic asymmetry is not adapted with asymmetrical shoe height. • Gait kinematic asymmetry are altered with asymmetrical shoe height. • Gait kinematic asymmetry changes may be due to reactive learning mechanisms. [ABSTRACT FROM AUTHOR]