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Stergiou -

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Walking with different types of cueing/stimulus (i.e. auditory, visual) has been shown to alter gait variability, thus emerging as an innovative therapeutical tool to restore abnormal gait variability in clinical populations. However, the majority of the research in this area has focused on auditory stimuli while visual stimuli are an understudied alternative that needs more attention, particularly due to the natural dependence on vision during walking. Furthermore, the time differences between the occurrences of the walking steps and the sensory cues, also known as asynchronies, have also received minimal attention, even though the ability to synchronize with different stimuli is of great importance. This study investigated how synchronizing to visual stimuli with different temporal structures could affect gait variability and the respective asynchronies. Participants performed four 15-min walking trials around an indoor track while wearing insole footswitches for the following conditions: a) self-paced walking, and b) walking with glasses that instructed the subjects to step in sync with a virtual moving bar. The stepping occurences of the moving bar were presented in three different ways b1) non-variable, b2) variable and b3) random. Stride times and asynchronies were determined, and the mean values along with the fractal scaling (an indicator of the complexity) in their time series, were calculated. The fractal scaling of the stride times was unaltered when participants walked with the variable stimulus as compared to the self-paced walking condition; while fractal scaling was significantly decreased during the non-variable and random conditions, indicating a loss of complexity for these two conditions. No differences were observed in the means or the fractal scaling of the asynchronies. The correlation analysis between stride times and asynchronies revealed a strong relationship for the non-variable condition but a weak relationship for both variable and random conditions. Taken together, the present study results supports the idea of an existing internal timekeeper that exhibits complexity. We have shown that this complex pattern is similar regardless of the stimulus condition, suggesting that the system’s complexity is likely to be expressed at the task performance level – asyncrhonies – when walking to a stimulus. Thus, future research in sensoriomotor gait synchronization should focus and further explore the role of the asynchronies, as it may be of clinical significance.


This is an Accepted Manuscript of an article published by Elsevier in Neuroscience Letters on April 4, 2019, available online:

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Neuroscience Letters



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