University of North Carolina, Chapel Hill
This project introduces and investigates the scientific premise that passive wearable therapeutic devices can enhance plantarflexor muscle performance during walking to elicit and promote lasting physiological and functional improvements for older adults. The investigators aim to quantify the preliminary efficacy of wearable plantarflexor resistance training to enhance gait performance in older adults, investigate neural and muscular mechanisms of adaptation, and identify target candidate characteristics for personalized treatment strategies. The investigators will test the hypothesis that, compared to baseline and unlike controls, WearAPT will increase peak ankle power output, stride length, habitual and maximum walking speeds, walking economy, and 6-min walk distance.
This proposal will address the critical need for novel and evidence-based therapeutics to enhance muscle function, mobility, and independence to those in our rapidly aging population. Walking disability in older adults is characterized by shorter steps, slower habitual walking speeds, and higher metabolic energy costs. These functional impairments stem from precipitous reductions in ankle (plantarflexor) push-off power output that cannot be improved by conventional strength training. Motivated by the need to overcome the poor compliance and functional transfer of traditional interventions and…
Inclusion Criteria: * insufficient weekly physical activity levels (i.e., ≤150 minutes moderate-intensity or ≤75 minutes vigorous-intensity activity) * self-select a habitual walking speed deemed indicative of age-related slowing (i.e., ≤1.1 m/s) * self-report at least some physical ability limitations (i.e., ≥4 on the "Stay Independent" questionnaire). Exclusion Criteria: * leg injury or fracture within the last 6 months * diagnosed anemia * neurological disorder of the legs such as peripheral neuropathy * vascular disorder of the legs such as peripheral arterial disease * taking medicatio…
Participants will complete two supervised, 20-min WearAPT sessions per week over the 6-week intervention period. Informed by a pilot study and designed to ensure a standardized starting point for all participants, all subjects will initially begin their first visit walking at their baseline preferred (self-selected) treadmill walking speed, and with 0 Nm of ankle resistive torque. The investigators will increase the resistance by 0.025 Nm/kg per minute, up to a maximum of 0.15 Nm/kg on the first session. On subsequent sessions, walking speed and resistance will be increased based on two evidence-based criteria monitored in 5-min intervals: (i) rate of perceived exertion (RPE) between 4 and 6, and (ii) a target heart rate indicative of moderate intensity activity (i.e., 50-70% maximum heart rate). The investigators will increase walking speed by 2.5% per session and resistive torque by 0.025 Nm/kg per week.
Participants randomly assigned to the control group will participate in pre- and post- laboratory visits and will complete a protocol of dose- (i.e., 20 min) and intensity-matched (i.e., heart rate) unresisted treadmill walking alone. Specifically, control participants will walk at a speed designed to elicit the same target within-session heart rate (i.e., 50-70% maximum).
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