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Biofeedback to Modulate Push-Off Int...

Browne, Michael Gordon.

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Biofeedback to Modulate Push-Off Intensity in Older Adults: Implications at the Muscle, Joint, Limb, and Whole-Body Levels.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Biofeedback to Modulate Push-Off Intensity in Older Adults: Implications at the Muscle, Joint, Limb, and Whole-Body Levels./
Author:	Browne, Michael Gordon.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2019,
Description:	158 p.
Notes:	Source: Dissertations Abstracts International, Volume: 80-12, Section: B.
Contained By:	Dissertations Abstracts International80-12B.
Subject:	Biomedical engineering. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=13812214
ISBN:	9781392201152

Biofeedback to Modulate Push-Off Intensity in Older Adults: Implications at the Muscle, Joint, Limb, and Whole-Body Levels.
Browne, Michael Gordon.

Biofeedback to Modulate Push-Off Intensity in Older Adults: Implications at the Muscle, Joint, Limb, and Whole-Body Levels. - Ann Arbor : ProQuest Dissertations & Theses, 2019 - 158 p.

Source: Dissertations Abstracts International, Volume: 80-12, Section: B.

Thesis (Ph.D.)--The University of North Carolina at Chapel Hill, 2019.

This item must not be sold to any third party vendors.

Even before clinically relevant reductions in preferred walking speed, older adults walk with a precipitous decrease in push-off intensity. This decrease in push-off intensity is characterized by reduced propulsive ground reaction forces and positive ankle power generation, resulting in compensatory increases in hip power generation known as a distal-to-proximal redistribution. These age-related changes may be considered maladaptive given evidence that reduced push-off intensity can increase metabolic energy expenditure. Nevertheless, older adults can volitionally enhance push-off intensity when tasks demand, such as walking faster or uphill. Therefore, the purpose of this dissertation was to design, implement, and fully characterize a suite of biofeedback paradigms capable of restoring older adults' push-off intensity during walking. First, we investigated whether older adults can volitionally increase push-off intensity. We discovered that not only do older adults retain the potential to increase ankle power using biofeedback, doing so reversed the distal-to-proximal redistribution and the recall of which increased preferred walking speed. Second, we investigated why older adults may walk with decreased push-off intensity. We used electromyographic biofeedback and in vivo ultrasound imaging to investigate the interplay between plantarflexor muscle activation, muscle force-length dynamics, and resultant ankle joint kinetics. We found that increasing plantarflexor EMG activity in older adults yields shorter fascicle lengths which may elicit counterproductive effects on muscle force generating potential and ankle joint moment generation during walking. Finally, we investigated a translational barrier to the clinical implementation of these biofeedback paradigms; should older adults enhance their push-off intensity? Specifically, we tested the influence of augmented push-off intensity on walking balance integrity. We found that while decreasing push-off intensity impaired walking balance integrity, older adults can increase push-off intensity without negative consequences on stability. Cumulatively, this dissertation provides an evidence-based roadmap for rehabilitation approaches to restore push-off intensity in our rapidly aging population while building confidence that doing so may translate to improved walking speeds without negatively affecting walking balance.

ISBN: 9781392201152Subjects--Topical Terms:

535387
Biomedical engineering.

Biofeedback to Modulate Push-Off Intensity in Older Adults: Implications at the Muscle, Joint, Limb, and Whole-Body Levels.
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520 $a Even before clinically relevant reductions in preferred walking speed, older adults walk with a precipitous decrease in push-off intensity. This decrease in push-off intensity is characterized by reduced propulsive ground reaction forces and positive ankle power generation, resulting in compensatory increases in hip power generation known as a distal-to-proximal redistribution. These age-related changes may be considered maladaptive given evidence that reduced push-off intensity can increase metabolic energy expenditure. Nevertheless, older adults can volitionally enhance push-off intensity when tasks demand, such as walking faster or uphill. Therefore, the purpose of this dissertation was to design, implement, and fully characterize a suite of biofeedback paradigms capable of restoring older adults' push-off intensity during walking. First, we investigated whether older adults can volitionally increase push-off intensity. We discovered that not only do older adults retain the potential to increase ankle power using biofeedback, doing so reversed the distal-to-proximal redistribution and the recall of which increased preferred walking speed. Second, we investigated why older adults may walk with decreased push-off intensity. We used electromyographic biofeedback and in vivo ultrasound imaging to investigate the interplay between plantarflexor muscle activation, muscle force-length dynamics, and resultant ankle joint kinetics. We found that increasing plantarflexor EMG activity in older adults yields shorter fascicle lengths which may elicit counterproductive effects on muscle force generating potential and ankle joint moment generation during walking. Finally, we investigated a translational barrier to the clinical implementation of these biofeedback paradigms; should older adults enhance their push-off intensity? Specifically, we tested the influence of augmented push-off intensity on walking balance integrity. We found that while decreasing push-off intensity impaired walking balance integrity, older adults can increase push-off intensity without negative consequences on stability. Cumulatively, this dissertation provides an evidence-based roadmap for rehabilitation approaches to restore push-off intensity in our rapidly aging population while building confidence that doing so may translate to improved walking speeds without negatively affecting walking balance.
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