Effects of walking speed, strength and range of motion on gait stability in healthy older adults

Falls pose a tremendous risk to those over 65 and most falls occur during locomotion. Older adults commonly walk slower, which many believe helps improve walking stability. While increased gait variability predicts future fall risk, increased variability is also caused by walking slower. Thus, we need to better understand how differences in age and walking speed independently affect dynamic stability during walking. We investigated if older adults improved their dynamic stability by walking slower, and how leg strength and flexibility (passive range of motion (ROM)) affected this relationship. Eighteen active healthy older and 17 healthy younger adults walked on a treadmill for 5min each at each of 5 speeds (80-120% of preferred). Local divergence exponents and maximum Floquet multipliers (FM) were calculated to quantify each subject's inherent local dynamic stability. The older subjects walked with the same preferred walking speeds as the younger subjects (p=0.860). However, these older adults still exhibited greater local divergence exponents (p<0.0001) and higher maximum FM (p<0.007) than the younger adults at all walking speeds. These older adults remained more locally unstable (p<0.04) even after adjusting for declines in both strength and ROM. In both age groups, local divergence exponents decreased at slower speeds and increased at faster speeds (p<0.0001). Maximum FM showed similar changes with speed (p<0.02). Both younger and older adults exhibited decreased instability by walking slower, in spite of increased variability. These increases in dynamic instability might be more sensitive indicators of future fall risk than changes in gait variability.     

Individual limb work does not explain the greater metabolic cost of walking in elderly adults.

Elderly adults consume more metabolic energy during walking than young adults. Our study tested the hypothesis that elderly adults consume more metabolic energy during walking than young adults because they perform more individual limb work on the center of mass. Thus we compared how much individual limb work young and elderly adults performed on the center of mass during walking. We measured metabolic rate and ground reaction force while 10 elderly and 10 young subjects walked at 5 speeds between 0.7 and 1.8 m/s. Compared with young subjects, elderly subjects consumed an average of 20% more metabolic energy (P=0.010), whereas they performed an average of 10% less individual limb work during walking over the range of speeds (P=0.028). During the single-support phase, elderly and young subjects both conserved approximately 80% of the center of mass mechanical energy by inverted pendulum energy exchange and performed a similar amount of individual limb work (P=0.473). However, during double support, elderly subjects performed an average of 17% less individual limb work than young subjects (P=0.007) because their forward speed fluctuated less (P=0.006). We conclude that the greater metabolic cost of walking in elderly adults cannot be explained by a difference in individual limb work. Future studies should examine whether a greater metabolic cost of stabilization, reduced muscle efficiency, greater antagonist cocontraction, and/or a greater cost of generating muscle force cause the elevated metabolic cost of walking in elderly adults.     

Effect of walking speed on inter-joint coordination differs between young and elderly adults

Investigating inter-joint coordination at different walking speeds in young and elderly adults could provide insights to age-related changes in neuromuscular control of gait. We examined effects of walking speed and age on the pattern and variability of inter-joint coordination. Gait analyses of 10 young and 10 elderly adults were performed with different self-selected speeds, including a preferred, faster, and slower speed. Continuous relative phase (CRP), derived from phase planes of two adjacent joints, was used to assess the inter-joint coordination. CRP patterns were examined with cross-correlation measures and root-mean-square (RMS) differences when comparing ensemble mean curves of the faster or slower speed to preferred speed walking. Variability of coordination for each participant was assessed with the average value of all standard deviations calculated for each data point over a gait cycle from all CRP curves, namely the deviation phase (DP). For hip-knee CRP pattern, RMS differences were significantly greater between the slower and preferred walking speeds than between the faster and preferred walking speeds in young adults, but this was not found in elderly adults. Significant group differences in RMS differences and cross-correlation measures were detected in hip-knee CRP patterns between the slower and preferred walking speeds. No significant walking speed or age effects were detected for the knee-ankle CRP. Significant walking speed effects were also detected in hip-knee DP values. However, no significant group differences were detected for all three speeds. These findings suggested that young and elder adults compromise changes of walking speed with different neuromuscular control strategies.     

Running energetics of the North American river otter: do short legs necessarily reduce efficiency on land?

Semi-aquatic mammals move between two very different media (air and water), and are subject to a greater range of physical forces (gravity, buoyancy, drag) than obligate swimmers or runners. This versatility is associated with morphological compromises that often lead to elevated locomotor energetic costs when compared to fully aquatic or terrestrial species. To understand the basis of these differences in energy expenditure, this study examined the interrelationships between limb morphology, cost of transport and biomechanics of running in a semi-aquatic mammal, the North American river otter. Oxygen consumption, preferred locomotor speeds, and stride characteristics were measured for river otters (body mass=11.1 kg, appendicular/axial length=29%) trained to run on a treadmill. To assess the effects of limb length on performance parameters, kinematic measurements were also made for a terrestrial specialist of comparable stature, the Welsh corgi dog (body mass=12.0 kg, appendicular/axial length=37%). The results were compared to predicted values for long legged terrestrial specialists. As found for other semi-aquatic mammals, the net cost of transport of running river otters (6.63 J kg(-1)min(-1) at 1.43 ms(-1)) was greater than predicted for primarily terrestrial mammals. The otters also showed a marked reduction in gait transition speed and in the range of preferred running speeds in comparison to short dogs and semi-aquatic mammals. As evident from the corgi dogs, short legs did not necessarily compromise running performance. Rather, the ability to incorporate a period of suspension during high speed running was an important compensatory mechanism for short limbs in the dogs. Such an aerial period was not observed in river otters with the result that energetic costs during running were higher and gait transition speeds slower for this versatile mammal compared to locomotor specialists.     

The metabolic and mechanical costs of step time asymmetry in walking

Animals use both pendular and elastic mechanisms to minimize energy expenditure during terrestrial locomotion. Elastic gaits can be either bilaterally symmetric (e.g. run and trot) or asymmetric (e.g. skip, canter and gallop), yet only symmetric pendular gaits (e.g. walk) are observed in nature. Does minimizing metabolic and mechanical power constrain pendular gaits to temporal symmetry? We measured rates of metabolic energy expenditure and calculated mechanical power production while healthy humans walked symmetrically and asymmetrically at a range of step and stride times. We found that walking with a 42 per cent step time asymmetry required 80 per cent (2.5 W kg⁻¹) more metabolic power than preferred symmetric gait. Positive mechanical power production increased by 64 per cent (approx. 0.24 W kg⁻¹), paralleling the increases we observed in metabolic power. We found that when walking asymmetrically, subjects absorbed more power during double support than during symmetric walking and compensated by increasing power production during single support. Overall, we identify inherent metabolic and mechanical costs to gait asymmetry and find that symmetry is optimal in healthy human walking.     

Fat mass limits lower-extremity relative strength and maximal walking performance in older women

The purpose of this study was to determine if excess fat negatively affects relative strength and walking gait performance in overweight, older women. Twenty-five older women (65–80 yr) were separated into normal weight (BMI < 25 kg m⁻², n = 11) and overweight groups (BMI ? 25 kg m⁻², n = 14). Strength and rate of torque development (RTD) of the knee extensors and flexors, ankle plantarflexors and dorsiflexors were measured. Participants walked at standard and maximal speeds during which muscle activation, spatiotemporal and kinetic gait variables were measured. Relative to mass, overweight older women had 24% lower maximal torque and 38% lower RTD than normal weight women. Maximal walking speed was slower in overweight (1.25 ± 0.22 vs. 1.54 ± 0.25 m s⁻¹, P = 0.004) and was correlated to strength (r = 0.53, P < 0.01) and fat mass (r = −0.65, P = 0.001). At maximal speed, overweight had 11% lower vertical ground reaction force relative to mass, 8% slower stride rate, 12% shorter strides, 13% longer foot–ground contact times, 21% longer double-limb support times, 65% greater knee extensor and 78% greater plantarflexor activation (P < 0.05). Overweight, older women demonstrated altered gait and reduced walking performance related to poor relative strength and rate of torque development of lower-extremity muscles.     

The cost of walking downhill: Is the preferred gait energetically optimal?

Humans tend to prefer walking patterns that minimize energetic cost, but must also maintain stability to avoid falling over. The relative importance of these two goals in determining the preferred gait pattern is not currently clear. We investigated the relationship between energetic cost and stability during downhill walking, a context in which gravitational energy will assist propulsion but may also reduce stability. We hypothesized that humans will not minimize energetic cost when walking downhill, but will instead prefer a gait pattern that increases stability. Simulations of a dynamic walking model were used to determine whether stable downhill gaits could be achieved using a simple control strategy. Experimentally, twelve healthy subjects walked downhill at 1.25 m/s (0, 0.05, 0.10, and 0.15 gradients). For each slope, subjects performed normal and relaxed trials, in which they were instructed to reduce muscle activity and allow gravity to maximally assist their gait. We quantified energetic cost, stride timing, and leg muscle activity. In our model simulations, increase in slope reduced the required actuation but also decreased stability. Experimental subjects behaved more like the model when using the relaxed rather than the normal walking strategy; the relaxed strategy decreased energetic cost at the steeper slopes but increased stride period variability, an indicator of instability. These results indicate that subjects do not take optimal advantage of the propulsion provided by gravity to decrease energetic cost, but instead prefer a more stable and more costly gait pattern.     

The energy expenditure of snowshoeing in packed vs. unpacked snow at low-level walking speeds

Snowshoeing is currently ranked as one of the top 20 participatory sports in the United States, and the number of participants almost tripled, from 440,000 to 1.2 million in 1998. Despite this large increase in participation, no scientific evidence exists to quantify any physiologic response to the activity. Therefore, the purpose of this investigation was to assess the energy expenditure of snowshoeing at selected low-level speeds and evaluate its acceptability as a form of aerobic conditioning exercise. Ten habitually active subjects (7 men, 3 women, mean age = 24 +/- 3.9 years, mass = 76.6 +/- 14.5 kg, height = 173.7 +/- 9.6 cm) were recruited. Steady state heart rate data were determined from 2 treadmill tests at 4 and 6 mph. Steady state heart rates at 4 mph and 6 mph from treadmill speeds were then reproduced outdoors under 2 snow conditions, packed, and unpacked snow, while caloric expenditure and speed were determined. Expired gases were collected in Douglas bags for both snowshoe and treadmill trials and then analyzed and corrected indoors for the fractional concentrations of carbon dioxide and oxygen. Data analyses indicate that caloric expenditure during snowshoeing may be considerably higher than previously reported. Snowshoeing on packed snow at 2.95 mph elicited a similar heart rate and energy expenditure response as walking on a treadmill at 4 mph or snowshoeing in unpacked snow at 2.04 mph (Vo(2) = 18.18 +/- 0.8 ml x kg(-1) x min(-1)). Snowshoeing on packed snow at 3.97 mph elicited the same heart rate and energy expenditure response as walking on a treadmill at 6 mph or snowshoeing on unpacked snow at 2.87 mph (Vo(2) = 36.72 +/- 0.8 ml x kg(-1) x min(-1)). Furthermore, increasing walking speed on snow by just 1 mph at slow speeds (2 and 3 mph) resulted in approximately twice the energy expenditure. Our data indicate that current estimates of energy expenditure while snowshoeing underestimate by greater than 50%. Apparently the energy expenditure during snowshoeing is much higher than previously considered and varies considerably because of snow terrain. Furthermore, energy expenditure levels similar to walking can be achieved on snowshoes at much slower speeds. This study represents an original investigation into energy expenditure during snowshoeing.     

Effects of obesity and sex on the energetic cost and preferred speed of walking.

The metabolic energy cost of walking is determined, to a large degree, by body mass, but it is not clear how body composition and mass distribution influence this cost. We tested the hypothesis that walking would be most expensive for obese women compared with obese men and normal-weight women and men. Furthermore, we hypothesized that for all groups, preferred walking speed would correspond to the speed that minimized the gross energy cost per distance. We measured body composition, maximal oxygen consumption, and preferred walking speed of 39 (19 class II obese, 20 normal weight) women and men. We also measured oxygen consumption and carbon dioxide production while the subjects walked on a level treadmill at six speeds (0.50-1.75 m/s). Both obesity and sex affected the net metabolic rate (W/kg) of walking. Net metabolic rates of obese subjects were only approximately 10% greater (per kg) than for normal-weight subjects, and net metabolic rates for women were approximately 10% greater than for men. The increase in net metabolic rate at faster walking speeds was greatest in obese women compared with the other groups. Preferred walking speed was not different across groups (1.42 m/s) and was near the speed that minimized gross energy cost per distance. Surprisingly, mass distribution (thigh mass/body mass) was not related to net metabolic rate, but body composition (% fat) was (r2= 0.43). Detailed biomechanical studies of walking are needed to investigate whether obese individuals adopt novel energy saving mechanisms during walking.     

Effect of prolonged free-walking fatigue on gait and physiological rhythm

This study examined the ways in which gait patterns and physiological rhythms such as those of muscle activity (tibialis anterior (TA) and biceps femoris (BF)) and cardiac activity are affected by the fatigue induced by prolonged free walking. Twelve normal subjects who walked for 3 h at their preferred pace were divided into two groups according to whether their mean gait cycle time (reciprocal of stride rate) during the second 90 min was higher (Group A: n=8) or lower (Group B: n=4) than that during the first 90 min. For Group A, the level of subjective fatigue during the walking task was significantly higher and the heart rate at rest was significantly lower than Group B. In Group A, prolonged walking significantly decreased the mean power frequency of the electromyography from TA, increased the variability of gait rhythm, decreased the largest Lyapunov exponent of the vertical component of back-waist acceleration, and decreased the amplitude of the vertical component of back-waist acceleration. Taking the onset timings of these changes into account, we propose that subjects who tire easily during prolonged walking first show local muscle fatigue at TA followed by instability of gait rhythm and then they slow their gait rhythm to enhance local dynamic stability. For both groups we constructed a physical fatigue index described by linear regression of gait and physiological variables. When we compared the subjective fatigue level with the fatigue level predicted using the index, we obtained a relatively high correlation coefficient for both groups (r=0.77).     

Gait variability magnitude but not structure is altered in essential tremor

Essential tremor (ET) is a common tremor disorder affecting postural/action tremor of the upper extremities and midline. Recent research revealed a cerebellar-like deficit during tandem gait in persons with ET, though spatiotemporal variability during normal gait in ET has been relatively ignored. The first purpose of this study was to investigate gait variability magnitude and structure in ET as compared to healthy older adults (HOA). To address this issue, 11 ET and 11 age-matched HOAs walked on a treadmill for 5 min at preferred walking speeds. HOAs walked for an additional minute while speed-matched to an ET participant. The second purpose was to describe the clinical correlates of gait variability in this population. To address this aim, 31 persons with ET walked on a treadmill for 5 min and completed the Fahn–Tolosa–Marin Tremor Rating Scale. Gait variability magnitude was derived by calculating coefficients of variation in stride length, stride time, step length, step time, and step width. Gait variability structure was derived using a detrended fluctuation analysis technique. At preferred walking speeds, ET participants walked significantly slower with significantly increased variability magnitude in all five spatiotemporal gait parameters. At speed-matched walking, ET participants exhibited significantly higher step width variability. Gait variability structure was not different between groups. We also observed that gait variability magnitude was predicted by severity of upper extremity and midline tremors. This study revealed that self-selected gait in ET is characterized by high variability that is associated with tremor severity in the upper extremity and midline.     

Evidence for energy savings from aerial running in the Svalbard rock ptarmigan (Lagopus muta hyperborea)

Svalbard rock ptarmigans were walked and run upon a treadmill and their energy expenditure measured using respirometry. The ptarmigan used three different gaits: a walking gait at slow speeds (less than or equal to 0.75 m s(-1)), grounded running at intermediate speeds (0.75 m s(-1) < U < 1.67 m s(-1)) and aerial running at high speeds (greater than or equal to 1.67 m s(-1)). Changes of gait were associated with reductions in the gross cost of transport (COT; J kg(-1) m(-1)), providing the first evidence for energy savings with gait change in a small crouched-postured vertebrate. In addition, for the first time (excluding humans) a decrease in absolute metabolic energy expenditure (rate of O(2) consumption) in aerial running when compared with grounded running was identified. The COT versus U curve varies between species and the COT was cheaper during aerial running than grounded running, posing the question of why grounded running should be used at all. Existing explanations (e.g. stability during running over rocky terrain) amount to just so stories with no current evidence to support them. It may be that grounded running is just an artefact of treadmill studies. Research investigating the speeds used by animals in the field is sorely needed.     

Biomechanical characteristics of elderly individuals walking on land and in water

In this study, we examined Spatial–temporal gait stride parameters, lower extremity joint angles, ground reaction forces (GRF) components, and electromyographic activation patterns of 10 healthy elderly individuals (70 ± 6 years) walking in water and on land and compared them to a reference group of 10 younger adults (29 ± 6 years). They all walked at self-selected comfortable speeds both on land and while immersed in water at the Xiphoid process level. Concerning the elderly individuals, the main significant differences observed were that they presented shorter stride length, slower speed, lower GRF values, higher horizontal impulses, smaller knee range of motion, lower ankle dorsiflexion, and more knee flexion at the stride’s initial contact in water than on land. Concerning the comparison between elderly individuals and adults, elderly individuals walked significantly slower on land than adults but both groups presented the same speed walking in water. In water, elderly individuals presented significantly shorter stride length, lower stride duration, and higher stance period duration than younger adults. That is, elderly individuals’ adaptations to walking in water differ from those in the younger age group. This fact should be considered when prescribing rehabilitation or fitness programs for these populations.     

The energy cost of walking or running on sand

Oxygen uptake (VO2) at steady state, heart rate and perceived exertion were determined on nine subjects (six men and three women) while walking (3-7 km.h-1) or running (7-14 km.h-1) on sand or on a firm surface. The women performed the walking tests only. The energy cost of locomotion per unit of distance (C) was then calculated from the ratio of VO2 to speed and expressed in J.kg-1.m-1 assuming an energy equivalent of 20.9 J.ml O2-1. At the highest speeds C was adjusted for the measured lactate contribution (which ranged from approximately 2% to approximately 11% of the total). It was found that, when walking on sand, C increased linearly with speed from 3.1 J.kg-1.m-1 at 3 km.h-1 to 5.5 J.kg-1.m-1 at 7 km.h-1, whereas on a firm surface C attained a minimum of 2.3 J.kg-1.m-1 at 4.5 km.h-1 being greater at lower or higher speeds. On average, when walking at speeds greater than 3 km.h-1, C was about 1.8 times greater on sand than on compact terrain. When running on sand C was approximately independent of the speed, amounting to 5.3 J.kg-1.m-1, i.e. about 1.2 times greater than on compact terrain. These findings could be attributed to a reduced recovery of potential and kinetic energy at each stride when walking on sand (approximately 45% to be compared to approximately 65% on a firm surface) and to a reduced recovery of elastic energy when running on sand.     

Kinematic analysis quantifies gait abnormalities associated with lameness in broiler chickens and identifies evolutionary gait differences

This is the first time that gait characteristics of broiler (meat) chickens have been compared with their progenitor, jungle fowl, and the first kinematic study to report a link between broiler gait parameters and defined lameness scores. A commercial motion-capturing system recorded three-dimensional temporospatial information during walking. The hypothesis was that the gait characteristics of non-lame broilers (n = 10) would be intermediate to those of lame broilers (n = 12) and jungle fowl (n = 10, tested at two ages: immature and adult). Data analysed using multi-level models, to define an extensive range of baseline gait parameters, revealed inter-group similarities and differences. Natural selection is likely to have made jungle fowl walking gait highly efficient. Modern broiler chickens possess an unbalanced body conformation due to intense genetic selection for additional breast muscle (pectoral hypertrophy) and whole body mass. Together with rapid growth, this promotes compensatory gait adaptations to minimise energy expenditure and triggers high lameness prevalence within commercial flocks; lameness creating further disruption to the gait cycle and being an important welfare issue. Clear differences were observed between the two lines (short stance phase, little double-support, low leg lift, and little back displacement in adult jungle fowl; much double-support, high leg lift, and substantial vertical back movement in sound broilers) presumably related to mass and body conformation. Similarities included stride length and duration. Additional modifications were also identified in lame broilers (short stride length and duration, substantial lateral back movement, reduced velocity) presumably linked to musculo-skeletal abnormalities. Reduced walking velocity suggests an attempt to minimise skeletal stress and/or discomfort, while a shorter stride length and time, together with longer stance and double-support phases, are associated with instability. We envisage a key future role for this highly quantitative methodology in pain assessment (associated with broiler lameness) including experimental examination of therapeutic agent efficacy.     

Steps to Take to Enhance Gait Stability: The Effect of Stride Frequency,Stride Length,and Walking Speed on Local Dynamic Stability and Margins of Stability

The purpose of the current study was to investigate whether adaptations of stride length, stride frequency, and walking speed, independently influence local dynamic stability and the size of the medio-lateral and backward margins of stability during walking. Nine healthy subjects walked 25 trials on a treadmill at different combinations of stride frequency, stride length, and consequently at different walking speeds. Visual feedback about the required and the actual combination of stride frequency and stride length was given during the trials. Generalized Estimating Equations were used to investigate the independent contribution of stride length, stride frequency, and walking speed on the measures of gait stability. Increasing stride frequency was found to enhance medio-lateral margins of stability. Backward margins of stability became larger as stride length decreased or walking speed increased. For local dynamic stability no significant effects of stride frequency, stride length or walking speed were found. We conclude that adaptations in stride frequency, stride length and/or walking speed can result in an increase of the medio-lateral and backward margins of stability, while these adaptations do not seem to affect local dynamic stability. Gait training focusing on the observed stepping strategies to enhance margins of stability might be a useful contribution to programs aimed at fall prevention.     

Energy cost of balance control during walking decreases with external stabilizer stiffness independent of walking speed

Human walking requires active neuromuscular control to ensure stability in the lateral direction, which inflicts a certain metabolic load. The magnitude of this metabolic load has previously been investigated by means of passive external lateral stabilization via spring-like cords. In the present study, we applied this method to test two hypotheses: (1) the effect of external stabilization on energy cost depends on the stiffness of the stabilizing springs, and (2) the energy cost for balance control, and consequently the effect of external stabilization on energy cost, depends on walking speed. Fourteen healthy young adults walked on a motor driven treadmill without stabilization and with stabilization with four different spring stiffnesses (between 760 and 1820 N m⁻¹) at three walking speeds (70%, 100%, and 130% of preferred speed). Energy cost was calculated from breath-by-breath oxygen consumption. Gait parameters (mean and variability of step width and stride length, and variability of trunk accelerations) were calculated from kinematic data. On average external stabilization led to a decrease in energy cost of 6% (p<0.005) as well as a decrease in step width (24%; p<0.001), step width variability (41%; p<0.001) and variability of medio-lateral trunk acceleration (12.5%; p<0.005). Increasing stabilizer stiffness increased the effects on both energy cost and medio-lateral gait parameters up to a stiffness of 1260 N m⁻¹. Contrary to expectations, the effect of stabilization was independent of walking speed (p=0.111). These results show that active lateral stabilization during walking involves an energetic cost, which is independent of walking speed.     

Do Humans Optimally Exploit Redundancy to Control Step Variability in Walking?

It is widely accepted that humans and animals minimize energetic cost while walking. While such principles predict average behavior, they do not explain the variability observed in walking. For robust performance, walking movements must adapt at each step, not just on average. Here, we propose an analytical framework that reconciles issues of optimality, redundancy, and stochasticity. For human treadmill walking, we defined a goal function to formulate a precise mathematical definition of one possible control strategy: maintain constant speed at each stride. We recorded stride times and stride lengths from healthy subjects walking at five speeds. The specified goal function yielded a decomposition of stride-to-stride variations into new gait variables explicitly related to achieving the hypothesized strategy. Subjects exhibited greatly decreased variability for goal-relevant gait fluctuations directly related to achieving this strategy, but far greater variability for goal-irrelevant fluctuations. More importantly, humans immediately corrected goal-relevant deviations at each successive stride, while allowing goal-irrelevant deviations to persist across multiple strides. To demonstrate that this was not the only strategy people could have used to successfully accomplish the task, we created three surrogate data sets. Each tested a specific alternative hypothesis that subjects used a different strategy that made no reference to the hypothesized goal function. Humans did not adopt any of these viable alternative strategies. Finally, we developed a sequence of stochastic control models of stride-to-stride variability for walking, based on the Minimum Intervention Principle. We demonstrate that healthy humans are not precisely “optimal,” but instead consistently slightly over-correct small deviations in walking speed at each stride. Our results reveal a new governing principle for regulating stride-to-stride fluctuations in human walking that acts independently of, but in parallel with, minimizing energetic cost. Thus, humans exploit task redundancies to achieve robust control while minimizing effort and allowing potentially beneficial motor variability.