Weerdesteyn Vivian, Hollands Kristen L, Hollands Mark A
Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands; Sint Maartenskliniek Research, Nijmegen, The Netherlands.
School of Health and Society, University of Salford, Manchester, United Kingdom.
Handb Clin Neurol. 2018;159:135-146. doi: 10.1016/B978-0-444-63916-5.00008-2.
Our activities of daily living inherently involve interacting with the physical environment. This interaction involves both reactive (feedback) and proactive (feedforward) gait adaptations. Reactive adaptations involve responses to mechanical perturbations and occur, for instance, when we stumble over a doorstep or slip on an icy spot on the pavement. Examples of proactive adaptations in response to visual stimuli include stepping over an obstacle, targeting precise foot placements when walking on rough terrain, stepping up to the pavement, or making a turn for going around a corner. These adaptations have to be implemented in our steady-state gait pattern, thus posing a challenge to center-of-mass control and maintenance of forward progression. Yet, despite the apparent complexity of adaptive bipedal walking, we commonly do this with remarkable ease. This chapter will provide a comprehensive overview of the behavioral strategies and control mechanisms that we apply for executing these common, yet complex, gait adaptations. In addition, how we use visual information for guiding proactive gait adaptations and path selection will be discussed. Finally, cognitive involvement during gait adaptations will also be addressed.
我们的日常生活活动本质上涉及与物理环境的交互。这种交互涉及反应性(反馈)和前瞻性(前馈)步态适应。反应性适应涉及对机械扰动的反应,例如,当我们在门阶上绊倒或在人行道上的结冰点滑倒时就会发生。对视觉刺激做出反应的前瞻性适应的例子包括跨过障碍物、在崎岖地形上行走时瞄准精确的脚部落点、走上人行道或转弯绕过拐角。这些适应必须在我们的稳态步态模式中实现,从而对质心控制和向前推进的维持构成挑战。然而,尽管适应性双足行走表面上很复杂,但我们通常能轻松做到。本章将全面概述我们用于执行这些常见但复杂的步态适应的行为策略和控制机制。此外,还将讨论我们如何利用视觉信息来指导前瞻性步态适应和路径选择。最后,也将探讨步态适应过程中的认知参与。