Case report: New perspectives on gait initiation strategies from a case of full toes amputation in a professional mountain climber.

IF 2.4 3区 医学 Q3 NEUROSCIENCES
Frontiers in Human Neuroscience Pub Date : 2024-09-26 eCollection Date: 2024-01-01 DOI:10.3389/fnhum.2024.1463249
Jorge L Storniolo, Veronica Farinelli, Mattia Onesti, Luca Correale, Leonardo A Peyré-Tartaruga, Roberto Esposti, Paolo Cavallari
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Abstract

Introduction: We studied the postural behaviour of a 52-year-old professional mountain climber who underwent bilateral amputation of all five toes after severe frostbite.

Methods: Two tasks were examined: static posturography (SP) and gait initiation (GI), both performed barefoot and with prosthetic shoes. During SP, the participant kept the upright stance for 30 s while an optoelectronic system with reflective markers recorded feet position and body sway, and two force plates measured the Center of Pressure (CoP) displacement and Ground Reaction Force (GRF) of each foot. During GI, the participant stood on the force plates for at least 10 s and then spontaneously started walking, while optoelectronic system was used to monitor heel-off events; wireless EMG probes recorded the anticipatory postural adjustments (APAs) in trunk and lower limb muscles.

Results: Compared to shod condition, during barefoot SP the participant showed a reduced anteroposterior (AP) and mediolateral (ML) extension of the Base of Support (BoS), and the whole-body CoP shifted about 7 mm more anteriorly, approaching the "safer" geometric center of the BoS. Despite this difference, the AP and ML ranges of CoP oscillations were similar in both conditions. In GI, the trunk dorsal muscles showed different APA patterns: when barefoot they were excitatory in the trailing and inhibitory in the leading side while they were bilaterally inhibitory when shod.

Discussion: In parallel to CoP shift toward a "safer" position in SP, in barefoot GI the body rotation toward the trailing side may reveal a more "cautious" approach; this also shows that different postural strategies may be adopted in GI by one and the same individual.

病例报告:从一名专业登山运动员的全脚趾截肢病例看步态启动策略的新视角。
简介我们研究了一名 52 岁的专业登山运动员的姿势行为:我们对两项任务进行了研究:静态姿势测量(SP)和步态启动(GI),这两项任务都是赤脚和穿义肢鞋进行的。在静态姿势测量过程中,受试者保持直立站姿 30 秒,带反射标记的光电系统记录双脚位置和身体摇摆,两个测力板测量每只脚的压力中心(CoP)位移和地面反作用力(GRF)。在GI期间,受试者站在测力板上至少10秒钟,然后自发开始行走,光电系统用于监测脚跟脱落事件;无线肌电图探头记录躯干和下肢肌肉的预期姿势调整(APA):与穿鞋状态相比,赤足 SP 期间受试者支撑基点(BoS)的前胸(AP)和内外侧(ML)伸展减少,全身 CoP 向前移了约 7 毫米,接近 BoS 的 "更安全 "几何中心。尽管存在这种差异,但两种情况下 CoP 振荡的 AP 和 ML 范围相似。在 GI 中,躯干背侧肌肉显示出不同的 APA 模式:赤脚时,它们在后侧兴奋,在前侧抑制,而穿鞋时,它们在双侧抑制:讨论:在 SP 中,CoP 转向 "更安全 "的位置,而在赤足 GI 中,身体转向后侧可能显示出一种更 "谨慎 "的方式;这也表明同一个人在 GI 中可能采取不同的姿势策略。
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来源期刊
Frontiers in Human Neuroscience
Frontiers in Human Neuroscience 医学-神经科学
CiteScore
4.70
自引率
6.90%
发文量
830
审稿时长
2-4 weeks
期刊介绍: Frontiers in Human Neuroscience is a first-tier electronic journal devoted to understanding the brain mechanisms supporting cognitive and social behavior in humans, and how these mechanisms might be altered in disease states. The last 25 years have seen an explosive growth in both the methods and the theoretical constructs available to study the human brain. Advances in electrophysiological, neuroimaging, neuropsychological, psychophysical, neuropharmacological and computational approaches have provided key insights into the mechanisms of a broad range of human behaviors in both health and disease. Work in human neuroscience ranges from the cognitive domain, including areas such as memory, attention, language and perception to the social domain, with this last subject addressing topics, such as interpersonal interactions, social discourse and emotional regulation. How these processes unfold during development, mature in adulthood and often decline in aging, and how they are altered in a host of developmental, neurological and psychiatric disorders, has become increasingly amenable to human neuroscience research approaches. Work in human neuroscience has influenced many areas of inquiry ranging from social and cognitive psychology to economics, law and public policy. Accordingly, our journal will provide a forum for human research spanning all areas of human cognitive, social, developmental and translational neuroscience using any research approach.
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