Nicolas Peyrot

Do mechanical gait parameters explain the higher metabolic cost of walking in obese adolescents

Net metabolic cost of walking normalized by body mass (C(W.BM(-1)); in J.kg(-1).m(-1)) is greater in obese than in normal-weight individuals, and biomechanical differences could be responsible for this greater net metabolic cost. We hypothesized that, in obese individuals, greater mediolateral body center of mass (COM) displacement and lower recovery of mechanical energy could induce an increase in the external mechanical work required to lift and accelerate the COM and thus in net C(W.BM(-1)). Body composition and standing metabolic rate were measured in 23 obese and 10 normal-weight adolescents. Metabolic and mechanical energy costs were assessed while walking along an outdoor track at four speeds (0.75-1.50 m/s). Three-dimensional COM accelerations were measured by means of a tri-axial accelerometer and gyroscope and integrated twice to obtain COM velocities, displacements, and fluctuations in potential and kinetic energies. Last, external mechanical work (J.kg(-1).m(-1)), mediolateral COM displacement, and the mechanical energy recovery of the inverted pendulum were calculated. Net C(W.BM(-1)) was 25% higher in obese than in normal-weight subjects on average across speeds, and net C(W.BM(-67)) (J.kg(-0.67).m(-1)) was significantly related to percent body fat (r(2) = 0.46). However, recovery of mechanical energy and the external work performed (J.kg(-1).m(-1)) were similar in the two groups. The mediolateral displacement was greater in obese subjects and significantly related to percent body fat (r(2) = 0.64). The mediolateral COM displacement, likely due to greater step width, was significantly related to net C(W.BM(-67)) (r(2) = 0.49). In conclusion, we speculate that the greater net C(W.BM(-67)) in obese subjects may be partially explained by the greater step-to-step transition costs associated with wide gait during walking.

A simple method for measuring power, force, velocity properties, and mechanical effectiveness in sprint running

This study aimed to validate a simple field method for determining force– and power–velocity relationships and mechanical effectiveness of force application during sprint running. The proposed method, based on an inverse dynamic approach applied to the body center of mass, estimates the step‐averaged ground reaction forces in runners sagittal plane of motion during overground sprint acceleration from only anthropometric and spatiotemporal data. Force– and power–velocity relationships, the associated variables, and mechanical effectiveness were determined (a) on nine sprinters using both the proposed method and force plate measurements and (b) on six other sprinters using the proposed method during several consecutive trials to assess the inter‐trial reliability. The low bias (<5%) and narrow limits of agreement between both methods for maximal horizontal force (638 ± 84 N), velocity (10.5 ± 0.74 m/s), and power output (1680 ± 280 W); for the slope of the force–velocity relationships; and for the mechanical effectiveness of force application showed high concurrent validity of the proposed method. The low standard errors of measurements between trials (<5%) highlighted the high reliability of the method. These findings support the validity of the proposed simple method, convenient for field use, to determine power, force, velocity properties, and mechanical effectiveness in sprint running.

Mechanical Work and Metabolic Cost of Walking after Weight Loss in Obese Adolescents

PURPOSE This study was performed to investigate whether changes in biomechanical parameters of walking explain the reduction in net metabolic cost after weight loss in obese adolescents. METHODS Body composition and metabolic and mechanical energy costs of walking at 1.25 m·s(-1) were assessed in 16 obese adolescents before and after a weight loss. Center of mass (COM) and foot accelerations were measured using two inertial sensors and integrated twice to determine COM and foot velocities and displacements. Potential and kinetic energy fluctuations of the COM and the external mechanical work were calculated. Lateral leg swing was calculated from foot displacements. RESULTS As expected, the decrease in net metabolic cost was greater, which would have been expected on the basis of the amount of weight loss. The smaller lateral leg swing after weight loss did not explain part of the decrease in net metabolic cost. The reduced body mass required less leg muscle work to raise and accelerate the COM as well as to support body weight. The decrease in body mass seems also associated with a lesser leg muscle work required to raise the COM because of smaller vertical motions. As a result of the inverted pendulum mechanism, the decrease in vertical motions (hence in potential energy fluctuations) was probably related to the decrease in mediolateral kinetic energy fluctuations. Moreover, the lesser amount of fat mass in the gynoid region seems related to the decrease in net metabolic cost of walking. CONCLUSIONS The reduction in net metabolic cost of walking after weight loss in weight-reduced adolescents is associated with changes in the biomechanical parameters of walking.

Why Does Walking Economy Improve after Weight Loss in Obese Adolescents

PURPOSE This study tested the hypothesis that the increase in walking economy (i.e., decrease in net metabolic rate per kilogram) after weight loss in obese adolescents is induced by a lower metabolic rate required to support the lower body weight and maintain balance during walking. METHODS Sixteen obese adolescent boys and girls were tested before and after a weight reduction program. Body composition and oxygen uptake while standing and walking at four preset speeds (0.75, 1, 1.25, and 1.5 m·s⁻¹) and at the preferred speed were quantified. Net metabolic rate and gross metabolic cost of walking-versus-speed relationships were determined. A three-compartment model was used to distinguish the respective parts of the metabolic rate associated with standing (compartment 1), maintaining balance and supporting body weight during walking (compartment 2), and muscle contractions required to move the center of mass and limbs (compartment 3). RESULTS Standing metabolic rate per kilogram (compartment 1) significantly increased after weight loss, whereas net metabolic rate per kilogram during walking decreased by 9% on average across speeds. Consequently, the gross metabolic cost of walking per unit of distance-versus-speed relationship and hence preferred walking speeds did not change with weight loss. Compartment 2 of the model was significantly lower after weight loss, whereas compartment 3 did not change. CONCLUSIONS The model showed that the improvement in walking economy after weight loss in obese adolescents was likely related to the lower metabolic rate of the isometric muscular contractions required to support the lower body weight and maintain balance during walking. Contrastingly, the part of the total metabolic rate associated with muscle contractions required to move the center of mass and limbs did not seem to be related to the improvement in walking economy in weight-reduced individuals.

Detection of swing heel-off event in gait initiation using force-plate data.

This study investigated the accuracy and reliability of four methods using force-plate data for detecting the swing heel-off (HO) time in gait initiation. Results of these methods were compared to those obtained by means of a reference method using a footswitch. Ten young healthy adults performed 18 forward gait initiation trials at self-selected speed and at maximal speed. Results showed that the method based on vertical impulse was the most accurate and reliable in determining HO in both speed conditions. The mean error obtained with this method was -8±10ms in the self-selected speed condition (-7±10ms in the maximal speed condition), with no significant effect of gait speed (P>0.05). These findings suggest that this method based on force-plate data is valid and reliable for detecting HO in forward gait initiation in the absence of additional hardware.

Effects of Extreme-Duration Heavy Load Carriage on Neuromuscular Function and Locomotion: A Military-Based Study

Trekking and military missions generally consist of carrying heavy loads for extreme durations. These factors have been separately shown to be sources of neuromuscular (NM) fatigue and locomotor alterations. However, the question of their combined effects remains unresolved, and addressing this issue required a representative context. Purpose The aim was to investigate the effects of extreme-duration heavy load carriage on NM function and walking characteristics. Methods Ten experienced infantrymen performed a 21-h simulated military mission (SMM) in a middle-mountain environment with equipment weighing ∼27 kg during battles and ∼43 kg during marches. NM function was evaluated for knee extensors (KE) and plantar flexors (PF) pre- and immediately post-SMM using isometric maximal voluntary contraction (MVC) measurement, neural electrical stimulation and surface EMG. The twitch-interpolation method was used to assess central fatigue. Peripheral changes were examined by stimulating the muscle in the relaxed state. The energy cost, mechanical work and spatio-temporal pattern of walking were also evaluated pre−/post-SMM on an instrumented treadmill in three equipment conditions: Sportswear, Battle and March. Results After the SMM, MVC declined by −10.2±3.6% for KE (P<0.01) and −10.7±16.1% for PF (P = 0.06). The origin of fatigue was essentially peripheral for both muscle groups. A trend toward low-frequency fatigue was detected for KE (5.5%, P = 0.08). These moderate NM alterations were concomitant with a large increase in perceived fatigue from pre- (rating of 8.3±2.2) to post-SMM (15.9±2.1, P<0.01). The SMM-related fatigue did not alter walking energetics or mechanics, and the different equipment carried on the treadmill did not interact with this fatigue either. Conclusion this study reports the first data on physiological and biomechanical consequences of extreme-duration heavy load carriage. Unexpectedly, NM function alterations due to the 21-h SMM were moderate and did not alter walking characteristics. Clinical Trial Registration Name: Effect of prolonged military exercises with high load carriage on neuromuscular fatigue and physiological/biomechanical responses. Number: NCT01127191.

Effects of Changing Body Weight Distribution on Mediolateral Stability Control during Gait Initiation

During gait initiation, anticipatory postural adjustments (APA) precede the execution of the first step. It is generally acknowledged that these APA contribute to forward progression but also serve to stabilize the whole body in the mediolateral direction during step execution. Although previous studies have shown that changes in the distribution of body weight between both legs influence motor performance during gait initiation, it is not known whether and how such changes affect a person’s postural stability during this task. The aim of this study was to investigate the effects of changing initial body weight distribution between legs on mediolateral postural stability during gait initiation. Changes in body weight distribution were induced under experimental conditions by modifying the frontal plane distribution of an external load located at the participants’ waists. Fifteen healthy adults performed a gait initiation series at a similar speed under three conditions: with the overload evenly distributed over both legs; with the overload strictly distributed over the swing-limb side; and with the overload strictly distributed over the stance-leg side. Our results showed that the mediolateral location of center-of-mass (CoM) during the initial upright posture differed between the experimental conditions, indicating modifications in the initial distribution of body weight between the legs according to the load distribution. While the parameters related to the forward progression remained unchanged, the alterations in body weight distribution elicited adaptive changes in the amplitude of APA in the mediolateral direction (i.e., maximal mediolateral shift of the center of pressure (CoP)), without variation in their duration. Specifically, it was observed that the amplitude of APA was modulated in such a way that mediolateral dynamic stability at swing foot-contact, quantified by the margin of stability (i.e., the distance between the base of support boundary and the extrapolated CoM position), did not vary between the conditions. These findings suggest that APA seem to be scaled as a function of the initial body weight distribution between both legs so as to maintain optimal conditions of stability during gait initiation.

Energy Expenditure in People with Diabetes Mellitus: A Review

Physical activity (PA) is an important non-therapeutic tool in primary prevention and treatment of diabetes mellitus (DM). To improve activity-based health management, patients need to quantify activity-related energy expenditure and the other components of total daily energy expenditure. This review explores differences between the components of total energy expenditure in patients with DM and healthy people and presents various tools for assessing the energy expenditure in subjects with DM. From this review, it appears that patients with uncontrolled DM have a higher basal energy expenditure (BEE) than healthy people which must be considered in the establishment of new BEE estimate equations. Moreover, studies showed a lower activity energy expenditure in patients with DM than in healthy ones. This difference may be partially explained by patient with DMs poor compliance with exercise recommendations and their greater participation in lower intensity activities. These specificities of PA need to be taken into account in the development of adapted tools to assess activity energy expenditure and daily energy expenditure in people with DM. Few estimation tools are tested in subjects with DM and this results in a lack of accuracy especially for their particular patterns of activity. Thus, future studies should examine sensors coupling different technologies or method that is specifically designed to accurately assess energy expenditure in patients with diabetes in daily life.

External Mechanical Work and Pendular Energy Transduction of Overground and Treadmill Walking in Adolescents with Unilateral Cerebral Palsy

Purpose: Motor impairments affect functional abilities and gait in children and adolescents with cerebral palsy (CP). Improving their walking is an essential objective of treatment, and the use of a treadmill for gait analysis and training could offer several advantages in adolescents with CP. However, there is a controversy regarding the similarity between treadmill and overground walking both for gait analysis and training in children and adolescents. The aim of this study was to compare the external mechanical work and pendular energy transduction of these two types of gait modalities at standard and preferred walking speeds in adolescents with unilateral cerebral palsy (UCP) and typically developing (TD) adolescents matched on age, height and body mass. Methods: Spatiotemporal parameters, external mechanical work and pendular energy transduction of walking were computed using two inertial sensors equipped with a triaxial accelerometer and gyroscope and compared in 10 UCP (14.2 ± 1.7 year) and 10 TD (14.1 ± 1.9 year) adolescents during treadmill and overground walking at standard and preferred speeds. Results: The treadmill induced almost identical mechanical changes to overground walking in TD adolescents and those with UCP, with the exception of potential and kinetic vertical and lateral mechanical works, which are both significantly increased in the overground-treadmill transition only in UCP (P < 0.05). Conclusions: Adolescents with UCP have a reduced adaptive capacity in absorbing and decelerating the speed created by a treadmill (i.e., dynamic stability) compared to TD adolescents. This may have an important implication in rehabilitation programs that assess and train gait by using a treadmill in adolescents with UCP.

Shoulder loading reliability in seated able-bodied subjects

Shoulder performance and sensorimotor control assessments help to identify shoulder instabilities and document the rehabilitation progress. Testing seated subjects in a position of hand prehension requires less controlled adjustments to maintain body balance in a clinically relevant situation. The objective of this work was to determine the test-retest repeatability of a novel shoulder stability test in seated subjects with the ipsi-lateral hand in prehension during four arm loading conditions. Able-bodied subjects were seated on a rigid chair fixed to a force plate. A horizontally and posteriorly directed force was applied to the hand for four 4 loading conditions ranging from 0 to 3 kg. Ten postural balance parameters were calculated from the center of pressure displacements and its corresponding free moments. Intra-class correlation coefficients were calculated for three consecutive trials and for four loading conditions. Generally, the intra-class correlations values increased gradually with the load and varied from 0.727 to 0.948. Tz values increased non-linearly with the applied load. The test-retest reliability of a new shoulder stability test in seated able-bodied subjects was high with sufficient loading (3 kg) and 3 trials.