Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
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.
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Gait retraining | Active Comparator | 8-week intervention. Intervention includes weekly gait retraining sessions with real-time electromyography biofeedback. |
|
| Gait retraining + strength training | Experimental | 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. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Gait retraining | Other | Gait retraining using real-time electromyography biofeedback performed once per week for eight weeks. During the gait retraining session the participant is walking on a treadmill while receiving information on calf muscle activation. A single session includes five bouts of walking each lasting for 5 minutes. During the first bout, the participant is receiving feedback (visual and auditive) on soleus muscle activation with the aim to increase it by 20% from their normal walking. During the second bout, the participant is receiving feedback (visual and auditive) on medial gastrocnemius muscle activation with the aim to decrease it by 20% from their normal walking. During the last three bouts, the participant is receiving feedback (visual and auditive) on the soleus to medial gastrocnemius muscle activation ratio with the aim to increase it by 20% from their normal walking. If hitting the target, the aim is increased by 5% for the subsequent bout. |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline in knee joint loading | 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. | within 1 weeks after intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline in energy cost of walking | Assessed using indirect calorimetry. | within 1 weeks after intervention |
| Change from baseline in standing balance | Sway during standing measured using a force plate with eyes open and closed |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline in triceps surae fascicle lengths | Soleus and gastrocnemius muscle fascicle length assessed using ultrasound imaging. | within 1 weeks after intervention |
| Change from baseline in triceps surae fascicle pennation angle |
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Lauri Stenroth, PhD | University of Eastern Finland | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Eastern Finland | Kuopio | Northern Savonia | 70100 | Finland |
Data obtained during the study will be shared with other researcher after the results have been published. Details of the data will be updated later.
Starting 6 months after publication
At request from the principal investigator.
Not provided
Not provided
| ID | Term |
|---|---|
| D020370 | Osteoarthritis, Knee |
| D051346 | Mobility Limitation |
| D010003 | Osteoarthritis |
| ID | Term |
|---|---|
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D012216 | Rheumatic Diseases |
Not provided
Not provided
| ID | Term |
|---|---|
| D055070 | Resistance Training |
| ID | Term |
|---|---|
| D005081 | Exercise Therapy |
| D012046 | Rehabilitation |
| D000359 | Aftercare |
| D003266 | Continuity of Patient Care |
Not provided
Not provided
Thirty older adults will be recruited and randomized into two groups. The other groups receive an intervention including strength training and gait retraining lasting 8 weeks while the other group receives only the gait retraining. Outcome measures are obtained before and after the intervention period.
Not provided
Not provided
Not provided
Not provided
|
| Gait retraining + strength training | Other | Gait retraining using real-time electromyography biofeedback performed once per week and home-based calf muscle strength training performed three times per week for eight weeks. The gait retraining is identical to the one intervention described for the intervention group "Gait retraining". The strength training is performed three times per week except for the first week in which it is performed two times. The session contained a warm-up (3x10 repetitions of two-legged heel raises) and maximal isometric calf muscle contractions. The maximal contractions are performed using a custom device with the ankle in dorsiflexion and the knee flexed by 100-120 degrees. Three sets of 10 repetitions (3-second contraction and 3-second rest) are performed with both legs and with maximal effort and 1-minute rest between the sets. |
|
| within 1 weeks after intervention |
| Change from baseline in Achilles tendon stiffness | Achilles tendon stiffness evaluated using combination of ultrasonography, motion analysis and force measurements. | within 1 weeks after intervention |
| Change from baseline in gait kinematics | Time series of lower limb joint angles during walking stride assessed using motion capture system and inverse kinematics. | within 1 weeks after intervention |
| Change from baseline in joint moments during walking | Time series of lower limb joint moments during walking stride assessed using inverse dynamics based on motion capture system and instrumented treadmill data. | within 1 weeks after intervention |
| Change from baseline in joint powers during walking | Time series of lower limb joint powers during walking stride assessed using inverse dynamics based on motion capture system and instrumented treadmill data. | within 1 weeks after intervention |
| Change from baseline in distribution of joint work during walking | 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. | within 1 weeks after intervention |
| Change from baseline in muscle-tendon function during walking | Muscle fascicle kinematics measured using dynamics ultrasonography during walking. | within 1 weeks after intervention |
| Change from baseline in soleus to gastrocnemius muscle activation ratio | Relative activation of soleus to medial gastrocnemius measured using electromyography. | within 1 weeks after intervention |
| Change from baseline in walking speed | Preferred and maximal walking speed. | within 1 weeks after intervention |
| Change from baseline in muscle strength | Maximal isometric muscle strength in ankle plantarflexion and knee extension and flexion. | within 1 weeks after intervention |
Soleus and gastrocnemius muscle pennation angle assessed using ultrasound imaging.
| within 1 weeks after intervention |
| Change from baseline in triceps surae muscle volume | Soleus and gastrocnemius muscle volume estimated with combination of ultrasound and magnetic resonance imaging. | within 1 weeks after intervention |
| Change from baseline in Achilles tendon cross-sectional area | Achilles tendon cross-sectional area assessed using magnetic resonance imaging. | within 1 weeks after intervention |
| Change from baseline in dynamics balance control | Perturbed standing balance test with measurement of center of pressure trajectory | within 1 weeks after intervention |
| Change from baseline in triceps surae muscle activity in response to balance perturbation | Perturbed standing balance test with measurement of triceps surae muscle activities. | within 1 weeks after intervention |
| D012816 |
| Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D005791 |
| Patient Care |
| D013812 | Therapeutics |
| D026741 | Physical Therapy Modalities |
| D064797 | Physical Conditioning, Human |
| D015444 | Exercise |
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |