Biomechanical Analysis of Gait Compensation Strategies as a Result of Muscle Restriction

Jessica Beltran Ullauri,Yoji Yamada,Shogo Okamoto,Yasuhiro Akiyama

doi:10.3390/app11188344

Jessica Beltran Ullauri, Yoji Yamada + Show 2 more

Open Access

https://doi.org/10.3390/app11188344

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Abstract

The loss of muscle mass with aging and consequent muscle weakness results in compensatory gait motions. Although these compensatory motions increase the cost of walking, they appear to be an attempt by the elderly to maintain safe ambulation. However, the relationship between the affected muscles and compensatory motions in the gait cycle is unclear. This study examined gait compensation in young subjects whose muscles were weakened with Muscle Activity Restriction Taping Technique, which restricts the muscle’s belly by tightening the lower limb(s). The study included different walking speeds (regular/slow) and restrictions (calf muscles/both calf and thigh muscles). It revealed that there was an active kinematic compensation chain, in which the non-restricted or less-restricted joints compensated for the affected joint to prevent foot drop, knee hyperextension in the terminal stance phase, and knee hyperflexion in the loading response phase, and to maintain the step length. Furthermore, joints could compensate for themselves when the muscles acting on the other joints were unable to assist, as observed on an ankle joint that compensated for itself to prevent foot drop when the knee and hip flexor muscles were restricted. Moreover, the observed compensation strategies agreed with a previously reported simulation on the gait compensations appearing along with muscle weakness. This study includes a comparison of these compensation strategies with those reported for the elderly. The results of this study provide an understanding of the mechanisms of gait compensation against limitations of gait ability.

Highlights

IntroductionWith the reduction of the lower-limb muscle mass, the gait suffers from several impairments because the loss of mass causes changes in the activity magnitude of the affected muscles and their periods of action along the gait cycle
The majority of the subjects (8 out of 10 subjects) compensated for the joint restriction with the non-restricted or less-restricted joints. This compensation behavior appeared to be independent of the order of the experimental trials and walking speeds
As a result of the muscle restriction with the Muscle Activity Restriction Taping Technique (MARTT), the majority of subjects exhibited motion compensation in the non-restricted joints. This compensation behavior agrees with the results reported in the gait simulations of Van der Krogt [17], who studied the effects of muscle weakness on human gait

Summary

Introduction

With the reduction of the lower-limb muscle mass, the gait suffers from several impairments because the loss of mass causes changes in the activity magnitude of the affected muscles and their periods of action along the gait cycle. A shorter range of activity of the GAS muscle has been reported in elderly with recurrent falls [9], and a lower activity of the same muscle has been found in the elderly during the late stance phase [10]. This last might explain the elderly less-powered ankle push-off [11]

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