Gradually learning to increase gait propulsion in young unimpaired adults

Herrero, Luciana; Franz, Jason R.; Lewek, Michael D.

doi:10.1016/j.humov.2020.102745

Cited by 6 publications

(5 citation statements)

References 28 publications

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“…Our evidence supporting interdependency between F P and walking speed provides valuable validation for individuals seeking to design and implement strategies to improve walking speed among older adults or individuals with gait pathology. Although walking speed is ultimately governed by interlimb coordination between F P and F B (Supplementary Figures 1, 2), F P has received much more attention as a contributor to walking performance (Peterson et al, 2011;Hsiao et al, 2016;Browne and Franz, 2018;Hedrick et al, 2021;Herrero et al, 2021) and a success metric following intervention (Bowden et al, 2006;Hsiao et al, 2015a;Lewek et al, 2018;Liu et al, 2021). For example, older adults and people with gait pathology walk at slower speeds and with diminished F P .…”

Section: Discussionmentioning

confidence: 99%

“…During steady-speed walking, F P and F B are relatively balanced during the stepto-step transition and their interaction explains much of the variance in mechanical work and metabolic cost required to walk (Donelan et al, 2002b;Kuo et al, 2005). Although interlimb coordination between F P and F B is what ultimately drives horizontal acceleration of the body's CoM, F P has garnered disproportionately significant attention as a contributor to walking performance (Peterson et al, 2011;Hsiao et al, 2016;Browne and Franz, 2018;Hedrick et al, 2021;Herrero et al, 2021) and a target metric for intervention (Bowden et al, 2006;Hsiao et al, 2015a;Lewek et al, 2018;Liu et al, 2021). However, that attention is informed to date by observational studies unable to establish dependency and computational studies unable to establish whether model predictions manifest in human subjects.…”

Section: Introductionmentioning

confidence: 99%

“…Humans typically generate F P via ankle plantarflexion using a combination of well-timed calf muscle contraction, elastic energy returned from the Achilles tendon, and effective limb orientation for mechanical advantage (Sawicki et al, 2009;Hsiao et al, 2015a;Lewek and Sawicki, 2019;Hedrick et al, 2021;Herrero et al, 2021). Because the ankle plantarflexor muscles and tendons account for ∼60% of the work performed in typical gait (DeVita et al, 2007;Sawicki et al, 2009), it is no anomaly that plantarflexor pathologies affect both walking speed and walking economy (Schrack et al, 2016;Das Gupta et al, 2019;Tavakkoli Oskouei et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

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Quantifying mechanical and metabolic interdependence between speed and propulsive force during walking

Pimentel

Feldman

Lewek

et al. 2022

Front. Sports Act. Living

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Walking speed is a useful surrogate for health status across the population. Walking speed appears to be governed in part by interlimb coordination between propulsive (FP) and braking (FB) forces generated during step-to-step transitions and is simultaneously optimized to minimize metabolic cost. Of those forces, FP generated during push-off has received significantly more attention as a contributor to walking performance. Our goal was to first establish empirical relations between FP and walking speed and then to quantify their effects on metabolic cost in young adults. To specifically address any link between FP and walking speed, we used a self-paced treadmill controller and real-time biofeedback to independently prescribe walking speed or FP across a range of condition intensities. Walking with larger and smaller FP led to instinctively faster and slower walking speeds, respectively, with ~80% of variance in walking speed explained by FP. We also found that comparable changes in either FP or walking speed elicited predictable and relatively uniform changes in metabolic cost, together explaining ~53% of the variance in net metabolic power and ~14% of the variance in cost of transport. These results provide empirical data in support of an interdependent relation between FP and walking speed, building confidence that interventions designed to increase FP will translate to improved walking speed. Repeating this protocol in other populations may identify other relations that could inform the time course of gait decline due to age and disease.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Quantifying mechanical and metabolic interdependence between speed and propulsive force during walking

Pimentel

Feldman

Lewek

et al. 2022

Front. Sports Act. Living

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“…The relation of modulation in the CoM-CoP distance at heel strike and toe-off has been observed in the older adult population for whom tripping is the major problem due to weak ankle power [38]. Moreover, this increased angle between CoM-CoP at toe-off (also known as trailing limb angle (TLA)) may contributes to the enhanced propulsion force during late stance [39][40][41] in transfemoral amputees.…”

Section: Introductionmentioning

confidence: 99%

Design and Validation of a Real-Time Visual Feedback System to Improve Minimum Toe Clearance (mTC) in Transfemoral Amputees

Tiwari

Joshi

2021

IEEE Trans. Neural Syst. Rehabil. Eng.

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Tripping is accompanied by reduced minimum toe clearance (mTC) during the swing phase of gait. The risk of fall due to tripping among transfemoral amputees is nearly 67% which is greater than the transtibial amputees. Therefore, intervention to improve mTC can potentially enhance the quality of life among transfemoral amputees. In this paper, we first develop a real-time visual feedback system with center of pressure (CoP) information. Next, we recruited six able-bodied and three transfemoral amputees to investigate the effect on mTC while participants were trained to shift the CoP anteriorly/posteriorly during heel strike. Finally, to assess the lasting effect of training on mTC, retention trials were conducted without feedback. During feedback, posterior shift in the CoP improved the mTC significantly from 4.68±0.40cm to 6.12±0.68cm (p<0.025) in able-bodied participants. A similar significant improvement in mTC from 4.60±0.55cm to 5.62±0.57cm was observed in amputees during posterior shift of CoP. Besides mTC, maximal toe clearances, i.e., maxTC1 and maxTC2, also showed a significant increase (p<0.025) during the posterior shift of CoP in both the participants. Moreover, during retention, mTC did not differ significantly (p>0.05) from feedback condition in amputee, suggesting a positive effect of feedback training. The foot-to-ground angle (FGA) at mTC increased significantly (P<0.025) during posterior shift feedback in able-bodied suggests active ankle dorsiflexion in increasing mTC. However, in amputees, FGA at mTC did not differ significantly during both anterior and posterior CoP shift feedback. The present findings suggest CoP feedback as a potential strategy during gait rehabilitation of transfemoral amputees.

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“…Humans typically generate a vigorous FP via ankle plantarflexion using a combination of well-timed calf muscle contraction, elastic energy returned from the Achilles tendon, and effective limb orientation for mechanical advantage. [14][15][16][17][18] Because the ankle plantarflexor muscles and tendons account for about 60% of the work performed in typical gait, 14,19 it is no anomaly that plantarflexor pathologies affect both walking speed and walking economy. 8,11,20 This suggests that FP, walking speed, and metabolic cost are inextricably linked, posing a longstanding scientific challenge with significant potential for improved clinical countermeasures.…”

Section: Introductionmentioning

confidence: 99%

Quantifying Cause-Effect Relations Between Walking Speed, Propulsive Force, and Metabolic Cost

Pimentel

Feldman

Lewek

et al. 2021

Preprint

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Walking speed is a useful surrogate for health status across the population. Walking speed appears to be governed in part by propulsive force (FP) generated during push-off and simultaneously optimized to minimize metabolic cost. However, no study to our knowledge has established empirical cause-effect relations between FP, walking speed, and metabolic cost, even in young adults. To overcome the potential linkage between these factors, we used a self-paced treadmill controller and real-time biofeedback to independently prescribe walking speed or FP across a range of condition intensities. Walking with larger and smaller FP led to instinctively faster and slower walking speeds, respectively, with about 80% of variance explained between those outcomes. We also found that comparable changes in either FP or walking speed elicited predictable and relatively uniform changes in metabolic cost, each explaining about ~53% of the variance in net metabolic power and ~15% of the variance in cost of transport, respectively. These findings build confidence that interventions designed to increase FP will translate to improved walking speed. Repeating this protocol in other populations may identify additional cause-effect relations that could inform the time course of gait decline due to age and disease.

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Gradually learning to increase gait propulsion in young unimpaired adults

Cited by 6 publications

References 28 publications

Quantifying mechanical and metabolic interdependence between speed and propulsive force during walking

Quantifying mechanical and metabolic interdependence between speed and propulsive force during walking

Design and Validation of a Real-Time Visual Feedback System to Improve Minimum Toe Clearance (mTC) in Transfemoral Amputees

Quantifying Cause-Effect Relations Between Walking Speed, Propulsive Force, and Metabolic Cost

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