Age-related changes in gait biomechanics and their impact on the metabolic cost of walking: Report from a National Institute on Aging workshop

Katherine A Boyer; Kate L Hayes; Brian R Umberger; Peter Gabriel Adamczyk; Jonathan F Bean; Jennifer S Brach; Brian C Clark; David J Clark; Luigi Ferrucci; James Finley; Jason R Franz; Yvonne M Golightly; Tibor Hortobágyi; Sandra Hunter; Marco Narici; Barbara Nicklas; Thomas Roberts; Gregory Sawicki; Eleanor Simonsick; Jane A Kent

doi:10.1016/j.exger.2023.112102

Age-related changes in gait biomechanics and their impact on the metabolic cost of walking: Report from a National Institute on Aging workshop

Exp Gerontol. 2023 Mar:173:112102. doi: 10.1016/j.exger.2023.112102. Epub 2023 Jan 21.

Authors

Katherine A Boyer¹, Kate L Hayes², Brian R Umberger³, Peter Gabriel Adamczyk⁴, Jonathan F Bean⁵, Jennifer S Brach⁶, Brian C Clark⁷, David J Clark⁸, Luigi Ferrucci⁹, James Finley¹⁰, Jason R Franz¹¹, Yvonne M Golightly¹², Tibor Hortobágyi¹³, Sandra Hunter¹⁴, Marco Narici¹⁵, Barbara Nicklas¹⁶, Thomas Roberts¹⁷, Gregory Sawicki¹⁸, Eleanor Simonsick⁹, Jane A Kent²

Affiliations

¹ Department of Kinesiology, University of Massachusetts Amherst, MA, USA; Department of Orthopedics and Physical Rehabilitation, University of Massachusetts Medical School, Worcester, MA, USA. Electronic address: kboyer@umass.edu.
² Department of Kinesiology, University of Massachusetts Amherst, MA, USA.
³ School of Kinesiology, University of Michigan, USA.
⁴ Department of Mechanical Engineering, University of Wisconsin-Madison, USA.
⁵ New England GRECC, VA Boston Healthcare System, Boston, MA, USA; Department of PM&R, Harvard Medical School, Boston, MA, USA; Spaulding Rehabilitation Hospital, Boston, MA, USA.
⁶ Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA.
⁷ Ohio Musculoskeletal and Neurological Institute and the Department of Biomedical Sciences, Ohio University, Athens, OH, USA.
⁸ Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, USA; Department of Physiology and Aging, University of Florida, Gainesville, FL, USA.
⁹ Intramural Research Program of the National Institute on Aging, NIH, Baltimore, MD, USA.
¹⁰ Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA.
¹¹ Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC, USA.
¹² College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, USA; Thurston Arthritis Research Center, Division of Rheumatology, Allergy, and Immunology, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.
¹³ Hungarian University of Sports Science, Department of Kinesiology, Budapest, Hungary; Institute of Sport Sciences and Physical Education, University of Pécs, Hungary; Somogy County Kaposi Mór Teaching Hospital, Kaposvár, Hungary; Center for Human Movement Sciences, University of Groningen Medical Center, Groningen, the Netherlands.
¹⁴ Department of Physical Therapy, Marquette University, Milwaukee, WI, USA.
¹⁵ Neuromuscular Physiology Laboratory, Department of Biomedical Sciences, University of Padova, Padova, Italy.
¹⁶ Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, USA.
¹⁷ Department of Ecology and Evolutionary Biology, Brown University, USA.
¹⁸ George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, USA.

Abstract

Changes in old age that contribute to the complex issue of an increased metabolic cost of walking (mass-specific energy cost per unit distance traveled) in older adults appear to center at least in part on changes in gait biomechanics. However, age-related changes in energy metabolism, neuromuscular function and connective tissue properties also likely contribute to this problem, of which the consequences are poor mobility and increased risk of inactivity-related disease and disability. The U.S. National Institute on Aging convened a workshop in September 2021 with an interdisciplinary group of scientists to address the gaps in research related to the mechanisms and consequences of changes in mobility in old age. The goal of the workshop was to identify promising ways to move the field forward toward improving gait performance, decreasing energy cost, and enhancing mobility for older adults. This report summarizes the workshop and brings multidisciplinary insight into the known and potential causes and consequences of age-related changes in gait biomechanics. We highlight how gait mechanics and energy cost change with aging, the potential neuromuscular mechanisms and role of connective tissue in these changes, and cutting-edge interventions and technologies that may be used to measure and improve gait and mobility in older adults. Key gaps in the literature that warrant targeted research in the future are identified and discussed.

Keywords: Fatigue; Mobility; Muscle energetics; Tendon; Wearable technology.

Publication types

Review
Research Support, N.I.H., Extramural

MeSH terms

Biomechanical Phenomena
Gait
National Institute on Aging (U.S.)*
United States
Walking*

Grants and funding

Z99 AG999999/ImNIH/Intramural NIH HHS/United States