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Older people may operate much closer to their maximum capabilities than young adults when ascending stairs due to their lower maximum musculoskeletal capabilities. The purpose of this study was to establish the joint moment and range of motion demands of stair ascent relative to maximum capabilities in elderly and young adults. Fifteen elderly (mean age 75 years) and 17 young adult (mean age 25 years) participants ascended a purpose-built 4-step staircase with force platforms embedded into the steps and kinematic data was acquired using motion capture. Maximum musculoskeletal capabilities were assessed using a dynamometer. This study showed for the first time that stair ascent approaches the joint moment limits at the ankle in both young and older participants ( approximately 90%). One of the most important and novel findings of this study was that elderly people were only capable of meeting the high demands by adopting a number of alternative strategies not observed in young adults: (i) applying the joint moments differently than young adults across the knee and ankle, (ii) translocating energy from the knee to the ankle, thereby enhancing the ankle joint moment upon maximum demand and (iii) by enabling the plantarflexors to act over a more favourable portion of the moment-angle relation upon maximum ankle joint moment demand. The elderly displayed a more cautious strategy to optimize positional stability during stair ascent, by maintaining a smaller separation between the centre of mass and centre of pressure in the frontal plane. It seems that elderly people may meet the demands of unaided stair ascent by adopting a number of alternative strategies to compensate for their reduced musculoskeletal capabilities.

The gastrocnemius medialis (GM) muscle plays an important role in stair negotiation. The aim of the study was to investigate the influence of cadence on GM muscle fascicle behaviour during stair ascent and descent. Ten male subjects (young adults) walked up and down a four-step staircase (with forceplates embedded in the steps) at three velocities (63, 88 and 116 steps/min). GM muscle fascicle length was measured using ultrasonography. In addition, kinematic and kinetic data of the lower legs, and GM electromyography (EMG) were measured. For both ascent and descent, the amount of fascicular shortening, shortening velocity, knee moment, ground reaction force and EMG activity increased monotonically with gait velocity. The ankle moment increased up to 88 steps/min where it reached a plateau. The lack of increase in ankle moment coinciding with further shortening of the fascicles can be explained by an increased shortening of the GM musculotendon complex (MTC), as calculated from the knee and ankle angle changes, between 88 and 116 steps/min only. For descent, the relative instant of maximum shortening, which occurred during touch down, was delayed at higher gait velocities, even to the extent that this event shifted from the double support to the single support phase.

In this study, we aimed to establish the joint moment and joint range of motion requirements of stair descent and the demands relative to maximal capacities in elderly and young adults. Participants descended a custom-built standard dimension four-step staircase, at their self-selected speed in a step-over manner. Kinetic data were acquired from force platforms embedded into each of the steps and into the floor at the base of the stairs. A motion analysis system was used to acquire kinematic data and joint moments were calculated using the kinematic and kinetic data. Maximum capacities (joint moment and joint range of motion) were assessed using a dynamometer. During stair descent the elderly generated lower absolute ankle joint moments than the young, which enabled them to operate at a similar relative proportion of their maximal capacity compared to young adults (75%). The knee joint moments during stair descent were similar between groups, but the elderly operated at a higher proportion of their maximal capacity (elderly: 42%; young: 30%). Ankle plantarflexion-dorsiflexion angle changes were similar between groups, which meant that the elderly operated at a higher proportion of their maximal assisted dorsiflexion angle. These results indicate that the elderly redistribute the joint moments in order to maintain the task demands within 'safe' limits.