Discriminating age and disability effects in locomotion: neuromuscular adaptations in musculoskeletal pathology

2004 ◽  
Vol 96 (1) ◽  
pp. 149-160 ◽  
Author(s):  
Chris A. McGibbon ◽  
David E. Krebs
Keyword(s):  
Power Generation ◽  
Lower Extremity ◽  
Sagittal Plane ◽  
Plantar Flexion ◽  
Analysis Of Covariance ◽  
Power Absorption ◽  
Age Related ◽  
Neuromuscular Adaptations ◽  
Musculoskeletal Pathology ◽  
Lower Extremity Dysfunction

We identified biomechanical variables indicative of lower extremity dysfunction, distinct from age-related gait adaptations, and examined interrelationships among these variables to better understand the neuromuscular adaptations in gait. Sagittal plane ankle, knee, and hip peak angles, moments, and powers and spatiotemporal parameters were acquired during preferred-speed gait in 120 subjects: 45 healthy young, 37 healthy elders, and 38 elders with functional limitations due to lower extremity musculoskeletal pathology, primarily arthritis. Multiple analysis of covariance with discriminate analysis, adjusted for gait speed, was used to identify the variables discriminating groups. Correlation analysis was used to explore interrelationships among these variables within each group. Healthy elders were discriminated (sensitivity 76%, specificity 82%) from young adults via decreased late-stance ankle plantar flexion angle, increased late-stance knee power absorption, and early-stance hip extensor power generation. Disabled elders were discriminated (sensitivity 74%, specificity 73%) from healthy elders via decreased late-stance ankle plantar flexor moment and power generation, increased early-stance ankle dorsiflexor moment, and late-stance hip flexor moment and power absorption. Relationships among variables showed a higher degree of coupling for the disabled elders compared with the healthy groups, suggesting a reduced ability to alter motor strategies. Our data suggest that, beyond age-related changes, elders with lower extremity dysfunction rely excessively on passive action of hip flexors to provide propulsion in late stance and contralateral ankle dorsiflexors to enhance stability. These findings support a growing body of evidence that gait changes with age and disablement have a neuromuscular basis, which may be informative in a motor control framework for physical therapy interventions.

Functional Data Analyses for the Assessment of Joint Power Profiles During Gait of Stroke Subjects

2014 ◽  
Vol 30 (2) ◽  
pp. 348-352 ◽  
Author(s):  
André G. P. Andrade ◽  
Janaine C. Polese ◽  
Leopoldo A. Paolucci ◽  
Hans-Joachim K. Menzel ◽  
Luci F. Teixeira-Salmela
Keyword(s):  
Power Generation ◽  
Gait Cycle ◽  
Sagittal Plane ◽  
Plantar Flexion ◽  
Knee Extension ◽  
Mathematical Function ◽  
Joint Power ◽  
Gait Biomechanics ◽  
Isolated Points ◽  
Parametric Analyses

Lower extremity kinetic data during walking of 12 people with chronic poststroke were reanalyzed, using functional analysis of variance (FANOVA). To perform the FANOVA, the whole curve is represented by a mathematical function, which spans the whole gait cycle and avoids the need to identify isolated points, as required for traditional parametric analyses of variance (ANOVA). The power variables at the ankle, knee, and hip joints, in the sagittal plane, were compared between two conditions: With and without walking sticks at comfortable and fast speeds. For the ankle joint, FANOVA demonstrated increases in plantar flexion power generation during 60–80% of the gait cycle between fast and comfortable speeds with the use of walking sticks. For the knee joint, the use of walking sticks resulted in increases in the knee extension power generation during 10–30% of the gait cycle. During both speeds, the use of walking sticks resulted in increased power generation by the hip extensors and flexors during 10–30% and 40–70% of the gait cycle, respectively. These findings demonstrated the benefits of applying the FANOVA approach to improve the knowledge regarding the effects of walking sticks on gait biomechanics and encourage its use within other clinical contexts.

scholarly journals Ankle-foot Orthosis With an Oil Damper Versus Nonarticulated Ankle-foot Orthosis in the Gait of Patients With Subacute Stroke: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Sumiko Yamamoto ◽  
Naoyuki Motojima ◽  
Yosuke Kobayashi ◽  
Yuji Osada ◽  
Souji Tanaka ◽  
...  
Keyword(s):  
Power Generation ◽  
Randomized Controlled Trial ◽  
Ankle Joint ◽  
Controlled Trial ◽  
Plantar Flexion ◽  
Vertical Angle ◽  
Power Absorption ◽  
Ankle Foot Orthosis ◽  
Randomized Controlled ◽  
Foot Orthosis

Abstract BackgroundGait improvement in patients with stroke using ankle-foot orthosis (AFO) has been compared to the effects of non-AFO use in previous studies, but the effect of different kinds of AFOs has not been clear. When considering the effect of different kinds of AFOs on gait, the dorsiflexion and plantar flexion moment of resistance is considered a key determinant of functional effect. In this study, the effect on gait of using an AFO with an oil damper (AFO-OD), which has plantar flexion resistance but no dorsiflexion resistance, and a nonarticulated AFO, which has both dorsiflexion and plantar flexion resistance, were compared in a randomized controlled trial. MethodsForty-one patients (31 men, 10 women; mean age 58.4 ± 11.3 years) in the subacute phase of stroke were randomly allocated to two groups to undergo 2 weeks of gait training by physiotherapists while wearing an AFO-OD or a nonarticulated AFO. A motion capture system was utilized to measure shod gait without orthosis at baseline and after training with the allocated AFO. Data analysis was performed focused on the spatial and temporal parameters, ground reaction force, shank-to-vertical angle, and ankle joint kinematics and kinetics. Two-way mixed ANOVA was performed to clarify the effect of AFO use and the difference between the two AFOs. ResultsThirty-six patients completed the study (17 in the AFO-OD group and 19 in the nonarticulated AFO group). Spatial and temporal parameters and ankle joint kinematics were improved after 2 weeks in both AFO groups. Interactions were found for the range of shank-to-vertical angles in paretic single stance and ankle peak power absorption. In the AFO-OD group, both parameters improved when the participants walked with the AFO compared to the shod gait, but there was no change in the nonarticulated AFO group. Power generation was not increased in either AFO group. ConclusionsThe results of this study showed that AFO with plantar flexion resistance but without dorsiflexion resistance improved the range of the shank-to-vertical angle and ankle power absorption but not power generation in a paretic stance. (336/350 words)Trial registration: UMIN000028126 Registered 1 August 2017,https://upload.umin.ac.jp/cgi-bin/icdr/ctr_menu_form_reg.cgi?recptno=R000032197

scholarly journals Lower Extremity Biomechanics During a Drop-Vertical Jump in Participants With or Without Chronic Ankle Instability

2018 ◽  
Vol 53 (4) ◽  
pp. 364-371 ◽  
Author(s):  
C. Collin Herb ◽  
Kaitlyn Grossman ◽  
Mark A. Feger ◽  
Luke Donovan ◽  
Jay Hertel
Keyword(s):  
Lower Extremity ◽  
Motion Capture ◽  
Sagittal Plane ◽  
Ankle Instability ◽  
Vertical Jump ◽  
Plantar Flexion ◽  
Reaction Force ◽  
Chronic Ankle Instability ◽  
Vertical Ground Reaction Force ◽  
Drop Vertical Jump

Context:  Chronic ankle instability (CAI) is a condition characterized by range-of-motion, neuromuscular, and postural-control deficits and subjective disability, reinjury, and posttraumatic osteoarthritis. Differences have been reported in kinematics, kinetics, surface electromyography (EMG), and ground reaction forces during functional tasks performed by those with CAI. These measures are often collected independently, and the research on collecting measures simultaneously during a movement task is limited. Objective:  To assess the kinematics and kinetics of the lower extremity, vertical ground reaction force (vGRF), and EMG of 4 shank muscles during a drop–vertical-jump (DVJ) task. Design:  Controlled laboratory study. Setting:  Motion-capture laboratory. Patients or Other Participants:  Forty-seven young, active adults in either the CAI (n = 24) or control (n = 23) group. Intervention(s):  Three-dimensional motion capture was performed using an electromagnetic motion-capture system. Lower extremity kinematics, frontal- and sagittal-plane kinetics, vGRF, and EMG of the shank musculature were collected while participants performed 10 DVJs. Main Outcome Measure(s):  Means and 90% confidence intervals were calculated for all measures from 100 milliseconds before to 200 milliseconds after force-plate contact. Results:  Patients with CAI had greater inversion from 107 to 200 milliseconds postcontact (difference = 4.01° ± 2.55°), smaller plantar-flexion kinematics from 11 to 71 milliseconds postcontact (difference = 5.33° ± 2.02°), greater ankle sagittal-plane kinetics from 11 to 77 milliseconds postcontact (difference = 0.17 ± 0.09 Nm/kg) and from 107 to 200 milliseconds postcontact (difference = 0.23 ± 0.03 Nm/kg), and smaller knee sagittal-plane kinematics from 95 to 200 milliseconds postcontact (difference = 8.23° ± 0.97°) than control participants after landing. The patients with CAI had greater vGRF from 94 to 98 milliseconds postcontact (difference = 0.83 ± 0.03 N/kg) and peroneal activity from 17 to 128 milliseconds postcontact (difference = 10.56 ± 4.52 N/kg) than the control participants. Conclusions:  Patients with CAI presented with differences in their landing strategies that may be related to continued instability. Kinematic and kinetic changes after ground contact and greater vGRF may be related to a faulty landing strategy. The DVJ task should be considered for rehabilitation protocols in these individuals.

The functional demands on the intact limb during walking for active transfemoral and transtibial amputees

2000 ◽  
Vol 24 (2) ◽  
pp. 117-125 ◽  
Author(s):  
L. Nolan ◽  
A. Lees
Keyword(s):  
Power Generation ◽  
Sagittal Plane ◽  
Video Camera ◽  
Joint Moments ◽  
Power Absorption ◽  
Prosthetic Limbs ◽  
Prosthesis Fitting ◽  
Limb Loading ◽  
Intact Limb

The aim of this study was to investigate the loading demands placed on the intact limb in terms of joint moments and power for active transfemoral and transtibial amputees in comparison to a group of ablebodied subjects. Four (4) transtibial, 4 transfemoral amputees and 10 ablebodied subjects walked at 1.2m.s1along a walkway whilst kinematic data from both the intact and prosthetic limbs, and kinetic data from the intact limb only were collected. A Panasonic VHS video camera was used to film subjects walking in the sagittal plane with simultaneous force data collected from a Kistler force platform. The amputees were found to compensate for the functional loss of one or more joints by increasing net joint moments and power output on their intact limb compared to ablebodied subjects. At the intact limb ankle, the range of motion, peak dorsiflexor moment and power generation at toeoff increased. At the intact limb knee, power generation during stance and extensor moments and power absorption at toeoff increased. At the intact limb hip, extensor moment and power absorption during stance, and hip flexor moment and power generation at toeoff increased. These findings were partly attributed to the prostheses used but mainly to adaptation mechanisms displayed by transfemoral and transtibial amputees. They have implications for the mobility of amputees and the long term health of their joints. It was recommended that prosthesis design, prosthesis fitting and training in the use of the prosthesis were all factors which could be investigated with a view to minimising intact limb loading.

scholarly journals IMU-Based Effects Assessment of the Use of Foot Orthoses in the Stance Phase during Running and Asymmetry between Extremities

Sensors ◽  
2021 ◽  
Vol 21 (9) ◽  
pp. 3277
Author(s):  
Juan Luis Florenciano Restoy ◽  
Jordi Solé-Casals ◽  
Xantal Borràs-Boix
Keyword(s):  
Contact Time ◽  
Stance Phase ◽  
Inertial Sensors ◽  
Sagittal Plane ◽  
Plantar Flexion ◽  
Foot Orthoses ◽  
Foot Kinematics ◽  
Running Injuries ◽  
The Right ◽  
Movement Differences

The objectives of this study were to determine the amplitude of movement differences and asymmetries between feet during the stance phase and to evaluate the effects of foot orthoses (FOs) on foot kinematics in the stance phase during running. In total, 40 males were recruited (age: 43.0 ± 13.8 years, weight: 72.0 ± 5.5 kg, height: 175.5 ± 7.0 cm). Participants ran on a running treadmill at 2.5 m/s using their own footwear, with and without the FOs. Two inertial sensors fixed on the instep of each of the participant’s footwear were used. Amplitude of movement along each axis, contact time and number of steps were considered in the analysis. The results indicate that the movement in the sagittal plane is symmetric, but that it is not in the frontal and transverse planes. The right foot displayed more degrees of movement amplitude than the left foot although these differences are only significant in the abduction case. When FOs are used, a decrease in amplitude of movement in the three axes is observed, except for the dorsi-plantar flexion in the left foot and both feet combined. The contact time and the total step time show a significant increase when FOs are used, but the number of steps is not altered, suggesting that FOs do not interfere in running technique. The reduction in the amplitude of movement would indicate that FOs could be used as a preventive tool. The FOs do not influence the asymmetry of the amplitude of movement observed between feet, and this risk factor is maintained. IMU devices are useful tools to detect risk factors related to running injuries. With its use, even more personalized FOs could be manufactured.

Muscle metabolism during exercise in young and older untrained and endurance-trained men

1993 ◽  
Vol 75 (5) ◽  
pp. 2125-2133 ◽  
Author(s):  
A. R. Coggan ◽  
A. M. Abduljalil ◽  
S. C. Swanson ◽  
M. S. Earle ◽  
J. W. Farris ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Muscle Mass ◽  
Citrate Synthase ◽  
Metabolic Response ◽  
Plantar Flexion ◽  
Muscle Metabolism ◽  
Resonance Spectroscopy ◽  
Age Related ◽  
Rate Of Increase ◽  
Response To Exercise

To examine effects of aging and endurance training on human muscle metabolism during exercise, 31P magnetic resonance spectroscopy was used to study the metabolic response to exercise in young (21–33 yr) and older (58–68 yr) untrained and endurance-trained men (n = 6/group). Subjects performed graded plantar flexion exercise with the right leg, with metabolic responses measured using a 31P surface coil placed over the lateral head of the gastrocnemius muscle. Muscle biopsy samples were also obtained for determination of citrate synthase activity. Rate of increase in P(i)-to-phosphocreatine ratio with increasing power output was greater (P < 0.01) in older untrained [0.058 +/- 0.022 (SD) W-1] and trained men (0.042 +/- 0.010 W-1) than in young untrained (0.038 +/- 0.017 W-1) and trained men (0.024 +/- 0.010 W-1). Plantar flexor muscle cross-sectional area and volume (determined using 1H magnetic resonance imaging) were 11–12% (P < 0.05) and 16–18% (P < 0.01) smaller, respectively, in older men. When corrected for this difference in muscle mass, age-related differences in metabolic response to exercise were reduced by approximately 50% but remained significant (P < 0.05). Citrate synthase activity was approximately 20% lower (P < 0.001) in older untrained and trained men than in corresponding young groups and was inversely related to P(i)-phosphocreatine slope (r = -0.63, P < 0.001). Age-related reductions in exercise capacity were associated with an altered muscle metabolic response to exercise, which appeared to be due to smaller muscle mass and lower muscle respiratory capacity of older subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

scholarly journals Age disrupts androgen receptor-modulated negative feedback in the gonadal axis in healthy men

2010 ◽  
Vol 299 (4) ◽  
pp. E675-E682 ◽  
Author(s):  
Johannes D. Veldhuis ◽  
Paul Y. Takahashi ◽  
Daniel M. Keenan ◽  
Peter Y. Liu ◽  
Kristi L. Mielke ◽  
...  
Keyword(s):  
Androgen Receptor ◽  
Negative Feedback ◽  
Pulse Frequency ◽  
Analysis Of Covariance ◽  
Double Blind ◽  
Healthy Men ◽  
Age Related ◽  
Lh Release ◽  
Lh Secretion ◽  
Double Blind Crossover Study

Testosterone (T) exerts negative feedback on the hypothalamo-pituitary (GnRH-LH) unit, but the relative roles of the CNS and pituitary are not established. We postulated that relatively greater LH responses to flutamide (brain-permeant antiandrogen) than bicalutamide (brain-impermeant antiandrogen) should reflect greater feedback via CNS than pituitary/peripheral androgen receptor-dependent pathways. To this end, 24 healthy men ages 20–73 yr, BMI 21–32 kg/m2, participated in a prospective, placebo-controlled, randomized, double-blind crossover study of the effects of antiandrogen control of pulsatile, basal, and entropic (pattern regularity) measurements of LH secretion. Analysis of covariance revealed that flutamide but not bicalutamide 1) increased pulsatile LH secretion ( P = 0.003), 2) potentiated the age-related abbreviation of LH secretory bursts ( P = 0.025), 3) suppressed incremental GnRH-induced LH release ( P = 0.015), and 4) decreased the regularity of GnRH-stimulated LH release ( P = 0.012). Furthermore, the effect of flutamide exceeded that of bicalutamide in 1) raising mean LH ( P = 0.002) and T ( P = 0.017) concentrations, 2) accelerating LH pulse frequency ( P = 0.013), 3) amplifying total (basal plus pulsatile) LH ( P = 0.002) and T ( P < 0.001) secretion, 4) shortening LH secretory bursts ( P = 0.032), and 5) reducing LH secretory regularity ( P < 0.001). Both flutamide and bicalutamide elevated basal (nonpulsatile) LH secretion ( P < 0.001). These data suggest the hypothesis that topographically selective androgen receptor pathways mediate brain-predominant and pituitary-dependent feedback mechanisms in healthy men.

Changes in postural stability with fatigue of lower extremity frontal and sagittal plane movers

2007 ◽  
Vol 26 (2) ◽  
pp. 214-218 ◽  
Author(s):  
Mahyar Salavati ◽  
Mojgan Moghadam ◽  
Ismaeil Ebrahimi ◽  
Amir Massoud Arab
Keyword(s):  
Lower Extremity ◽  
Postural Stability ◽  
Sagittal Plane

scholarly journals Sex-dependent Pathological Aging Effect on Caudate Functional Connectivity in Mild Cognitive Impairment

2021 ◽  
Author(s):  
Zhengshi Yang ◽  
Jessica Z.K. Caldwell ◽  
Jeffrey L. Cummings ◽  
Aaron Ritter ◽  
Jefferson W. Kinney ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Functional Connectivity ◽  
Aging Effect ◽  
Analysis Of Covariance ◽  
Aging Effects ◽  
Mixed Effect ◽  
Effect Analysis ◽  
Pathological Aging ◽  
Age Related

Abstract Purpose To assess the pathological aging effect on caudate functional connectivity among mild cognitive impairment (MCI) participants and examine whether and how sex and amyloid contribute to this process. Materials and Methods 277 functional magnetic resonance imaging (fMRI) sessions from 163 cognitive normal (CN) older adults and 309 sessions from 139 participants with MCI were included as the main sample in our analysis. Pearson’s correlation was used to characterize the functional connectivity (FC) between caudate and each brain region, then caudate nodal strength was computed to quantify the overall caudate FC strength. Association analysis between caudate nodal strength and age was carried out in MCI and CN separately using linear mixed effect (LME) model with covariates (education, handedness, sex, Apolipoprotein E4 and intra-subject effect). Analysis of covariance was conducted to investigate sex, amyloid status and their interaction effects on aging with the fMRI data subset having amyloid status available. LME model was applied to women and men separately within MCI group to evaluate aging effects on caudate nodal strength and each region’s connectivity with caudate. We then evaluated the roles of sex and amyloid status in the associations of neuropsychological scores with age or caudate nodal strength. An independent cohort was used to validate the sex-dependent aging effects in MCI. Results The MCI group had significantly stronger age-related increase of caudate nodal strength compared to the CN group. Analyzing women and men separately revealed that the aging effect on caudate nodal strength among MCI participants was significant only for women (left: P=6.23x10−7, right: P=3.37x10−8), but not for men (P>0.3 for bilateral caudate). The aging effects on caudate nodal strength were not significantly mediated by brain amyloid burden. Caudate connectivity with ventral prefrontal cortex substantially contributed to the aging effect on caudate nodal strength in women with MCI. Higher caudate nodal strength is significantly related to worse cognitive performance in women but not in men with MCI. Conclusion Sex modulates the pathological aging effects on caudate nodal strength in MCI regardless of amyloid status. Caudate nodal strength may be a sensitive biomarker of pathological aging in women with MCI.

Lower Extremity Joint Work During Acceleration, Deceleration, and Steady State Running

2017 ◽  
Vol 33 (1) ◽  
pp. 56-63 ◽  
Author(s):  
D.S. Blaise Williams ◽  
Jonathan H. Cole ◽  
Douglas W. Powell
Keyword(s):  
Steady State ◽  
Lower Extremity ◽  
Sagittal Plane ◽  
Three Dimensional ◽  
Joint Work ◽  
Negative Work ◽  
Relative Contribution ◽  
Acceleration And Deceleration ◽  
The Individual ◽  
Positive Work

Running during sports and for physical activity often requires changes in velocity through acceleration and deceleration. While it is clear that lower extremity biomechanics vary during these accelerations and decelerations, the work requirements of the individual joints are not well understood. The purpose of this investigation was to measure the sagittal plane mechanical work of the individual lower extremity joints during acceleration, deceleration, and steady-state running. Ten runners were compared during acceleration, deceleration, and steady-state running using three-dimensional kinematics and kinetics measures. Total positive and negative joint work, and relative joint contributions to total work were compared between conditions. Total positive work progressively increased from deceleration to acceleration. This was due to greater ankle joint work during acceleration. While there was no significant change in total negative work during deceleration, there was a greater relative contribution of the knee to total negative work with a subsequent lower relative ankle negative work. Each lower extremity joint exhibits distinct functional roles in acceleration compared with deceleration during level running. Deceleration is dominated by greater contributions of the knee to negative work while acceleration is associated with a greater ankle contribution to positive work.

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