The effect of walking speed on quality of gait in older adults

Background: Gait quality characteristics can contribute to the identification of individuals at risk of falls. Since older adults with high fall risk tend to walk slower than older adults with a lower fall risk, walking speed may underlie differences in gait quality characteristics. Research question: How does walking speed affect gait quality characteristics in older people? Methods: We investigated the effect of walking speed on gait characteristics in 11 older adults (aged 69.6 ± 4.1 years). Trunk accelerations (Dynaport MoveMonitor) were recorded during 5 min of treadmill walking at four different speeds. From these trunk accelerations we calculated step frequency, root mean square, harmonic ratio, index of harmonicity, sample entropy and logarithmic divergence rate per stride. Results: Our results showed that all gait characteristics were affected by walking speed, except for sample entropy in antero-posterior (AP) direction. An increase in walking speed resulted in a higher step frequency, higher standard deviation, more symmetric gait, more smooth vertical (VT) accelerations, less smooth accelerations in medio-lateral (ML) and AP directions, less regular dynamics in ML direction, more regular dynamics in VT direction, and a more stable gait pattern overall. Significance: These findings suggest that, within a range of 0.5–1.4 m/s, a lower walking speed results in a lower gait quality, which may underlie differences in gait quality between older fallers and non-fallers

Self-perceived gait stability modulates the effect of daily life gait quality on prospective falls in older adults

BACKGROUND: Quality of gait during daily life activities and perceived gait stability are both independent risk factors for future falls in older adults. RESEARCH QUESTION: We investigated whether perceived gait stability modulates the association between gait quality and falling in older adults. METHODS: In this prospective cohort study, we used one-week daily-life trunk acceleration data of 272 adults over 65 years of age. Sample entropy (SE) of the 3D acceleration signals was calculated to quantify daily life gait quality. To quantify perceived gait stability, the level of concern about falling was assessed using the Falls Efficacy Scale international (FES-I) questionnaire and step length, estimated from the accelerometer data. A fall calendar was used to record fall incidence during a six-month follow up period. Logistic regression analyses were performed to study the association between falling and SE, step length or FES-I score, and their interactions. RESULTS: High (i.e., poor) SE in vertical direction was significantly associated with falling. FES-I scores significantly modulated this association, whereas step length did not. Subgroup analyses based on FES-I scores showed that high SE in the vertical direction was a risk factor for falls only in older adults who had a high (i.e. poor) FES-I score. In conclusion, perceived gait stability modulates the association between gait quality and falls in older adults such that an association between gait quality and falling is only present when perceived gait stability is poor. SIGNIFICANCE: The results of the present study indicate that the effectiveness of interventions for fall prevention, aimed at improving gait quality, may be affected by a modulating effect of perceived gait stability. Results indicate that interventions to reduce falls in older adults might sort most effectiveness in populations with both a poor physiological and psychological status

Optimal stride frequencies in running at different speeds

During running at a constant speed, the optimal stride frequency (SF) can be derived from the u-shaped relationship between SF and heart rate (HR). Changing SF towards the optimum of this relationship is beneficial for energy expenditure and may positively change biomechanics of running. In the current study, the effects of speed on the optimal SF and the nature of the u-shaped relation were empirically tested using Generalized Estimating Equations. To this end, HR was recorded from twelve healthy (4 males, 8 females) inexperienced runners, who completed runs at three speeds. The three speeds were 90%, 100% and 110% of self-selected speed. A self-selected SF (SFself) was determined for each of the speeds prior to the speed series. The speed series started with a free-chosen SF condition, followed by five imposed SF conditions (SFself, 70, 80, 90, 100 strides·min-1) assigned in random order. The conditions lasted 3 minutes with 2.5 minutes of walking in between. SFself increased significantly (p<0.05) with speed with averages of 77, 79, 80 strides·min-1 at 2.4, 2.6, 2.9 m·s-1, respectively). As expected, the relation between SF and HR could be described by a parabolic curve for all speeds. Speed did not significantly affect the curvature, nor did it affect optimal SF. We conclude that over the speed range tested, inexperienced runners may not need to adapt their SF to running speed. However, since SFself were lower than the SFopt of 83 strides·min-1, the runners could reduce HR by increasing their SFself

Constant force muscle stretching induces greater acute deformations and changes in passive mechanical properties compared to constant length stretching

Stretching is applied to lengthen shortened muscles in pathological conditions such as joint contractures. We investigated (i) the acute effects of different types of stretching, i.e. constant length (CL) and constant force (CF) stretching, on acute deformations and changes in passive mechanical properties of medial gastrocnemius muscle (MG) and (ii) the association of acute muscle–tendon deformations or changes in mechanical properties with the impulse or maximal strain of stretching. Forty-eight hindlimbs from 13 male and 12 female Wistar rats (13 weeks old, respectively 424.6 ± 35.5 and 261.8 ± 15.6 g) were divided into six groups (n = 8 each). The MG was initially stretched to a length at which the force was 75%, 95%, or 115% of the force corresponding to estimated maximal dorsiflexion and held at either CF or CL for 30 min. Before and after the stretching protocol, the MG peak force and peak stiffness were assessed by lengthening the passive muscle to the length corresponding to maximal ankle dorsiflexion. Also, the muscle belly length and tendon length were measured. CF stretching affected peak force, peak stiffness, muscle belly length, and tendon length more than CL stretching (p &lt; 0.01). Impulse was associated only with the decrease in peak force, while maximal strain was associated with the decrease in peak force, peak stiffness, and the increase in muscle belly length. We conclude that CF stretching results in greater acute deformations and changes in mechanical properties than CL stretching, which appears to be dependent predominantly on the differences in imposed maximal strain.</p

Older adults with weaker muscle strength stand up from a sitting position with more dynamic trunk use

The ability to stand up from a sitting position is essential for older adults to live independently. Body-fixed inertial sensors may provide an approach for quantifying the sit-to-stand (STS) in clinical settings. The aim of this study was to determine whether measurements of STS movements using body-fixed sensors yield parameters that are informative regarding changes in STS performance in older adults with reduced muscle strength. In twenty-seven healthy older adults, handgrip strength was assessed as a proxy for overall muscle strength. Subjects were asked to stand up from a chair placed at three heights. Trunk movements were measured using an inertial sensor fixed to the back. Duration, angular range, and maximum angular velocity of STS phases, as well as the vertical velocity of the extension phase, were calculated. Backwards elimination using Generalized Estimating Equations was used to determine if handgrip strength predicted the STS durations and trunk kinematics. Weaker subjects (i.e., with lower handgrip strength) were slower during the STS and showed a larger flexion angular range and a larger extension angular range. In addition, weaker subjects showed a greater maximum angular velocity, which increased with lower seat heights. Measurements with a single inertial sensor did reveal that older adults with lower handgrip strength employed a different strategy to stand up from a sitting position, involving more dynamic use of the trunk. This effect was greatest when elevating body mass. Trunk kinematic parameters were more sensitive to reduced muscle strength than durations

Weight bearing exercise can elicit similar peak muscle activation as medium–high intensity resistance exercise in elderly women

Purpose: To assess whether stepping-based weight bearing exercise (WBE) can elicit peak activation of upper leg muscles similar to resistance exercise (RE) at an intensity required to induce strength gains in elderly women. Methods: Muscular activation of several upper leg muscles was measured during RE and WBE in a cohort of 19 healthy elderly women (69.3 ± 3.4 years). WBE consisted of forward and lateral stepping with step heights of 10, 20 and 30 cm. Muscular activation was compared to 60% of one-repetition maximum (1-RM) of congruent RE. Results: Peak activation during WBE was higher than RE at 60% 1-RM during forward and lateral stepping in vastus lateralis starting at 20 cm (p = 0.049 and p = 0.001), and biceps femoris at 30 cm step height (p = 0.024 and p = 0.030). Gluteus maximus peak activation matched RE at 60% 1-RM at 20 and 30 cm step height regardless of step direction (p ≥ 0.077). Peak activation of the rectus femoris and gluteus medius matched RE activation at 60% 1-RM during lateral stepping at 30 cm (p = 0.355 and p = 0.243, respectively) but not during forward stepping. WBE did not induce similar activation as RE in the semitendinosus. Conclusion: In WBE, most upper leg muscles were recruited at an equal or higher intensity than in RE at 60% 1-RM. Lateral stepping at 30 cm step height showed the highest training potential of all WBE’s applied

An adaptive, real-time cadence algorithm for unconstrained sensor placement

This paper evaluates a new and adaptive real-time cadence detection algorithm (CDA) for unconstrained sensor placement during walking and running. Conventional correlation procedures, dependent on sensor position and orientation, may alternately detect either steps or strides and consequently suffer from false negatives or positives. To overcome this limitation, the CDA validates correlation peaks as strides using the Sylvester's criterion (SC). This paper compares the CDA with conventional correlation methods.22 volunteers completed 7 different circuits (approx. 140 m) at three gaits-speeds: walking (1.5 m s- 1), running (3.4 m s- 1), and sprinting (5.2 and 5.7 m s- 1), disturbed by various gait-related activities. The algorithm was simultaneously evaluated for 10 different sensor positions. Reference strides were obtained from a foot sensor using a dedicated offline algorithm.The described algorithm resulted in consistent numbers of true positives (85.6-100.0%) and false positives (0.0-2.9%) and showed to be consistently accurate for cadence feedback across all circuits, subjects and sensors (mean ± SD: 98.9 ± 0.2%), compared to conventional cross-correlation (87.3 ± 13.5%), biased (73.0 ± 16.2) and unbiased (82.2 ± 20.6) autocorrelation procedures.This study shows that the SC significantly improves cadence detection, resulting in robust results for various gaits, subjects and sensor positions

Ground reaction forces during walking with different load and slope combinations in rats

BACKGROUND: Treadmill animal models are commonly used to study effects of exercise on bone. Since mechanical loading induces bone strain, resulting in bone formation, exercise that induces higher strains is likely to cause more bone formation. Our aim was to investigate the effect of slope and additional load on limb bone strain. METHODS: Horizontal and vertical ground reaction forces on left fore-limb (FL) and hind-limb (HL) of twenty 23-week old female Wistar rats (weight 279 ± 26 g) were measured for six combinations of SLOPE (-10°, 0°, +10°) and LOAD (0 to 23% of body mass). Peak force (Fmax), rate of force rise (RC), stance time (Tstance) and impulse (Fint) on FLs and HLs were analyzed. RESULTS: For the FL, peak ground reaction forces and rate of force rise were highest when walking downward -10° with load (Fmax = 2.09±0.05 N, FLRC = 34±2 N/s) For the HL, ground reaction forces and rate of force rise were highest when walking upward +10°, without load (Fmax = 2.20±0.05 N, HLRC = 34±1 N/s). Load increased stance time. Without additional load, estimates for the highest FL loading (slope is -10°) were larger than for the highest HL loading (slope is +10°) relative to level walking. CONCLUSIONS: Thus, walking downward has a higher impact on FL bones, while walking upward is a more optimal HL exercise. Additional load may have a small effect on FL loading