Browsing by Author "Fino, Peter C."
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- Classifying Step and Spin Turns Using Wireless Gyroscopes and Implications for Fall Risk AssessmentsFino, Peter C.; Frames, Christopher W.; Lockhart, Thurmon E. (MDPI, 2015-05-06)Recent studies have reported a greater prevalence of spin turns, which are more unstable than step turns, in older adults compared to young adults in laboratory settings. Currently, turning strategies can only be identified through visual observation, either in-person or through video. This paper presents two unique methods and their combination to remotely monitor turning behavior using three uniaxial gyroscopes. Five young adults performed 90° turns at slow, normal, and fast walking speeds around a variety of obstacles while instrumented with three IMUs (attached on the trunk, left and right shank). Raw data from 360 trials were analyzed. Compared to visual classification, the two IMU methods’ sensitivity/specificity to detecting spin turns were 76.1%/76.7% and 76.1%/84.4%, respectively. When the two methods were combined, the IMU had an overall 86.8% sensitivity and 92.2% specificity, with 89.4%/100% sensitivity/specificity at slow speeds. This combined method can be implemented into wireless fall prevention systems and used to identify increased use of spin turns. This method allows for longitudinal monitoring of turning strategies and allows researchers to test for potential associations between the frequency of spin turns and clinically relevant outcomes (e.g., falls) in non-laboratory settings.
- Locomotor deficits in recently concussed athletes and matched controls during single and dual-task turning gait: preliminary resultsFino, Peter C.; Nussbaum, Maury A.; Brolinson, Per Gunnar (2016-07-25)Background There is growing evidence that mild traumatic brain injury (concussion) can affect locomotor characteristics for prolonged periods of time even when physical signs and symptoms are absent. While most locomotor deficits post-concussion have involved straight walking, turning gait has received little attention despite its pervasiveness in everyday locomotion and athletic competition. Methods This study longitudinally examined kinematic characteristics during preplanned turning in a small sample of recently concussed athletes (n = 4) and healthy matched control athletes (n = 4) to examine potential deficits during single and dual-task turning gait over the initial 6 weeks post-injury, with a one-year follow-up. Turning path kinematics (curvature, obstacle clearance, path length), stride kinematics (stride length, stride width, stride time), and inclination angles were calculated from motion capture of participants walking around an obstacle. Results Concussed athletes had larger dual-task costs in turning speed and stride time compared to healthy controls. After controlling for speed and turn curvature, recently concussed athletes increased their inclination towards the inside of the turn over time and decreased their stride time compared to controls indicating a prolonged recovery. Kinematic differences between groups were estimated to recover to healthy levels between 100 and 300 days post-injury, suggesting future prospective longitudinal studies should span 6–12 months post-injury. Conclusion Turning gait should be included in future studies of concussion and may be a clinically useful tool. Future longitudinal studies should consider examining gait changes for up to 6–12 months post-injury.
- Longitudinal Locomotor and Postural Control Following Mild Traumatic Brain InjuryFino, Peter C. (Virginia Tech, 2016-02-05)Millions of people sustain a mild traumatic brain injury (concussion) each year. While most clinical signs and symptoms resolve within 7-10 days for the majority of typical concussions, some gait and balance tasks have shown abnormalities lasting beyond the resolution of clinical symptoms. These abnormalities can persist after athletes have been medically cleared for competition, yet the implications of such changes are unclear. Most prior research has examined straight gait and standard measures of balance, yet there is a lack of knowledge regarding potential persistent effects on non-straight maneuvers or on indicators of motor control variability or complexity. To expand the knowledge of post-concussion locomotor and postural changes, this investigation examined the recovery of recently concussed athletes longitudinally, over the course of one year, in three domains: 1) path selection and body kinematics during turning gait, 2) non-linear local dynamic stability during straight gait, and 3) postural control complexity during quiet standing. Compared to matched health controls, concussed athletes exhibited significant and persistent differences in turning kinematics, local dynamic stability, and postural complexity over the initial six weeks following injury. These motor differences may increase the risk of injury to concussed athletes who are cleared to return to play. Given the persistent nature of these effects, future clinical tests may benefit from incorporating gait assessments before returning athletes to competition. Future research should prospectively and longitudinally monitor locomotor and postural control in conjunction with structural and functional changes within the brain to better understand the pathophysiology of concussions and potential rehabilitation strategies.