Volume 11, Issue 3 (12-2025)
J Sport Biomech 2025, 11(3): 288-304 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Salimi K, Nakhaei K, Tabatabai Ghomsheh S F, Tehrani P, Shojaei S. Comparison of Kinetic and Kinematic Parameters of Walking Between Healthy Individuals and Patients with Heart Disease. J Sport Biomech 2025; 11 (3) :288-304
URL: http://biomechanics.iauh.ac.ir/article-1-375-en.html
URL: http://biomechanics.iauh.ac.ir/article-1-375-en.html
Kamran Salimi1 
, Koorosh Nakhaei *2 , Seyed Farhad Tabatabai Ghomsheh3 , Pedram Tehrani1 , Shahrokh Shojaei1
, Koorosh Nakhaei *2 , Seyed Farhad Tabatabai Ghomsheh3 , Pedram Tehrani1 , Shahrokh Shojaei1
1- Department of Biomedical Engineering, CT.C., Islamic Azad University, Tehran, Iran.
2- Department of Biomedical Engineering, Faculty of Technology and Engineering, Islamshahr Branch, Islamic Azad University, Islamshahr, Iran.
3- Pediatric Neurorehabilitation Research Center, Ergonomics Department, Faculty of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
2- Department of Biomedical Engineering, Faculty of Technology and Engineering, Islamshahr Branch, Islamic Azad University, Islamshahr, Iran.
3- Pediatric Neurorehabilitation Research Center, Ergonomics Department, Faculty of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Abstract: (55 Views)
Objective Cardiovascular diseases, particularly chronic heart failure, impair cardiac function, leading to muscle weakness and reduced motor control—factors that negatively affect gait quality. This study aimed to compare gait parameters between patients with chronic heart failure and healthy individuals.
Methods Twenty patients with chronic heart failure (mean age: 54 ± 1.9 years; BMI: 22.5 ± 4.5) and twenty healthy controls (mean age: 54.3 ± 1.6 years; BMI: 26.5 ± 1.5) participated in the study. Kinematic and kinetic data from the dominant lower limb were collected during walking using a Basler 3D motion analysis system and a Kistler force plate. Statistical analysis was performed using SPSS software, employing independent t-tests and Mann–Whitney U tests, with the significance level set at p < 0.05.
Results Significant differences in kinetic and kinematic gait parameters were observed between the patient and control groups. In the sagittal plane, ankle plantarflexion moments and knee and hip extension moments were reduced. In the frontal plane, decreases were found in knee varus and hip adduction moments. In the transverse plane, knee external rotation and hip internal rotation moments were also diminished. Hip and knee joint ranges of motion were significantly reduced, and ground reaction forces differed in the sagittal plane. While joint stiffness did not differ significantly, patients exhibited unstable gait patterns.
Conclusion Chronic heart failure substantially alters gait biomechanics. Decreased joint moments and range of motion across all planes, along with lateral muscle weakness and compensatory strategies, contribute to impaired gait stability. Although joint stiffness did not differ significantly, variability in the data suggested underlying functional instability. Notably, only the ground reaction force in the sagittal plane showed a significant difference.
Methods Twenty patients with chronic heart failure (mean age: 54 ± 1.9 years; BMI: 22.5 ± 4.5) and twenty healthy controls (mean age: 54.3 ± 1.6 years; BMI: 26.5 ± 1.5) participated in the study. Kinematic and kinetic data from the dominant lower limb were collected during walking using a Basler 3D motion analysis system and a Kistler force plate. Statistical analysis was performed using SPSS software, employing independent t-tests and Mann–Whitney U tests, with the significance level set at p < 0.05.
Results Significant differences in kinetic and kinematic gait parameters were observed between the patient and control groups. In the sagittal plane, ankle plantarflexion moments and knee and hip extension moments were reduced. In the frontal plane, decreases were found in knee varus and hip adduction moments. In the transverse plane, knee external rotation and hip internal rotation moments were also diminished. Hip and knee joint ranges of motion were significantly reduced, and ground reaction forces differed in the sagittal plane. While joint stiffness did not differ significantly, patients exhibited unstable gait patterns.
Conclusion Chronic heart failure substantially alters gait biomechanics. Decreased joint moments and range of motion across all planes, along with lateral muscle weakness and compensatory strategies, contribute to impaired gait stability. Although joint stiffness did not differ significantly, variability in the data suggested underlying functional instability. Notably, only the ground reaction force in the sagittal plane showed a significant difference.
Type of Study: Applicable |
Subject:
Special
Received: 2025/04/19 | Accepted: 2025/07/29 | Published: 2025/07/29
Received: 2025/04/19 | Accepted: 2025/07/29 | Published: 2025/07/29
References
1. Chahal J, Gómez-Aristizábal A, Shestopaloff K, Bhatt S, Chaboureau A, Fazio A, et al. Bone marrow mesenchymal stromal cell treatment in patients with osteoarthritis results in overall improvement in pain and symptoms and reduces synovial inflammation. Stem cells translational medicine. 2019;8(8):746-57. [DOI:10.1002/sctm.18-0183] [PMID]
2. Enayati M, Mardani-Hamooleh M, Farahani Nia M, Haghani S. Relationship between spiritual intelligence and illness-related worries in hospitalized patients with heart failure in Mazandaran, Iran. Iran Journal of Nursing. 2022;35(138):434-47. [DOI:10.32598/ijn.35.138.764.29]
3. Maghsodi H, Ebrahimi M, Ghanbari A, Hejaziyan SH. Investigation of the Anti-inflammatory Properties of Iranian Nigella sativa L in Reducing the Expression of Pre-Inflammatory Cytokines of TNF-α and IL-18 in Human THP-1 Cells. Journal of Ilam University of Medical Sciences. 2017;25(3):147-59. [DOI:10.29252/sjimu.25.3.147]
4. Arnold EM, Ward SR, Lieber RL, Delp SL. A model of the lower limb for analysis of human movement. Annals of biomedical engineering. 2010;38:269-79. [DOI:10.1007/s10439-009-9852-5] [PMID]
5. Panizzolo FA, Maiorana AJ, Naylor LH, Lichtwark GA, Dembo L, Lloyd DG, et al. Is the soleus a sentinel muscle for impaired aerobic capacity in heart failure? Medicine and science in sports and exercise. 2015;47(3):498-508. [DOI:10.1249/MSS.0000000000000431] [PMID]
6. Rezaei M, Najafian Razavi M, Mazandarani E. The Kinematics Gait Pattern Analysis of Thin, Normal and Obese Children. Journal of Sport Biomechanics. 2018;4(2):49-57.
7. Forman DE, Fleg JL, Kitzman DW, Brawner CA, Swank AM, McKelvie RS, et al. 6-min walk test provides prognostic utility comparable to cardiopulmonary exercise testing in ambulatory outpatients with systolic heart failure. Journal of the American College of Cardiology. 2012;60(25):2653-61. [DOI:10.1016/j.jacc.2012.08.1010] [PMID]
8. Najafian Razavi M. The Comparison of Gait Kinematics in Over-Weight and Normal-Weight People across Age Groups. Journal of Sport Biomechanics. 2022;8(3):214-30. [DOI:10.61186/JSportBiomech.8.3.214]
9. Hasandokht T, Salari A, Salari A, Fazeli A, Ashkan M. Evaluation of relation between cardiovascular risk factors and osteoarthritis: Results of a cross-sectional Study. Feyz Medical Sciences Journal. 2019;23(2):209-15.
10. McGibbon CA, Krebs DE, Puniello MS. Mechanical energy analysis identifies compensatory strategies in disabled elders' gait. Journal of biomechanics. 2001;34(4):481-90. [DOI:10.1016/S0021-9290(00)00220-7] [PMID]
11. Cahalin LP, Mathier MA, Semigran MJ, Dec GW, DiSalvo TG. The six-minute walk test predicts peak oxygen uptake and survival in patients with advanced heart failure. Chest. 1996;110(2):325-32. [DOI:10.1378/chest.110.2.325] [PMID]
12. Shokrallahnia-Roshan A, Sadeghi H, Shirani S, Nejatian M. Effects of Strength Training and Cardiac Rehabilitation Programs on the Biomechanical Parameters of Blood Flow Velocity and Blood Flow Rate and Its Relation With Arterial Stiffness Index in Brachial and Femoral Arteries with Coronary Artery Bypass Grafting Patients (CABG). Archives of Rehabilitation. 2013;14(2):38-45.
13. Gibbs N, Diamond R, Sekyere EO, Thomas WD. Management of knee osteoarthritis by combined stromal vascular fraction cell therapy, platelet-rich plasma, and musculoskeletal exercises: a case series. Journal of pain research. 2015:799-806. [DOI:10.2147/JPR.S92090] [PMID]
14. Masoli M, Fabian D, Holt S, Beasley R, Program GIfA. The global burden of asthma: executive summary of the GINA Dissemination Committee report. Allergy. 2004;59(5):469-78. [DOI:10.1111/j.1398-9995.2004.00526.x] [PMID]
15. Razaghi A, Sadeghi H, Johari Moghadam A, azma k, Motamedi P. The Effect of Exercise-Based Cardiac Rehabilitation In two ways Aerobic and Aerobic-Resistance Exercises on the Biomechanical Function of Cardiac Patients (MI, PCI, and CABG). Razi Journal of Medical Sciences. 2020;26(12):138-48.
16. Boyd R, Fatone S, Rodda J, Olesch C, Starr R, Cullis E, et al. High-or low-technology measurements of energy expenditure in clinical gait analysis? Developmental Medicine and Child Neurology. 1999;41(10):676-82. [DOI:10.1111/j.1469-8749.1999.tb00522.x] [PMID]
17. Celis R, Pipinos II, Scott-Pandorf MM, Myers SA, Stergiou N, Johanning JM. Peripheral arterial disease affects kinematics during walking. Journal of vascular surgery. 2009;49(1):127-32. [DOI:10.1016/j.jvs.2008.08.013] [PMID]
18. The Criteria Committee of the New York Heart Association. Nomenclature and criteria for diagnosis of diseases of the heart and great vessels. 9th ed. Boston, MA: Little, Brown & Co; 1994. p. 253-256.
19. Karatsidis A, Jung M, Schepers HM, Bellusci G, de Zee M, Veltink PH, et al. Predicting kinetics using musculoskeletal modeling and inertial motion capture. arXiv preprint 2018. arXiv:180101668.
20. Panizzolo FA, Maiorana A, Naylor LH, Rubenson J. Gait analysis in chronic heart failure: The calf as a locus of impaired walking capacity. Journal of Biomechanics. 2014;47(15):3719-25. [DOI:10.1016/j.jbiomech.2014.09.015] [PMID]
21. Ozcan EB, Saglam M, Vardar-Yagli N, et al. Impaired balance and gait characteristics in patients with chronic heart failure. Heart Lung Circulation. 2022;31(6):832-40. [DOI:10.1016/j.hlc.2021.10.015] [PMID]
22. Crespo-Ruiz B, Del Rosario-Garrido M, Cuesta-Vargas AI. Kinematic analysis of gait in patients with heart failure and controls: A cross-sectional study. Gait Posture. 2017;55:36-41.
23. Neptune RR, Zajac FE, Kautz SA. Muscle force redistributions during walking in persons with post-stroke hemiparesis. Journal of Biomechanics. 2004;37(6):403-12. [DOI:10.1016/j.jbiomech.2003.11.001] [PMID]
24. Heiden TL, Sandroff BM, Motl RW. Biomechanical and energetic determinants of walking performance in multiple sclerosis. Clinical Biomechanics. 2016;33:6-11.
25. Eng JJ, Winter DA. Kinetic analysis of human walking: Data interpretation and recommendations for improvement. Physical Therapy. 1995;75(9):776-85.
26. Ogaya S. Joint stiffness in patients with heart failure: a pilot study using gait analysis. Clinical Biomechanics. 2020;74:20-6.
27. Ozcan EB, Saglam M, Vardar-Yagli N, et al. Impaired balance and gait characteristics in patients with chronic heart failure. Heart, Lung and Circulation. 2022;31(6):832-40. [DOI:10.1016/j.hlc.2021.10.015] [PMID]
28. Neptune RR, Kautz SA, Zajac FE. Contributions of the individual ankle plantar flexors to support, forward progression and swing initiation during walking. Journal of Biomechanics. 2001;34(11):1387-98. [DOI:10.1016/S0021-9290(01)00105-1] [PMID]
29. Crespo-Ruiz B, Cuesta-Vargas AI. Kinematic analysis of gait in patients with heart failure and controls: A cross-sectional study. Gait & Posture. 2017;55:36-41.
30. Barker K, et al. Ground reaction force characteristics in patients with chronic heart failure. European Journal of Physical and Rehabilitation Medicine. 2013;49(3):351-7.
31. Dingwell JB, Cusumano JP. Nonlinear time series analysis of normal and pathological human walking. Chaos. 2000;10(4):848-63. [DOI:10.1063/1.1324008] [PMID]
32. Rahman H, Pipinos II, Johanning JM, Myers SA. Gait variability is affected more by peripheral artery disease than by vascular occlusion. Public Library of Science. 2021;16(3):e0241727. [DOI:10.1371/journal.pone.0241727] [PMID]
33. Piri A, Jafarnejadgero A, Ebrahimipour H, Nasri S. A review of the effects of exercise on body mechanics during translational movements in individuals with foot pronation: 2019-2022. Journal of Shahid Sadoughi University of Medical Sciences. 2023; 31(4):6544-60. [DOI:10.18502/ssu.v31i4.13024]
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Journal of Sport Biomechanics
Department of Sport Biomechanics, Faculty of Humanities, Islamic Azad University, Hamedan Branch, Prof. Mousivand Blvd, Imam Khomeini Blvd, Hamedan, Iran.
Journal Tel: +98 81 34494042
Website: http://biomechanics.iauh.ac.ir
Email: sportbiomechanics@iauh.ac.ir
