Variation in the human Achilles tendon moment arm during walking

The Achilles tendon (AT) moment arm is an important determinant of ankle moment and power generation during locomotion. Load and depth-dependent variations in the AT moment arm are generally not considered, but may be relevant given the complex triceps surae architecture. We coupled motion analysis and ultrasound imaging to characterize AT moment arms during walking in 10 subjects. Muscle loading during push-off amplified the AT moment arm by 10% relative to heel strike. AT moment arms also varied by 14% over the tendon thickness. In walking, AT moment arms are not strictly dependent on kinematics, but exhibit important load and spatial dependencies.     

The contraction-induced increase in Achilles tendon moment arm: A three-dimensional study

The present study aimed to re-examine the influence of the isometric plantarflexors contraction on the Achilles tendon moment arm (ATMA) and the factors influencing the ATMA in three-dimensions. A series of coronal magnetic resonance images of the right ankle were recorded at foot positions of 10° of dorsiflexion, neutral position, and 10° of plantarflexion for the rest condition and the plantarflexors contraction condition at 30% maximal voluntary effort. The shortest distance between the talocrural joint axis and the line of action of the Achilles tendon force projected to the orthogonal plane of the talocrural joint axis was determined as the ATMA. The ATMA determined in the contraction condition was significantly greater by 8 mm than that determined in the rest condition. The talocrural joint axis was displaced anteriorly by 3 mm and distally by 2 mm due to the muscle contraction. As the same time, the line of action of the Achilles tendon force was displaced posteriorly by 5 mm and medially by 2 mm. These linear displacements of the talocrural joint axis and the line of action of the Achilles tendon force accounted for the difference in the ATMAs between the two conditions by 35.9 and 62.4%, respectively. These angular displacements accounted for the total of 0.4% increase in the ATMA. These results confirm the previous findings reported in two-dimensional studies and found that the linear displacement of the line of action of the Achilles tendon force is the primary source of the contraction-induced increase in the ATMA.     

Gait analysis in chronic heart failure: The calf as a locus of impaired walking capacity

Reduced walking capacity, a hallmark of chronic heart failure (CHF), is strongly correlated with hospitalization and morbidity. The aim of this work was to perform a detailed biomechanical gait analysis to better identify mechanisms underlying reduced walking capacity in CHF. Inverse dynamic analyses were conducted in CHF patients and age- and exercise level-matched control subjects on an instrumented treadmill at self-selected treadmill walking speeds and at speeds representing +20% and –20% of the subjects’ preferred speed. Surprisingly, no difference in preferred speed was observed between groups, possibly explained by an optimization of the mechanical cost of transport in both groups (the mechanical cost to travel a given distance; J/kg/m). The majority of limb kinematics and kinetics were also similar between groups, with the exception of greater ankle dorsiflexion angles during stance in CHF. Nevertheless, over two times greater ankle plantarflexion work during stance and per distance traveled is required for a given triceps surae muscle volume in CHF patients. This, together with a greater reliance on the ankle compared to the hip to power walking in CHF patients, especially at faster speeds, may contribute to the earlier onset of fatigue in CHF patients. This observation also helps explain the high correlation between triceps surae muscle volume and exercise capacity that has previously been reported in CHF. Considering the key role played by the plantarflexors in powering walking and their association with exercise capacity, our findings strongly suggest that exercise-based rehabilitation in CHF should not omit the ankle muscle group.     

In vivo determination of the Achilles tendon moment arm in three-dimensions

Two-dimensional methods have been applied to determine the Achilles tendon moment arm in previous studies, although the talocrural joint rotates in three-dimension. The purpose of this study was to develop a method for determining the Achilles tendon moment arm in three-dimensions (3DMA). A series of sagittal ankle images were obtained at ankle positions of -20°, -10° (dorsiflexed position), 0° (neutral position), +10°, +20°, and +30° (plantarflexed position). The talocrural joint axis was determined as the finite helical axis of the ankle joint over 20° of displacement, and the 3DMA was determined as the shortest distance from the talocrural joint axis to the line of action of the Achilles tendon force. The corresponding 2DMA was determined with the center of rotation method using the images captured on the sagittal plane passing through the mid-point of the medio-lateral width of the tibia. The 3DMA ranged from 35 to 41 mm across various ankle positions and was, on average, 11 mm smaller than 2DMA. The difference between the two measures was attributable primarily to the deviations of the talocrural joint axis from the anatomical medio-lateral direction. The deviations on the coronal plane (21.4±20.7°) and on the transverse planes (14.8±22.6°) accounted for the errors of 1.3 mm and 3.0 mm, respectively. In addition, selecting either a medially or laterally misaligned sagittal-plane image for determining the 2DMA gave rise to error by 3.5 mm. The remaining difference was accounted for by the random measurement error.     

Estimates of Achilles tendon moment arm differ when axis of ankle rotation is derived from ankle motion

The plantarflexor moment arm of the Achilles tendon determines the mechanical advantage of the triceps surae and also indirectly affects muscle force generation by setting the amount of muscle-tendon shortening per unit of ankle joint rotation. The Achilles tendon moment arm may be determined geometrically from an axis (or center) of joint rotation and the line of action of the tendon force, but such moment arms may be sensitive to the location of the joint axis. Using motion analysis to track an ultrasound probe overlying the Achilles tendon along with markers on the shank and foot, we measured Achilles tendon moment arm during loaded and unloaded dynamic plantarflexion motions in 15 healthy subjects. Three representations of the axis or center of rotation of the ankle were considered: (1) a functional axis, defined by motions of the foot and shank; (2) a transmalleolar axis; and (3) a transmalleolar midpoint. Moment arms about the functional axis were larger than those found using the transmalleolar axis and transmalleolar midpoint (all p < 0.001). Moment arms computed with the functional axis increased with plantarflexion angle (all p < 0.001), and increased with loading in the most plantarflexed position (p < 0.001) but these patterns were not observed when either using a transmalleolar axis or transmalleolar midpoint. Functional axis moment arms were similar to those estimated previously using magnetic resonance imaging, suggesting that using a functional axis for ultrasound-based geometric estimates of Achilles tendon moment arm is an improvement over landmark-based methods.     

Impact of ankle foot orthosis stiffness on Achilles tendon and gastrocnemius function during unimpaired gait

Ankle foot orthoses (AFOs) are designed to improve gait for individuals with neuromuscular conditions and have also been used to reduce energy costs of walking for unimpaired individuals. AFOs influence joint motion and metabolic cost, but how they impact muscle function remains unclear. This study investigated the impact of different stiffness AFOs on medial gastrocnemius muscle (MG) and Achilles tendon (AT) function during two walking speeds. We performed gait analyses for eight unimpaired individuals. Each individual walked at slow and very slow speeds with a 3D printed AFO with no resistance (free hinge condition) and four levels of ankle dorsiflexion stiffness: 0.25 Nm/°, 1 Nm/°, 2 Nm/°, and 3.7 Nm/°. Motion capture, ultrasound, and musculoskeletal modeling were used to quantify MG and AT lengths with each AFO condition. Increasing AFO stiffness increased peak AFO dorsiflexion moment with decreased peak knee extension and peak ankle dorsiflexion angles. Overall musculotendon length and peak AT length decreased, while peak MG length increased with increasing AFO stiffness. Peak MG activity, length, and velocity significantly decreased with slower walking speed. This study provides experimental evidence of the impact of AFO stiffness and walking speed on joint kinematics and musculotendon function. These methods can provide insight to improve AFO designs and optimize musculotendon function for rehabilitation, performance, or other goals.     

Motor unit firing rates of the gastrocnemii during maximal brief steady-state contractions in humans

The human triceps surae (soleus, medial (MG) and lateral (LG) gastrocnemii) is complex and important for posture and gait. The soleus exhibits markedly lower motor unit firing rates (MUFRs; ∼16 Hz) during maximal voluntary isometric contraction (MVC) than other limb muscles, but this information is unknown for the MG and LG. During multiple visits, subjects performed a series of 5–7, ∼7-s plantar flexor MVCs with tungsten microelectrodes inserted into the MG and LG. During a separate testing session, another group of subjects performed submaximal isometric contractions at 25%, 50%, and 75% MVC with inserted fine-wires in the MG, LG and soleus. Maximum steady-state MUFRs for MG and LG (∼23 Hz) were not different, but faster than prior reports for the soleus. No differences between the three triceps surae components were detected for 25% or 50% MVC, but at 75% MVC, the MG MUFRs were 31% greater than soleus. The triceps surae exhibit similar torque modulation strategies at <75% MVC, but to achieve higher contraction intensities (>75% MVC) the gastrocnemii rely on faster rates to generate maximal torque than the soleus. Therefore, the MG and LG exhibit a larger range of MUFR capacities.     

The effects of long-term simulated microgravity on neuromuscular performance in men and women

The effects are reported of prolonged exposure to simulated microgravity (strict bed rest in an antiorthostatic position -6 degrees head-down tilt, HDT) on voluntary and electrically evoked contractions of the triceps surae muscle in men (n = 6) and women (n = 4). The subjects served as their own controls. Bed rest is a model that has commonly been used to simulate spaceflight. Measurements made in the control condition (10-8 days before the beginning of HDT) and after 120-days of HDT (on the 3rd day after it ended) included examination of the properties of isometric maximal voluntary contractions (MVC), isometric twitch contractions (Pt) and tetanic contractions (Po). After HDT, the MVC decreased by means of 44% and 33%, P, by means of 36% and 11%, Po by means of 34% and 24%, in the men and the women, respectively. The difference between Po and MVC, expressed as a percentage of Po and referred to as force deficiency (FD), has also been calculated. The FD increased by means of 60% and 28.8% in the men and the women, respectively. Time-to-peak tension of the triceps surae muscle increased by means of 12% and 14% in the men and the women, respectively, but half-relaxation time decreased by means of 9% and 19%. Total contraction time increased by a mean of 23% in the men and decreased by a mean of 17% in the women. Force-velocity of properties of the triceps surae muscle calculated according to a relative scale of voluntary contraction development significantly decreased more in the women than the men. The calculations of the same properties of electrically evoked contraction development did not differ substantially from the initial physiological state. It can be concluded that not only were the contractile properties of the triceps surae muscle significantly different in the men and the women, but that the effects of exposure to simulated microgravity on these properties were also different. These differences may be explained by sex differences in the muscle tissue itself and in its maximal neural activation.     

Biomechanical mechanism for transitions in phase and frequency of arm and leg swing during walking

As humans increase walking speed, there are concurrent transitions in the frequency ratio between arm and leg movements from 2:1 to 1:1 and in the phase relationship between the movements of the two arms from in-phase to out-of-phase. Superharmonic resonance of a pendulum with monofrequency excitation had been proposed as a potential model for this phenomenon. In this study, an alternative model of paired pendulums with multiple-frequency excitations is explored. It was predicted that the occurrence of the concurrent transitions was a function of (1) changes in the magnitude ratio of shoulder accelerations at step and stride frequencies that accompany changes in walking speed and (2) proximity of these frequencies to the natural resonance frequencies of the arms modeled as a pair of passive pendulums. Model predictions were compared with data collected from 14 healthy young subjects who were instructed to walk on a treadmill. Walking speeds were manipulated between 0.18 and 1.52 m/s in steps of 0.22 m/s. Kinematic data for the arms and shoulders were collected using a 3D motion analysis system, and simulations were conducted in which the movements of a double-pendulum system excited by the accelerations at the suspension point were analyzed to determine the extent to which the arms acted as passive pendulums. It was confirmed that the acceleration waveforms at the shoulder are composed primarily of stride and step frequency components. Between the shoulders, the stride frequency components were out-of-phase, while the step frequency components were in-phase. The amplitude ratio of the acceleration waveform components at the step and stride frequencies changed as a function of walking speed and were associated with the occurrence of the transitions. Simulation results using these summed components as excitatory inputs to the double-pendulum system were in agreement with actual transitions in 80% of the cases. The potential role of state-dependent active muscle contraction at shoulder joints on the occurrence of the transitions was discussed. Due to the tendency of arm movements to stay in the vicinity of their primary resonance frequency, these active muscle forces were hypothesized to function as escapements that created limit cycle oscillations at the shoulders resonant frequency.     

The effects of Achilles tendon compliance on triceps surae mechanics and energetics in walking

Achilles tendon (AT) compliance can affect the generation and transmission of triceps surae muscle forces, and thus has important biomechanical consequences for walking performance. However, the uniarticular soleus (SOL) and the biarticular (GAS) function differently during walking, with in vivo evidence suggesting that their associated fascicles and tendinous structures exhibit unique kinematics during walking. Given the strong association between muscle fiber length, velocity and force production, we conjectured that SOL and GAS mechanics and energetic behavior would respond differently to altered AT compliance. To test this, we characterized GAS and SOL muscle and tendon mechanics and energetics due to systematic changes in tendon compliance using musculoskeletal simulations of walking. Increased tendon compliance enlarged GAS and SOL tendon excursions, shortened fiber operation lengths and affected muscle excitation patterns. For both muscles, an optimal tendon compliance (tendon strains of approximately 5% with maximum isometric force) existed that minimized metabolic energy consumption. However, GAS muscle-tendon mechanics and energetics were significantly more sensitive to changes in tendon compliance than were those for SOL. In addition, GAS was not able to return stored tendon energy during push-off as effectively as SOL, particularly for larger values of tendon compliance. These fundamental differences between GAS and SOL sensitivity to altered tendon compliance seem to arise from the biarticular nature of GAS. These insights are potentially important for understanding the functional consequences of altered Achilles tendon compliance due to aging, injury, or disease.     

Achilles tendon moment arm length is smaller in children with cerebral palsy than in typically developing children

When studying muscle and whole-body function in children with cerebral palsy (CP), knowledge about both internal and external moment arms is essential since they determine the mechanical advantage of a muscle over an external force. Here we asked if Achilles tendon moment arm (MA_AT) length is different in children with CP and age-matched typically developing (TD) children, and if MA_AT can be predicted from anthropometric measurements. Sixteen children with CP (age: 10y 7 m ± 3y, 7 hemiplegia, 12 diplegia, GMFCS level: I (11) and II (8)) and twenty TD children (age: 10y 6 m ± 3y) participated in this case-control study. MA_AT was calculated at 20° plantarflexion by differentiating calcaneus displacement with respect to ankle angle. Seven anthropometric variables were measured and related to MA_AT. We found normalized MA_AT to be 15% (∼7 mm) smaller in children with CP compared to TD children (p = 0.003). MA_AT could be predicted by all anthropometric measurements with tibia length explaining 79% and 72% of variance in children with CP and TD children, respectively. Our findings have important implications for clinical decision making since MA_AT influences the mechanical advantage about the ankle, which contributes to movement function and is manipulated surgically.     

Achilles tendon loading during walking: application of a novel optic fiber technique

An optic fiber (? 0.5 mm) was utilized for the study of Achilles tendon forces (ATF) in eight volunteers who walked over a 10 m force platform at three speeds (1.1 ± 0.1 m × s⁻¹, 1.5 ± 0.1 m × s⁻¹ and 1.8 ± 0.2 m × s⁻¹). The presented ATF-time curves showed great intersubject variation in magnitudes of the sudden release of force after initial contact and in the peak ATF's (1430 ± 500 N). This intersubject variation in the peak force decreased only by 4% when cross-sectional area of the tendon was considered. Measured ground reaction forces and plantar pressures confirmed that the subjects walked quite normally during recordings. The peak ATF was found to be rather insensitive to speed in contrast to the rate of ATF development which increased 32% ( p < 0.5) from slow to fast walking speed. It is concluded that the optic fiber technique can be applied to study loading of the musculo-tendinous complex during normal locomotion such as walking. Accepted: 13 October 1997     

Effect of prosthetic alignment changes on socket reaction moment impulse during walking in transtibial amputees

The alignment of a lower limb prosthesis affects the way load is transferred to the residual limb through the socket, and this load is critically important for the comfort and function of the prosthesis. Both magnitude and duration of the moment are important factors that may affect the residual limb health. Moment impulse is a well-accepted measurement that incorporates both factors via moment–time integrals. The aim of this study was to investigate the effect of alignment changes on the socket reaction moment impulse in transtibial prostheses. Ten amputees with transtibial prostheses participated in this study. The socket reaction moment impulse was measured at a self-selected walking speed using a Smart Pyramid™ in 25 alignment conditions, including a nominal alignment (clinically aligned by a prosthetist), as well as angle malalignments of 2°, 4° and 6° (abduction, adduction, extension and flexion) and translation malalignments of 5 mm, 10 mm and 15 mm (lateral, medial, anterior and posterior). The socket reaction moment impulse of the nominal alignment was compared for each condition. The relationship between the alignment and the socket reaction moment impulse was clearly observed in the coronal angle, coronal translation and sagittal translation alignment changes. However, this relationship was not evident in the sagittal angle alignment changes. The results of this study suggested that the socket reaction moment impulse could potentially serve as a valuable parameter to assist the alignment tuning process for transtibial prostheses. Further study is needed to investigate the influence of the socket reaction moment impulse on the residual limb health.     

Effects of aging and arm swing on the metabolic cost of stability in human walking

To gain insight into the mechanical determinants of walking energetics, we investigated the effects of aging and arm swing on the metabolic cost of stabilization. We tested two hypotheses: (1) elderly adults consume more metabolic energy during walking than young adults because they consume more metabolic energy for lateral stabilization, and (2) arm swing reduces the metabolic cost of stabilization during walking in young and elderly adults. To test these hypotheses, we provided external lateral stabilization by applying bilateral forces (10% body weight) to a waist belt via elastic cords while young and elderly subjects walked at 1.3m/s on a motorized treadmill with arm swing and with no arm swing. We found that the external stabilizer reduced the net rate of metabolic energy consumption to a similar extent in elderly and young subjects. This reduction was greater (6-7%) when subjects walked with no arm swing than when they walked normally (3-4%). When young or elderly subjects eliminated arm swing while walking with no external stabilization, net metabolic power increased by 5-6%. We conclude that the greater metabolic cost of walking in elderly adults is not caused by a greater cost of lateral stabilization. Moreover, arm swing reduces the metabolic cost of walking in both young and elderly adults likely by contributing to stability.     

Differential activation of the plantar flexor muscles in balance control across different feet orientations on the ground

The ankle plantar flexor muscles act synergistically to control quiet and dynamic body balance. Previous research has shown that the medial (MG) and lateral (LG) gastrocnemii, and soleus (SOL) are differentially activated as a function of motor task requirements. In the present investigation, we evaluated modulation of the plantar flexors' activation from feet orientation on the ground in an upright stance and the ensuing reactive response to a perturbation. A single group of young participants (n = 24) was evaluated in a task requiring initial stabilization of body balance against a backward pulling load (5% or 10% of body weight) attached to their trunk, and then the balance was suddenly perturbed, releasing the load. Four feet orientations were compared: parallel (0°), outward orientation at 15° and 30°, and the preferred orientation (M = 10.5°). Results revealed a higher activation magnitude of SOL compared to MG-LG when sustaining quiet balance against the 10% load. In the generation of reactive responses, MG was characterized by earlier, steeper, and proportionally higher activation than LG-SOL. Feet orientation at 30° led to higher muscular activation than the other orientations, while the activation relationship across muscles was unaffected by feet orientation. Our results support the conclusion of task-specific differential modulation of the plantar flexor muscles for balance control.     

Age-related mechanical work expenditure during normal walking: The Baltimore Longitudinal Study of Aging

The aim of this cross-sectional study was to delineate age-associated kinematic and kinetic gait patterns of normal walking, and to test the hypothesis that older adults exhibit gait patterns that reduce generative mechanical work expenditures (MWEs). We studied 52 adult Baltimore Longitudinal Study of Aging participants (means age 72±9, from 60 to 92 years) who could walk 4 m unaided. Three-dimensional kinematic and kinetic parameters assessed during rotation-defined gait periods were used to estimate MWEs for the rotation of lower extremities about the medial–lateral (ML) and anterior–posterior (AP) axes of proximal joints, which represent MWEs in the AP and ML sides, respectively. Relationships between gait parameters and age were examined using regression analysis with adjustments for walking speed, sex, height, and weight. Older age was associated with slower self-selected walking speed (p<0.001), shorter stride length (p<0.001), and greater propensity of landing flat-footed (p=0.003). With older age, hip generative MWE for thigh rotation was lower about the AP axis (hip abduction and adduction) during stance (p=0.010) and higher about the ML axis (hip extension and flexion) during late stance (p<0.001). Knee absorptive MWE for shank rotation about the AP axis (knee abduction and adduction) during early stance was also lower with older age (p<0.003). These age-related gait patterns may represent a compensatory effort to maintain balance and may also reflect mobility limitations.     

A simple but reliable method for measuring 3D Achilles tendon moment arm geometry from a single,static magnetic resonance scan

Current methods for measuring in vivo 3D muscle-tendon moment arms generally rely on the acquisition of magnetic resonance imaging (MRI) scans at multiple joint angles. However, for patients with musculoskeletal pathologies such as fixed contractures, moving a joint through its full range of motion is not always feasible. The purpose of this research was to develop a simple, but reliable in vivo 3D Achilles tendon moment arm (ATMA) technique from a single static MRI scan. To accomplish this, for nine healthy adults (5 males, 4 females), the geometry of a cylinder was fit to the 3D form of the talus dome, which was used to estimate the talocrural flexion/extension axis, and a fifth-order polynomial fit to the line of action of the Achilles tendon. The single static scan in vivo 3D ATMA estimates were compared to estimates obtained from the same subjects at the same ankle joint angles using a previously validated 3D dynamic MRI based in vivo ATMA measurement technique. The ATMA estimates from the single scan in vivo 3D method (52.5 mm ± 5.6) were in excellent agreement (ICC = 0.912) to the validated in vivo 3D method (51.5 mm ± 5.1). These data show reliable in vivo 3D ATMA can be obtained from a single MRI scan for healthy adult populations. The single scan, in vivo 3D ATMA technique provides researchers with a simple, but reliable method for obtaining subject-specific ATMAs for musculoskeletal modelling purposes.     

Effect of 120 days of bed-rest with and without countermeasures on the mechanical properties of the triceps surae muscle in young women

The effect of a 120-day 6° head-down tilt (HDT) bed rest with and without countermeasures on the mechanical properties of the human triceps surae muscle was studied in eight healthy young women subjects. One group [n = 4, mean age 31.5 (SEM 1.7) years] underwent a 120-day HDT only and a second group [n = 4; mean age 28.0 (SEM 1.1) years] underwent HDT with countermeasures (physical training). The results showed that the contractile properties of the skeletal muscle studied changed considerably. After HDT without countermeasures the maximal voluntary contraction (MVC) had decreased by 36% (P < 0.05), and the electrically evoked tetanic tension at 150 Hz (P _o) and isometric twitch contraction (P _t) had decreased by 24% (P < 0.02) and 12% (P < 0.05), respectively. Time- to-peak tension (TPT) of the twitch had significantly increased by 14% (P<0.05), but half-relaxation time (1/2RT), and total contraction time (TCT) had decreased by 19% (P<0.05) and 18% (P<0.05), respectively. The difference between P _o and MVC expressed as a percentage of P _o and referred to as force deficiency (FD), was also calculated. The FD had increased by 40% (P<0.001). The rate of increase of voluntary contractions calculated according to a relative scale had significantly reduced, but for the electrically evoked contraction no substantial changes were observed. After HDT with countermeasures TPT, 1/2RT and TCT of the twitch had decreased by 4%, 7%, 19%, respectively in relation to the control condition. Training had caused a decrease of 3% (P>0.05) in MVC, and P _t, and in P _o of 14%, and of 9% (P>0.05), respectively. The FD had decreased significantly by 10% (P<0.02). The rate of increase of electrically evoked tetanic tension did not change significantly during HDT with countermeasures but the rate of increase in isometric voluntary tension development was increased. Physical training provided a reserve of neuromuscular function, which attenuated the effect of bed rest. The experimental findings indicated that neural as well as muscle adaptation occurred in response to HDT with countermeasures. Accepted: 7 November 1997     

Influence of gait speed on free vertical moment during walking

Free vertical moment (FVM) of ground reaction is recognized to be a meaningful indicator of torsional stress on the lower limbs when walking. The purpose of this study was to examine whether and how gait speed influences the FVM when walking. Fourteen young healthy adults performed a series of overground walking trials at three different speeds: low, preferred and fast. FVM was measured during the stance phase of the dominant leg using a force platform embedded in a 10 m-long walkway. Transverse plane kinematic parameters of the foot and pelvis were measured using a motion capture system. Results showed a significant decrease in peak abduction FVM (i.e., resisting internal foot rotation) and an increase in peak adduction FVM (i.e., resisting external foot rotation), together with an increase in gait speed. Concomitantly, we observed a decrease in the foot progression angle and an increase in the peak pelvis rotation velocity in the transverse plane with an increase in gait speed. A significant positive correlation was found between the pelvis rotation velocity and the peak adduction moment, suggesting that pelvis rotation influences the magnitude of adduction FVM. Furthermore, we also found significant correlations between the peak adduction FVM and both the step length and frequency, indicating that the alterations in FVM may be ascribed to changes in these two key variables of gait speed. These speed-related changes in FVM should be considered when this parameter is used in gait assessment, particularly when used as an index for rehabilitation and injury prevention.     

Effect of age and speed on the step-to-step transition phase during walking

Gait is a powerful measurement tool to evaluate the functional decline throughout ageing. Falls in elderly adults happen mainly during the redirection of the center of mass of the body (CoM) in the transition between steps. In young adults, this step–to–step transition begins before the double contact phase (DC) with a simultaneous forward and upward acceleration of the CoM. We hypothesize that, compared to young adults, elderly adults would exhibit unbalanced contribution of the back leg and the front leg during the transition. We calculated the mean vertical push-off done by the back leg (F_BACK) and the mean impact force on the front leg (F_FRONT) during the transition. Eight young (mean ± SD; age: 24 ± 2 y) and 19 elderly (age: 74 ± 6 y) healthy adults walked on a force-measuring treadmill at five selected speeds ranging from 0.56 to 1.67 m·s⁻¹. Results show that, at mid and high speeds, elderly adults exhibit a smaller F_BACK compared to young adults, possibly linked to the decreased plantar flexion of the back foot. As a consequence, F_FRONT is significantly increased and the transition begins lately in the step, at the beginning of DC. Also, elderly adults show an inability to accelerate the CoM upward and forward simultaneously. Our findings show a different adaptation of the step–to–step transition with speed in elderly adults and identify two potential indicators of gait impairment with age: the F_FRONT/F_BACK contribution and the synchronization between the upward and forward acceleration of the CoM during the transition.