Energy cost, mechanical work, and efficiency of hemiparetic walking

Detrembleur, Christine; Dierick, Frédéric; Stoquart, Gaëtan; Chantraine, Frédéric; Lejeune, Thierry

doi:10.1016/s0966-6362(02)00193-5

Cited by 181 publications

(168 citation statements)

References 39 publications

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“…Various alterations of muscle properties such as increased muscle tone or contracture, modified muscle fibre size and type, altered mechanical and morphological properties of intra-and extra-cellular material [4] may also lead to decreased efficiency. A previous study [5] conducted in nine chronic hemiparetic patients confirmed that the increase of the energy expended per metre (C, the net energetic cost, J kg À1 m À1 ) was inversely related to walking speed. C was shown to be up to two times greater than normal values in slower patients (1.7 km h À1 ), whereas it was only 1.2 times greater in faster patients (3.6 km h À1 ).…”

Section: Introductionmentioning

confidence: 61%

“…Hemiparetic gait is typically asymmetric with the healthy lower limb producing more work than the pathological one [7]. Therefore, the normal efficiency found by Detrembleur et al [5] could be explained by the fact that only minimal mechanical work is done by the impaired lower limb. If the healthy lower limb performs most of the mechanical work, where muscles are working under normal conditions, then whole body efficiency should remain normal even if spasticity, contracture and cocontraction may partially decrease efficiency (h) in the impaired lower limb.…”

Section: Introductionmentioning

confidence: 99%

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Section: Introductionmentioning

confidence: 61%

Section: Introductionmentioning

confidence: 99%

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“…Before this study, although energy recovery had been used to examine the effect of aging [18], patients with different disorders [2,10] and knee OA [9,27], the effects of hip and ankle OA have not been explored in this context. One of the goals for patient care and treatment for individuals with OA is to establish gait patterns that allow normal activities to be conducted with minimal pain and fatigue.…”

Section: Discussionmentioning

confidence: 99%

“…When energy exchange is efficient, it can reduce the amount of muscular effort needed to accelerate and decelerate the center of mass [4-7, 11, 12, 14, 15, 19]. Energy exchange is affected by age and disease [2,10,13,18,27,28]. However, the effect of OA in all three major lower extremity joints on the mechanical work of the center of mass is poorly understood.…”

Section: Introductionmentioning

confidence: 99%

“…However, the effect of OA in all three major lower extremity joints on the mechanical work of the center of mass is poorly understood. Although calculation of energy recovery is a long-standing technique that has been applied to studies of nonhuman animals and asymptomatic humans [4][5][6][7]15], only a few studies have examined gait in subjects older than 45 years and gait as affected by disorders [10,13,18], and those who have examined OA have examined the effect of knee OA on recovery [11,27]. There is little information regarding the effect of hip and ankle OA on recovery, although it can be predicted from models of energy recovery [4][5][6][7]27].…”

Section: Introductionmentioning

confidence: 99%

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Hip, Knee, and Ankle Osteoarthritis Negatively Affects Mechanical Energy Exchange

Queen

Sparling

Schmitt

2016

Clinical Orthopaedics &Amp; Related Research

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Background Individuals with osteoarthritis (OA) of the lower limb find normal locomotion tiring compared with individuals without OA, possibly because OA of any lower limb joint changes limb mechanics and may disrupt transfer of potential and kinetic energy of the center of mass during walking, resulting in increased locomotor costs. Although recovery has been explored in asymptomatic individuals and in some patient populations, the effect of changes in these gait parameters on center of mass movements and mechanical work in patients with OA in specific joints has not been well examined. The results can be used to inform clinical interventions and rehabilitation that focus on improving energy recovery. Questions/purposes We hypothesized that (1) individuals with end-stage lower extremity OA would exhibit a decrease in walking velocity compared with asymptomatic individuals and that the joint affected with OA would differntially influence walking velocity, (2) individuals with end-stage lower extremity OA would show decreased energy recovery compared with asymptomatic individuals and that individuals with end-stage hip and ankle OA would have greater reductions in recovery than would individuals with end-stage knee OA owing to restrictions in hip and ankle motion, and (3) that differences in the amplitude and congruity of the center of mass would explain the differences in energy recovery that are observed in each population. Methods Ground reaction forces at a range of self-selected walking speeds were collected from individuals with end-stage radiographic hip OA (n = 27; 14 males, 13 females; average age, 55.6 years; range, 41-70 years), knee OA (n = 20; seven males, 13 females; average age, 61.7 years; range, 49-74 years), ankle OA (n = 30; 14 males, 16 females; average age, 57 years; range, 45-70 years), and asymptomatic individuals (n = 13; eight males, five females; average age, 49.8 years; range, 41-67 years). Participants were all patients with end-stage OA who were scheduled to have joint replacement surgery within 4 weeks of testing. All patients were identified by the orthopaedic surgeon as having end-stage radiographic disease and to be a candidate for joint replacement surgery. Patients were excluded if they had pain at any other lower Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Clinical Orthopaedics and Related Research 1 neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDAapproval status, of any drug or device prior to clinical use. Each author certifies that his or...

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The Young Athlete with a Motor Disability

Longmuir¹

2007

The Young Athlete

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Energy cost, mechanical work, and efficiency of hemiparetic walking

Cited by 181 publications

References 39 publications

Efficiency of work production by spastic muscles

Efficiency of work production by spastic muscles

Hip, Knee, and Ankle Osteoarthritis Negatively Affects Mechanical Energy Exchange

The Young Athlete with a Motor Disability

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