The influence of a unilateral fixed ankle on metabolic and mechanical demands during walking in unimpaired young adults

The plantarflexors provide a major source of propulsion during walking. When mechanical power generation from the plantarflexor muscles is limited, other joints may compensate to maintain a consistent walking velocity, but likely at increased metabolic cost. The purpose of this study was to determine how a unilateral reduction in ankle plantarflexor power influences the redistribution of mechanical power generation within and across limbs and the associated change in the metabolic cost of walking. Twelve unimpaired young adults walked with an ankle brace on the dominant limb at 1.2 m/s on a dual-belt instrumented treadmill. Lower extremity kinematics and kinetics as well as gas exchange data were collected in two conditions: (1) with the brace unlocked (FREE) and (2) with the brace locked (FIXED). The brace significantly reduced ankle plantarflexion excursion by 12.96±3.60° (p<0.001) and peak ankle mechanical power by 1.03±0.51. W/kg (p<0.001) in the FIXED versus FREE condition. Consequently, metabolic power (W/kg) of walking in the FIXED condition increased by 7.4% compared to the FREE condition (p=0.03). Increased bilateral hip mechanical power generation was observed in the FIXED condition (p<0.001). These results suggest that walking with reduced ankle power increases metabolic demand due to the redistribution of mechanical power generation from highly efficient ankle muscle-tendons to less efficient hip muscle-tendons. A within and across limb redistribution of mechanical workload represents a potential mechanism for increased metabolic demand in pathological populations with plantarflexion deficits or those that walk with an ankle-foot orthosis that restricts range of motion.