Lower limb muscle activation patterns in response to calf muscle EMG biofeedback before and after an 8-week gait retraining intervention in older adults
Abstract
For some patients, knee osteoarthritis is associated with excessive tibiofemoral joint loading, which contributes to cartilage degeneration. Modifying muscle coordination during walking, particularly between the soleus and medial gastrocnemius, may help reduce joint loading. Strength training of the soleus could further support this process by increasing muscle force generation capacity, potentially making new activation patterns more efficient and easier to learn. This study examined the effects of an 8-week neuromuscular coordination gait retraining program using real-time electromyography (EMG) biofeedback targeting the calf muscles in 30 healthy older adults, with gait retraining as the primary intervention. Half of the participants were randomly assigned to receive additional soleus strength training to assess its added value. During treadmill walking, participants received visual and auditory feedback designed to promote a more soleus-dominant coordination strategy. EMG and 3D motion capture data were collected before and after the intervention during baseline and feedback trials, and post-intervention during a retention trial without feedback. Participants showed a significant shift toward a soleus-dominant coordination pattern during feedback trials both before (0.460 ± 0.098 vs. 0.440 ± 0.098, p = 0.002, Cohen's dz = 0.64) and after (0.492 ± 0.086 vs. 0.464 ± 0.091, p z = 1.05) the intervention. This pattern was partially retained without feedback, though to a…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 30 participants or records.
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