Conway Katie A, Bissette Randall G, Franz Jason R
University of North Carolina and North Carolina State University.
J Appl Biomech. 2018 Dec 1;34(6):474-482. doi: 10.1123/jab.2017-0389.
Aging and many gait pathologies are characterized by reduced propulsive forces and ankle moment and power generation during trailing leg push-off in walking. Despite those changes, we posit that many individuals retain an underutilized reserve for enhancing push-off intensity during walking that may be missed using conventional dynamometry. By using a maximum ramped impeding force protocol and maximum speed walking, we gained mechanistic insight into the factors that govern push-off intensity and the available capacity thereof during walking in young subjects. We discovered in part that young subjects walking at their preferred speed retain a reserve capacity for exerting larger propulsive forces of 49%, peak ankle power of 43%, and peak ankle moment of 22% during push-off-the latter overlooked by maximum isometric dynamometry. We also provide evidence that these reserve capacities are governed at least in part by the neuromechanical behavior of the plantarflexor muscles, at least with regard to ankle moment generation. We envision that a similar paradigm used to quantify propulsive reserves in older adults or people with gait pathology would empower the more discriminate and personalized prescription of gait interventions seeking to improve push-off intensity and thus walking performance.
衰老以及许多步态病理学特征表现为行走过程中后足蹬离时推进力、踝关节力矩及功率产生降低。尽管存在这些变化,但我们认为许多人在行走过程中仍保留着未充分利用的储备能力,可用于增强蹬离强度,而使用传统测力法可能会忽略这一点。通过采用最大斜坡阻力方案和最大速度行走,我们深入了解了年轻受试者行走过程中控制蹬离强度及其可用能力的因素。我们部分发现,以其偏好速度行走的年轻受试者在蹬离过程中保留了储备能力,可施加更大的推进力(49%)、峰值踝关节功率(43%)和峰值踝关节力矩(22%)——最大等长测力法忽略了后者。我们还提供了证据表明,这些储备能力至少部分受跖屈肌神经力学行为的控制,至少在踝关节力矩产生方面如此。我们设想,用于量化老年人或步态病理学患者推进储备的类似范式,将有助于更有针对性地、个性化地开具旨在改善蹬离强度从而提高行走性能的步态干预处方。