Abstract
The purpose of this paper is to discuss how knowledge of the biomechanics of walking
can be used to inform the prescription of resistance exercises for people with mobility
limitations. Muscle weakness is a key physical impairment that limits walking in commonly
occurring neurologic conditions such as cerebral palsy, traumatic brain injury, and
stroke. Few randomized trials to date have shown conclusively that strength training
improves walking in people living with these conditions. This appears to be because
(1) the most important muscle groups for forward propulsion when walking have not
been targeted for strengthening, and (2) strength training protocols have focused
on slow and heavy resistance exercises, which do not improve the fast muscle contractions
required for walking. We propose a theoretical framework to improve exercise prescription
by integrating the biomechanics of walking with the principles of strength training
outlined by the American College of Sports Medicine to prescribe exercises that are
specific to improving the task of walking. The high angular velocities that occur
in the lower limb joints during walking indicate that resistance exercises targeting
power generation would be most appropriate. Therefore, we propose the prescription
of plyometric and ballistic resistance exercise, applied using the American College
of Sports Medicine guidelines for task specificity, once people with neurologic conditions
are ambulating, to improve walking outcomes. This new theoretical framework for resistance
training ensures that exercise prescription matches how the muscles work during walking.
Keywords
List of abbreviations:
ACSM (American College of Sports Medicine), CP (cerebral palsy), TBI (traumatic brain injury)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 25, 2019
Footnotes
Disclosures: none.
Identification
Copyright
© 2019 by the American Congress of Rehabilitation Medicine
