Kinematic strategies for obstacle-crossing in older adults with mild cognitive impairment
IntroductionMild cognitive impairment (MCI) is considered a transitional stage between soundness of mind and dementia, often involving problems with memory, which may lead to abnormal postural control and altered end-point control when dealing with neuromechanical challenges during obstacle-crossing...
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| Format: | Article |
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Frontiers Media S.A.
2022-12-01
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| Series: | Frontiers in Aging Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnagi.2022.950411/full |
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| author | Shiuan-Huei Lu Yi-Chun Kuan Yi-Chun Kuan Yi-Chun Kuan Yi-Chun Kuan Kuan-Wen Wu Hsuan-Yu Lu Yu-Lin Tsai Yu-Lin Tsai Hsiang-Ho Chen Hsiang-Ho Chen Tung-Wu Lu Tung-Wu Lu |
| author_facet | Shiuan-Huei Lu Yi-Chun Kuan Yi-Chun Kuan Yi-Chun Kuan Yi-Chun Kuan Kuan-Wen Wu Hsuan-Yu Lu Yu-Lin Tsai Yu-Lin Tsai Hsiang-Ho Chen Hsiang-Ho Chen Tung-Wu Lu Tung-Wu Lu |
| author_sort | Shiuan-Huei Lu |
| collection | DOAJ |
| description | IntroductionMild cognitive impairment (MCI) is considered a transitional stage between soundness of mind and dementia, often involving problems with memory, which may lead to abnormal postural control and altered end-point control when dealing with neuromechanical challenges during obstacle-crossing. The study aimed to identify the end-point control and angular kinematics of the pelvis-leg apparatus while crossing obstacles for both leading and trailing limbs.Methods12 patients with MCI (age: 66.7 ± 4.2 y/o; height: 161.3 ± 7.3 cm; mass: 62.0 ± 13.6 kg) and 12 healthy adults (age: 67.7 ± 2.9 y/o; height: 159.3 ± 6.1 cm; mass: 61.2 ± 12.0 kg) each walked and crossed obstacles of three different heights (10, 20, and 30% of leg length). Angular motions of the pelvis and lower limbs and toe-obstacle clearances during leading- and trailing-limb crossings were calculated. Two-way analyses of variance were used to study between-subject (group) and within-subject (obstacle height) effects on the variables. Whenever a height effect was found, a polynomial test was used to determine the trend. A significance level of α = 0.05 was set for all tests.ResultsPatients with MCI significantly increased pelvic anterior tilt, hip abduction, and knee adduction in the swing limb during leading-limb crossing when compared to controls (p < 0.05). During trailing-limb crossing, the MCI group showed significantly decreased pelvic posterior tilt, as well as ankle dorsiflexion in the trailing swing limb (p < 0.05).ConclusionPatients with MCI adopt altered kinematic strategies for successful obstacle-crossing. The patients were able to maintain normal leading and trailing toe-obstacle clearances for all tested obstacle heights with a specific kinematic strategy, namely increased pelvic anterior tilt, swing hip abduction, and knee adduction during leading-limb crossing, and decreased pelvic posterior tilt and swing ankle dorsiflexion during trailing-limb crossing. The current results suggest that regular monitoring of obstacle-crossing kinematics for reduced toe-obstacle clearance or any signs of changes in crossing strategy may be helpful for early detection of compromised obstacle-crossing ability in patients with single-domain amnestic MCI. Further studies using a motor/cognitive dual-task approach on the kinematic strategies adopted by multiple-domain MCI will be needed for a complete picture of the functional adaptations in such a patient group. |
| first_indexed | 2024-04-13T05:03:15Z |
| format | Article |
| id | doaj.art-0e15c50c7ba34fb3ba6d4e03fa4cfc93 |
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| issn | 1663-4365 |
| language | English |
| last_indexed | 2024-04-13T05:03:15Z |
| publishDate | 2022-12-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Aging Neuroscience |
| spelling | doaj.art-0e15c50c7ba34fb3ba6d4e03fa4cfc932022-12-22T03:01:15ZengFrontiers Media S.A.Frontiers in Aging Neuroscience1663-43652022-12-011410.3389/fnagi.2022.950411950411Kinematic strategies for obstacle-crossing in older adults with mild cognitive impairmentShiuan-Huei Lu0Yi-Chun Kuan1Yi-Chun Kuan2Yi-Chun Kuan3Yi-Chun Kuan4Kuan-Wen Wu5Hsuan-Yu Lu6Yu-Lin Tsai7Yu-Lin Tsai8Hsiang-Ho Chen9Hsiang-Ho Chen10Tung-Wu Lu11Tung-Wu Lu12Department of Biomedical Engineering, National Taiwan University, Taipei City, TaiwanDepartment of Biomedical Engineering, National Taiwan University, Taipei City, TaiwanTaipei Neuroscience Institute, Taipei Medical University, Taipei City, TaiwanDementia Center and Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, TaiwanDepartment of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, TaiwanDepartment of Orthopaedic Surgery, National Taiwan University Hospital, University, Taipei City, TaiwanDepartment of Biomedical Engineering, National Taiwan University, Taipei City, TaiwanDepartment of Biomedical Engineering, National Taiwan University, Taipei City, TaiwanDepartment of Orthopaedic Surgery, National Taiwan University Hospital, University, Taipei City, TaiwanSchool of Biomedical Engineering, Taipei Medical University, Taipei City, TaiwanDepartment of Biomedical Engineering and Center for Biomedical Engineering, Chang Gung University, Taoyuan City, TaiwanDepartment of Biomedical Engineering, National Taiwan University, Taipei City, TaiwanDepartment of Orthopaedic Surgery, School of Medicine, National Taiwan University, Taipei City, TaiwanIntroductionMild cognitive impairment (MCI) is considered a transitional stage between soundness of mind and dementia, often involving problems with memory, which may lead to abnormal postural control and altered end-point control when dealing with neuromechanical challenges during obstacle-crossing. The study aimed to identify the end-point control and angular kinematics of the pelvis-leg apparatus while crossing obstacles for both leading and trailing limbs.Methods12 patients with MCI (age: 66.7 ± 4.2 y/o; height: 161.3 ± 7.3 cm; mass: 62.0 ± 13.6 kg) and 12 healthy adults (age: 67.7 ± 2.9 y/o; height: 159.3 ± 6.1 cm; mass: 61.2 ± 12.0 kg) each walked and crossed obstacles of three different heights (10, 20, and 30% of leg length). Angular motions of the pelvis and lower limbs and toe-obstacle clearances during leading- and trailing-limb crossings were calculated. Two-way analyses of variance were used to study between-subject (group) and within-subject (obstacle height) effects on the variables. Whenever a height effect was found, a polynomial test was used to determine the trend. A significance level of α = 0.05 was set for all tests.ResultsPatients with MCI significantly increased pelvic anterior tilt, hip abduction, and knee adduction in the swing limb during leading-limb crossing when compared to controls (p < 0.05). During trailing-limb crossing, the MCI group showed significantly decreased pelvic posterior tilt, as well as ankle dorsiflexion in the trailing swing limb (p < 0.05).ConclusionPatients with MCI adopt altered kinematic strategies for successful obstacle-crossing. The patients were able to maintain normal leading and trailing toe-obstacle clearances for all tested obstacle heights with a specific kinematic strategy, namely increased pelvic anterior tilt, swing hip abduction, and knee adduction during leading-limb crossing, and decreased pelvic posterior tilt and swing ankle dorsiflexion during trailing-limb crossing. The current results suggest that regular monitoring of obstacle-crossing kinematics for reduced toe-obstacle clearance or any signs of changes in crossing strategy may be helpful for early detection of compromised obstacle-crossing ability in patients with single-domain amnestic MCI. Further studies using a motor/cognitive dual-task approach on the kinematic strategies adopted by multiple-domain MCI will be needed for a complete picture of the functional adaptations in such a patient group.https://www.frontiersin.org/articles/10.3389/fnagi.2022.950411/fullmild cognitive impairmentkinematics strategiesbalance control strategiesobstacle-crossingfall risk |
| spellingShingle | Shiuan-Huei Lu Yi-Chun Kuan Yi-Chun Kuan Yi-Chun Kuan Yi-Chun Kuan Kuan-Wen Wu Hsuan-Yu Lu Yu-Lin Tsai Yu-Lin Tsai Hsiang-Ho Chen Hsiang-Ho Chen Tung-Wu Lu Tung-Wu Lu Kinematic strategies for obstacle-crossing in older adults with mild cognitive impairment Frontiers in Aging Neuroscience mild cognitive impairment kinematics strategies balance control strategies obstacle-crossing fall risk |
| title | Kinematic strategies for obstacle-crossing in older adults with mild cognitive impairment |
| title_full | Kinematic strategies for obstacle-crossing in older adults with mild cognitive impairment |
| title_fullStr | Kinematic strategies for obstacle-crossing in older adults with mild cognitive impairment |
| title_full_unstemmed | Kinematic strategies for obstacle-crossing in older adults with mild cognitive impairment |
| title_short | Kinematic strategies for obstacle-crossing in older adults with mild cognitive impairment |
| title_sort | kinematic strategies for obstacle crossing in older adults with mild cognitive impairment |
| topic | mild cognitive impairment kinematics strategies balance control strategies obstacle-crossing fall risk |
| url | https://www.frontiersin.org/articles/10.3389/fnagi.2022.950411/full |
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