Isolating the energetic and mechanical consequences of imposed reductions in ankle and knee flexion during gait
| Autor: | Theresa L. Libera, Matthew E. Berno, Gregory S. Sawicki, Michael D. Lewek, Emily M. McCain, Katherine R. Saul |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male musculoskeletal diseases 030506 rehabilitation Weakness medicine.medical_specialty Knee Joint medicine.medical_treatment Health Informatics Walking lcsh:RC321-571 Young Adult 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation Humans Medicine Biomechanics Knee Metabolic cost Range of Motion Articular lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry Gait Circumduction Rehabilitation business.industry Research musculoskeletal system Adaptation Physiological Brace Biomechanical Phenomena medicine.anatomical_structure Female Ankle medicine.symptom 0305 other medical science business Range of motion human activities Ankle Joint 030217 neurology & neurosurgery |
| Zdroj: | Journal of NeuroEngineering and Rehabilitation Journal of NeuroEngineering and Rehabilitation, Vol 18, Iss 1, Pp 1-13 (2021) |
| ISSN: | 1743-0003 |
| DOI: | 10.1186/s12984-021-00812-8 |
| Popis: | Background Weakness of ankle and knee musculature following injury or disorder results in reduced joint motion associated with metabolically expensive gait compensations to enable limb support and advancement. However, neuromechanical coupling between the ankle and knee make it difficult to discern independent roles of these restrictions in joint motion on compensatory mechanics and metabolic penalties. Methods We sought to determine relative impacts of ankle and knee impairment on compensatory gait strategies and energetic outcomes using an unimpaired cohort (N = 15) with imposed unilateral joint range of motion restrictions as a surrogate for reduced motion resulting from gait pathology. Participants walked on a dual-belt instrumented treadmill at 0.8 m s−1 using a 3D printed ankle stay and a knee brace to systematically limit ankle motion (restricted-ank), knee motion (restricted-knee), and ankle and knee motion (restricted-a + k) simultaneously. In addition, participants walked without any ankle or knee bracing (control) and with knee bracing worn but unrestricted (braced). Results When ankle motion was restricted (restricted-ank, restricted-a + k) we observed decreased peak propulsion relative to the braced condition on the restricted limb. Reduced knee motion (restricted-knee, restricted-a + k) increased restricted limb circumduction relative to the restricted-ank condition through ipsilateral hip hiking. Interestingly, restricted limb average positive hip power increased in the restricted-ank condition but decreased in the restricted-a + k and restricted-knee conditions, suggesting that locking the knee impeded hip compensation. As expected, reduced ankle motion, either without (restricted-ank) or in addition to knee restriction (restricted-a + k) yielded significant increase in net metabolic rate when compared with the braced condition. Furthermore, the relative increase in metabolic cost was significantly larger with restricted-a + k when compared to restricted-knee condition. Conclusions Our methods allowed for the reproduction of asymmetric gait characteristics including reduced propulsive symmetry and increased circumduction. The metabolic consequences bolster the potential energetic benefit of targeting ankle function during rehabilitation. Trial registration N/A. |
| Databáze: | OpenAIRE |
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