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Journal articles on the topic 'Downhill walking'

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Published: 4 June 2021
Last updated: 20 February 2023

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1

Gault, Mandy, Richard Clements, and Mark Willems. "Eccentric contraction-induced muscle injury does not change walking economy in older adults." Journal of Human Kinetics 27, no. 1 (March 1, 2011): 55–65. http://dx.doi.org/10.2478/v10078-011-0005-1.

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Eccentric contraction-induced muscle injury does not change walking economy in older adultsThe aim of the study was to examine whether self-selected walking speed during downhill treadmill walking by older adults would result in muscle injury and changes in physiological responses during level walking. Twenty-six participants (age: 67 ± 4 yrs; height: 1.69 ± 0.09 m; body mass: 74.9 ± 13.1kg) were assigned to level (n = 11, 30 min, 0%) or downhill walking (n=15, 30 min, -10%) at a self-selected walking speed. Self-selected walking speed and exercise intensity were similar for both groups (level: 4.2±0.4 km·hr-1, 42±6% VO2max; downhill: 4.6±0.6 km·hr-1, 44±15% VO2max). After 48-hours, downhill walking had reduced maximal voluntary isometric force of the m. quadriceps femoris (-15%, P<0.001), indicative of muscle injury, but no changes were observed for walking economy, minute ventilation, heart rate and respiratory exchange ratio during level walking. For older adults, downhill walking at a selfselected walking speed causes muscle injury without any detrimental effect on walking economy. Regular downhill walking at a self-selected walking speed by older adults is an eccentric endurance activity that may have the potential to improve cardiovascular fitness and muscle strength.
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2

Maeo, Sumiaki, Masayoshi Yamamoto, Hiroaki Kanehisa, and Kazunori Nosaka. "Prevention of downhill walking-induced muscle damage by non-damaging downhill walking." PLOS ONE 12, no. 3 (March 13, 2017): e0173909. http://dx.doi.org/10.1371/journal.pone.0173909.

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3

Bottoni, Giuliamarta, Dieter Heinrich, Philipp Kofler, Michael Hasler, and Werner Nachbauer. "The Effect of Uphill and Downhill Walking on Joint-Position Sense: A Study on Healthy Knees." Journal of Sport Rehabilitation 24, no. 4 (November 2015): 349–52. http://dx.doi.org/10.1123/jsr.2014-0192.

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Context:During sport activity, knee proprioception might worsen. This decrease in proprioceptive acuity negatively influences motor control and therefore may increase injury risk. Hiking is a common activity characterized by a higher-intensity-exercise phase during uphill walking and a lower-intensity-exercise phase during downhill walking. Pain and injuries are reported in hiking, especially during the downhill phase.Objective:To examine the effect of a hiking-fatigue protocol on joint-position sense.Design:Repeated measures.Setting:University research laboratory.Participants:24 nonprofessional sportswomen without knee injuries.Main Outcome Measures:Joint-position sense was tested at the beginning, after 30 min uphill walking, and after 30 min downhill walking on a treadmill (continuous protocol).Results:After downhill walking, joint-position sense was significantly worse than in the test at the beginning (P = .035, α = .05). After uphill walking, no differences were observed in comparison with the test at the beginning (P = .172, α = .05) or the test after downhill walking (P = .165, α = .05).Conclusion:Downhill walking causes impairment in knee-joint-position sense. Considering these results, injury-prevention protocols for hiking should focus on maintaining and improving knee proprioception during the descending phase.
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4

Oliveira, Thiago Pires de, Leonardo Coelho Rabello de Lima, Felipe Bruno Dias de Oliveira, Benedito Sérgio Denadai, and Camila Coelho Greco. "Efeito do treinamento de caminhada no declive em variáveis neuromusculares." Brazilian Journal of Kinanthropometry and Human Performance 20, no. 3 (June 20, 2018): 332–41. http://dx.doi.org/10.5007/1980-0037.2018v20n3p332.

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Walking involves small adjustments to maintain body balance. However, the demand for these adjustments may be different during downhill walking. The aim of this study was to analyze the effect of periodized downhill walking training on neuromuscular responses of knee flexors (KF). Seventeen active males (Age = 22.9 ± 3.9 years) were randomly assigned into two groups: control, level walking (CG, N = 8) and downhill walking (DWG, N = 9). Individuals performed the following procedures, in different days: 1) Maximal voluntary contractions to determine peak torque (PT) and rate of torque development (RTD) at different time intervals from the onset of muscle contraction. The test was performed before (Pre) and after (Post) a 4-week downhill walking training period. PT and peak RTD did not change after the training period (p > 0.05). However, there was significant increase in RTD at 150 ms and 200 ms after the onset of muscle contraction (p < 0.05). Additionally, the electromyographic activity (root mean square) of the biceps femoris and semitendineous muscles presented an increase after the training period (p < 0.05). Thus, downhill walking training can promote improvement RTD and muscle activity in the late phase of muscle contraction, which can have important implications during downhill walking, in which a rapid action of KF can help body balance against the disturbance generated by the slope.
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5

Camillo, Carlos Augusto, Chris Burtin, Miek Hornikx, Heleen Demeyer, Kristien De Bent, Hans van Remoortel, Christian R. Osadnik, Wim Janssens, and Thierry Troosters. "Physiological responses during downhill walking." Chronic Respiratory Disease 12, no. 2 (March 10, 2015): 155–64. http://dx.doi.org/10.1177/1479972315575717.

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6

Allam, Hatem H., Alaa Shafie, Abdulrahman J. Almalki, Dhefallal E. Almalki, Tarek Alsayad, Ahmed M. Alziyadi, Mosfer A. Al-walah, and Lamiaa K. Elsayyad. "Effect of Application of Repeated Downhill Walking Bouts on Ankle Isokinetic Parameters in Children with Obesity." Applied Bionics and Biomechanics 2022 (January 28, 2022): 1–7. http://dx.doi.org/10.1155/2022/1128794.

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Background. Obesity among children became of high concern. Obesity can affect many health aspects including muscular strength. Downhill walking is a useful intervention to enhance muscular strength, especially in older adults. Objective. The current study’s purpose was to investigate the effect of repeated bouts of downhill walking on ankle isokinetic parameters in children with obesity. Methods. 32 obese male children aged from 8 to 12 years engaged in the study. The children were divided into two groups: the level walking group (LWG) ( n = 16 ) and the downhill walking group (DWG) ( n = 16 ). Participants in both groups walked 20 minutes on the treadmill, two sessions per week for 6 weeks, with a speed of 5 km/h, and the treadmill slope used for the DWG was set at –20%. Isokinetic dynamometry (Cybex 6000) was used to analyze the normalized eccentric and concentric torque of both ankle dorsiflexors and plantar flexors of the dominant leg in all participants. Results. The normalized peak torques for eccentric plantar flexion, concentric plantar flexion, eccentric dorsiflexion, and concentric dorsiflexion significantly increased by 38.66%, 23.87%, 38.58%, and 15.51%, respectively, after repeated bouts of downhill walking. Level walking resulted in nonsignificant improvement in the muscular torques. Conclusion. Downhill walking is a beneficial intervention in improving ankle muscular torques of obese children.
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7

Huang, Yu-Ping, Kwantae Kim, Chen-Yi Song, Yat-Hon Chen, and Hsien-Te Peng. "How Arch Support Insoles Help Persons with Flatfoot on Uphill and Downhill Walking." Journal of Healthcare Engineering 2017 (2017): 1–6. http://dx.doi.org/10.1155/2017/9342789.

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The main purpose of this study was to investigate the effect of arch support insoles on uphill and downhill walking of persons with flatfoot. Sixteen healthy college students with flatfoot were recruited in this study. Their heart rate, peak oxygen uptake (VO2), and median frequency (MDF) of surface electromyogram were recorded and analyzed. Nonparametric Wilcoxon signed-rank test was used for statistical analysis. The main results were as follows: (a) peak VO2significantly decreased with arch support insoles compared with flat insoles during uphill and downhill walking (arch support insole versus flat insole: uphill walking, 20.7 ± 3.6 versus 31.6 ± 5.5; downhill walking, 10.9 ± 2.3 versus 16.9 ± 4.2); (b) arch support insoles could reduce the fatigue of the rectus femoris muscle during downhill walking (MDF slope of arch support insole: 0.03 ± 1.17, flat insole: −6.56 ± 23.07); (c) insole hardness would increase not only the physical sensory input but also the fatigue of lower-limb muscles particularly for the rectus femoris muscle (MDF slope of arch support insole: −1.90 ± 1.60, flat insole: −0.83 ± 1.10) in persons with flatfoot during uphill walking. The research results show that arch support insoles could effectively be applied to persons with flatfoot to aid them during uphill and downhill walking.
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8

Akpinar, Berkcan, Eric Thorhauer, Scott Tashman, James J. Irrgang, Freddie H. Fu, and William J. Anderst. "Tibiofemoral Cartilage Contact Differences Between Level Walking and Downhill Running." Orthopaedic Journal of Sports Medicine 7, no. 4 (April 1, 2019): 232596711983616. http://dx.doi.org/10.1177/2325967119836164.

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Background: Some studies have suggested that altered tibiofemoral cartilage contact behavior (arthrokinematics) may contribute to long-term cartilage degeneration, potentially leading to tibiofemoral osteoarthritis. However, few studies have assessed normal tibiofemoral arthrokinematics during dynamic activities. Purpose: To characterize tibiofemoral arthrokinematics during the impact phase of level walking and downhill running. Study Design: Descriptive laboratory study. Methods: Arthrokinematic data were collected on uninjured knees of 44 participants (mean age, 20.7 ± 6.6 years). Using a dynamic stereoradiographic imaging system with superimposed 3-dimensional bone models from computed tomography and magnetic resonance imaging of participant-specific tibiofemoral joints, arthrokinematics were assessed during the first 15% of the gait cycle during level walking and the first 10% of the gait cycle during downhill running. Results: During level walking and downhill running, the medial compartment had a greater cartilage contact area versus the lateral compartment. Both compartments had a significantly less cartilage contact area during running versus walking (medial compartment gait cycle affected: 8%-10%; lateral compartment gait cycle affected: 5%-10%). Further, medial and lateral compartment tibiofemoral contact paths were significantly more posterior and longer during downhill running. Conclusion: There was a decreased tibiofemoral cartilage contact area during downhill running compared with level walking, suggesting that underlying bone morphology may play a key role in determining the size of cartilage contact regions. Clinical Relevance: This study provides the first data characterizing tibiofemoral cartilage contact patterns during level walking and downhill running. These results provide evidence in support of performing biomechanical assessments during both level walking and downhill running to obtain a comprehensive picture of tibiofemoral cartilage behavior after clinical interventions.
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9

Holm, Jonathan K., Jonas Contakos, Sang-Wook Lee, and John Jang. "Energetics and Passive Dynamics of the Ankle in Downhill Walking." Journal of Applied Biomechanics 26, no. 4 (November 2010): 379–89. http://dx.doi.org/10.1123/jab.26.4.379.

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This study investigated the energetics of the human ankle during the stance phase of downhill walking with the goal of modeling ankle behavior with a passive spring and damper mechanism. Kinematic and kinetic data were collected on eight male participants while walking down a ramp with inclination varying from 0° to 8°. The ankle joint moment in the sagittal plane was calculated using inverse dynamics. Mechanical energy injected or dissipated at the ankle joint was computed by integrating the power across the duration of the stance phase. The net mechanical energy of the ankle was approximately zero for level walking and monotonically decreased (i.e., became increasingly negative) during downhill walking as the slope decreased. The indication is that the behavior of the ankle is energetically passive during downhill walking, playing a key role in dissipating energy from one step to the next. A passive mechanical model consisting of a pin joint coupled with a revolute spring and damper was fit to the ankle torque and its parameters were estimated for each downhill slope using linear regression. The passive model demonstrated good agreement with actual ankle dynamics as indicated by low root-mean-square error values. These results indicate the stance phase behavior of the human ankle during downhill walking may be effectively duplicated by a passive mechanism with appropriately selected spring and damping characteristics.
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10

WANTA, D. M., F. J. NAGLE, and P. WEBB. "Metabolic response to graded downhill walking." Medicine & Science in Sports & Exercise 25, no. 1 (January 1993): 159–62. http://dx.doi.org/10.1249/00005768-199301000-00022.

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11

Park, K. S., J. W. Navalta, and D. A. Sedlock. "CARDIOVASCULAR RESPONSE TO GRADED DOWNHILL WALKING." Medicine & Science in Sports & Exercise 33, no. 5 (May 2001): S30. http://dx.doi.org/10.1097/00005768-200105001-00171.

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12

Dean, Elizabeth, and Jocelyn Ross. "Downhill walking induces rapid shallow breathing." Pfl�gers Archiv European Journal of Physiology 415, no. 3 (December 1989): 351–54. http://dx.doi.org/10.1007/bf00370887.

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13

Antonellis, Prokopios, Cory M. Frederick, Arash Mohammadzadeh Gonabadi, and Philippe Malcolm. "Modular footwear that partially offsets downhill or uphill grades minimizes the metabolic cost of human walking." Royal Society Open Science 7, no. 2 (February 2020): 191527. http://dx.doi.org/10.1098/rsos.191527.

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Walking on different grades becomes challenging on energetic and muscular levels compared to level walking. While it is not possible to eliminate the cost of raising or lowering the centre of mass (COM), it could be possible to minimize the cost of distal joints with shoes that offset downhill or uphill grades. We investigated the effects of shoe outsole geometry in 10 participants walking at 1 m s −1 on downhill, level and uphill grades. Level shoes minimized metabolic rate during level walking ( P second-order effect < 0.001). However, shoes that entirely offset the (overall) treadmill grade did not minimize the metabolic rate of walking on grades: shoes with a +3° (upward) inclination minimized metabolic rate during downhill walking on a −6° grade, and shoes with a −3° (downward) inclination minimized metabolic rate during uphill walking on a +6° grade ( P interaction effect = 0.023). Shoe inclination influenced (distal) ankle joint parameters, including soleus muscle activity, ankle moment and work rate, whereas treadmill grade influenced (whole-body) ground reaction force and COM work rate as well as (distal) ankle joint parameters including tibialis anterior and plantarflexor muscle activity, ankle moment and work rate. Similar modular footwear could be used to minimize joint loads or assist with walking on rolling terrain.
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14

Samaei, Afshin, Amir Hoshang Bakhtiary, Abdolhamid Hajihasani, Elham Fatemi, and Fatemeh Motaharinezhad. "Uphill and Downhill Walking in Multiple Sclerosis." International Journal of MS Care 18, no. 1 (January 1, 2016): 34–41. http://dx.doi.org/10.7224/1537-2073.2014-072.

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Background: Various exercise protocols have been recommended for patients with multiple sclerosis (MS). We investigated the effects of uphill and downhill walking exercise on mobility, functional activities, and muscle strength in MS patients. Methods: Thirty-four MS patients were randomly allocated to either the downhill or uphill treadmill walking group for 12 sessions (3 times/wk) of 30 minutes' walking on a 10% negative slope (n = 17) or a 10% positive slope (n = 17), respectively. Measurements were taken before and after the intervention and after 4-week follow-up and included fatigue by Modified Fatigue Impact Scale; mobility by Modified Rivermead Mobility Index; disability by Guy's Neurological Disability Scale; functional activities by 2-Minute Walk Test, Timed 25-Foot Walk test, and Timed Up and Go test; balance indices by Biodex Balance System; and quadriceps and hamstring isometric muscles by torque of left and right knee joints. Analysis of variance with repeated measures was used to investigate the intervention effects on the measurements. Results: After the intervention, significant improvement was found in the downhill group versus the uphill group in terms of fatigue, mobility, and disability indices; functional activities; balance indices; and quadriceps isometric torque (P &lt; .05). The results were stable at 4-week follow-up. Conclusions: Downhill walking on a treadmill may improve muscle performance, functional activity, and balance control in MS patients. These findings support the idea of using eccentric exercise training in MS rehabilitation protocols.
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NAGLE, F. J., P. WEBB, and D. M. WANTA. "Energy exchange in downhill and uphill walking." Medicine & Science in Sports & Exercise 22, no. 4 (August 1990): 540???544. http://dx.doi.org/10.1249/00005768-199008000-00021.

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16

Gault, Mandy L., Richard E. Clements, and Mark E. T. Willems. "Cardiovascular Responses During Downhill Treadmill Walking at Self-Selected Intensity in Older Adults." Journal of Aging and Physical Activity 21, no. 3 (July 2013): 335–47. http://dx.doi.org/10.1123/japa.21.3.335.

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Cardiovascular responses of older adults to downhill (DTW, –10% incline) and level treadmill walking (0%) at self-selected walking speed (SSWS) were examined. Fifteen participants (age 68 ± 4 yr, height 1.69 ± 0.08 m, body mass 74.7 ± 8.1 kg) completed two 15-min walks at their SSWS (4.6 ± 0.6 km/hr). Cardiovascular responses were estimated using an arterial-volume finger clamp and infrared plethysmography. Oxygen consumption was 25% lower during DTW and associated with lower values for stroke volume (9.9 ml/beat), cardiac output (1.0 L/min), arteriovenous oxygen difference (a-v O2 diff, 2.4 ml/L), and systolic blood pressure (10 mmHg), with no differences in heart rate or diastolic and mean arterial blood pressure. Total peripheral resistance (TPR) was higher (2.11 mmHg) during DTW. During downhill walking, an exercise performed with reduced cardiac strain, endothelial changes, and reduced metabolic demand may be responsible for the different responses in TPR and a-v O2 diff. Future work is warranted on whether downhill walking is suitable for higher risk populations.
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Hong, Shih-Wun, Cheng-Hua Wu, Tung-Wu Lu, Jwu-Sheng Hu, Jia-Da Li, Tsai-Hsueh Leu, and Chia-En Huang. "BIOMECHANICAL STRATEGIES AND THE LOADS IN THE LOWER LIMBS DURING DOWNHILL WALKING WITH DIFFERENT INCLINATION ANGLES." Biomedical Engineering: Applications, Basis and Communications 26, no. 06 (December 2014): 1450071. http://dx.doi.org/10.4015/s1016237214500719.

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Downhill walking places greater demands on the lower limb joints with a greater risk of falling when compared with level walking. The current study aimed to quantify the 3D joint kinematics and kinetics of the locomotor system, and their interactions with the trunk during downhill walking. Fifteen young adults walked at a self-selected pace on a 3-m walkway with slopes of 0°, 5°, 10°, and 15° while their kinematic and kinetic data were measured. A complete 3D biomechanical analysis of the locomotor system was performed on these data. The results showed that with increasing downhill angles young healthy adults increased the posterior tilt of the pelvis and lateral trunk bending towards the stance limb, as well as the peak dorsiflexor and extensor moments at the ankle and knee, respectively, during the first half of the stance phase (SP), and increased the peak moments at the hip during the second half of the SP. The associated joint forces also varied with increasing slopes over the SP. When the overall mechanical demands were considered over the SP, the angular extensor and plantarflexor impulses at the knee and ankle were found to increase linearly with increasing slopes. The current results may serve as baseline data for future studies on downhill walking, and for clinical applications in various patient groups.
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18

Lee, Kyoung Min, Byung-Cho Min, and Seungbum Koo. "Effects of walking speed and slope on foot pressure in young healthy adults." Foot & Ankle Orthopaedics 3, no. 3 (July 1, 2018): 2473011418S0030. http://dx.doi.org/10.1177/2473011418s00308.

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Category: Basic Sciences/Biologics Introduction/Purpose: Although pedobarographic measurement is increasingly used for clinical and research purposes, relatively few published studies have investigated regarding effects of walking speed and slope. This study examined pedobarographic findings in young healthy adults with regard to different walking speeds and slopes. Methods: Twenty young healthy adults (mean age 22.4 years, SD 1.2 years; 10 males and 10 females) were recruited. Dynamic pedobarographic data were obtained during treadmill walking with different walking speeds (3.2 km/hr, 4.3 km/hr, and 5.4 km/hr) and slopes (-8°, -4°, 0°, 4°, and 8°). Pedobarographic data including peak pressure and pressure-time integral were measured on five plantar segments: medial forefoot (MFF), lateral forefoot (LFF), medial midfoot (MMF), lateral midfoot (LMF), and heel. Distribution of foot pressure between medial and lateral sides, and between anterior and posterior aspects were calculated as varus/valgus index and forefoot/heel index, respectively. Walking speed of 4.3 km/hr on 0° of slope was considered as standard walking condition. Results: Varus/valgus index of peak pressure showed significant increase on the slope of 8° and the walking speed of 4.3 km/hr (p=0.036) and 5.4 km/hr (p=0.007). Forefoot/heel index of peak pressure significantly decreased on downhill walking. Varus/valgus index of pressure-time integral showed significant increase when uphill and downhill slope was greater and walking speed was faster compared with standard with walking condition. Forefoot/heel index of pressure-time integral showed significant increase in downhill walking while significant decrease was observed during uphill walking. Conclusion: Changes of walking speed and slope caused those of foot pressure distribution. Therefore, combination of walking speed and speed might be associated with pressure related symptoms and disorders of the foot.
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19

Duan, C., M. D. Delp, D. A. Hayes, P. D. Delp, and R. B. Armstrong. "Rat skeletal muscle mitochondrial [Ca2+] and injury from downhill walking." Journal of Applied Physiology 68, no. 3 (March 1, 1990): 1241–51. http://dx.doi.org/10.1152/jappl.1990.68.3.1241.

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The purpose of this study was to evaluate the relationship between mitochondrial Ca2+ concentration (MCC) and the extent of muscle injury in rats that have performed prolonged downhill walking (eccentric exercise). MCC was used as an indicator of elevated [Ca2+] in the muscles, and injury was estimated from histochemical analysis of muscle cross sections by determining the numbers of intact fibers per unit area in the muscles. Elevations in MCC in the soleus and vastus intermedius muscles over time postexercise were inversely related (P less than 0.05) to the number of intact fibers per square millimeter in the respective muscles after downhill walking. Verapamil administration attenuated the elevation in MCC and injury in histochemical sections resulting from the downhill walking in soleus muscle, but intraperitoneal injection of the chelators EDTA or ethylene glycol-bis(beta-aminoethylether)-N,N,N′,N′- tetraacetic acid significantly attenuated the increases in MCC and injury to both the vastus intermedius and soleus muscles in the downhill walkers. The chelators appear to exert their “protective” effects within the specific muscles that show the injury and do not significantly affect serum [Ca2+]. It is concluded that increases in MCC occur during exercise-induced fiber injury and that elevations in cellular Ca2+ may have a role in the etiology of the injury process.
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20

Fellin, Rebecca E., Joseph F. Seay, Karen N. Gregorczyk, and Leif Hasselquist. "Spatiotemporal Parameters are not Substantially Influenced by Load Carriage or Inclination During Treadmill and Overground Walking." Journal of Human Kinetics 50, no. 1 (April 1, 2016): 27–35. http://dx.doi.org/10.1515/hukin-2015-0138.

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AbstractInfluences of load carriage and inclination on spatiotemporal parameters were examined during treadmill and overground walking. Ten soldiers walked on a treadmill and overground with three load conditions (00 kg, 20 kg, 40 kg) during level, uphill (6% grade) and downhill (-6% grade) inclinations at self-selected speed, which was constant across conditions. Mean values and standard deviations for double support percentage, stride length and a step rate were compared across conditions. Double support percentage increased with load and inclination change from uphill to level walking, with a 0.4% stance greater increase at the 20 kg condition compared to 00 kg. As inclination changed from uphill to downhill, the step rate increased more overground (4.3 ± 3.5 steps/min) than during treadmill walking (1.7 ± 2.3 steps/min). For the 40 kg condition, the standard deviations were larger than the 00 kg condition for both the step rate and double support percentage. There was no change between modes for step rate standard deviation. For overground compared to treadmill walking, standard deviation for stride length and double support percentage increased and decreased, respectively. Changes in the load of up to 40 kg, inclination of 6% grade away from the level (i.e., uphill or downhill) and mode (treadmill and overground) produced small, yet statistically significant changes in spatiotemporal parameters. Variability, as assessed by standard deviation, was not systematically lower during treadmill walking compared to overground walking. Due to the small magnitude of changes, treadmill walking appears to replicate the spatiotemporal parameters of overground walking.
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Butterfield, Timothy A., Timothy R. Leonard, and Walter Herzog. "Differential serial sarcomere number adaptations in knee extensor muscles of rats is contraction type dependent." Journal of Applied Physiology 99, no. 4 (October 2005): 1352–58. http://dx.doi.org/10.1152/japplphysiol.00481.2005.

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Sarcomerogenesis, or the addition of sarcomeres in series within a fiber, has a profound impact on the performance of a muscle by increasing its contractile velocity and power. Sarcomerogenesis may provide a beneficial adaptation to prevent injury when a muscle consistently works at long lengths, accounting for the repeated-bout effect. The association between eccentric exercise, sarcomerogenesis and the repeated-bout effect has been proposed to depend on damage, where regeneration allows sarcomeres to work at shorter lengths for a given muscle-tendon unit length. To gain additional insight into this phenomenon, we measured fiber dynamics directly in the vastus lateralis (VL) muscle of rats during uphill and downhill walking, and we measured serial sarcomere number in the VL and vastus intermedius (VI) after chronic training on either a decline or incline grade. We found that the knee extensor muscles of uphill walking rats undergo repeated active concentric contractions, and therefore they suffer no contraction-induced injury. Conversely, the knee extensor muscles during downhill walking undergo repeated active eccentric contractions. Serial sarcomere numbers change differently for the uphill and downhill exercise groups, and for the VL and VI muscles. Short muscle lengths for uphill concentric-biased contractions result in a loss of serial sarcomeres, and long muscle lengths for downhill eccentric-biased contractions result in a gain of serial sarcomeres.
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22

Ahmadi, Sirous, Peter J. Sinclair, and Glen M. Davis. "Muscle Oxygenation after Downhill Walking- Induced Muscle Soreness." Medicine & Science in Sports & Exercise 39, Supplement (May 2007): S39. http://dx.doi.org/10.1249/01.mss.0000273041.68107.42.

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23

Sakurai, Shinji, Markus Kuster, and Graeme A. Wood. "Measurement system of joint kinetics in downhill walking." Journal of Biomechanics 27, no. 6 (January 1994): 767. http://dx.doi.org/10.1016/0021-9290(94)91246-7.

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Kuster, M., S. Sakurai, and G. A. Wood. "Kinematics and kinetics of downhill versus level walking." Journal of Biomechanics 27, no. 6 (January 1994): 806. http://dx.doi.org/10.1016/0021-9290(94)91347-1.

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25

Garnier, Yoann M., Christos Paizis, Alain Martin, and Romuald Lepers. "Corticospinal excitability changes following downhill and uphill walking." Experimental Brain Research 237, no. 8 (June 4, 2019): 2023–33. http://dx.doi.org/10.1007/s00221-019-05576-1.

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26

Yang, Yea-Ru, Ya-Yun Lee, Shih-Jung Cheng, and Ray-Yau Wang. "Downhill Walking Training in Individuals with Parkinsonʼs Disease." American Journal of Physical Medicine & Rehabilitation 89, no. 9 (September 2010): 706–14. http://dx.doi.org/10.1097/phm.0b013e3181e721c5.

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27

Camillo, Carlos Augusto, Christian Robert Osadnik, Chris Burtin, Stephanie Everaerts, Miek Hornikx, Heleen Demeyer, Matthias Loeckx, et al. "Effects of downhill walking in pulmonary rehabilitation for patients with COPD: a randomised controlled trial." European Respiratory Journal 56, no. 3 (May 22, 2020): 2000639. http://dx.doi.org/10.1183/13993003.00639-2020.

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The development of contractile muscle fatigue (CMF) affects training responses in patients with chronic obstructive pulmonary disease (COPD). Downhill walking induces CMF with lower dyspnoea and fatigue than level walking. This study compared the effect of pulmonary rehabilitation (PR) comprising downhill walking training (DT) to PR comprising level walking (conventional training (CT)) in patients with COPD.In this randomised controlled trial, 35 patients (62±8 years; forced expiratory volume in 1 s (FEV1) 50±17% predicted) were randomised to DT or CT. Exercise tolerance (6-minute walk test distance (6MWD); primary outcome), muscle function, symptoms, quality-of-life and physical activity levels were assessed before and after PR. Absolute training changes and the proportion of patients exceeding the 30 m 6MWD minimally important difference (MID) were compared between groups. Quadriceps muscle biopsies were collected after PR in a subset of patients to examine physiological responses to long-term eccentric training.No between-group differences were observed in absolute 6MWD improvement (mean 6MWD change 77±46 m DT versus 56±47 m CT; p=0.45), however 94% of patients in DT exceeded the 6MWD MID compared to 65% in CT (p=0.03). Patients in DT tended to have larger improvements than CT in other outcomes. Muscle biopsy analyses did not differ between groups.PR incorporating downhill walking confers similar magnitudes of effects to PR with conventional walking across clinical outcomes in patients with COPD, however, offers a more reliable stimulus to maximise the achievement of clinically relevant gains in functional exercise tolerance in people with COPD.
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Lam, Tania, and Volker Dietz. "Transfer of Motor Performance in an Obstacle Avoidance Task to Different Walking Conditions." Journal of Neurophysiology 92, no. 4 (October 2004): 2010–16. http://dx.doi.org/10.1152/jn.00397.2004.

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The aim of this study was to examine whether subjects who have learned a skilled locomotor task can transfer the acquired performance to conditions involving either a change in the external coordinates or in the sensory input from one leg. Subjects were trained to step over an obstacle with minimal foot clearance without visual information about either the obstacle or their legs during treadmill walking. Leg muscle activity and joint kinematics were recorded and analyzed. Acoustic signals provided feedback about foot clearance over the obstacle. After successful training, the transfer of learning between level and downhill walking and to walking with additional weight attached to the leg was examined. It was found that once subjects learned to step over the obstacle at an optimal foot clearance, they could transfer their performance within the first step over the obstacle in the new walking conditions. Closer examination of the transfer between level and downhill walking revealed no consistent kinematic strategy across subjects. To transfer the learned performance to walking with additional weight, subjects consistently and automatically increased biceps femoris muscle activation. The results are discussed in the context of emerging concepts in the neural control of walking and motor learning.
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Li, Longchuan, Fumihiko Asano, and Isao Tokuda. "High-Frequency Vibration of Leg Masses for Improving Gait Stability of Compass Walking on Slippery Downhill." Journal of Robotics and Mechatronics 31, no. 4 (August 20, 2019): 621–28. http://dx.doi.org/10.20965/jrm.2019.p0621.

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Towards improving the stability of point-foot biped robot on slippery downhill, a novel and indirect control method is introduced in this paper using active wobbling masses attached to both legs. The whole dynamics which contains walking, sliding and wobbling, can be dominated by high-frequency oscillation via entrainment effect. Stable gaits are therefore achieved by controlling only 1% of the whole system where the original passive dynamic walking fails. First, we derive the equations of dynamics and control for this indirectly controlled biped walking on slippery downhill. Second, we numerically show the possibility of improving the stability with high-frequency oscillation. We also find the main effect of wobbling motion on walking via phase-plane plot. Third, we prove that the range of stable walking with respect to frictional coefficient can be enlarged by employing suitable high-frequency oscillation via parametric study. Our method will be further applied to more general conditions in real tasks which contain different locomotion types, where the whole dynamics could be dominated by high-frequency oscillation and the phase properties of the dynamics will be positively utilized.
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30

Stern, Keith A., and Jinger S. Gottschall. "Altering Footwear Type Influences Gait During Level Walking and Downhill Transitions." Journal of Applied Biomechanics 28, no. 5 (November 2012): 481–90. http://dx.doi.org/10.1123/jab.28.5.481.

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The purpose of our study was to determine if altering the insoles within footwear or walking barefoot, as an attempt to increase or decrease cutaneous stimuli, would improve dynamic balance during a hill-walking task. We hypothesize that compared with foam insoles or iced bare feet, textured insoles or bare feet will result in greater speeds, longer step lengths, narrower step width, shorter stance time, and less tibialis anterior (TA), soleus (SOL), and lateral gastrocnemius (LG) activity during key gait cycle phases. Ten, healthy college students, 5 men and 5 women, completed the protocol that consisted of level walking and downhill transition walking in five different footwear insole or barefoot conditions. During level walking, conditions with the hypothesized greater cutaneous stimuli resulted in greater step length, which relates to a more stable gait. In detail, the texture insole condition average step length was 3% longer than the regular insole condition, which was 5% longer than the ice condition (p < .01). The same signals of increased stability were evident during the more challenging downhill transition stride. Step length during the barefoot condition was 8% longer than the ice condition (p < .05) and step width during the regular footwear condition was 5% narrower than the foam condition (p = .05). To add, during the preswing phase of level walking, TA activity of the textured insole condition was 30% less than the foam insole. Although our data show that footwear conditions alter gait patterns and lower leg muscle activity during walking, there is not enough evidence to support the hypothesis that textured insoles will improve dynamic balance as compared with other footwear types.
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31

Nguyen, Dac Minh Tuan, Virgile Lecoultre, Andrew P. Hills, and Yves Schutz. "How Does a Hilly Urban Environment Influence Daily Physical Activity in Obese Individuals?" Journal of Physical Activity and Health 10, no. 5 (July 2013): 617–25. http://dx.doi.org/10.1123/jpah.10.5.617.

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Background:Increases in physical activity (PA) are promoted by walking in an outdoor environment. Along with walking speed, slope is a major determinant of exercise intensity, and energy expenditure. The hypothesis was that in free-living conditions, a hilly environment diminishes PA to a greater extent in obese (OB) when compared with control (CO) individuals.Methods:To assess PA types and patterns, 28 CO (22 ± 2 kg/m2) and 14 OB (33 ± 4 kg/m2) individuals wore during an entire day 2 accelerometers and 1 GPS device, around respectively their waist, ankle and shoulder. They performed their usual PA and were asked to walk an additional 60 min per day.Results:The duration of inactivity and activity with OB individuals tended to be, respectively, higher and lower than that of CO individuals (P = .06). Both groups spent less time walking uphill/downhill than on the level (20%, 19%, vs. 61% of total walking duration, respectively, P < .001). However OB individuals spent less time walking uphill/downhill per day than CO (25 ± 15 and 38 ± 15 min/d, respectively, P < 0.05) and covered a shorter distance per day (3.8 km vs 5.2 km, P < 0.01).Conclusions:BMI and outdoor topography should also be considered when prescribing extra walking in free-living conditions.
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Schwameder, Hermann, Robin Roithner, Erich Muller, Wolfgang Niessen, and Christian Raschner. "Knee joint forces during downhill walking with hiking poles." Journal of Sports Sciences 17, no. 12 (January 1999): 969–78. http://dx.doi.org/10.1080/026404199365362.

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33

Vrieling, A. H., H. G. van Keeken, T. Schoppen, E. Otten, J. P. K. Halbertsma, A. L. Hof, and K. Postema. "Uphill and downhill walking in unilateral lower limb amputees." Gait & Posture 28, no. 2 (August 2008): 235–42. http://dx.doi.org/10.1016/j.gaitpost.2007.12.006.

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34

Aminian, K., Ph Robert, E. Jéquier, and Y. Schutz. "Level, downhill and uphill walking identification using neural networks." Electronics Letters 29, no. 17 (1993): 1563. http://dx.doi.org/10.1049/el:19931042.

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35

LOONEY, DAVID P., WILLIAM R. SANTEE, ERIC O. HANSEN, PETER J. BONVENTRE, CHRISTOPHER R. CHALMERS, and ADAM W. POTTER. "Estimating Energy Expenditure during Level, Uphill, and Downhill Walking." Medicine & Science in Sports & Exercise 51, no. 9 (September 2019): 1954–60. http://dx.doi.org/10.1249/mss.0000000000002002.

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36

Arand, Manuela. "Von Downhill Walking bis Galileo — innovative Rehabilitationsstrategien bei COPD." Pneumo News 9, no. 6 (October 2017): 47. http://dx.doi.org/10.1007/s15033-017-0764-z.

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37

Kuster, M., S. Sakurai, and G. A. Wood. "Kinematic and kinetic comparison of downhill and level walking." Clinical Biomechanics 10, no. 2 (March 1995): 79–84. http://dx.doi.org/10.1016/0268-0033(95)92043-l.

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38

Miles, Mary P., Laura C. Horrigan, Sara E. Jay, Karen M. Brown, Jay W. Porter, and Andrea N. Steward. "Concentric and eccentric exercise, glycemic responses to a postexercise meal, and inflammation in women with high versus low waist circumference." Applied Physiology, Nutrition, and Metabolism 41, no. 12 (December 2016): 1262–70. http://dx.doi.org/10.1139/apnm-2016-0281.

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Carbohydrate ingestion and level of concentric versus eccentric muscle activity may alter exercise-induced health benefits for individuals who have high waist circumference as a metabolic risk factor. The purpose of this study was to determine whether metabolic and inflammation responses to an exercise recovery meal differ between women with lower (Lo-WC, <80 cm) compared with higher (Hi-WC) waist circumference when the exercise is primarily concentric (uphill walking; UPHILL) versus primarily eccentric (downhill walking; DOWNHILL). Recreationally active women (age, 18–39 years; body mass index, 19–35.4 m·kg−2; Lo-WC, n = 13; Hi-WC, n = 10) completed UPHILL, DOWNHILL, and resting (CONTROL) conditions followed 30 min later by a mixed meal tolerance test (MMTT) with carbohydrates to protein ratio of 4:1, and blood glucose, insulin, and inflammation markers were compared across conditions. Compared with Lo-WC, the Hi-WC group had higher (p < 0.05) (i) insulin during the MMTT in CONTROL (mean ± SE; 48.5 ± 8.2 vs 22.9 ± 2.8 pmol·L−1), (ii) baseline (0.7 ± 0.4 vs 2.0 ± 1.7 pg·mL−1) interleukin-6 (IL-6), and (iii) IL-6 responses 8 h after UPHILL and CONTROL. Both groups had (i) increases in IL-6 at 0 h after UPHILL and at 8 h after DOWNHILL, and (ii) lower glycemic responses in UPHILL. Women with Hi-WC had higher IL-6 at rest and delayed increases in IL-6 after a high-carbohydrate meal in all conditions. This is consistent with an inflammation response to the meal and or uphill walking exercise. However, both concentrically and eccentrically biased exercises offered benefits to insulin responses to a high carbohydrate meal for Hi-WC.
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39

O’Brien, Kevin, Michele Basso, and James Schmiedeler. "2299." Journal of Clinical and Translational Science 1, S1 (September 2017): 61. http://dx.doi.org/10.1017/cts.2017.220.

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OBJECTIVES/SPECIFIC AIMS: Incomplete spinal cord injury (iSCI) is a life-long disability that typically results in a profound loss of locomotion capability. Current rehabilitation methods rarely restore full community ambulation, which in turn limits quality of life. Most individuals with iSCI exhibit persistent deficits in eccentric muscle control and reach recovery plateaus below the levels necessary for independent community ambulation. Eccentric motor control is essential during the weight acceptance phase of gait, which is emphasized during downhill walking. METHODS/STUDY POPULATION: The overground locomotion of subjects with chronic iSCI was analyzed both prior to and following a 12-week downhill body-weight-supported treadmill training regimen and compared to that of matched healthy controls in terms of kinematics, kinetics, and EMG activation. RESULTS/ANTICIPATED RESULTS: We expect to find significant differences between the controls and subjects with iSCI, with deficits in eccentric motor control accounting for some of these differences. In addition, we expect the downhill training to yield significant improvement in eccentric muscle control that translates into improvements in functional, overground walking for the subjects with iSCI. DISCUSSION/SIGNIFICANCE OF IMPACT: The goal is to determine if downhill training can improve eccentric motor control and extend recovery beyond established plateaus. OpenSim modeling of the experimental data will help quantify changes in eccentric control of individual muscles to clarify where specific gains are made.
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40

Knapik, Joseph, Charles Hickey, Samson Ortega, James Nagel, and Rene de Pontbriand. "Energy Cost of Walking in Four Types of Snowshoes." Proceedings of the Human Factors and Ergonomics Society Annual Meeting 41, no. 1 (October 1997): 702–6. http://dx.doi.org/10.1177/1071181397041001154.

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Four Marines walked on snow at 4 km/h with four types of snowshoes. Grade of the terrain was about 2.4% and the Marines walked once downhill and once uphill with each snowshoe. Expired respiratory gases (for energy cost measures) and heart rates were collected continuously. The Pride and Military Standard models had a lower energy cost than the Montana model and tended to have a lower cost than the British model. Correlations between snowshoe mass/surface area ratios and energy cost were 0.81 and 0.72 on the uphill and downhill portions of the course, respectively. Data suggested several design characteristics may be favorable from an energy cost perspective: 1) a foot hinge-and-binding system that allows the snowshoe to be dragged across the snow, 2) an upturned front that pushes snow away and allows a more horizontal displacement of the snowshoe during locomotion, and 3) a lower mass to surface area ratio.
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41

Harper, Sara E., Rebecca A. Roembke, John D. Zunker, Darryl G. Thelen, and Peter G. Adamczyk. "Wearable Tendon Kinetics." Sensors 20, no. 17 (August 26, 2020): 4805. http://dx.doi.org/10.3390/s20174805.

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This study introduces a noninvasive wearable system for investigating tendon loading patterns during outdoor locomotion on variable terrain. The system leverages shear wave tensiometry, which is a new approach for assessing tendon load by tracking wave speed within the tissue. Our wearable tensiometry system uses a battery-operated piezoelectric actuator to induce micron-scale shear waves in a tendon. A data logger monitors wave propagation by recording from two miniature accelerometers mounted on the skin above the tendon. Wave speed is determined from the wave travel time between accelerometers. The wearable system was used to record Achilles tendon wave speed at 100 Hz during 1-km outdoor walking trials in nine young adults. Inertial measurement units (IMUs) simultaneously monitored participant position, walking speed, and ground incline. An analysis of 5108 walking strides revealed the coupled biomechanical effects of terrain slope and walking speed on tendon loading. Uphill slopes increased the tendon wave speed during push-off, whereas downhill slopes increased tendon wave speeds during early stance braking. Walking speed significantly modulated peak tendon wave speed on uphill slopes but had less influence on downhill slopes. Walking speed consistently induced greater early stance wave speeds for all slopes. These observations demonstrate that wearable shear wave tensiometry holds promise for evaluating tendon tissue kinetics in natural environments and uncontrolled movements. There are numerous practical applications of wearable tensiometry spanning orthopedics, athletics, rehabilitation, and ergonomics.
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42

Miró, Francisco, Alfonso M. Galisteo, Juan L. Garrido-Castro, and Joaquín Vivo. "Surface Electromyography of the Longissimus and Gluteus Medius Muscles in Greyhounds Walking and Trotting on Ground Flat, Up, and Downhill." Animals 10, no. 6 (June 3, 2020): 968. http://dx.doi.org/10.3390/ani10060968.

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In the field of canine rehabilitation, knowledge of muscle function in the therapeutic exercises prescribed is needed by physical therapists and veterinary surgeons. To gain insight into the function of longissimus dorsi (LD) and gluteus medius (GM) muscles in dogs, five Greyhounds performing leash walking and trotting on the ground flat, up (+7%), and downhill (−7%) were studied by surface electromyography, and the mean and maximum activity was compared. For the same incline, the surface electromyography (sEMG) of LD was higher (p < 0.05) at the trot than at the walk. In LD muscle, trotting uphill showed significantly higher maximum activity than any other exercise. A change of +7% incline or −7% decline affected (increased or decreased, respectively) the mean sEMG of the LD and GM muscles of dogs walking or trotting on the ground. When combined, the influence of gait and incline on electromyographic activity was analyzed, and walking at certain inclines showed no difference with trotting at certain inclines. Walking and trotting up and downhill added separate therapeutic value to flat motion. The results of the present study might contribute to a better understanding of the function of LD and GM muscles in dogs, this being especially useful for the field of canine rehabilitation.
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43

Yang, Jiemeng, Chen He, Zhongjun Mo, Junchao Guo, Run Ji, Yu Wang, Chunjing Tao, and Yubo Fan. "The Effects of Pedestrian Environment on Ambulation with a Walking Frame in Elderly Individuals: A Survey and Experimental Study." International Journal of Environmental Research and Public Health 19, no. 15 (July 30, 2022): 9327. http://dx.doi.org/10.3390/ijerph19159327.

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Understanding the effects of sloped roads in the pedestrian environment on the body during ambulation with a walking frame can help design friendlier living environments for elderly individuals. A survey of the characteristics of walking frames used in different pedestrian environments was investigated in five communities, and a controlled study of the effects of a sloped road on a subject with different walking frames was carried out as foundational research in the laboratory. A synchronous acquisition system consisting of a wireless motion capture module and a physiological information recording module was applied to collect data on the motion of the shoulder joint and skin conductance response (SCR) of fingers in one participant. Force data were collected from sensors placed on the four legs of the walking frame. The experimental data obtained during different tasks were quantitatively analyzed. Compared to flat ground, the shoulder joint rotated in the opposite direction in horizontal and internal/external planes when using a wheeled walking frame on an uphill road, and the supportive force decreased on both uphill and downhill roads. The range of motion of the shoulder joint reduced and the direction of the shoulder joint motion changed when using a footed walking frame on both uphill and downhill roads. Additionally, the peak value of the supportive force on the uphill road appeared in the first 50% of the gait cycle, which was earlier than in the other cases. In addition, walking on the uphill road with a walking frame had a maximum SCR value, which means a greater impact of psychological arousal. Biomechanics of the shoulder joint and psychological arousal are closely related to the ease of walking on a sloped road with a walking frame. These findings are beneficial for designing more appropriate environments for elderly individuals who walk with aids.
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44

Chernyshev, Vadim, Vladimir Arykantsev, Anton Goncharov, and Nikolay Sharonov. "Features of slopes overcoming by walking devices." Robotics and Technical Cybernetics 9, no. 3 (September 30, 2021): 234–40. http://dx.doi.org/10.31776/rtcj.9309.

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For mobile robots designed to work in extreme conditions, an important characteristic is the value of the overcoming slope. For wheeled and tracked vehicles, the angle of the overcoming slope is limited by the adhesion properties of the soil. The walking device can provide overcoming of higher slopes, since the analogue of the adhesion coefficient for walking machines, with a large footprint track depth, can be significantly greater than 1. The paper discusses the results of experimental studies of the features of overcoming slopes by a walking device in weak soil conditions. When mobile robots overcoming inclines, they may overturn or slide downhill. It is shown that on soft soils the sliding of walking machines downhill is unlikely because of significant deformations of the soil under the support elements. On the other hand, the deformation of the soil worsens the resistance of the walking vehicle to overturning. A method of increasing resistance to overturning by controlling the position of the robot body by separately regulating the conditional clearance of walking mechanisms is considered. The possibility of adjusting the clearance in the propulsion unit on the basis of Umnov-Chebyshev cyclic walking mechanisms is shown. Climbing slopes requires a certain amount of traction. The values of the additional power and the force characteristics of the walking device’s drive necessary for successful overcoming of slopes have been determined. The results of the work can be demand in the development of walking machines and mobile robots. Key words Mobile robots, walking machines, interaction with the ground, traction and coupling properties, overcoming slopes, tipping resistance, mathematical modeling, field tests. Acknowledgements Research was partially supported by RFBR and the Administration of the Volgograd region, research projects no. 19-08-01180 a, 19-48-340007 p_a.
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45

Maeo, Sumiaki, Masayoshi Yamamoto, Hiroaki Kanehisa, and Kazunori Nosaka. "Protection against Muscle Damage in Downhill Walking by Preconditioning Exercise." Medicine & Science in Sports & Exercise 47 (May 2015): 510. http://dx.doi.org/10.1249/01.mss.0000477833.04096.5e.

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46

Hoffman, B. W., A. G. Cresswell, T. J. Carroll, and G. A. Lichtwark. "Muscle fascicle strains in human gastrocnemius during backward downhill walking." Journal of Applied Physiology 116, no. 11 (June 1, 2014): 1455–62. http://dx.doi.org/10.1152/japplphysiol.01431.2012.

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Extensive muscle damage can be induced in isolated muscle preparations by performing a small number of stretches during muscle activation. While typically these fiber strains are large and occur over long lengths, the extent of exercise-induced muscle damage (EIMD) observed in humans is normally less even when multiple high-force lengthening actions are performed. This apparent discrepancy may be due to differences in muscle fiber and tendon dynamics in vivo; however, muscle and tendon strains have not been quantified during muscle-damaging exercise in humans. Ultrasound and an infrared motion analysis system were used to measure medial gastrocnemius fascicle length and lower limb kinematics while humans walked backward, downhill for 1 h (inducing muscle damage), and while they walked briefly forward on the flat (inducing no damage). Supramaximal tibial nerve stimulation, ultrasound, and an isokinetic dynamometer were used to quantify the fascicle length-torque relationship pre- and 2 h postexercise. Torque decreased ∼23%, and optimal fascicle length shifted rightward ∼10%, indicating that EIMD occurred during the damage protocol even though medial gastrocnemius fascicle stretch amplitude was relatively small (∼18% of optimal fascicle length) and occurred predominantly within the ascending limb and plateau region of the length-torque curve. Furthermore, tendon contribution to overall muscle-tendon unit stretch was ∼91%. The data suggest the compliant tendon plays a role in attenuating muscle fascicle strain during backward walking in humans, thus minimizing the extent of EIMD. As such, in situ or in vitro mechanisms of muscle damage may not be applicable to EIMD of the human gastrocnemius muscle.
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47

Joseph, C. W., E. J. Bradshaw, T. P. Furness, J. Kemp, and R. A. Clark. "Early changes in Achilles tendon behaviourin vivofollowing downhill backwards walking." Journal of Sports Sciences 34, no. 13 (October 29, 2015): 1215–21. http://dx.doi.org/10.1080/02640414.2015.1102955.

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48

Nottle, C., and K. Nosaka. "The magnitude of muscle damage induced by downhill backward walking." Journal of Science and Medicine in Sport 8, no. 3 (August 2005): 264–73. http://dx.doi.org/10.1016/s1440-2440(05)80037-4.

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49

Scaglioni-Solano, Pietro, and Luis Fernando Aragón-Vargas. "Age-related differences when walking downhill on different sloped terrains." Gait & Posture 41, no. 1 (January 2015): 153–58. http://dx.doi.org/10.1016/j.gaitpost.2014.09.022.

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50

Kuster, M., G. A. Wood, S. Sakurai, and G. Blatter. "Downhill walking: A stressful task for the anterior cruciate ligament?" Knee Surgery, Sports Traumatology, Arthroscopy 2, no. 1 (March 1994): 2–7. http://dx.doi.org/10.1007/bf01552646.

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