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

Panizzolo, FA, Naylor, LH, Green, DJ, Rubenson, J, Maiorana, AJ, Dembo, L and Lloyd, DG (2014) Gait analysis in chronic heart failure: The calf as a locus of impaired walking capacity. Journal of Biomechanics, 47 (15). pp. 3719-3725. ISSN 1873-2380

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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.

Item Type: Article
Additional Information: NOTICE: this is the author’s version of a work that was accepted for publication in Journal of Biomechanics. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Biomechanics, 47(15, 2014 DOI:10.1016/j.jbiomech.2014.09.015
Uncontrolled Keywords: 0903 Biomedical Engineering, 1106 Human Movement And Sports Science, 0913 Mechanical Engineering
Subjects: R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions: Sport & Exercise Sciences
Publisher: Elsevier
Date Deposited: 15 Apr 2015 09:52
Last Modified: 04 Sep 2021 14:32
DOI or ID number: 10.1016/j.jbiomech.2014.09.015
URI: https://researchonline.ljmu.ac.uk/id/eprint/852
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