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Background: Patients with shoulder pain may have proprioceptive and balance deficits. However, studies on balance in patients with shoulder pain are scarce. Objective: This study aims to investigate if patients with chronic shoulder pain demonstrate deficits in standing and walking balance and to study the relationship between outcome measures of balance and age and body mass index (BMI). Materials and Methods: This case–control study was conducted at Dammam Medical Complex, Dammam, Saudi Arabia, between March and November 2018. The study recruited patients (n = 15) with chronic shoulder pain (>4 months) and healthy controls (n = 15) matched for age, gender and BMI. Standing balance was tested using a Challenge Disc test, the Romberg test and timed unipedal stance test (UPST). Walking balance was assessed using the timed up and go (TUG) test, stance phase duration and center of pressure (COP) deviation. Independent t-tests were used to investigate the differences between the two groups in demographic data and all the outcome measurements. Pearson correlation coefficients were used for correlation analysis. Results: No statistically significant differences were found between the two groups in any outcome of the standing balance (P ≥ 0.095) or walking balance (P ≥ 0.160). However, medium effect sizes were found for the UPST (η2: ≥0.06), Challenge Disc (η2: 0.06), TUG (Cohen's d: 0.54) and COP deviation (Cohen's d: 0.53). There was a moderate correlation between BMI and Challenge Disc (P = 0.025) and between age and Challenge Disc (P = 0.012) in both the groups. Conclusion: Patients with chronic shoulder pain had lower balance measurements compared with healthy people, although this difference was not statistically significant.

Background Reactive balance recovery evokes a negative peak of cortical electroencephalography (EEG) activity (N1) that is simultaneous to brainstem-mediated automatic balance-correcting muscle activity. This study follows up on an observation from a previous study, in which N1 responses were larger in individuals who seemed to have greater difficulty responding to support-surface perturbations. Research Question We hypothesized that people engage more cortical activity when balance recovery is more challenging. We predicted that people with lower balance ability would exhibit larger cortical N1 responses during balance perturbations. Methods In 20 healthy young adults (11 female, ages 19–38) we measured the amplitude of the cortical N1 response evoked by 48 backward translational support-surface perturbations of unpredictable timing and amplitude. Perturbations included a Small (8 cm) perturbation that was identical across participants, as well as Medium (13−15 cm) and Large (18−22 cm) perturbations scaled to participant height to control for height-related differences in perturbation difficulty. To assess individual differences in balance ability, we measured the distance traversed on a narrow (0.5-inch wide) 12-foot beam across 6 trials. We tested whether the cortical N1 response amplitude was correlated to balance ability across participants. Results Cortical N1 amplitudes in response to standing balance perturbations (54 ± 18 μV) were inversely correlated to the distance traveled in the difficult beam-walking task (R2 = 0.20, p = 0.029). Further, there was a significant interaction between performance on the beam-walking task and the effect of perturbation magnitude on the cortical N1 response amplitude, whereby individuals who performed worse on the beam-walking task had greater increases in N1 amplitudes with increases in perturbation magnitude. Significance Cortical N1 response amplitudes may reflect greater cortical involvement in balance recovery when challenged. This increased cortical involvement may reflect cognitive processes such as greater perceived threat or attention to balance, which have the potential to influence subsequent motor control.

An essential component of human walking is the control of balance. Inadequate balance control can lead to falls and injuries, which are major concerns for older adults and those with walking impediments. Previous examinations of balance control during walking have largely been focused on stepping strategies, such as step placement control and stance ankle torque, that directly control the location of the center of pressure relative to the body center of mass. However, a relatively unappreciated approach is to indirectly affect the center of mass through inertial balancing strategies, where parts of the body like the trunk and arms are moved to induce a stabilizing reaction force. Inertial balance can significantly contribute to balance recovery during standing and on constrained surfaces such a tight-rope. However, the contribution of these inertial controls has scarcely been examined during walking, and particularly for lateral stability, which is thought to require more active control than forward stability. I intend to bridge this gap by demonstrating how inertial strategies can contribute to lateral balance control in response to perturbations during walking. This work consists of a model of human walking and an experiment. A simple dynamical model is used to predict how both stepping and inertial strategies may be controlled to achieve lateral balance. The model walks in 3D largely through passive dynamics but also has active control for key degrees of freedom such as push-off, step placement, and trunk roll. I show how stepping and inertial balance controls may be designed using a once-per-step hybrid control scheme, and demonstrate how the two can be coupled operationally to counteract against lateral balance disturbances. The experiment consists of lateral perturbations applied to human subjects as they walk. I designed a force feedback device to apply perturbations to a freely moving subject on an instrumented treadmill, with ability to modulate the timing and amount of force applied. The experiments were designed to induce a variety of balance strategies, both while walking normally and with constraints on available step placement, similar to a narrow walkway. This demonstrates how humans modulate and select from a continuum of control between stepping and inertial strategies. There were several model predictions that were validated by the experiment. One is that perturbations during different parts of the stride call for different amounts of foot placement, due in part to the time available before the next footfall. The model also predicts that multiple balance strategies should contribute simultaneously, and particularly so with narrow walking constraints. Experiments show that humans do modulate their foot placement according to perturbation direction and timing, with greater placement for earlier perturbations in a step. However, stance ankle torque and inertial balance strategies also contribute to a smaller degree throughout the stride, affecting the rate and timing of falling, and thus the amount of foot placement needed. These effects were amplified in the presence of narrow stepping constraints. This dissertation shows how balance during walking is controllable by multiple strategies and quantifies how humans employ them in combination. Inertial balance strategies are employed in many cases, particularly when there is considerable time before the next footfall. This work also demonstrates how computational models can explain active balance control, and how humans can flexibly combine multiple strategies to accommodate various challenges and constraints.

Background Walking balance in older adults is disproportionately susceptible to lateral instability provoked by optical flow perturbations. The prolonged exposure to these perturbations could promote reactive balance control and increased balance confidence in older adults, but this scientific premise has yet to be investigated. This proof of concept study was designed to investigate the propensity for time-dependent tuning of walking balance control and the presence of aftereffects in older adults following a single session of optical flow perturbation training. Methods Thirteen older adults participated in a randomized, crossover design performed on different days that included 10 min of treadmill walking with (experimental session) and without (control session) optical flow perturbations. We used electromyographic recordings of leg muscle activity and 3D motion capture to quantify foot placement kinematics, lateral margin of stability, and antagonist coactivation during normal walking (baseline), early (min 1) and late (min 10) responses to perturbations, and aftereffects immediately following perturbation cessation (post). Results At their onset, perturbations elicited 17% wider and 7% shorter steps, higher step width and length variability (+171% and +132%, respectively), larger and more variable margins of stability (MoS), and roughly twice the antagonist leg muscle coactivation (p-values

Purpose Most current lower extremity exoskeletons emphasize assistance for walking rather than stability. The purpose of this paper is to propose a rehabilitation gait based on the transfer of gravity center to improve the balance of exoskeleton rehabilitation training of the hemiplegic patients in the frontal plane, reducing the dependence on crutches/walking frames. Design/methodology/approach The real-time and predictable instability factors of human and exoskeleton system (HES) are analyzed. Inspired by the walking balance strategy of the blind, a rehabilitation gait based on the transfer of gravity center is proposed and studied by modeling and experimental test and is finally applied to the prototype – Zhejiang University lower extremity exoskeleton (ZJULEEX) – to verify its feasibility. Findings At least three real-time and predictable factors cause the instability of HES, and the factor of lateral tilt caused by gravity should be focused in the balance control of frontal plane. With the proposed gait, the hip height of stepping leg of HES does not reduce obviously even when the crutches do not work, which can improve the balance of HES. Research limitations/implications However, the rehabilitation gait control needs to be more complete and intelligent to response to other types of perturbations to further improve the balance of HES. In addition, more clinical trials should be conducted to evaluate the effect of the proposed gait. Social implications May bring happiness to the rehabilitation of patients with hemiplegia. Originality/value The rehabilitation gait based on the transfer of gravity center to improve the balance of HES is first proposed and applied to HES.

Background This study presents a new approach to measure and analyze the walking balance of humans by collecting motion sensor data in a smartphone. Objective We aimed to develop a mobile health (mHealth) app that can measure the walking movements of human individuals and analyze the differences in the walking movements of different individuals based on their health conditions. A smartphone’s motion sensors were used to measure the walking movements and analyze the rotation matrix data by calculating the variation of each xyz rotation, which shows the variables in walking-related movement data over time. Methods Data were collected from 3 participants, that is, 2 healthy individuals (1 female and 1 male) and 1 male with back pain. The participant with back pain injured his back during strenuous exercise but he did not have any issues in walking. The participants wore the smartphone in the middle of their waistline (as the center of gravity) while walking. They were instructed to walk straight at their own pace in an indoor hallway of a building. The walked a distance of approximately 400 feet. They walked for 2-3 minutes in a straight line and then returned to the starting location. A rotation vector in the smartphone, calculated by the rotation matrix, was used to measure the pitch, roll, and yaw angles of the human body while walking. Each xyz-rotation vector datum was recalculated to find the variation in each participant’s walking movement. Results The male participant with back pain showed a diminished level of walking balance with a wider range of xyz-axis variations in the rotations compared to those of the healthy participants. The standard deviation in the xyz-axis of the male participant with back pain was larger than that of the healthy male participant. Moreover, the participant with back pain had the widest combined range of right-to-left and forward-to-backward motions. The healthy male participant showed smaller standard deviation while walking than the male participant with back pain and the female healthy participant, indicating that the healthy male participant had a well-balanced walking movement. The walking movement of the female healthy participant showed symmetry in the left-to-right (x-axis) and up-to-down (y-axis) motions in the x-y variations of rotation vectors, indicating that she had lesser bias in gait than the others. Conclusions This study shows that our mHealth app based on smartphone sensors and rotation vectors can measure the variations in the walking movements of different individuals. Further studies are needed to measure and compare walking movements by age, gender, as well as types of health problems or disease. This app can help in finding differences in gait in people with diseases that affect gait.

Research Objectives To examine sensorimotor control of walking with various haptic input modalities in people with multiple sclerosis (pwMS). Design Cross-sectional observational study. Setting Research gait laboratory. Participants Ethics approval and informed consent were obtained prior to data collection. Participants included 30 pwMS and 29 controls matched for age (±3 years) and sex. All participants were ≥ 18 years of age, and able to walk 10 m without support. Participants with conditions or injuries other than MS that could impair walking were excluded. Interventions Not applicable. Main Outcome Measures Walking without haptic input (no-touch: NT) was compared to three walking conditions with haptic input: haptic anchors (small weights on strings: HA), using a four-wheeled walker (4WW) with light touch (4WW-LT) and using a 4WW by placing weight through the handles (4WW-W). Inertial sensors (Mobility Lab, APDM) measured stride length1, gait speed2, percentage double support/stride (%DS)3, mediolateral trunk range of motion (ML-tROM)4, and lateral step variability (LSV)5. Repeated measures ANOVA examined within-and between-group differences. Results Group effects showed PwMS spent significantly greater time in %DS and had more LSV compared to controls. All participants spent less time in %DS in the 4WW-W condition compared to the other forms of haptic input. Both 4WW conditions and the haptic anchors reduced ML-tROM compared to NT. LSV was reduced with 4WW-LT and 4WW-W compared to HA and NT conditions. All participants walked significantly faster using 4WW-LT compared to all conditions. Conclusions PwMS walked with more caution and less consistent foot placement than controls. Adding only haptic input (anchors and 4WW-LT conditions) reduced ML-tROM similar to the 4WW-W condition (haptic input + mechanical support). 4WW-LT and 4WW-W demonstrated the added benefit of reducing LSV suggesting sensory information from a 4WW may improve walking balance control in pwMS; however, the reduced LSV may be due to the presence of the 4WW frame. PwMS could be encouraged to use a 4WW in different ways to support walking balance. Author(s) Disclosures Authors declare no conflict of interest.

The parameters of walking have been studied from the viewpoints of joint rotation and translation of body. The balance and symmetry of walking are indispensable features to understand for healthy walking, while also being a personal characteristic. However, quantification has not been easy to carry out in the case of the conventional gait parameters COG (center of gravity) and ZMP (zero moment point). In this approach, the CP (crossing point) is proposed to quantify the concept of symmetry and balance by comparing it to the COG and ZMP. The CP is estimated based on the intersection between the hip line and the ankle line. While the hip line is fixed on the upper body where the COG is, the ankle line is altered depending on the each footfall, where the ZMP is. Therefore, the values of COG, ZMP, and CP have similar or different tendencies in terms of whether balanced walking results in symmetry or not. The validity of this is verified by carrying out a simulation with robot walking, and an experiment using human walking. Through additional experiments, it was noticed that the CP was able to improve the role of COG and ZMP in terms of not only stability, but also its relationship with the movement range of the lower limbs.

Humanoid Soccer Robot is one of the divisions in the Robocup Competition. Robocup is an organization that focuses on research and development of soccer robots. With the aim to build a robot soccer team that will be able to fight humans in 2050. In humanoid robots, the main problem in developing humanoid robots is how to make humanoid robots run stably on uneven surfaces. This paper describes how to maintain the stability of the humanoid football robot called EROS, by optimizing walking movements. Optimization is done by adjusting the movement of walking to the footing conditions. The default robot position will be adjusted based on the position of the robot's center of pressure (CoP), which is then combined with the Linear Inverted Pendulum Model (LIPM). To find out the condition of the pedestal base, the pressure sensor is mounted on the sole of the robot's feet. So it is known the position of the pressure center on the robot, which will be used as a parameter in planning the walking motion. This system has been implemented on humanoid robots with a height of 520 mm, as well as running on synthetic grass under different conditions at a constant speed. From the experiments that have been done it can be seen that by applying this method makes the robot more stable when it is on an uneven surface.

During human walking, step width is predicted by mediolateral motion of the pelvis, a relationship that can be attributed to a combination of passive body dynamics and active sensorimotor control. The purpose of the present study was to investigate whether humans modulate the active control of step width in response to a novel mechanical environment. Participants were repeatedly exposed to a force-field that either assisted or perturbed the normal relationship between pelvis motion and step width, separated by washout periods to detect the presence of potential after-effects. As intended, force-field assistance directly strengthened the relationship between pelvis displacement and step width. This relationship remained strengthened with repeated exposure to assistance, and returned to baseline afterward, providing minimal evidence for assistance-driven changes in active control. In contrast, force-field perturbations directly weakened the relationship between pelvis motion and step width. Repeated exposure to perturbations diminished this negative direct effect, and produced larger positive after-effects once the perturbations ceased. Both of these results provide evidence of gradual changes in active control in response to perturbations. In the longer term, these methods may be useful for improving deficits in the active control of step width often observed among clinical populations with poor walking balance.

Healthy aging modifies neuromuscular control of dynamic balance. Challenging tasks could amplify such modifications, providing clinical insights. We examined the effects of age and walking condition difficulty on neuromuscular control of walking balance. We analyzed whole-body kinematics and activity of 13 right leg and trunk muscles in 17 young (11 males and 6 females; age 24 ± 3 years) and 14 older adults (3 males and 11 females; age 69 ± 4 years) while walking on a taped line on the floor and a 6-cm wide beam. Spatiotemporal parameters of gait, margin of stability, motor performance, and muscle synergies were estimated. Regardless of age, maintaining walking balance was more difficult on the beam compared to the taped line as evidenced by a shorter distance walked (17.3%), a reduction in step length (5.8%) and speed (10.3%), as well as a 40.0% smaller margin of stability during beam vs. tape walking. The number of muscle synergies was also higher during beam vs. tape walking. Compared to younger adults, older adults had larger margin of stability during beam walking. Older adults also had higher muscle co-activity within each muscle synergy and greater variance accounted for by the first muscle synergy regardless of condition. Such age-effects may be interpreted as a safer, less efficient, and less complex neuromuscular modular control strategy. In conclusion, beam walking increased the difficulty of maintaining walking balance and induced adaptations in modular control. It seems that healthy older adults reduce the complexity and efficiency of neuromuscular control of walking to preserve walking balance.

Background Altered standing balance during pregnancy has been previously reported. To date, body center of mass (bCOM) motion has not been used to track balance changes in this population. We recently compared three methods to determine the torso center of mass (tCOM) location (via force plate acquired center of pressure calculation, using Pavol surface anthropometry measurements, and a combination of the two) to use in calculating the bCOM during pregnancy. Research question This current research explored two questions: (1) does walking balance change during pregnancy, and (2) do the methods for identifying tCOM location affect the resulting balance measures? Methods Fifteen pregnant women were recruited to perform 60-second trial of treadmill walking at 4-week intervals from 12 weeks gestation until delivery. Walking balance was measured as bCOM motion within the base of support. Gestation time and anthropometric model (force plate, Pavol, and combination) were repeated-measures independent variables in a general linear mixed model analysis. Results There was a significant decrease in walking balance during pregnancy. As gestation progressed, we observed non-linear changes in the bCOM motion within the base of support over time, with some changes starting early in pregnancy and others not starting until late 2nd trimester. The anthropometric model used to locate the bCOM significantly influences balance measures. The results of this study indicate that the force plate method is more appropriate for locating the tCOM in the anterior and lateral directions. Significance The results of this study will inform clinicians and patients about the gestational stage-associated changes in balance during pregnancy that increase the risk of falling and injury. Researchers should also carefully consider the method for locating the bCOM.

BACKGROUND: Dancesport is a popular activity among older adults who look for fun and fitness in Korea. Studies reported positive sociological and psychological effects of dancesport. But, little studies were performed to evaluate the effects of dancesport on balance performances. OBJECTIVE: The objective of the present study was to evaluate the effects of dancesport for 15 weeks on walking balance and standing balance of older adults. METHODS: Older adults regularly participated in the dancesport program 3 times a week for 15 weeks. The program included Rumba, Cha-cha-cha, and Jive. They exercised the prescribed dancesport at intermediate level for 50–60 mins for each time. A total 22 reflective markers were placed on the anatomical landmarks and 8 cameras were used to measure 3-D positions of participants. Also, center of pressure (COP) data were measured to analyze standing balance using a ground reaction board at 1200 Hz for 30 seconds. One-way analysis of variance (ANOVA) was performed to test the effects of 15 weeks of dancesport on walking balance and standing balance. RESULTS: The results suggested that, after 15 weeks of dancesport participation, older adults’ walking balance (48.3 ± 20.3 cm2 vs 38.2 ± 18.2 cm2) and standing balance (COP area: 189.4 ± 85.4 mm2 vs 103.5 ± 55.4mm2, COP distance: 84.2 ± 34.4 cm vs 76.5 ± 21.4 cm) were significantly improved. CONCLUSION: Performing dancesport would require moving center of mass rapidly and frequently while maintaining posture. This may result in improving walking balance and standing balance in the present study. The study concluded that dancesport would be an effective exercise method in enhancing postural stability of older adults.

Most current hip exoskeletons emphasize assistance for walking rather than stability. The goal of this paper is to develop a novel, high-power, self-balancing, and passively and software-controlled actively compliant hip exoskeleton that can assist with movement and maintain balance in both the sagittal and frontal planes. The developed hip exoskeleton includes powered hip abduction/adduction and hip flexion/extension joints. Each actuation unit employs a modular and compact series elastic actuator (SEA) with a high torque-to-weight ratio. It provides mechanical compliance at the interface between the exoskeleton and the wearer to ensure safety and a natural gait in the coupled wearer-exoskeleton system. A new balance controller based on the extrapolated center of mass concept is presented for maintaining walking stability. This controller reacts to perturbations in balance and produces a compliant guidance force through a combination of the passive elasticity of the SEA and active compliant control based on adaptive admittance control. The function of the hip exoskeleton is not to override human control, but rather to involve the wearer in movement control in order to avoid conflicts between wearer and exoskeleton. Our preliminary experiments on a healthy subject wearing the hip exoskeleton demonstrate the potential effectiveness of the proposed hip exoskeleton and controller for walking balance control.

People with chronic stroke (PwCS) are susceptible to mediolateral losses of balance while walking, possibly due in part to inaccurate control of mediolateral paretic foot placement. We hypothesized that mediolateral foot placement errors when stepping to stationary or shifting visual targets would be larger for paretic steps than for steps taken by neurologically-intact individuals, hereby referred to as controls. Secondarily, we hypothesized that paretic foot placement errors would be correlated with previously identified deficits in isolated paretic hip abduction accuracy. 34 PwCS and 12 controls walked overground on an instrumented mat used to quantify foot placement location relative to parallel lines separated by various widths (10, 20, 30 cm). With stationary step width targets, foot placement errors were larger for paretic steps than for either non-paretic or control steps, most notably for the narrowest prescribed step width (mean absolute errors of 3.9, 2.3, and 1.9 cm, respectively). However, no differences in foot placement accuracy were observed immediately following visual target shifts, as all groups required multiple steps to achieve the new prescribed step width. Paretic hip abduction accuracy was moderately correlated with mediolateral foot placement accuracy when stepping to stationary targets (r = 0.49), but not shifting targets (r = 0.16). The present results suggest that a reduced ability to accurately abduct the paretic leg contributes to inaccurate paretic foot placement. However, the need to ensure mediolateral walking balance through mechanically-appropriate foot placement may often override the prescribed goal of stepping to visual targets, a concern of particular importance for narrow steps.

[abstFig src='/00290002/02.jpg' width='270' text='Appearance of a subject' ] In this study, we present a method for the evaluation of the perturbation of walking balance resulting from additional task loads. For the evaluation, we compared pose differences between normal walking and walking under multi-task conditions. We employed an inertial measurement unit (IMU) sensor attached to the hips and the shoulders of subjects, through which we determined the orientation of the shoulder with respect to the hip. We focused on the variation width of orientation and utilized the increase rate from the variation width for normal walking to that for walking under multi-task conditions. By analyzing the correlation between the rate and the evaluation factor determined by employing a conventional fall-risk assessment method, which is related to cognitive and motor functions, we defined a walking balance evaluation criterion. The results indicate that calculation and auditory tasks affect the walking balance.

Paraplegics are a type of Spinal Cord Injury (SCI) disabled persons who need walking support for day-to-day mobility. Stability is a major concern while designing walking support systems. This research is an attempt to design an Exoskeleton with necessary walking stability based on humanoid bipedal robot. A parallel-serial chain of 25 joint axes legs-only exoskeleton named Lower Extremity Exoskeleton Robot (LEE Robot) is modeled and simulated for walking stability using posture adjustment and the law of balance techniques. It includes PD controllers for posture adjustment and walking balance. Zero Moment Point (ZMP) technique is implemented in the simulation to test the Exoskeleton walking stability.

This paper proposes a force-reactive walking control framework for humanoid robots, which consists of ankle and stepping strategies for stabilization during physical human-robot interaction (pHRI). Contact forces measured by robotic skin are explicitly considered in the proposed framework. The ankle strategy aims to keep the footstep location and duration within a nominal range, and this strategy is used to generate physical cues to inform the human partner about the robot's walking intentions. Thereafter, only when the ankle strategy cannot keep the walking balance, the stepping strategy adjusts the footstep location, the duration of single support phase, and the timing to start the next step to follow the partner's intention, which is derived via the contact interaction. By exploiting these two strategies, pHRI can be achieved where intentions of the partner and the robot are mutually exchanged. In a real experiment with a full-sized humanoid robot, where the partner teaches the footstep to the robot, our proposed framework succeeded in adjusting the footstep according to multiple contact forces related to the partner's intention, while basically trying to keep its own nominal footstep.

Rapid motor learning may occur in situations where individuals perceive a threat of injury if they do not perform a task well. This rapid motor learning may be facilitated by improved motor performance and, consequently, more errorless practice. As a first step towards understanding the role of perceived threat on rapid motor learning, the purpose of this study was to determine how performance of a motor task is affected in situations where perceived threat of injury is high. We hypothesized that perceived threat of injury in a virtual environment would result in improved performance of a walking task (i.e., walking on a narrow beam). Results demonstrated that increased perceived threat of injury yielded slightly greater, but not statistically significant, balance performance in virtual environments (median percentage of successful steps: 78.8%, 48.3%, and 55.2% in the real low-threat, virtual low-threat, and virtual high-threat environments, respectively). These results may be partially attributed to habituation to threat over time and practice. If implemented carefully, virtual reality technology can be an effective tool for investigating walking balance in environments that are perceived as threatening.

Purpose The aims of this study were to describe participants' demographic characteristics by adherence levels and to examine the association between participants' baseline physical function and their adherence to an evidence-based group exercise program. Design A prospective exploratory study (N = 36,373). Methods Participants' physical function was assessed using 30-second chair-stand, arm-curl, and 8-foot up-and-go tests. Adherence was calculated as the proportion of attended sessions over offered sessions. Findings Participants' mean adherence was 52%. Older male, Asian/Pacific Islander race, and Washington State residents with fewer chronic conditions showed higher adherence. Multinomial logistic regression showed the baseline 30-second chair-stand, arm-curl, and 8-foot up-and-go tests significantly predict adherence levels after controlling for demographics. Conclusions Stronger upper- and lower-extremity strength and better walking balance and mobility are associated with higher adherence to exercise programs in older adults. Clinical relevance The results underscored the importance of offering classes at various physical function levels while considering participants' individual needs.

Objective: To evaluate construct validity and reproducibility of the Functional Gait Assessment (FGA) for measuring walking balance capacity in persons after stroke. Design: Cross-sectional study. Setting: Inpatient and outpatient rehabilitation center. Subjects: Fifty-two persons post-stroke (median (25% and 75% percentiles)) time post-stroke 6 (5–10) weeks) with independent walking ability (mean gait speed 1.1 ± .4 m/s). Methods: Subjects completed a standardized FGA twice within one to eight days by the same investigator. Validity was evaluated by testing hypotheses on the association with two timed walking tests, Berg Balance Scale, and the mobility domain of the Stroke Impact Scale using correlation coefficients ( r), and with Functional Ambulation Categories using the Kruskal–Wallis test. Reproducibility of FGA scores was assessed with intraclass correlation coefficient and standard error of measurement. Results: Subjects scored a median of 22 out of 30 points at the first FGA. Moderate to high significant correlations ( r .61–.83) and significant differences in FGA median scores between the Functional Ambulation Categories were found. Eight hypotheses (80%) could be confirmed. Inter-rater, intra-rater, and test–retest reliability of the total scores were excellent. The standard error of measurement and minimal detectable change were 2 and 6 points, respectively. No relevant ceiling effect was observed. Conclusion: The FGA demonstrated good measurement properties in persons after stroke and yielded no ceiling effect in contrast to other capacity measures. In clinical practice, a measurement error of 6 points should be taken into account in interpreting changes in walking balance.

Modeling and assessing balance ability for elderly people is an important and realistic task with a view to assisting them in mobility status, correcting postures and preventing accidental falling. The aim of this study was to develop a novel kinematic feature-based evaluation method for elderly balance ability by using factor analysis. Based on the kinematics, twenty-five feature indicators were first extracted from walking gait data, which were collected by deploying twenty-four monitoring points on the body of the elderly subjects. Then, two main factors were identified by using factor analysis that affect the walking balance ability of the elderly, and the comprehensive evaluation scoring model of the elderly balance ability was constructed. Finally, real data from all the elderly subjects in free walking state were used to validate our method. The results of empirical analysis confirm the validity and usefulness of the proposed method.

In this research, we aimed to evaluate the effectiveness of a slope board by proposing visual tactile redirected walking using a parallel component of gravity on a slope to realize a new infinite linear walking experience. Specifically, when placing a plate with a diameter of approximately 1.2 m and an inclination of 0°, 5°, and 10° around the column and walking while placing a hand on the cylinder over the plate, the inclination is in a virtual space. Based on the results of the locus of locomotion measured during the experiment and the questionnaire answers of the walking sensation developed in this study, the straight walking sensation and walking balance sense were observed to be highest in the 10° inclination condition.

The purpose of this work was to analyze the variation of some gait descriptors when additional tasks (motor and cognitive with low and high load levels) were performed during walking, in 10 young healthy subjects. From one inertial sensor located at lumbar level, spatio-temporal parameters and measures of acceleration and jerk root mean square were extracted. The latter were normalized to make them independent from gait speed variations occurred during the different trials. Statistical analysis showed significant differences on the most of parameters between single and high cognitive level walking: the variations in acceleration-related measures were associated to a worsen in the walking balance, and those reported in jerk ones to a change in the smoothness, leading to an alteration in gait stability. The other two conditions presented just a trend, maybe due to the too low complexity of the tasks for the chosen population.

Rapid motor learning may occur in situations where individuals perceive a threat if they do not perform a task well. This rapid motor learning may be facilitated by improved motor performance and, consequently, more errorless practice. As a first step towards understanding the role of perceived threat on rapid motor learning, the purpose of this study was to determine how performance of a motor task is affected in situations where perceived threat is high. We hypothesized that perceived threat in a virtual environment would result in improved performance of a walking task (i.e., walking on a narrow beam). Results demonstrated that increased perceived threat did not yield statistically significantly greater balance performance in the high-threat virtual environment (median percentage of successful steps: 78.8%, 48.3%, and 55.2% in the real low-threat, virtual low-threat, and virtual high-threat environments, respectively). These results may be partially attributed to habituation to threat over time and practice. If implemented carefully, virtual reality technology can be an effective tool for investigating walking balance in environments that are perceived as threatening.

Objectives Remote assessment of gait in patients' homes has become a valuable tool for monitoring the progression of Parkinson's disease (PD). However, these measurements are often not as accurate or reliable as clinical evaluations because it is challenging to objectively distinguish the unique gait characteristics of PD. We explore the inference of patients' stage of PD from their gait using machine learning analyses of data gathered from their smartphone sensors. Specifically, we investigate supervised machine learning (ML) models to classify the severity of the motor part of the UPDRS (MDS-UPDRS 2.10-2.13). Our goals are to facilitate remote monitoring of PD patients and to answer the following questions: (1) What is the patient PD stage based on their gait? (2) Which features are best for understanding and classifying PD gait severities? (3) Which ML classifier types best discriminate PD patients from healthy controls (HC)? and (4) Which ML classifier types can discriminate the severity of PD gait anomalies? Methodology Our work uses smartphone sensor data gathered from 9520 patients in the mPower study, of whom 3101 participants uploaded gait recordings and 344 subjects and 471 controls uploaded at least 3 walking activities. We selected 152 PD patients who performed at least 3 recordings before and 3 recordings after taking medications and 304 HC who performed at least 3 walking recordings. From the accelerometer and gyroscope sensor data, we extracted statistical, time, wavelet and frequency domain features, and other lifestyle features were derived directly from participants' survey data. We conducted supervised classification experiments using 10-fold cross-validation and measured the model precision, accuracy, and area under the curve (AUC). Results The best classification model, best feature, highest classification accuracy, and AUC were (1) random forest and entropy rate, 93% and 0.97, respectively, for walking balance (MDS-UPDRS-2.12); (2) bagged trees and MinMaxDiff, 95% and 0.92, respectively, for shaking/tremor (MDS-UPDRS-2.10); (3) bagged trees and entropy rate, 98% and 0.98, respectively, for freeze of gait; and (4) random forest and MinMaxDiff, 95% and 0.99, respectively, for distinguishing PD patients from HC. Conclusion Machine learning classification was challenging due to the use of data that were subjectively labeled based on patients' answers to the MDS-UPDRS survey questions. However, with use of a significantly larger number of subjects than in prior work and clinically validated gait features, we were able to demonstrate that automatic patient classification based on smartphone sensor data can be used to objectively infer the severity of PD and the extent of specific gait anomalies.

The walking balance of transtibial person has been widely documented in many literature. However, the effect of walking balance of transtibial amputee between body weight and a prosthetic foot is not widely known. This study was used for gait analysis to measure the walking equilibrium parameters amputated from 14 people with transtibial. To reduce variability among subjects at the time of testing, we carried out washing out for all subjects for 2 days. Data generated that all subjects walked in one direction straight to measure the walking balance and kinetic parameters. Design experiment with a crossover design, subjects with amputations walked for a distance of 80 meters, estimated time of 6 minutes and speeds about 1.20 to 0.15 m per sec, during the gait phase. The movement of the ankle in the plantar flexion position is reduced because in the final phase, the standing ankle becomes flexible. Correlation analysis shows that the effect of walking balance when wearing a prosthetic foot is measured during 1 gait cycle. The results depend on the design of prosthetic foot and how to walk.