Effects of Improved Calf Muscle Function on Gait, Balance and Joint Loading in Older Adults
- Conditions
- Mobility LimitationOsteoarthritis, KneeAccidental Fall
- Interventions
- Other: Gait retraining + strength trainingOther: Gait retraining
- Registration Number
- NCT03921801
- Lead Sponsor
- University of Eastern Finland
- Brief Summary
This study investigates the role of calf muscle function in gait performance, balance and knee joint loading.
Previous studies have linked age-related loss of calf muscle function with impairments in gait performance and balance, and increased loading of the areas of the knee joint that are susceptible to the development of osteoarthritis. In this study, an exercise intervention targeting structural and neural aspects of impaired calf muscle function with ageing is utilized. The intervention lasts 8 weeks and includes either biofeedback training using electromyography to alter muscle activation patterns or a combination of biofeedback training and strength training for the calf muscle to modify calf function during walking. The study will test whether the intervention improves walking speed, reduces the metabolic cost of walking, improves standing balance and reduces knee joint loading.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 30
- age between 65 and 75
- dependent living status
- not able to walk without an assistive device or for 30 min without stopping
- diagnosed neurological disease or joint disorder and pain during walking
- surgery on lower extremities
- current musculoskeletal injury
- previous cardiovascular event or symptoms during exercise (acute ECG change, coronary disease, symptomatic arrhythmia, symptomatic coronary stenosis, heart failure, myocarditis, pericarditis, pulmonary embolism, pulmonary infarct, artery bulge or rupture risk)
- body mass index <18 or >35 kg/m2
- contraindications for magnetic resonance imaging
- Mini Mental State Examination score of 23 points and lower
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Gait retraining + strength training Gait retraining + strength training 8-week intervention. Intervention includes weekly gait retraining sessions with real-time electromyography biofeedback and home-based strength training session for plantarflexor muscles three times per week. Gait retraining Gait retraining 8-week intervention. Intervention includes weekly gait retraining sessions with real-time electromyography biofeedback.
- Primary Outcome Measures
Name Time Method Change from baseline in knee joint loading within 1 weeks after intervention Change in tibiofemoral compressive loading during walking estimated using musculoskeletal modeling and simulation. Loading is calculated separately for medial and lateral compartments of the tibiofemoral joint.
- Secondary Outcome Measures
Name Time Method Change from baseline in joint moments during walking within 1 weeks after intervention Time series of lower limb joint moments during walking stride assessed using inverse dynamics based on motion capture system and instrumented treadmill data.
Change from baseline in walking speed within 1 weeks after intervention Preferred and maximal walking speed.
Change from baseline in muscle strength within 1 weeks after intervention Maximal isometric muscle strength in ankle plantarflexion and knee extension and flexion.
Change from baseline in joint powers during walking within 1 weeks after intervention Time series of lower limb joint powers during walking stride assessed using inverse dynamics based on motion capture system and instrumented treadmill data.
Change from baseline in distribution of joint work during walking within 1 weeks after intervention Distribution of total positive lower limb work between the joints during walking assessed using inverse dynamics based on motion capture system and instrumented treadmill data.
Change from baseline in energy cost of walking within 1 weeks after intervention Assessed using indirect calorimetry.
Change from baseline in Achilles tendon stiffness within 1 weeks after intervention Achilles tendon stiffness evaluated using combination of ultrasonography, motion analysis and force measurements.
Change from baseline in standing balance within 1 weeks after intervention Sway during standing measured using a force plate with eyes open and closed
Change from baseline in muscle-tendon function during walking within 1 weeks after intervention Muscle fascicle kinematics measured using dynamics ultrasonography during walking.
Change from baseline in soleus to gastrocnemius muscle activation ratio within 1 weeks after intervention Relative activation of soleus to medial gastrocnemius measured using electromyography.
Change from baseline in gait kinematics within 1 weeks after intervention Time series of lower limb joint angles during walking stride assessed using motion capture system and inverse kinematics.
Trial Locations
- Locations (1)
University of Eastern Finland
🇫🇮Kuopio, North Savo, Finland