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kinematic analyses yield little information 0268-0033/$ Effects of cadence on energy generation and absorption at lower extremity joints during gait ´` Luci Fuscaldi Teixeira-Salmela a.. Campus Pampulha. Introduction It is well known in the study of normal human gait. Walking speed 1.Author's personal copy Available online at www. the ability to adjust the speed is an important mechanism that requires different levels of muscular activities for appropriate adaptations to changes in the task demands. Ó 2008 Elsevier Ltd. Self-selected walking speed is a well-known indicator of overall gait performance and is commonly used to assess locomotor ability. and 120 steps/min. doi:10. Teixeira-Salmela). Brazil b ´ ´ ´ ´ ´ Ecole de readaptation. Luis Fernando Requiao ˜ a ˆ Department of Physical Therapy. Marie-Helene Milot Clinical Biomechanics 23 (2008) 769–778 www. were shown to be influenced by walking cadence. independent of laterality. However.see front matter Ó 2008 Elsevier Ltd. E-mail address: lfts@ufmg. knee. the corresponding values were 34%. muscle activity * Corresponding author. respectively. Fourteen healthy subjects were assessed walking at both natural and imposed cadences of 60. knee.02. Canada Received 31 July 2007. that muscles are the main sources of energy generation and absorption. Mechanical work. Universidade Federal de Minas Gerais. In general. 6627. All rights reserved. accepted 15 February 2008 Abstract Background. Findings. 31270-010 Belo Horizonte. One of the main roles of the muscles is the control of the magnitude and duration of acceleration and deceleration of individual body segments to permit safe forward progression (Bishop et al. b b Denis Gravel . Keywords: Gait analysis.F.clinbiomech. 2004). 80. Information regarding kinetic changes associated with walking speed is important for identifying alterations in locomotor disorders caused by pathological processes. When walking. ANOVAs followed by planned contrasts were used to assess the effects of laterality. A 3D motion analysis system.elsevier. Universite de Montreal and Centre de recherche Interdisciplinaire en Readaptation (CRIR). resulting in a larger muscular force output (Den Otter et al. The ankle. All rights reserved.*. joint. were shown to be influenced by the walking cadence.007 . independent of laterality. ´ ´ Institut de readaptation de Montreal. 21%. Methods. and related software were used to obtain kinematic and kinetic data. gait speed alone does not contribute substantially to the understanding of the nature of gait deficiencies nor to guide intervention protocols. Power and mechanical work. 2004. as well as the contributions of individual joints to the total energy generated and absorbed. By the same token. Power and mechanical work. 2004).1016/j. Neptune et al. and cadence. as opposed to those arising solely from altered speeds. Energy. Interpretation.sciencedirect. and 33%. The relative contributions to the total positive and negative work across the four cadences were calculated for each joint. and 26%. as well as the contributions of individual joints to the total energy generated and absorbed. tends to increase at faster walking speeds.2008. and hip contributions to the total limb generation and absorption at the lowest cadence were 53%. Biomechanics. Avenida Antonio Carlos. Sylvie Nadeau b. and ankle.. These findings will be helpful for identifying walking strategies and adaptations in populations with gait disorders. (L. force platforms. Minas Gerais. Net joint powers were calculated across cycles and the area under the positive and negative phases of the power curves provided the mechanical work generated and absorbed at the hip. and at the highest cadence.

Chen et al. 1996. The knee joint muscles act mainly eccentrically and the rate of absorption of energy is greater with increases in walking speed (Olney et al. originating from eccentric contractions. 1997.. 2006.F. 2005).. information which is related to kinetic changes to walking speed is important for identifying alterations in locomotor disorders caused by pathological processes. Olney et al. Methods 2.. 1994a. the relative contributions of each muscle group to the total energy generation or absorption should be studied. and ankle muscles in the sagittal plane. extent.. The assessment of ˜ the joint power parameter is more sensitive to instantaneous muscle effects to generate or absorb energy.. 1983. 1997. 1994. integrate the power curve over time and provide. recruited from the community. Teixeira-Salmela et al. Teixeira-Salmela et al. 2001. The interplay between these energy sources facilitates successful progression during walking (Chen et al. On the other hand. Positive work performed during concentric contractions. whereas higher power generation by the hip extensors in early stance was a typical. / Clinical Biomechanics 23 (2008) 769–778 about the mechanisms underlying normal and abnormal movement patterns. the ankle plantarflexors. produces energy flow from the segments to the muscles to decelerate the body. 2001. on the other hand. Winter.. Because decreasing gait speed or cadence is commonly observed in locomotor disorders. who had no previous history of lower limb injuries and showed no obvious gait abnormalities. in some cases. hip flexors.. specific adaptation of above (Seroussi et al. According to Winter (1983b). The study of variations in positive and negative energy contributions would provide baseline data and yield information that would be useful in understanding and treating gait deviations. 2.. knee. Therefore. Participants Fourteen healthy volunteers participated in the study.1. (1997) investigated the influences of walking speed on mechanical joint power during gait and demonstrated that the relative contributions to mechanical work of muscles about the knee and hip were positively correlated with speed. whereas negative work. 1994. whereas for the later. 2005) and used as comparative data in ˜ another study (Milot et al. 1994. information on kinetic changes with gait speed or cadence in normal subjects is important to pinpoint specific modifications related to the pathology. 2001). and degree of compensation across joints and to suggest more efficient methods of correction. Olney et al. Previous studies have shown high correlations between positive power bursts of these muscle groups and gait velocity or cadence both with normal (Sadeghi et al. Winter. 1996) and belowknee amputees (Gitter et al. it was decided to use cadence as the controlling parameter in the present study. 1991... 1997. results in energy flow from muscles to the segments to accelerate the body. while negative work at the hip and ankle also results in increases at higher walking speeds. 1983). 2004.. Work parameters. 1994).. Olney and Richards. the interaction between different muscle groups in generating and absorbing power is relevant for the understanding the compensatory mechanisms in pathological conditions.. they were greater when originated from the hip flexors.. 1991). The moment of force parameter provides insights about the predominant muscle groups at a given joint and about the level of the mechanical effort that is produced when relatively expressed to the maximal force capabilities (Milot et al.2.. In this context. 1983). 2006). In normal children. 1982. Teixeira-Salmela et al. Gait assessment Participants walked with their own low-heeled shoes along a nine-m walkway over three embedded force plat- . McGibbon et al. the estimation of the relative contribution of each joint to the total energy generated and absorbed during gait at different speeds seems to be a useful approach to understand the nature. 2001).. additional meaningful measures (Winter. Winter. Therefore. Moreover. and hip extensors are the main muscle groups that contribute to energy generation in the sagittal plane (Chen et al. Winter. Siegel et al. 2001). 1991. low-performing elderly (Graf et al. and pathological subjects (Mueller et al. 1994a. Requiao et al.. 1994). Teixeira-Salmela et al. based on ethical approval from the local research review board. 1994b). Moreover.. For example. Several kinetic parameters have been proposed to evaluate gait. Nadeau et al.. 1994b. while negatively correlated with ankle muscles. as opposed to those arising solely from altered speeds. 2. (2001) investigated the relative contributions to energy generation for stroke and healthy subjects walking at similar speeds and observed that for the former... 2005). 1991... the purpose of the present study was to employ an analytical model to estimate the effects of walking cadence and laterality on the positive and negative mechanical work performed by the hip. 1991) to understand normal (Chen et al. Thus.Author's personal copy 770 L. All participants provided consent prior to their evaluation. When walking on level surfaces. Data related to the mechanical level of effort during gait at different cadences have been published in a previous study for this group of participants (Requiao et al.. but does not take into account the duration of force application. Hermodsson et al. the plantarflexors predominated. 1983a) and abnormal walking patterns (Mansour et al. cadence does not affect the energy generation and absorption pattern shapes over a stride and it is largely controlled by the mechanical power generation and absorption. kinetic analyses provide a better understanding of normal motor patterns and result in new directions for diagnosing the causes of abnormal motor patterns observed in pathological gait profiles (Olney et al. patients with diabetic peripheral neuropathy were able to attenuate the decreased push-off by emphasizing hip flexor muscles (Mueller et al.

MA.. The power curves at the hip. right and left at the T8 level. subjects were required to walk at their natural cadence. (4)) Limb W positive ¼ W positive þ W positive þ W positive Knee Ankle Limb Hip W negative Limb ð3Þ ð4Þ ¼ W negative Ankle þ W negative Knee þ W negative Hip The relative contributions (Cont) of each joint to the total positive or total negative work was calculated by dividing the work values generated or absorbed by each joint by the total energy value. USA) force platforms. knee. T12 spinous process. These data were also filtered with a 4th-order Butterworth zero-lag filter. mid-foot. controlled by a metronome. and multiplied by 100. respectively. were digitally filtered using a 4th-order Butterworth zero-lag filter. Five walking trials for each side were collected at the four cadences. 80 and 120 steps/min. for each cadence. along with body mass and height. mid-thigh.h i ContAnkle ¼ W positive þ W negative W positive þ W negative Ankle Ankle Limb Limb ð6Þ . The same was carried out for the total absorbed Limb work (W negative . The accuracy for the Optotrak system and for the location of the center of pressure of force platforms was 1 mm and 3 mm (RMS mean values). 1983) Z tf P dt for P > 0 ð1Þ W positive ¼ J W negative ¼ J Z ti tf P dt ti for P < 0 ð2Þ where J refers to the joint (ankle. Contpositive ¼ W positive W positive Ankle Ankle Limb . and head of fibula). Teixeira-Salmela et al.Author's personal copy L. using Eq. Waterloo. (3)) of each lower limb ðW positive Þ. knee and hip joints. (5)) in a gait cycle was calculated as followed: . and ankle. Canada) was used to calculate the relative angles from a rotation matrix using a cardanic sequence. the muscles absorbed energy by contracting eccentrically. the energy generated and absorbed at the ankle. For each imposed cadence. and eversion–inversion. A successful trial was defined as one in which the subject appropriately contacted the force platform.e. which were normalized to 100%. and ti and tf to the initial and final gait cycle times. leg (lateral malleolus. infrared markers were placed bilaterally on the following locations: foot (lateral heel. In addition. The foot contact and ground reaction forces served to determine the gait cycles. for a total of 40 trials. left iliac crest). Prior to data collection. the joint contributions to the total work observed in a gait cycle were also computed. respectively. and dorsiflexion–plantarflexion for the ankle joint. 1991) performed with Kingait3 software (Mishac Kinetics. knee or hip). and lateral femoral condyle). Canada) was used to estimate the net moments at the ankle. shanks (medial malleoli). knee. keeping the metronomic rhythm. Eq. Anthropometric measurements. transverse rotation. with a cut-off frequency of 6 Hz. C7 spinous process. three AMTI (Advanced Medical Technologies. Ground reaction forces were collected at 600 Hz with three force platforms embedded in the nine-m walkway. Eq. i. For example. An inverse dynamic approach (Winter. whereas the integral of the negative phase (Wnegative. the contribution to the positive work by the ankle (Eq. pelvis (right and left ASIS. mid shank. the subject hit one force platform with one foot. thigh (greater trochanter. Eq. knee. to abduction–adduction. pelvis (left and right posterior superior iliac spine. Stride characteristics were recorded with three foot-switches located on the soles of their shoes (heel. Newton. When the product (M * x) was positive. the work generated by the flexors and extensors for all joints were summed to produce the total positive work (Eq. A three-dimensional (3D) Optotrak motion analysis system. First. (2)). P to the joint power. (6) as an example for the ankle h i. / Clinical Biomechanics 23 (2008) 769–778 771 forms of standardized dimensions. and ankle were analyzed on the basis of all cadences and all phases of power generation and absorption were identified. followed by three other imposed cadences of 60. tip of foot). negative negative ContAnkle ¼ W Ankle W negative ð5Þ Limb Finally. fifth metatarsal head). provided the absorbed work (Winter. and iliac crests) and trunk (left glenohumeral joint) were digitized with a probe to define the local axis of each segment. and head (right and left occipital). so that the local x. Data processing The coordinate data. were manually collected. and hip was computed without consideration to the muscle groups involved at a given joint.3. For all cadences. with a cut-off frequency of 10 Hz and resampled at 60 Hz to match the kinematic data. consisting of length and diameter of segments. trunk (L3. respectively. 13 specific anatomical points on the feet (heel posterior point. using the landmark locations as references.F. The area under the positive phase of the power curve provided the mechanical work generated (Wpositive. and right and left acromium). The data analysis (Mishac Kinetics. Waterloo. (1)) at the hip. and tip of the foot). dorsum. y and z axes corresponded. the three trials showing the closest cadences were averaged for each side. sampled at 60 Hz. In addition. thighs (medial femoral condyles). and related software were used to obtain kinematic and kinetic data. the muscles generated energy by contracting concentrically and when the product was negative. 2. longitudinal rotation and flexion–extension for the hip and knee joints. Net joint powers (P) were calculated for each instant in time as the product of net moments across the joint (M) and the relative angular velocity between the adjacent limb segments (x).

5] 0. respectively.Author's personal copy 772 L.79–1.42 ± 0.3) years. Bonferroni corrections for multiple comparisons in terms of cadence conditions were applied to contrast results. Teixeira-Salmela et al.75–1.4 ± 0. Power profiles (Watts) across cadences: (A) at the hip.7] 1.3 ± 0.008 (0. Gait power profiles were described. focused contrasts were performed to locate the differences.2 [1. Results Fourteen healthy subjects (seven women and seven men) completed the evaluation. three major power phases were observed (Fig. The mean age. 3. 1.2 [1.1 ± 12. but not statistically analyzed.0 [95. (B) at the knee. At the hip.05 to 0.82] 80 83.53] 120 115.16).5 ± 0.1 [1.7] 1.7 [77.09 [0.4] 0. ANOVA revealed that the four cadences produced highly significant gait speed differences (P = 0.7] 1.1–1.24 [0.92 ± 0.2–1. Spatio-temporal measures Table 1 presents the description of the spatio-temporal variables for the natural and imposed cadences and the actual cadences were close to the prescribed ones.0001). no differences were found between the natural and the imposed 120 cadences (P = 0.5] 1. Since no main effects for laterality were found (see Section 3). 1A): A 200 60 150 100 80 Natural 120 H3 Watts 50 H1 0 -50 H2 -100 0 10 20 30 40 50 60 70 80 90 100 Percent of Gait Cycle B 200 150 100 60 80 Natural 120 Watts 50 0 -50 -100 0 K2 K1 10 20 30 40 50 K3 60 70 80 K4 90 100 Percent of Gait Cycle C 200 A2 60 80 Natural 120 150 100 Table 1 Means (±SD) and range [min–max] of spatio-temporal measures for the dominant side across cadences (n = 14) Measure Cadence 60 Cadence reached (steps/min) Stride length (m) Speed (m/s) 65. 1.F. and (C) at the ankle joint.1 [79.0 (±13.2–129. stature and body mass were 46. and 72.9) kg.7] 1.10 [0. Gait speed and stride length increased with cadences and greater variability was observed for the natural and 120 prescribed cadences.1.7 ± 2.4.51–0.0–75. the data for the dominant and non-dominant sides were collapsed and a two-way within-factor repeated measures ANOVA was used to assess joint and cadence effects and interactions.0–1.8 [61.1 [1.2.0 (±14.67 ± 0.2 ± 0. Power profiles The overall average patterns for the ankle.8] 1.05/6).25 ± 0.9–141. However.70 (±0.07] Natural 105. . changing the significance level from 0.3–85.1–1. and hip for the dominant side across all cadences are presented in super-imposed graphs.85] Watts 50 0 -50 -100 0 10 20 30 A1 40 50 60 70 80 90 100 Percent of Gait Cycle Fig.05. to demonstrate changes associated with the cadence. Data analyses All statistical analyses were carried out using SPSS for Windows. Whenever a main effect or interaction effect was significant. 3.8 ± 4.10) m. knee.08–1. / Clinical Biomechanics 23 (2008) 769–778 2. Descriptive statistics and tests for normality (Shapiro-Wilk) were performed for all outcome variables.3 ± 13. The curve patterns had several characteristics that were common to all subjects. Differences in spatio-temporal parameters between the four cadences were identified by repeated measures ANOVA followed by planned contrasts with a significance level of a < 0. 3. Only one subject was left-side dominant.22 [1.

In the present study.2. P < 0. P < 0.42 m/s. 1B). except for the knee and hip at the lower cadences of 60 and 80 and for the ankle and hip for higher cadences (natural and 120). df = 6.35 m/s assessed with healthy older adult subjects (Teixeira. 3. significant effects for joint (F = 143. 1991. while others found it diffi- . whose speed values rarely surpass 1. except between the natural and 120 cadence. there was a joint effect for all cadences (P < 0. Teixeira-Salmela et al. P < 0. knee. Moreover. P < 0. df = 6. Figs. df = 6. For the energy generating values (Table 2 and Fig.001) were demonstrated.67 to 1. Moreover. df = 2. Statistical analyses revealed that ankle energy was significantly higher than at the knee and hip energy at lower cadences (60 and 80).42 m/s (Olney et al. while the knee energy level was significantly higher than the hip and ankle energy for higher cadences (natural and 120 cadence). In addition. Energy variables 3. whereas at higher cadences (natural and 120). 1A–C. 2B).21).08). there was a joint effect for all cadences. 3B). P < 0.3. these cadences were chosen to match those usually demonstrated by subjects with locomotor disabilities walking at natural speeds. 1996. the contributions of the individual joints to the total generated and absorbed energy during gait was also influenced by cadence. The reasons behind these non-significant differences may be related to the large variations across subjects. there was a joint effect for all cadences (P = 0. Four main issues will be discussed in the following sections. and became positive during late stance (pull-off phase). Teixeira-Salmela et al.41). 1994. planned contrast analyses showed significant differences for all joints across all cadences (P < 0. No main effects were observed for the relative contributions to energy absorption. For the contributions to energy generation (Table 2 and Fig. no differences were found between 60 and 80 (P = 0. df = 2. Joint contributions ANOVA revealed that the contributions to energy generation and absorption at the individual joints also changed with cadence (Table 2). df = 2.001 and F = 22.54.F. Olney and Richards. For the energy absorbing values (Table 2 and Fig. however. No differences were found at the hip joint and for the ankle between 60 and 80 (P = 0. subsequent analyses used planned contrasts for comparisons for joint or cadence effects.001) across all cadences.1. For the knee. and ankle joints across cadences. Joint and cadence effects Table 2 provides the descriptive data related to energy generated and absorbed. The results indicated that at lower cadences (60 and 80). analyses showed joint-by-cadence interactions. Analyses for relative contributions to energy generation demonstrated significant effects for joint (F = 143.03) and joint-by-cadence interaction (F = 10.98.65–1. df = 2.001). respectively.3. Spatio-temporal measures The four investigated cadences resulted in mean speeds ranging from 0. two major phases were observed at the ankle: negative power was recorded at early and mid-stance with a large positive peak at late stance. 3. Since the ANOVA revealed significant interactions between joints and cadences. Moreover. significant differences were found only for the knee and hip joints (P < 0.. P < 0. 1C. as well as the relative contributions of the hip.3. 2001). P = 0. 2 and 3 illustrate the mechanical energy generated and absorbed. As shown in Fig.64. cadence (F = 36. except between the natural and 120 cadence. suggesting that speed differences should be minimized when comparing power values between walking trials in other studies.51). the ankle and hip showed similar contributions. four major power phases were identified.001).79. 4. For respective energy generation and absorption. planned contrast analyses showed significant differences for the knee across all cadences (P = 0. and joint-bycadence interactions (F = 10. similar contributions were observed for the knee and hip. subsequent analyses used planned contrasts for comparisons of joint or cadence effects. As shown in Fig.1. and between natural and the 120 cadence (P = 0..001 and F = 12. 2A). in relation to cadence. which were not significantly different (P = 0. which were very similar than those of 0. No differences in gait speed were found between the higher natural cadences and the imposed one of 120 steps/min. For the knee.001). df = 6.001).98. negative during the second half. P < 0. except between the ankle and hip at the imposed cadence of 120. P < 0.03).Author's personal copy L. except for those at the hip between natural and the 120 cadence.79. df = 2. with power being primarily negative (Fig. For the contributions to energy absorption (Table 2 and Fig. independent of the side of the body. as well as the relative contributions of each lower extremity joint to the total positive and negative work during gait.98.001). Since ANOVA revealed significant interactions between joints and cadences.001 and F = 3. 3A). It appears that some subjects had a higher natural cadence than the 120 steps/min.001). 1998). and between natural and the 120 cadence (P = 0. df=2. / Clinical Biomechanics 23 (2008) 769–778 773 the power was positive during the first half of the stance phase. a common pattern for all joints was reflected by a consistent trend towards higher values of power bursts for all joints as the cadence increased.001 and F = 12. as well as the energy contributions at each joint for the natural and imposed cadences for all subjects.54. Discussion The present study assessed the work generation and absorption. except for the natural and the 120 cadence. Mechanical work about the lower extremity joints was shown to be influenced by the walking cadence. P = 0.95. 4.001).001 and F = 3. analyses showed significant decreases at the ankle joint and significant increases for the hip joint across all cadences (P < 0.09).95.

3 [9.2 [7.7 P þ ðW þ W À Þ 14 6.7 18.9] 29.2 [12–77] 33.9 [24–81] 100 49.3 17.5 6.5 [3.7 WÀ 7.8–20.8 15 4.5 8.5 [10–52] 32.6 .6 25.1–28.6 14.6 7 3.8 [5.6 10 4.3 7.7 [9–33] 28. and hip joints across cadences (n = 28) Ankle W+ 60 steps Mean SD Range Cont (%) to WLimb 80 steps Mean SD Range Cont (%) to WLimb Natural Mean SD Range Cont (%) to WLimb 120 steps Mean SD Range Cont (%) to WLimb 13.6 [18–46] 46.6 6.7 11.2 [36–93] 100 84 25 [57–139] 100 94.1 [45–175] 100 L.6] 24.5 [11–33.5 [29–75] 100 63.1 P þ ðW þ W À Þ 28 9.5 [19–55] 100 44.3 [3–20] 21 15.9 26.3 2.3 10.3 12.5 [6.3 7.7–24.5 30.2] 59.5 [8.5 WÀ 14.5 31.3 4.2] 15.4] 40.22 [21–48] 33.6 4. Teixeira-Salmela et al.1] 24.8 [4.1 13.5 [10–28.8 4.5 3.9] 31.5 5.3 4.7 [20–47] 37.5–47.8 [4.4] 25.4–23.3–29.7 [5–23.7 [6.4 3.8 31.7–24.7 29.Author's personal copy 774 Table 2 Means (±SD).1 16.9–22.9] 28.3 [13–52] 31.7 [18–42] 52.8 12.8 [19–90] 100 WÀ 30.9 Knee W+ 3.9 11.5 [2.4 8.7 7.2 18. 5 4.4 [15–52] 30.1] 42.8 [4.7–23.6 [1.7] 17.4 [0.7 10.3–23.7] 43.3–11.14 [13–45] 100 35.7–16.9] 45.5–35.8–8.7 7 [4–28] 34.3 12.5–19.1 19.9 13.5 [10–33] 100 27.2] 18.9–13.2 [23–67] 100 45.1 8.0] 15.2 5.4 33.8 [5.6 10.1 [2.7 5.2 22.5–26.5] 30 13.6] 28 13 5.6 2. knee.F.5 14.6] 54.6 2 [0.6 11 [12–55] 100 39.6 14.2 [5–27] 24.0] 29.8 [17–77] 100 P þ ðW þ W À Þ 53.4 [0. / Clinical Biomechanics 23 (2008) 769–778 11.8 WÀ 8.6 8.8 [5–30] 26.4] 27.6 7.5 Limb(ankle+knee+hip) W+ 22.4 19.9–12.3–9.4 P ðW þ þ W À Þ Hip W+ 5.3 4.2 5 [9. range [min–max] of positive and negative work (Joules) and contributions (%) to positive and negative work at ankle.3] 47.7 [10–38.3 18.8] 37.2 22.6 12.5] 48.3 17.5 [2.7 32 10.5 2.3 3.

4. knee. the effects of cadence were consistent.. Cadence influenced the mechanical work performed by the muscles acting at the hip. Graf et al. Considering that energy changes were closely associated with differences in gait speed. 2004. which were also shown by Graf et al. Teixeira-Salmela et al. (B) Relative contributions of the hip. Fig. %) to energy generation across cadences. This supported previous findings (Chen et al. 2005. Miyoshi et al.e. Olney et al. In fact. (2005) and could reflect adjustments of the lower limb to more efficiently meet different task demands or to attenuate fatigue and share the effort across muscles when the cadence increases.F.. and ankle joints (Joules. 1997.2. 1997) that the total energy generated and absorbed by the knee showed the largest increases (175%) in response to cadence changes. Cadence effects The influences of speed on kinetic parameters has been extensively investigated (Bishop et al. The net result was an overlap of the distributions of gait speed measured at the natural and 120 cadence resulting in non-significant differences.. knee. (1998) suggested that the variability observed in able-bodied gait may be the result of multiple normal dynamic strategies employed by different subjects and should be considered in studies investigating gait. Den Otter et al. and ankle joints (percentages. and parameters used. Significant correlations between the same work phases across cadences indicate the same pattern with increases in cadence. Kim and Eng (2004) observed that the magnitude of kinematic and kinetic gait profiles were significantly related to gait speed in all three planes. Vardaxis et al. It is possible that some subjects may have used their plantarflexors more than hip flexors or extensors. it was not surprising that differences between the natural and imposed 120 cadence for energy parameters did not reach statistical significance. while others may have done the reverse. The hip also showed substantial increases of 126%. / Clinical Biomechanics 23 (2008) 769–778 775 A Mechanical Energy (J) 30 25 20 15 10 5 Ankle Knee Hip A Mechanical Energy (J) 30 Ankle 25 20 15 10 5 0 Knee Hip 0 60 steps 80 steps Natural 120 steps 60 steps 80 steps Natural Ankle Knee Hip 120 steps B B 80 70 60 50 Ankle Knee Hip 70 60 50 40 % 30 20 10 0 (%) 40 30 20 10 0 60 steps 80 steps Natural 120 steps 60 steps 80 steps Natural 120 steps Fig. (B) Relative contributions of the hip. cult to reach the prescribed 120 steps/min cadence. %) to energy absorption across cadences. and ankle joints (percentages.. The present findings supported the evidence of a trade-off between the hip and ankle joints.. and ankle joints (Joules. 2. 3. 2005). Previous analyses of the level of effort during the period of energy generation for this group of subjects has revealed that the level of effort increased with gait cadence but the increases were more pronounced for the hip muscles (Requiao et al. J) across cadences. Chen et al. However. methodology.. reinforcing the findings that . 2004. knee. the absence of significant correlations between different work phases at a given cadence indicates that the subjects did not adopt consistent patterns to generate or absorb work. (A) Mechanical energy absorption at the hip. knee...Author's personal copy L.. J) across cadences. knee. (A) Mechanical energy generation at the hip. whereas the ankle demonstrated the smallest changes. Energy generation ˜ around the knee was minimal compared to that generated at the ankle and hip joints. i. they used different strategies to accomplish the task. 2004. 1994) and independent of the selected population. and ankle.

knee. Energy absorption is not only associated with an active contraction but passive contributions to energy absorption should also be considered. In the present study. only 44% of the total energy generated originated from these muscles. indicating large contributions of hip muscles for speed modulation. / Clinical Biomechanics 23 (2008) 769–778 the knee muscles mainly absorb. It is also important to note that the ankle had a larger absolute increase in positive work (6. For instance. and with low-performing elderly subjects (Graf et al. In fact. These findings suggest that. Winter. (1977) demonstrated that the muscle moment about the hip and knee showed greater dependencies on speed. which were selected post-hoc and subsequently classified into three categories based on their actual walking speeds. there are parallel findings in the literature.F. indicating that all three joints played similar roles in contributing to the sum of the total energy used. 1983). cadences were tightly controlled. the negative work at the ankle actually decreased (À2. and hip contributed 53%. the moment at the ankle did not substantially change.3 J) across cadences than did the knee (4. they were not strictly imposed.3. the contributions of the knee as a energy modulator should not be underestimated. but differences in the assessment protocols make comparisons difficult. 4. On the other hand. The contributions to work from the muscles about the knee and hip showed increases at higher cadences. At the lowest cadence. at the lowest cadence. (1997) on contributions of the lower extremity joints to the total work generated within three walking groups of healthy children. contributions to kinetic energy existed from sagittal and non-sagittal plane motions (Vardaxis et al. these discrepancies were less evident and the contributions by each joint to the total energy were more balanced. increases were seen at the hip and knee joints.. become even more obvious. and 26%. knee. however. and ankle muscles suggest a shift of work to larger muscle groups at faster cadences. 21%. adults (Winter. which supported the limitations of the sagittal plane model. Winter. while those from the muscles about the ankle substantially decreased. However. and hip in relation to cadence.9 J). Neptune et al. at the highest cadence. the passive energy absorbed by the rectus femoris at the end of stance may have assisted hip flexors in limb propulsion. knee. 16%) across cadences.6%). Contributions to energy generation and absorption When expressed as a percentage of work contributions. The transition patterns between the energy generation/absorption of the hip. There were relatively small increases in the positive work for the knee (136%) and much greater changes at the hip (221%).. It has been reported that with normal subjects. they were actually quite different. at the fastest cadence. 1983). The contributions of the muscles about the hip to the total energy generated increased from 24% at the lower to 38% at higher cadences. a value that was about half of the amount of the positive work at the hip (11. which showed the smallest increases in work values in response to changes in cadence. 33% from the knee and 33% from the hip. Although the positive and negative work increased at about the same amount for the knee and hip joints across cadences. but the most striking changes were observed at the knee. since they were responsible for about one third of the total work performed at the highest cadence. whereas knee contributions increased from 16% to 19%. were always higher for the negative work. Few studies have evaluated the relative contributions of the muscles about the ankle to the total energy generated during gait at different speeds. 1983). which increased from 25% at the lowest cadence to 45% at the highest. about 60% of the total energy generated resulted from the muscles about the ankle. when the cadence was up to 120 steps/ min. respectively. Important increases observed at the knee joint might be the result of the work of numerous biarticular muscles in promoting energy flow between segments and transferring energy from the leg to the thigh to increase overall gait speed. (2005) reported that the larger transverse pelvic rotations employed by low-performing subjects may be a . the power-energy capability of the knee muscles was functionally relevant.Author's personal copy 776 L. studies with children (Chen et al. 1998). By the same token. In addition. Teixeira-Salmela et al. optimize energy consumption during gait. Negative work supplied by the knee has been reported to be highly correlated with speed and one of the best predictors in gains in walking performance (Olney et al. It appears that at increased cadences. For instance. whereas increases of 6. respectively. only power and work performed in the sagittal plane during concentric and eccentric contractions were evaluated and it was observed that the differences between the positive and negative values for the total limb work. It is interesting to note how the total contributions at each joint to the sum of the total limb generation and absorption changed when cadences were increased. Andriacchi et al. The findings of the present study are somewhat in agreement with those of Chen et al.0 and 14.6 J were found for the hip and knee. This shift of energy to larger and more proximal muscle groups may permit muscles to work at a lower percentage of their maximum capacity and. 1991. Regarding the respective contributions to energy absorption. whereas. muscles generate and absorb energy at faster rates.. the variations of behavior of the ankle. therefore.. Participants were instructed to walk at various speeds. rather than generate energy (Olney et al. 2005) have shown that the work at the ankle demonstrated the least sensitivity to speed variations. there were much larger increases in the negative work for the knee (192%) and less for the hip (70. 1997).. Graf et al. (1997). However. 34% of the total energy was provided by the structures about the ankle. For the different behaviors of the muscles at the ankle. the ankle. (2004) observed that forces developed from stretched passive hip structures assisted plantarflexors during the swing initiation.6). while in the study of Chen et al. Therefore. at faster cadences.3 J. In the present study. 1994.

2004.. J.A.J. Phys. 51–59. 1995. 299–308.. 2005.J. J.C. Krebs. Gitter. Hip and ankle walking strategies: effect on peak plantar pressures and implications for neuropathic ulceration.P.. Rehabil.... were shown to be influenced by the walking cadence..... 10. The ankle. Czerniecki. Richards. Nadeau.. 34. 136–148. C. Work and power in gait of stroke patients.. M. Allard.. P.. Ogle. J. For instance.R. Schaaf.. Mechanical work adaptations of above-knee amputee ambulation. Miyoshi. S.. Olney. Sahrmann.J. S.J. Med.R. Rehabil. Milot. Winter. S. Med.....M. 2003). Patel. T. Rehabil. 2004. 1994b.P. Malouin.. S. C. Sinacore. D.. D. ˜ Gagnon. Geurts. / Clinical Biomechanics 23 (2008) 769–778 777 compensatory mechanism to increase step length and gait speed. and 33%. T. Mueller. 2001. 753–758. 309– 314. D. J. the major portion of this movement is performed in the sagittal plane. J.. Olney. Biomech. Thelen. Ekdahl. S. 1994. C. Walking speed as a basis for normal and abnormal gait measurements. C. N. S. McBride.H. especially for the hip joint. McFadyen. joint moments and ground reaction forces during walking in water..M. body support and forward progression were found to occur because power redistribution between the legs and trunk occurred through muscular force generation. and degree of compensation between joints and suggest more efficient methods of correction. Acknowledgments Canadian Institute of Health Research.E. 5.O. Hoogstrate. ˜ Graf. The influence of walking speed on mechanical joint power during gait. Sadeghi. Gait Posture 4. Magnitude and pattern of 3D kinematic and kinetic gait profiles in persons with stroke: relationship to walking speed. Duhaime.. Monga. I. S. because the goal of locomotion is to support body weight against gravity while generating forward motion (Eng and Winter..M. Gravel. so that the adductors substantially contributed to hip flexion. and 26%.. knee. where concentric and eccentric works are performed (Nadeau et al.. 18. D. Yamamoto. Chen. future studies should also include measures of power and work in the frontal plane of movement.. Ther. 1997. Gait Posture 6. I.. 1994. Quantification of level of effort at the plantarflexors and hip extensors and flexor muscles in healthy subjects walking at different cadences. hip flexors. Conclusions The findings demonstrated that the performance of the dominant and non-dominant sides was very similar. S. Mulder. S. J.. 70. the corresponding values were 34%. Nadeau. B.. Am. Nakazawa.. Requiao.H. Hermodsson. Kinetic analysis of the lower limbs during walking: what information can be gained from a three-dimensional model? J. Kuo. 1982. S.J..J. 171– 176. M. T. In addition. T. 142–148. Rev. 74..F. J. Ounpuu. 15. Gait Posture 20. Rehabil.. Eng. Gitter. Requiao. Simon. 26. Weaver. 393–405. DeGroot. 2006. M. 481–490. Crit.M. Mechanical energy analysis identifies compensatory strategies in disabled elders’ gait. It could be argued that underestimation of power and work might have occurred because of the absence of motion evaluation in the frontal and transverse planes and that produced by isometric muscle activity. Eng. Gait Posture 20. or eccentric activity. Czerniecki.. D... regardless of whether produced from concentric.P. A. then work would inappropriately be attributed to hip flexors. B. Bishop. Kim. Orthot. J..P.. Arch.E..F. S. H. Med. if the lower limb was laterally rotated. and hip contributions to the total limb generation and absorption at the lowest cadence were 53%. Biomech. P.. Andriacchi. M. Gait Posture 19.J.A.S. Akai. However. Nadeau. Ther. 950– 959. J. D. Temporal. J. 1996. D. Persson. 261–268. particularly at the hip joint. Med. Judge. 2001. Med. Frontal and sagittal analysis of the stair climbing task in healthy adults over 40 years: what are the challenges compared to level walking? Clin.. and Fonds de la Recherche en ´ ´ Sante du Quebec (FRSQ).D. Kautz. I..A.D. 1977. Biomech. Gravel... M. 1991. M.. Electromyogr. extent. Rehabil Med.. Neptune. J. Differences in the gait characteristics of patients with diabetes and peripheral neuropathy compared with age-matched controls. Nowak. Strube. 2177–2183.. M.. 1–24. M. 21%. A... M... Lesh. The estimation of the relative contributions of each joint to the total energy generated and absorbed during gait at different speeds could provide a useful approach to understand the nature.R. 2004.. Effect of the walking speed to the lower limb joint angular displacements. K. 872–885. Kinesiol. 194–205.. Roxendal.O. Nadeau.D. Y. 270–278. Gait Posture 19.. Int. 80.. independent of laterality. CAPES (Brazilian Government Agency). 134– 139.. Phys. A.H. Phys. Seroussi.. J. Bilateral level of effort of the plantar flexors. Gait in male trans-tibial amputees: a comparative study with healthy subjects in relation to walking speed. independent of the joint or cadence. isometric..M.R. D. McGibbon. 1996. McBride.D. Rehabil. Daly. S. S. A. Muscle force redistributes segmental power for body progression during walking. Muscle power compensatory mechanisms in below-knee amputee gait. R. Olney.A. 2070–2075. Gravel.G. Griffin.. respectively....D. Phys. S. Puniello. K.M. J.. L. Teixeira-Salmela et al. Zajac. A. D. 1991. 2001. Mueller. T. Am. Pathare. At the highest cadence. Phys. 2003. Biomechanical analysis of the influence of prosthetic feet on below-knee amputee walking.F. 15. 2004. Determinants. Phys.A... Phys.. K.E. However. and extensors during gait in hemiparetic and healthy individuals. 140–146. Rehabil. The effect of walking speed on lower-extremity joint powers among elderly adults who exhibit low physical performance. 18. 72. Power and mechanical work. Prosthet. Med. Biomech. Rehabil. Den Otter. Minor. Galante.. D.. J. and kinetic variables related to gait speed in subjects with hemiplegia: a regression approach..N. Mansour. F... 77. 1209–1214. R.. F. 68–77. G. 86. 28... Arch.J.. 13. The present findings provide baseline data for identifying changes in individuals with locomotor disorders. M. as well as the contributions of individual joints to the total energy generated and absorbed. L.Author's personal copy L.. Brunt. J. The effect of velocity on the strategies used during gait termination. Olney. 2005. Phys. Bourbonnais. Hemiparetic gait following stroke: part 1: characteristics. T. 1196–1200. kinematic. Griffin.. D. M. J. 25–32. 74. S. B. Arch. Milot.. 33%. Arch.. Disabil. Shirota. Duysens. A three dimensional multi-segmental analysis of the energetics of normal and pathological human gait. 2004. . Biomech..A. Stroke 37. 1994a. Speed related changes in muscle activity from normal to very slow walking speeds. 724–732. 75..N. Phys. References Andriacchi.J. L.M. 1995). limiting factors and compensatory strategies in gait. M..

302–330. Lachance. Siegel. Olney. natural. Rehabil. Motor Behav. D. S. M. Joint moment control of mechanical energy flow during normal gait. 147–154. 1998. I. Teixeira-Salmela.F.A. L. Gait Posture 19. 2001. Relat. T. Biomechanical motor patterns in normal walking. Orthop. P. Winter. Allard. Energy generation and absorption at the ankle and knee during fast.. .. Queen’s University.. The impact of a program of muscle strengthening and physical conditioning on impairment and disability in chronic stroke survivors. Med.D. L.. V. 17. Winter. Hum. Stanhope. S.J.Author's personal copy 778 L. Teixeira-Salmela et al.. 2004. 1991. D. 121–136. J. kinematic and kinetic variables during gait in chronic stroke survivors..A..M. Winter. Res... Ph. Kingston. and slow cadences. Classification of able-bodied gait using 3-D muscle powers. / Clinical Biomechanics 23 (2008) 769–778 Vardaxis.. Clin. 53–60.J. Effects of muscle strengthening and physical conditioning training on temporal. Ontario.L. 33. Dissertation. Nadeau. 69– 75.F. Elderly and Pathological.A. L.. Sci. Teixeira. Duhaime. D.. 175. J. Mcbride. S.. The Biomechanics and Motor Control of Human Gait: Normal. Mov. K. 1983a.F.. 1983b. University of Waterloo Press. Kepple. 1998. Waterloo. 15..G.

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