Sunday, November 16, 2025 11/16/2025

A framework for feasible translation to enhance foot and ankle function in aging and mobility

Award Number: R01AR081287
ORGANIZATION: NATIONAL INSTITUTE OF ARTHRITIS & MUSCULOSKELETAL & SKIN DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/15/2022
PERIOD OF PERFORMANCE END DATE: 08/31/2027

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A framework for feasible translation to enhance foot and ankle function in aging and mobility - PROJECT SUMMARY This proposal will address the critical need for new and modifiable targets to enhance mobility and restore independence to those in our rapidly aging population. Due to reduced ankle push-off power, older adults walk slower and with higher metabolic energy cost than younger adults. As our central premise, we contend that hallmark age-associated deficits in push-off intensity during walking have been far too often mistakenly attributed solely to the plantarflexor muscles, and instead originate interdependently with those in the active, passive, and structural regulation of foot mechanical power. This premise paves the way for translational opportunities to augment foot structure and function to enhance independence and quality of life. This study combines the research agendas of two highly productive investigators and leverages the research infrastructure of two peer institutions. Aim 1 will be the first to study mechanical power interactions between the human foot and ankle in governing reduced push-off intensity and walking economy in older adults across a wide variety of everyday walking tasks. By combining metabolic measurements with state-of-the-art biomechanical and bioenergetic modeling, we will test the hypothesis that older adults exhibit higher mechanical energy losses via foot structures than young adults – aging effects that: (i) are larger for walking tasks that increase foot demand, (ii) misappropriate ankle moment and power during push-off, and thereby (iii) correlate with shorter 6 min walk distance and increased metabolic energy cost compared to young adults. Aim 2 will provide mechanistic insight into aging effects on the active, passive, and structural regulation of foot-ankle mechanical power interactions during walking. Using a series of controlled loading paradigms on a dynamometer combined with advanced in vivo ultrasound imaging and novel electromyographic biofeedback, we will test the hypotheses that older adults exhibit: (i) reduced foot and plantarflexor muscle strength and (ii) lower structural stiffness of and (iii) reduced structural connectivity between series elastic tissues spanning the foot and ankle – changes that require elevated plantar intrinsic muscle activation to maintain requisite foot stiffness and associate with reduced ankle moment and power output during push-off in walking. Finally, as a translational benchmark, Aim 3 will show that shoe- stiffness modifications that act in parallel with the plantar aponeurosis and intrinsic muscles can mitigate age- associated deficits in push-off function during walking. Supported by promising pilot data, we will test the hypotheses that older adults walking with increased shoe insole stiffness will exhibit: (i) smaller mechanical energy losses at the foot, (ii) more favorable plantarflexor muscle contractile dynamics, (iii) greater peak ankle moment and power output, and thus (iv) longer 6 min walk distance and reduced whole-body metabolic energy cost. Ultimately, this work will establish a paradigm shift in our biomechanical understanding and clinical management of age-related mobility impairment toward feasible and cost-effective devices to modify foot-ankle function – an outcome with significant potential to enhance independence and quality of life for millions.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $1,135,992 )
2025	2025	UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL	104 AIRPORT DR STE 2200	CHAPEL HILL	NC	27599	ORANGE	USA	Arthritis, Musculoskeletal and Skin Diseases Research	002	4	9/18/2025	SUPPLEMENT FOR EXPANSION	$119,828
2025	2025	UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL	104 AIRPORT DR STE 2200	CHAPEL HILL	NC	27599	ORANGE	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	4	9/17/2025	EXTENSION WITH OR WITHOUT FUNDS	$1,016,164
2025	2024	UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL	104 AIRPORT DR STE 2200	CHAPEL HILL	NC	27599	ORANGE	USA	Arthritis, Musculoskeletal and Skin Diseases Research	001	3	9/18/2025	NON-COMPETING CONTINUATION	$0
														Subtotal = $1,135,992

Issue Date FY: 2024 ( Subtotal = $591,280 )
2024	2024	UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL	104 AIRPORT DR STE 2200	CHAPEL HILL	NC	27599	ORANGE	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	3	8/13/2024	NON-COMPETING CONTINUATION	$517,491
2024	2024	UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL	104 AIRPORT DR STE 2200	CHAPEL HILL	NC	27599	ORANGE	USA	Arthritis, Musculoskeletal and Skin Diseases Research	001	3	9/18/2024	SUPPLEMENT FOR EXPANSION	$73,789
														Subtotal = $591,280

Issue Date FY: 2023 ( Subtotal = $536,976 )
2023	2023	UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL	104 AIRPORT DR STE 2200	CHAPEL HILL	NC	27599	ORANGE	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	2	8/11/2023	NON-COMPETING CONTINUATION	$536,976
														Subtotal = $536,976

Issue Date FY: 2022 ( Subtotal = $560,728 )
2022	2022	UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL	104 AIRPORT DR STE 2200	CHAPEL HILL	NC	27599	ORANGE	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	1	9/13/2022	NEW	$560,728
														Subtotal = $560,728

Grand Total All Awards = $2,824,976

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A framework for feasible translation to enhance foot and ankle function in aging and mobility

Award Number: R01AR081287

ORGANIZATION: NATIONAL INSTITUTE OF ARTHRITIS & MUSCULOSKELETAL & SKIN DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/15/2022

PERIOD OF PERFORMANCE END DATE: 08/31/2027

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