Margaux Simon

Navigating public environments requires adjustments to one’s walking patterns to avoid stationary and moving obstacles. It is known that physical inactivity induces alterations in motor capacities, but the impact of inactivity on anticipatory locomotor adjustments (ALA) has not been studied. The purpose of the present exploratory study was to compare ALAs and related muscle co-contraction during a pedestrian circumvention task between active (AA) and inactive young adults (IA). Fourteen AA and fourteen IA were placed in a virtual environment simulating a public park. Participants circumvented virtual pedestrians walking towards them. Walking speed, onset of deviation, clearance, foot placement strategies and muscle co-contraction were analysed on a total of 26 participants (13 in each group; 2 excluded due to technical issues). IA exhibited slower walking speeds compared to the AA during circumvention condition but not during unobstructed walking condition. The distance at the onset of trajectory deviation was larger for IA. Both groups increased co-contraction for pedestrian circumvention at the ankle and left hip and IA displayed greater ankle co-contraction overall. No significant group differences were observed in minimum clearance. This study suggests that an inactive lifestyle influences ALAs by inducing a cautious behavior during pedestrian circumvention.

Objective The objective was to document the acceptability of rehabilitation exoskeletons from the perspective of users with spinal cord injury (SCI) and healthcare professionals (HP). Methods This mixed-methods systematic review considered quantitative, qualitative and mixed methods studies that included adults with SCI using an exoskeleton for gait rehabilitation, as well as HP working within rehabilitation settings with individuals with SCI who used an exoskeleton. A convergent integrated approach per the Joanna Briggs Institute (JBI) was used. Results A total of 22 studies were included. Overall, individuals with SCI and HP expressed a favorable level of acceptability. Participants reported a positive affective attitude, an overall satisfaction, and several psychological benefits. Few burdens, ethical issues and opportunity costs have also been reported in the studies. Maintaining realistic expectations towards exoskeleton use and ensuring the appropriate selection of users is important for intervention coherence. In general, there was a positive perception regarding effectiveness and self-efficacy. Nevertheless, only a limited number of studies focused primarily on measuring acceptability, revealing an important gap in the literature. Conclusions The acceptability of exoskeletons among people with SCI and HP tends to be positive, which is promising for the sustainable implementation of this technology. However, there is still a lack of knowledge about the acceptability of HP, with only two studies conducted among this population. It is crucial to persevere in documenting the acceptability of exoskeletons, notably by standardizing comprehensive approaches for measuring acceptability, and to continue refining this technology.

Navigating public environments requires adjustments to one’s walking patterns to avoid stationary and moving obstacles. It is known that physical inactivity induces alterations in motor capacities, but the impact of inactivity on anticipatory locomotor adjustments (ALA) has not been studied. The purpose of the present study was to compare ALAs and related muscle co-contraction during a pedestrian circumvention task between active (AA) and inactive young adults (IA). Thirteen AA and thirteen IA were placed in a virtual environment simulating a public park. Participants circumvented virtual pedestrians walking towards them. Walking speed, onset of deviation, clearance, foot placement strategies and muscle co-contraction were analysed. IA exhibited slower walking speeds compared to the AA during circumvention condition but not during unobstructed walking condition. The distance at the onset of trajectory deviation was larger for IA. Both groups increased co-contraction for pedestrian circumvention at the ankle and left hip and IA displayed greater ankle co-contraction overall. No significant group differences were observed in minimum clearance. This study suggests that an inactive lifestyle influences ALAs by inducing a cautious behavior during pedestrian circumvention.

Corticospinal excitability is subject to alterations after stroke. While the reversal of these alterations has been proposed as an underlying mechanism for improved walking capacity after gait-specific training, this has not yet been clearly demonstrated. Therefore, the objective of this review is to evaluate the effect of gait-specific training on corticospinal excitability in stroke survivors. We conducted an electronic database search in four databases (i.e., Medline, Embase, CINAHL and Web of Science) in June 2022. Two authors screened in an independent way all the studies and selected those that investigated the effect of gait-specific training on variables such as motor-evoked potential amplitude, motor threshold, map size, latency, and corticospinal silent period in stroke survivors. Nineteen studies investigating the effect of gait-specific training on corticospinal excitability were included. Some studies showed an increased MEP amplitude (7/16 studies), a decreased latency (5/7studies), a decreased motor threshold (4/8 studies), an increased map size (2/3 studies) and a decreased cortical silent period (1/2 study) after gait-specific training. No change has been reported in terms of short interval intracortical inhibition after training. Five studies did not report any significant effect after gait-specific training on corticospinal excitability. The results of this systematic review suggest that gait-specific training modalities can drive neuroplastic adaptation among stroke survivors. However, given the methodological disparity of the included studies, additional clinical trials of better methodological quality are needed to establish conclusions. The results of this review can therefore be used to develop future studies to better understand the effects of gait-specific training on the central nervous system.