The Metabolic Cost of Walking in healthy young and older adults – A Systematic Review and Meta Analysis

Gupta, Shubham; Bobbert, Maarten F.; Kistemaker, Dinant A.

doi:10.1038/s41598-019-45602-4

Cited by 52 publications

(58 citation statements)

References 52 publications

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“…Cardiopulmonary metabolic energy cost is an important variable in daily life and has been studied extensively. Also, the cardiopulmonary metabolic energy cost has become an important clinical tool for evaluating human exercise capacity and for predicting outcomes [17,18]. The results of this study are consistent with those of previous studies showing that net cardiopulmonary metabolic energy cost expenditures increased signi cantly as the treadmill slope increased [7,12].…”

Section: Discussionsupporting

confidence: 88%

Correlation Between Cardiopulmonary Metabolic Energy Cost and Lower-limb Muscle Activity During Inclined Treadmill Gait in Older Adults

Kim

Lee

et al. 2021

Preprint

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Background: Inclined walking requires more cardiopulmonary metabolic energy and muscle strength than flat-level walking. This study sought to investigate changes in lower-limb muscle activity and cardiopulmonary metabolic energy cost during treadmill walking with different inclination grades and to discern any correlation between these two measures in older adults.Methods: Twenty-four healthy older adults (n = 11 males; mean age: 75.3 ± 4.0 years) participated. All participants walked on a treadmill that was randomly inclined at 0% (condition 1), 10% (condition 2), and 16% (condition 3) for five minutes each. Simultaneous measurements of lower-limb muscle activity and cardiopulmonary metabolic energy cost during inclined treadmill walking were collected. Measured muscles included the rectus abdominis (RA), erector spinae (ES), rectus femoris (RF), biceps femoris (BF), vastus medialis (VM), tibialis anterior (TA), medial head of the gastrocnemius (GCM), and soleus (SOL) muscles on the right side. Results: As compared with 0% inclined treadmill gait, the 10% inclined treadmill gait increased the net cardiopulmonary metabolic energy cost by 22.9%, while the 16% inclined treadmill gait increased the net cardiopulmonary metabolic energy cost by 44.2%. In the stance phase, as the slope increased, activity was significantly increased in the RA, RF, VM, BF, GCM, and SOL muscles. In the swing phase, As the slope increased activity was significantly increased in the RA, RF, VM, BF, and TA muscles. SOL muscle activity was most relevant to the change in cardiopulmonary metabolic energy cost in the stance phase of inclined treadmill walking. The relationship between the increase in cardiopulmonary metabolic energy cost and changes in muscle activity was also significant in the VM, GCM, and RF.Conclusion: This study demonstrated that changes in SOL, VM, GCM, and RA muscle activity had a significant relationship with cardiopulmonary metabolic energy cost increment during inclined treadmill walking. These results can be used as basic data for various gait-training programs and as an indicator in the development of assistive algorithms of wearable walking robots for older adults. Trial registration: Clinical trials registration information: ClinicalTrials.gov Identifier: NCT04614857 (05/11/2020).

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Section: Discussionsupporting

confidence: 88%

Correlation Between Cardiopulmonary Metabolic Energy Cost and Lower-limb Muscle Activity During Inclined Treadmill Gait in Older Adults

Kim

Lee

et al. 2021

Preprint

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“…When summarizing published data on differences between YA and OA for MCoW, we found OA have a statistically significantly elevated MCoW compared to YA (Das Gupta et al 2019). However, we could not determine whether this elevation was caused directly by age or was due to confounders and in particular due to walking on a treadmill.…”

Section: Discussionmentioning

confidence: 59%

Metabolic cost in healthy fit older adults and young adults during overground and treadmill walking

et al. 2021

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Purpose The purpose of this study was to determine whether net metabolic cost of walking is affected by age per se. Methods We selected 10 healthy, active older adults (mean age 75 years) and 10 young adults (mean age 26 years), and determined their preferred overground walking speed. On the same day, in a morning and afternoon session, we had them walk at that speed overground and on a treadmill while we measured oxygen consumption rate. From the latter we subtracted the rate in sitting and calculated net metabolic cost. Results Anthropometrics were not different between the groups nor was preferred walking speed (1.27 m s−1 both groups). There was no difference in net metabolic cost of overground walking between older and young adults (e.g., in the morning 2.64 and 2.56 J kg−1 m−1, respectively, p > 0.05). In the morning session, net metabolic cost of walking was higher on the treadmill than overground in our older adults by 0.6 J kg−1 m−1 (p < 0.05), but not in young adults. Conclusion First, there is no effect of age per se on metabolic cost of overground walking. Second, older adults tend to have higher metabolic cost of walking on a treadmill than walking overground at preferred speed, and adaptation may take a long time. The commonly reported age-related elevation of metabolic cost of walking may be due to confounding factors causing preferred walking speed to be lower in older adults, and/or due to older adults reacting differently to treadmill walking than young adults.

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“…The effect of aging on walking economy has been studied extensively with consistent findings of higher gross and net cost of walking in healthy older adults compared with their younger counterparts (eg, for review see 42 ). In line with previous observations, we also reported a 16% to 12% higher net energy cost of walking in older than in young adults at both slow (0.83 m.s −1 ) and fast speeds (1.39m.s −1 ) 25,28,42 . This increase in the energy cost of walking in older adults is multifactorial and remains unclear.…”

Section: Discussionmentioning

confidence: 99%

Distal‐to‐proximal joint mechanics redistribution is a main contributor to reduced walking economy in older adults

Delabastita

Hollville

Catteau

et al. 2021

Scandinavian Med Sci Sports

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Age‐related neural and musculoskeletal declines affect mobility and the quality of life of older adults. To date, the mechanisms underlying reduced walking economy in older adults still remain elusive. In this study, we wanted to investigate which biomechanical factors were associated with the higher energy cost of walking in older compared with young adults. Fourteen younger (24 ± 2 years) and fourteen older (74 ± 4 years) adults were tested. Plantarflexor strength and Achilles tendon stiffness were evaluated during a dynamometer test. Medial gastrocnemius fascicle length, ground reaction forces, joint kinematics, and oxygen consumption were measured during walking treadmill at 0.83 and 1.39 m.s−1. Energy cost of walking, lower‐limb joint mechanics, muscle‐tendon unit, and tendinous tissues length were calculated. The energy cost of walking was higher at 0.83 m.s‐1 (+16%; P = .005) and plantarflexor strength lower (−31%; P = .007) in older adults. Achilles tendon stiffness and medial gastrocnemius fascicle length changes did not differ between older and young adults. The reduction in ankle mechanics was compensated by increases in hip mechanics in older adults during walking. The hip extensor moment was the only significant predictor of the energy cost of walking (adjusted R2: 0.35‐0.38). The higher energy cost in older adults is mainly associated with their distal‐to‐proximal redistribution of joint mechanics during walking possibly due to plantarflexor weakness. In our study, medial gastrocnemius fascicle and tendinous tissue behavior did not explain the higher energy cost of walking in older compared to young adults.

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The Metabolic Cost of Walking in healthy young and older adults – A Systematic Review and Meta Analysis

Cited by 52 publications

References 52 publications

Correlation Between Cardiopulmonary Metabolic Energy Cost and Lower-limb Muscle Activity During Inclined Treadmill Gait in Older Adults

Correlation Between Cardiopulmonary Metabolic Energy Cost and Lower-limb Muscle Activity During Inclined Treadmill Gait in Older Adults

Metabolic cost in healthy fit older adults and young adults during overground and treadmill walking

Distal‐to‐proximal joint mechanics redistribution is a main contributor to reduced walking economy in older adults

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