Medial Unloader Braces and Lateral Heel Wedges Do not Alter Gait Biomechanics in Healthy Young Adults

2019 ◽  
Vol 28 (4) ◽  
pp. 354-359 ◽  
Author(s):  
Jonathan S. Goodwin ◽  
Robert A. Creighton ◽  
Brian G. Pietrosimone ◽  
Jeffery T. Spang ◽  
J. Troy Blackburn
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Lower Extremity ◽  
Frontal Plane ◽  
Heel Strike ◽  
Orthotic Devices ◽  
Healthy Individuals ◽  
Gait Biomechanics ◽  
Orthopedic Injury ◽  
Unloader Brace

Context: Orthotic devices such as medial unloader knee braces and lateral heel wedges may limit cartilage loading following trauma or surgical repair. However, little is known regarding their effects on gait biomechanics in young, healthy individuals who are at risk of cartilage injury during physical activity due to greater athletic exposure compared with older adults. Objective: Determine the effect of medial unloader braces and lateral heel wedges on lower-extremity kinematics and kinetics in healthy, young adults. Design: Cross-sectional crossover design. Setting: Laboratory setting. Patients: Healthy, young adults who were recreationally active (30 min/d for 3 d/wk) between 18 and 35 years of age, who were free from orthopedic injury for at least 6 months, and with no history of lower-extremity orthopedic surgery. Interventions: All subjects completed normal over ground walking with a medial unloader brace at 2 different tension settings and a lateral heel wedge for a total of 4 separate walking conditions. Main Outcome Measures: Frontal plane knee angle at heel strike, peak varus angle, peak internal knee valgus moment, and frontal plane angular impulse were compared across conditions. Results: The medial unloader brace at 50% (−2.04° [3.53°]) and 100% (−1.80° [3.63°]) maximum load placed the knee in a significantly more valgus orientation at heel strike compared with the lateral heel wedge condition (−0.05° [2.85°]). However, this difference has minimal clinical relevance. Neither of the orthotic devices altered knee kinematics or kinetics relative to the control condition. Conclusions: Although effective in older adults and individuals with varus knee alignment, medial unloader braces and lateral heel wedges do not influence gait biomechanics in young, healthy individuals.

Effects of Age and Speed on Peak Lower Extremity Joint Torques During Gait When Controlling Speed and Step Length

2010 ◽  
Author(s):  
Dennis E. Anderson ◽  
Michael L. Madigan
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Muscle Strength ◽  
Lower Extremity ◽  
Age Differences ◽  
Step Length ◽  
Gait Pattern ◽  
Joint Torques ◽  
Age Related ◽  
Stable Gait

Significant age differences in self-selected gait kinetics have been reported in the literature. These include reduced torque and power at the ankle and increased work at the hip in older adults as compared to young adults [1, 2]. The reasons for these differences are complex and not fully understood. It is possible older adults adapt their gait to a safer, more stable gait pattern [3]. However, differences in gait may also be due to age-related neuromuscular changes such as reduced muscle strength in older adults [4].

scholarly journals POSTURAL SWAY IN LOWER EXTREMITY AMPUTEES AND OLDER ADULTS MAY SUGGEST INCREASED FALL RISK IN AMPUTEES

2020 ◽  
Vol 3 (2) ◽  
Author(s):  
Hamid Bateni
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Lower Extremity ◽  
Frequency Domain ◽  
Visual Information ◽  
Fall Risk ◽  
Postural Sway ◽  
Proprioceptive Information ◽  
Eyes Closed ◽  
Eyes Open

BACKGROUND: Falls can be detrimental to overall health and quality of life for lower extremity amputees. Most previous studies of postural steadiness focus on quantification of time series variables extracted from postural sway signals. While it has been suggested that frequency domain variables can provide more valuable information, few current studies have evaluated postural sway in amputees using frequency domain variables. OBJECTIVE: To determine time and frequency domain variables of postural sway among lower extremity amputees vs. healthy young and older adult controls. METHODOLOGY: Participants were assigned to 3 groups:  lower extremity amputation (n=6), healthy young adults (n=10), and healthy older adults (n=10). Standing barefoot on a force platform, each individual completed 3 trials of each of 3 standing conditions: eyes open, eyes closed, and standing on a foam balance pad. Time and frequency domain variables of postural sway were computed and analyzed. RESULTS: Comparison of older adults, younger adults, and amputees on the three conditions of standing eyes open, eyes closed, and on foam revealed significant differences between groups. Mean mediolateral (ML) sway distance from the center of pressure (COP), total excursions and sway velocity was significantly higher for amputees and older adults when compared to young adults (p<0.05). Furthermore, power of sway signal was substantially lower for both amputees and older adults. When compared to that of older adults, postural steadiness of amputees was more affected by the eyes closed condition, whereas older adults’ was more affected when sensory and proprioceptive information was perturbed by standing on foam.  CONCLUSION: Our findings showed that fall risk is greater in amputees than in young adults without amputation. Additionally, amputees may rely more heavily on visual information than proprioceptive information for balance, in contrast to older and young adults without amputation.  Layman's Abstract Falls can be detrimental to overall health and quality of life for lower extremity amputees. We evaluated postural sway and concluded that amputees have an increased fall risk and may rely more heavily on visual information for balance than do individuals without amputation. Article PDF Link:https://jps.library.utoronto.ca/index.php/cpoj/article/view/33804/26600 How To Cite: Bateni H. Postural sway in lower extremity amputees and older adults may suggest increased fall risk in amputees. Canadian Prosthetics & Orthotics Journal. 2020;Volume 3, Issue 2, No.4. https://doi.org/10.33137/cpoj.v3i2.33804 Corresponding Author: Hamid Bateni, PhD Physical Therapy Program, School of Allied Health and Communicative Disorders, Northern Illinois University, DeKalb, Illinois, USA.E-mail: [email protected]: https://orcid.org/0000-0001-9083-1817

scholarly journals Effects of age and surface instability on the control of the center of mass

2021 ◽  
Author(s):  
Maud van den Bogaart ◽  
Sjoerd M. Bruijn ◽  
Joke Spildooren ◽  
Jaap H. van Dieën ◽  
Pieter Meyns
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Postural Control ◽  
Center Of Mass ◽  
Frontal Plane ◽  
Head Orientation ◽  
Balance Performance ◽  
Counter Rotation ◽  
Balance Loss ◽  
Balance Board

AbstractDuring standing, posture can be controlled by accelerating the Center of Mass (CoM) through shifting the center of pressure (CoP) within the base of support by applying ankle moments (“CoP mechanism”), or through the “counter-rotation mechanism”, i.e., changing the angular momentum of segments around the CoM to change the direction of the ground reaction force. Postural control develops over the lifespan; at both the beginning and the end of the lifespan adequate postural control appears more challenging. In this study, we aimed to assess mediolateral balance performance and the related use of the postural control mechanisms in children, older adults and young adults when standing on different (unstable) surfaces. Sixteen pre-pubertal children (6-9y), 17 young adults (18-24y) and eight older adults (65-80y) performed bipedal upright standing trials of 16 seconds on a rigid surface and on three balance boards that could freely move in the frontal plane, varying in height (15-19 cm) of the surface of the board above the point of contact with the floor. Full body kinematics (16 segments, 48 markers, using SIMI 3D-motion analysis system (GmbH) and DeepLabCut and Anipose) were retrieved. Performance related outcome measures, i.e., the number of trials with balance loss and the Root Mean Square (RMS) of the time series of the CoM acceleration, the contributions of the CoP mechanism and the counter-rotation mechanism to the CoM acceleration in the frontal plane and selected kinematic measures, i.e. the orientation of the board and the head and the Mean Power Frequency (MPF) of the balance board orientation and the CoM acceleration were determined. Balance loss only occurred when standing on the highest balance board, twice in one older adult once in one young adult. In children and older adults, the RMS of the CoM accelerations were larger, corresponding to poorer balance performance. Across age groups and conditions, the contribution of the CoP mechanism to the total CoM acceleration was much larger than that of the counter-rotation mechanisms, ranging from 94%-113% vs 23%-38% (with totals higher than 100% indicating opposite effects of both mechanisms). Deviations in head orientation were small compared to deviations in balance board orientation. We hypothesize that the CoP mechanism is dominant, since the counter-rotation mechanism would conflict with stabilizing the orientation of the head in space.

Task-Switching Training and Transfer

2018 ◽  
Vol 32 (3) ◽  
pp. 106-130 ◽  
Author(s):  
Zsófia Anna Gaál ◽  
István Czigler
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Cognitive Training ◽  
Task Switching ◽  
Difficulty Level ◽  
Training Procedure ◽  
Far Transfer ◽  
Near Transfer ◽  
Related Potentials ◽  
Transfer Tasks

Abstract. We used task-switching (TS) paradigms to study how cognitive training can compensate age-related cognitive decline. Thirty-nine young (age span: 18–25 years) and 40 older (age span: 60–75 years) women were assigned to training and control groups. The training group received 8 one-hour long cognitive training sessions in which the difficulty level of TS was individually adjusted. The other half of the sample did not receive any intervention. The reference task was an informatively cued TS paradigm with nogo stimuli. Performance was measured on reference, near-transfer, and far-transfer tasks by behavioral indicators and event-related potentials (ERPs) before training, 1 month after pretraining, and in case of older adults, 1 year later. The results showed that young adults had better pretraining performance. The reference task was too difficult for older adults to form appropriate representations as indicated by the behavioral data and the lack of P3b components. But after training older adults reached the level of performance of young participants, and accordingly, P3b emerged after both the cue and the target. Training gain was observed also in near-transfer tasks, and partly in far-transfer tasks; working memory and executive functions did not improve, but we found improvement in alerting and orienting networks, and in the execution of variants of TS paradigms. Behavioral and ERP changes remained preserved even after 1 year. These findings suggest that with an appropriate training procedure older adults can reach the level of performance seen in young adults and these changes persist for a long period. The training also affects the unpracticed tasks, but the transfer depends on the extent of task similarities.

Inefficient Encoding as an Explanation for Age-Related Deficits in Recollection-Based Processing

2014 ◽  
Vol 28 (3) ◽  
pp. 148-161 ◽  
Author(s):  
David Friedman ◽  
Ray Johnson
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Cognitive Processes ◽  
Brain Activity ◽  
Memory Performance ◽  
Brain Regions ◽  
Semantic Retrieval ◽  
Age Related ◽  
The Face ◽  
Episodic Memories

A cardinal feature of aging is a decline in episodic memory (EM). Nevertheless, there is evidence that some older adults may be able to “compensate” for failures in recollection-based processing by recruiting brain regions and cognitive processes not normally recruited by the young. We review the evidence suggesting that age-related declines in EM performance and recollection-related brain activity (left-parietal EM effect; LPEM) are due to altered processing at encoding. We describe results from our laboratory on differences in encoding- and retrieval-related activity between young and older adults. We then show that, relative to the young, in older adults brain activity at encoding is reduced over a brain region believed to be crucial for successful semantic elaboration in a 400–1,400-ms interval (left inferior prefrontal cortex, LIPFC; Johnson, Nessler, & Friedman, 2013 ; Nessler, Friedman, Johnson, & Bersick, 2007 ; Nessler, Johnson, Bersick, & Friedman, 2006 ). This reduced brain activity is associated with diminished subsequent recognition-memory performance and the LPEM at retrieval. We provide evidence for this premise by demonstrating that disrupting encoding-related processes during this 400–1,400-ms interval in young adults affords causal support for the hypothesis that the reduction over LIPFC during encoding produces the hallmarks of an age-related EM deficit: normal semantic retrieval at encoding, reduced subsequent episodic recognition accuracy, free recall, and the LPEM. Finally, we show that the reduced LPEM in young adults is associated with “additional” brain activity over similar brain areas as those activated when older adults show deficient retrieval. Hence, rather than supporting the compensation hypothesis, these data are more consistent with the scaffolding hypothesis, in which the recruitment of additional cognitive processes is an adaptive response across the life span in the face of momentary increases in task demand due to poorly-encoded episodic memories.

Older adults consider others’ intentions less but allocentric outcomes more than young adults during an ultimatum game.

2020 ◽  
Vol 35 (7) ◽  
pp. 974-980
Author(s):  
Isu Cho ◽  
Hyun-joo Song ◽  
Hackjin Kim ◽  
Sunhae Sul
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Ultimatum Game

scholarly journals Exercise Strategies for Optimizing Aerobic Capacity and Skeletal Muscle Performance in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 528-528
Author(s):  
Dallin Tavoian ◽  
David Russ ◽  
Brian Clark
Keyword(s):  
Older Adults ◽  
Lower Extremity ◽  
Aerobic Capacity ◽  
Muscle Performance ◽  
Moderate Intensity ◽  
Continuous Training ◽  
Maximal Aerobic Capacity ◽  
Comparable Amount ◽  
Supervised Exercise ◽  
Type Of Exercise

Abstract Most older adults do not exercise regularly. Among those who do, the majority only perform one type of exercise, and— as such— are either not getting the benefits of endurance exercise or resistance exercise. The aim of this pilot study was to determine which standalone exercise strategy has the greatest effect on both cardiorespiratory and lower-extremity muscular function in insufficiently active older adults 60 to 75 years of age (N = 14). Participants were randomly assigned to either resistance training (RT, n=5), moderate intensity continuous training on a stationary bicycle (MICT, n=4), or high-intensity interval training on a stationary bicycle (HIIT, n=5) for supervised exercise sessions three times per week for 12 weeks. Maximal oxygen consumption increased a comparable amount in all groups (11.9±11.2% for HIIT vs. 8.0±14.8% for MICT vs 9.8±5.7% for RT). Leg extensor power did not change in the HIIT group (-0.34±5.2%), but increased by 5.2±9.7% in the MICT group and 14.5±26.1% in the RT group. Leg extensor strength decreased by 1.7±22.1% in the HIIT group and 0.6±6.4% in the MICT group, but increased by 27.3±21.2% in the RT group. These findings demonstrate that RT results in improved lower-extremity strength and power, as well as improvements in maximal aerobic capacity comparable to MICT and HIIT in older adults. Thus, RT should be promoted as an essential exercise strategy for older adults, particularly for individuals who are inactive or that are only performing one type of exercise regularly.

scholarly journals Plasma acylcarnitines and risk of lower-extremity functional impairment in older adults: a nested case–control study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Francisco Félix Caballero ◽  
Ellen A. Struijk ◽  
Alberto Lana ◽  
Antonio Buño ◽  
Fernando Rodríguez-Artalejo ◽  
...  
Keyword(s):  
Older Adults ◽  
Confidence Interval ◽  
Lower Extremity ◽  
Functional Impairment ◽  
Odds Ratio ◽  
Case Control Study ◽  
Case Control ◽  
Community Dwelling ◽  
Control Study ◽  
Long Chain

AbstractElevated concentrations of acylcarnitines have been associated with higher risk of obesity, type 2 diabetes and cardiovascular disease. The aim of the present study was to assess the association between L-carnitine and acylcarnitine profiles, and 2-year risk of incident lower-extremity functional impairment (LEFI). This case–control study is nested in the Seniors-ENRICA cohort of community-dwelling older adults, which included 43 incident cases of LEFI and 86 age- and sex- matched controls. LEFI was assessed with the Short Physical Performance Battery. Plasma L-carnitine and 28 acylcarnitine species were measured. After adjusting for potential confounders, medium-chain acylcarnitines levels were associated with 2-year incidence of LEFI [odds ratio per 1-SD increase: 1.69; 95% confidence interval: 1.08, 2.64; p = 0.02]. Similar results were observed for long-chain acylcarnitines [odds ratio per 1-SD increase: 1.70; 95% confidence interval: 1.03, 2.80; p = 0.04]. Stratified analyses showed a stronger association between medium- and long-chain acylcarnitines and incidence of LEFI among those with body mass index and energy intake below the median value. In conclusion, higher plasma concentrations of medium- and long-chain acylcarnitines were associated with higher risk of LEFI. Given the role of these molecules on mitochondrial transport of fatty acids, our results suggest that bioenergetics dysbalance contributes to LEFI.

scholarly journals Multidimensional Sleep Health and Physical Functioning in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 428-428
Author(s):  
Caitlan Tighe ◽  
Ryan Brindle ◽  
Sarah Stahl ◽  
Meredith Wallace ◽  
Adam Bramoweth ◽  
...  
Keyword(s):  
Older Adults ◽  
Lower Extremity ◽  
Grip Strength ◽  
Physical Functioning ◽  
Gait Speed ◽  
The United States ◽  
Depression Symptoms ◽  
Sleep Health ◽  
Lower Extremity Strength ◽  
Sleep Parameters

Abstract Prior studies link specific sleep parameters to physical functioning in older adults. Recent work suggests the utility of examining sleep health from a multidimensional perspective, enabling consideration of an individual’s experience across multiple different sleep parameters (e.g., quality, duration, timing). We examined the associations of multidimensional sleep health with objective, performance-based measures of physical functioning in older adults. We conducted a secondary analysis of 158 adults (Mage=71.8 years; 51.9% female) who participated in the Midlife in the United States (MIDUS) 2 and MIDUS Refresher studies. We used data from daily diaries, wrist actigraphy, and self-report measures to derive a composite multidimensional sleep health score ranging from 0-6, with higher scores indicating better sleep health. Physical function was assessed using gait speed during a 50-foot timed walk, lower extremity strength as measured by a chair stand test, and grip strength assessed with dynamometers. We used hierarchical regression to examine the associations between sleep health and gait speed, lower extremity strength, and grip strength. Age, sex, race, education, depression symptoms, medical comorbidity, and body mass index were covariates in each model. In adjusted analyses, better multidimensional sleep health was significantly associated with faster gait speed (B=.03, p=.01). Multidimensional sleep health was not significantly associated with lower limb strength (B=-.12, p=.89) or grip strength (B=.45, p=.40). Gait speed is a key indicator of functional capacity as well as morbidity and mortality in older adults. Multidimensional sleep health may be a therapeutic target for improving physical functioning and health in older adults.

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