Falls are the leading cause of injuries among Canadians who are aged at 65 years and over. The assessment of dynamic stability has been proved as an effective method to identify fall-prone elderly individuals, which is essential to fall prevention. Tai Chi has been recommended as an effective exercise to prevent falls by the American Geriatric Society and British Geriatric Society. It is important to examine dynamic stability among Tai Chi practitioners and to explore the mechanisms of the effects of Tai Chi practice on fall prevention. This study examined the dynamic postural stability which is assessed by center of mass (COM) range of motion, COM - center of pressure (COP) separation, and temporospacial measures of gait during obstacle-walking in two groups: Tai Chi group and healthy controls. Fifteen participants in each group were asked to complete two walking conditions, level walking and 20cm-obstacle walking. Results showed that when compared with Tai Chi group, control group adopted a conservative crossing strategy with a significantly smaller crossing stride, higher heel clearance, and smaller pre horizontal distance to make obstacle crossing as safe as possible. This conservative strategy indicates the inability to cross obstacle casually and it may be associated with the decline in muscle strength and proprioception. It also showed that Tai Chi practitioners displayed a significantly larger COM range of motion in both anteroposterior (AP) and mediolateral (ML) direction (p<0.05) and a significantly larger COM-COP separation in ML direction (p <0.01), as compared with control group. The larger range of motion of COM and distance between COM and COP indicates that Tai Chi practitioners have a better ability to tolerate unsteadiness, which means if perturbation occurs, Tai Chi practitioners have a larger range to shift COM in the boundary of base of support.

xiii, 122 p. A print copy of this thesis is available through the UO Libraries. Search the library catalog for the location and call number. / Currently the information on attention-balance control interactions following concussion is incomplete and not given particular consideration during clinical examinations of concussion. The purposes of this dissertation were to (1) test different gait paradigms for their sensitivity of identifying concussion symptoms and to (2) test how individual components of attention interact with gait performance. The long-term goal of this study is to establish more functional and succinct protocols for return-to-play decisions. Grade II (AAN guidelines) concussed individuals were recruited to participate in testing at 2, 6, 14, and 28 days post-injury. Gait and components of attention were analyzed during each session through a number of different paradigms. Control subjects were matched by stature, age, and athletic participation. The results indicate that the dynamic balance deficits following a concussion are immediately identified with an attention dividing gait task. Obstacle crossing identified more conservative adaptations 2 weeks after injury. A task combining the two did not clearly identify concussion deficits. Two components of attention showed promise as interacting with gait to cause balance deficits. The spatial orientation component showed an interaction with obstacle avoidance indicating that the same concussed individuals that had poor spatial orientation of attention also came closer to hitting the obstacle during crossings. An analysis of divided attention showed that concussed individuals performing poorly in one task also performed poorly in the other during a dual-task paradigm, but during any one particular trial there was a trade-off between task performances, which was not present in control individuals. The findings of this dissertation point to the use of a divided attention task to distinguish concussed individuals from healthy individuals immediately after a possible injurious event. How several different components of attention interact with gait performance is identified. Finally, if a concussion has occurred, an obstacle crossing task might be suitable for a long-term analysis of full recovery of balance control. Ultimately, it is my hope that the information provided here will lead to functionally relevant and clinically executable tests of concussed individuals before they are placed in harm's way due purely to an incomplete diagnosis of their injuries. / Adviser: Li-Shan Chou

Footwear can affect postural stability in individuals, particularly in elderly people. Aging-related decline in postural stability, particularly in the mediolateral (ML) direction, is a risk factor for falls and fall-related injuries among older adults. This study aimed to investigate the effects of high cushioned and minimal shoes on dynamic postural stability in ML during obstacle crossing in defined older and younger adults. Six healthy older adults (50–60 years old, body weight: 74.8 kg, body height: 168.0 cm) and six healthy younger adults (18–32 years old, body weight: 73.8 kg, body height: 174.8 cm) participated in the study. A Vicon motion analysis system with 10 optical cameras was used to capture the obstacle (20 cm height) crossing motion of the participants at 200 Hz, and ground reaction forces of obstacle crossing were collected at 1000 Hz. Motion data of obstacle crossing were collected at three shoe conditions, namely, minimal shoe, high cushioned shoe and barefoot (control). Data from five trials of obstacle crossing for each shoe condition were processed using Vicon Nexus software 2.11.0 and Matlab R2013b. Displacement and velocity of centre of mass (COM) in the ML direction, COM–centre of pressure (COP) ML separation, step length, step velocity, toe clearance, pre-horizontal distance, hip flexion angle and hip abduction angle during obstacle crossing were examined. One-way ANOVA with pairwise analysis showed that toe clearance was significantly larger in the high cushioned shoe conditions than in the minimal shoe and barefoot conditions in older adults (high cushioned shoes vs. barefoot: p = 0.019; cushioned shoes vs. minimal shoes: p = 0.031) and younger adults (high cushioned shoes vs. barefoot: p = 0.016; high cushioned shoes vs. minimal shoes: p = 0.000). No significant difference in the measures was found between the minimal shoe and barefoot conditions in each group. Compared with older adults, younger adults showed significantly larger step length in barefoot condition (p = 0.000) and minimal shoe (p = 0.016). Independent t-test for examination of the significant difference of the means of each measure when the shoe condition was changed showed that only step length and step velocity were significantly different between older and younger adults. When the shoe condition was changed from minimal shoe or barefoot to high cushioned shoe, older adults showed significantly bigger change in step velocity (10.04 ± 4.39 cm/s for older; 1.87 ± 0.81 cm/s for younger; p = 0.034) and step length (14.26 ± 6.99 cm for older; 2.086 ± 1.13 cm for younger; p = 0.041) than younger adults. This result indicates that older adults had 23% greater total range of step length and 12% greater total range of step velocity compared with younger adults when shoe condition changed. Moreover, older adults showed 16% smaller total range in their maximal COM-COP ML separations than younger adults when shoe condition changed. It is concluded that high cushioned shoes can influence dynamic postural stability in the ML direction during obstacle crossing in younger and older adults. The minimal shoe and barefoot conditions did not show significant influence on postural stability in the ML direction during obstacle crossing in older and younger adults. The minimal shoe on dynamic postural stability in the ML direction is not significant. Age differences in dynamic postural stability in the ML direction during obstacle crossing were found at the same shoe conditions. Moreover, when shoe condition was changed, shoe cushioning conditions affected postural stability to a larger extent in older adults compared with younger adults. The high cushioned shoe led to a more challenged postural stability in adults aged 50 to 60 than younger adults aged 18 to 32.

Occasionally healthy older adults trip over stationary objects even when seen well in advance. These are known as “inadvertent” trips. The purpose of this study was to determine the prevalence of inadvertent trips in older males and older females under conditions of normal vision with good lighting. We also determined their relationship with unobstructed gait measures and other risk factors associated with falls during everyday activities. Forty-one subjects stepped over an obstacle (height set to 25% of leg length) 100 times. The obstacle was contacted by 15 participants (37%) in a total of 29 trials (0.7% of all trials). Of the 29 obstacle contacts, 52% occurred with lead limb. There was no difference in the frequency of contacts between males and females. Slower stride speed, shorter stride length, and increased gait cycle time variability during unobstructed walking were associated with contacts during the obstacle crossing trials (p <u><</u> 0.041). Inadvertent trips were also associated with the number of prescription medications taken by participants (p = 0.019) and participants’ maximum reported rating-of-fatigue (p = 0.022<u>)</u>. Fatigue was an important factor and 36 subjects (88%) reported an increase in their fatigue across trials highlighting the importance of considering fatigue in all obstacle crossing studies using older adults. We conclude that inadvertent trips are not uncommon in older adults and point to useful future areas of research and risk factors that could be targeted by fall intervention programs

yes / Background Unilateral trans-tibial amputees have bilaterally reduced toe clearance, and an increased risk of foot contact, while crossing obstacles compared to the able-bodied. While the able-bodied tend to lead with a ‘preferred’ limb it is equivocal whether amputees prefer to lead with the intact or prosthetic limb. This study determined the effects of laterality, compared to side of amputation, on amputees' obstacle crossing performance. To help understand why laterality could affect performance we also assessed knee proprioception for both limbs. Methods Foot placement and toe clearance parameters were recorded while nine amputees crossed obstacles of varying heights leading with both their intact and prosthetic limbs. Joint-position sense was also assessed. Participants self-reported which limb was their preferred (dominant) limb. Findings There were no significant differences in foot placements or toe clearance variability across lead-limb conditions. There were no significant differences in toe clearance between intact and prosthetic lead-limbs (p = 0.28) but toe clearance was significantly higher when amputees led with their preferred compared to non-preferred limb (p = 0.025). There was no difference in joint-position sense between the intact and residual knees (p = 0.34) but joint-position sense tended to be more accurate for the preferred, compared to non-preferred limb (p = 0.08). Interpretation Findings suggest that, despite the mechanical constraints imposed by use of a prosthesis, laterality may be as important in lower-limb amputees as it is in the able bodied. This suggests that amputees should be encouraged to cross obstacles leading with their preferred limb. / Engineering and Physical Sciences Research Council

Yes / Background: When trans-tibial amputees cross obstacles leading with their prosthesis, foot clearance is achieved using compensatory swing-phase kinematics. Such compensation would suggest able-bodied individuals normally use swing-phase ankle dorsiflexion to attain adequate obstacle clearance, however, direct evidence of such contribution is equivocal. The present study determined the contribution of sagittal plane ankle motion in achieving lead-limb clearance during obstacle negotiation. Methods: 12 male able-bodied individuals (ages 18-30) completed obstacle crossing trials while walking on a flat surface. Lead-limb (right) ankle motion was manipulated using a knee-ankle-foot orthosis. Trials were completed with the ankle restricted at a neutral angle or unrestricted (allowing ~ ±15  plantar/dorsiflexion). Findings: Restricted ankle motion caused significant increase in trail-limb foot placement distance before the obstacle (p=0.005); significant decrease in vertical toe clearance (p<0.003), vertical heel clearance (p=0.045) and lead-limb foot placement distance after the obstacle (p=0.045); but no significant changes in knee angle at instant of crossing or in average walking speed. Interpretation: The shifts in foot placements altered the part of swing that the lead-limb was in when the foot crossed the obstacle, which led to a decrease in clearance. These adaptations may have been due to being unable to dorsiflex the ankle to ‘lift’ the toes in mid-swing or to being unable to plantarflex the ankle during initial contact following crossing, which changed how the lead-limb was to be loaded. These findings suggest individuals using ankle bracing or those with ankle arthrodesis, will have reduced gait safety when negotiating obstacles.

Yes / Trips over obstacles are one of the main causes of falling in older adults, with vision playing an important role in successful obstacle negotiation. We determined whether a horizontal-vertical illusion, superimposed onto low-height obstacles to create a perceived increase in obstacle height, increased foot clearances during obstacle negotiation thus reducing the likelihood of tripping. Eleven adults (mean ± 1 SD: age 27.3 ± 5.1 years) negotiated obstacles of varying heights (3, 5, 7 cm) with four different appearance conditions; two were obstacles with a horizontal-vertical illusion (vertical stripes of different thickness) superimposed on the front, one was a plain obstacle and the fourth a plain obstacle with a horizontal black line painted on the top edge. Foot clearance parameters were compared across conditions. Both illusions led to a significant increase in foot clearance when crossing the obstacle, compared to the plain condition, irrespective of obstacle height. Superimposing a horizontal-vertical illusion onto low-height obstacles can increase foot clearance, and its use on the floor section of a double-glazing door frame for example may reduce the incidence of tripping in the home.

No / The purpose of this article is to determine the relative importance to adaptive locomotion of peripheral visual cues provided by different parts of the visual field. Twelve subjects completed obstacle crossing trials while wearing goggles that provided four visual conditions: upper visual field occlusion, lower visual field occlusion (LO), circumferential peripheral visual field occlusion (CPO), and full vision. The obstacle was either positioned as a lone structure or within a doorframe. Given that subjects completed the task safely without cues from the lower or peripheral visual field, this suggests that subjects used exteroceptive information provided in a feed-forward manner under these conditions. LO and CPO led to increased foot placement distance from the obstacle and to increased toe clearance over the obstacle with a reduced crossing-walking velocity. The increased variability of dependent measures under LO and CPO suggests that exproprioceptive information from the peripheral visual field is generally used to provide online control of lower limbs. The presence of the doorframe facilitated lead-foot placement under LO by providing exproprioceptive cues in the upper visual field. However, under CPO conditions, the doorframe led to a further reduction in crossing velocity and increase in trail-foot horizontal distance and lead-toe clearance, which may have been because of concerns about hitting the doorframe with the head and/or upper body. Our findings suggest that exteroceptive cues are provided by the central visual field and are used in a feed-forward manner to plan the gait adaptations required to safely negotiate an obstacle, whereas exproprioceptive information is provided by the peripheral visual field and used online to “fine tune” adaptive gait. The loss of the upper and lower peripheral visual fields together had a greater effect on adaptive gait compared with the loss of the lower visual field alone, likely because of the absence of lamellar flow visual cues used to control egomotion.

Locomotion requires visuospatial attention. However, the role and cortical control of visuospatial attention during locomotion remain unclear. Four experiments were conducted in this study to examine the role and cortical control of visuospatial attention during locomotion in healthy young adults. In the first experiment, we employed a visuospatial attention task at different phases of obstacle crossing during gait. The results suggested that toe-obstacle clearance was significantly reduced for the trailing limb when distraction interfered with visuospatial attention during the approaching phase of obstacle crossing. In the second experiment, subjects performed a visual Stroop task while approaching and crossing an obstacle during gait. The results for the second experiment indicated toe-obstacle clearance was significantly increased for the leading and trailing limbs. Taken together, it was found that different visual attention tasks lead to distinct modifications on obstacle crossing behaviors. In the third and fourth experiments, anodal transcranial direct current stimulation (tDCS) was applied over the right posterior parietal cortex (PPC) to examine the aftereffects on attention function and locomotor behavior. The results suggested that the orienting attention was significantly improved after anodal tDCS. In addition, the aftereffects of anodal tDCS potentially enhanced cognitive and motor performance while interacting with a challenging obstacle-crossing task in young healthy adults, suggesting that the right PPC contributes to attending visuospatial information during locomotion. This study demonstrated that visuospatial attention is critical for planning during locomotion and the right PPC contributes to this interplay of the neural processing of visuospatial attention during locomotion. This dissertation includes previously published and unpublished co-authored material.

This thesis presents two simulations of a heavy hybrid vehicle, the first part of the thesis is focused on the specifications of the vehicle designed in accordance with the requirements based on the literature study of the soils where the vehicle will travel. The second part presents the study of the vehicle through two simulations. The first simulation is oriented on the dynamical behavior of the vehicle. The second simulation focuses on the energy management of the vehicle. The presented thesis is a multi-disciplinary study, combining knowledge on vehicle dynamics, hydraulic suspensions and hybrid systems. The dynamical simulation of the vehicle has been performed with Matlab/Simulink and the third party program Delft-Tire for the tire modelling. Specials features of Matlab have been used; SimMechanics for the modelling of the parts, links and joints of the vehicle, and SimHydraulics for the modelling of the hydraulic suspensions. The principal tests performed on the vehicle by the dynamical simulation are the tests defined by the NATO - STANAG standards as AVTP 03-170. The tests are a crossing obstacle test and different sine wave roads. The obstacle of the obstacle crossing test is an APG-10 obstacle, an 10 inch high step with vertical edges. The objective of this simulation is to verify the design of the suspension and to observe the forces created in each link of the suspension system in order to design the chassis and the suspension system. The sine wave driving tests are performed to highlight the influence of the different hydraulic connections. Finally the slalom test presents the influence of the hydraulic anti-roll bar. The results show that the vehicle suspension verifies the STANAG standard. The results show also that the forces applied at the wheel by the obstacle crossing defined in the AVTP 03- 170 are directly related to the diameter and the stiffness of the tire. The maximum forces encountered at the wheel corresponds to 2.5 G vertically and 1.5 G longitudinally. The sine wave driving and the slalom test are showing the benefits and the need for advanced hydraulic suspensions. The second simulation is the modelling of the hybrid power management of the vehicle. The simulation has been performed with the objectives to create a tool for sizing series hybrid powertrain. This simulation has also been performed with Matlab/Simulink and the Simscape Library. The tool created show that when, the vehicle is equipped with 150 kW of power generation and 300 kW of battery would be able to drive at a constant speed of 10 km/h with the terrain inputs evaluated from the literature study, but to create sufficient result the input parameters of the tools need to have a better definition.