Encouraging More Youthful Mechanics and Energetics of Locomotion through Intervention for Older Adults

A special issue of Biomechanics (ISSN 2673-7078). This special issue belongs to the section "Neuromechanics".

Deadline for manuscript submissions: closed (15 December 2023) | Viewed by 8769

Special Issue Editors

Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, 152 MacNider Hall, Chapel Hill, NC 27599, USA
Interests: neuromuscular biomechanics; sensorimotor control; aging and age-related mobility impairment
Department of Kinesiology, University of Massachusetts, Amherst, MA 01003, USA
Interests: biomechanics, motion analysis, osteoarthritis, tissue mechanics, overuse injury

Special Issue Information

Dear Colleagues,

Age-related changes in the mechanics and energetics of walking have the potential to negatively affect gait performance, walking economy and fatigability, biomechanics, stability, and reslience to balance challenges. Younger adults are universally used to establish the benchmark for healthy gait mechanics and energetics and, thereby, targets for determining the efficacy of interventions prescribed for older adults. Unfortunately, this introduces at least two challenges that may fundamentally limit the broader impact of our translational efforts. The first is that the results of observational studies designed to compare younger and older adults are unable to establish the cause-and-effect relations needed to have a genuine mechanisms-based focus for intervention design and prescription. The second is whether or not our translational goals should be guided by: (i) intervening by default to minimize or eliminate age-related differences in walking mechanics and energetics, and (ii) the principle that steering walking mechanics and energetics in older adults to resemble those in younger adults will maximize clinical impact and improve independence and quality of life. Indeed, older adults differ from young adults in substantial ways and, in many cases, experience inter-dependent declines in the structure, morphology, composition, and function of nearly all neuromusculoskeletal tissues and processes responsible for powering locomotion.

This Special Issue is, therefore, interested in succint perspectives or reviews (by invitation) or original research articles focusing on:

  • Interventions designed to rejuvinate the mechanics and energetics of locomotion in older adults in enduring ways, including, but not limited to, endurance activities, strength or power training, perturbation training, footwear modifications, and/or assistive robotic technologies;
  • Confounders and comorbidities that could influence the efficacy of intervention prescription to rejuvinate the mechanics and energetics of walking in older adults, including but not limited to pain, stiffness, fatigability, movement variability, pathology, and neuropsychological factors of aging, such as self-efficacy and kinesiophobia;
  • Innovative experimental approaches to probed mechanisms or pathways for restoration of mechanics and energetics of locomotion in older adults;
  • Modeling and simulation approaches to accelerate throughput in the design and evaluation of interventions to rejuvinate the mechanics and energetics of walking in older adults.

Dr. Jason R. Franz
Dr. Katherine Boyer
Guest Editors

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Published Papers (5 papers)

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Research

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9 pages, 755 KiB  
Article
Clinical Validation of Estimated Muscle Activations during Phases of Elderly Gait
Biomechanics 2023, 3(4), 552-560; https://doi.org/10.3390/biomechanics3040044 - 16 Nov 2023
Viewed by 673
Abstract
This study validated muscle activation estimations generated by OpenSim during the gait of elderly fallers. Ten healthy elderly participants walked on an instrumented treadmill, monitored by motion capture, force platforms, and 12 surface EMG sensors. Static optimization was used to calculate muscle activations, [...] Read more.
This study validated muscle activation estimations generated by OpenSim during the gait of elderly fallers. Ten healthy elderly participants walked on an instrumented treadmill, monitored by motion capture, force platforms, and 12 surface EMG sensors. Static optimization was used to calculate muscle activations, evaluated through cosine similarity, comparing them with EMG signals from 12 muscles of the right leg. Findings revealed varied similarity levels across muscles and gait phases. During stance phase, tibialis anterior (TIBA), peroneus longus (PERL), soleus (SOL), gastrocnemius lateralis (GASL), semitendinosus (SEMI), tensor fasciae latae (TFL), and rectus femoris (RECF) demonstrated poor similarity (cosim < 0.6), while gluteus medius (GMED), biceps femoris long head (BFLH), and vastus lateralis (VL) exhibited moderate similarity (0.6 ≤ cosim ≤ 0.8), and gluteus maximus (GMAX) and vastus medialis (VASM) displayed high similarity (cosim > 0.8). During the swing phase, only SOL demonstrated inadequate similarity, while GASL, GMAX, GMED, BFLH, SEMI, TFL, RECF, and VASL exhibited moderate similarity, and TIBA, PERL, and VASM showed high similarity. Comparing the different 10% intervals of the gait cycle generally produced more favorable similarity results. For most of the muscles and intervals, good agreement was found. Moderate agreement was estimated in the cases of TIBA (0–10%), PERL (60–70%), GASL (60–70%), TFL (10–20%), RECF (0–10%, 80–100%), and GMED (50–60%). Bad agreement was found in the cases of SOL (60–70%), GASL (0–10%), and TFL (0–10%). In conclusion, the study’s validation outcomes were acceptable in most cases, underlining the potential for user-friendly musculoskeletal modeling routines to study muscle output during elderly gait. Full article
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11 pages, 2415 KiB  
Article
Split-Belt Treadmill Training Improves Mechanical Energetics and Metabolic Cost in Women with Unilateral Hip Osteoarthritis: A Proof-of-Concept Study
Biomechanics 2023, 3(2), 220-230; https://doi.org/10.3390/biomechanics3020019 - 20 May 2023
Cited by 1 | Viewed by 1545
Abstract
We have shown that step length asymmetry seen in hip osteoarthritis (OA) is associated with poorer mechanical energy exchange and higher metabolic cost. Thus, we conducted this proof-of-concept study to investigate whether modifying step length through split-belt treadmill training can improve walking energetics. [...] Read more.
We have shown that step length asymmetry seen in hip osteoarthritis (OA) is associated with poorer mechanical energy exchange and higher metabolic cost. Thus, we conducted this proof-of-concept study to investigate whether modifying step length through split-belt treadmill training can improve walking energetics. We conducted split-belt treadmill training in four periods with simultaneous motion and metabolic analyses in 10 women with unilateral hip OA. Using repeated measures ANOVA, we evaluated changes across each period, in step length asymmetry, mechanical energy exchange, and O2 rate. We also examined changes in hip range of motion and peak plantarflexor moment. We used Spearman correlations (rho) to assess the strength of associations between variables at baseline and after adaptation. We found that step length asymmetry and O2 rate decreased (p = 0.007, p < 0.001) and mechanical energy exchange increased (p < 0.001). Reduced step length asymmetry was associated with reduced O2 rate (rho = 0.732, p = 0.016). Hip range of motion increased (p < 0.001) and was associated with decreased step length asymmetry (rho = 0.818, p = 0.004), indicating a potential mechanism. These findings suggest that reducing step length asymmetry by split-belt treadmill training could improve walking energetics in hip OA people. Full article
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26 pages, 2294 KiB  
Article
Locomotor Adaptation Training to Prevent Mobility Disability
Biomechanics 2022, 2(3), 395-420; https://doi.org/10.3390/biomechanics2030031 - 04 Aug 2022
Viewed by 1680
Abstract
Mobility disability is prevalent in aging populations. While existing walking interventions improve aspects related to mobility, meaningful and sustained changes leading to preventing and reversing mobility disability have remained elusive. Split-belt treadmills can be used to train gait adaptability and may be a [...] Read more.
Mobility disability is prevalent in aging populations. While existing walking interventions improve aspects related to mobility, meaningful and sustained changes leading to preventing and reversing mobility disability have remained elusive. Split-belt treadmills can be used to train gait adaptability and may be a potential long-term rehabilitation tool for those at risk for mobility decline. As adaptability is necessary for community walking, we investigated the feasibility of a small, randomized controlled 16-week gait adaptability training program in a cohort of 38 sedentary older adults at risk for mobility disability. Individuals were randomly assigned to one of three groups: traditional treadmill training, split-belt treadmill training, or no-contact control. Both treadmill interventions included progressive training 3 days a week, focusing on increasing duration and speed of walking. Cognitive, functional, cardiovascular, and gait assessments were completed before and after the intervention. While individuals were able to complete split-belt treadmill training, only Timed Up and Go performance was significantly improved compared to traditional treadmill training. As the stimulus provided by the split-belt training was difficult to control, we did not observe a clear benefit for split-belt treadmill training over traditional treadmill training. Our findings indicate a cautionary tale about the implementation of complex training interventions. Full article
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21 pages, 2553 KiB  
Article
Assessing Balance Loss and Stability Control in Older Adults Exposed to Gait Perturbations under Different Environmental Conditions: A Feasibility Study
Biomechanics 2022, 2(3), 374-394; https://doi.org/10.3390/biomechanics2030030 - 29 Jul 2022
Cited by 1 | Viewed by 1675
Abstract
This study investigated the feasibility of a perturbation-based balance protocol that incorporates a novel computer-controlled movable platform, the Surefooted Trainer, to induce losses of balance during overground walking under various environmental conditions. Twenty apparently healthy older adults (66.7 ± years old) participated in [...] Read more.
This study investigated the feasibility of a perturbation-based balance protocol that incorporates a novel computer-controlled movable platform, the Surefooted Trainer, to induce losses of balance during overground walking under various environmental conditions. Twenty apparently healthy older adults (66.7 ± years old) participated in this study. The acceptability and safety of the perturbation-based balance protocol were assessed by tracking adherence, adverse events, and subjective physical and mental demands after the intervention. Additionally, biomechanical variables during perturbed and non-perturbed trials were analyzed and compared with behavioral outcomes. Overall, 95% of the participants completed the study. There were no serious or non-serious adverse events. The margin of stability and step length after perturbations were significantly lower during slip-perturbations in which the environmental conditions were more challenging. For trip-perturbation conditions, the maximum trunk angle was higher during the trials that resulted in losses of balance. We conclude that the Surefooted Trainer is an acceptable and valid device for an overground walking perturbation-based assessment and training protocol in older adults. Full article
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6 pages, 629 KiB  
Perspective
Mechanics and Energetics of Human Feet: A Contemporary Perspective for Understanding Mobility Impairments in Older Adults
Biomechanics 2022, 2(4), 494-499; https://doi.org/10.3390/biomechanics2040038 - 23 Sep 2022
Viewed by 2116
Abstract
Much of our current understanding of age-related declines in mobility has been aided by decades of investigations on the role of muscle–tendon units spanning major lower extremity joints (e.g., hip, knee and ankle) for powering locomotion. Yet, mechanical contributions from foot structures are [...] Read more.
Much of our current understanding of age-related declines in mobility has been aided by decades of investigations on the role of muscle–tendon units spanning major lower extremity joints (e.g., hip, knee and ankle) for powering locomotion. Yet, mechanical contributions from foot structures are often neglected. This is despite the emerging evidence of their critical importance in youthful locomotion. With the rapid growth in the field of human foot biomechanics over the last decade, our theoretical knowledge of young asymptomatic feet has transformed, from long-held views of the foot as a stiff lever and a shock absorber to that of a versatile system that can modulate mechanical power and energy output to accommodate various locomotor task demands. In this perspective review, we predict that the next set of impactful discoveries related to locomotion in older adults will emerge by integrating the novel tools and approaches that are currently transforming the field of human foot biomechanics. By illuminating the functions of the feet in older adults, we envision that future investigations will refine our mechanistic understanding of mobility deficits affecting our aging population, which may ultimately inspire targeted interventions to rejuvenate the mechanics and energetics of locomotion. Full article
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