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Biomedical subjects

Onno G Meijer

Publications and source records attributed to Onno G Meijer.

9 recordsLinked to original sources
PubMed2006

How do persons with chronic low back pain speed up and slow down? Trunk-pelvis coordination and lumbar erector spinae activity during gait.

In healthy walking, the timing between trunk and pelvic rotations, as well as erector spinae (ES) activity varies systematically with walking velocity, whereas a comparable velocity-dependent adaptation of trunk-pelvis coordination is often reduced or absent in persons with low back pain (LBP). Based on the hypothesis that trunk-pelvis coordination is linked to overall gait stability, persons with LBP can be expected to have difficulties in dealing with perturbations. We examined the ability of 12 persons with LBP and 12 controls to adapt trunk and pelvis rotations and ES activity to sudden changes in velocity. 3D angular movements of thoracic, lumbar, and pelvic segments and surface EMG were recorded during treadmill walking at six different velocities, which increased or decreased unexpectedly. Relative phases of segmental rotations were determined and (in-)variant properties of kinematics and ES activity were studied using principal component analysis. Compared to healthy controls, persons with LBP exhibited a reduced ability to adapt trunk-pelvis coordination and ES muscle activity to changes in velocity. Altered coordination and muscular control may reflect an attempt to stabilise the spine and prevent the occurrence of unexpected perturbations. The assessment of gait patterns in terms of coordination may help clinicians to quantify movement impairments and may suggest interventions aimed at facilitating the emergence of desired coordination patterns.

Acceleration↗
PubMed2005

Effects of chronic low back pain on trunk coordination and back muscle activity during walking: changes in motor control.

Low back pain (LBP) is often accompanied by changes in gait, such as a decreased (preferred) walking velocity. Previous studies have shown that LBP diminishes the normal velocity-induced transverse counter-rotation between thorax and pelvis, and that it globally affects mean erector spinae (ES) activity. The exact nature and causation of these effects, however, are not well understood. The aim of the present study was to examine in detail the effect of walking velocity on global trunk coordination and ES activity as well as their variability to gain further insights into the effects of non-specific LBP on gait. The study included 19 individuals with non-specific LBP and 14 healthy controls. Gait kinematics and ES activity were recorded during treadmill walking at (1) a self-selected (comfortable) velocity, and (2) sequentially increased velocities from 1.4 up to maximally 7.0 km/h. Pain intensity, fear of movement and disability were measured before the experiment. The angular movements of thorax, lumbar and pelvis were recorded in three dimensions. ES activity was recorded with pairs of surface electrodes. Trunk-pelvis coordination and mean amplitude of ES activity were analyzed. In addition, invariant and variant properties of trunk kinematics and ES activity were studied using principal component analysis (PCA). Comfortable walking velocity was significantly lower in the LBP participants. In the transverse plane, the normal velocity-induced change in pelvis-thorax coordination from more in-phase to more antiphase was diminished in the LBP participants, while lumbar and pelvis rotations were more in-phase compared to the control group. In the frontal plane, intersegmental timing was more variable in the LBP than in the control participants, with additional irregular movements of the thorax. Rotational amplitudes were not significantly different between the LBP and control participants. In the LBP participants, the pattern of ES activity was affected in terms of increased (residual) variability, timing deficits, amplitude modifications and frequency changes. The gait of the LBP participants was characterized by a more rigid and less variable kinematic coordination in the transverse plane, and a less tight and more variable coordination in the frontal plane, accompanied by poorly coordinated activity of the lumbar ES. Pain intensity, fear of movement and disability were all unrelated to the observed changes in coordination, suggesting that the observed changes in trunk coordination and ES activity were a direct consequence of LBP per se. Clinically, the results imply that conservative therapy should consider gait training as well as exercises aimed at improving both intersegmental and muscle coordination.

Adult↗
PubMed2004

Effects of experimentally induced pain and fear of pain on trunk coordination and back muscle activity during walking.

OBJECTIVE: To examine the effects of experimentally induced pain and fear of pain on trunk coordination and erector spinae EMG activity during gait. DESIGN: In 12 healthy subjects, hypertonic saline (acute pain) and isotonic saline (fear of pain) were injected into erector spinae muscle, and unpredictable electric shocks (fear of impending pain) were presented during treadmill walking at different velocities, while trunk kinematics and EMG were recorded. BACKGROUND: Chronic low back pain patients often have disturbed trunk coordination and enhanced erector spinae EMG while walking, which may either be due to the pain itself or to fear of pain, as is suggested by studies on both low back pain patients and healthy subjects. METHODS: The effects of the aforementioned pain-related manipulations on trunk coordination and EMG were examined. Results. Trunk kinematics was not affected by the manipulations. Induced pain led to an increase in EMG variability and induced fear of pain to a decrease in mean EMG amplitude during double stance. CONCLUSIONS: Induced pain and fear of pain have subtle effects on erector spinae EMG activity during walking while leaving the global pattern of EMG activity and trunk kinematics unaffected. This suggests that the altered gait observed in low back pain patients is probably a complex evolved consequence of a lasting pain, rather than a simple immediate effect. RELEVANCE: Variability of EMG data and kinematics may explain pain-dependent alterations of motor control, which in turn might contribute to a further understanding of the development of movement impairments in low back pain.

Adaptation, Physiological↗
PubMed2004

PCA in studying coordination and variability: a tutorial.

OBJECTIVE: To explain and underscore the use of principal component analysis in clinical biomechanics as an expedient, unbiased means for reducing high-dimensional data sets to a small number of modes or structures, as well as for teasing apart structural (invariant) and variable components in such data sets. DESIGN: The method is explained formally and then applied to both simulated and real (kinematic and electromyographic) data for didactical purposes, thus illustrating possible applications (and pitfalls) in the study of coordinated movement. BACKGROUND: In the sciences at large, principal component analysis is a well-known method to remove redundant information in multidimensional data sets by means of mode reduction. At present, principal component analysis is starting to penetrate the fundamental and clinical study of human movement, which amplifies the need for an accessible explanation of the method and its possibilities and limitations. Besides mode reduction, we discuss principal component analysis in its capacity as a data-driven filter, allowing for a separation of invariant and variant properties of coordination, which, arguably, is essential in studies of motor variability. METHODS: Principal component analysis is applied to kinematic and electromyographic time series obtained during treadmill walking by healthy humans. RESULTS: Common signal structures or modes are identified in the time series that turn out to be readily interpretable. In addition, the identified coherent modes are eliminated from the data, leaving a filtered, residual pattern from which useful information may be gleaned regarding motor variability. CONCLUSIONS: Principal component analysis allows for the detection of modes (information reduction) in both kinematic and electromyographic data sets, as well as for the separation of invariant structure and variance in those data sets. RELEVANCE: Principal component analysis can be successfully applied to movement data, both as feature extractor and as data-driven filter. Its potential for the (clinical) study of human movement sciences (e.g., diagnostics and evaluation of interventions) is evident but still largely untapped.

Algorithms↗
PubMed2004

Gait coordination in pregnancy: transverse pelvic and thoracic rotations and their relative phase.

OBJECTIVE: To examine the effects of pregnancy on the coordination of transverse pelvic and thoracic rotations during gait. DESIGN: Gait of healthy pregnant women and nulligravidae was studied during treadmill walking at predetermined velocities ranging from 0.17 to 1.72 m/s. BACKGROUND: pelvis-thorax coordination during walking is altered in women with postpartum pregnancy-related pelvic girdle pain. This coordination has not been investigated in a healthy pregnant population. METHODS: Comfortable walking velocity was established. Amplitudes of pelvic and thoracic rotations were calculated. Their coordination was characterized by relative Fourier phase and its standard deviation. RESULTS: Comfortable walking velocity was significantly reduced. The amplitudes of pelvic and thoracic rotations were somewhat reduced, with significantly smaller intra-individual standard deviations. Also pelvis-thorax relative Fourier phase was somewhat smaller, its intra-individual standard deviation was negatively correlated with week of pregnancy, and significantly lower at velocities > or = 1.06 m/s. CONCLUSIONS: The general pattern of gait kinematics in pregnant women is very similar to that of nulligravidae. Still, it appears that pregnant women experience difficulties in realizing the more anti-phase pelvis-thorax coordination that is required at higher walking velocities. RELEVANCE: The present study shows that gait in healthy pregnancy is remarkably normal, but some differences in pelvis-thorax coordination were detected. In healthy pregnancy, anti-phase pelvis-thorax coordination appears difficult, but less so than in pregnancy-related pelvic girdle pain. Better understanding of gait in healthy pregnancy may provide insight into the gait problems of women with pregnancy-related pelvic girdle pain.

Adaptation, Physiological↗
PubMed2002

Pelvis-thorax coordination in the transverse plane during walking in persons with nonspecific low back pain.

STUDY DESIGN: Transverse pelvis and thorax rotations were studied during walking in 39 patients with nonspecific low back pain and 19 healthy participants. OBJECTIVES: To gain insight into the consequences of low back pain for gait and to identify clinically useful measures for characterizing the quality of walking in patients with low back pain. SUMMARY OF BACKGROUND DATA: Gait studies in patients with low back pain have reported a decrease in walking velocity. In normal gait, in-phase pelvis-thorax coordination (synchronicity) evolves toward antiphase coordination (counterrotation) as walking velocity increases. This study examined the effect of walking velocity on pelvis and thorax rotations in patients with low back pain. METHODS: Amplitudes of pelvis and thorax rotations were calculated, and spectral analyses were performed. Pelvis-thorax coordination was characterized in terms of relative Fourier phase, and coupling strength was assessed by means of cross-spectral analysis. RESULTS: In comparison with healthy participants, relative Fourier phase was significantly smaller in low back pain patients for walking velocities of 3.8 km/h and higher, whereas coupling strength was significantly higher for velocities from 1.4 to 3.0 km/h. No significant group differences were found in amplitude or spectral content of individual pelvis and thorax rotations. CONCLUSION: In comparison with healthy participants, the gait of patients with low back pain was characterized by a more rigid, less flexible pelvis-thorax coordination in the absence of significant differences in the kinematics of the component rotations. This result suggests that coordination measures are more adequate in assessing quality of walking in patients with low back pain than are kinematic measures pertaining to the individual segment rotations, and that conservative therapy should use methods aimed at improving intersegmental coordination.

Adult↗
PubMedDate not supplied

Gait in patients with pregnancy-related pain in the pelvis: an emphasis on the coordination of transverse pelvic and thoracic rotations.

OBJECTIVE: To quantify gait impairments in women with pregnancy-related pain in the pelvis which persisted post-partum.Design. Nine patients and nine healthy subjects were studied during treadmill walking at different velocities. BACKGROUND: Walking problems in patients with pregnancy-related pain in the pelvis have been known to exist for a long time. To date, no quantitative gait studies have been conducted in this population. METHODS: Maximum attainable walking velocity was determined, amplitudes of pelvic and thoracic rotations were calculated, and spectral analysis was used to assess the harmonicity of these rotations. Coordination between pelvic and thoracic rotations was characterized as mean relative Fourier phase and weighted coherence. RESULTS: Maximum attainable walking velocity was highly variable between patients, but on average significantly lower than in healthy controls. Moreover, patients had a significantly lower mean relative Fourier phase (again, highly variable) and higher weighted coherence. The other parameters did not differ significantly between groups. CONCLUSIONS: Coordination between pelvic and thoracic rotations in the transverse plane was affected in patients with pregnancy-related pain in the pelvis. Individual patients may apply different strategies during walking to cope with the underlying problems. RELEVANCE: Pregnancy-related pain in the pelvis is poorly understood. Patients with this condition are known to have problems with locomotion. The present study reveals that gait coordination is altered. Theoretically, this underlines the importance of analysing coordination in pathological movement. Clinically, better understanding the gait problems of women with pregnancy-related pain in the pelvis may contribute to more appropriate treatments.

Adult↗