Development of neuronal prosthetics, where neuronal activity is used to control artificial limbs, has so far relied on decoding kinematic parameters of movements, such as movement position or velocity. In addition to kinematic control, proper control of forces exerted by the prosthetic device is necessary for successful interaction with the environment. In our study, we analysed the possibility of classifying and decoding different grasp related forces during active grasping. Two macaque monkeys were trained to reach, grasp and pull an object in response to visual cues. Cues instructed the monkeys to grasp the object with one out of two grip types (precision or side grip) and pull the object with one of two different forces (0.5N or 2N). Monkeys obtained a food reward after successfully performing the instructed grip and pull. During the task execution, we recorded electrophysiological signals from the multielectrode arrays implanted intracortically in the hand and arm area of the monkey’s motor cortex. Six different parameters of the grip: four pressure forces on each side of the object, pull force on the object and the object displacement, were recorded simultaneously with the neuronal activity. Recorded neuronal activity was used to classify different grip types or loading forces, and to decode the continuous traces of different forces during the grip. Our results show that kinetic grip parameters can be decoded with high accuracy, thereby improving the feasibility of constructing fully functional anthropomorphic neuronal prosthesis that relies on kinetic (force) control.

Listed In: Biomechanical Engineering, Neuroscience

Background and Aim: Type 2 Diabetes (T2DM) in midlife represents a potent risk factor for the development of dementia in later life. Early indicators to highlight particular individuals with T2DM who are at risk of cognitive decline are lacking. Subtle abnormalities in gait (and particularly dual-task gait with a cognitive task) have emerged as a potential predictor of cognitive decline in older adults, but have not been investigated in patients with T2DM. The ENBIND Study (Exploring Novel Biomarkers of Brain health IN Diabetes) aims to assess patients with T2DM in midlife without cognitive impairment and follow participants over the course of several years to establish early predictors of cognitive decline in this poorly characterised yet high-risk group. Methods: Patients with midlife T2DM (40-65 yrs) were recruited at the time of their diabetic clinic appointment. Patients were excluded if they had a diagnosis of peripheral neuropathy, peripheral vascular disease, musculoskeletal disease, previous stroke, any form of diagnosed cognitive impairment or diabetic retinopathy/nephropathy. Patients underwent medical/diabetes assessment and examination by a physician. Cognition was screened using the Montreal Cognitive Assessment (MoCA) and assessed using a computerised cognitive battery designed for prodromal Alzheimer's Disease (CANTAB®). Gait was then assessed using both a raw clinical measure (stopwatch) and Shimmer® Inertial Measurement Units (IMUs) across four tasks: (i) 30 metre walk at a normal pace (turn at 15m), (ii) 30 metre fast walk (turn at 15m) (iii) dual cognitive-gait task (reciting alternate letters of the alphabet) and (iv) a long walk at a self-selected pace. Between group differences were assessed using t-tests and appropriate non-parametric equivalents Results: 20 participants with T2DM (52.05 yrs ± 2.13) and 10 matched healthy volunteers (mean age 52.2 yrs ± 2.74) were recruited. T2DM was associated with a significantly lower score on the MoCA (29.2 vs 27.6; p=0.0452). Participants with T2DM had slower but non-significant self-selected (0.87 ms-1 vs 0.8ms-1) and fast gait speed (0.66 ms-1 vs 0.59 ms-1). On the dual-cognitive task, participants with T2DM made more errors (1.1 vs 0.6), and had higher dual-task cost (9.17% vs 2.7%, p=0.014). Dual-task cost (the percentage decrement in walking speed due to introduction of the cognitive task) was significantly correlated with total MoCA score (R2 = 0.17, p =0.031). Discussion: Otherwise healthy participants with midlife T2DM display significantly poorer scores on MoCA. Performance on the dual-cognitive gait task was significantly correlated with MoCA score. Our study adds evidence to the presence of cognitive decrements in midlife T2DM, in-keeping with its role as a potent risk factor for the later development of dementia. We provide early data to support the utility of simple clinical gait analysis, particularly where a dual-cognitive paradigm is employed. Expansion of the sample size of patients in this study as well as longitudinal follow up should afford more detailed insight into using gait as a potential marker for cognition in this high risk cohort
Listed In: Biomechanical Engineering, Biomechanics, Gait, Neuroscience

Bilateral vestibular hypofunction (BVH) is a bilateral reduction or loss of vestibular function resulting in balance deficits and an increased falls risk. As part of a larger study, this experiment aimed to assess how spatiotemporal gait characteristics and their variability change across different walking speeds in patients with BVH. Nine patients (55±15y) with BVH have participated thus far. Experiments were conducted on the CAREN Extended system (Motekforce Link, Amsterdam, The Netherlands). Following multiple familiarisation trials, the participants completed five recorded two minute walking bouts at different speeds (0.6m/s, 0.8m/s, 1.0m/s, 1.2m/s and 1.4m/s). 60 strides per speed were analysed and the means, standard deviations and coefficients of variation (CV) of stride length and time, step length and width, double support time and swing phase toe clearance were calculated. Stride length, step length and toe clearance all increased with increases in walking speed (P<0.001). Stride and double support time decreased with increased walking speed (P<0.0001). No walking speed effect was found for step width (P=0.25). Significant reductions in variability with increases in walking speed were found for stride length, stride time, step length, toe clearance (P<0.01) and double support time (P<0.05). A significant increase in step width variability was observed with increases in walking speed (P=0.0033). These preliminary data suggest that while anteroposterior gait characteristics may improve in terms or variability with increases in walking speed in these patients, mediolateral motions may become more variable, which may have implications for mediolateral stability and falls risk in patients with BVH.
Listed In: Biomechanics, Gait, Neuroscience

Multisensory integration is driven by a process of sensory reweighting during which each input is assigned a weight depending on the current functional state of a particular sensory system, the task itself and the context in which it is being performed. The primary aim of this study was to determine which of the two inputs between ankle proprioception and vision is upweighed during a postural control task when the two inputs provide conflicting information pertaining to direction of body sway. Achilles tendon vibration and visual flow were used to create sensory conflict, which produced center of pressure (COP) sway in opposite directions when applied independently. The baseline conditions (1) consisted of eyes open quiet stance condition, eyes closed with vibration applied on the Achilles tendons (2) and eyes open with visual flow (3). The experimental condition simultaneously combined vibration and visual flow. COP excursions were recorded in 10 healthy young adults to evaluate the magnitude and direction of sway produced by vibration and/or visual flow. Additionally, lower body joint kinematics were evaluated to understand the multi-segmental strategies and their adaptation to the various sensory manipulations. The results showed that visual flow moderated the extent of backward COP and ankle angular displacement produced when vibration was applied independently. Additionally, visual flow was also found to reduce the extent of predominant hip strategy generated by ankle vibration. The findings show that visual input plays a significant role in maintaining stability and that ankle proprioception is downweighed during conflicts between vision and proprioception. This has important implication for balance training using controlled visual flow in patients with balance disorders and elderly.
Listed In: Biomechanics, Neuroscience, Posturography

Purpose: Research supports the use of ballroom dance to improve balance in individuals with Parkinson’s disease (PD). This study used the Mark Morris Dance for PD program as a template for dance classes to examine the effects of dance on gait, balance, and quality of life in individuals with PD. Subjects : Eleven individuals with mild to moderate PD participated in the study. Methods : A trained instructor led dance classes for subjects once a week for 12 weeks. Participants were encouraged to use the Mark Morris Dance for PD At Home DVD twice a week for 45 minutes. Classes included a 20 min. seated warm up; a 20 min. supported standing portion focused on balance and strength; and 30 min. partnered movements for swing, shag, or tango. Data collected before and after the intervention included gait parameters (Protokinetics Zeno walkway), sway area (AMTI force platform) during mCTSIB, Mini-BESTest, Falls Efficacy Scale, Apathy Scale and PDQ-39. A paired-samples t-test was performed. Results : Participants had significant decrease in apathy following the intervention (P = 0.018). A significant decrease in the percentage of the double support phase of gait indicated individuals spent less time with both feet in contact with the ground (P = 0.019). Conclusions : An instructor-led dance class based on the Dance for PD program once per week for 12 weeks improved certain aspects of quality of life, but not necessarily gait and balance. Further research with increased frequency of supervised dance classes is indicated.
Listed In: Gait, Neuroscience, Physical Therapy