Renata Luisa Bona

Adaptations to changing speed, load, and gradient in human walking: cost of transport, optimal speed, and pendulum.

It has been observed that the optimal speed (OPT) of human walking is independent of load on level surfaces because of the unaltered trajectory of the center of mass and consequent conservation of the pendular mechanism. However, the role of the inverted pendulum mechanism that combines speed, load, and gradient during walking remains unknown. In the present study, 10 subjects walked on a treadmill, with and without loading (25% of the body mass), at different speeds and slopes (0%, +7%, and +15%). The three‐dimensional motion and VO2 were simultaneously registered. The mechanical external and internal work and the cost of transport (C) changed with the speed and gradient, but the load only affected C. OPT decreased with increasing gradient, and the pendular mechanics (R) was modified mainly as a result of changes in speed and gradient. OPT and R were independent of the load in these gradients. Remarkably, R increased with increasing speed and decreased (to 30%) with an increasing gradient; moreover, R was independent of load. Therefore, the energy‐saving strategy by the pendular mechanism persists, although at a diminished level, in loaded walking on gradients and partially explains the OPT in this condition.

The pendular mechanism does not determine the optimal speed of loaded walking on gradients

The pendular mechanism does not act as a primary mechanism in uphill walking due to the monotonic behavior of the mechanical energies of the center of mass. Nevertheless, recent evidence shows that there is an important minimization of energy expenditure by the pendular mechanism during walking on uphill gradients. In this study, we analyzed the optimum speed (OPT) of loaded human walking and the pendulum-like determining variables (Recovery R, Instantaneous pendular re-conversion Rint, and Congruity percentage %Cong). Ten young men walked on a treadmill at five different speeds and at three different treadmill incline gradients (0, +7 and +15%), with and without a load carried in their backpacks. We used indirect calorimetry and 3D motion analysis, and all of the data were analyzed by computational algorithms. Rint increased at higher speeds and decreased with increasing gradient. R and %Cong decreased with increasing gradient and increased with speed, independent of load. Thus, energy conversion by the pendular mechanism during walking on a 15% gradient is supported, and although this mechanism can explain the maintenance of OPT at low walking speeds, the pendular mechanism does not fully explain the energy minimization at higher speeds.

Electromyography and economy of walking in chronic heart failure and heart transplant patients

Background Patients with chronic heart failure frequently report intolerance to exercise and present with changes in walk pattern, but information about heart transplant patients is lacking. Alterations of the gait pattern are related to interaction changes between the metabolism, neurological system and the mechanical demands of the locomotor task. The aim of this study was to investigate the electromyographic cost, coactivation and cost of transport of walking of chronic heart failure and heart transplant patients. Design This research was of an exploratory, cross-sectional design. Methods Twelve chronic heart failure patients, twelve healthy controls and five heart transplant patients participated in the study. Electromyographic data and oxygen uptake were collected simultaneously at five walking speeds. Results In the experimental groups, the electromyographic cost, percentage of coactivation in the leg and cost of transport were higher than in controls. The electromyographic cost was in line with the cost of transport. The minimum electromyographic cost matched with the self-selected walking speed in controls, while in chronic heart failure and heart transplant patients, it was reached at speeds higher than the self-selected walking speed. Conclusion The largest postural isometric activation and antagonist activation resulted in the highest metabolic demand. These findings are of great clinical relevance because they support the concept that interventions in order to improve the muscle performance in these patients can increase the self-selected walking speed and therefore the metabolic economy of walking.

Effect of walking speed in heart failure patients and heart transplant patients

Background: Chronic heart failure patients present higher cost of transport and some changes in pattern of walking, but the same aspects have not yet been investigated in heart transplant patients. Methods: The aim of this study was to investigate both metabolic and mechanicals parameters, at five different walking speeds on treadmill, in chronic heart failure and heart transplant patients. Twelve chronic heart failure patients, twelve healthy controls and five heart transplant patients participated in the study. Tridimensional kinematics data and oxygen uptake were collected simultaneously. Findings: In both experimental groups the self‐selected walking speed was lower than in controls, and lower than the expected optimal walking speed. At that speed all groups showed the best ventilatory efficiency. On contrary, chronic heart failure and heart transplant patients reached the minimum cost of transport and the maximum recovery at greater speeds than the self‐selected walking speed. Their mechanical efficiency was lower than in controls, while their metabolic cost and mechanical work were on average larger. Interpretation: We conclude that actions, like a physical training, that could increase the self‐selected walking speed in these patients, could also increase their economy and optimize the mechanical parameters of walking. We propose a rehabilitation index, based on the theoretical optimal walking speed, to measure the improvements during a physical rehabilitation therapy. These results have an important clinical relevance and can help to improve the quality of life of heart failure and transplant patients. Highlights:We tested the influence of speed around the self‐selected walking speed.Chronic heart failure, heart transplant patients present higher cost of transport.The lower ventilatory efficiency is associated with walking speed in patients.The low walking speed in both patients group is associated to lower recovery.Increasing the walking speed of both patients group can improve their life quality.