title: Enhanced arm swing alters interlimb coordination during overground walking in individuals with traumatic brain injury.
abstract: The current study investigated interlimb coordination in individuals with traumatic brain injury (TBI) during overground walking. The study involved 10 participants with coordination, balance, and gait abnormalities post-TBI, as well as 10 sex- and age-matched healthy control individuals. Participants walked 12m under two experimental conditions: 1) at self-selected comfortable walking speeds; and 2) with instructions to increase the amplitude and out-of-phase coordination of arm swinging. The gait was assessed with a set of spatiotemporal and kinematic parameters including the gait velocity, step length and width, double support time, lateral displacement of the center of mass, the amplitude of horizontal trunk rotation, and angular motions at shoulder and hip joints in sagittal plane. Interlimb coordination (coupling) was analyzed as the relative phase angles between the left and right shoulders, hips, and contralateral shoulders and hips, with an ideal out-of-phase coupling of 180° and ideal in-phase coupling of 0°. The TBI group showed much less interlimb coupling of the above pairs of joint motions than the control group. When participants were required to increase and synchronize arm swinging, coupling between shoulder and hip motions was significantly improved in both groups. Enhanced arm swinging was associated with greater hip and shoulder motion amplitudes, and greater step length. No other significant changes in spatiotemporal or kinematic gait characteristics were found in either group. The results suggest that arm swinging may be a gait parameter that, if controlled properly, can improve interlimb coordination during overground walking in patients with TBI.
authors.affiliation: Doctoral Program in Physical Therapy, Central Michigan University, Mt. Pleasant, MI, USA. Electronic address: ustin1k@cmich.edu.
authors.forename: Ksenia I
authors.initials: KI
authors.lastname: Ustinova
authors.affiliation: School of Engineering and Technology, Central Michigan University, Mt. Pleasant, MI, USA.
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Langenderfer
authors.affiliation: Doctoral Program in Physical Therapy, Central Michigan University, Mt. Pleasant, MI, USA.
authors.forename: Nilanthy
authors.initials: N
authors.lastname: Balendra
mesh_terms: D000328:Adult; D000368:Aged; D001132:Arm / Q000503:physiopathology*; D001259:Ataxia / Q000503:physiopathology*; D001696:Biomechanical Phenomena; D000070642:Brain Injuries, Traumatic / Q000503:physiopathology*; D005260:Female; D005684:Gait; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012399:Rotation; D012782:Shoulder / Q000503:physiopathology; D060726:Torso / Q000503:physiopathology; D016138:Walking
keywords: Arm-leg coordination; Gait; Neurological rehabilitation