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Item Differentiating Between Walking and Stair Climbing Using Raw Accelerometry Data(Springer, 2019-05-10) Fadel, William F.; Urbanek, Jacek K.; Albertson, Steven R.; Li, Xiaochun; Chomistek, Andrea K.; Harezlak, Jaroslaw; Biostatistics, School of Public HealthWearable accelerometers provide an objective measure of human physical activity. They record high frequency unlabeled three-dimensional time series data. We extract meaningful features from the raw accelerometry data and based on them develop and evaluate a classification method for the detection of walking and its sub-classes, i.e. level walking, descending stairs and ascending stairs. Our methodology is tested on a sample of 32 middle-aged subjects for whom we extracted features based on the Fourier and wavelet transforms. We build subject-specific and group-level classification models utilizing a tree-based methodology. We evaluate the effects of sensor location and tuning parameters on the classification accuracy of the tree models. In the group-level classification setting, we propose a robust feature inter-subject normalization and evaluate its performance compared to unnormalized data. The overall classification accuracy for the three activities at the subject-specific level was on average 87.6%, with the ankle-worn accelerometers showing the best performance with an average accuracy 90.5%. At the group-level, the average overall classification accuracy for the three activities using the normalized features was 80.2% compared to 72.3% for the unnormalized features. In summary, a framework is provided for better use and feature extraction from raw accelerometry data to differentiate among different walking modalities as well as considerations for study design.Item Exercise Induced Changes of Vital Signs in Adults with Sickle Cell Disease(Wiley, 2021) Johnson, Solomon; Gordeuk, Victor R.; Machado, Roberto; Gibbs, J. Simon R.; Hildesheim, Mariana; Little, Jane A.; Kato, Gregory J.; Gladwin, Mark T.; Nouraie, Mehdi; Medicine, School of MedicineThe six-minute walk test (6MWT) has been used in patients with sickle cell disease (SCD), in conjunction with tricuspid regurgitant velocity (TRV) and plasma N-terminal pro-brain natriuretic peptide (NT-pro BNP), to assess risk of having pulmonary hypertension. Exercise-induced vital sign changes (VSCs) are predictors of clinical outcomes in other diseases. In this study, we assess the predictors and prognostic value of 6MWT VSC in adult SCD patients. Data from a multinational study of SCD patients (Treatment of Pulmonary Hypertension with Sildenafil: walk-PHaSST) were used to calculate the 6MWT VSC. Predictors of VSC were identified by a multivariable analysis, and a survival analysis was conducted by the Cox proportional hazard method. An increase in heart rate was observed in 90% of the 630 SCD adults, 77% of patients had an increase in systolic blood pressure (SBP), and 50% of patients had a decrease in oxygen saturation. TRV (odds ratio [OR] = 1.82, p = .020), absolute reticulocyte count (OR = 1.03, p < .001), and hemoglobin (OR = 0.99, p = .035) predicted oxygen desaturation ≥ 3% during the 6MWT. In the adjusted analysis, SBP increase during the 6MWT was associated with improved survival (hazards ratio = 0.3, 95% confidence interval: 0.1-0.8). Increases in heart rate and blood pressure, as well as oxygen desaturation, are common in adults with SCD during the 6MWT. VSC is associated with markers of anemia and TRV and can be used for risk stratification. Any increase in SBP during the 6MWT was associated with improved survival and may be indicative of a patient's ability to increase stroke volume.Item The human preference for symmetric walking often disappears when one leg is constrained(The Physiological Society, 2021) Browne, Michael G.; Smock, Cameron S.; Roemmich, Ryan T.; Medicine, School of MedicineWe hypothesized that minimization of metabolic power could drive people to walk asymmetrically when one leg is constrained We studied healthy young adults and independently constrained one or both step lengths to be markedly shorter or longer than preferred using visual feedback When one leg was constrained to take a shorter or longer step than preferred, asymmetric walking patterns were less metabolically costly than symmetric walking patterns When one leg was constrained to take a shorter or longer step than preferred and the other leg was allowed to move freely, most participants naturally adopted an asymmetric gait People may prefer to walk asymmetrically to minimize metabolic power when the function of one leg is constrained during fixed-speed treadmill walking ABSTRACT: The bilateral symmetry inherent in healthy human walking is often disrupted in clinical conditions that primarily affect one leg (e.g. stroke). This seems intuitive: with one leg constrained, gait becomes asymmetric. However, the emergence of asymmetry is not inevitable. Consider that symmetric walking could be preserved by matching the movement of the unconstrained leg to that of the constrained leg. While this is theoretically possible, it is rarely observed in clinical populations. Here, we hypothesized that minimization of metabolic power could drive people to walk asymmetrically when one leg is constrained, even when symmetric walking remains possible. We tested this hypothesis by performing two experiments in healthy adults. In Experiment 1, we constrained one step to be markedly shorter or longer than preferred. We observed that participants could significantly reduce metabolic power by adopting an asymmetric gait (one short/long step, one preferred step) rather than maintaining a symmetric gait (bilateral short/long steps). Indeed, when allowed to walk freely in this situation, participants naturally adopted a less effortful asymmetric gait. In Experiment 2, we applied a milder constraint that more closely approximated magnitudes of step length asymmetry that are observed in clinical populations. Responses in this experiment were more heterogeneous, though most participants adopted an asymmetric gait. These findings support two central conclusions: (1) symmetry is not necessarily energetically optimal in constrained human walking, and (2) people may prefer to walk asymmetrically to minimize metabolic power when one leg is constrained during fixed-speed treadmill walking, especially when the constraint is large.Item Research Bites: Walk for a Better Night of Sleep!(Wolters Kluwer, 2020-05) Yoke, Mary; Kinesiology, School of Health and Human SciencesItem Signals from posterior parietal area 5 to motor cortex during locomotion(Oxford University Press, 2023) Beloozerova, Irina N.; Nilaweera, Wijitha U.; Di Prisco, Gonzalo Viana; Marlinski, Vladimir; Pharmacology and Toxicology, School of MedicineArea 5 of the parietal cortex is part of the "dorsal stream" cortical pathway which processes visual information for action. The signals that area 5 ultimately conveys to motor cortex, the main area providing output to the spinal cord, are unknown. We analyzed area 5 neuronal activity during vision-independent locomotion on a flat surface and vision-dependent locomotion on a horizontal ladder in cats focusing on corticocortical neurons (CCs) projecting to motor cortex from the upper and deeper cortical layers and compared it to that of neighboring unidentified neurons (noIDs). We found that upon transition from vision-independent to vision-dependent locomotion, the low discharge of CCs in layer V doubled and the proportion of cells with 2 bursts per stride tended to increase. In layer V, the group of 2-bursters developed 2 activity peaks that coincided with peaks of gaze shifts along the surface away from the animal, described previously. One-bursters and either subpopulation in supragranular layers did not transmit any clear unified stride-related signal to the motor cortex. Most CC group activities did not mirror those of their noID counterparts. CCs with receptive fields on the shoulder, elbow, or wrist/paw discharged in opposite phases with the respective groups of pyramidal tract neurons of motor cortex, the cortico-spinal cells.