Gait analysis in chronic heart failure: The calf as a locus of impaired walking capacity
MetadataShow full item record
Reduced walking capacity, a hallmark of chronic heart failure (CHF), is strongly correlated with hospitalization and morbidity. The aim of this work was to perform a detailed biomechanical gait analysis to better identify mechanisms underlying reduced walking capacity in CHF. Inverse dynamic analyses were conducted in CHF patients and age- and exercise level-matched control subjects on an instrumented treadmill at self-selected treadmill walking speeds and at speeds representing +20% and –20% of the subjects’ preferred speed. Surprisingly, no difference in preferred speed was observed between groups, possibly explained by an optimization of the mechanical cost of transport in both groups (the mechanical cost to travel a given distance; J/kg/m). The majority of limb kinematics and kinetics were also similar between groups, with the exception of greater ankle dorsiflexion angles during stance in CHF. Nevertheless, over two times greater ankle plantarflexion work during stance and per distance traveled is required for a given triceps surae muscle volume in CHF patients. This, together with a greater reliance on the ankle compared to the hip to power walking in CHF patients, especially at faster speeds, may contribute to the earlier onset of fatigue in CHF patients. This observation also helps explain the high correlation between triceps surae muscle volume and exercise capacity that has previously been reported in CHF. Considering the key role played by the plantarflexors in powering walking and their association with exercise capacity, our findings strongly suggest that exercise-based rehabilitation in CHF should not omit the ankle muscle group.
Showing items related by title, author, creator and subject.
Turner, Sian Elizabeth (2009)Background and research questions. The characterization of chronic persistent asthma in an older adult population is not well defined. This is due to the difficulties in separating the diagnosis of asthma from that of ...
Brown, Annette (2002)Maintenance of physical function with advancing age is vital to continued independent living, which is highly valued by older people. Although commonly associated with the ageing process, loss of functional ability may ...
Soleus fascicle length changes are conserved between young and old adults at their preferred walking speedPanizzolo, F.; Green, D.; Lloyd, D.; Maiorana, Andrew; Rubenson, J. (2013)Older adults have been shown to naturally select a walking speed approximately 20% slower than younger adults. We explored the possibility that a reduction in preferred speed in older adults represents a strategy to ...