Best-Compromise Control Strategy Between Mechanical Energy Expenditure and Foot Clearance for Obstacle-Crossing in Older Adults: Effects of Tai-Chi Chuan Practice

Author: Chien-Chung Kuo1,2, Sheng-Chang Chen3, Jr-Yi Wang3,4, Tsung-Jung Ho5,6,7, Tung-Wu Lu3
Affiliation:
1 Department of Orthopedics, China Medical University Hospital, Taichung, Taiwan.
2 Department of Orthopedics, School of Medicine, China Medical University, Taichung, Taiwan.
3 Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan.
4 Department of Orthopedics, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
5 Integration Center of Traditional Chinese and Modern Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
6 Department of Chinese Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
7 School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan.
Conference/Journal: Front Bioeng Biotechnol
Date published: 2021 Dec 2
Other: Volume ID: 9 , Pages: 774771 , Special Notes: doi: 10.3389/fbioe.2021.774771. , Word Count: 215


Background: Obstacle-crossing increases the risk of falls in older people. This study aimed to identify the effects of long-term Tai-Chi Chuan (TCC) practice on the control strategies for obstacle-crossing in older people. Methods: A multi-objective optimal control technique with measured gait data was used to identify the control strategies adopted by 15 long-term TCC practitioners and 15 healthy controls when crossing obstacles of different heights, in terms of the best-compromise weighting sets for the conflicting objectives of minimizing energy expenditure and maximizing the toe-obstacle and heel-obstacle clearances. Results and Conclusions: The long-term TCC older practitioners adopted a best-compromise control strategy similar to those adopted by young adults, with greater weightings on the minimization of the mechanical energy expenditure and smaller weightings on foot-clearance as compared to non-TCC controls (TCC: 0.72, 0.14, 0.14; Control: 0.55, 0.225, 0.225). This strategy enabled the long-term TCC older practitioners to cross obstacles with significantly greater leading-toe clearances but with relatively less mechanical energy expenditure. With the current approach, further simulations of obstacle-crossing mechanics with a given weighting set will be useful for answering clinically relevant what-if questions, such as what abilities would be needed if the non-TCC older people were to cross obstacles using the crossing strategy of the TCC people.

Keywords: Tai-Chi Chuan; gait analysis; obstacle crossing; optimal control; risk of fall.

PMID: 34926422 PMCID: PMC8675231 DOI: 10.3389/fbioe.2021.774771

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