Achilles tendon loading is lower in older adults than young adults across a broad range of walking speeds.

Abstract

The purpose of this study was to investigate age-related differences in Achilles tendon loading during gait. Fourteen young (7F/7M, 26±5years) and older (7F/7M, 67±5years) adults without current neurological or orthopaedic impairment participated. Shear wave tensiometry was used to measure tendon stress by tracking Achilles tendon wave speed. The wave speed-stress relationship was calibrated using simultaneously collected tensiometer and force plate measures during a standing sway task. Tendon stress was computed from the force plate measures using subject-specific ultrasound measures of tendon moment arm and cross-sectional area. All subjects exhibited a highly linear relationship between wave speed squared and tendon stress (mean R2>0.9), with no significant age-group differences in tensiometer calibration parameters. Tendon wave speed was monitored during treadmill walking at four speeds (0.75, 1.00, 1.25, and 1.50m/s) and used to compute the stress experienced by the tendon. Relative to young adults, older adults exhibited 22% lower peak tendon wave speeds. Peak tendon stress during push-off in older adults (24.8MPa) was 32% less than that in the young adults (36.7MPa) (p=0.01). There was a moderate increase (+11%) in peak tendon stress across both groups when increasing speed from 0.75 to 1.50m/s (main effect of speed, p=0.01). Peak tendon loading during late swing did not differ between age groups (mean 3.8MPa in young and 4.2MPa in older adults). These age-related alterations in tendon tissue loading may affect the mechanobiological stimuli underlying tissue remodeling and thereby alter the propensity for tendon injury and disease.