Biomechanical responses of Nordic walking in people with Parkinson's disease.

In healthy adults, Nordic walking (NW) is known to increase the external mechanical energy fluctuations, though the external work is unaltered due to an improved pendulum-like recovery in comparison with free walking (FW). We aimed to compare mechanical, pendulum-like, and spatiotemporal parameters of gait at different speeds with and without NW poles in people with Parkinson's disease and healthy controls. The study included 11 people (aged 65.6 ± 7.0 years) with idiopathic Parkinson's disease, scoring between 1 and 1.5 on the Hoehn and Yahr scale (H&Y), and nine healthy controls (aged 70.0 ± 5.6 years). All the people were experienced Nordic walkers. Walking tests were performed at 1.8 km h-1 and 4.7 km h-1 , on eight 3D force platforms on a walkway. We found greater pendulum-like energy recovery (p < 0.05) in the Parkinson group during NW than in FW, while external mechanical work remained similar (p > 0.05). People with Parkinson's disease showed a major increase in vertical and forward energy fluctuations using poles than in healthy controls. In addition, the Parkinson group showed increased stride frequency and reduced stride length compared to controls in the NW and FW conditions. Our findings partly justify the lower walking economy in Parkinson's disease due to reduced pendulum-like mechanism at commonly used speeds. NW alters gait mechanics similarly in Parkinson group and healthy control, increasing the total mechanical work. Therefore, NW can be a compelling strategy for rehabilitation because of its potential for improving functional mobility, increasing pendulum-like mechanism in Parkinson's disease.

Biomechanical, physiological and anthropometrical predictors of performance in recreational runners.

Background: The maximal running speed (VMAX) determined on a graded treadmill test is well-recognized as a running performance predictor. However, few studies have assessed the variables that predict VMAX in recreationally active runners. Methods: We used a mathematical procedure combining Fick's law and metabolic cost analysis to verify the relation between (1) VMAX versus anthropometric and physiological determinants of running performance and, (2) theoretical metabolic cost versus running biomechanical parameters. Linear multiple regression and bivariate correlation were applied. We aimed to verify the biomechanical, physiological, and anthropometrical determinants of VMAX in recreationally active runners. Fifteen recreationally active runners participated in this observational study. A Conconi and a stead-steady running test were applied using a heart rate monitor and a simple video camera to register the physiological and mechanical variables, respectively. Results: Statistical analysis revealed that the speed at the second ventilatory threshold, theoretical metabolic cost, and fat-mass percentage confidently estimated the individual running performance as follows: VMAX = 58.632 + (-0.183 * fat percentage) + (-0.507 * heart rate percentage at second ventilatory threshold) + (7.959 * theoretical metabolic cost) (R2 = 0.62, p = 0.011, RMSE = 1.50 km.h-1). Likewise, the theoretical metabolic cost was significantly explained (R2 = 0.91, p = 0.004, RMSE = 0.013 a.u.) by the running spatiotemporal and elastic-related parameters (contact and aerial times, stride length and frequency, and vertical oscillation) as follows: theoretical metabolic cost = 10.421 + (4.282 * contact time) + (-3.795 * aerial time) + (-2.422 * stride length) + (-1.711 * stride frequency) + (0.107 * vertical oscillation). Conclusion: Critical determinants of elastic mechanism, such as maximal vertical force and vertical and leg stiffness were unrelated to the metabolic economy. VMAX, a valuable marker of running performance, and its physiological and biomechanical determinants can be effectively evaluated using a heart rate monitor, treadmill, and a digital camera, which can be used in the design of training programs to recreationally active runners.

The metabolic cost of emulated aerodynamic drag forces in marathon running.

The benefits of drafting for elite marathon runners are intuitive, but the quantitative energetic and time savings are still unclear due to the different methods used for converting aerodynamic drag force reductions to gross metabolic power savings. Further, we lack a mechanistic understanding of the relationship between aerodynamic drag forces and ground reaction forces (GRFs) over a range of running velocities. Here, we quantified how small horizontal impeding forces affect gross metabolic power and GRF over a range of velocities in competitive runners. In three sessions, 12 runners completed six 5-min trials with 5 min of recovery in-between. We tested one velocity per session (12, 14, and 16 km/h), at three horizontal impeding force conditions (0, 4, and 8 N) applied at the waist of the runners. On average, gross metabolic power increased by 6.13% per 1% body weight of horizontal impeding force but the increases varied considerably between individuals (4.17%-8.14%). With greater horizontal impeding force, braking GRF impulses decreased, whereas propulsive GRF impulses increased, but the impulses were not related to individual changes in gross metabolic power. Combining our findings with those of previous aerodynamics studies, we estimate that for a solo runner (52 kg) at 2-h marathon pace, overcoming aerodynamic drag force (1.39% BW) comprises 7.8% of their gross metabolic power and drafting can save between 3 min 42 s and 5 min 29 s.NEW & NOTEWORTHY We measured the metabolic and biomechanical effects of small horizontal impeding forces (representing realistic aerodynamic drag forces) on high-caliber runners across a range of velocities. Combining our metabolic results with existing aerodynamic models indicates that at 2-h marathon pace, optimal drafting likely allows a marathoner to run between 3 min 42 s and 5 min 29 s faster. Our rule-of-thumb (∼6% increase in gross metabolic power per 1% body weight of horizontal impeding force) will allow others to estimate the performance enhancement of different drafting formations.

Modelling 5-km Running Performance on Level and Hilly Terrains in Recreational Runners.

Incline and level running on treadmills have been extensively studied due to their different cardiorespiratory and biomechanical acute responses. However, there are no studies examining the performance determinants of outdoor running on hilly terrains. We aimed to investigate the influence of anthropometrics, muscle strength, and cardiorespiratory and gait spatiotemporal parameters during level (0%) and inclined (+7%) running on performance in level and hilly 5-km races. Twenty male recreational runners completed two 5-km outdoor running tests (0% vs. +7% and −7%), and two submaximal (10 km·h−1) and incremental treadmill tests at 0 and 7% slopes, after complete laboratory evaluations. The velocity at maximal oxygen consumption (VO2max) evaluated at 7% incline and level treadmill running were the best performance predictors under both hilly (R2 = 0.72; p < 0.05) and level (R2 = 0.85; p < 0.01) conditions, respectively. Inclusion of ventilatory and submaximal heart rate data improved the predictive models up to 100%. Conversely, none of the parameters evaluated in one condition contributed to the other condition. The spatiotemporal parameters and the runners' strength levels were not associated to outdoor performances. These results indicate that the vVO2max evaluated at similar slopes in the lab can be used to predict 5-km running performances on both level and hilly terrains.

Relationship between knee extensor and flexor muscle strength and age in professional volleyball players.

We aimed to analyse the relationship of peak torque (PT) of the knee extensors (Ext) and flexors (Fle) with age, and the relationship between conventional ratio and age progression in volleyball players. A total of 41 elite male volleyball players (age: 25.0 ± 6.1 years, body mass: 93.0 ± 9.8 kg, height: 198.0 ± 6.8 cm) were evaluated in a isokinetic dynamometer at speeds of 60, 180 and 300 deg/s, and at dominant (D) and non-dominant (ND) legs. In general, the knee flexor and extensor muscles varied greatly among the athletes (from 81 to 156 N.m for flexors; from 116 to 250 N.m for extensors at 300 deg/s and at dominant side). The mass-specific PT of knee extensors showed strong and negative correlation with ageing at 60 and 180 deg/s (r = -0.52-0.62, p < 0.01). The conventional ratio showed regular and positive relationship at all evaluated velocities (60°.s-1, r = 0.453, p < 0.01; 180°.s-1, r = 0.498, p < 0.01; 300°.s-1, r = 0.316, p = 0.04). The results demonstrated that volleyball players are susceptible to age-related effects on muscular performance during their career; this finding illustrates the importance of adopting training strategies to improve the production of strength in the lower limbs, which is essential for vertical jumps.

Gait parameters of Parkinson's disease compared with healthy controls: a systematic review and meta-analysis.

We systematically reviewed observational and clinical trials (baseline) studies examining differences in gait parameters between Parkinson's disease (PD) in on-medication state and healthy control. Four electronic databases were searched (November-2018 and updated in October-2020). Independent researchers identified studies that evaluated gait parameters measured quantitatively during self-selected walking speed. Risk of bias was assessed using an instrument proposed by Downs and Black (1998). Pooled effects were reported as standardized mean differences and 95% confidence intervals using a random-effects model. A total of 72 studies involving 3027 participants (1510 with PD and 1517 health control) met the inclusion criteria. The self-selected walking speed, stride length, swing time and hip excursion were reduced in people with PD compared with healthy control. Additionally, PD subjects presented higher cadence and double support time. Although with a smaller difference for treadmill, walking speed is reduced both on treadmill (.13 m s-1) and on overground (.17 m s-1) in PD. The self-select walking speed, stride length, cadence, double support, swing time and sagittal hip angle were altered in people with PD compared with healthy control. The precise determination of these modifications will be beneficial in determining which intervention elements are most critical in bringing about positive, clinically meaningful changes in individuals with PD (PROSPERO protocol CRD42018113042).

The relationship between height of vertical jumps, functionality and fall episodes in patients with chronic obstructive pulmonary disease: A case-control study.

This study aimed to compare the height of jumps and functional parameters in patients with chronic obstructive pulmonary disease (COPD) to those in healthy people, in addition to assessing the relationship among variables in patients with COPD. Twenty patients with COPD (forced expiratory volume [FEV1] % of predicted: 39.98 ± 11.69%; age: 62.95 ± 8.06 years) and 16 healthy people (FEV1% of predicted: 97.44 ± 14.45%; age: 59.94 ± 6.43 years) were evaluated, and all participants performed the Squat Jump (SJ) and Counter Movement Jump (CMJ) tests to assess rapid force considering the jumping height. Functional capacity was assessed using the self-selected walking speed tests, walking speed in 10 m, walking test in 6 min, balance on one leg, sitting and standing, timed up and go, and a stair-climbing test. In addition, the questionnaires on recall of falls, Falls Efficacy Scale-International (concern with falling), International Physical Activity Questionnaires, and Saint George Respiratory Questionnaire were administered. The height of the jumps showed no difference between the groups, but the COPD group performed worse in most functional tests and was more afraid of falling. The number of falls was correlated with height in the SJ (r = -0.51) and CMJ (r = -0.62) jumps (p < 0.05), and with the performance in different functional tests. We suggest that interventions targeting rapid force may bring improvements in functional mobility and physical fitness as well as reducing fall episodes in patients with COPD.

Triceps Surae Muscle-Tendon Properties as Determinants of the Metabolic Cost in Trained Long-Distance Runners.

Purpose: This study aimed to determine whether triceps surae's muscle architecture and Achilles tendon parameters are related to running metabolic cost (C) in trained long-distance runners. Methods: Seventeen trained male recreational long-distance runners (mean age = 34 years) participated in this study. C was measured during submaximal steady-state running (5 min) at 12 and 16 km h-1 on a treadmill. Ultrasound was used to determine the gastrocnemius medialis (GM), gastrocnemius lateralis (GL), and soleus (SO) muscle architecture, including fascicle length (FL) and pennation angle (PA), and the Achilles tendon cross-sectional area (CSA), resting length and elongation as a function of plantar flexion torque during maximal voluntary plantar flexion. Achilles tendon mechanical (force, elongation, and stiffness) and material (stress, strain, and Young's modulus) properties were determined. Stepwise multiple linear regressions were used to determine the relationship between independent variables (tendon resting length, CSA, force, elongation, stiffness, stress, strain, Young's modulus, and FL and PA of triceps surae muscles) and C (J kg-1m-1) at 12 and 16 km h-1. Results: SO PA and Achilles tendon CSA were negatively associated with C (r 2 = 0.69; p < 0.001) at 12 km h-1, whereas SO PA was negatively and Achilles tendon stress was positively associated with C (r 2 = 0.63; p = 0.001) at 16 km h-1, respectively. Our results presented a small power, and the multiple linear regression's cause-effect relation was limited due to the low sample size. Conclusion: For a given muscle length, greater SO PA, probably related to short muscle fibers and to a large physiological cross-sectional area, may be beneficial to C. Larger Achilles tendon CSA may determine a better force distribution per tendon area, thereby reducing tendon stress and C at submaximal speeds (12 and 16 km h-1). Furthermore, Achilles tendon morphological and mechanical properties (CSA, stress, and Young's modulus) and triceps surae muscle architecture (GM PA, GM FL, SO PA, and SO FL) presented large correlations with C.

Stress and recovery perception, creatine kinase levels, and performance parameters of male volleyball athletes in a preseason for a championship.

BACKGROUND: Training load and adequate recovery have been identified as essential elements to improve well-being and performance in team sports and avoid non-functional overreaching and overtraining. OBJECTIVE: This cohort study sought to analyze the stress and recovery perceptions, creatine kinase levels (CK), and vertical jump performance of volleyball athletes at different training times during a championship preseason. METHODS: Thirteen high-level male volleyball players (23.80 ± 5.40 years, 91.50 ± 8.80 kg, and 193.10 ± 6.40 cm) completed the RESTQ-Sport questionnaire on stress and recovery perception, and blood samples were collected to evaluate CK levels. These measures were performed six times over 16 weeks, while jumps such as squat jump (SJ), countermovement jump (CMJ), and countermovement jump arm (CMJA) were performed at three of those times for specific performance evaluation. RESULTS: The stress perception and recovery perception indices increased and decreased, respectively, in the pre-competitive phase, while CK levels presented an initial rise, maintenance over the training period, and a drop. Vertical jump heights increased significantly throughout the preparatory period regardless of the type of jump. In all training phases, CMJA values exceeded CMJ and SJ values, and CMJ values exceeded SJ values. CONCLUSIONS: Positive adaptations were elicited by training stimuli, resulting in improvements in performance. Conversely, load training variables indicated higher levels of stress and muscle damage, together with lower perceptions of recovery during the championship preseason.

Nordic walking training in elderly, a randomized clinical trial. Part II: Biomechanical and metabolic adaptations.

BACKGROUND: Nordic walking is an attractive method of endurance training. Nevertheless, the biomechanic response due to the additional contribution of using poles in relation to free walking training has been less explored in the elderly. PURPOSE: This randomized parallel controlled trial aimed to assess the effects of 8 weeks of Nordic walking and free walking training on the walking economy, mechanical work, metabolically optimal speed, and electromyographic activation in elderly. METHODS: Thirty-three sedentary elderly were randomized into Nordic walking (n = 16) and free walking group (n = 17) with equalized loads. Submaximal walking tests were performed from 1 to 5 km h-1 on the treadmill. RESULTS: Walking economy was improved in both free and Nordic walking groups (x2 4.91, p = 0.014) and the metabolically optimal speed was increased by approximately 0.5 km h-1 changing the speed-cost profile. The electromyographic activation in lower and upper limbs, pendular recovery, and total, external, and internal mechanical work remained unchanged (p > 0.05). Interestingly, the internal mechanical work associated with arm movement was higher in the Nordic walking group than in the free walking group after training, while the co-contraction from upper limb muscles was reduced similarly to both groups. CONCLUSIONS: Eight weeks of Nordic walking training effectively improved the walking economy and functionality as well as maintained the gait mechanics, similar to free walking training in elderly people. This enhancement in the metabolic economy may have been mediated by a reduction in the co-contraction from upper limb muscles. TRIAL REGISTRATION: ClinicalTrails.gov NCT03096964.

Landing-Takeoff Asymmetries Applied to Running Mechanics: A New Perspective for Performance.

BACKGROUND: Elastic bouncing is a physio-mechanical model that can elucidate running behavior in different situations, including landing and takeoff patterns and the characteristics of the muscle-tendon units during stretch and recoil in running. An increase in running speed improves the body's elastic mechanisms. Although some measures of elastic bouncing are usually carried out, a general description of the elastic mechanism has not been explored in running performance. This study aimed to compare elastic bouncing parameters between the higher- and lower-performing athletes in a 3000 m test. METHODS: Thirty-eight endurance runners (men) were divided into two groups based on 3000 m performance: the high-performance group (Phigh; n = 19; age: 29 ± 5 years; mass: 72.9 ± 10 kg; stature: 177 ± 8 cm; 3000time: 656 ± 32 s) and the low-performance group (Plow; n = 19; age: 32 ± 6 years; mass: 73.9 ± 7 kg; stature: 175 ± 5 cm; 3000time: 751 ± 29 s). They performed three tests on different days: (i) 3000 m on a track; (ii) incremental running test; and (iii) a running biomechanical test on a treadmill at 13 different speeds from 8 to 20 km h-1. Performance was evaluated using the race time of the 3000 m test. The biomechanics variables included effective contact time (t ce), aerial time (t ae), positive work time (t push), negative work time (t break), step frequency (f step), and elastic system frequency (f sist), vertical displacement (S v) in t ce and t ae (S ce and S ae), vertical force, and vertical stiffness were evaluated in a biomechanical submaximal test on treadmill. RESULTS: The t ae, f sist, vertical force and stiffness were higher (p < 0.05) and t ce and f step were lower (p < 0.05) in Phigh, with no differences between groups in t push and t break. CONCLUSION: The elastic bouncing was optimized in runners of the best performance level, demonstrating a better use of elastic components.

Gait and functionality of individuals with visual impairment who participate in sports.

BACKGROUND: Individuals with visual impairment (VI) have often been observed to walk slower than individuals with unimpaired vision. These observations might be confounded by typical low levels of physical activity and greater sedentary behavior in individuals with VI than the overall population. RESEARCH QUESTION: Here, we compared gait and balance measures between individuals with VI who participate in disability sports, and activity level matched sighted individuals. METHODS: We assessed static balance, anthropometry, self-selected walking speed, locomotion rehabilitation index, and lower limb muscular endurance; and applied physical activity level and fear of falling questionnaires. RESULTS: Individuals with VI who participate in disability sports, self-selected a similar walking speed (1.29 ±â€¯0.26 m/s) as active sighted individuals (1.39 ±â€¯0.21 m/s). Locomotor rehabilitation index and muscular endurance of lower limbs were also similar between groups. Individuals with VI presented lower static balance (42.0 ±â€¯17.0s) than the sighted control group (45.0 ±â€¯0s) when the controls were tested with their eyes open. However, no difference was found when the controls were tested with their eyes closed (30.3 ±â€¯17.0s). Furthermore, individuals with VI showed a greater fear of falling. SIGNIFICANCE: In conclusion, individuals with VI who participate in disability sports, as goalball and football, walk with similar self-selected walking speeds as active sighted individuals, but have slightly worse static balance and fear of falling.