Original Research ARTICLE
Combined resistance and stretching exercise training benefits stair descent biomechanics in older adults
- 1Department of Sport and Physical Activity, Bournemouth University, United Kingdom
- 2Research Centre for Musculoskeletal Science & Sports Medicine, School of Healthcare Science, Manchester Metropolitan University, United Kingdom
- 3Rise and Going Consultancy, United Kingdom
- 4Department of Biomedical and Electronics Engineering, University of Bradford, United Kingdom
- 5Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, United Kingdom
Introduction Stair descent is a physically demanding activity of daily life and common risk for falls. Age-related deteriorations in ankle joint capacities make stair descent particularly challenging for older adults in built environments, where larger rise steps are encountered. Exercise training may allow older adults to safely cope with the high biomechanical demands of stair descent. However, little is known about the demands of increased rise stairs for older adults, nor the impact of exercise.
Aim We investigated whether the effects of lower-limb resistance training would alter joint kinetics and movement strategies for older adults when descending standard rise, and increased rise stairs.
Method Fifteen older adults descended a four-step stair adjusted to standard rise (170 mm), and increased rise (255 mm) on separate visits. Between these two visits, randomly-allocated participants underwent 16 weeks of either: resistance exercise training (n=8) or habitual activity (n=7). Kinetic data were measured from step-mounted force plates, and kinematic data from motion-capture cameras. Training involved twice-weekly sessions of lower-limb resistance exercises (three sets of ~8 repetitions at ~80% three-repetition maximum), and static plantarflexor stretching (three, 45 s holds per leg).
Results - Standard stairs Peak ankle joint moments increased (p<0.002) and knee joint moments decreased (p<0.01) during descent after exercise training. Peak centre of pressure-centre of mass (CoP-CoM) separations increased in posterior (p=0.005) and medio-lateral directions (p=0.04) after exercise training. Exercise training did not affect CoM descent velocity or acceleration. Increased rise stairs Required greater ankle, knee and hip moments (p<0.001), peak downwards CoM velocity and acceleration (p=0.0001), and anterior-posterior CoP-CoM separation (p=0.0001), but lower medial-lateral CoP-CoM separation (p<0.05), when compared to standard stair descent. Exercise training did not affect joint kinetics or movement strategies.
Discussion Exercise training increased the maximum joint ROM, strength and force production of the ankle, and enabled a greater ankle joint moment to be produced in single-leg support (lowering phase) during standard stair descent. Descending increased rise stairs raised the task demand; exercise training could not overcome this. Future research should prioritise the ankle joint in stair descent, particularly targeting plantarflexor torque development across stairs of varying riser heights.
Keywords: stair negotiation, stability, joint moment, Stretching, Ageing, Movement Control
Received: 11 Dec 2018;
Accepted: 21 Jun 2019.
Edited by:Martin Burtscher, University of Innsbruck, Austria
Reviewed by:Stephan Pramsohler, Hermann Buhl Institute
Hermann Schwameder, University of Salzburg, Austria
Copyright: © 2019 Gavin, Reeves, Jones, Roys, Buckley, BALTZOPOULOS and Maganaris. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dr. James P. Gavin, Bournemouth University, Department of Sport and Physical Activity, Poole, United Kingdom, J.P.Gavin@soton.ac.uk