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Jakubowski KL, Ludvig D, Lee SSM, Perreault EJ. Aging Does Not Alter Ankle, Muscle, and Tendon Stiffness at Low Loads Relevant to Stance. Ann Biomed Eng 2024:10.1007/s10439-024-03547-4. [PMID: 38816561 DOI: 10.1007/s10439-024-03547-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 05/10/2024] [Indexed: 06/01/2024]
Abstract
Older adults have difficulty maintaining balance when faced with postural disturbances, a task that is influenced by the stiffness of the triceps surae and Achilles tendon. Age-related changes in Achilles tendon stiffness have been reported at matched levels of effort, but measures typically have not been made at matched loads, which is important due to age-dependent changes in strength. Moreover, there has been limited investigation into age-dependent changes in muscle stiffness. Here, we investigate how age alters muscle and tendon stiffness and their influence on ankle stiffness. We hypothesized that age-related changes in muscle and tendon contribute to reduced ankle stiffness in older adults and evaluated this hypothesis when either load or effort were matched. We used B-mode ultrasound with joint-level perturbations to quantify ankle, muscle, and tendon stiffness across a range of loads and efforts in seventeen healthy younger and older adults. At matched loads relevant to standing and the stance phase of walking, there was no significant difference in ankle, muscle, or tendon stiffness between groups (all p > 0.13). However, at matched effort, older adults exhibited a significant decrease in ankle (27%; p = 0.008), muscle (37%; p = 0.02), and tendon stiffness (22%; p = 0.03) at 30% of maximum effort. This is consistent with our finding that older adults were 36% weaker than younger adults in plantarflexion (p = 0.004). Together, these results indicate that, at the loads tested in this study, there are no age-dependent changes in the mechanical properties of muscle or tendon, only differences in strength that result in altered ankle, muscle, and tendon stiffness at matched levels of effort.
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Affiliation(s)
- Kristen L Jakubowski
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA.
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Tech, Atlanta, GA, USA.
- Shirley Ryan AbilityLab, Chicago, IL, USA.
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, USA.
| | - Daniel Ludvig
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
- Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Sabrina S M Lee
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, Canada
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, USA
| | - Eric J Perreault
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
- Shirley Ryan AbilityLab, Chicago, IL, USA
- Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, USA
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Smith RE, Shelton AD, Sawicki GS, Franz JR. The effects of plantarflexor weakness and reduced tendon stiffness with aging on gait stability. PLoS One 2024; 19:e0302021. [PMID: 38625839 PMCID: PMC11020829 DOI: 10.1371/journal.pone.0302021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 03/26/2024] [Indexed: 04/18/2024] Open
Abstract
Falls among older adults are a costly public health concern. Such falls can be precipitated by balance disturbances, after which a recovery strategy requiring rapid, high force outputs is necessary. Sarcopenia among older adults likely diminishes their ability to produce the forces necessary to arrest gait instability. Age-related changes to tendon stiffness may also delay muscle stretch and afferent feedback and decrease force transmission, worsening fall outcomes. However, the association between muscle strength, tendon stiffness, and gait instability is not well established. Given the ankle's proximity to the onset of many walking balance disturbances, we examined the relation between both plantarflexor strength and Achilles tendon stiffness with walking-related instability during perturbed gait in older and younger adults-the latter quantified herein using margins of stability and whole-body angular momentum including the application of treadmill-induced slip perturbations. Older and younger adults did not differ in plantarflexor strength, but Achilles tendon stiffness was lower in older adults. Among older adults, plantarflexor weakness associated with greater whole-body angular momentum following treadmill-induced slip perturbations. Weaker older adults also appeared to walk and recover from treadmill-induced slip perturbations with more caution. This study highlights the role of plantarflexor strength and Achilles tendon stiffness in regulating lateral gait stability in older adults, which may be targets for training protocols seeking to minimize fall risk and injury severity.
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Affiliation(s)
- Ross E. Smith
- Joint Dept. of Biomedical Engineering, UNC Chapel Hill and NC State University, Chapel Hill, North Carolina, United States of America
| | - Andrew D. Shelton
- Joint Dept. of Biomedical Engineering, UNC Chapel Hill and NC State University, Chapel Hill, North Carolina, United States of America
| | - Gregory S. Sawicki
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, Georgia, United States of America
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia, United States of America
| | - Jason R. Franz
- Joint Dept. of Biomedical Engineering, UNC Chapel Hill and NC State University, Chapel Hill, North Carolina, United States of America
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de Almeida Nagata C, Hamu TCDDS, Pelicioni PHS, Durigan JLQ, Garcia PA. Influence of lower limb isokinetic muscle strength and power on the occurrence of falls in community-dwelling older adults: A longitudinal study. PLoS One 2024; 19:e0300818. [PMID: 38573888 PMCID: PMC10994367 DOI: 10.1371/journal.pone.0300818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 03/05/2024] [Indexed: 04/06/2024] Open
Abstract
INTRODUCTION Previous studies have highlighted the association between lower limb muscle strength and falls in older adults. However, a comprehensive understanding of the specific influence of each lower limb muscle group on fall occurrences remains lacking. OBJECTIVE This study aimed to investigate the impact of knee, ankle, and hip muscle strength and power on falls in older adults, with the goal of identifying which muscle groups are more predictive of fall risk in this population. METHODS This longitudinal observational study enrolled 94 community-dwelling older adults. Muscle strength and power of the ankle's plantiflexors and dorsiflexors, knee flexors and extensors, and hip flexors, extensors, adductors, and abductors were assessed using a Biodex System 4 Pro® isokinetic dynamometer. Fall occurrences were monitored through monthly telephone contact over a year. RESULTS Participants, with a median age of 69 years (range 64-74), included 67% women, and 63.8% reported a sedentary lifestyle. Among them, 45,7% of older adults were classified as fallers. Comparative analyses revealed that non-fallers displayed significantly superior isokinetic muscle strength in the hip abductors and adductors, along with higher muscle power in the hip abductors, hip flexors, and knee flexors compared to fallers. Multivariate logistic regression analysis indicated that a 1 Nm/Kg increase in hip abductor strength reduced the chance of a fall by 86.3%, and a 1 Watt increase in hip flexor power reduced the chance of a fall by 3.6%. CONCLUSION The findings indicate that hip abductor strength and hip flexor power can be considered protective factors against falls in independent older adults in the community. These findings may contribute to developing effective fall-prevention strategies for this population.
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Affiliation(s)
| | | | - Paulo Henrique Silva Pelicioni
- School of Health Sciences, University of New South Wales, Randwick, NSW, Australia
- Neuroscience Research Australia, University of New South Wales, Randwick, NSW, Australia
| | - João Luiz Quagliotti Durigan
- Universidade de Brasília, Laboratory of Muscle and Tendon Plasticity, Programa de Pós-Graduação em Educação Física, Brasília, DF, Brazil
| | - Patrícia Azevedo Garcia
- Universidade de Brasília, Programa de Pós-Graduação em Ciências da Reabilitação, Brasília, DF, Brazil
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Brüll L, Santuz A, Mersmann F, Bohm S, Schwenk M, Arampatzis A. Spatiotemporal modulation of a common set of muscle synergies during unpredictable and predictable gait perturbations in older adults. J Exp Biol 2024; 227:jeb247271. [PMID: 38506185 PMCID: PMC11058090 DOI: 10.1242/jeb.247271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 03/14/2024] [Indexed: 03/21/2024]
Abstract
Muscle synergies as functional low-dimensional building blocks of the neuromotor system regulate the activation patterns of muscle groups in a modular structure during locomotion. The purpose of the current study was to explore how older adults organize locomotor muscle synergies to counteract unpredictable and predictable gait perturbations during the perturbed steps and the recovery steps. Sixty-three healthy older adults (71.2±5.2 years) participated in the study. Mediolateral and anteroposterior unpredictable and predictable perturbations during walking were introduced using a treadmill. Muscle synergies were extracted from the electromyographic activity of 13 lower limb muscles using Gaussian non-negative matrix factorization. The four basic synergies responsible for unperturbed walking (weight acceptance, propulsion, early swing and late swing) were preserved in all applied gait perturbations, yet their temporal recruitment and muscle contribution in each synergy were modified (P<0.05). These modifications were observed for up to four recovery steps and were more pronounced (P<0.05) following unpredictable perturbations. The recruitment of the four basic walking synergies in the perturbed and recovery gait cycles indicates a robust neuromotor control of locomotion by using activation patterns of a few and well-known muscle synergies with specific adjustments within the synergies. The selection of pre-existing muscle synergies while adjusting the time of their recruitment during challenging locomotor conditions may improve the effectiveness to deal with perturbations and promote the transfer of adaptation between different kinds of perturbations.
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Affiliation(s)
- Leon Brüll
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, 10115 Berlin, Germany
- Berlin School of Movement Science, Humboldt-Universität zu Berlin, 10115 Berlin, Germany
- Network Aging Research, Heidelberg University, 69115 Heidelberg, Germany
| | - Alessandro Santuz
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, 10115 Berlin, Germany
- Berlin School of Movement Science, Humboldt-Universität zu Berlin, 10115 Berlin, Germany
| | - Falk Mersmann
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, 10115 Berlin, Germany
- Berlin School of Movement Science, Humboldt-Universität zu Berlin, 10115 Berlin, Germany
| | - Sebastian Bohm
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, 10115 Berlin, Germany
- Berlin School of Movement Science, Humboldt-Universität zu Berlin, 10115 Berlin, Germany
| | - Michael Schwenk
- Network Aging Research, Heidelberg University, 69115 Heidelberg, Germany
- Institute of Sports and Sports Sciences, Heidelberg University, 69120 Heidelberg, Germany
- Department of Sport Science, Human Performance Research Center, University of Konstanz, 78464 Konstanz, Germany
| | - Adamantios Arampatzis
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, 10115 Berlin, Germany
- Berlin School of Movement Science, Humboldt-Universität zu Berlin, 10115 Berlin, Germany
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Wullems JA, Degens H, Verschueren SMP, Morse CI, Grant DM, Onambélé-Pearson GL. Sedentary behaviour (especially accumulation pattern) has an independent negative impact on skeletal muscle size and architecture in community-dwelling older adults. PLoS One 2024; 19:e0294555. [PMID: 38394127 PMCID: PMC10889859 DOI: 10.1371/journal.pone.0294555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 11/03/2023] [Indexed: 02/25/2024] Open
Abstract
Prolonged sedentary behaviour (SB) i.e. longer bouts, is suggested to have a range of negative health effects, independent of habitual light and medium-to-vigorous physical activity (LIPA or MVPA). Any effect on musculoskeletal size, architecture or morphology has seldom been reported in older adults. Moreover, no study has yet determined if any association would persist following adjustment for covariates. Therefore, the aim of the present study was to investigate the associations between SB, and properties of the Gastrocnemius Medialis (GM) muscle, in a cross-sectional sample of older adults using compositional data analysis. 105 healthy older adults (73±6y) wore a thigh mounted tri-axial accelerometer for seven consecutive days, and underwent ultrasound [e.g. muscle length (Lm), anatomical cross-sectional area (ACSA), muscle volume (VM), fascicle length (LF), & physiological cross-sectional area (PCSA)], body composition (e.g. DEXA) and health (e.g. medical history) assessments. In-unadjusted models, SB time was negatively associated with ACSA at 75% of Lm (R2adj = 0.085), VM (R2adj = 0.020), and PCSA (R2adj = 0.039). Standing was positively associated with pennation angle (R2adj = 0.110), which persisted following co-variate adjustment (R2adj = 0.296). In fully adjusted models, both SB & LIPA time were associated with ACSA at 75% of Lm (Both R2adj = 0.393). Standing and light activity time were also associated with LF, VM, & PCSA (R2adj 0.116-0.573). In fully adjusted models, SB pattern parameters (i.e. the manner in which sedentary behaviour is accumulated daily throughout waking hours such as the timing, duration and frequency of sedentary bouts), were associated with GM muscle properties (R2adj 0.156-0.564) including LM, LF, and VM. The pattern, rather than accumulated daily SB time, was associated with the size and architecture of the GM. Our results suggest that regardless of co-existing habitual physical activities, SB bouts should be kept short and frequently interrupted to offset some of the deleterious ageing-related muscle architecture characteristics changes.
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Affiliation(s)
- Jorgen A. Wullems
- Department of Sport and Exercise Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Hans Degens
- Department of Life Sciences, Manchester Metropolitan University, Manchester, United Kingdom
- Lithuanian Sports University, Kaunas, Lithuania
| | - Sabine M. P. Verschueren
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Christopher I. Morse
- Department of Sport and Exercise Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
| | - Dale M. Grant
- Department of Sport and Exercise Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
| | - Gladys L. Onambélé-Pearson
- Department of Sport and Exercise Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
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Cubillos LH, Rouse EJ, Augenstein TE, Joshi V, Claflin ES, Krishnan C. Reliability and minimal detectable change of stiffness and other mechanical properties of the ankle joint in standing and walking. Gait Posture 2024; 108:56-62. [PMID: 37988887 PMCID: PMC10854263 DOI: 10.1016/j.gaitpost.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Ankle joint stiffness and viscosity are fundamental mechanical descriptions that govern the movement of the body and impact an individual's walking ability. Hence, these internal properties of a joint have been increasingly used to evaluate the effects of pathology (e.g., stroke) and in the design and control of robotic and prosthetic devices. However, the reliability of these measurements is currently unclear, which is important for translation to clinical use. RESEARCH QUESTION Can we reliably measure the mechanical impedance parameters of the ankle while standing and walking? METHODS Eighteen able-bodied individuals volunteered to be tested on two different days separated by at least 24 h. Participants received several small random ankle dorsiflexion perturbations while standing and during the stance phase of walking using a custom-designed robotic platform. Three-dimensional motion capture cameras and a 6-component force plate were used to quantify ankle joint motions and torque responses during normal and perturbed conditions. Ankle mechanical impedance was quantified by computing participant-specific ensemble averages of changes in ankle angle and torque due to perturbation and fitting a second-order parametric model consisting of stiffness, viscosity, and inertia. The test-retest reliability of each parameter was assessed using intraclass correlation coefficients (ICCs). We also computed the minimal detectable change (MDC) for each impedance parameter to establish the smallest amount of change that falls outside the measurement error of the instrument. RESULTS In standing, the reliability of stiffness, viscosity, and inertia was good to excellent (ICCs=0.67-0.91). During walking, the reliability of stiffness and viscosity was good to excellent (ICCs=0.74-0.84) while that of inertia was fair to good (ICCs=0.47-0.68). The MDC for a single subject ranged from 20%- 65% of the measurement mean but was higher (>100%) for inertia during walking. SIGNIFICANCE Results indicate that dynamic measures of ankle joint impedance were generally reliable and could serve as an adjunct clinical tool for evaluating gait impairments.
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Affiliation(s)
- Luis H Cubillos
- Department of Physical Medicine and Rehabilitation, Michigan Medicine, Ann Arbor, MI, USA; Robotics Department, University of Michigan, Ann Arbor, MI, USA
| | - Elliott J Rouse
- Robotics Department, University of Michigan, Ann Arbor, MI, USA; Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Thomas E Augenstein
- Department of Physical Medicine and Rehabilitation, Michigan Medicine, Ann Arbor, MI, USA; Robotics Department, University of Michigan, Ann Arbor, MI, USA
| | - Varun Joshi
- Department of Physical Medicine and Rehabilitation, Michigan Medicine, Ann Arbor, MI, USA; Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, USA; School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - Edward S Claflin
- Department of Physical Medicine and Rehabilitation, Michigan Medicine, Ann Arbor, MI, USA
| | - Chandramouli Krishnan
- Department of Physical Medicine and Rehabilitation, Michigan Medicine, Ann Arbor, MI, USA; Robotics Department, University of Michigan, Ann Arbor, MI, USA; Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, USA; School of Kinesiology, University of Michigan, Ann Arbor, MI, USA; Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA; Department of Physical Therapy, University of Michigan-Flint, Flint, MI, USA.
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Kinoshita M, Maeo S, Kobayashi Y, Eihara Y, Ono M, Sato M, Sugiyama T, Kanehisa H, Isaka T. Triceps surae muscle hypertrophy is greater after standing versus seated calf-raise training. Front Physiol 2023; 14:1272106. [PMID: 38156065 PMCID: PMC10753835 DOI: 10.3389/fphys.2023.1272106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/29/2023] [Indexed: 12/30/2023] Open
Abstract
Background: The triceps surae muscle plays important roles in fundamental human movements. However, this muscle is relatively unresponsive to resistance training (difficult to hypertrophy) but prone to atrophy with inactivity compared with other muscles. Thus, identifying an effective training modality for the triceps surae is warranted. This study compared triceps surae muscle hypertrophy after standing/knee-extended versus seated/knee-flexed plantarflexion (calf-raise) training, where the gastrocnemius is lengthened and shortened, respectively. Methods: Fourteen untrained adults conducted calf-raise training with one leg in a standing/knee-extended position and the other leg in a seated/knee 90°-flexed position at 70% of one-repetition maximum. Each leg performed 10 repetitions/set, 5 sets/session, 2 sessions/week for 12 weeks. Before and after the intervention, magnetic resonance imaging scans were obtained to assess muscle volume of each and the whole triceps surae. Results: Muscle volume significantly increased in all three muscles and the whole triceps surae for both legs (p ≤ 0.031), except for the gastrocnemius muscles of the seated condition leg (p = 0.147-0.508). The changes in muscle volume were significantly greater for the standing than seated condition leg in the lateral gastrocnemius (12.4% vs. 1.7%), medial gastrocnemius (9.2% vs. 0.6%), and whole triceps surae (5.6% vs. 2.1%) (p ≤ 0.011), but similar between legs in the soleus (2.1% vs. 2.9%, p = 0.410). Conclusion: Standing calf-raise was by far more effective, therefore recommended, than seated calf-raise for inducing muscle hypertrophy of the gastrocnemius and consequently the whole triceps surae. This result and similar between-condition hypertrophy in the soleus collectively suggest that training at long muscle lengths promotes muscle hypertrophy.
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Affiliation(s)
- Momoka Kinoshita
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Sumiaki Maeo
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
- Institute of Advanced Research for Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Yuuto Kobayashi
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Yuuri Eihara
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Munetaka Ono
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Mauto Sato
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Takashi Sugiyama
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
- Institute of Advanced Research for Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Hiroaki Kanehisa
- Institute of Advanced Research for Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
- Department of Physical Education, National Institute of Fitness and Sports in Kanoya, Kanoya, Japan
| | - Tadao Isaka
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
- Institute of Advanced Research for Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
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Jakubowski KL, Ludvig D, Lee SS, Perreault EJ. At matched loads, aging does not alter ankle, muscle, or tendon stiffness. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.11.25.568676. [PMID: 38045313 PMCID: PMC10690239 DOI: 10.1101/2023.11.25.568676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Older adults have difficulty maintaining balance when faced with postural disturbances, a task that is influenced by the stiffness of the triceps surae and Achilles tendon. Age-related changes in Achilles tendon stiffness have been reported at matched levels of effort, but measures typically have not been made at matched loads, which is important due to age-dependent changes in strength. Moreover, age-dependent changes in muscle stiffness have yet to be tested. Here, we investigate how age alters muscle and tendon stiffness and their influence on ankle stiffness. We hypothesized that age-related changes in muscle and tendon contribute to reduced ankle stiffness in older adults and evaluated this hypothesis when either load or effort were matched. We used B-mode ultrasound with joint-level perturbations to quantify ankle, muscle, and tendon stiffness across a range of loads and efforts in seventeen healthy younger and older adults. At matched loads, there was no significant difference in ankle, muscle, or tendon stiffness between groups (all p>0.13). However, at matched effort, older adults exhibited a significant decrease in ankle (27%; p=0.008), muscle (37%; p=0.02), and tendon stiffness (22%; p=0.03) at 30% of maximum effort. This is consistent with our finding that older adults were 36% weaker than younger adults in plantarflexion (p=0.004). Together these results indicate that, at the loads tested in this study, there are no age-dependent changes in the mechanical properties of muscle or tendon, only differences in strength that result in altered ankle, muscle, and tendon stiffness at matched levels of effort.
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Affiliation(s)
- Kristen L. Jakubowski
- Department of Biomedical Engineering, Northwestern University, Evanston, IL
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Tech, Atlanta, GA
| | - Daniel Ludvig
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Tech, Atlanta, GA
- Shirley Ryan AbilityLab, Chicago, IL
| | - Sabrina S.M. Lee
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Canada
| | - Eric J. Perreault
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Tech, Atlanta, GA
- Shirley Ryan AbilityLab, Chicago, IL
- Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL
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Differences in motor response to stability perturbations limit fall-resisting skill transfer. Sci Rep 2022; 12:21901. [PMID: 36535994 PMCID: PMC9763399 DOI: 10.1038/s41598-022-26474-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
This study investigated transfer of improvements in stability recovery performance to novel perturbations. Thirty adults (20-53 yr) were assigned equally to three treadmill walking groups: groups exposed to eight trip perturbations of either low or high magnitude and a third control group that walked unperturbed. Following treadmill walking, participants were exposed to stability loss from a forward-inclined position (lean-and-release) and an overground trip. Lower limb joint kinematics for the swing phase of recovery steps was compared for the three tasks using statistical parametric mapping and recovery performance was analysed by margin of stability and base of support. The perturbation groups improved stability (greater margin of stability) over the eight gait perturbations. There was no group effect for stability recovery in lean-and-release. For the overground trip, both perturbation groups showed similar enhanced stability recovery (margin of stability and base of support) compared to controls. Differences in joint angle kinematics between treadmill-perturbation and lean-and-release were more prolonged and greater than between the two gait perturbation tasks. This study indicates that: (i) practising stability control enhances human resilience to novel perturbations; (ii) enhancement is not necessarily dependent on perturbation magnitude; (iii) differences in motor response patterns between tasks may limit transfer.
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Ferreira RN, Ribeiro NF, Figueiredo J, Santos CP. Provoking Artificial Slips and Trips towards Perturbation-Based Balance Training: A Narrative Review. SENSORS (BASEL, SWITZERLAND) 2022; 22:9254. [PMID: 36501958 PMCID: PMC9740792 DOI: 10.3390/s22239254] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/29/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
Humans' balance recovery responses to gait perturbations are negatively impacted with ageing. Slip and trip events, the main causes preceding falls during walking, are likely to produce severe injuries in older adults. While traditional exercise-based interventions produce inconsistent results in reducing patients' fall rates, perturbation-based balance training (PBT) emerges as a promising task-specific solution towards fall prevention. PBT improves patients' reactive stability and fall-resisting skills through the delivery of unexpected balance perturbations. The adopted perturbation conditions play an important role towards PBT's effectiveness and the acquisition of meaningful sensor data for studying human biomechanical reactions to loss of balance (LOB) events. Hence, this narrative review aims to survey the different methods employed in the scientific literature to provoke artificial slips and trips in healthy adults during treadmill and overground walking. For each type of perturbation, a comprehensive analysis was conducted to identify trends regarding the most adopted perturbation methods, gait phase perturbed, gait speed, perturbed leg, and sensor systems used for data collection. The reliable application of artificial perturbations to mimic real-life LOB events may reduce the gap between laboratory and real-life falls and potentially lead to fall-rate reduction among the elderly community.
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Affiliation(s)
- Rafael N. Ferreira
- Center for MicroElectroMechanical Systems, University of Minho, 4800-058 Guimarães, Portugal
- LABBELS—Associate Laboratory, 4710-057 Braga, Portugal
- LABBELS—Associate Laboratory, 4800-058 Guimarães, Portugal
| | - Nuno Ferrete Ribeiro
- Center for MicroElectroMechanical Systems, University of Minho, 4800-058 Guimarães, Portugal
- LABBELS—Associate Laboratory, 4710-057 Braga, Portugal
- LABBELS—Associate Laboratory, 4800-058 Guimarães, Portugal
- MIT Portugal Program, School of Engineering, University of Minho, 4800-058 Guimarães, Portugal
| | - Joana Figueiredo
- Center for MicroElectroMechanical Systems, University of Minho, 4800-058 Guimarães, Portugal
- LABBELS—Associate Laboratory, 4710-057 Braga, Portugal
- LABBELS—Associate Laboratory, 4800-058 Guimarães, Portugal
| | - Cristina P. Santos
- Center for MicroElectroMechanical Systems, University of Minho, 4800-058 Guimarães, Portugal
- LABBELS—Associate Laboratory, 4710-057 Braga, Portugal
- LABBELS—Associate Laboratory, 4800-058 Guimarães, Portugal
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McCrum C, Bhatt TS, Gerards MHG, Karamanidis K, Rogers MW, Lord SR, Okubo Y. Perturbation-based balance training: Principles, mechanisms and implementation in clinical practice. Front Sports Act Living 2022; 4:1015394. [PMID: 36275443 PMCID: PMC9583884 DOI: 10.3389/fspor.2022.1015394] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/20/2022] [Indexed: 02/05/2023] Open
Abstract
Since the mid-2000s, perturbation-based balance training has been gaining interest as an efficient and effective way to prevent falls in older adults. It has been suggested that this task-specific training approach may present a paradigm shift in fall prevention. In this review, we discuss key concepts and common issues and questions regarding perturbation-based balance training. In doing so, we aim to provide a comprehensive synthesis of the current evidence on the mechanisms, feasibility and efficacy of perturbation-based balance training for researchers and practitioners. We address this in two sections: "Principles and Mechanisms" and "Implementation in Practice." In the first section, definitions, task-specificity, adaptation and retention mechanisms and the dose-response relationship are discussed. In the second section, issues related to safety, anxiety, evidence in clinical populations (e.g., Parkinson's disease, stroke), technology and training devices are discussed. Perturbation-based balance training is a promising approach to fall prevention. However, several fundamental and applied aspects of the approach need to be further investigated before it can be widely implemented in clinical practice.
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Affiliation(s)
- Christopher McCrum
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Tanvi S. Bhatt
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois, Chicago, IL, United States
| | - Marissa H. G. Gerards
- Department of Epidemiology, Care and Public Health Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
- Department of Physiotherapy, Maastricht University Medical Center (MUMC+), Maastricht, Netherlands
| | - Kiros Karamanidis
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, London, United Kingdom
| | - Mark W. Rogers
- Department of Physical Therapy and Rehabilitation Science, School of Medicine, University of Maryland, Baltimore, MD, United States
| | - Stephen R. Lord
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Yoshiro Okubo
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
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12
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Role of Knee and Ankle Extensors' Muscle-Tendon Properties in Dynamic Balance Recovery from a Simulated Slip. SENSORS 2022; 22:s22093483. [PMID: 35591172 PMCID: PMC9104373 DOI: 10.3390/s22093483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/24/2022] [Accepted: 04/29/2022] [Indexed: 02/05/2023]
Abstract
Participants exposed to a simulated slip with forward loss of balance (FLB) develop large lower limb joint moments which may be a limiting factor for those whose muscle-tendon units’ (MTUs) properties are deteriorated. Whether the age-related decline in these properties limits participants’ capacity to recover their balance following a slip with FLB remains unclear. We combined isokinetic dynamometry, ultrasound and EMG to understand how knee extensor and ankle plantarflexor muscle strength and power, rate of moment development, electromechanical delay, and tendon stiffness affected the balance of young (25.3 ± 3.9 years) and older adults (62.8 ± 7.1 years) when recovering from a single slip with FLB triggered whilst walking on a split-belt instrumented treadmill. Except for the patellar tendon’s stiffness, knee extensor and ankle plantarflexor electromechanical delays, older adults’ MTUs properties were deteriorated compared to those of young participants (p < 0.05). We found no significant relationship between age or the MTUs properties of participants and balance recovery. These findings provide additional support that neither maximal nor explosive strength training are likely to be successful in preventing a fall for healthy older adults, and that other type of interventions, such as task-specific training that has already proved efficacious in reducing the risk of falling, should be developed.
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13
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König M, Santuz A, Epro G, Werth J, Arampatzis A, Karamanidis K. Differences in muscle synergies among recovery responses limit inter-task generalisation of stability performance. Hum Mov Sci 2022; 82:102937. [PMID: 35217390 DOI: 10.1016/j.humov.2022.102937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 01/24/2022] [Accepted: 02/13/2022] [Indexed: 11/28/2022]
Abstract
Generalisation of adaptations is key to effective stability control facing variety of postural threats during daily life activity. However, in a previous study we could demonstrate that adaptations to stability control do not necessarily transfer to an untrained motor task. Here, we examined the dynamic stability and modular organisation of motor responses to different perturbations (i.e. unpredictable gait-trip perturbations and subsequent loss of anterior stability in a lean-and-release protocol) in a group of young and middle-aged adults (n = 57; age range 19-53 years) to detect potential neuromotor factors limiting transfer of adaptations within the stability control system. We hypothesized that the motor system uses different modular organisation in recovery responses to tripping and lean-and-release, which may explain lack in positive transfer of adaptations in stability control. After eight trip-perturbations participants increased their dynamic stability during the first recovery step (p < 0.001), yet they showed no significant improvement to the untrained lean-and-release transfer task compared to controls who did not undergo the perturbation exposure (p = 0.44). Regarding the neuromuscular control of responses, lower number of synergies (3 vs. 4) was found for the lean-and-release compared to the gait-trip perturbation task, revealing profound differences in both the timing and function of the recruited muscles to match the biomechanical specificity of different perturbations. Our results provide indirect evidence that the motor system uses different modular organisation in diverse perturbation responses, what possibly inhibits inter-task generalisation of adaptations in stability control.
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Affiliation(s)
- Matthias König
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, SE1 0AA London, United Kingdom.
| | - Alessandro Santuz
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, 10117 Berlin, Germany; Berlin School of Movement Science, Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Gaspar Epro
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, SE1 0AA London, United Kingdom
| | - Julian Werth
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, SE1 0AA London, United Kingdom
| | - Adamantios Arampatzis
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, 10117 Berlin, Germany; Berlin School of Movement Science, Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Kiros Karamanidis
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, SE1 0AA London, United Kingdom
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14
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Head-Mounted and Hand-Held Displays Diminish the Effectiveness of Fall-Resisting Skills. SENSORS 2022; 22:s22010344. [PMID: 35009886 PMCID: PMC8749840 DOI: 10.3390/s22010344] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/23/2021] [Accepted: 12/28/2021] [Indexed: 02/04/2023]
Abstract
Use of head-mounted displays (HMDs) and hand-held displays (HHDs) may affect the effectiveness of stability control mechanisms and impair resistance to falls. This study aimed to examine whether the ability to control stability during locomotion is diminished while using HMDs and HHDs. Fourteen healthy adults (21–46 years) were assessed under single-task (no display) and dual-task (spatial 2-n-back presented on the HMD or the HHD) conditions while performing various locomotor tasks. An optical motion capture system and two force plates were used to assess locomotor stability using an inverted pendulum model. For perturbed standing, 57% of the participants were not able to maintain stability by counter-rotation actions when using either display, compared to the single-task condition. Furthermore, around 80% of participants (dual-task) compared to 50% (single-task) showed a negative margin of stability (i.e., an unstable body configuration) during recovery for perturbed walking due to a diminished ability to increase their base of support effectively. However, no evidence was found for HMDs or HHDs affecting stability during unperturbed locomotion. In conclusion, additional cognitive resources required for dual-tasking, using either display, are suggested to result in delayed response execution for perturbed standing and walking, consequently diminishing participants’ ability to use stability control mechanisms effectively and increasing the risk of falls.
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15
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McCrum C, Vaes AW, Delbressine JM, Koopman M, Liu WY, Willems P, Meijer K, Spruit MA. A pilot study on the feasibility and effectiveness of treadmill-based perturbations for assessing and improving walking stability in chronic obstructive pulmonary disease. Clin Biomech (Bristol, Avon) 2022; 91:105538. [PMID: 34823220 DOI: 10.1016/j.clinbiomech.2021.105538] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 10/22/2021] [Accepted: 11/17/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Falls risk is elevated in chronic obstructive pulmonary disease (COPD). However, there is a lack of evidence regarding the contributing factors. Here, we examined the feasibility of, and initial responses to, large walking perturbations in COPD, as well as the adaptation potential of people with COPD to repeated walking perturbations that might indicate potential for perturbation-based balance training in COPD. METHODS 12 participants with COPD undergoing inpatient pulmonary rehabilitation and 12 age-gender-matched healthy control participants walked on an instrumented treadmill and experienced repeated treadmill-belt acceleration perturbations (leading to a forward balance loss). Three-dimensional motion capture was used to quantify the stability of participants body position during perturbed walking. Feasibility, stability following the initial perturbations and adaptation to repeated perturbations were assessed. FINDINGS Using perturbations in this manner was feasible in this population (no harness assists and participants completed the minimum number of perturbations). No clear, specific deficit in reactive walking stability in COPD was found (no significant effects of participant group on stability or recovery step outcomes). There were mixed results for the adaptability outcomes which overall indicated some adaptability to repeated perturbations, but not to the same extent as the healthy control participants. INTERPRETATION Treadmill-based perturbations during walking are feasible in COPD. COPD does not appear to result in significant deficits in stability following sudden perturbations and patients do demonstrate some adaptability to repeated perturbations. Perturbation-based balance training may be considered for fall prevention in research and practice in people with COPD.
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Affiliation(s)
- Christopher McCrum
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands.
| | - Anouk W Vaes
- Research and Development, CIRO, Horn, the Netherlands
| | | | - Maud Koopman
- Research and Development, CIRO, Horn, the Netherlands; Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Wai-Yan Liu
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands; Research and Development, CIRO, Horn, the Netherlands; Department of Orthopaedic Surgery, Máxima Medical Center, Eindhoven, the Netherlands; Department of Orthopaedic Surgery, Catharina Hospital, Eindhoven, the Netherlands
| | - Paul Willems
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Kenneth Meijer
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Martijn A Spruit
- Research and Development, CIRO, Horn, the Netherlands; Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands
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16
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Debelle H, Maganaris CN, O'Brien TD. Biomechanical Mechanisms of Improved Balance Recovery to Repeated Backward Slips Simulated by Treadmill Belt Accelerations in Young and Older Adults. Front Sports Act Living 2021; 3:708929. [PMID: 34622205 PMCID: PMC8490723 DOI: 10.3389/fspor.2021.708929] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 08/20/2021] [Indexed: 11/13/2022] Open
Abstract
Aim: Exposure to repeated gait perturbations improves the balance of older adults (OAs) and decreases their risks of falling, but little is known about the underpinning mechanical adjustments. We aimed to quantify the changing temporo-spatial and kinetic characteristics of balance recovery following repeated backward slips to better understand the mechanical adjustments responsible for improved balance. Methods: We exposed 17 young adults (YAs) (25.2 ± 3.7 years) and 17 OAs (62.4 ± 6.6 years) to 10 backward slips simulated on an instrumented treadmill by unilateral backward belt accelerations. We measured the balance of the participants (margin of stability: MoS), balance recovery (nsteps: number of steps necessary to return to a steady gait for at least three consecutive steps), temporo-spatial (step length), and kinetics [ground reaction force (GRF) angle, lower limb joint moments] for 15 steps following each slip. The results were compared with baseline. Results: Participants in both groups improved their MoS and nsteps with repeated exposure to the slips, but no significant effect of age was detected. During the perturbed step, the GRF vector was directed more posteriorly during mid-stance and more anteriorly during push-off than baseline, which resulted in a longer step. These adjustments were maintained from the first (Slip01) to the last (Slip10) slip, and by Slip10 were correlated with better balance (MoS) on the second recovery step. During the first recovery step following Slip01, participants developed lower plantarflexor and larger knee extensor moments whilst taking a shorter step, these adjustments were correlated with poorer balance and were not maintained with repeated slips. Joint moments and step length of the first recovery step returned to normal levels by Slip10. Conclusion: Young adults and OAs improved their balance with repeated slips. The adjustments that were positively correlated with balance (changes in step length, GRF angle) were maintained whilst those that were not (changes in joint moments) were discarded. All the responses observed in Slip10 were observed in Slip01. The observed balance improvements were achieved by refining the initial strategy rather than by developing a new one. The underlying mechanics were correlated with step length of the first recovery steps, which was associated with balance and should be monitored in fall prevention interventions.
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Affiliation(s)
- Héloïse Debelle
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Constantinos N Maganaris
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Thomas D O'Brien
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
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17
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Bosquée J, Werth J, Epro G, Hülsdünker T, Potthast W, Meijer K, Ellegast R, Karamanidis K. The ability to increase the base of support and recover stability is limited in its generalisation for different balance perturbation tasks. Eur Rev Aging Phys Act 2021; 18:20. [PMID: 34615457 PMCID: PMC8493681 DOI: 10.1186/s11556-021-00274-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/17/2021] [Indexed: 11/10/2022] Open
Abstract
Background The assessment of stability recovery performance following perturbations contributes to the determination of fall resisting skills. This study investigated the association between stability recovery performances in two perturbation tasks (lean-and-release versus tripping). Methods Healthy adults (12 young: 24 ± 3 years; 21 middle-aged: 53 ± 5 years; 11 old: 72 ± 5 years) were suddenly released from a forward-inclined position attempting to recover stability with a single step. In a second task, all participants experienced a mechanically induced trip during treadmill walking. To assess dynamic stability performance, the antero-posterior margin of stability (MoS), the base of support (BoS), and the rate of increase in BoS were determined at each foot touchdown (TD) for both tasks. Results Only weak to moderate correlations in dynamic stability performance parameters were found between the two tasks (0.568 > r > 0.305, 0.001 < p < 0.04). A separation of participants according to the number of steps required to regain stability in the lean-and-release task revealed that multiple- (more than one step) compared to single-steppers showed a significantly lower MoS at TD (p = 0.003; g = 1.151), lower BoS at TD (p = 0.019; g = 0.888) and lower rate of increase in BoS until TD (p = 0.002; g = 1.212) after release. Despite these profound subgroup differences in the lean-and-release task, no differences between multiple- and single-steppers were observed in the stability recovery performance during tripping. Conclusion The results provide evidence that the ability to effectively control dynamic stability following a sudden balance disturbance in adults across a wide age range is limited in its generalisation for different perturbation tasks.
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Affiliation(s)
- Jil Bosquée
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, 103 Borough Road, SE1 0AA, London, UK
| | - Julian Werth
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, 103 Borough Road, SE1 0AA, London, UK
| | - Gaspar Epro
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, 103 Borough Road, SE1 0AA, London, UK
| | - Thorben Hülsdünker
- Department of Exercise and Sport Science, LUNEX International University of Health, Exercise and Sports, Differdange, Luxembourg
| | - Wolfgang Potthast
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, Cologne, Germany
| | - Kenneth Meijer
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, PO Box 616, 6200 MD, Maastricht, The Netherlands
| | - Rolf Ellegast
- Institute for Occupational Safety and Health of the German Social Accident Insurance (IFA), Sankt Augustin, Germany
| | - Kiros Karamanidis
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, 103 Borough Road, SE1 0AA, London, UK.
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18
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Sloot LH, Malheiros S, Truijen S, Saeys W, Mombaur K, Hallemans A, van Criekinge T. Decline in gait propulsion in older adults over age decades. Gait Posture 2021; 90:475-482. [PMID: 34619614 DOI: 10.1016/j.gaitpost.2021.09.166] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 08/26/2021] [Accepted: 09/02/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Despite strong evidence that walking speed and forward propulsion decline with increasing age, their relationship is still poorly understood. While changes in the ankle and hip mechanics have been described, few studies have reported the effect of ageing on the whole leg's contribution to propulsion. RESEARCH QUESTION The aim of this study was to investigate age-related changes in the work performed by the leg on the center of mass (COM) push-off power during walking in adults aged 20-86 years. Specifically, we evaluated how deterioration in COM push-off power relates to changes in ankle and hip kinetics as well as age and walking speed. METHODS Motion, ground reaction forces and gastrocnemius muscle activity were recorded in 138 adults during overground walking at self-selected speed. Age-related differences in variables between decades were analyzed with an ANOVA, while the relation between COM push-off power and joint kinetic variables, as well as walking speed and biological age, was evaluated using correlations and multiple regression analysis. RESULTS From the age of 70 years and onwards, COM push-off power was significantly decreased. The decline in COM push-off power was mostly explained by a decline in average ankle push-off power (72 %), and to a lesser extent by peak hip extension moment (3 %). There was no re-distribution of ankle-to-hip push-off power. The decline in COM push-off power seemed more related to walking speed (explaining 54 % of the variance) than biological age (only 4 %). SIGNIFICANCE Findings indicate that age-related decline in COM push-off power in able-bodied adults starts from the age of 70 years, which is before changes have been found in kinematics, but still later than generally presumed. This decrease in push-off power was more related to walking speed than biological age, which emphasizes the need to better understand the reason for speed decline in older adults.
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Affiliation(s)
- Lizeth H Sloot
- ORB Lab, Institute of Computer Engineering (ZITI), Heidelberg University, Heidelberg, Germany.
| | - Susanne Malheiros
- ORB Lab, Institute of Computer Engineering (ZITI), Heidelberg University, Heidelberg, Germany.
| | - Steven Truijen
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Belgium.
| | - Wim Saeys
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Belgium; RevArte Rehabilitation Hospital, Edegem, Antwerp, Belgium.
| | - Katja Mombaur
- ORB Lab, Institute of Computer Engineering (ZITI), Heidelberg University, Heidelberg, Germany; Department of Systems Design Engineering & Department of Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, Canada.
| | - Ann Hallemans
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Belgium; Multidisciplinary Motor Centre Antwerp (M2OCEAN), University of Antwerp, Belgium.
| | - Tamaya van Criekinge
- Multidisciplinary Motor Centre Antwerp (M2OCEAN), University of Antwerp, Belgium; Department of Rehabilitation Sciences, KU Leuven Campus Bruges, Bruges, Belgium.
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19
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Song PYH, Sturnieks DL, Davis MK, Lord SR, Okubo Y. Perturbation-Based Balance Training Using Repeated Trips on a Walkway vs. Belt Accelerations on a Treadmill: A Cross-Over Randomised Controlled Trial in Community-Dwelling Older Adults. Front Sports Act Living 2021; 3:702320. [PMID: 34490425 PMCID: PMC8417700 DOI: 10.3389/fspor.2021.702320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/21/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Walkway and treadmill induced trips have contrasting advantages, for instance walkway trips have high-ecological validity whereas belt accelerations on a treadmill have high-clinical feasibility for perturbation-based balance training (PBT). This study aimed to (i) compare adaptations to repeated overground trips with repeated treadmill belt accelerations in older adults and (ii) determine if adaptations to repeated treadmill belt accelerations can transfer to an actual trip on the walkway. Method: Thirty-eight healthy community-dwelling older adults underwent one session each of walkway and treadmill PBT in a randomised crossover design on a single day. For both conditions, 11 trips were induced to either leg in pseudo-random locations interspersed with 20 normal walking trials. Dynamic balance (e.g., margin of stability) and gait (e.g., step length) parameters from 3D motion capture were used to examine adaptations in the walkway and treadmill PBT and transfer of adaptation from treadmill PBT to a walkway trip. Results: No changes were observed in normal (no-trip) gait parameters in both training conditions, except for a small (0.9 cm) increase in minimum toe elevation during walkway walks (P < 0.01). An increase in the margin of stability and recovery step length was observed during walkway PBT (P < 0.05). During treadmill PBT, an increased MoS, step length and decreased trunk sway range were observed (P < 0.05). These adaptations to treadmill PBT did not transfer to a walkway trip. Conclusions: This study demonstrated that older adults could learn to improve dynamic stability by repeated exposure to walkway trips as well as treadmill belt accelerations. However, the adaptations to treadmill belt accelerations did not transfer to an actual trip. To enhance the utility of treadmill PBT for overground trip recovery performance, further development of treadmill PBT protocols is recommended to improve ecological authenticity.
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Affiliation(s)
- Patrick Y H Song
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW, Australia.,Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Daina L Sturnieks
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW, Australia.,Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Michael K Davis
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW, Australia.,College of Health Sciences, University of Delaware, Newark, DE, United States
| | - Stephen R Lord
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW, Australia.,Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Yoshiro Okubo
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW, Australia.,Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
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20
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Deng L, Zhang X, Xiao S, Wang B, Fu W. Gender Difference in Architectural and Mechanical Properties of Medial Gastrocnemius-Achilles Tendon Unit In Vivo. Life (Basel) 2021; 11:life11060569. [PMID: 34204461 PMCID: PMC8234309 DOI: 10.3390/life11060569] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 06/15/2021] [Accepted: 06/15/2021] [Indexed: 12/19/2022] Open
Abstract
This study aims to explore whether gender differences exist in the architectural and mechanical properties of the medial gastrocnemius–Achilles tendon unit (gMTU) in vivo. Thirty-six healthy male and female adults without training experience and regular exercise habits were recruited. The architectural and mechanical properties of the gMTU were measured via an ultrasonography system and MyotonPRO, respectively. Independent t-tests were utilized to quantify the gender difference in the architectural and mechanical properties of the gMTU. In terms of architectural properties, the medial gastrocnemius (MG)’s pennation angle and thickness were greater in males than in females, whereas no substantial gender difference was observed in the MG’s fascicle length; the males possessed Achilles tendons (ATs) with a longer length and a greater cross-sectional area than females. In terms of mechanical properties, the MG’s vertical stiffness was lower and the MG’s logarithmic decrement was greater in females than in males. Both genders had no remarkable difference in the AT’s vertical stiffness and logarithmic decrement. Gender differences of individuals without training experience and regular exercise habits exist in the architectural and mechanical properties of the gMTU in vivo. The MG’s force-producing capacities, ankle torque, mechanical efficiency and peak power were higher in males than in females. The load-resisting capacities of AT were greater and the MG strain was lesser in males than in females. These findings suggest that males have better physical fitness, speed and performance in power-based sports events than females from the perspective of morphology and biomechanics.
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Affiliation(s)
- Liqin Deng
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China; (L.D.); (X.Z.); (S.X.); (B.W.)
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai 200438, China
| | - Xini Zhang
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China; (L.D.); (X.Z.); (S.X.); (B.W.)
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai 200438, China
| | - Songlin Xiao
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China; (L.D.); (X.Z.); (S.X.); (B.W.)
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai 200438, China
| | - Baofeng Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China; (L.D.); (X.Z.); (S.X.); (B.W.)
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai 200438, China
| | - Weijie Fu
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China; (L.D.); (X.Z.); (S.X.); (B.W.)
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai 200438, China
- Correspondence: ; Tel.: +86-21-6550-7368
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21
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Tomlinson DJ, Erskine RM, Morse CI, Pappachan JM, Sanderson-Gillard E, Onambélé-Pearson GL. The combined effects of obesity and ageing on skeletal muscle function and tendon properties in vivo in men. Endocrine 2021; 72:411-422. [PMID: 33484409 PMCID: PMC8128745 DOI: 10.1007/s12020-020-02601-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/24/2020] [Indexed: 02/08/2023]
Abstract
PURPOSE We investigated the combined impact of ageing and obesity on Achilles tendon (AT) properties in vivo in men, utilizing three classification methods of obesity. METHOD Forty healthy, untrained men were categorised by age (young (18-49 years); older (50-80 years)), body mass index (BMI; normal weight (≥18.5-<25); overweight (≥25-<30); obese (≥30)), body fat% (normal adipose (<28%); high adiposity (≥28%)) and fat mass index (FMI; normal (3-6); excess fat (>6-9); high fat (>9). Assessment of body composition used dual-energy X-ray absorptiometry, gastrocnemius medialis (GM)/AT properties used dynamometry and ultrasonography and endocrine profiling used multiplex luminometry. RESULTS Older men had lower total range of motion (ROM; -11%; P = 0.020), GM AT force (-29%; P < 0.001), stiffness (-18%; P = 0.041), Young's modulus (-22%; P = 0.011) and AT stress (-28%; P < 0.001). All three methods of classifying obesity revealed obesity to be associated with lower total ROM (P = 0.014-0.039). AT cross sectional area (CSA) was larger with higher BMI (P = 0.030). However, after controlling for age, higher BMI only tended to be associated with greater tendon stiffness (P = 0.074). Interestingly, both AT CSA and stiffness were positively correlated with body mass (r = 0.644 and r = 0.520) and BMI (r = 0.541 and r = 0.493) in the young but not older adults. Finally, negative relationships were observed between AT CSA and pro-inflammatory cytokines TNF-α, IL-6 and IL-1β. CONCLUSIONS This is the first study to provide evidence of positive adaptations in tendon stiffness and size in vivo resulting from increased mass and BMI in young but not older men, irrespective of obesity classification.
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Affiliation(s)
- David J Tomlinson
- Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, UK.
| | - Robert M Erskine
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Liverpool, UK
- Institute of Sport, Exercise & Health, University College London, London, UK
| | - Christopher I Morse
- Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, UK
| | - Joseph M Pappachan
- Department of Endocrinology and Metabolism, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - Emmanuel Sanderson-Gillard
- Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, UK
| | - Gladys L Onambélé-Pearson
- Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, UK
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22
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Tavakkoli Oskouei S, Malliaras P, Jansons P, Hill K, Soh SE, Jaberzadeh S, Perraton L. Is Ankle Plantar Flexor Strength Associated With Balance and Walking Speed in Healthy People? A Systematic Review and Meta-Analysis. Phys Ther 2021; 101:6106269. [PMID: 33481996 DOI: 10.1093/ptj/pzab018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 12/01/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the association between ankle plantar flexor muscle (PF) strength and balance and walking speed in healthy adults. METHODS Four databases (Ovid MEDLINE, Ovid EMBASE, CINAHL Plus, and SPORTDiscus) were searched from inception to December 2019. Studies with any design were included if the association between PF strength and balance and walking speed was investigated among healthy adults. Articles were screened for eligibility independently by 2 reviewers. Study characteristics and Pearson r values derived from the association between PF strength and balance and walking speed were extracted. Thirty-four studies were eligible. The main group of interest in the studies was older adults. Pearson r values were transformed to rz values using Fisher z-transformation. Meta-analysis of rz values was conducted and then back-transformed to r. RESULTS In older adults, PF maximal isometric strength had a positive weak association with static balance (r = 0.20; 95% CI = 0.08-0.32), a positive moderate association with dynamic reactive balance (r = 0.42; 95% CI = 0.32-0.57) and proactive balance (r = 0.55; 95% CI = 0.18-1.06), and a positive weak association with preferred walking speed (r = 0.29; 95% CI = 0.19-0.41) and maximum walking speed (r = 0.34; 95% CI = 0.06-0.63). In younger adults, there was a moderate association between early-phase PF rate of torque development and reactive balance (0.42 < r < 0.52). CONCLUSIONS PF strength appears to be moderately associated with dynamic reactive and proactive balance and weakly associated with static balance and walking speed. This finding highlights the potential role of PF strength in dynamic reactive and proactive balance. IMPACT This meta-analysis showed that ankle PF strength might be important for challenging dynamic balance tasks.
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Affiliation(s)
- Sanam Tavakkoli Oskouei
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Peter Malliaras
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Paul Jansons
- Bone and Muscle Health Research Group, School of Clinical Sciences at Monash Health, Monash Medical Centre, Victoria, Australia
| | - Keith Hill
- Ageing and Independent Living (RAIL) Research Centre, Monash University, Victoria, Australia
| | - Sze-Ee Soh
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia.,Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Shapour Jaberzadeh
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Luke Perraton
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
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23
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Debelle H, Harkness-Armstrong C, Hadwin K, Maganaris CN, O'Brien TD. Recovery From a Forward Falling Slip: Measurement of Dynamic Stability and Strength Requirements Using a Split-Belt Instrumented Treadmill. Front Sports Act Living 2020; 2:82. [PMID: 33345073 PMCID: PMC7739594 DOI: 10.3389/fspor.2020.00082] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 05/28/2020] [Indexed: 11/13/2022] Open
Abstract
Aim: Falls commonly occur from trips and slips while walking. Recovery strategies from trips and backward falling slips have been extensively studied. However, until recently, forward falling slips (FFSs) have been considered less dangerous and have been understudied. This study aimed first to create an application to realistically simulate FFSs using a split-belt instrumented treadmill and then to understand the biomechanical requirements for young adults to recover from an FFS. Methods: We developed a semi-automatic custom-made application on D-Flow that triggered FFSs by briefly and unexpectedly increasing the speed (a = 5 m·s-2) of the right belt during stance. To validate the protocol, we tested against criteria defined for an ecologically and experimentally valid FFS: unexpected occurrence of the slip, increased foot velocity, forward loss of balance during the slip and consistent perturbation timing. We evaluated the recovery strategies of 17 young adults by measuring dynamic stability, joint moments and ground reaction force (GRF) vector angles before, during and on 15 steps following the FFS. Results: The application successfully triggered FFSs, according to the criteria we defined. Participants' balance returned to normal for a minimum of three consecutive steps in 10.9 (7.0) steps. Recovery from the FFSs was characterised by larger hip flexor and knee extensor moments to support the centre of mass during the slip, and a longer first recovery step with large hip extensor moments to arrest the fall followed by large knee extensor moments to raise and advance the centre of mass into the next step (p < 0.001 compared with normal gait). Subsequent steps progressively returned to normal. Conclusion: This is the first study to experimentally simulate FFSs meeting the aforementioned criteria, and to measure their effects on the dynamic balance and kinetic parameters. The split-belt instrumented treadmill proved a promising tool to better study the mechanisms of falls and recovery. The required large hip and knee joint moments generally agree with findings on trips and backward falling slips and provide an indication of the functional capacities that should be targeted in fall-prevention interventions. These findings should be used to better understand and target the mechanisms of balance loss and falls in older adults following FFSs.
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Affiliation(s)
- Héloïse Debelle
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Carla Harkness-Armstrong
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Kathryn Hadwin
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Constantinos N Maganaris
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Thomas D O'Brien
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
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24
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Van Wouwe T, Ting LH, De Groote F. Interactions between initial posture and task-level goal explain experimental variability in postural responses to perturbations of standing balance. J Neurophysiol 2020; 125:586-598. [PMID: 33326357 DOI: 10.1152/jn.00476.2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Postural responses to similar perturbations of standing balance vary widely within and across subjects. Here, we identified two sources of variability and their interactions by combining experimental observations with computational modeling: differences in posture at perturbation onset across trials and differences in task-level goals across subjects. We first collected postural responses to unpredictable backward support-surface translations during standing in 10 young adults. We found that maximal trunk lean in postural responses to backward translations were highly variable both within subjects (mean of ranges = 28.3°) and across subjects (range of means = 39.9°). Initial center of mass (COM) position was correlated with maximal trunk lean during the response, but this relation was subject specific (R2 = 0.29-0.82). We then used predictive simulations to assess causal relations and interactions with task-level goal. Our simulations showed that initial posture explains the experimentally observed intrasubject variability with a more anterior initial COM position increasing the use of the hip strategy. Differences in task-level goal explain observed intersubject variability with prioritizing effort minimization leading to ankle strategies and prioritizing stability leading to hip strategies. Interactions between initial posture and task-level goal explain observed differences in intrasubject variability across subjects. Our findings suggest that variability in initial posture due to increased sway as observed in older adults might increase the occurrence of less stable postural responses to perturbations. Insight in factors causing movement variability will advance our ability to study the origin of differences between groups and conditions.NEW & NOTEWORTHY Responses to perturbations of standing balance vary both within and between individuals. By combining experimental observations with computational modeling, we identified causes of observed kinematic variability in healthy young adults. First, we found that trial-by-trial differences in posture at perturbation onset explain most of the kinematic variability observed within subjects. Second, we found that differences in prioritizing effort versus stability explained differences in the postural response as well as differences in trial-by-trial variability across subjects.
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Affiliation(s)
- Tom Van Wouwe
- Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Lena H Ting
- W.H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, Georgia.,Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University, Atlanta, Georgia
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25
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Chang TT, Li Z, Wang XQ, Zhang ZJ. Stiffness of the Gastrocnemius-Achilles Tendon Complex Between Amateur Basketball Players and the Non-athletic General Population. Front Physiol 2020; 11:606706. [PMID: 33362580 PMCID: PMC7758317 DOI: 10.3389/fphys.2020.606706] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 11/13/2020] [Indexed: 12/28/2022] Open
Abstract
Muscle and tendon stiffness are related to sports performance, tendinopathy, and tendon degeneration. However, the effects of habitual loading on muscle and tendon mechanical properties are unclear. Using amateur basketball players as examples, we investigated the effects of mechanical loading on the stiffness of the gastrocnemius–Achilles tendon (AT) complex in non-dominant and dominant lower limbs. Then, we evaluated the correlation between gastrocnemius and AT stiffness. Forty participants (20 amateur basketball players; 20 normal non-athletic persons) were recruited for this study. Stiffness of the gastrocnemius–AT complex was assessed using MyotonPRO at neutral position and 10° dorsiflexion of the ankle joint in participants from amateur basketball players and the non-athletic general population. Our results showed a greater stiffness of the gastrocnemius–AT complex in amateur basketball players than that in healthy non-athletic subjects at neutral position and 10° dorsiflexion of the ankle joint (P < 0.05). No significant difference in stiffness was found between the non-dominant and dominant lower limbs either in amateur basketball players or in generally healthy subjects (P > 0.05). A significant positive correlation was obtained between stiffness of the AT and medial gastrocnemius (MG) in amateur basketball players (neutral position: r = 0.726 and P = 0.001; dorsiflexion 10°: r = 0.687 and P = 0.001). The amateur basketball players exhibit significantly higher stiffness value in Achilles and gastrocnemius. This is possibly caused by repeated training effects. The symmetric stiffness of the AT and gastrocnemius exists both in amateur basketball players and generally healthy subjects. A significant correlation between the AT and the MG was found in amateur basketball players.
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Affiliation(s)
- Tian-Tian Chang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Zhe Li
- The First Clinical Medical School, Shaanxi University of Chinese Medicine, Xi'an, China
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Zhi-Jie Zhang
- Rehabilitation Therapy Center, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Luoyang, China
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26
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Abstract
Falls are the leading cause of injury related death in older adults. In this piece, a motor learning lens is applied to falls, and falls are viewed as three interdependent phases: 1) destabilization, 2) descent, and 3) impact. This review examines how movements can be performed in the descent and impact phases to potentially reduce fall-related injuries. The evidence that movements performed during the descent and impact phases are voluntary motor skills that can be learned by older adults is reviewed. Data from young adult and older adult studies suggest that safe landing strategies can reduce impact force, are voluntary, and are learnable. In conclusion, safe landing strategies may provide a complimentary approach to reduce fall-related injuries.
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Affiliation(s)
- Katherine L Hsieh
- Motor Control Research Laboratory, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, IL, USA
| | - Jacob J Sosnoff
- Motor Control Research Laboratory, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, IL, USA
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27
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Massot C, Guyot MA, Donze C, Simoneau E, Gillet C, Leteneur S. Ankle dysfunction in multiple sclerosis and the effects on walking. Disabil Rehabil 2019; 43:2454-2463. [PMID: 31854195 DOI: 10.1080/09638288.2019.1702726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE Even in the early stage of the disease, for patients suffering from multiple sclerosis (MS), the most common and reported biomechanical alterations in the lower limb are located at the ankle joint. However, the effects of these impairments on gait deterioration should be discussed. MATERIALS AND METHODS This review was written according to the PRISMA guidelines. The search focussed on biomechanical changes (kinetic, kinematic, and electromyographic data) at the ankle during gait in MS patients. The search was performed in the databases: Pubmed, Web of Science, and Cochrane Library. RESULTS Eleven studies were included. The reduction in the ankle range of motion (RoM) induced by increased cocontractions of the tibialis anterior and triceps surae muscles could be a compensatory strategy to improve body-weight support and balance during the stance phase. CONCLUSIONS Future rehabilitation programmes should consider the control of weight support at the ankle during gait training.Implications for rehabilitationThe ankle supports and stabilises the body during the stance phase of gait.The reduced ankle range of motion in multiple sclerosis (MS), even at an early stage of the disease, is due to cocontractions of tibialis anterior and triceps surae and could be a compensatory strategy to be more stable.Rehabilitation programmes for MS patients should focus on the control of body segments motion during the weight transfer above the ankle.
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Affiliation(s)
- Caroline Massot
- Service de Médecine Physique et de Réadaptation, Hôpital Saint Philibert, Lomme, France
| | - Marc-Alexandre Guyot
- Service de Médecine Physique et de Réadaptation, Hôpital Saint Philibert, Lomme, France
| | - Cécile Donze
- Service de Médecine Physique et de Réadaptation, Hôpital Saint Philibert, Lomme, France
| | - Emilie Simoneau
- Université Lille Nord de France, Lille, France.,UPHF, LAMIH, Valenciennes, France.,CNRS, UMR, Valenciennes, France
| | - Christophe Gillet
- Université Lille Nord de France, Lille, France.,UPHF, LAMIH, Valenciennes, France.,CNRS, UMR, Valenciennes, France
| | - Sébastien Leteneur
- Université Lille Nord de France, Lille, France.,UPHF, LAMIH, Valenciennes, France.,CNRS, UMR, Valenciennes, France
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28
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Older adults demonstrate interlimb transfer of reactive gait adaptations to repeated unpredictable gait perturbations. GeroScience 2019; 42:39-49. [PMID: 31776885 PMCID: PMC7031170 DOI: 10.1007/s11357-019-00130-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 10/22/2019] [Indexed: 11/29/2022] Open
Abstract
The ability to rapidly adjust gait to cope with unexpected mechanical perturbations declines with ageing. Previous studies, however, have not ensured that gait stability pre-perturbation was equivalent across participants or age groups which may have influenced the outcomes. In this study, we investigate if age-related differences in stability following gait perturbations remain when all participants walk with equivalent stability. We also examine if interlimb transfer of gait adaptations are observed in healthy older adults, by examining if adaptation to repeated perturbations of one leg can benefit stability recovery when the other leg is perturbed. During walking at their stability-normalised walking speeds (young: 1.32 ± 0.07 m/s; older: 1.31 ± 0.13 m/s; normalised to an average margin of stability of 0.05 m), 30 young and 28 older healthy adults experienced ten unpredictable treadmill belt accelerations (the first and last applied to the right leg, the others to the left leg). Using kinematic data, we assessed the margins of stability during unperturbed walking and the first eight post-perturbation recovery steps. Older adults required three more steps to recover during the first perturbation to each leg than the young adults. Yet, after repeated perturbations of the left leg, older adults required only one more step to recover. Interestingly, for the untrained right leg, the older adults could regain stability with three fewer steps, indicating interlimb transfer of the improvements. Age differences in reactive gait stability remain even when participants’ walk with equivalent stability. Furthermore, we show that healthy older adults can transfer improvements in balance recovery made during repeated perturbations to one limb to their recovery following a perturbation to the untrained limb.
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29
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König M, Epro G, Seeley J, Potthast W, Karamanidis K. Retention and generalizability of balance recovery response adaptations from trip perturbations across the adult life span. J Neurophysiol 2019; 122:1884-1893. [DOI: 10.1152/jn.00380.2019] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
For human locomotion, varying environments require adjustments of the motor system. We asked whether age affects gait balance recovery adaptation, its retention over months, and the transfer of adaptation to an untrained reactive balance task. Healthy adults (26 young, 27 middle-aged, and 25 older; average ages 24, 52, and 72 yr, respectively) completed two tasks. The primary task involved treadmill walking: either unperturbed (control; n = 39) or subject to unexpected trip perturbations (training; n = 39). A single trip perturbation was repeated after a 14-wk retention period. The secondary transfer task, before and after treadmill walking, involved sudden loss of balance in a lean-and-release protocol. For both tasks, the anteroposterior margin of stability (MoS) was calculated at foot touchdown. For the first (i.e., novel) trip, older adults required one more recovery step ( P = 0.03) to regain positive MoS compared with younger, but not middle-aged, adults. However, over several trip perturbations, all age groups increased their MoS for the first recovery step to a similar extent (up to 70%) and retained improvements over 14 wk, although a decay over time was found for older adults ( P = 0.002; middle-aged showing a tendency for decay: P = 0.076). Thus, although adaptability in reactive gait stability control remains effective across the adult life span, retention of adaptations over time appears diminished with aging. Despite these robust adaptations, the perturbation training group did not show superior improvements in the transfer task compared with age-matched controls (no differences in MoS changes), suggesting that generalizability of acquired fall-resisting skills from gait-perturbation training may be limited. NEW & NOTEWORTHY The human neuromotor system preserves its adaptability across the adult life span. However, although adaptability in reactive gait stability control remains effective as age increases, retention of recovery response adaptations over time appears to be reduced with aging. Furthermore, acquired fall-resisting skills from single-session perturbation training seem task specific, which may limit the generalizability of such training to the variety of real-life falls.
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Affiliation(s)
- Matthias König
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, London, United Kingdom
| | - Gaspar Epro
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, London, United Kingdom
| | - John Seeley
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, London, United Kingdom
| | - Wolfgang Potthast
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, Germany
| | - Kiros Karamanidis
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, London, United Kingdom
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30
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Karamanidis K, Epro G, McCrum C, König M. Improving Trip- and Slip-Resisting Skills in Older People: Perturbation Dose Matters. Exerc Sport Sci Rev 2019; 48:40-47. [DOI: 10.1249/jes.0000000000000210] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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31
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König M, Epro G, Seeley J, Catalá-Lehnen P, Potthast W, Karamanidis K. Retention of improvement in gait stability over 14 weeks due to trip-perturbation training is dependent on perturbation dose. J Biomech 2019; 84:243-246. [DOI: 10.1016/j.jbiomech.2018.12.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 11/08/2018] [Accepted: 12/06/2018] [Indexed: 11/29/2022]
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32
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McCrum C, Karamanidis K, Willems P, Zijlstra W, Meijer K. Retention, savings and interlimb transfer of reactive gait adaptations in humans following unexpected perturbations. Commun Biol 2018; 1:230. [PMID: 30564751 PMCID: PMC6294781 DOI: 10.1038/s42003-018-0238-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 11/28/2018] [Indexed: 11/09/2022] Open
Abstract
Reactive locomotor adaptations are crucial for safe mobility, but remain relatively unexplored. Here we assess reactive gait adaptations, and their retention, savings and interlimb transfer. Using new methods to normalise walking speed and perturbation magnitude, we expose eighteen healthy adults to ten unexpected treadmill belt accelerations during walking (the first and last perturbing the right leg, the others perturbing the left leg) on two days, one month apart. Analysis of the margins of stability using kinematic data reveals that humans reactively adapt gait, improving stability and taking fewer recovery steps, and fully retain these adaptations over time. On re-exposure, retention and savings lead to further improvements in stability. Currently, the role of interlimb transfer is unclear. Our findings show that humans utilise retention and savings in reactive gait adaptations to benefit stability, but that interlimb transfer may not be exclusively responsible for improvements following perturbations to the untrained limb.
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Affiliation(s)
- Christopher McCrum
- 1Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, P.O. Box 616, Maastricht, 6200 MD The Netherlands.,2Institute of Movement and Sport Gerontology, German Sport University Cologne, Am Sportpark Müngersdorf 6, Cologne, 50933 Germany
| | - Kiros Karamanidis
- 3Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, 103 Borough Road, London, SE1 0AA UK
| | - Paul Willems
- 1Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, P.O. Box 616, Maastricht, 6200 MD The Netherlands
| | - Wiebren Zijlstra
- 2Institute of Movement and Sport Gerontology, German Sport University Cologne, Am Sportpark Müngersdorf 6, Cologne, 50933 Germany
| | - Kenneth Meijer
- 1Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, P.O. Box 616, Maastricht, 6200 MD The Netherlands
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33
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Epro G, Mierau A, McCrum C, Leyendecker M, Brüggemann GP, Karamanidis K. Retention of gait stability improvements over 1.5 years in older adults: effects of perturbation exposure and triceps surae neuromuscular exercise. J Neurophysiol 2018. [PMID: 29537914 DOI: 10.1152/jn.00513.2017] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
The plantarflexors play a crucial role in recovery from sudden disturbances to gait. The objective of this study was to investigate whether medium (months)- or long(years)-term exercise-induced enhancement of triceps surae (TS) neuromuscular capacities affects older adults' ability to retain improvements in reactive gait stability during perturbed walking acquired from perturbation training sessions. Thirty-four adult women (65 ± 7 yr) were recruited to a perturbation training group ( n = 13) or a group that additionally completed 14 wk of TS neuromuscular exercise ( n = 21), 12 of whom continued with the exercise for 1.5 yr. The margin of stability (MoS) was analyzed at touchdown of the perturbed step and the first recovery step following eight separate unexpected trip perturbations during treadmill walking. TS muscle-tendon unit mechanical properties and motor skill performance were assessed with ultrasonography and dynamometry. Two perturbation training sessions (baseline and after 14 wk) caused an improvement in the reactive gait stability to the perturbations (increased MoS) in both groups. The perturbation training group retained the reactive gait stability improvements acquired over 14 wk and over 1.5 yr, with a minor decay over time. Despite the improvements in TS capacities in the additional exercise group, no benefits for the reactive gait stability following perturbations were identified. Therefore, older adults' neuromotor system shows rapid plasticity to repeated unexpected perturbations and an ability to retain these adaptations in reactive gait stability over a long time period, but an additional exercise-related enhancement of TS capacities seems not to further improve these effects. NEW & NOTEWORTHY Older adults' neuromotor system shows rapid plasticity to repeated exposure to unexpected perturbations to gait and an ability to retain the majority of these adaptations in reactive recovery responses over a prolonged time period of 1.5 yr. However, an additional exercise-related enhancement of TS neuromuscular capacities is not necessarily transferred to the recovery behavior during unexpected perturbations to gait in older adults.
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Affiliation(s)
- G Epro
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University , United Kingdom.,Institute of Biomechanics and Orthopaedics, German Sport University Cologne , Cologne , Germany
| | - A Mierau
- Institute of Movement and Neurosciences, German Sport University Cologne , Cologne , Germany.,Department of Exercise and Sport Science, LUNEX International University of Health, Exercise and Sports, Differdange, Luxembourg
| | - C McCrum
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+ , Maastricht , The Netherlands.,Institute of Movement and Sport Gerontology, German Sport University Cologne , Cologne , Germany
| | - M Leyendecker
- Institute of Movement and Neurosciences, German Sport University Cologne , Cologne , Germany
| | - G-P Brüggemann
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne , Cologne , Germany.,Cologne Center for Musculoskeletal Biomechanics, Medical Faculty, University of Cologne , Cologne , Germany
| | - K Karamanidis
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University , United Kingdom
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