ECSS Paris 2023: CP-BM03
INTRODUCTION: The 6-Minute Walk Test (6MWT) is commonly used to assess cardiorespiratory functional capacity in healthy1 and clinical populations. However, its interpretation concerning movement information typically relies solely on total distance covered, providing little information about locomotor and pacing strategies. Although changes in walking patterns (e.g., step frequency and amplitude) are known to be related to the onset of fatigue, these alterations are not captured in the 6MWT evaluation. Thus, this study aimed to quantify within‑ and between‑subject variability in walking patterns throughout the 6MWT. METHODS: Thirty-two apparently healthy participants (age = 28 ± 8.93, BMI = 24.83 ± 4.15) completed a 6MWT while wearing an ankle accelerometer (tri-axial, 100 Hz, GT3X, ActiGraph). The test was conducted on a 30-meter course marked at 5 and 25 meters. Thus, 20-meter segments were recorded as participants crossed both marks. The first segment served as an individualized reference template, which was compared with the subsequent segments. Time and frequency domain gait features such as amplitude, energy, step frequency, and morphological similarity metrics were computed for each segment. Within‑ and between‑subject variability was quantified using coefficients of variation (CoV) and intraclass correlation coefficients (ICC) with 95% confidence intervals (RStudio 2025.09.2+418). RESULTS: Within-subject variability across all segments ranged between 2.8 to 5.6% CoV and ranged from 0.61 to 0.93 ICC. Step amplitude and energy showed the highest stability (ICC > 0.90). While step frequency had the highest variability (ICC: 0.61-0.72), possibly reflecting pacing adjustments. As expected, between‑subject variability was larger than within variability (6.1-21.2% CoV), with step frequency exhibiting the greatest inter‑individual variability (21.2%). CONCLUSION: Six minutes of standardized walking are sufficient to reveal meaningful within‑subject variability in frequency‑related gait features. These intra‑ and inter‑individual gait differences remain underexplored, yet they may offer valuable insights into locomotor control and cardiorespiratory fitness beyond total distance walked. References 1- Albergoni A, Hettinga FJ, Stut W, Sartor F. Factors Influencing Walking and Exercise Adherence in Healthy Older Adults Using Monitoring and Interfacing Technology: Preliminary Evidence. Int J Environ Res Public Health. 2020 Aug 24;17(17):6142. doi: 10.3390/ijerph17176142. PMID: 32846988; PMCID: PMC7503601.
Read CV Moira RaimoECSS Paris 2023: CP-BM03
INTRODUCTION: Participation in sports has numerous health related benefits; however, head trauma from concussions and repetitive head impacts are associated with elevated rates of neurodegenerative diseases. While RHI sports (ice hockey, American football, wrestling, and Men’s Lacrosse) have head impacts as a normal part of the sport, Football/Soccer has fewer RHI and are more intermittent. Gait performance is critical to functional independence and health related quality of life. For most athletes, college sports is their highest level of sport participation; therefore, we assessed gait performance at the conclusion of athletes collegiate careers. METHODS: There were 76 participants divided into four groups 1) RHI (N=18, 100% Male, HT: 180.3 + 8.9 cm, WT: 85.5 + 20.2 kg), 2) Soccer (N=17, 58.8% Female, HT: 173.0 + 8.8 cm, WT: 68.2 + 10.5 kg), 3) Non-RHI Sports (N=20, 80% Female, HT: 172.4 + 12.6, WT: 67.4 + 8.5 kg), 4) Non-Athletes (55% Female, HT: 169.1 + 9.4 cm, WT: 77.7 + 17.6 kg). All assessments were completed in the same semester as the end of the athlete’s final season and the non-athletes were assessed in their senior year of undergraduate. All participants competed five trials of single task gait on a reliable and valid 8-meter instrumented walkway (GAITRite, Franklin, NJ, USA). The mean gait velocity and step length were compared with a one-way ANOVA while controlling for sex, height, and concussion history. RESULTS: There was no Group effect for Gait Velocity (F: 0.616, p=0.6067, R2=0.02) and exploratory analysis did not identify any group differences (RHI: 1.18 + 0.17 m/s, Soccer: 1.16 + 0.12, Non-RHI: 1.21 + 0.16 m/s, Non-Athlete: 1.22 + 0.13 m/s). There was no Group effect for Step Length (F: 2.07, p=0.111, R2=0.08) and and exploratory analysis did not identify any group differences (RHI: 61.4 + 8.7 cm, Soccer: 62.6 + 7.0 cm, Non-RHI: 65.3 + 8.2 cm, Non-Athlete: 67.0 + 6.8 cm). CONCLUSION: At the conclusion of their athletic career, there were no group differences identified in gait performance based on sports participation. While head trauma, either concussions or RHI, may have long-term degenerative effects, the results of this study suggest that no impairments are noted are the conclusion of their collegiate athletic career which should represent the vast majority of their lifelong head trauma. While the long-term effects of RHI remain to be fully determined, these results suggest that RHI may not adversely affect gait performance in the short-term when the individual is still young, but long-term assessment remains critical to fully elucidate adverse neurological effects of RHI.
Read CV Thomas BuckleyECSS Paris 2023: CP-BM03
INTRODUCTION: Parkinson's disease (PD) is characterized by motor and cognitive deficits that become markedly evident during dual-task (DT) walking, where a secondary cognitive or motor task is performed simultaneously. While spatiotemporal gait alterations under DT are well-documented, a comprehensive synthesis of the underlying biomechanical and neurophysiological changes is lacking. This systematic review aimed to characterize the biomechanical gait alterations under DT conditions in individuals with PD, identify associated neurophysiological correlates, and evaluate the methodological quality of the existing evidence. METHODS: A systematic literature search was conducted across five databases (PubMed, Scopus, Web of Science, Cochrane Library, EBSCO) from 2000 to 2025, following PRISMA guidelines. Forty-four studies meeting the PECOS inclusion criteria were included. Studies involved PD patients in the “ON” medication state during DT walking, compared to healthy controls. Methodological quality was assessed using the AXIS tool and a customized DT-checklist, and the review protocol was registered in PROSPERO (CRD420251004404). Meta-analyses, meta-regressions, and subgroup analyses examining the effects of disease severity, DT type, and walking modality are currently in progress. RESULTS: Preliminary synthesis indicates that DT consistently exacerbates gait impairments in PD, with reductions in stride length (10–20%), gait speed (15–30%), and knee joint range of motion (5–12°), alongside increased stride time variability (20–40%). Cognitive DTs, such as Stroop or serial subtraction tasks, induced greater deterioration than motor DTs, particularly in individuals with the Postural Instability/Gait Difficulty phenotype (+35% step variability) and those experiencing freezing of gait (−28% speed). Overground walking imposed greater DT costs (−22% speed) than treadmill walking, and motion capture systems were more sensitive than walkway-based measures in detecting kinematic alterations. Neurophysiological studies using fNIRS revealed compensatory hyperactivation of the prefrontal cortex, suggesting a shift from automatic to controlled movement. External cueing and dopaminergic medication partially mitigated DT-related deficits. CONCLUSION: DT walking in PD is characterized by shortened strides, slowed gait, increased variability, and a stiffened gait pattern, driven by heightened cognitive control and compensatory prefrontal activation. These preliminary findings highlight the potential of DT assessment as a functional biomarker and underscore the need for standardized protocols and integration of cognitive load measures to guide precision rehabilitation. Ongoing meta-analyses and subgroup investigations will provide further quantitative confirmation of these effects.
Read CV Andrea PaternoECSS Paris 2023: CP-BM03