Gait analysis in chronic heart failure: The calf as a locus of impaired walking capacity

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 analyse...

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Main Authors: Panizzolo, F., Maiorana, Andrew, Naylor, L., Dembo, L., Lloyd, D., Green, D., Rubenson, J.
Format: Journal Article
Published: Elsevier 2014
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/9646
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author Panizzolo, F.
Maiorana, Andrew
Naylor, L.
Dembo, L.
Lloyd, D.
Green, D.
Rubenson, J.
author_facet Panizzolo, F.
Maiorana, Andrew
Naylor, L.
Dembo, L.
Lloyd, D.
Green, D.
Rubenson, J.
author_sort Panizzolo, F.
building Curtin Institutional Repository
collection Online Access
description 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.
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spelling curtin-20.500.11937-96462018-03-29T09:05:56Z Gait analysis in chronic heart failure: The calf as a locus of impaired walking capacity Panizzolo, F. Maiorana, Andrew Naylor, L. Dembo, L. Lloyd, D. Green, D. Rubenson, J. Heart failure Gait mechanics Triceps surae Muscle work 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. 2014 Journal Article http://hdl.handle.net/20.500.11937/9646 10.1016/j.jbiomech.2014.09.015 Elsevier restricted
spellingShingle Heart failure
Gait mechanics
Triceps surae
Muscle work
Panizzolo, F.
Maiorana, Andrew
Naylor, L.
Dembo, L.
Lloyd, D.
Green, D.
Rubenson, J.
Gait analysis in chronic heart failure: The calf as a locus of impaired walking capacity
title Gait analysis in chronic heart failure: The calf as a locus of impaired walking capacity
title_full Gait analysis in chronic heart failure: The calf as a locus of impaired walking capacity
title_fullStr Gait analysis in chronic heart failure: The calf as a locus of impaired walking capacity
title_full_unstemmed Gait analysis in chronic heart failure: The calf as a locus of impaired walking capacity
title_short Gait analysis in chronic heart failure: The calf as a locus of impaired walking capacity
title_sort gait analysis in chronic heart failure: the calf as a locus of impaired walking capacity
topic Heart failure
Gait mechanics
Triceps surae
Muscle work
url http://hdl.handle.net/20.500.11937/9646