Metabolic Energy Cost Of Walking Research Articles

Does human foot anthropometry relate to plantar flexor fascicle mechanics and metabolic energy cost across various walking speeds?

Foot structures define the leverage in which the ankle muscles push off against the ground during locomotion. While prior studies have indicated that inter-individual variation in anthropometry (e.g. heel and hallux lengths) can directly affect force production of ankle plantar flexor muscles, its effect on the metabolic energy cost of locomotion has been inconclusive. Here, we tested the hypotheses that shorter heels and longer halluces are associated with slower plantar flexor (soleus) shortening velocity and greater ankle plantar flexion moment, indicating enhanced force potential as a result of the force-velocity relationship. We also hypothesized that such anthropometry profiles would reduce the metabolic energy cost of walking at faster walking speeds. Healthy young adults (N=15) walked at three speeds (1.25, 1.75 and 2.00 m s-1), and we collected in vivo muscle mechanics (via ultrasound), activation (via electromyography) and whole-body metabolic energy cost of transport (via indirect calorimetry). Contrary to our hypotheses, shorter heels and longer halluces were not associated with slower soleus shortening velocity or greater plantar flexion moment. Additionally, longer heels were associated with reduced metabolic cost of transport, but only at the fastest speed (2.00ms-1, R2=0.305, P=0.033). We also found that individuals with longer heels required less increase in plantar flexor (soleus and gastrocnemius) muscle activation to walk at faster speeds, potentially explaining the reduced metabolic cost.

Developing an Optimized Low-Cost Transtibial Energy Storage and Release Prosthetic Foot Using Three-Dimensional Printing

Abstract This paper presents the results of an investigative study on the development of an affordable and functional prosthetic foot for below knee amputees. A prototype was successfully manufactured using three-dimensional (3D) printing technology. This continuously evolving technology enables the rapid production of prosthetics that are individually customized for each patient. Our prototype was developed after conducting a topology optimization study that interestingly converged to the shape of the biological human foot. Afterward, a design was envisioned where a simple energy storage and release (ESAR) mechanism was implemented to replace the Achilles tendon, which minimizes the metabolic energy cost of walking. Our mechanism can successfully manage 70% of the energy compared to a normal person during each walking step. A finite element (FE) model of the prosthetic was developed and validated using experimental tests. Then, this FE model was used to confirm the safe operation of the prosthetic through simulating different loading scenarios according to the ISO standard. A prototype was successfully tested by a healthy person using an adapter that was designed and 3D printed for this purpose. Our study clearly showed that customizable prosthetics could be produced at a fraction 1/60 of the cost of the commercially sold ones.

On the biological mechanics and energetics of the hip joint muscle–tendon system assisted by passive hip exoskeleton

Passive exoskeletons have potential advantages in reducing metabolic energy cost. We consider a passive elastic exoskeleton (peEXO) providing hip flexion moment to assist hip flexors during walking, our goal is to use a biomechanical model to explore the biological mechanics and energetics of the hip joint muscle–tendon–exotendon system for obtaining the optimum stiffness of this peEXO at the muscle-level. Based on our developed hip musculoskeletal model capable of replicating human-like behaviors, the hip peEXO is firstly abstracted as a spring (i.e. exotendon), we then simulate the peEXO assisted human walking over a series of stiffnesses, the biological muscle–tendon dynamics is optimally solved by minimizing the total metabolic cost of muscles. The simulation results are consistent with the experimental data of walking with an exoskeleton prototype. We find peEXO of minor stiffness helps reducing the muscle force, activation, and metabolic energy cost of hip flexors, especially the iliopsoas; while stiffer peEXO causes extra metabolic energy cost of antagonist muscles especially the gluteus maximus. With an optimum rotational stiffness of 350 Nm rad−1, the peEXO can reduce the metabolic energy cost of walking by ~7.1% and the hip joint muscles simultaneously have a 3% muscle efficiency promotion. The changes in muscle–tendon dynamics indicate it is more economical to assist the hip joint compared with the ankle joint, and periods of high muscle activation are ideal assistance phases for hip joint muscles. The modeling framework provides deep insights into the potential muscle-level mechanisms which are difficult to study via experiments alone, which is helpful to recover the mechanism of how energy cost is reduced under the external passive assistance and guide the design of passive hip EXOs.

THE EFFECTS OF PHYSICAL AND COGNITIVE TRAINING ON MOBILITY AND EXECUTIVE FUNCTIONS IN OLDER ADULTS

Studies suggest that physical exercise and cognitive training interventions can help improve cognitive functions and mobility in older adults. However, the specific impact of different types of exercise programs and cognitive training on mobility and cognition in sedentary older adults is not fully understood. To investigate this, 68 healthy sedentary participants over the age of 60 (M=68.58, SD=4.68) have been randomized to one of the three 12 weeks training programs (Aerobic (AE)=23, Motor Functions (MF)=24, Cognition(COG)=21). Before and after the training program, the participants underwent physical fitness tests (VO2Max; timed-up-and-go – TUG; metabolic energy cost of walking – MECW), and cognitive evaluations (MMSE, and a modified computerized Stroop task). The AE consisted of high intensity training on a recumbent bicycle. The MF consisted of full-body exercises focusing on coordination, balance, stretching, flexibility without raising the heart rate. The COG training consisted of Ipad exercises focusing on executive functions. Repeated measures ANOVAs revealed a mobility improvement in TUG in all three groups (F(1,65)=9.25, P<.00), an improvement in VO2Max only in the AE group (F(2,65)=4.68, P<.01), an improvement in MECW only in the HM group (F(2,65)=3.35, P<.04), an improvement in Stroop inhibition reaction time only in the COG and MF groups (F(2,65)=25.83, P<.00), and an improvement in Stroop switching reaction time in all groups, with the highest benefit in the COG group (F(2,65)=38.75, P<.00). The study shows that three separate training programs targeting specific mechanisms can improve mobility and confirms the beneficial effects of exercise on cognition.

Altered Achilles tendon function during walking in people with diabetic neuropathy: implications for metabolic energy saving.

The Achilles tendon (AT) has the capacity to store and release elastic energy during walking, contributing to metabolic energy savings. In diabetes patients, it is hypothesized that a stiffer Achilles tendon may reduce the capacity for energy saving through this mechanism, thereby contributing to an increased metabolic cost of walking (CoW). The aim of this study was to investigate the effects of diabetes and diabetic peripheral neuropathy (DPN) on the Achilles tendon and plantarflexor muscle-tendon unit behavior during walking. Twenty-three nondiabetic controls (Ctrl); 20 diabetic patients without peripheral neuropathy (DM), and 13 patients with moderate/severe DPN underwent gait analysis using a motion analysis system, force plates, and ultrasound measurements of the gastrocnemius muscle, using a muscle model to determine Achilles tendon and muscle-tendon length changes. During walking, the DM and particularly the DPN group displayed significantly less Achilles tendon elongation (Ctrl: 1.81; DM: 1.66; and DPN: 1.54 cm), higher tendon stiffness (Ctrl: 210; DM: 231; and DPN: 240 N/mm), and higher tendon hysteresis (Ctrl: 18; DM: 21; and DPN: 24%) compared with controls. The muscle fascicles of the gastrocnemius underwent very small length changes in all groups during walking (~0.43 cm), with the smallest length changes in the DPN group. Achilles tendon forces were significantly lower in the diabetes groups compared with controls (Ctrl: 2666; DM: 2609; and DPN: 2150 N). The results strongly point toward the reduced energy saving capacity of the Achilles tendon during walking in diabetes patients as an important factor contributing to the increased metabolic CoW in these patients. NEW & NOTEWORTHY From measurements taken during walking we observed that the Achilles tendon in people with diabetes and particularly people with diabetic peripheral neuropathy was stiffer, was less elongated, and was subject to lower forces compared with controls without diabetes. These altered properties of the Achilles tendon in people with diabetes reduce the tendon's energy saving capacity and contribute toward the higher metabolic energy cost of walking in these patients.

Exoskeleton plantarflexion assistance for elderly

Elderly are confronted with reduced physical capabilities and increased metabolic energy cost of walking. Exoskeletons that assist walking have the potential to restore walking capacity by reducing the metabolic cost of walking. However, it is unclear if current exoskeletons can reduce energy cost in elderly. Our goal was to study the effect of an exoskeleton that assists plantarflexion during push-off on the metabolic energy cost of walking in physically active and healthy elderly. Seven elderly (age 69.3±3.5y) walked on treadmill (1.11ms2) with normal shoes and with the exoskeleton both powered (with assistance) and powered-off (without assistance). After 20min of habituation on a prior day and 5min on the test day, subjects were able to walk with the exoskeleton and assistance of the exoskeleton resulted in a reduction in metabolic cost of 12% versus walking with the exoskeleton powered-off. Walking with the exoskeleton was perceived less fatiguing for the muscles compared to normal walking. Assistance resulted in a statistically nonsignificant reduction in metabolic cost of 4% versus walking with normal shoes, likely due to the penalty of wearing the exoskeleton powered-off. Also, exoskeleton mechanical power was relatively low compared to previously identified optimal assistance magnitude in young adults. Future exoskeleton research should focus on further optimizing exoskeleton assistance for specific populations and on considerate integration of exoskeletons in rehabilitation or in daily life. As such, exoskeletons should allow people to walk longer or faster than without assistance and could result in an increase in physical activity and resulting health benefits.

The metabolic cost of changing walking speeds is significant, implies lower optimal speeds for shorter distances, and increases daily energy estimates.

Humans do not generally walk at constant speed, except perhaps on a treadmill. Normal walking involves starting, stopping and changing speeds, in addition to roughly steady locomotion. Here, we measure the metabolic energy cost of walking when changing speed. Subjects (healthy adults) walked with oscillating speeds on a constant-speed treadmill, alternating between walking slower and faster than the treadmill belt, moving back and forth in the laboratory frame. The metabolic rate for oscillating-speed walking was significantly higher than that for constant-speed walking (6-20% cost increase for ±0.13-0.27 m s(-1) speed fluctuations). The metabolic rate increase was correlated with two models: a model based on kinetic energy fluctuations and an inverted pendulum walking model, optimized for oscillating-speed constraints. The cost of changing speeds may have behavioural implications: we predicted that the energy-optimal walking speed is lower for shorter distances. We measured preferred human walking speeds for different walking distances and found people preferred lower walking speeds for shorter distances as predicted. Further, analysing published daily walking-bout distributions, we estimate that the cost of changing speeds is 4-8% of daily walking energy budget.

Comparison of the metabolic energy cost of overground and treadmill walking in older adults

We assessed whether the metabolic energy cost of walking was higher when measured overground or on a treadmill in a population of healthy older adults. We also assessed the association between the two testing modes. Participants (n = 20, 14 men and 6 women aged between 65 and 83 years of age) were randomly divided into two groups. Half of them went through the overground-treadmill sequence while the other half did the opposite order. A familiarization visit was held for each participant prior to the actual testing. For both modes of testing, five walking speeds were experimented (0.67, 0.89, 1.11, 1.33 and 1.67 m s(-1)). Oxygen uptake was monitored for all walking speeds. We found a significant difference between treadmill and track metabolic energy cost of walking, whatever the walking speed. The results show that walking on the treadmill requires more metabolic energy than walking overground for all experimental speeds (P < 0.05). The association between both measures was low to moderate (0.17 < ICC < 0.65), and the standard error of measurement represented 6.9-15.7% of the average value. These data indicate that metabolic energy cost of walking results from a treadmill test does not necessarily apply in daily overground activities. Interventions aiming at reducing the metabolic energy cost of walking should be assessed with the same mode as it was proposed during the intervention. If the treadmill mode is necessary for any purposes, functional overground walking tests should be implemented to obtain a more complete and specific evaluation.

Mind your step: Metabolic energy cost while walking an enforced gait pattern

The energy cost of walking could be attributed to energy related to the walking movement and energy related to balance control. In order to differentiate between both components we investigated the energy cost of walking an enforced step pattern, thereby perturbing balance while the walking movement is preserved.Nine healthy subjects walked three times at comfortable walking speed on an instrumented treadmill. The first trial consisted of unconstrained walking. In the next two trials, subject walked while following a step pattern projected on the treadmill. The steps projected were either composed of the averaged step characteristics (periodic trial), or were an exact copy including the variability of the steps taken while walking unconstrained (variable trial).Metabolic energy cost was assessed and center of pressure profiles were analyzed to determine task performance, and to gain insight into the balance control strategies applied.Results showed that the metabolic energy cost was significantly higher in both the periodic and variable trial (8% and 13%, respectively) compared to unconstrained walking. The variation in center of pressure trajectories during single limb support was higher when a gait pattern was enforced, indicating a more active ankle strategy. The increased metabolic energy cost could originate from increased preparatory muscle activation to ensure proper foot placement and a more active ankle strategy to control for lateral balance. These results entail that metabolic energy cost of walking can be influenced significantly by control strategies that do not necessary alter global gait characteristics.

Anterior cruciate ligament reconstruction improves the metabolic energy cost of level walking at customary speeds

The metabolic energy cost of walking is altered by pathological changes in gait. It is thought that anterior cruciate ligament (ACL) deficiency alters the energy requirement for level walking through its effect on gait pattern. In this study, it is hypothesised that the metabolic energy cost of walking would improve after ACL reconstruction. Eight patients who were undergoing ACL reconstruction for an isolated rupture were included in this prospective study. Clinical examinations, Lysholm scores and metabolic tests were performed preoperatively and at 3, 6 and 12 months after ACL reconstruction using autologous quadruple hamstring tendons. For the metabolic evaluation, net oxygen cost was calculated while walking on a treadmill at 50-, 70- and 90-m/min velocities. A two-way factorial ANOVA was performed in order to evaluate the primary effects and interactions of the time point and velocity variables on net oxygen cost. All patients had positive Lachman and anterior drawer tests preoperatively that became negative postoperatively and remained negative until the last follow-up point. The mean preoperative Lysholm score was 66, whereas the mean postoperative follow-up scores were 85, 91 and 94, respectively. The interaction between follow-up time point and velocity was not significant. Regardless of the selected velocity, the net oxygen cost was lower than that at preoperative levels at each postoperative time point (p < 0.05). The results of the present study indicate that the energy cost of level walking in chronic ACL-deficient patients improves after ACL reconstruction. Cause-effect-based studies with correlation evaluations that compare kinetic, kinematic and electromyographic data and metabolic cost calculations should facilitate more accurate analyses. Therapeutic study, Level 4.

Metabolic cost and mechanical work during walking after tibiotalar arthrodesis and the influence of footwear

Background This study examined metabolic energy cost and external mechanical work for step-to-step transitions after tibiotalar arthrodesis, and the effect of MBT rocker bottom shoes. Methods Oxygen uptake, forceplate and kinematic data were recorded in 18 controls and 15 patients while walking at a fixed speed of 1.25 m/s in three walking conditions: barefoot, normal walking shoes and MBT rocker bottom shoes. Metabolic energy cost, external mechanical work, and the roll-over shape of the ankle–foot complex were analyzed. Findings Tibiotalar arthrodesis leads to higher metabolic energy cost during walking. During step-to-step transitions positive work during push-off with the impaired ankle was decreased but negative work during collision was not affected. The roll-over shape of the ankle–foot complex did not differ between groups and shoe conditions. However, both in patients and controls rocker bottom shoes did lead to decreased positive work at push-off and increased negative work at collision and consequently higher metabolic energy cost of walking. Interpretation External mechanical work for step-to-step transitions is not different between patients and controls and could not account for the higher metabolic energy cost in patients. Apparently, patients adopt a different walking strategy that limits step-to-step transition cost but nevertheless induces a higher metabolic energy cost. Despite restricted ankle movement, patients retain a normal roll-over shape of the ankle–foot complex. MBT shoes do not affect roll-over shape and appear to have a counterproductive effect on step-to-step transition cost and walking economy.

Ankle fixation need not increase the energetic cost of human walking

We tested whether the metabolic energy cost of walking with the ankles immobilized can be comparable to normal walking. Immobilization of any lower extremity joint usually causes greater energy expenditure. Fixation of the ankle might be expected to eliminate the work it normally performs, to detrimental effect. But fixation using lightweight boots with curved rocker bottoms can also bring some benefits, so that the overall energetic effect might be quite small. We measured oxygen consumption, kinematics, and ground reaction forces in six ( N = 6) able-bodied human volunteers walking at 1.25 m/s in three conditions: normal walking in street shoes, walking with ankles immobilized by walking boots, and normally with ankles free but also weighted to match the mass of the walking boots. We estimated metabolic energy expenditure, joint work, and overall work performed on the body center of mass as a function of ankle fixation. Ankle fixation with walking boots caused the total rate of energy expenditure for walking to increase by 4.1% compared to normal ( P = 0.003), but differed by an insignificant amount (0.4% less, P = 0.78) compared to walking with equivalent ankle weight. Compared to normal walking, ankle fixation can reduce ankle torque and work during the stance phase, most notably during late stance. This apparently makes up for the loss of ability to push-off as normal. With a suitably lightweight apparatus and curved rocker bottom surface, loss of ankle motion need not increase energy expenditure for walking.

Ergonomic effects of load carriage on the upper and lower back on metabolic energy cost of walking

We examined the effects of load carriage position on the energy cost of walking defined as the ratio of the 2-min steady-state oxygen consumption to the speed and economical speed. Fourteen healthy men walked on a treadmill at various speeds without and with load on the lower and upper back, which corresponded to 15% of their body mass. The energy cost of walking significantly decreased during walking with load than without load at slower speeds. A significant decrease in the energy cost of walking was also observed while carrying the load on the upper back than on the lower back at 60–80 m/min. The economical speed significantly decreased when carrying the load on the upper and lower back, and it was significantly correlated with body height. These findings suggest that an optimal carrying method is evident to reduce physical stress during walking with loads.

Effects of obesity and sex on the energetic cost and preferred speed of walking

The metabolic energy cost of walking is determined, to a large degree, by body mass, but it is not clear how body composition and mass distribution influence this cost. We tested the hypothesis that walking would be most expensive for obese women compared with obese men and normal-weight women and men. Furthermore, we hypothesized that for all groups, preferred walking speed would correspond to the speed that minimized the gross energy cost per distance. We measured body composition, maximal oxygen consumption, and preferred walking speed of 39 (19 class II obese, 20 normal weight) women and men. We also measured oxygen consumption and carbon dioxide production while the subjects walked on a level treadmill at six speeds (0.50-1.75 m/s). Both obesity and sex affected the net metabolic rate (W/kg) of walking. Net metabolic rates of obese subjects were only approximately 10% greater (per kg) than for normal-weight subjects, and net metabolic rates for women were approximately 10% greater than for men. The increase in net metabolic rate at faster walking speeds was greatest in obese women compared with the other groups. Preferred walking speed was not different across groups (1.42 m/s) and was near the speed that minimized gross energy cost per distance. Surprisingly, mass distribution (thigh mass/body mass) was not related to net metabolic rate, but body composition (% fat) was (r2= 0.43). Detailed biomechanical studies of walking are needed to investigate whether obese individuals adopt novel energy saving mechanisms during walking.

A feedback-controlled treadmill (treadmill-on-demand) and the spontaneous speed of walking and running in humans

A novel apparatus, composed by a controllable treadmill, a computer, and an ultrasonic range finder, is here proposed to help investigation of many aspects of spontaneous locomotion. The acceleration or deceleration of the subject, detected by the sensor and processed by the computer, is used to accelerate or decelerate the treadmill in real time. The system has been used to assess, in eight subjects, the self-selected speed of walking and running, the maximum "reasonable" speed of walking, and the minimum reasonable speed of running at different gradients (from level up to +25%). This evidenced the speed range at which humans neither walk nor run, from 7.2 +/- 0.6 to 8.4 +/- 1.1 km/h for level locomotion, slightly narrowing at steeper slopes. These data confirm previous results, obtained indirectly from stride frequency recordings. The self-selected speed of walking decreases with increasing gradient (from 5.0 +/- 0.8 km/h at 0% to 3.0 +/- 0.9 km/h at +25%) and seems to be approximately 30% higher than the speed that minimizes the metabolic energy cost of walking, obtained from the literature, at all the investigated gradients. The advantages, limitations, and potential applications of the newly proposed methodology in physiology, biomechanics, and pathology of locomotion are discussed in this paper.