Best-Compromise Control Strategy Between Mechanical Energy Expenditure and Foot Clearance for Obstacle-Crossing in Older Adults: Effects of Tai-Chi Chuan Practice

Chien-Chung Kuo; Sheng-Chang Chen; Jr-Yi Wang; Tsung-Jung Ho; Tung-Wu Lu

doi:10.3389/fbioe.2021.774771

Best-Compromise Control Strategy Between Mechanical Energy Expenditure and Foot Clearance for Obstacle-Crossing in Older Adults: Effects of Tai-Chi Chuan Practice

Front Bioeng Biotechnol. 2021 Dec 2:9:774771. doi: 10.3389/fbioe.2021.774771. eCollection 2021.

Authors

Chien-Chung Kuo^{1

2}, Sheng-Chang Chen³, Jr-Yi Wang^{3

4}, Tsung-Jung Ho^{5

6

7}, Tung-Wu Lu³

Affiliations

¹ Department of Orthopedics, China Medical University Hospital, Taichung, Taiwan.
² Department of Orthopedics, School of Medicine, China Medical University, Taichung, Taiwan.
³ Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan.
⁴ Department of Orthopedics, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
⁵ Integration Center of Traditional Chinese and Modern Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
⁶ Department of Chinese Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
⁷ School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan.

Abstract

Background: Obstacle-crossing increases the risk of falls in older people. This study aimed to identify the effects of long-term Tai-Chi Chuan (TCC) practice on the control strategies for obstacle-crossing in older people. Methods: A multi-objective optimal control technique with measured gait data was used to identify the control strategies adopted by 15 long-term TCC practitioners and 15 healthy controls when crossing obstacles of different heights, in terms of the best-compromise weighting sets for the conflicting objectives of minimizing energy expenditure and maximizing the toe-obstacle and heel-obstacle clearances. Results and Conclusions: The long-term TCC older practitioners adopted a best-compromise control strategy similar to those adopted by young adults, with greater weightings on the minimization of the mechanical energy expenditure and smaller weightings on foot-clearance as compared to non-TCC controls (TCC: 0.72, 0.14, 0.14; Control: 0.55, 0.225, 0.225). This strategy enabled the long-term TCC older practitioners to cross obstacles with significantly greater leading-toe clearances but with relatively less mechanical energy expenditure. With the current approach, further simulations of obstacle-crossing mechanics with a given weighting set will be useful for answering clinically relevant what-if questions, such as what abilities would be needed if the non-TCC older people were to cross obstacles using the crossing strategy of the TCC people.

Keywords: Tai-Chi Chuan; gait analysis; obstacle crossing; optimal control; risk of fall.