Physical performance tests after stroke: reliability and validity.

PubMed

Maeda, A; Yuasa, T; Nakamura, K; Higuchi, S; Motohashi, Y

2000-01-01

To evaluate the reliability and validity of the modified physical performance tests for stroke survivors who live in a community. The subjects included 40 stroke survivors and 40 apparently healthy independent elderly persons. The physical performance tests for the stroke survivors comprised two physical capacity evaluation tasks that represented physical abilities necessary to perform the main activities of daily living, e.g., standing-up ability (time needed to stand up from bed rest) and walking ability (time needed to walk 10 m). Regarding the reliability of tests, significant correlations were confirmed between test and retest of physical performance tests with both short and long intervals in individuals after stroke. Regarding the validity of tests, the authors studied the significant correlations between the maximum isometric strength of the quardriceps muscle and the time needed to walk 10 m, centimeters reached while sitting and reaching, and the time needed to stand up from bed rest. The authors confirmed that there were significant correlations between the instrumental activity of daily living and the time needed to stand up from bed rest, along with the time needed to walk 10 m for the stroke survivors. These physical performance tests are useful guides for evaluating a level of activity of daily living and physical frailty of stroke survivors living in a community.

Initial Outcomes from a Multicenter Study Utilizing the Indego Powered Exoskeleton in Spinal Cord Injury.

PubMed

Tefertiller, Candy; Hays, Kaitlin; Jones, Janell; Jayaraman, Arun; Hartigan, Clare; Bushnik, Tamara; Forrest, Gail F

2018-01-01

Objective: To assess safety and mobility outcomes utilizing the Indego powered exoskeleton in indoor and outdoor walking conditions with individuals previously diagnosed with a spinal cord injury (SCI). Methods: We conducted a multicenter prospective observational cohort study in outpatient clinics associated with 5 rehabilitation hospitals. A convenience sample of nonambulatory individuals with SCI ( N = 32) completed an 8-week training protocol consisting of walking training 3 times per week utilizing the Indego powered exoskeleton in indoor and outdoor conditions. Participants were also trained in donning/doffing the exoskeleton during each session. Safety measures such as adverse events (AEs) were monitored and reported. Time and independence with donning/doffing the exoskeleton as well as walking outcomes to include the 10-meter walk test (10MWT), 6-minute walk test (6MWT), Timed Up & Go test (TUG), and 600-meter walk test were evaluated from midpoint to final evaluations. Results: All 32 participants completed the training protocol with limited device-related AEs, which resulted in no interruption in training. The majority of participants in this trial were able to don and doff the Indego independently. Final walking speed ranged from 0.19 to 0.55 m/s. Final average indoor and outdoor walking speeds among all participants were 0.37 m/s ( SD = 0.08, 0.09, respectively), after 8 weeks of training. Significant ( p < .05) improvements were noted between midpoint and final gait speeds in both indoor and outdoor conditions. Average walking endurance also improved among participants after training. Conclusion: The Indego was shown to be safe for providing upright mobility to 32 individuals with SCIs who were nonambulatory. Improvements in speed and independence were noted with walking in indoor and outdoor conditions as well as with donning/doffing the exoskeleton.

The performance of stroke survivors in turning-while-walking while carrying out a concurrent cognitive task compared with controls.

PubMed

Chan, Wing-Nga; Tsang, William Wai-Nam

2017-01-01

Turning-while-walking is one of the commonest causes of falls in stroke survivors. It involves cognitive processing and may be challenging when performed concurrently with a cognitive task. Previous studies of dual-tasking involving turning-while-walking in stroke survivors show that the performance of physical tasks is compromised. However, the design of those studies did not address the response of stroke survivors under dual-tasking condition without specifying the task-preference and its effect on the performance of the cognitive task. First, to compare the performance of single-tasking and dual-tasking in stroke survivors. Second, to compare the performance of stroke survivors with non-stroke controls. Fifty-nine stroke survivors and 45 controls were assessed with an auditory Stroop test, a turning-while-walking test, and a combination of the two single tasks. The outcome of the cognitive task was measured by the reaction time and accuracy of the task. The physical task was evaluated by measuring the turning duration, number of steps to turn, and time to complete the turning-while-walking test. Stroke survivors showed a significantly reduced accuracy in the auditory Stroop test when dual-tasking, but there was no change in the reaction time. Their performance in the turning-while-walking task was similar under both single-tasking and dual-tasking condition. Additionally, stroke survivors demonstrated a significantly longer reaction time and lower accuracy than the controls both when single-tasking and dual-tasking. They took longer to turn, with more steps, and needed more time to complete the turning-while-walking task in both tasking conditions. The results show that stroke survivors with high mobility function performed the auditory Stroop test less accurately while preserving simultaneous turning-while-walking performance. They also demonstrated poorer performance in both single-tasking and dual-tasking as compared with controls.

Short-term and practice effects of metronome pacing in Parkinson's disease patients with gait freezing while in the 'on' state: randomized single blind evaluation.

PubMed

Cubo, Esther; Leurgans, Sue; Goetz, Christopher G

2004-12-01

In a randomized single blind parallel study, we tested the efficacy of an auditory metronome on walking speed and freezing in Parkinson's disease (PD) patients with freezing gait impairment during their 'on' function. No pharmacological treatment is effective in managing 'on' freezing in PD. Like visual cues that can help overcome freezing, rhythmic auditory pacing may provide cues that help normalize walking pace and overcome freezing. Non-demented PD patients with freezing during their 'on' state walked under two conditions, in randomized order: unassisted walking and walking with the use of an audiocassette with a metronome recording. The walking trials were randomized and gait variables were rated from videotapes by a blinded evaluator. Outcome measures were total walking time (total trial time-total freezing time), which was considered the time over a course of specified length, freezing time, average freeze duration and number of freezes. All outcomes were averaged across trials for each person and then compared across conditions using Signed Rank tests. Twelve non-demented PD patients with a mean age of 65.8 +/- 11.2 years, and mean PD duration of 12.4 +/- 7.3 years were included. The use of the metronome slowed ambulation and increased the total walking time (P < 0.0005) only during the first visit, without affecting any freezing variable. In the nine patients who took the metronome recording home and used it daily for 1 week while walking, freezing remained unimproved. Though advocated in prior publications as a walking aid for PD patients, auditory metronome pacing slows walking and is not a beneficial intervention for freezing during their 'on' periods.

Can an aversive, extinction-resistant memory trigger impairments in walking adaptability? An experimental study using adult rats.

PubMed

Medeiros, Filipe Mello; de Carvalho Myskiw, Jociane; Baptista, Pedro Porto Alegre; Neves, Laura Tartari; Martins, Lucas Athaydes; Furini, Cristiane Regina Guerino; Izquierdo, Iván; Xavier, Léder Leal; Hollands, Kristen; Mestriner, Régis Gemerasca

2018-02-05

Cognitive demands can influence the adaptation of walking, a crucial skill to maintain body stability and prevent falls. Whilst previous research has shown emotional load tunes goal-directed movements, little attention has been given to this finding. This study sought to assess the effects of suffering an extinction-resistant memory on skilled walking performance in adult rats, as an indicator of walking adaptability. Thus, 36 Wistar rats were divided in a two-part experiment. In the first part (n=16), the aversive, extinction-resistance memory paradigm was established using a fear-conditioning chamber. In the second, rats (n=20) were assessed in a neutral room using the ladder rung walking test before and tree days after inducing an extinction-resistance memory. In addition, the elevated plus-maze test was used to control the influence of the anxiety-like status on gait adaptability. Our results revealed the shock group exhibited worse walking adaptability (lower skilled walking score), when compared to the sham group. Moreover, the immobility time in the ladder rung walking test was similar to the controls, suggesting that gait adaptability performance was not a consequence of the fear generalization. No anxiety-like behavior was observed in the plus maze test. Finally, correlation coefficients also showed the skilled walking performance score was positively correlated with the number of gait cycles and trial time in the ladder rung walking test and the total crossings in the plus maze. Overall, these preliminary findings provide evidence to hypothesize an aversive, extinction-resistant experience might change the emotional load, affecting the ability to adapt walking. Copyright © 2017. Published by Elsevier B.V.

Give your ideas some legs: the positive effect of walking on creative thinking.

PubMed

Oppezzo, Marily; Schwartz, Daniel L

2014-07-01

Four experiments demonstrate that walking boosts creative ideation in real time and shortly after. In Experiment 1, while seated and then when walking on a treadmill, adults completed Guilford's alternate uses (GAU) test of creative divergent thinking and the compound remote associates (CRA) test of convergent thinking. Walking increased 81% of participants' creativity on the GAU, but only increased 23% of participants' scores for the CRA. In Experiment 2, participants completed the GAU when seated and then walking, when walking and then seated, or when seated twice. Again, walking led to higher GAU scores. Moreover, when seated after walking, participants exhibited a residual creative boost. Experiment 3 generalized the prior effects to outdoor walking. Experiment 4 tested the effect of walking on creative analogy generation. Participants sat inside, walked on a treadmill inside, walked outside, or were rolled outside in a wheelchair. Walking outside produced the most novel and highest quality analogies. The effects of outdoor stimulation and walking were separable. Walking opens up the free flow of ideas, and it is a simple and robust solution to the goals of increasing creativity and increasing physical activity. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Evaluation of the microsoft kinect skeletal versus depth data analysis for timed-up and go and figure of 8 walk tests.

PubMed

Hotrabhavananda, Benjamin; Mishra, Anup K; Skubic, Marjorie; Hotrabhavananda, Nijaporn; Abbott, Carmen

2016-08-01

We compared the performance of the Kinect skeletal data with the Kinect depth data in capturing different gait parameters during the Timed-up and Go Test (TUG) and Figure of 8 Walk Test (F8W). The gait parameters considered were stride length, stride time, and walking speed for the TUG, and number of steps and completion time for the F8W. A marker-based Vicon motion capture system was used for the ground-truth measurements. Five healthy participants were recruited for the experiment and were asked to perform three trials of each task. Results show that depth data analysis yields stride length and stride time measures with significantly low percentile errors as compared to the skeletal data analysis. However, the skeletal and depth data performed similar with less than 3% of absolute mean percentile error in determining the walking speed for the TUG and both parameters of F8W. The results show potential capabilities of Kinect depth data analysis in computing many gait parameters, whereas, the Kinect skeletal data can also be used for walking speed in TUG and F8W gait parameters.

The Dynamical Classification of Centaurs which Evolve into Comets

NASA Astrophysics Data System (ADS)

Wood, Jeremy R.; Horner, Jonathan; Hinse, Tobias; Marsden, Stephen; Swinburne University of Technology

2016-10-01

Centaurs are small Solar system bodies with semi-major axes between Jupiter and Neptune and perihelia beyond Jupiter. Centaurs can be further subclassified into two dynamical categories - random walk and resonance hopping. Random walk Centaurs have mean square semi-major axes (< a2 >) which vary in time according to a generalized diffusion equation where < a2 > ~t2H. H is the Hurst exponent with 0 < H < 1, and t is time. The behavior of < a2 > for resonance hopping Centaurs is not well described by generalized diffusion.The aim of this study is to determine which dynamical type of Centaur is most likely to evolve into each class of comet. 31,722 fictional massless test particles were integrated for 3 Myr in the 6-body problem (Sun, Jovian planets, test particle). Initially each test particle was a member of one of four groups. The semi-major axes of all test particles in a group were clustered within 0.27 au from a first order, interior Mean Motion resonance of Neptune. The resonances were centered at 18.94 au, 22.95 au, 24.82 au and 28.37 au.If the perihelion of a test particle reached < 4 au then the test particle was considered to be a comet and classified as either a random walk or resonance hopping Centaur. The results showed that over 4,000 test particles evolved into comets within 3 Myr. 59% of these test particles were random walk and 41% were resonance hopping. The behavior of the semi-major axis in time was usually well described by generalized diffusion for random walk Centaurs (ravg = 0.98) and poorly described for resonance hopping Centaurs (ravg = 0.52). The average Hurst exponent was 0.48 for random walk Centaurs and 0.20 for resonance hopping Centaurs. Random walk Centaurs were more likely to evolve into short period comets while resonance hopping Centaurs were more likely to evolve into long period comets. For each initial cluster, resonance hopping Centaurs took longer to evolve into comets than random walk Centaurs. Overall the population of random walk Centaurs averaged 143 kyr to evolve into comets, and the population of resonance hopping Centaurs averaged 164 kyr.

Investigation of the immediate pre-operative physical capacity of patients scheduled for elective abdominal surgery using the 6-minute walk test.

PubMed

Soares, S M T P; Jannuzzi, H P C; Kassab, M F O; Nucci, L B; Paschoal, M A

2015-09-01

To evaluate the effects of repetition of the 6-minute walk test in patients scheduled to undergo abdominal surgery within the next 48 hours, and to verify the physical capacity of these subjects before surgery. Cross-sectional study. University teaching hospital. Forty-two patients scheduled for elective abdominal surgery within the next 48 hours. Distance walked in the 6-minute walk test, heart rate, peripheral oxygen saturation, dyspnoea and leg fatigue. Thirty-one patients (74%) were able to walk for a longer distance when the test was repeated. In these subjects, the mean increase in distance walked was 35.4 [standard deviation (SD) 19.9]m. Heart rate, dyspnoea and leg fatigue increased significantly over time on both tests (P<0.05). The mean heart rate at the end of the sixth minute was significantly higher on the second test (P=0.022). Peripheral oxygen saturation remained above 90% in both tests. The furthest distance walked was, on average, 461.3 (SD 89.7)m. This value was significantly lower than that predicted for the sample (P<0.001). Patients scheduled to undergo abdominal surgery were able to walk further when they performed a second 6-minute walk test. Moreover, they showed reduced physical ability before surgery. These findings suggest that repetition of the 6-minute walk test may increase the accuracy of the distance walked, which is useful for studies assessing the physical capacity of patients undergoing abdominal surgery. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Pilates exercise training vs. physical therapy for improving walking and balance in people with multiple sclerosis: a randomized controlled trial.

PubMed

Kalron, Alon; Rosenblum, Uri; Frid, Lior; Achiron, Anat

2017-03-01

Evaluate the effects of a Pilates exercise programme on walking and balance in people with multiple sclerosis and compare this exercise approach to conventional physical therapy sessions. Randomized controlled trial. Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Israel. Forty-five people with multiple sclerosis, 29 females, mean age (SD) was 43.2 (11.6) years; mean Expanded Disability Status Scale (S.D) was 4.3 (1.3). Participants received 12 weekly training sessions of either Pilates ( n=22) or standardized physical therapy ( n=23) in an outpatient basis. Spatio-temporal parameters of walking and posturography parameters during static stance. Functional tests included the Time Up and Go Test, 2 and 6-minute walk test, Functional Reach Test, Berg Balance Scale and the Four Square Step Test. In addition, the following self-report forms included the Multiple Sclerosis Walking Scale and Modified Fatigue Impact Scale. At the termination, both groups had significantly increased their walking speed ( P=0.021) and mean step length ( P=0.023). According to the 2-minute and 6-minute walking tests, both groups at the end of the intervention program had increased their walking speed. Mean (SD) increase in the Pilates and physical therapy groups were 39.1 (78.3) and 25.3 (67.2) meters, respectively. There was no effect of group X time in all instrumented and clinical balance and gait measures. Pilates is a possible treatment option for people with multiple sclerosis in order to improve their walking and balance capabilities. However, this approach does not have any significant advantage over standardized physical therapy.

"On" freezing in Parkinson's disease: resistance to visual cue walking devices.

PubMed

Kompoliti, K; Goetz, C G; Leurgans, S; Morrissey, M; Siegel, I M

2000-03-01

To measure "on" freezing during unassisted walking (UW) and test if two devices, a modified inverted stick (MIS) and a visual laser beam stick (LBS) improved walking speed and number of "on" freezing episodes in patients with Parkinson's disease (PD). Multiple visual cues can overcome "off' freezing episodes and can be useful in improving gait function in parkinsonian patients. These devices have not been specifically tested in "on" freezing, which is unresponsive to pharmacologic manipulations. Patients with PD, motor fluctuations and freezing while "on," attempted walking on a 60-ft track with each of three walking conditions in a randomized order: UW, MIS, and LBS. Total time to complete a trial, number of freezes, and the ratio of walking time to the number of freezes were compared using Friedman's test. Twenty-eight patients with PD, mean age 67.81 years (standard deviation [SD] 7.54), mean disease duration 13.04 years (SD 7.49), and mean motor Unified Parkinson's Disease Rating Scale score "on" 32.59 (SD 10.93), participated in the study. There was a statistically significant correlation of time needed to complete a trial and number of freezes for all three conditions (Spearman correlations: UW 0.973, LBS 0.0.930, and MIS 0.842). The median number of freezes, median time to walk in each condition, and median walking time per freeze were not significantly different in pairwise comparisons of the three conditions (Friedman's test). Of the 28 subjects, six showed improvement with the MIS and six with the LBS in at least one outcome measure. Assisting devices, specifically based on visual cues, are not consistently beneficial in overcoming "on" freezing in most patients with PD. Because this is an otherwise untreatable clinical problem and because occasional subjects do respond, cautious trials of such devices under the supervision of a health professional should be conducted to identify those patients who might benefit from their long-term use.

Effect of divided attention on gait in subjects with and without cognitive impairment.

PubMed

Pettersson, Anna F; Olsson, Elisabeth; Wahlund, Lars-Olof

2007-03-01

The aim of this study was to investigate the influence of cognition on motor function using 2 simple everyday tasks, talking and walking, in younger subjects with Alzheimer's disease and mild cognitive impairment. A second aim was to evaluate reliability for the dual-task test Talking While Walking. Walking speed during single and dual task and time change between single and dual task were compared between groups. The test procedure was repeated after 1 week. Subjects with AD had lower walking speed and greater time change between single and dual task compared with healthy controls. Reliability for Talking While Walking was very good. The results show that motor function in combination with a cognitive task, as well as motor function alone, influences subjects with Alzheimer's disease in a negative way and that decreased walking speed during single- and dual-task performance may be an early symptom in Alzheimer's disease.

Over ground walking and body weight supported walking improve mobility equally in cerebral palsy: a randomised controlled trial.

PubMed

Swe, Ni Ni; Sendhilnnathan, Sunitha; van Den Berg, Maayken; Barr, Christopher

2015-11-01

To assess partial body weight supported treadmill training versus over ground training for walking ability in children with mild to moderate cerebral palsy. Randomised controlled trial. A Special Needs school in Singapore. Thirty children with cerebral palsy, aged 6-18, with a Gross Motor Function Classification System score of II-III. Two times 30 minute sessions of walking training per week for 8 weeks, progressed as tolerated, either over ground (control) or using partial body weight supported treadmill training (intervention). The 10 metre walk test, and the 6 minute walk test. Secondary measures were sub-sections D and E on the Gross Motor Function Measure. Outcomes were assessed at baseline, and after 4 and 8 weeks of training. There was no effect of group allocation on any outcome measure, while time was a significant factor for all outcomes. Walking speed improved significantly more in the intervention group by week 4 (0.109 (0.067)m/s vs 0.048 (0.071)m/s, P=0.024) however by week 8 the change from baseline was similar (intervention 0.0160 (0.069)m/s vs control 0.173 (0.109)m/s, P=0.697). All gains made by week 4 were significantly improved on by week 8 for the 10 metre walk test, 6 minute walk test, and the gross motor function measure. Partial body weight supported treadmill training is no more effective than over ground walking at improving aspects of walking and function in children with mild to moderate cerebral palsy. Gains seen in 4 weeks can be furthered by 8 weeks. © The Author(s) 2015.

Evaluating walking in patients with multiple sclerosis: which assessment tools are useful in clinical practice?

PubMed

Bethoux, Francois; Bennett, Susan

2011-01-01

Walking limitations are among the most visible manifestations of multiple sclerosis (MS). Regular walking assessments should be a component of patient management and require instruments that are appropriate from the clinician's and the patient's perspectives. This article reviews frequently used instruments to assess walking in patients with MS, with emphasis on their validity, reliability, and practicality in the clinical setting. Relevant articles were identified based on PubMed searches using the following terms: "multiple sclerosis AND (walking OR gait OR mobility OR physical activity) AND (disability evaluation)"; references of relevant articles were also searched. Although many clinician- and patient-driven instruments are available, not all have been validated in MS, and some are not sensitive enough to detect small but clinically important changes. Choosing among these depends on what needs to be measured, psychometric properties, the clinical relevance of results, and practicality with respect to space, time, and patient burden. Of the instruments available, the clinician-observed Timed 25-Foot Walk and patient self-report 12-Item Multiple Sclerosis Walking Scale have properties that make them suitable for routine evaluation of walking performance. The Dynamic Gait Index and the Timed Up and Go test involve other aspects of mobility, including balance. Tests of endurance, such as the 2- or 6-Minute Walk, may provide information on motor fatigue not captured by other tests. Quantitative measurement of gait kinetics and kinematics, and recordings of mobility in the patient's environment via accelerometry or Global Positioning System odometry, are currently not routinely used in the clinical setting.

Evaluating Walking in Patients with Multiple Sclerosis

PubMed Central

Bennett, Susan

2011-01-01

Walking limitations are among the most visible manifestations of multiple sclerosis (MS). Regular walking assessments should be a component of patient management and require instruments that are appropriate from the clinician's and the patient's perspectives. This article reviews frequently used instruments to assess walking in patients with MS, with emphasis on their validity, reliability, and practicality in the clinical setting. Relevant articles were identified based on PubMed searches using the following terms: “multiple sclerosis AND (walking OR gait OR mobility OR physical activity) AND (disability evaluation)”; references of relevant articles were also searched. Although many clinician- and patient-driven instruments are available, not all have been validated in MS, and some are not sensitive enough to detect small but clinically important changes. Choosing among these depends on what needs to be measured, psychometric properties, the clinical relevance of results, and practicality with respect to space, time, and patient burden. Of the instruments available, the clinician-observed Timed 25-Foot Walk and patient self-report 12-Item Multiple Sclerosis Walking Scale have properties that make them suitable for routine evaluation of walking performance. The Dynamic Gait Index and the Timed Up and Go test involve other aspects of mobility, including balance. Tests of endurance, such as the 2- or 6-Minute Walk, may provide information on motor fatigue not captured by other tests. Quantitative measurement of gait kinetics and kinematics, and recordings of mobility in the patient's environment via accelerometry or Global Positioning System odometry, are currently not routinely used in the clinical setting. PMID:24453700

The effects of smartphone multitasking on gait and dynamic balance.

PubMed

Lee, Jeon Hyeong; Lee, Myoung Hee

2018-02-01

[Purpose] This study was performed to analyze the influence of smartphone multitasking on gait and dynamic balance. [Subjects and Methods] The subjects were 19 male and 20 female university students. There were 4 types of gait tasks: General Gait (walking without a task), Task Gait 1 (walking while writing a message), Task Gait 2 (walking while writing a message and listening to music), Task Gait 3 (walking while writing a message and having a conversation). To exclude the learning effect, the order of tasks was randomized. The Zebris FDM-T treadmill system (Zebris Medical GmbH, Germany) was used to measure left and right step length and width, and a 10 m walking test (10MWT) was conducted for gait velocity. In addition, a Timed Up and Go test (TUG) was used to measure dynamic balance. All the tasks were performed 3 times, and the mean of the measured values was analyzed. [Results] There were no statistically significant differences in step length and width. There were statistically significant differences in the 10MWT and TUG tests. [Conclusion] Using a smartphone while walking decreases a person's dynamic balance and walking ability. It is considered that accident rates are higher when using a smartphone.

Dynamic and functional balance tasks in subjects with persistent whiplash: a pilot trial.

PubMed

Stokell, Raina; Yu, Annie; Williams, Katrina; Treleaven, Julia

2011-08-01

Disturbances in static balance have been demonstrated in subjects with persistent whiplash. Some also report loss of balance and falls. These disturbances may contribute to difficulties in dynamic tasks. The aim of this study was to determine whether subjects with whiplash had deficits in dynamic and functional balance tasks when compared to a healthy control group. Twenty subjects with persistent pain following a whiplash injury and twenty healthy controls were assessed in single leg stance with eyes open and closed, the step test, Fukuda stepping test, tandem walk on a firm and soft surface, Singleton test with eyes open and closed, a stair walking test and the timed 10 m walk with and without head movement. Subjects with whiplash demonstrated significant deficits (p < 0.01) in single leg stance with eyes closed, the step test, tandem walk on a firm and soft surface, stair walking and the timed 10 m walk with and without head movement when compared to the control subjects. Specific assessment and rehabilitation directed towards improving these deficits may need to be considered in the management of patients with persistent whiplash if these results are confirmed in a larger cohort. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

Uphill and Downhill Walking in Multiple Sclerosis

PubMed Central

Samaei, Afshin; Hajihasani, Abdolhamid; Fatemi, Elham; Motaharinezhad, Fatemeh

2016-01-01

Background: Various exercise protocols have been recommended for patients with multiple sclerosis (MS). We investigated the effects of uphill and downhill walking exercise on mobility, functional activities, and muscle strength in MS patients. Methods: Thirty-four MS patients were randomly allocated to either the downhill or uphill treadmill walking group for 12 sessions (3 times/wk) of 30 minutes' walking on a 10% negative slope (n = 17) or a 10% positive slope (n = 17), respectively. Measurements were taken before and after the intervention and after 4-week follow-up and included fatigue by Modified Fatigue Impact Scale; mobility by Modified Rivermead Mobility Index; disability by Guy's Neurological Disability Scale; functional activities by 2-Minute Walk Test, Timed 25-Foot Walk test, and Timed Up and Go test; balance indices by Biodex Balance System; and quadriceps and hamstring isometric muscles by torque of left and right knee joints. Analysis of variance with repeated measures was used to investigate the intervention effects on the measurements. Results: After the intervention, significant improvement was found in the downhill group versus the uphill group in terms of fatigue, mobility, and disability indices; functional activities; balance indices; and quadriceps isometric torque (P < .05). The results were stable at 4-week follow-up. Conclusions: Downhill walking on a treadmill may improve muscle performance, functional activity, and balance control in MS patients. These findings support the idea of using eccentric exercise training in MS rehabilitation protocols. PMID:26917996

Kinematic Validation of a Multi-Kinect v2 Instrumented 10-Meter Walkway for Quantitative Gait Assessments.

PubMed

Geerse, Daphne J; Coolen, Bert H; Roerdink, Melvyn

2015-01-01

Walking ability is frequently assessed with the 10-meter walking test (10MWT), which may be instrumented with multiple Kinect v2 sensors to complement the typical stopwatch-based time to walk 10 meters with quantitative gait information derived from Kinect's 3D body point's time series. The current study aimed to evaluate a multi-Kinect v2 set-up for quantitative gait assessments during the 10MWT against a gold-standard motion-registration system by determining between-systems agreement for body point's time series, spatiotemporal gait parameters and the time to walk 10 meters. To this end, the 10MWT was conducted at comfortable and maximum walking speed, while 3D full-body kinematics was concurrently recorded with the multi-Kinect v2 set-up and the Optotrak motion-registration system (i.e., the gold standard). Between-systems agreement for body point's time series was assessed with the intraclass correlation coefficient (ICC). Between-systems agreement was similarly determined for the gait parameters' walking speed, cadence, step length, stride length, step width, step time, stride time (all obtained for the intermediate 6 meters) and the time to walk 10 meters, complemented by Bland-Altman's bias and limits of agreement. Body point's time series agreed well between the motion-registration systems, particularly so for body points in motion. For both comfortable and maximum walking speeds, the between-systems agreement for the time to walk 10 meters and all gait parameters except step width was high (ICC ≥ 0.888), with negligible biases and narrow limits of agreement. Hence, body point's time series and gait parameters obtained with a multi-Kinect v2 set-up match well with those derived with a gold standard in 3D measurement accuracy. Future studies are recommended to test the clinical utility of the multi-Kinect v2 set-up to automate 10MWT assessments, thereby complementing the time to walk 10 meters with reliable spatiotemporal gait parameters obtained objectively in a quick, unobtrusive and patient-friendly manner.

Kinematic Validation of a Multi-Kinect v2 Instrumented 10-Meter Walkway for Quantitative Gait Assessments

PubMed Central

Geerse, Daphne J.; Coolen, Bert H.; Roerdink, Melvyn

2015-01-01

Walking ability is frequently assessed with the 10-meter walking test (10MWT), which may be instrumented with multiple Kinect v2 sensors to complement the typical stopwatch-based time to walk 10 meters with quantitative gait information derived from Kinect’s 3D body point’s time series. The current study aimed to evaluate a multi-Kinect v2 set-up for quantitative gait assessments during the 10MWT against a gold-standard motion-registration system by determining between-systems agreement for body point’s time series, spatiotemporal gait parameters and the time to walk 10 meters. To this end, the 10MWT was conducted at comfortable and maximum walking speed, while 3D full-body kinematics was concurrently recorded with the multi-Kinect v2 set-up and the Optotrak motion-registration system (i.e., the gold standard). Between-systems agreement for body point’s time series was assessed with the intraclass correlation coefficient (ICC). Between-systems agreement was similarly determined for the gait parameters’ walking speed, cadence, step length, stride length, step width, step time, stride time (all obtained for the intermediate 6 meters) and the time to walk 10 meters, complemented by Bland-Altman’s bias and limits of agreement. Body point’s time series agreed well between the motion-registration systems, particularly so for body points in motion. For both comfortable and maximum walking speeds, the between-systems agreement for the time to walk 10 meters and all gait parameters except step width was high (ICC ≥ 0.888), with negligible biases and narrow limits of agreement. Hence, body point’s time series and gait parameters obtained with a multi-Kinect v2 set-up match well with those derived with a gold standard in 3D measurement accuracy. Future studies are recommended to test the clinical utility of the multi-Kinect v2 set-up to automate 10MWT assessments, thereby complementing the time to walk 10 meters with reliable spatiotemporal gait parameters obtained objectively in a quick, unobtrusive and patient-friendly manner. PMID:26461498

Impact of Pilates Exercise in Multiple Sclerosis: A Randomized Controlled Trial.

PubMed

Duff, Whitney R D; Andrushko, Justin W; Renshaw, Doug W; Chilibeck, Philip D; Farthing, Jonathan P; Danielson, Jana; Evans, Charity D

2018-01-01

Pilates is a series of exercises based on whole-body movement and may improve mobility in people with multiple sclerosis (MS). The purpose of this study was to determine the effect of Pilates on walking performance in people with MS. 30 individuals with MS who were not restricted to a wheelchair or scooter (Patient-Determined Disease Steps scale score <7) were randomized to receive Pilates (twice weekly) and massage therapy (once weekly) or once-weekly massage therapy only (control group). The Pilates was delivered in a group setting (five to ten participants per session). The primary outcome was change in walking performance (6-Minute Walk Test) after 12 weeks. Secondary outcomes included functional ability (Timed Up and Go test), balance (Fullerton Advanced Balance Scale), flexibility (sit and reach test), body composition (dual-energy X-ray absorptiometry), core endurance (plank-hold test), and muscle strength and voluntary activation (quadriceps). Intention-to-treat analysis was performed using a two-factor repeated-measures analysis of variance. Walking distance increased by a mean (SD) of 52.4 (40.2) m in the Pilates group versus 15.0 (34.1) m in the control group (group × time, P = .01). Mean (SD) time to complete the Timed Up and Go test decreased by 1.5 (2.8) seconds in the Pilates group versus an increase of 0.3 (0.9) seconds in the control group (group × time, P = .03). There were no other significant differences between groups over time. Pilates improved walking performance and functional ability in persons with MS and is a viable exercise option to help manage the disease.

Effect of Body Weight-supported Walking on Exercise Capacity and Walking Speed in Patients with Knee Osteoarthritis: A Randomized Controlled Trial

PubMed Central

Someya, Fujiko

2013-01-01

Abstract Objective: To compare the effect of body-weight-supported treadmill training (BWSTT) and full-body-weight treadmill training (FBWTT) on patients with knee osteoarthritis (OA). Methods: Design was Randomized controlled trial. Patients with knee osteoarthritis (n = 30; mean age, 76.0±7.5 y) were randomly assigned to BWSTT or FBWTT group. All patients performed 20 min walking exercise twice a week for 6 weeks under the supervision of the therapist. Main measures were 10-meter walking test (10MWT), functional reach test (FRT), timed get up and go test (TUG), one-leg standing test, 6-minute walking test (6MWT), the parameters set on the treadmill, MOS Short-Form 36-Item Health Survey (SF36), Japanese Knee Osteoarthritis Measure (JKOM). Results: Twenty-five patients (10 men, 15 women; mean age, 76.5 ± 8.0 y) completed the experiment. Exercise capacity, indicated by the heart rate, was similar in both groups. After 3 weeks of BWSTT, the patients performed significantly better in the 10-m and 6-min walking tests. This was not the case with FBWTT even after 6 weeks training. Pain levels assessed were significantly improved after 3 weeks of BWSTT and 6 weeks of FBWTT. There were no significant improvements in either group assessed by the FRT, one-leg standing time test, TUG, or SF -36 questionnaire. Conclusions: BWSTT enhanced exercise capacity in terms of walking speed and pain reduction after 3 weeks; however, there was no significant improvement in patients' functional abilities or quality of life. PMID:25792901

Cognitive processing speed is related to fall frequency in older adults with multiple sclerosis.

PubMed

Sosnoff, Jacob J; Balantrapu, Swathi; Pilutti, Lara A; Sandroff, Brian M; Morrison, Steven; Motl, Robert W

2013-08-01

To examine mobility, balance, fall risk, and cognition in older adults with multiple sclerosis (MS) as a function of fall frequency. Retrospective, cross-sectional design. University research laboratory. Community-dwelling persons with MS (N=27) aged between 50 and 75 years were divided into 2 groups-single-time (n=11) and recurrent (n=16; >2 falls/12 mo) fallers-on the basis of fall history. Not applicable. Mobility was assessed using a variety of measures including Multiple Sclerosis Walking Scale-12, walking speed (Timed 25-Foot Walk test), endurance (6-Minute Walk test), and functional mobility (Timed Up and Go test). Balance was assessed with the Berg Balance Scale, posturography, and self-reported balance confidence. Fall risk was assessed with the Physiological Profile Assessment. Cognitive processing speed was quantified with the Symbol Digit Modalities Test and the Paced Auditory Serial Addition Test. Recurrent fallers had slower cognitive processing speed than single-time fallers (P ≤.01). There was no difference in mobility, balance, or fall risk between recurrent and single-time fallers (P>.05). Results indicated that cognitive processing speed is associated with fall frequency and may have implications for fall prevention strategies targeting recurrent fallers with MS. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Effectiveness of two Arthritis Foundation programs: Walk With Ease, and YOU Can Break the Pain Cycle

PubMed Central

Bruno, Michelle; Cummins, Susan; Gaudiano, Lisha; Stoos, Johanna; Blanpied, Peter

2006-01-01

Objective: To evaluate the effectiveness of two Arthritis Foundation programs: Walk With Ease (WWE) and YOU Can Break The Pain Cycle (PC). Design: Quasi-experimental, repeated measures design. Retested at six weeks and four months. Setting: Community based intervention. Participants: Volunteer sample of 163 adults with arthritis recruited through mailings, newspapers, and flyers. Interventions: Subjects participated in a 90 minute seminar (PC, Group A), a six-week walking program (WWE, Group B), or both programs (Group C). Main outcome measures: Survey assessment of arthritis knowledge, general health, self-management activities, confidence, physical abilities, depression, health distress, and how arthritis affects their life. A Squat Test, a Six Minute Walk test, and a Timed Functional Walk Test were also administered. Results: Subjects in Group B were more confident, less depressed, had less health distress, and less pain than subjects in Group A. Scores of Group C were between Group A and B scores. Differences in groups over time indicated that the WWE resulted in increased confidence, physical abilities, time spent in self-management activities and decreased pain and fatigue. All groups increased in walking endurance at six weeks, and increased in health distress at four months. Conclusion: Subjects in different programs differed on impact of arthritis. These programs provide effective arthritis management opportunities. PMID:18046884

42 CFR 84.104 - Gas tightness test; minimum requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 1 1 Walks at 4.8 km. (3 miles) per hour 2 8 10 Pulls 20 kg. (45 pound) weight to 5 feet 30 times in... times respectively. Walks at 4.8 km. (3 miles) per hour 3 5 3 4 8 12 18 Sampling and readings 2 2 2 2 2 Walks at 4.8 km. (3 miles) per hour 3 5 8 12 18 Sampling and readings 2 2 2 2 2 Walks at 4.8 km. (3...

42 CFR 84.104 - Gas tightness test; minimum requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 1 1 Walks at 4.8 km. (3 miles) per hour 2 8 10 Pulls 20 kg. (45 pound) weight to 5 feet 30 times in... times respectively. Walks at 4.8 km. (3 miles) per hour 3 5 3 4 8 12 18 Sampling and readings 2 2 2 2 2 Walks at 4.8 km. (3 miles) per hour 3 5 8 12 18 Sampling and readings 2 2 2 2 2 Walks at 4.8 km. (3...

42 CFR 84.104 - Gas tightness test; minimum requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 1 1 Walks at 4.8 km. (3 miles) per hour 2 8 10 Pulls 20 kg. (45 pound) weight to 5 feet 30 times in... times respectively. Walks at 4.8 km. (3 miles) per hour 3 5 3 4 8 12 18 Sampling and readings 2 2 2 2 2 Walks at 4.8 km. (3 miles) per hour 3 5 8 12 18 Sampling and readings 2 2 2 2 2 Walks at 4.8 km. (3...

Long-term interventions effects of robotic training on patients after anterior cruciate ligament reconstruction.

PubMed

Hu, Chunying; Huang, Qiuchen; Yu, Lili; Zhou, Yue; Gu, Rui; Ye, Miao; Ge, Meng; Xu, Yanfeng; Liu, Jianfeng

2016-08-01

[Purpose] The aim of this study was to examine the long-term interventions effects of robot-assisted therapy rehabilitation on functional activity levels after anterior cruciate ligament reconstruction. [Subjects and Methods] The subjects were 8 patients (6 males and 2 females) who received anterior cruciate ligament reconstruction. The subjects participated in robot-assisted therapy lasting for one month. The Timed Up-and-Go test, 10-Meter Walk test, Functional Reach Test, surface electromyography of the vastus lateralis and vastus medialis, and extensor strength of isokinetic movement of the knee joint were evaluated before and after the intervention. [Results] The average value of the of vastus medialis EMG, Functional Reach Test, and the maximum and average extensor strength of the knee joint isokinetic movement increased significantly, and the time of the 10-Meter Walk test decreased significantly. [Conclusion] These results suggest that walking ability and muscle strength can be improved by robotic walking training as a long-term intervention.

Long-term interventions effects of robotic training on patients after anterior cruciate ligament reconstruction

PubMed Central

Hu, Chunying; Huang, Qiuchen; Yu, Lili; Zhou, Yue; Gu, Rui; Ye, Miao; Ge, Meng; Xu, Yanfeng; Liu, Jianfeng

2016-01-01

[Purpose] The aim of this study was to examine the long-term interventions effects of robot-assisted therapy rehabilitation on functional activity levels after anterior cruciate ligament reconstruction. [Subjects and Methods] The subjects were 8 patients (6 males and 2 females) who received anterior cruciate ligament reconstruction. The subjects participated in robot-assisted therapy lasting for one month. The Timed Up-and-Go test, 10-Meter Walk test, Functional Reach Test, surface electromyography of the vastus lateralis and vastus medialis, and extensor strength of isokinetic movement of the knee joint were evaluated before and after the intervention. [Results] The average value of the of vastus medialis EMG, Functional Reach Test, and the maximum and average extensor strength of the knee joint isokinetic movement increased significantly, and the time of the 10-Meter Walk test decreased significantly. [Conclusion] These results suggest that walking ability and muscle strength can be improved by robotic walking training as a long-term intervention. PMID:27630396

SIRRACT: An international randomized clinical trial of activity feedback during inpatient stroke rehabilitation enabled by wireless sensing

PubMed Central

Dorsch, Andrew K.; Thomas, Seth; Xu, Xiaoyu; Kaiser, William; Dobkin, Bruce H.

2014-01-01

Background Walking-related disability is the most frequent reason for inpatient stroke rehabilitation. Task-related practice is a critical component for improving patient outcomes. Objective To test the feasibility of providing quantitative feedback about daily walking performance and motivating greater skills practice via remote sensing. Methods In this phase III randomized, single blind clinical trial, patients participated in conventional therapies while wearing wireless sensors (tri-axial accelerometers) at both ankles. Activity-recognition algorithms calculated the speed, distance, and duration of walking bouts. Three times a week, therapists provided either feedback about performance on a 10-meter walk (speed-only) or walking speed feedback plus a review of walking activity recorded by the sensors (augmented). Primary outcomes at discharge included total daily walking time, derived from the sensors, and a timed 15-meter walk. Results Sixteen rehabilitation centers in 11 countries enrolled 135 participants over 15 months. Sensors recorded more than 1800 days of therapy, 37,000 individual walking bouts, and 2.5 million steps. No significant differences were found between the two feedback groups in daily walking time (15.1±13.1min vs. 16.6±14.3min, p=0.54) or 15-meter walking speed (0.93±0.47m/s vs. 0.91±0.53m/s, p=0.96). Remarkably, 30% of participants decreased their total daily walking time over their rehabilitation stay. Conclusions In this first trial of remote monitoring of inpatient stroke rehabilitation, augmented feedback beyond speed alone did not increase the time spent practicing or improve walking outcomes. Remarkably modest time was spent walking. Wireless sensing, however, allowed clinicians to audit skills practice and provided ground truth regarding changes in clinically important, mobility-related activities. PMID:25261154

[Trail walking test for assessment of motor cognitive interference in older adults. Development and evaluation of the psychometric properties of the procedure].

PubMed

Schott, Nadja

2015-12-01

Activities of daily living (ADL), such as walking, often involve the added complexity of walking while doing other activities (i.e. dual task walking). A complex walking task may require a greater motor and mental capacity, resulting in decrements in gait performance not seen for simple walking tasks. The purpose of this study was to determine if the trail walking test (TWT), the mobile adaptation of the trail making test (TMT), could be a reliable and valid early detection tool to discriminate between non-fallers and fallers. This study examined dual task costs of a cognitive and a sensorimotor task (walking) in 94 older adults aged 50-81 years (average age M = 67.4 years, SD ± 7.34). Based on the idea of the paper and pencil TMT, participants walked along a fixed pathway (TWT-1), stepped on targets with increasing sequential numbers (i.e. 1, 2, 3, TWT-2), and increasing sequential numbers and letters (i.e. 1, A, 2, B, 3, C, TWT-3). The dual task costs were calculated for each task. Additionally, the following tests were conducted: TMT, block tapping test (BTT), timed up and go (TUG) test, 30s chair rising test, 10 m walking time test with and without head turns, German physical activity questionnaire (German PAQ-50 +) and the activities-specific balance confidence (ABC-D) scale. The TWT performance times as well as errors increased with increasing age. Reliability coefficients were high (interclass correlation ICC > 0.90). Correlations between the different TWT conditions and potential falls-related predictors were moderate to high (r = -0.430 to 0.699). Of the participants 34 % reported falling in the past year. The stepwise logistic regression analysis revealed that the dual task costs for the numbers and letters (odds ratio OR 1.162, 95 % confidence interval CI 1.058-1.277, p = 0.002), the ABC-D (OR 0.767, 95 % CI 0.651-0.904, p = 0.002) and exercise (OR 1.027, 95 % CI 1.008-1.046, p = 0.006) were significantly related to falls and 91.6 % of cases were correctly classified. The results indicate that high-level cognitive processes interfere with automatic processes such as walking. The TWT which converts a relevant fall risk-associated standard neuropsychological test (TMT) with increasing cognitive load into a mobility task, was shown to be a feasible, reliable and valid tool for older adults to discriminate between non-fallers and fallers.

Can Change in Prolonged Walking Be Inferred From a Short Test of Gait Speed Among Older Adults Who Are Initially Well-Functioning?

PubMed Central

Neogi, Tuhina; King, Wendy C.; LaValley, Michael P.; Kritchevsky, Stephen B.; Nevitt, Michael C.; Harris, Tamara B.; Ferrucci, Luigi; Simonsick, Eleanor M.; Satterfield, Suzanne; Strotmeyer, Elsa S.; Zhang, Yuqing

2014-01-01

Background The ability to walk for short and prolonged periods of time is often measured with separate walking tests. It is unclear whether decline in the 2-minute walk coincides with decline in a shorter 20-m walk among older adults. Objective The aim of this study was to describe patterns of change in the 20-m walk and 2-minute walk over 8 years among a large cohort of older adults. Should change be similar between tests of walking ability, separate retesting of prolonged walking may need to be reconsidered. Design A longitudinal, observational cohort study was conducted. Methods Data were from 1,893 older adults who were well-functioning (≥70 years of age). The 20-m walk and 2-minute walk were repeatedly measured over 8 years to measure change during short and prolonged periods of walking, respectively. Change was examined using a dual group-based trajectory model (dual model), and agreement between walking trajectories was quantified with a weighted kappa statistic. Results Three trajectory groups for the 20-m walk and 2-minute walk were identified. More than 86% of the participants were in similar trajectory groups for both tests from the dual model. There was high chance-corrected agreement (kappa=.84; 95% confidence interval=.82, .86) between the 20-m walk and 2-minute walk trajectory groups. Limitations One-third of the original Health, Aging and Body Composition (Health ABC) study cohort was excluded from analysis due to missing clinic visits, followed by being excluded for health reasons for performing the 2-minute walk, limiting generalizability to healthy older adults. Conclusions Patterns of change in the 2-minute walk are similar to those in the 20-m walk. Thus, separate retesting of the 2-minute walk may need to be reconsidered to gauge change in prolonged walking. PMID:24786943

Assessing gait adaptability in people with a unilateral amputation on an instrumented treadmill with a projected visual context.

PubMed

Houdijk, Han; van Ooijen, Mariëlle W; Kraal, Jos J; Wiggerts, Henri O; Polomski, Wojtek; Janssen, Thomas W J; Roerdink, Melvyn

2012-11-01

Gait adaptability, including the ability to avoid obstacles and to take visually guided steps, is essential for safe movement through a cluttered world. This aspect of walking ability is important for regaining independent mobility but is difficult to assess in clinical practice. The objective of this study was to investigate the validity of an instrumented treadmill with obstacles and stepping targets projected on the belt's surface for assessing prosthetic gait adaptability. This was an observational study. A control group of people who were able bodied (n=12) and groups of people with transtibial (n=12) and transfemoral (n=12) amputations participated. Participants walked at a self-selected speed on an instrumented treadmill with projected visual obstacles and stepping targets. Gait adaptability was evaluated in terms of anticipatory and reactive obstacle avoidance performance (for obstacles presented 4 steps and 1 step ahead, respectively) and accuracy of stepping on regular and irregular patterns of stepping targets. In addition, several clinical tests were administered, including timed walking tests and reports of incidence of falls and fear of falling. Obstacle avoidance performance and stepping accuracy were significantly lower in the groups with amputations than in the control group. Anticipatory obstacle avoidance performance was moderately correlated with timed walking test scores. Reactive obstacle avoidance performance and stepping accuracy performance were not related to timed walking tests. Gait adaptability scores did not differ in groups stratified by incidence of falls or fear of falling. Because gait adaptability was affected by walking speed, differences in self-selected walking speed may have diminished differences in gait adaptability between groups. Gait adaptability can be validly assessed by use of an instrumented treadmill with a projected visual context. When walking speed is taken into account, this assessment provides unique, quantitative information about walking ability in people with a lower-limb amputation.

Effect of Surgical Curve Correction on Exercise Tolerance and Physical Capacities in Patients of Severe Spinal Deformity.

PubMed

Patil, Prateek C; Rathod, Ashok K; Borde, Mandar; Singh, Vishwajeet; Singh, Hemant U

2016-12-01

Traditionally, surgical intervention for patients with a spinal deformity has been considered for cosmetic benefits, but surgical intervention can alter the lung physiology or volumes and in turn leads to increase in physical capacity and exercise tolerance. Therefore, we conducted this to determine whether a surgical correction would restore the lung physiology, physical capacity and exercise tolerance in patients with kyphoscoliosis. To evaluate the usage of six-minute walk test scores and modified Borg scores as tools/measures for exercise tolerance in patients with spinal deformity and to study the effects of surgical correction of spinal deformity on exercise tolerance with above parameters as the measures. Thirty patients with spinal deformity, who had undergone surgery for deformity correction, were evaluated. All patients were investigated pre-operatively with x-rays of the spine (anteroposterior and lateral views). Clinical tests like breath holding time (after full inspiration) in number of seconds, modified Borg scores, six-minute walk test scores (heart rate, respiratory rate, maximum distance walked); were recorded as measures of exercise tolerance. The patients were followed up on the first, third, sixth and twelfth month post-operatively and tested clinically for breath holding time, modified Borg scores, six-minute walk test scores (heart rate, respiratory rate, maximum distance walked) and x-rays of the spine (anteroposterior and lateral views). In our study, breath holding time (p-value = 0.001) and modified Borg scores (p-value = 0.012) showed a significant improvement at 12 months post-operatively. We noted similar findings with heart rate, respiratory rate and maximum distance walked after a six-minute walk test. Improvements were noted in all the parameters, especially in the group of patients with greater than 60 degrees of cobb angle. However, the differences between the two groups (pre-operative cobb angle less than 60 degrees and pre-operative cobb angle more than 60 degrees) were not significant. The results were analysed and tested for significance using Student's t-test (paired and unpaired as appropriate) and Wilcoxon signed rank test. Surgical correction in cases of spinal deformity improves the cosmetic appearance and balance in the patients. Favourable results of surgical intervention were found in exercise tolerance with improvements in modified Borg scores, six-minute walk test results and breath holding time. The above parameters appear to be good tools for the assessment of physical capacity and exercise tolerance in patients with spinal deformity.

The effects of smartphone multitasking on gait and dynamic balance

PubMed Central

Lee, Jeon Hyeong; Lee, Myoung Hee

2018-01-01

[Purpose] This study was performed to analyze the influence of smartphone multitasking on gait and dynamic balance. [Subjects and Methods] The subjects were 19 male and 20 female university students. There were 4 types of gait tasks: General Gait (walking without a task), Task Gait 1 (walking while writing a message), Task Gait 2 (walking while writing a message and listening to music), Task Gait 3 (walking while writing a message and having a conversation). To exclude the learning effect, the order of tasks was randomized. The Zebris FDM-T treadmill system (Zebris Medical GmbH, Germany) was used to measure left and right step length and width, and a 10 m walking test (10MWT) was conducted for gait velocity. In addition, a Timed Up and Go test (TUG) was used to measure dynamic balance. All the tasks were performed 3 times, and the mean of the measured values was analyzed. [Results] There were no statistically significant differences in step length and width. There were statistically significant differences in the 10MWT and TUG tests. [Conclusion] Using a smartphone while walking decreases a person’s dynamic balance and walking ability. It is considered that accident rates are higher when using a smartphone. PMID:29545698

Novel algorithm for a smartphone-based 6-minute walk test application: algorithm, application development, and evaluation.

PubMed

Capela, Nicole A; Lemaire, Edward D; Baddour, Natalie

2015-02-20

The 6-minute walk test (6MWT: the maximum distance walked in 6 minutes) is used by rehabilitation professionals as a measure of exercise capacity. Today's smartphones contain hardware that can be used for wearable sensor applications and mobile data analysis. A smartphone application can run the 6MWT and provide typically unavailable biomechanical information about how the person moves during the test. A new algorithm for a calibration-free 6MWT smartphone application was developed that uses the test's inherent conditions and smartphone accelerometer-gyroscope data to report the total distance walked, step timing, gait symmetry, and walking changes over time. This information is not available with a standard 6MWT and could help with clinical decision-making. The 6MWT application was evaluated with 15 able-bodied participants. A BlackBerry Z10 smartphone was worn on a belt at the mid lower back. Audio from the phone instructed the person to start and stop walking. Digital video was independently recorded during the trial as a gold-standard comparator. The average difference between smartphone and gold standard foot strike timing was 0.014 ± 0.015 s. The total distance calculated by the application was within 1 m of the measured distance for all but one participant, which was more accurate than other smartphone-based studies. These results demonstrated that clinically relevant 6MWT results can be achieved with typical smartphone hardware and a novel algorithm.

The 6-minute walk test, motor function measure and quantitative thigh muscle MRI in Becker muscular dystrophy: A cross-sectional study.

PubMed

Fischer, Dirk; Hafner, Patricia; Rubino, Daniela; Schmid, Maurice; Neuhaus, Cornelia; Jung, Hans; Bieri, Oliver; Haas, Tanja; Gloor, Monika; Fischmann, Arne; Bonati, Ulrike

2016-07-01

Becker muscular dystrophy (BMD) has an incidence of 1 in 16 000 male births. This cross-sectional study investigated the relation between validated functional scores and quantitative MRI (qMRI) of thigh muscles in 20 ambulatory BMD patients, aged 18.3-60 years (mean 31.2; SD 11.1). Clinical assessments included the motor function measure (MFM) and its subscales, as well as timed function tests such as the 6-minute walk test (6MWT) and the timed 10-m run/walk test. Quantitative MRI of the thigh muscles included the mean fat fraction (MFF) using a 2-point Dixon (2-PD) technique, and transverse relaxation time (T2) measurements. The mean MFM value was 80.4%, SD 9.44 and the D1 subscore 54.5%, SD 19.9. The median 6MWT was 195m, IQR 160-330.2. The median 10-m run/walk test was 7.4 seconds, IQR 6.1-9.3. The mean fat fraction of the thigh muscles was 55.6%, SD 17.4%, mean T2 relaxation times of all muscles: 69.9 ms, SD 14.4. The flexors had the highest MFF and T2 relaxation times, followed by the extensors and the adductors. MFF and global T2 relaxation times were highly negatively correlated with the MFM total, D1-subscore and 6MWT, and positively correlated with the 10 m run/walk test time (p < 0.01). Age was not correlated with MFF, global T2 relaxation time or clinical assessments. Both MFF and T2 measures in the thigh muscle were well correlated with clinical function in BMD and may serve as a surrogate outcome measure in clinical trials. Copyright © 2016 Elsevier B.V. All rights reserved.

Impact of Pilates Exercise in Multiple Sclerosis

PubMed Central

Duff, Whitney R.D.; Andrushko, Justin W.; Renshaw, Doug W.; Chilibeck, Philip D.; Farthing, Jonathan P.; Danielson, Jana

2018-01-01

Abstract Background: Pilates is a series of exercises based on whole-body movement and may improve mobility in people with multiple sclerosis (MS). The purpose of this study was to determine the effect of Pilates on walking performance in people with MS. Methods: 30 individuals with MS who were not restricted to a wheelchair or scooter (Patient-Determined Disease Steps scale score <7) were randomized to receive Pilates (twice weekly) and massage therapy (once weekly) or once-weekly massage therapy only (control group). The Pilates was delivered in a group setting (five to ten participants per session). The primary outcome was change in walking performance (6-Minute Walk Test) after 12 weeks. Secondary outcomes included functional ability (Timed Up and Go test), balance (Fullerton Advanced Balance Scale), flexibility (sit and reach test), body composition (dual-energy X-ray absorptiometry), core endurance (plank-hold test), and muscle strength and voluntary activation (quadriceps). Intention-to-treat analysis was performed using a two-factor repeated-measures analysis of variance. Results: Walking distance increased by a mean (SD) of 52.4 (40.2) m in the Pilates group versus 15.0 (34.1) m in the control group (group × time, P = .01). Mean (SD) time to complete the Timed Up and Go test decreased by 1.5 (2.8) seconds in the Pilates group versus an increase of 0.3 (0.9) seconds in the control group (group × time, P = .03). There were no other significant differences between groups over time. Conclusions: Pilates improved walking performance and functional ability in persons with MS and is a viable exercise option to help manage the disease. PMID:29670495

Effect of coordination movement using the PNF pattern underwater on the balance and gait of stroke patients

PubMed Central

Kim, Kyoung; Lee, Dong-Kyu; Jung, Sang-In

2015-01-01

[Purpose] To investigate the effect of coordination movement using the Proprioceptive Neuromuscular Facilitation pattern underwater on the balance and gait of stroke patients. [Subjects and Methods] Twenty stroke patients were randomly assigned to an experimental group that performed coordination movement using the Proprioceptive Neuromuscular Facilitation pattern underwater and a control group (n =10 each). Both the groups underwent neurodevelopmental treatment, and the experimental group performed coordination movement using the Proprioceptive neuromuscular facilitation pattern underwater. Balance was measured using the Berg Balance Scale and Functional Reach Test, and gait was measured using the 10-Meter Walk Test and Timed Up and Go Test. To compare in-group data before and after the intervention, paired t-test was used. Independent t-test was used to compare differences in the results of the Berg Balance Scale, Functional Reach Test, 10-Meter Walk Test, and Timed Up and Go Test before and after the intervention between the groups. [Results] Comparison within the groups showed significant differences in the results of the Berg Balance Scale, Functional Reach Test, 10-Meter Walk Test, and Timed Up and Go Test before and after the experimental intervention. On comparison between the groups, there were greater improvements in the scores of the Berg Balance Scale, Functional Reach Test, 10-Meter Walk Test, and Timed Up and Go Test in the experimental group. [Conclusion] The findings demonstrate that coordination movement using the Proprioceptive Neuromuscular Facilitation pattern under water has a significant effect on the balance and gait of stroke patients. PMID:26834335

Reliability of the Timed Up and Go test and Ten-Metre Timed Walk Test in Pregnant Women with Pelvic Girdle Pain.

PubMed

Evensen, Natalie M; Kvåle, Alice; Braekken, Ingeborg H

2015-09-01

There is a lack of functional objective tests available to measure functional status in women with pelvic girdle pain (PGP). The purpose of this study was to establish test-retest and intertester reliability of the Timed Up and Go (TUG) test and Ten-metre Timed Walk Test (10mTWT) in pregnant women with PGP. A convenience sample of women was recruited over a 4-month period and tested on two occasions, 1 week apart to determine test-retest reliability. Intertester reliability was established between two assessors at the first testing session. Subjects were instructed to undertake the TUG and 10mTWT at maximum speed. One practise trial and two timed trials for each walking test was undertaken on Day 1 and one practise trial and one timed trial on Day 2. Seventeen women with PGP aged 31.1 years (SD [standard deviation] = 2.3) and 28.7 weeks pregnant (SD = 7.4) completed gait testing. Test-retest reliability using the intraclass correlation coefficient (ICC) was excellent for the TUG (0.88) and good for the 10mTWT (0.74). Intertester reliability was determined in the first 13 participants with excellent ICC values being found for both walking tests (TUG: 0.95; 10mTWT: 0.94). This study demonstrated that the TUG and 10mTWT undertaken at fast pace are reliable, objective functional tests in pregnant women with PGP. While both tests are suitable for use in the clinical and research settings, we would recommend the TUG given the findings of higher test-retest reliability and as this test requires less space and time to set up and score. Future studies in a larger sample size are warranted to confirm the results of this study. Copyright © 2015 John Wiley & Sons, Ltd.

Relationship between physical function and biomechanical gait patterns in boys with haemophilia.

PubMed

Stephensen, D; Taylor, S; Bladen, M; Drechsler, W I

2016-11-01

The World Federation of Haemophilia recommends joint and muscle health is evaluated using X-ray and magnetic resonance imaging, together with clinical examination scores. To date, inclusion of performance-based functional activities to monitor children with the condition has received little attention. To evaluate test-retest repeatability of physical function tests and quantify relationships between physical function, lower limb muscle strength and gait patterns in young boys with haemophilia. Timed 6-minute walk, timed up and down stairs, timed single leg stance, muscle strength of the knee extensors, ankle dorsi and plantar flexors, together with joint biomechanics during level walking were collected from 21 boys aged 6-12 years with severe haemophilia. Measures of physical function and recording of muscle strength with a hand-held myometer were repeatable (ICC > 0.78). Distances walked in six minutes, time taken to go up and down a flight of stairs and lower limb muscle strength correlated closely with ankle range of motion, together with peak knee flexion and ankle dorsi and plantarflexion moments during walking (P < 0.05). Alterations in gait patterns of boys with haemophilia appear to be associated with changes in performance of physical function and performance seems to depend on their muscle strength. Timed 6-minute walk test, timed up and down steps test and muscle strength of the knee extensors showed the strongest correlation with biomechanical joint function, and hence might serve as a basis for the clinical monitoring of physical function outcomes in children with haemophilia. © 2016 John Wiley & Sons Ltd.

Real-time feedback enhances forward propulsion during walking in old adults.

PubMed

Franz, Jason R; Maletis, Michela; Kram, Rodger

2014-01-01

Reduced propulsive function during the push-off phase of walking plays a central role in the deterioration of walking ability with age. We used real-time propulsive feedback to test the hypothesis that old adults have an underutilized propulsive reserve available during walking. 8 old adults (mean [SD], age: 72.1 [3.9] years) and 11 young adults (age: 21.0 [1.5] years) participated. For our primary aim, old subjects walked: 1) normally, 2) with visual feedback of their peak propulsive ground reaction forces, and 3) with visual feedback of their medial gastrocnemius electromyographic activity during push-off. We asked those subjects to match a target set to 20% and 40% greater propulsive force or push-off muscle activity than normal walking. We tested young subjects walking normally only to provide reference ground reaction force values. Walking normally, old adults exerted 12.5% smaller peak propulsive forces than young adults (P<0.01). However, old adults significantly increased their propulsive forces and push-off muscle activities when we provided propulsive feedback. Most notably, force feedback elicited propulsive forces that were equal to or 10.5% greater than those of young adults (+20% target, P=0.87; +40% target, P=0.02). With electromyographic feedback, old adults significantly increased their push-off muscle activities but without increasing their propulsive forces. Old adults with propulsive deficits have a considerable and underutilized propulsive reserve available during level walking. Further, real-time propulsive feedback represents a promising therapeutic strategy to improve the forward propulsion of old adults and thus maintain their walking ability and independence. © 2013.

Race walking gait and its influence on race walking economy in world-class race walkers.

PubMed

Gomez-Ezeiza, Josu; Torres-Unda, Jon; Tam, Nicholas; Irazusta, Jon; Granados, Cristina; Santos-Concejero, Jordan

2018-03-06

The aim of this study was to determine the relationships between biomechanical parameters of the gait cycle and race walking economy in world-class Olympic race walkers. Twenty-One world-class race walkers possessing the Olympic qualifying standard participated in this study. Participants completed an incremental race walking test starting at 10 km·h -1 , where race walking economy (ml·kg -1 ·km -1 ) and spatiotemporal gait variables were analysed at different speeds. 20-km race walking performance was related to race walking economy, being the fastest race walkers those displaying reduced oxygen cost at a given speed (R = 0.760, p < 0.001). Longer ground contact times, shorter flight times, longer midstance sub-phase and shorter propulsive sub-phase during stance were related to a better race walking economy (moderate effect, p < 0.05). According to the results of this study, the fastest race walkers were more economi cal than the lesser performers. Similarly, shorter flight times are associated with a more efficient race walking economy. Coaches and race walkers should avoid modifying their race walking style by increasing flight times, as it may not only impair economy, but also lead to disqualification.

Record statistics of a strongly correlated time series: random walks and Lévy flights

NASA Astrophysics Data System (ADS)

Godrèche, Claude; Majumdar, Satya N.; Schehr, Grégory

2017-08-01

We review recent advances on the record statistics of strongly correlated time series, whose entries denote the positions of a random walk or a Lévy flight on a line. After a brief survey of the theory of records for independent and identically distributed random variables, we focus on random walks. During the last few years, it was indeed realized that random walks are a very useful ‘laboratory’ to test the effects of correlations on the record statistics. We start with the simple one-dimensional random walk with symmetric jumps (both continuous and discrete) and discuss in detail the statistics of the number of records, as well as of the ages of the records, i.e. the lapses of time between two successive record breaking events. Then we review the results that were obtained for a wide variety of random walk models, including random walks with a linear drift, continuous time random walks, constrained random walks (like the random walk bridge) and the case of multiple independent random walkers. Finally, we discuss further observables related to records, like the record increments, as well as some questions raised by physical applications of record statistics, like the effects of measurement error and noise.

Voluntary driven exoskeleton as a new tool for rehabilitation in chronic spinal cord injury: a pilot study.

PubMed

Aach, Mirko; Cruciger, Oliver; Sczesny-Kaiser, Matthias; Höffken, Oliver; Meindl, Renate Ch; Tegenthoff, Martin; Schwenkreis, Peter; Sankai, Yoshiyuki; Schildhauer, Thomas A

2014-12-01

Treadmill training after traumatic spinal cord injury (SCI) has become an established therapy to improve walking capabilities. The hybrid assistive limb (HAL) exoskeleton has been developed to support motor function and is tailored to the patients' voluntary drive. To determine whether locomotor training with the exoskeleton HAL is safe and can increase functional mobility in chronic paraplegic patients after SCI. A single case experimental A-B (pre-post) design study by repeated assessments of the same patients. The subjects performed 90 days (five times per week) of HAL exoskeleton body weight supported treadmill training with variable gait speed and body weight support. Eight patients with chronic SCI classified by the American Spinal Injury Association (ASIA) Impairment Scale (AIS) consisting of ASIA A (zones of partial preservation [ZPP] L3-S1), n=4; ASIA B (with motor ZPP L3-S1), n=1; and ASIA C/D, n=3, who received full rehabilitation in the acute and subacute phases of SCI. Functional measures included treadmill-associated walking distance, speed, and time, with additional analysis of functional improvements using the 10-m walk test (10MWT), timed-up and go test (TUG test), 6-minute walk test (6MWT), and the walking index for SCI II (WISCI II) score. Secondary physiologic measures including the AIS with the lower extremity motor score (LEMS), the spinal spasticity (Ashworth scale), and the lower extremity circumferences. Subjects performed standardized functional testing before and after the 90 days of intervention. Highly significant improvements of HAL-associated walking time, distance, and speed were noticed. Furthermore, significant improvements have been especially shown in the functional abilities without the exoskeleton for over-ground walking obtained in the 6MWT, TUG test, and the 10MWT, including an increase in the WISCI II score of three patients. Muscle strength (LEMS) increased in all patients accompanied by a gain of the lower limb circumferences. A conversion in the AIS was ascertained in one patient (ASIA B to ASIA C). One patient reported a decrease of spinal spasticity. Hybrid assistive limb exoskeleton training results in improved over-ground walking and leads to the assumption of a beneficial effect on ambulatory mobility. However, evaluation in larger clinical trials is required. Copyright © 2014 Elsevier Inc. All rights reserved.

[Effect of "Xingnao Kaiqiao Zhenfa" (Acupuncture Technique for Restoring Consciousness) Combined with Rehabilitation Training on Nerve Repair and Expression of Growth-associated Protein-43 of Peri-ischemic Cortex in Ischemic Stroke Rats].

PubMed

Xu, Lei; Yan, Xing-Zhou; Li, Zhen-Yu; Cao, Xiao-Fang; Wang, Min

2017-06-25

To observe the effect of "Xingnao Kaiqiao Zhenfa" (acupuncture technique for restoring consciousness) combined with enriched rehabilitation training on motor function and expression of growth-associated protein-43 (GAP-43) of peri-ischemic cortex in ischemic stroke rats, so as to investigate its mechanism underlying improvement of ischemic stroke. SD rats were randomly divided into sham operation, model, rehabilitation and comprehensive rehabilitation groups, which were further divided into 3 time-points:7, 14 and 21 d ( n =6 in each). Cerebral ischemia(CI) model was established by occlusion of the middle cerebral artery with heat-coagulation. The rehabilitation group was treated by enriched rehabilitation training, once a day. The comprehensive rehabilitation group was treated by acupuncture combined with enriched rehabilitation training. Acupuncture was applied to bilateral "Neiguan"(PC 6) and "Shuigou"(GV 26) for 30 min, once a day. The neurological function score, balance-beam walking test and rotating-rod walking test were evaluated at the end of the corresponding treatment time. The expression of GAP-43 in peri-ischemic cortex was detected by immunohistochemistry. In comparison with the sham operation group, the scores of neurological function, beam walking test and rotating-rod walking test were significantly higher in the model group ( P <0.01). There were no significant changes in the scores of balance-beam walking and rotating-rod walking tests in the rehabilitation group compared with the model group on day 7 ( P >0.05). Compared with the model group at the other time points, the scores of neurological function, balance-beam walking test and rotating-rod walking test were significantly lower in the rehabilitation and comprehensive rehabilitation groups ( P <0.05). Compared with the rehabilitation group, the scores of neurological function, balance-beam walking test and rotating-rod walking test were significantly lower in the comprehensive rehabilitation group ( P <0.05). In comparison with the sham operation group, the number of GAP-43 positive cells of peri-ischemic cortex was significantly higher in the model group ( P <0.01). Compared with the model group, the numbers of GAP-43 positive cells of peri-ischemic cortex were significantly increased in the rehabilitation and comprehensive rehabilitation groups ( P <0.01). The number of GAP-43 positive cells of peri-ischemic cortex in the comprehensive rehabilitation group was significantly higher than that in the rehabilitation group ( P <0.01). "Xingnao Kaiqiao Zhenfa" combined with enriched rehabilitation training can promote the recovery of nerve function in ischemic stroke rats, which may be associated with its effect in up-regulating the expression of GAP-43 in the peri-ischemic cortex.

Could the two-minute step test be an alternative to the six-minute walk test for patients with systolic heart failure?

PubMed

Węgrzynowska-Teodorczyk, Kinga; Mozdzanowska, Dagmara; Josiak, Krystian; Siennicka, Agnieszka; Nowakowska, Katarzyna; Banasiak, Waldemar; Jankowska, Ewa A; Ponikowski, Piotr; Woźniewski, Marek

2016-08-01

The consequence of exercise intolerance for patients with heart failure is the difficulty climbing stairs. The two-minute step test is a test that reflects the activity of climbing stairs. The aim of the study design is to evaluate the applicability of the two-minute step test in an assessment of exercise tolerance in patients with heart failure and the association between the six-minute walk test and the two-minute step test. Participants in this study were 168 men with systolic heart failure (New York Heart Association (NYHA) class I-IV). In the study we used the two-minute step test, the six-minute walk test, the cardiopulmonary exercise test and isometric dynamometer armchair. Patients who performed more steps during the two-minute step test covered a longer distance during the six-minute walk test (r = 0.45). The quadriceps strength was correlated with the two-minute step test and the six-minute walk test (r = 0.61 and r = 0.48). The greater number of steps performed during the two-minute step test was associated with higher values of peak oxygen consumption (r = 0.33), ventilatory response to exercise slope (r = -0.17) and longer time of exercise during the cardiopulmonary exercise test (r = 0.34). Fatigue and leg fatigue were greater after the two-minute step test than the six-minute walk test whereas dyspnoea and blood pressure responses were similar. The two-minute step test is well tolerated by patients with heart failure and may thus be considered as an alternative for the six-minute walk test. © The European Society of Cardiology 2016.

Metronome rate and walking foot contact time in young adults.

PubMed

Dickstein, Ruth; Plax, Michael

2012-02-01

It is assumed that when people walk guided by an audible constant rate, they match foot contact to the external pace. The purpose of this preliminary study was to test that assumption by examining the temporal relationship between audible signals generated by a metronome and foot contact time during gait. Ten healthy young women were tested in walking repetitions guided by metronome rates of 60, 110, and 150 beats/min. Metronome beats and foot contact times were collected in real time. The findings indicated that foot contact was not fully synchronized with the auditory signals; the shortest time interval between the metronome beat and foot contact time was at the prescribed rate of 60 beats/min., while the longest interval was at the rate of 150 beats/min. The correlation between left and right foot contact times was highest with the slowest rate and lowest with the fastest rate.

Short-burst interval treadmill training walking capacity and performance in cerebral palsy: a pilot study.

PubMed

Bjornson, Kristie F; Moreau, Noelle; Bodkin, Amy Winter

2018-04-16

To examine the effect of short-burst interval locomotor treadmill training (SBLTT) on walking capacity and performance in cerebral palsy (CP). Twelve children with spastic diplegic CP (average 8.6 years) across Gross Motor Function Classification System levels II (8) and III (4) were randomized to 20 SBLTT sessions over 4 or 10 weeks. SBLTT consisted of alternating 30 seconds of slow and fast walking for 30 minutes/session. Outcomes included the 10 m walk test, one-minute walk test (1MWT), and timed-up-and go (TUG) (capacity) and StepWatch (performance) collected at baseline, post, and 6 weeks post. Fast speed (+.11, p = .04; +.11 m/s, p = .006), 1MWT (+11.2; +11.7 m, p = .006) and TUG (-1.7; -1.9 seconds, p = .006) improved post SBLTT and 6 weeks, respectively. Walking performance increased: average strides/day (+948; +1712, p < .001) and percent time in high strides rates (+0.4, p = 0.07; +0.2, p = .008). Pilot study suggests SBLTT may improve short-term walking capacity and performance.

Effects of 12-week supervised treadmill training on spatio-temporal gait parameters in patients with claudication.

PubMed

Konik, Anita; Kuklewicz, Stanisław; Rosłoniec, Ewelina; Zając, Marcin; Spannbauer, Anna; Nowobilski, Roman; Mika, Piotr

2016-01-01

The purpose of the study was to evaluate selected temporal and spatial gait parameters in patients with intermittent claudication after completion of 12-week supervised treadmill walking training. The study included 36 patients (26 males and 10 females) aged: mean 64 (SD 7.7) with intermittent claudication. All patients were tested on treadmill (Gait Trainer, Biodex). Before the programme and after its completion, the following gait biomechanical parameters were tested: step length (cm), step cycle (cycle/s), leg support time (%), coefficient of step variation (%) as well as pain-free walking time (PFWT) and maximal walking time (MWT) were measured. Training was conducted in accordance with the current TASC II guidelines. After 12 weeks of training, patients showed significant change in gait biomechanics consisting in decreased frequency of step cycle (p < 0.05) and extended step length (p < 0.05). PFWT increased by 96% (p < 0.05). MWT increased by 100% (p < 0.05). After completing the training, patients' gait was more regular, which was expressed via statistically significant decrease of coefficient of variation (p < 0.05) for both legs. No statistically significant relation between the post-training improvement of PFWT and MWT and step length increase and decreased frequency of step cycle was observed (p > 0.05). Twelve-week treadmill walking training programme may lead to significant improvement of temporal and spatial gait parameters in patients with intermittent claudication. Twelve-week treadmill walking training programme may lead to significant improvement of pain-free walking time and maximum walking time in patients with intermittent claudication.

Relationship between asymmetry of quiet standing balance control and walking post-stroke.

PubMed

Hendrickson, Janna; Patterson, Kara K; Inness, Elizabeth L; McIlroy, William E; Mansfield, Avril

2014-01-01

Spatial and temporal gait asymmetry is common after stroke. Such asymmetric gait is inefficient, can contribute to instability and may lead to musculoskeletal injury. However, understanding of the determinants of such gait asymmetry remains incomplete. The current study is focused on revealing if there is a link between asymmetry during the control of standing balance and asymmetry during walking. This study involved review of data from 94 individuals with stroke referred to a gait and balance clinic. Participants completed three tests: (1) walking at their usual pace; (2) quiet standing; and (3) standing with maximal loading of the paretic side. A pressure sensitive mat recorded placement and timing of each footfall during walking. Standing tests were completed on two force plates to evaluate symmetry of weight bearing and contribution of each limb to balance control. Multiple regression was conducted to determine the relationships between symmetry during standing and swing time, stance time, and step length symmetry during walking. Symmetry of antero-posterior balance control and weight bearing were related to swing time and step length symmetry during walking. Weight-bearing symmetry, weight-bearing capacity, and symmetry of antero-posterior balance control were related to stance time symmetry. These associations were independent of underlying lower limb impairment. The results support the hypothesis that impaired ability of the paretic limb to control balance may contribute to gait asymmetry post-stroke. Such work suggests that rehabilitation strategies that increase the contribution of the paretic limb to standing balance control may increase symmetry of walking post-stroke. Copyright © 2013 Elsevier B.V. All rights reserved.

The effectiveness of body weight-supported gait training and floor walking in patients with chronic stroke.

PubMed

Peurala, Sinikka H; Tarkka, Ina M; Pitkänen, Kauko; Sivenius, Juhani

2005-08-01

To compare body weight-supported exercise on a gait trainer with walking exercise overground. Randomized controlled trial. Rehabilitation hospital. Forty-five ambulatory patients with chronic stroke. Patients were randomized to 3 groups: (1) gait trainer exercise with functional electric stimulation (GTstim), (2) gait trainer exercise without stimulation (GT), and (3) walking overground (WALK). All patients practiced gait for 15 sessions during 3 weeks (each session, 20 min), and they received additional physiotherapy 55 minutes daily. Ten-meter walk test (10MWT), six-minute walk test (6MWT), lower-limb spasticity and muscle force, postural sway tests, Modified Motor Assessment Scale (MMAS), and FIM instrument scores were recorded before, during, and after the rehabilitation and at 6 months follow-up. The mean walking distance using the gait trainer was 6900+/-1200 m in the GTstim group and 6500+/-1700 m in GT group. In the WALK group, the distance was 4800+/-2800 m, which was less than the walking distance obtained in the GTstim group (P=.027). The body-weight support was individually reduced from 30% to 9% of the body weight over the course of the program. In the pooled 45 patients, the 10MWT (P<.001), 6MWT (P<.001), MMAS (P<.001), dynamic balance test time (P<.001), and test trip (P=.005) scores improved; however, no differences were found between the groups. Both the body weight-supported training and walking exercise training programs resulted in faster gait after the intensive rehabilitation program. Patients' motor performance remained improved at the follow-up.

Why the null matters: statistical tests, random walks and evolution.

PubMed

Sheets, H D; Mitchell, C E

2001-01-01

A number of statistical tests have been developed to determine what type of dynamics underlie observed changes in morphology in evolutionary time series, based on the pattern of change within the time series. The theory of the 'scaled maximum', the 'log-rate-interval' (LRI) method, and the Hurst exponent all operate on the same principle of comparing the maximum change, or rate of change, in the observed dataset to the maximum change expected of a random walk. Less change in a dataset than expected of a random walk has been interpreted as indicating stabilizing selection, while more change implies directional selection. The 'runs test' in contrast, operates on the sequencing of steps, rather than on excursion. Applications of these tests to computer generated, simulated time series of known dynamical form and various levels of additive noise indicate that there is a fundamental asymmetry in the rate of type II errors of the tests based on excursion: they are all highly sensitive to noise in models of directional selection that result in a linear trend within a time series, but are largely noise immune in the case of a simple model of stabilizing selection. Additionally, the LRI method has a lower sensitivity than originally claimed, due to the large range of LRI rates produced by random walks. Examination of the published results of these tests show that they have seldom produced a conclusion that an observed evolutionary time series was due to directional selection, a result which needs closer examination in light of the asymmetric response of these tests.

Modulation of walking speed by changing optic flow in persons with stroke

PubMed Central

Lamontagne, Anouk; Fung, Joyce; McFadyen, Bradford J; Faubert, Jocelyn

2007-01-01

Background Walking speed, which is often reduced after stroke, can be influenced by the perception of optic flow (OF) speed. The present study aims to: 1) compare the modulation of walking speed in response to OF speed changes between persons with stroke and healthy controls and 2) investigate whether virtual environments (VE) manipulating OF speed can be used to promote volitional changes in walking speed post stroke. Methods Twelve persons with stroke and 12 healthy individuals walked on a self-paced treadmill while viewing a virtual corridor in a helmet-mounted display. Two experiments were carried out on the same day. In experiment 1, the speed of an expanding OF was varied sinusoidally at 0.017 Hz (sine duration = 60 s), from 0 to 2 times the subject's comfortable walking speed, for a total duration of 5 minutes. In experiment 2, subjects were exposed to expanding OFs at discrete speeds that ranged from 0.25 to 2 times their comfortable speed. Each test trial was paired with a control trial performed at comfortable speed with matching OF. For each of the test trials, subjects were instructed to walk the distance within the same time as during the immediately preceding control trial. VEs were controlled by the CAREN-2 system (Motek). Instantaneous changes in gait speed (experiment 1) and the ratio of speed changes in the test trial over the control trial (experiment 2) were contrasted between the two groups of subjects. Results When OF speed was changing continuously (experiment 1), an out-of-phase modulation was observed in the gait speed of healthy subjects, such that slower OFs induced faster walking speeds, and vice versa. Persons with stroke displayed weaker (p < 0.05, T-test) correlation coefficients between gait speed and OF speed, due to less pronounced changes and an altered phasing of gait speed modulation. When OF speed was manipulated discretely (experiment 2), a negative linear relationship was generally observed between the test-control ratio of gait speed and OF speed in healthy and stroke individuals. The slope of this relationship was similar between the stroke and healthy groups (p > 0.05, T-test). Conclusion Stroke affects the modulation of gait speed in response to changes in the perception of movement through different OF speeds. Nevertheless, the preservation of even a modest modulation enabled the persons with stroke to increase walking speed when presented with slower OFs. Manipulation of OF speed using virtual reality technology could be implemented in a gait rehabilitation intervention to promote faster walking speeds after stroke. PMID:17594501

The six-minute walk test is an excellent predictor of functional ambulation after total knee arthroplasty

PubMed Central

2013-01-01

Background The Six-minute walk (6MW) and Timed-Up-and-Go (TUG) are short walk tests commonly used to evaluate functional recovery after total knee arthroplasty (TKA). However, little is known about walking capacity of TKA recipients over extended periods typical of everyday living and whether these short walk tests actually predict longer, more functional distances. Further, short walk tests only correlate moderately with patient-reported outcomes. The overarching aims of this study were to compare the performance of TKA recipients in an extended walk test to healthy age-matched controls and to determine the utility of this extended walk test as a research tool to evaluate longer term functional mobility in TKA recipients. Methods The mobility of 32 TKA recipients one year post-surgery and 43 healthy age-matched controls were assessed using the TUG, 6MW and 30-minute walk (30MW) tests. The latter test was repeated one week later. Self-reported function was measured using the WOMAC Index and a physical activity questionnaire. Results 30MW distance was significantly shorter amongst TKA recipients (mean 2108 m [95% CI 1837 to 2381 m]; Controls 3086 m [2981 to 3191 m], P < 0.001). Test-retest repeatability was high (ICC = 0.97, TKA; 0.96, Controls). Amongst TKA recipients, the 30MW distance correlated strongly with the shorter tests (6MW, r = 0.97, P < 0.001; TUG, r = −0.82, P < 0.001). Multiple regression modeling found 6MW distance to be the only significant predictor (P < 0.001) of 30MW distance, explaining 96% of the variability. The TUG test models were moderate predictors of WOMAC function (55%) and physical activity (36%) and were stronger predictors than 6MW and 30 MW tests. Conclusions Though TKA recipients are able to walk for 30 minutes one year post-surgery, their performance falls significantly short of age-matched norms. The 30MW test is strongly predicted by 6MW test performance, thus providing strong construct validity for the use of the 6MW test in the TKA population. Neither a short nor long walk test is a strong predictor of patient-reported function after TKA. PMID:23617377

Motor fatigue measurement by distance-induced slow down of walking speed in multiple sclerosis.

PubMed

Phan-Ba, Rémy; Calay, Philippe; Grodent, Patrick; Delrue, Gael; Lommers, Emilie; Delvaux, Valérie; Moonen, Gustave; Belachew, Shibeshih

2012-01-01

Motor fatigue and ambulation impairment are prominent clinical features of people with multiple sclerosis (pMS). We hypothesized that a multimodal and comparative assessment of walking speed on short and long distance would allow a better delineation and quantification of gait fatigability in pMS. Our objectives were to compare 4 walking paradigms: the timed 25-foot walk (T25FW), a corrected version of the T25FW with dynamic start (T25FW(+)), the timed 100-meter walk (T100MW) and the timed 500-meter walk (T500MW). Thirty controls and 81 pMS performed the 4 walking tests in a single study visit. The 4 walking tests were performed with a slower WS in pMS compared to controls even in subgroups with minimal disability. The finishing speed of the last 100-meter of the T500MW was the slowest measurable WS whereas the T25FW(+) provided the fastest measurable WS. The ratio between such slowest and fastest WS (Deceleration Index, DI) was significantly lower only in pMS with EDSS 4.0-6.0, a pyramidal or cerebellar functional system score reaching 3 or a maximum reported walking distance ≤ 4000 m. The motor fatigue which triggers gait deceleration over a sustained effort in pMS can be measured by the WS ratio between performances on a very short distance and the finishing pace on a longer more demanding task. The absolute walking speed is abnormal early in MS whatever the distance of effort when patients are unaware of ambulation impairment. In contrast, the DI-measured ambulation fatigability appears to take place later in the disease course.

Comparison of forward versus backward walking using body weight supported treadmill training in an individual with a spinal cord injury: a single subject design.

PubMed

Moriello, Gabriele; Pathare, Neeti; Cirone, Cono; Pastore, Danielle; Shears, Dacia; Sulehri, Sahira

2014-01-01

Body weight supported treadmill training (BWSTT) is a task-specific intervention that promotes functional locomotion. There is no research evaluating the effect of backward walking (BW) using BWSTT in individuals with spinal cord injury (SCI). The purpose of this single subject design was to examine the differences between forward walking (FW) and BW training using BWSTT in an individual with quadriparesis. The participant was a 57-year-old male with incomplete C3-C6 SCI. An ABABAB design (A = BW; B = FW; each phase = 3 weeks of biweekly sessions) was utilized. Outcome measures included: gait parameters; a timed 4-meter walk; the 5-repetition sit-to-stand test (STST); tandem stance time; and 6-minute walk test (6MWT). Data was analyzed with split level method of trend estimation. Improvements in gait parameters, on the timed 4-meter walk, 6MWT, tandem balance and aerobic endurance were similar with FW and BW training. The only difference between FW and BW training was that BW training resulted in greater improvements in the STST. The results of this study suggest that in this individual backward walking training was advantageous, resulting in improved ability to perform the 5-repetition STST. It is suspected that these changes can be attributed to the differences in muscle activation and task difficulty between FW and BW.

Phase walk analysis of leptokurtic time series.

PubMed

Schreiber, Korbinian; Modest, Heike I; Räth, Christoph

2018-06-01

The Fourier phase information play a key role for the quantified description of nonlinear data. We present a novel tool for time series analysis that identifies nonlinearities by sensitively detecting correlations among the Fourier phases. The method, being called phase walk analysis, is based on well established measures from random walk analysis, which are now applied to the unwrapped Fourier phases of time series. We provide an analytical description of its functionality and demonstrate its capabilities on systematically controlled leptokurtic noise. Hereby, we investigate the properties of leptokurtic time series and their influence on the Fourier phases of time series. The phase walk analysis is applied to measured and simulated intermittent time series, whose probability density distribution is approximated by power laws. We use the day-to-day returns of the Dow-Jones industrial average, a synthetic time series with tailored nonlinearities mimicing the power law behavior of the Dow-Jones and the acceleration of the wind at an Atlantic offshore site. Testing for nonlinearities by means of surrogates shows that the new method yields strong significances for nonlinear behavior. Due to the drastically decreased computing time as compared to embedding space methods, the number of surrogate realizations can be increased by orders of magnitude. Thereby, the probability distribution of the test statistics can very accurately be derived and parameterized, which allows for much more precise tests on nonlinearities.

Physical factors underlying the association between lower walking performance and falls in older people: a structural equation model.

PubMed

Shimada, Hiroyuki; Tiedemann, Anne; Lord, Stephen R; Suzukawa, Megumi; Makizako, Hyuma; Kobayashi, Kumiko; Suzuki, Takao

2011-01-01

The purpose of this study was to determine the interrelationships between lower limb muscle performance, balance, gait and falls in older people using structural equation modeling. Study participants were two hundred and thirteen people aged 65 years and older (mean age, 80.0 ± 7.1 years), who used day-care services in Japan. The outcome measures were the history of falls three months retrospectively and physical risk factors for falling, including performance in the chair stand test (CST), one-leg standing test (OLS), tandem walk test, 6m walking time, and the timed up-and-go (TUG) test. Thirty-nine (18.3%) of the 213 participants had fallen at least one or more times during the preceding 3 months. The fall group had significantly slower 6m walking speed and took significantly longer to undertake the TUG test than the non-fall group. In a structural equation model, performance in the CST contributed significantly to gait function, and low gait function was significantly and directly associated with falls in older people. This suggests that task-specific strength exercise as well as general mobility retraining should be important components of exercise programs designed to reduce falls in older people. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Reliability of the Fox-walk test in patients with rheumatoid arthritis.

PubMed

Verberkt, Cornelia Antonia; Fridén, Cecilia; Grooten, Wilhelmus Johannes Andreas; Opava, Christina H

2012-01-01

The Fox-walk test is a new method used to estimate aerobic capacity outside a clinical environment, which may be useful in the implementation of daily health-enhancing physical activity. The aim of our study was to investigate the reliability of the test in people with rheumatoid arthritis (RA). Fifteen participants performed the Fox-walk test three times with weekly intervals. The intraclass correlation coefficient (ICC), the standard error of measurement (SEM) and the smallest detectable change (SDC) were used to estimate the reliability. General health perception, lower limb pain and fatigue were measured to determine their potential influence on the reliability. There were no systematic differences between the three test occasions (p = 0.190) and the reliability was almost perfect (ICC = 0.982). None of the covariates influenced the reliability. The SEM was 0.999 ml/kg/min or 3.4% and the SDC was 2.769 ml/kg/min or 9.4%. These findings demonstrate that the Fox-walk test is reliable in people with RA and enables differentiation between people with RA and monitoring progress. The validity of the test among people with RA is still to be determined. • The Fox-walk test is a new method to estimate aerobic capacity and could be performed walking or running. • The test is self administered without expensive equipment and is available in 150 public places in Sweden and several other European countries. • The Fox-walk test is a reliable test for use among people with rheumatoid arthritis monitoring the progress of their physical activity.

Estimating cardiorespiratory fitness in well-functioning older adults: treadmill validation of the long distance corridor walk.

PubMed

Simonsick, Eleanor M; Fan, Ellen; Fleg, Jerome L

2006-01-01

To determine criterion validity of the 400-m walk component of the Long Distance Corridor Walk (LDCW) and develop equations for estimating peak oxygen consumption (VO2) from 400-m time and factors intrinsic to test performance (e.g., heart rate (HR) and systolic blood pressure (SBP) response) in older adults. Cross-sectional validation study. Gerontology Research Center, National Institute on Aging, Baltimore, Maryland. Healthy volunteers (56 men and 46 women) aged 60 to 91 participating in the Baltimore Longitudinal Study of Aging between August 1999 and July 2000. The LDCW, consisting of a 2-minute walk followed immediately by a 400-m walk "done as quickly as possible" over a 20-m course was administered the day after maximal treadmill testing. HR and SBP were measured before testing and at the end of the 400-m walk. Weight, height, activity level, perceived effort, and stride length were also acquired. Peak VO2 ranged from 12.2 to 31.1 mL oxygen/kg per minute, and 400-m time ranged from 2 minutes 52 seconds to 6 minutes 18 seconds. Correlation between 400-m time and peak VO2 was -0.79. The estimating equation from linear regression included 400-m time (partial coefficient of determination (R2)=0.625), long versus short stride (partial R2=0.090), ending SBP (partial R2=0.019), and a correction factor for fast 400-m time (<240 seconds; partial R2=0.020) and explained 75.5% of the variance in peak VO2 (correlation coefficient=0.87). A 400-m walk performed as part of the LDCW provides a valid estimate of peak VO2 in older adults. Incorporating low-cost, safe assessments of fitness in clinical and research settings can identify early evidence of physical decline and individuals who may benefit from therapeutic interventions.

Effects of an Exercise Protocol for Improving Handgrip Strength and Walking Speed on Cognitive Function in Patients with Chronic Stroke.

PubMed

Kim, Jaeeun; Yim, Jongeun

2017-11-13

BACKGROUND Handgrip strength and walking speed predict and influence cognitive function. We aimed to investigate an exercise protocol for improving handgrip strength and walking speed, applied to patients with chronic stroke who had cognitive function disorder. MATERIAL AND METHODS Twenty-nine patients with cognitive function disorder participated in this study, and were randomly divided into one of two groups: exercise group (n=14) and control group (n=15). Both groups underwent conventional physical therapy for 60 minutes per day. Additionally, the exercise group followed an exercise protocol for handgrip using the hand exerciser, power web exerciser, Digi-Flex (15 minutes); and treadmill-based weight loading training on their less-affected leg (15 minutes) using a sandbag for 30 minutes, three times per day, for six weeks. Outcomes, including cognitive function and gait ability, were measured before and after the training. RESULTS The Korean version of Montreal Cognitive Assessment (K-MoCA), Stroop test (both simple and interference), Trail Making-B, Timed Up and Go, and 10-Meter Walk tests (p<0.05) yielded improved results for the exercise group compared with the control group. Importantly, the K-MoCA, Timed Up and Go, and 10-Meter Walk test results were significantly different between the two groups (p<0.05). CONCLUSIONS The exercise protocol for improving handgrip strength and walking speed had positive effects on cognitive function in patients with chronic stroke.

Narrowing beam-walking is a clinically feasible approach for assessing balance ability in lower-limb prosthesis users.

PubMed

Sawers, Andrew; Hafner, Brian J

2018-05-08

Challenging clinical balance tests are needed to expose balance deficits in lower-limb prost-hesis users. This study examined whether narrowing beam-walking could overcome conceptual and practical limitations identified in fixed-width beam-walking. Cross-sectional. Unilateral lower-limb prosthesis users. Participants walked 10 times along a low, narrowing beam. Performance was quantified using the normalized distance walked. Heuristic rules were applied to determine whether the narrowing beam task was "too easy," "too hard," or "appropriately challenging" for each participant. Linear regression and Bland-Altman plots were used to determine whether combinations of the first 5 trials could predict participants' stable beam-walking performance. Forty unilateral lower-limb prosthesis users participated. Narrowing beam-walking was appropriately challenging for 98% of participants. Performance stabilized for 93% of participants within 5 trials, while 62% were stable across all trials. The mean of trials 3-5 accurately predicted stable performance. A clinical narrowing beam-walking test is likely to challenge a range of lower-limb prosthesis users, have minimal administrative burden, and exhibit no floor or ceiling effects. Narrowing beam-walking is therefore a clinically viable method to evaluate lower-limb prosthesis users' balance ability, but requires psychometric testing before it is used to assess fall risk.

Anxiety sensitivity predicts increased perceived exertion during a 1-mile walk test among treatment-seeking smokers.

PubMed

Farris, Samantha G; Uebelacker, Lisa A; Brown, Richard A; Price, Lawrence H; Desaulniers, Julie; Abrantes, Ana M

2017-12-01

Smoking increases risk of early morbidity and mortality, and risk is compounded by physical inactivity. Anxiety sensitivity (fear of anxiety-relevant somatic sensations) is a cognitive factor that may amplify the subjective experience of exertion (effort) during exercise, subsequently resulting in lower engagement in physical activity. We examined the effect of anxiety sensitivity on ratings of perceived exertion (RPE) and physiological arousal (heart rate) during a bout of exercise among low-active treatment-seeking smokers. Adult daily smokers (n = 157; M age  = 44.9, SD = 11.13; 69.4% female) completed the Rockport 1.0 mile submaximal treadmill walk test. RPE and heart rate were assessed during the walk test. Multi-level modeling was used to examine the interactive effect of anxiety sensitivity × time on RPE and on heart rate at five time points during the walk test. There were significant linear and cubic time × anxiety sensitivity effects for RPE. High anxiety sensitivity was associated with greater initial increases in RPE during the walk test, with stabilized ratings towards the last 5 min, whereas low anxiety sensitivity was associated with lower initial increase in RPE which stabilized more quickly. The linear time × anxiety sensitivity effect for heart rate was not significant. Anxiety sensitivity is associated with increasing RPE during moderate-intensity exercise. Persistently rising RPE observed for smokers with high anxiety sensitivity may contribute to the negative experience of exercise, resulting in early termination of bouts of prolonged activity and/or decreased likelihood of future engagement in physical activity.

Treadmill Training with HAL Exoskeleton-A Novel Approach for Symptomatic Therapy in Patients with Limb-Girdle Muscular Dystrophy-Preliminary Study.

PubMed

Sczesny-Kaiser, Matthias; Kowalewski, Rebecca; Schildhauer, Thomas A; Aach, Mirko; Jansen, Oliver; Grasmücke, Dennis; Güttsches, Anne-Katrin; Vorgerd, Matthias; Tegenthoff, Martin

2017-01-01

Purpose: Exoskeletons have been developed for rehabilitation of patients with walking impairment due to neurological disorders. Recent studies have shown that the voluntary-driven exoskeleton HAL® (hybrid assistive limb) can improve walking functions in spinal cord injury and stroke. The aim of this study was to assess safety and effects on walking function of HAL® supported treadmill therapy in patients with limb-girdle muscular dystrophy (LGMD). Materials and Methods: Three LGMD patients received 8 weeks of treadmill training with HAL® 3 times a week. Outcome parameters were 10-meter walk test (10 MWT), 6-minute walk test, and timed-up-and-go test (TUG). Parameters were assessed pre and post training and 6 weeks later (follow-up). Results: All patients completed the therapy without adverse reactions and reported about improvement in endurance. Improvements in outcome parameters after 8 weeks could be demonstrated. Persisting effects were observed after 6 weeks for the 10 MWT and TUG test (follow-up). Conclusions: HAL® treadmill training in LGMD patients can be performed safely and enables an intensive highly repetitive locomotor training. All patients benefitted from this innovative method. Upcoming controlled studies with larger cohorts should prove its effects in different types of LGMD and other myopathies.

Treadmill Training with HAL Exoskeleton—A Novel Approach for Symptomatic Therapy in Patients with Limb-Girdle Muscular Dystrophy—Preliminary Study

PubMed Central

Sczesny-Kaiser, Matthias; Kowalewski, Rebecca; Schildhauer, Thomas A.; Aach, Mirko; Jansen, Oliver; Grasmücke, Dennis; Güttsches, Anne-Katrin; Vorgerd, Matthias; Tegenthoff, Martin

2017-01-01

Purpose: Exoskeletons have been developed for rehabilitation of patients with walking impairment due to neurological disorders. Recent studies have shown that the voluntary-driven exoskeleton HAL® (hybrid assistive limb) can improve walking functions in spinal cord injury and stroke. The aim of this study was to assess safety and effects on walking function of HAL® supported treadmill therapy in patients with limb-girdle muscular dystrophy (LGMD). Materials and Methods: Three LGMD patients received 8 weeks of treadmill training with HAL® 3 times a week. Outcome parameters were 10-meter walk test (10 MWT), 6-minute walk test, and timed-up-and-go test (TUG). Parameters were assessed pre and post training and 6 weeks later (follow-up). Results: All patients completed the therapy without adverse reactions and reported about improvement in endurance. Improvements in outcome parameters after 8 weeks could be demonstrated. Persisting effects were observed after 6 weeks for the 10 MWT and TUG test (follow-up). Conclusions: HAL® treadmill training in LGMD patients can be performed safely and enables an intensive highly repetitive locomotor training. All patients benefitted from this innovative method. Upcoming controlled studies with larger cohorts should prove its effects in different types of LGMD and other myopathies. PMID:28848377

Rearing in enriched environment increases parvalbumin-positive small neurons in the amygdala and decreases anxiety-like behavior of male rats.

PubMed

Urakawa, Susumu; Takamoto, Kouich; Hori, Etsuro; Sakai, Natsuko; Ono, Taketoshi; Nishijo, Hisao

2013-01-25

Early life experiences including physical exercise, sensory stimulation, and social interaction can modulate development of the inhibitory neuronal network and modify various behaviors. In particular, alteration of parvalbumin-expressing neurons, a gamma-aminobutyric acid (GABA)ergic neuronal subpopulation, has been suggested to be associated with psychiatric disorders. Here we investigated whether rearing in enriched environment could modify the expression of parvalbumin-positive neurons in the basolateral amygdala and anxiety-like behavior. Three-week-old male rats were divided into two groups: those reared in an enriched environment (EE rats) and those reared in standard cages (SE rats). After 5 weeks of rearing, the EE rats showed decreased anxiety-like behavior in an open field than the SE rats. Under another anxiogenic situation, in a beam walking test, the EE rats more quickly traversed an elevated narrow beam. Anxiety-like behavior in the open field was significantly and negatively correlated with walking time in the beam-walking test. Immunohistochemical tests revealed that the number of parvalbumin-positive neurons significantly increased in the basolateral amygdala of the EE rats than that of the SE rats, while the number of calbindin-D28k-positive neurons did not change. These parvalbumin-positive neurons had small, rounded soma and co-expressed the glutamate decarboxylase (GAD67). Furthermore, the number of parvalbumin-positive small cells in the basolateral amygdala tended to positively correlate with emergence in the center arena of the open field and negatively correlated with walking time in the beam walking test. Rearing in the enriched environment augmented the number of parvalbumin-containing specific inhibitory neuron in the basolateral amygdala, but not that of calbindin-containing neuronal phenotype. Furthermore, the number of parvalbumin-positive small neurons in the basolateral amygdala was negatively correlated with walking time in the beam walking test and tended to be positively correlated with activity in the center arena in the open field test. The results suggest that rearing in the enriched environment augmented parvalbumin-positive specific neurons in the basolateral amygdala, which induced behavioral plasticity that was reflected by a decrease in anxiety-like behavior in anxiogenic situations.

Rearing in enriched environment increases parvalbumin-positive small neurons in the amygdala and decreases anxiety-like behavior of male rats

PubMed Central

2013-01-01

Background Early life experiences including physical exercise, sensory stimulation, and social interaction can modulate development of the inhibitory neuronal network and modify various behaviors. In particular, alteration of parvalbumin-expressing neurons, a gamma-aminobutyric acid (GABA)ergic neuronal subpopulation, has been suggested to be associated with psychiatric disorders. Here we investigated whether rearing in enriched environment could modify the expression of parvalbumin-positive neurons in the basolateral amygdala and anxiety-like behavior. Results Three-week-old male rats were divided into two groups: those reared in an enriched environment (EE rats) and those reared in standard cages (SE rats). After 5 weeks of rearing, the EE rats showed decreased anxiety-like behavior in an open field than the SE rats. Under another anxiogenic situation, in a beam walking test, the EE rats more quickly traversed an elevated narrow beam. Anxiety-like behavior in the open field was significantly and negatively correlated with walking time in the beam-walking test. Immunohistochemical tests revealed that the number of parvalbumin-positive neurons significantly increased in the basolateral amygdala of the EE rats than that of the SE rats, while the number of calbindin-D28k-positive neurons did not change. These parvalbumin-positive neurons had small, rounded soma and co-expressed the glutamate decarboxylase (GAD67). Furthermore, the number of parvalbumin-positive small cells in the basolateral amygdala tended to positively correlate with emergence in the center arena of the open field and negatively correlated with walking time in the beam walking test. Conclusion Rearing in the enriched environment augmented the number of parvalbumin-containing specific inhibitory neuron in the basolateral amygdala, but not that of calbindin-containing neuronal phenotype. Furthermore, the number of parvalbumin-positive small neurons in the basolateral amygdala was negatively correlated with walking time in the beam walking test and tended to be positively correlated with activity in the center arena in the open field test. The results suggest that rearing in the enriched environment augmented parvalbumin-positive specific neurons in the basolateral amygdala, which induced behavioral plasticity that was reflected by a decrease in anxiety-like behavior in anxiogenic situations. PMID:23347699

Perceived barriers to walking for physical activity.

PubMed

Dunton, Genevieve F; Schneider, Margaret

2006-10-01

Although the health benefits of walking for physical activity have received increasing research attention, barriers specific to walking are not well understood. In this study, questions to measure barriers to walking for physical activity were developed and tested among college students. The factor structure, test-retest and internal consistency reliability, and discriminant and criterion validity of the perceived barriers were evaluated. A total of 305 undergraduate students participated. Participants had a mean age (+/- SD) of 20.6 (+/- 3.02) years, and 70.3% were female. Participants responded to a questionnaire assessing barriers specific to walking for physical activity. Perceived barriers to vigorous exercise, walking for transportation and recreation, and participation in lifestyle activities (such as taking the stairs instead of the elevator) were also assessed. Subsamples completed the walking barriers instrument a second time after 5 days in order to determine test-retest reliability (n = 104) and wore an accelerometer to measure moderate-intensity physical activity (n = 85). Factor analyses confirmed the existence of three factors underlying the perceived barriers to walking questions: appearance (four items), footwear (three items), and situation (three items). Appearance and situational barriers demonstrated acceptable reliability, discriminant validity, and relations with physical activity criteria. After we controlled for barriers to vigorous exercise, appearance and situational barriers to walking explained additional variation in objectively-measured moderate physical activity. The prediction of walking for physical activity, especially walking that is unstructured and spontaneous, may be improved by considering appearance and situational barriers. Assessing barriers specific to walking may have important implications for interventions targeting walking as means for engaging in physical activity.

Reproducibility and Validity of the 6-Minute Walk Test Using the Gait Real-Time Analysis Interactive Lab in Patients with COPD and Healthy Elderly

PubMed Central

Meijer, Kenneth; Delbressine, Jeannet M.; Willems, Paul J.; Franssen, Frits M. E.; Wouters, Emiel F. M.; Spruit, Martijn A.

2016-01-01

Background The 6-minute walk test (6MWT) in a regular hallway is commonly used to assess functional exercise capacity in patients with chronic obstructive pulmonary disease (COPD). However, treadmill walking might provide additional advantages over overground walking, especially if virtual reality and self-paced treadmill walking are combined. Therefore, this study aimed to assess the reproducibility and validity of the 6MWT using the Gait Real-time Analysis Interactive Lab (GRAIL) in patients with COPD and healthy elderly. Methodology/Results Sixty-one patients with COPD and 48 healthy elderly performed two 6MWTs on the GRAIL. Patients performed two overground 6MWTs and healthy elderly performed one overground test. Differences between consecutive 6MWTs and the test conditions (GRAIL vs. overground) were analysed. Patients walked further in the second overground test (24.8 m, 95% CI 15.2–34.4 m, p<0.001) and in the second GRAIL test (26.8 m, 95% CI 13.9–39.6 m). Healthy elderly improved their second GRAIL test (49.6 m, 95% CI 37.0–62.3 m). The GRAIL 6MWT was reproducible (intra-class coefficients = 0.65–0.80). The best GRAIL 6-minute walk distance (6MWD) in patients was shorter than the best overground 6MWD (-27.3 ± 49.1 m, p<0.001). Healthy elderly walked further on the GRAIL than in the overground condition (23.6 ± 41.4 m, p<0.001). Validity of the GRAIL 6MWT was assessed and intra-class coefficient values ranging from 0.74–0.77 were found. Conclusion The GRAIL is a promising system to assess the 6MWD in patients with COPD and healthy elderly. The GRAIL 6MWD seems to be more comparable to the 6MWDs assessed overground than previous studies on treadmills have reported. Furthermore, good construct validity and reproducibility were established in assessing the 6MWD using the GRAIL in patients with COPD and healthy elderly. PMID:27607426

Hybrid Assistive Limb Exoskeleton HAL in the Rehabilitation of Chronic Spinal Cord Injury: Proof of Concept; the Results in 21 Patients.

PubMed

Jansen, Oliver; Grasmuecke, Dennis; Meindl, Renate C; Tegenthoff, Martin; Schwenkreis, Peter; Sczesny-Kaiser, Matthias; Wessling, Martin; Schildhauer, Thomas A; Fisahn, Christian; Aach, Mirko

2018-02-01

The use of mobile exoskeletons is becoming more and more common in the field of spinal cord injury (SCI) rehabilitation. The hybrid assistive limb (HAL) exoskeleton provides a tailored support depending on the patient's voluntary drive. After a pilot study in 2014 that included 8 patients with chronic SCI, this study of 21 patients with chronic SCI serves as a proof of concept. It was conducted to provide further evidence regarding the efficacy of exoskeletal-based rehabilitation. Functional assessment included walking speed, distance, and time on a treadmill, with additional analysis of functional mobility using the following tests: 10-meter walk test (10MWT), timed up and go (TUG) test, 6-minute walk test (6MWT), and the walking index for SCI II (WISCI-II) score. After a training period of 90 days, all 21 patients significantly improved their functional and ambulatory mobility without the exoskeleton. Patients were assessed by the 6MWT, the TUG test, and the 10MWT, which also indicated an increase in the WISCI-II score along with significant improvements in HAL-associated walking speed, distance, and time. Although, exoskeletons are not yet an established treatment in the rehabilitation of spinal cord injuries, the devices will play a more important role in the future. The HAL exoskeleton training enables effective, body weight-supported treadmill training and is capable of improving ambulatory mobility. Future controlled studies are required to enable a comparison of the new advances in the field of SCI rehabilitation with traditional over-ground training. Copyright © 2017 Elsevier Inc. All rights reserved.

The effects of backward walking training on balance and mobility in an individual with chronic incomplete spinal cord injury: A case report.

PubMed

Foster, Hannah; DeMark, Lou; Spigel, Pamela M; Rose, Dorian K; Fox, Emily J

2016-10-01

Individuals with incomplete spinal cord injuries (ISCIs) commonly face persistent gait impairments. Backward walking training may be a useful rehabilitation approach, providing novel gait and balance challenges. However, little is known about the effects of this approach for individuals with ISCIs. The purpose of this case report was to describe the effects of backward walking training on strength, balance, and upright mobility in an individual with chronic ISCI. A 28-year-old female, 11-years post ISCI (C4, AIS D) completed 18-sessions of backward walking training on a treadmill with partial body-weight support and overground. Training emphasized stepping practice, speed, and kinematics. Outcome measures included: Lower Extremity Motor Score, Berg Balance Scale (BBS), Sensory Organization Test (SOT), 10-Meter Walk Test (10MWT), 3-meter backward walking test, Timed Up and Go (TUG), and Activities-Specific Balance Confidence (ABC) Scale. Strength did not change. Improved balance was evident based on BBS (20 to 37/56) and SOT scores (27 to 40/100). Upright mobility improved based on TUG times (57 to 32.7 s), increased 10MWT speed (0.23 to 0.31 m/s), and backward gait speed (0.07 to 0.12 m/s). Additionally, self-reported balance confidence (ABC Scale) increased from 36.9% to 49.6%. The results suggest that backward walking may be a beneficial rehabilitation approach; examination of the clinical efficacy is warranted.

The effects of backward walking training on balance and mobility in an individual with chronic incomplete spinal cord injury: A case report

PubMed Central

Foster, Hannah; DeMark, Lou; Spigel, Pamela M.; Rose, Dorian K.; Fox, Emily J.

2016-01-01

Background/Purpose Individuals with incomplete spinal cord injuries (ISCIs) commonly face persistent gait impairments. Backward walking training may be a useful rehabilitation approach, providing novel gait and balance challenges. However, little is known about the effects of this approach for individuals with ISCIs. The purpose of this case report was to describe the effects of backward walking training on strength, balance and upright mobility in an individual with chronic ISCI. Methods A 28-year-old female, 11-years post ISCI (C4, AIS D) completed 18-sessions of backward walking training on a treadmill with partial body-weight support and overground. Training emphasized stepping practice, speed, and kinematics. Outcome measures included: Lower Extremity Motor Score, Berg Balance Scale (BBS), Sensory Organization Test (SOT); 10-Meter Walk Test (10MWT), 3-meter backward walking test, Timed Up and Go (TUG), and Activities-Specific Balance Confidence (ABC) Scale. Results Strength did not change. Improved balance was evident based on BBS (20 to 37/56) and SOT scores (27 to 40/100). Upright mobility improved based on TUG times (57 to 32.7 s), increased 10MWT speed (0.23 to 0.31 m/s), and backward gait speed (0.07 to 0.12 m/s). Additionally, self-reported balance confidence (ABC Scale) increased from 36.9% to 49.6%. Conclusions The results suggest that backward walking may be a beneficial rehabilitation approach; examination of the clinical efficacy is warranted. PMID:27482619

Evaluating physical capacity in patients with chronic obstructive pulmonary disease: comparing the shuttle walk test with the encouraged 6-minute walk test.

PubMed

Rosa, Fernanda Warken; Camelier, Aquiles; Mayer, Anamaria; Jardim, José Roberto

2006-01-01

To evaluate the applicability of the incremental (shuttle) walk test in patients with chronic obstructive pulmonary disease and compare the performance of those patients on the shuttle walk test to that of the same patients on the encouraged 6-minute walk test. A cross-sectional study was conducted, in which 24 patients with chronic obstructive pulmonary disease were selected. In random order, patients were, after an initial practice period, submitted to a shuttle walk test and an encouraged 6-minute walk test. The patients obtained a higher heart rate (expressed as a percentage of that predicted based on gender and age) on the encouraged 6-minute walk test (84.1 +/- 11.4%) than on the shuttle walk test (76.4 +/- 9.7%) (p = 0.003). The post-test sensation of dyspnea (Borg scale) was also higher on the encouraged 6-minute walk test. On average, the patients walked 307.0 +/- 89.3 meters on the shuttle walk test and 515.5 +/- 102.3 meters on the encouraged 6-minute walk test (p < 0.001). There was a good correlation between the two tests in terms of the distance walked (r = 0.80, p < 0.001). The shuttle walk test is simple and easy to implement in patients with chronic obstructive pulmonary disease. The encouraged 6-minute walk test produced higher post-test heart rate and greater post-test sensation of dyspnea than did the shuttle walk test.

Predictive value of health-related fitness tests for self-reported mobility difficulties among high-functioning elderly men and women.

PubMed

Hämäläinen, H Pauliina; Suni, Jaana H; Pasanen, Matti E; Malmberg, Jarmo J; Miilunpalo, Seppo I

2006-06-01

The functional independence of elderly populations deteriorates with age. Several tests of physical performance have been developed for screening elderly persons who are at risk of losing their functional independence. The purpose of the present study was to investigate whether several components of health-related fitness (HRF) are valid in predicting the occurrence of self-reported mobility difficulties (MD) among high-functioning older adults. Subjects were community-dwelling men and women, born 1917-1941, who participated in the assessment of HRF [6.1-m (20-ft) walk, one-leg stand, backwards walk, trunk side-bending, dynamic back extension, one-leg squat, 1-km walk] and who were free of MD in 1996 (no difficulties in walking 2- km, n=788; no difficulties in climbing stairs, n=647). Postal questionnaires were used to assess the prevalence of MD in 1996 and the occurrence of new MD in 2002. Logistic regression analysis was used as the statistical method. Both inability to perform the backwards walk and a poorer result in it were associated with risk of walking difficulties in the logistic model, with all the statistically significant single test items included. Results of 1-km walk time and one-leg squat strength test were also associated with risk, although the squat was statistically significant only in two older birth cohorts. Regarding stair-climbing difficulties, poorer results in the 1-km walk, dynamic back extension and one-leg squat tests were associated with increased risk of MD. The backwards walk, one-leg squat, dynamic back extension and 1-km walk tests were the best predictors of MD. These tests are recommended for use in screening high-functioning older people at risk of MD, as well as to target physical activity counseling to those components of HRF that are important for functional independence.

Feasibility and Safety of a Powered Exoskeleton for Assisted Walking for Persons With Multiple Sclerosis: A Single-Group Preliminary Study.

PubMed

Kozlowski, Allan J; Fabian, Michelle; Lad, Dipan; Delgado, Andrew D

2017-07-01

To examine the feasibility, safety, and secondary benefit potential of exoskeleton-assisted walking with one device for persons with multiple sclerosis (MS). Single-group longitudinal preliminary study with 8-week baseline, 8-week intervention, and 4-week follow-up. Outpatient MS clinic, tertiary care hospital. Participants (N=13; age range, 38-62y) were mostly women with Expanded Disability Status Scale scores ranging from 5.5 to 7.0. Exoskeleton-assisted walk training. Primary outcomes were accessibility (enrollment/screen pass), tolerability (completion/dropout), learnability (time to event for standing, walking, and sitting with little or no assistance), acceptability (satisfaction on the device subscale of the Quebec User Evaluation of Satisfaction with Assistive Technology version 2), and safety (event rates standardized to person-time exposure in the powered exoskeleton). Secondary outcomes were walking without the device (timed 25-foot walk test and 6-minute walk test distance), spasticity (Modified Ashworth Scale), and health-related quality of life (Patient-Reported Outcomes Measurement and Information System pain interference and Quality of Life in Neurological Conditions fatigue, sleep disturbance, depression, and positive affect and well-being). The device was accessible to 11 and tolerated by 5 participants. Learnability was moderate, with 5 to 15 sessions required to walk with minimal assistance. Safety was good; the highest adverse event rate was for skin issues at 151 per 1000 hours' exposure. Acceptability ranged from not very satisfied to very satisfied. Participants who walked routinely improved qualitatively on sitting, standing, or walking posture. Two participants improved and 2 worsened on ≥1 quality of life domain. The pattern of spasticity scores may indicate potential benefit. The device appeared feasible and safe for about a third of our sample, for whom routine exoskeleton-assisted walking may offer secondary benefits. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Generating linear regression model to predict motor functions by use of laser range finder during TUG.

PubMed

Adachi, Daiki; Nishiguchi, Shu; Fukutani, Naoto; Hotta, Takayuki; Tashiro, Yuto; Morino, Saori; Shirooka, Hidehiko; Nozaki, Yuma; Hirata, Hinako; Yamaguchi, Moe; Yorozu, Ayanori; Takahashi, Masaki; Aoyama, Tomoki

2017-05-01

The purpose of this study was to investigate which spatial and temporal parameters of the Timed Up and Go (TUG) test are associated with motor function in elderly individuals. This study included 99 community-dwelling women aged 72.9 ± 6.3 years. Step length, step width, single support time, variability of the aforementioned parameters, gait velocity, cadence, reaction time from starting signal to first step, and minimum distance between the foot and a marker placed to 3 in front of the chair were measured using our analysis system. The 10-m walk test, five times sit-to-stand (FTSTS) test, and one-leg standing (OLS) test were used to assess motor function. Stepwise multivariate linear regression analysis was used to determine which TUG test parameters were associated with each motor function test. Finally, we calculated a predictive model for each motor function test using each regression coefficient. In stepwise linear regression analysis, step length and cadence were significantly associated with the 10-m walk test, FTSTS and OLS test. Reaction time was associated with the FTSTS test, and step width was associated with the OLS test. Each predictive model showed a strong correlation with the 10-m walk test and OLS test (P < 0.01), which was not significant higher correlation than TUG test time. We showed which TUG test parameters were associated with each motor function test. Moreover, the TUG test time regarded as the lower extremity function and mobility has strong predictive ability in each motor function test. Copyright © 2017 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

Balance and gait in children with dyslexia.

PubMed

Moe-Nilssen, Rolf; Helbostad, Jorunn L; Talcott, Joel B; Toennessen, Finn Egil

2003-05-01

Tests of postural stability have provided some evidence of a link between deficits in gross motor skills and developmental dyslexia. The ordinal-level scales used previously, however, have limited measurement sensitivity, and no studies have investigated motor performance during walking in participants with dyslexia. The purpose of this study was to investigate if continuous-scaled measures of standing balance and gait could discriminate between groups of impaired and normal readers when investigators were blind to group membership during testing. Children with dyslexia ( n=22) and controls ( n=18), aged 10-12 years, performed walking tests at four different speeds (slow-preferred-fast-very fast) on an even and an uneven surface, and tests of unperturbed and perturbed body sway during standing. Body movements were registered by a triaxial accelerometer over the lower trunk, and measures of reaction time, body sway, walking speed, step length and cadence were calculated. Results were controlled for gender differences. Tests of standing balance with eyes closed did not discriminate between groups. All unperturbed standing tests with eyes open showed significant group differences ( P<0.05) and classified correctly 70-77.5% of the subjects into their respective groups. Mean walking speed during very fast walking on both flat and uneven surface was > or =0.2 m/s ( P< or =0.01) faster for controls than for the group with dyslexia. This test classified 77.5% and 85% of the subjects correctly on flat and uneven surface, respectively. Cadence at preferred or very fast speed did not differ statistically between groups, but revealed significant group differences when all subjects were compared at a normalised walking speed ( P< or =0.04). Very fast walking speed as well as cadence at a normalised speed discriminated better between groups when subjects were walking on an uneven surface compared to a flat floor. Continuous-scaled walking tests performed in field settings may be suitable for motor skill assessment as a component of a screening tool for developmental dyslexia.

Effects of neuromuscular electrostimulation in patients with heart failure admitted to ward.

PubMed

de Araújo, Carlos José Soares; Gonçalves, Fernanda Souza; Bittencourt, Hugo Souza; dos Santos, Noélia Gonçalves; Mecca Junior, Sérgio Vitor; Neves, Júlio Leal Bandeira; Fernandes, André Maurício Souza; Aras Junior, Roque; dos Reis, Francisco José Farias Borges; Guimarães, Armênio Costa; Rodrigues Junior, Erenaldo de Souza; Carvalho, Vitor Oliveira

2012-11-15

Neuromuscular electrostimulation has become a promising issue in cardiovascular rehabilitation. However there are few articles published in the literature regarding neuromuscular electrostimulation in patients with heart failure during hospital stay. This is a randomized controlled pilot trial that aimed to investigate the effect of neuromuscular electrostimulation in the walked distance by the six-minute walking test in 30 patients admitted to ward for heart failure treatment in a tertiary cardiology hospital. Patients in the intervention group performed a conventional rehabilitation and neuromuscular electrostimulation. Patients underwent 60 minutes of electrostimulation (wave frequency was 20 Hz, pulse duration of 20 us) two times a day for consecutive days until hospital discharge. The walked distance in the six-minute walking test improved 75% in the electrostimulation group (from 379.7 ± 43.5 to 372.9 ± 46.9 meters to controls and from 372.9 ± 62.4 to 500 ± 68 meters to electrostimulation, p<0.001). On the other hand, the walked distance in the control group did not change. The neuromuscular electrostimulation group showed greater improvement in the walked distance in the six-minute walking test in patients admitted to ward for compensation of heart failure.

Sex and age-level differences of walking time in preschool children on an obstacle frame

PubMed Central

2012-01-01

Background Stepping over an obstacle is a kind of compound movement that makes walking more difficult, especially for preschool children. This study examines sex and age-level differences in walking time in preschool children on an obstacle frame. Methods The participants included 324 healthy preschool children: four-year-old boys (51) and girls (51), five-year-old boys (50) and girls (60), and six-year-old boys (62) and girls (50). A 5 cm- or 10 cm-high obstacle (depth 11.5 cm, width 23.5 cm) was set at the halfway point of a 200 cm × 10 cm walking course. Results The participants walked to the end of the course and back as fast as possible under three conditions: no obstacle, low obstacle and high obstacle. Walking time showed age-level differences in all conditions, but there were no differences in sex. Age levels were divided into two groups, with one group within the first six months of their birthday, and the second group within the last six months of that year. Walking time for children in the first half of their fourth year was longer than that of the five- and six-year-old children. In addition, for children in the last half of their fourth year, walking time was longer than both sexes in the last half of their fifth and sixth years. The children in the latter half of their fifth year had a longer walking time in the high obstacle condition than those in the last half of their sixth year. In the four-year-old participants, walking time was shorter with no obstacles than with a high obstacle frame. Conclusions In the above data, obstacle course walking time does not show a gender difference, except that the four-year-old participants needed longer than the five- and six-year-old children. Setting the obstacle 10 cm high also produced a different walking time in the five- and six-year-old participants. The high obstacle step test (10 cm) best evaluated the dynamic balance of preschool children. PMID:22738328

Early or delayed provision of an ankle-foot orthosis in patients with acute and subacute stroke: a randomized controlled trial.

PubMed

Nikamp, Corien Dm; Buurke, Jaap H; van der Palen, Job; Hermens, Hermie J; Rietman, Johan S

2017-06-01

(1) To study the effects of providing ankle-foot orthoses in subjects with (sub)acute stroke; and (2) to study whether the point in time at which an ankle-foot orthosis is provided post-stroke (early or delayed) influences these effects. Randomized controlled trial. Rehabilitation centre. Unilateral hemiparetic stroke subjects with indication for use of an ankle-foot orthosis and maximal six weeks post-stroke. Subjects were randomly assigned to: early provision (at inclusion; Week 1) or delayed provision (eight weeks later; Week 9). 10-metre walk test, 6-minute walk test, Timed Up and Go Test, stairs test, Functional Ambulation Categories, Berg Balance Scale, Rivermead Mobility Index and Barthel Index; assessed in Weeks 1, 3, 9 and 11. A total of 33 subjects were randomized (16 early, 17 delayed). Positive effects of ankle-foot orthoses were found two weeks after provision, both when provided early (significant effects on all outcomes) or delayed (Berg Balance Scale p = 0.011, Functional Ambulation Categories p = 0.008, 6-minute walk test p = 0.005, Timed Up and Go Test p = 0.028). Comparing effects after early and delayed provision showed that early provision resulted in increased levels of improvement on Berg Balance Scale (+5.1 points, p = 0.002), Barthel Index (+1.9 points, p = 0.002) and non-significant improvements on 10-metre walk test (+0.14 m/s, p = 0.093) and Timed Up and Go Test (-5.4 seconds, p = 0.087), compared with delayed provision. We found positive effects of providing ankle-foot orthoses in (sub)acute stroke subjects that had not used these orthoses before.

Walking adaptability therapy after stroke: study protocol for a randomized controlled trial.

PubMed

Timmermans, Celine; Roerdink, Melvyn; van Ooijen, Marielle W; Meskers, Carel G; Janssen, Thomas W; Beek, Peter J

2016-08-26

Walking in everyday life requires the ability to adapt walking to the environment. This adaptability is often impaired after stroke, and this might contribute to the increased fall risk after stroke. To improve safe community ambulation, walking adaptability training might be beneficial after stroke. This study is designed to compare the effects of two interventions for improving walking speed and walking adaptability: treadmill-based C-Mill therapy (therapy with augmented reality) and the overground FALLS program (a conventional therapy program). We hypothesize that C-Mill therapy will result in better outcomes than the FALLS program, owing to its expected greater amount of walking practice. This is a single-center parallel group randomized controlled trial with pre-intervention, post-intervention, retention, and follow-up tests. Forty persons after stroke (≥3 months) with deficits in walking or balance will be included. Participants will be randomly allocated to either C-Mill therapy or the overground FALLS program for 5 weeks. Both interventions will incorporate practice of walking adaptability and will be matched in terms of frequency, duration, and therapist attention. Walking speed, as determined by the 10 Meter Walking Test, will be the primary outcome measure. Secondary outcome measures will pertain to walking adaptability (10 Meter Walking Test with context or cognitive dual-task and Interactive Walkway assessments). Furthermore, commonly used clinical measures to determine walking ability (Timed Up-and-Go test), walking independence (Functional Ambulation Category), balance (Berg Balance Scale), and balance confidence (Activities-specific Balance Confidence scale) will be used, as well as a complementary set of walking-related assessments. The amount of walking practice (the number of steps taken per session) will be registered using the treadmill's inbuilt step counter (C-Mill therapy) and video recordings (FALLS program). This process measure will be compared between the two interventions. This study will assess the effects of treadmill-based C-Mill therapy compared with the overground FALLS program and thereby the relative importance of the amount of walking practice as a key aspect of effective intervention programs directed at improving walking speed and walking adaptability after stroke. Netherlands Trial Register NTR4030 . Registered on 11 June 2013, amendment filed on 17 June 2016.

EFFECTS OF STRENGTH TRAINING ON PHYSICAL FUNCTION: INFLUENCE OF POWER, STRENGTH, AND BODY COMPOSITION

PubMed Central

Hanson, Erik D.; Srivatsan, Sindhu R.; Agrawal, Siddhartha; Menon, Kalapurakkal S.; Delmonico, Matthew J.; Wang, Min Q.; Hurley, Ben F.

2010-01-01

The purpose of this study was to determine (a) the effects of strength training (ST) on physical function and (b) the influence of strength, power, muscle volume (MV), and body composition on physical function. Healthy, inactive adults (n = 50) aged 65 years and older underwent strength, power, total body composition (% fat and fat free mass [FFM]), and physical function testing before and after 22 weeks of ST. Physical function testing consisted of tasks designed to mimic common physical activities of daily living (ADL). To improve internal validity of the assessment of mid-thigh intermuscular fat, subcutaneous fat, and knee extensors MV, a 10-week unilateral ST program using the untrained leg as an internal control preceded 12 weeks of whole-body ST. Strength, power, and FFM increased significantly with ST (all p < 0.05), whereas rapid walk, 5 chair stands, and get up and go time decreased significantly with ST in the overall group (all p < 0.05). Women improved significantly in both walking test times (both p < 0.05) but not in the stair climb test, whereas men improved in the stair climb test (p < 0.05) but not in walking test times. Multiple regression analysis revealed the highest R2 (0.28) for the change in chair stands time, followed by stair climb and usual walk at 0.27 and 0.21, respectively. ST improves performance in functional tasks important for ADLs. Changes in strength, power, and FFM are predictors of ST-induced improvements in these tasks. PMID:19910811

Walking Back to the Future.

PubMed

Loeffler, Jonna; Raab, Markus; Cañal-Bruland, Rouwen

2017-09-01

Embodied cognition frameworks suggest a direct link between sensorimotor experience and cognitive representations of concepts ( Shapiro, 2011 ). We examined whether this holds also true for concepts that cannot be directly perceived with the sensorimotor system (i.e., temporal concepts). To test this, participants learned object-space (Exp. 1) or object-time (Exp. 2) associations. Afterwards, participants were asked to assign the objects to their location in space/time meanwhile they walked backward, forward, or stood on a treadmill. We hypothesized that walking backward should facilitate the online processing of "behind"/"past"-related stimuli, but hinder the processing of "ahead"/"future"-related stimuli, and a reversed effect for forward walking. Indeed, "ahead"- and "future"-related stimuli were processed slower during backward walking. During forward walking and standing, stimuli were processed equally fast. The results provide partial evidence for the activation of specific spatial and temporal concepts by whole-body movements and are discussed in the context of movement familiarity.

A community-based aquatic exercise program to improve endurance and mobility in adults with mild to moderate intellectual disability.

PubMed

Hakim, Renée M; Ross, Michael D; Runco, Wendy; Kane, Michael T

2017-02-01

The purpose of this study was to investigate the impact of a community-based aquatic exercise program on physical performance among adults with mild to moderate intellectual disability (ID). Twenty-two community-dwelling adults with mild to moderate ID volunteered to participate in this study. Participants completed an 8-week aquatic exercise program (2 days/wk, 1 hr/session). Measures of physical performance, which were assessed prior to and following the completion of the aquatic exercise program, included the timed-up-and-go test, 6-min walk test, 30-sec chair stand test, 10-m timed walk test, hand grip strength, and the static plank test. When comparing participants' measures of physical performance prior to and following the 8-week aquatic exercise program, improvements were seen in all measures, but the change in scores for the 6-min walk test, 30-sec chair stand test, and the static plank test achieved statistical significance ( P <0.05). An 8-week group aquatic exercise program for adults with ID may promote improvements in endurance and balance/mobility.

Reliability and Clinical Significance of Mobility and Balance Assessments in Multiple Sclerosis

ERIC Educational Resources Information Center

Learmonth, Yvonne C.; Paul, Lorna; McFadyen, Angus K.; Mattison, Paul; Miller, Linda

2012-01-01

The aim of the study was to establish the test-retest reliability, clinical significance and precision of four mobility and balance measures--the Timed 25-Foot Walk, Six-minute Walk, Timed Up and Go and the Berg Balance Scale--in individuals moderately affected by multiple sclerosis. Twenty four participants with multiple sclerosis (Extended…

Logical-Rule Models of Classification Response Times: A Synthesis of Mental-Architecture, Random-Walk, and Decision-Bound Approaches

ERIC Educational Resources Information Center

Fific, Mario; Little, Daniel R.; Nosofsky, Robert M.

2010-01-01

We formalize and provide tests of a set of logical-rule models for predicting perceptual classification response times (RTs) and choice probabilities. The models are developed by synthesizing mental-architecture, random-walk, and decision-bound approaches. According to the models, people make independent decisions about the locations of stimuli…

Different motor tasks impact differently on cognitive performance of older persons during dual task tests.

PubMed

Simoni, David; Rubbieri, Gaia; Baccini, Marco; Rinaldi, Lucio; Becheri, Dimitri; Forconi, Tatiana; Mossello, Enrico; Zanieri, Samanta; Marchionni, Niccolò; Di Bari, Mauro

2013-07-01

Dual task paradigm states that the introduction of a second task during a cognitive or motor performance results in a decreased performance in either task. Treadmill walk, often used in clinical applications of dual task testing, has never been compared to overground walk, to ascertain its susceptibility to interference from a second task. We compared the effects of overground and treadmill gait on dual task performance. Gait kinematic parameters and cognitive performance were obtained in 29 healthy older adults (mean age 75 years, 14 females) when they were walking freely on a sensorized carpet or during treadmill walking with an optoelectronic system, in single task or dual task conditions, using alternate repetition of letters as a cognitive verbal task. During overground walking, speed, cadence, step length stride length, and double support time (all with P value<0.001) and cognitive performance (number of correct words, P<0.001) decreased substantially from single to dual task testing. When subjects walked at a fixed speed on the treadmill, cadence decreased significantly (P=0.005), whereas cognitive performance remained unaffected. Both motor and cognitive performances decline during dual task testing with overground walking. Conversely, cognitive performance remains unaffected in dual task testing on the treadmill. In the light of current dual task paradigm, these findings may have relevant implication for our understanding of motor control, as they suggest that treadmill walk does not involve brain areas susceptible to interference from the introduction of a cognitive task. Copyright © 2013 Elsevier Ltd. All rights reserved.

Immediate effects of transcutaneous electrical nerve stimulation on six-minute walking test, Borg scale questionnaire and hemodynamic responses in patients with chronic heart failure.

PubMed

Ganguie, Majid Ashraf; Moghadam, Behrouz Attarbashi; Ghotbi, Nastaran; Shadmehr, Azadeh; Masoumi, Mohammad

2017-12-01

[Purpose] This study examined the immediate effects of transcutaneous electrical nerve stimulation on a six-minute walking test, Borg scale questionnaire and hemodynamic responses in patients with chronic heart failure. [Subjects and Methods] Thirty patients with stable systolic chronic heart failure came to the pathophysiology laboratory three times. The tests were randomly performed in three sessions. In one session, current was applied to the quadriceps muscles of both extremities for 30 minutes and a six-minute walking test was performed immediately afterward. In another session, the same procedure was followed except that the current intensity was set to zero. In the third session, the patients walked for six minutes without application of a current. The distance covered in each session was measured. At the end of each session, the subjects completed a Borg scale questionnaire. [Results] The mean distance traveled in the six-minute walking test and the mean score of the Borg scale questionnaire were significantly different across sessions. The mean systolic and diastolic pressures showed no significant differences across sessions. [Conclusion] The increase in distance traveled during the six-minute walking test and decrease in fatigue after the use of current may be due to a decrease in sympathetic overactivity and an increase in peripheral and muscular microcirculation in these patients.

Immediate effects of transcutaneous electrical nerve stimulation on six-minute walking test, Borg scale questionnaire and hemodynamic responses in patients with chronic heart failure

PubMed Central

Ganguie, Majid Ashraf; Moghadam, Behrouz Attarbashi; Ghotbi, Nastaran; Shadmehr, Azadeh; Masoumi, Mohammad

2017-01-01

[Purpose] This study examined the immediate effects of transcutaneous electrical nerve stimulation on a six-minute walking test, Borg scale questionnaire and hemodynamic responses in patients with chronic heart failure. [Subjects and Methods] Thirty patients with stable systolic chronic heart failure came to the pathophysiology laboratory three times. The tests were randomly performed in three sessions. In one session, current was applied to the quadriceps muscles of both extremities for 30 minutes and a six-minute walking test was performed immediately afterward. In another session, the same procedure was followed except that the current intensity was set to zero. In the third session, the patients walked for six minutes without application of a current. The distance covered in each session was measured. At the end of each session, the subjects completed a Borg scale questionnaire. [Results] The mean distance traveled in the six-minute walking test and the mean score of the Borg scale questionnaire were significantly different across sessions. The mean systolic and diastolic pressures showed no significant differences across sessions. [Conclusion] The increase in distance traveled during the six-minute walking test and decrease in fatigue after the use of current may be due to a decrease in sympathetic overactivity and an increase in peripheral and muscular microcirculation in these patients. PMID:29643590

The effects of the length of rain boots on balance during treadmill walking

PubMed Central

Yang, Hee-Ra; Kim, Mi-Kyoung; Yoo, Kyung-Tae

2015-01-01

[Purpose] Effects of muscle fatigue on lower-extremity balance were evaluated in 12 healthy young women in their 20s while they walked on a treadmill wearing rain boots of different lengths. [Methods] The rain boots were divided into three groups based on the shaft length (Long, Middle, Short). Romberg’s test was applied and limits of stability were measured before and after treadmill walking. [Results] Romberg’s test showed a significant main effect for time. There were significant differences between the center of gravity area, length, and velocity when the eyes were open and the center of gravity length, velocity, and length/cm2 when the eyes were closed. Changes in the limits of stability also showed a significant main effect of time. There were significant differences in pre-test and post-test values in the left, right, forward, and total directions. [Conclusion] It was found that muscle fatigue in the lower extremities generated by walking in rain boots affected the joints and the adjuster muscles, depending on shaft lengths. Compensation due to visual feedback and the length of the boot shaft affected movement of the distal joints, resulting in a reduced ability to balance. PMID:26644688

Fractal analysis of the ambulation pattern of Japanese quail.

PubMed

Kembro, J M; Perillo, M A; Pury, P A; Satterlee, D G; Marín, R H

2009-03-01

1. The study examined the practicality and usefulness of fractal analyses in evaluating the temporal organisation of avian ambulatory behaviour by using female Japanese quail in their home boxes as the model system. To induce two locomotion activity levels, we tested half of the birds without disturbance (Unstimulated) and the other half when food was scattered on the floor of the home box after 3 h of feeder withdrawal (Stimulated). 2. Ambulatory activity was recorded during 40 min at a resolution of 1 s and evaluated by: (1) detrended fluctuation analyses (DFA), (2) the frequency distribution of the duration of the walking or non-walking events (FDD-W or FDD-NW, respectively), and (3) the transition probabilities between walking/non-walking states. Conventional measures of total time spent walking and average duration of the walking/non-walking events were also employed. 3. DFA showed a decreased value of the self-similarity parameter (alpha; indicative of a more complex ambulatory pattern) in Stimulated birds compared to their Unstimulated counterparts. The FDD-NW showed a more negative scaling factor in Stimulated than in Unstimulated birds. Stimulated birds also had more transitions between non-walking and walking states, consistent with stimulated exploratory activity. No differences were found between groups in the FDD-W, in percentage of total time spent walking, or in average duration of the walking events. 4. The temporal walking pattern of female Japanese quail has a fractal structure and its organisation and complexity is altered when birds are stimulated to explore. The fractal analyses detected differences between the Unstimulated and Stimulated groups that went undetected by the traditional measurements of the percentage of total time spent walking and the duration of the walking events suggesting its usefulness as a tool for behavioural studies.

Gait Pattern Alterations during Walking, Texting and Walking and Texting during Cognitively Distractive Tasks while Negotiating Common Pedestrian Obstacles

PubMed Central

Licence, Sammy; Smith, Robynne; McGuigan, Miranda P.; Earnest, Conrad P.

2015-01-01

Objectives Mobile phone texting is a common daily occurrence with a paucity of research examining corresponding gait characteristics. To date, most studies have participants walk in a straight line vs. overcoming barriers and obstacles that occur during regular walking. The aim of our study is to examine the effect of mobile phone texting during periods of cognitive distraction while walking and negotiating barriers synonymous with pedestrian traffic. Methods Thirty participants (18-50y) completed three randomized, counter-balanced walking tasks over a course during: (1) normal walking (control), (2) texting and walking, and (3) texting and walking whilst being cognitively distraction via a standard mathematical test performed while negotiating the obstacle course. We analyzed gait characteristics during course negotiation using a 3-dimensional motion analysis system and a general linear model and Dunnet-Hsu post-hoc procedure the normal walking condition to assess gait characteristic differences. Primary outcomes included the overall time to complete the course time and barrier contact. Secondary outcomes included obstacle clearance height, step frequency, step time, double support phase and lateral deviation. Results Participants took significantly longer (mean ± SD) to complete the course while texting (24.96±4.20 sec) and during cognitive distraction COG (24.09±3.36 sec) vs. normal walking (19.32±2.28 sec; all, P<0.001). No significant differences were noted for barrier contacts (P = 0.28). Step frequency, step time, double support phase and lateral deviation all increased in duration during the texting and cognitive distraction trial. Texting and being cognitively distracted also increased obstacle clearance versus the walking condition (all, P<0.02). Conclusions Texting while walking and/or being cognitively distracted significantly affect gait characteristics concordant to mobile phone usage resulting in a more cautious gate pattern. Future research should also examine a similar study in older participants who may be at a greater risk of tripping with such walking deviations. PMID:26222430

Google Maps offers a new way to evaluate claudication.

PubMed

Khambati, Husain; Boles, Kim; Jetty, Prasad

2017-05-01

Accurate determination of walking capacity is important for the clinical diagnosis and management plan for patients with peripheral arterial disease. The current "gold standard" of measurement is walking distance on a treadmill. However, treadmill testing is not always reflective of the patient's natural walking conditions, and it may not be fully accessible in every vascular clinic. The objective of this study was to determine whether Google Maps, the readily available GPS-based mapping tool, offers an accurate and accessible method of evaluating walking distances in vascular claudication patients. Patients presenting to the outpatient vascular surgery clinic between November 2013 and April 2014 at the Ottawa Hospital with vasculogenic calf, buttock, and thigh claudication symptoms were identified and prospectively enrolled in our study. Onset of claudication symptoms and maximal walking distance (MWD) were evaluated using four tools: history; Walking Impairment Questionnaire (WIQ), a validated claudication survey; Google Maps distance calculator (patients were asked to report their daily walking routes on the Google Maps-based tool runningmap.com, and walking distances were calculated accordingly); and treadmill testing for onset of symptoms and MWD, recorded in a double-blinded fashion. Fifteen patients were recruited for the study. Determination of walking distances using Google Maps proved to be more accurate than by both clinical history and WIQ, correlating highly with the gold standard of treadmill testing for both claudication onset (r = .805; P < .001) and MWD (r = .928; P < .0001). In addition, distances were generally under-reported on history and WIQ. The Google Maps tool was also efficient, with reporting times averaging below 4 minutes. For vascular claudicants with no other walking limitations, Google Maps is a promising new tool that combines the objective strengths of the treadmill test and incorporates real-world walking environments. It offers an accurate, efficient, inexpensive, and readily accessible way to assess walking distances in patients with peripheral vascular disease. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Identification of walking human model using agent-based modelling

NASA Astrophysics Data System (ADS)

Shahabpoor, Erfan; Pavic, Aleksandar; Racic, Vitomir

2018-03-01

The interaction of walking people with large vibrating structures, such as footbridges and floors, in the vertical direction is an important yet challenging phenomenon to describe mathematically. Several different models have been proposed in the literature to simulate interaction of stationary people with vibrating structures. However, the research on moving (walking) human models, explicitly identified for vibration serviceability assessment of civil structures, is still sparse. In this study, the results of a comprehensive set of FRF-based modal tests were used, in which, over a hundred test subjects walked in different group sizes and walking patterns on a test structure. An agent-based model was used to simulate discrete traffic-structure interactions. The occupied structure modal parameters found in tests were used to identify the parameters of the walking individual's single-degree-of-freedom (SDOF) mass-spring-damper model using 'reverse engineering' methodology. The analysis of the results suggested that the normal distribution with the average of μ = 2.85Hz and standard deviation of σ = 0.34Hz can describe human SDOF model natural frequency. Similarly, the normal distribution with μ = 0.295 and σ = 0.047 can describe the human model damping ratio. Compared to the previous studies, the agent-based modelling methodology proposed in this paper offers significant flexibility in simulating multi-pedestrian walking traffics, external forces and simulating different mechanisms of human-structure and human-environment interaction at the same time.

Effect of aquatic versus land based exercise programs on physical performance in severely burned patients: a randomized controlled trial.

PubMed

Zoheiry, Ibrahim M; Ashem, Haidy N; Ahmed, Hamada Ahmed Hamada; Abbas, Rami

2017-12-01

[Purpose] To compare the effect of an aquatic-based versus a land-based exercise regimen on the physical performance of severely burned patients. [Subjects and Methods] Forty patients suffering from severe burn (total body surface area more than 30%) were recruited from several outpatient clinics in Greater Cairo. Their ages ranged between 20 to 40 years and were randomly assigned into two equal groups: group (A), which received an aquatic based exercise program, and group (B), which received a land-based exercise program. The exercise program, which took place in 12 consecutive weeks, consisted of flexibility, endurance, and lower and upper body training. Physical performance was assessed using 30 seconds chair stand test, stair climb test, 30 meter fast paced walk test, time up and go test, 6-minute walk test and a VO2max evaluation. [Results] Significantly increase in the 30 second chair stand, 6-minute walk, 30 meter fast paced walk, stair climb, and VO2 max tests and significantly decrease in the time up and go test in group A (aquatic based exercise) compared with group B (a land-based exercise) at the post treatment. [Conclusion] Twelve-week program of an aquatic program yields improvement in both physical performance and VO2 max in patients with severe burns.

Effect of aquatic versus land based exercise programs on physical performance in severely burned patients: a randomized controlled trial

PubMed Central

Zoheiry, Ibrahim M.; Ashem, Haidy N.; Ahmed, Hamada Ahmed Hamada; Abbas, Rami

2017-01-01

[Purpose] To compare the effect of an aquatic-based versus a land-based exercise regimen on the physical performance of severely burned patients. [Subjects and Methods] Forty patients suffering from severe burn (total body surface area more than 30%) were recruited from several outpatient clinics in Greater Cairo. Their ages ranged between 20 to 40 years and were randomly assigned into two equal groups: group (A), which received an aquatic based exercise program, and group (B), which received a land-based exercise program. The exercise program, which took place in 12 consecutive weeks, consisted of flexibility, endurance, and lower and upper body training. Physical performance was assessed using 30 seconds chair stand test, stair climb test, 30 meter fast paced walk test, time up and go test, 6-minute walk test and a VO2max evaluation. [Results] Significantly increase in the 30 second chair stand, 6-minute walk, 30 meter fast paced walk, stair climb, and VO2 max tests and significantly decrease in the time up and go test in group A (aquatic based exercise) compared with group B (a land-based exercise) at the post treatment. [Conclusion] Twelve-week program of an aquatic program yields improvement in both physical performance and VO2 max in patients with severe burns. PMID:29643605

Effects of the six-minute walking test on dyspnea and activities of daily living in pneumoconiosis patients.

PubMed

Kim, Eun-Jin; Kim, Hye-Soon; Lee, Myung-Hee

2014-10-01

The purpose of this study was to examine the effects of walking exercise through a 6-min walking test on subjective dyspnea, pulmonary function test, arterial blood gas analysis, and activities of daily living to provide base data for the nursing intervention of pneumoconiosis patients. The subjects were pneumoconiosis patients men aged over 60. This quasi-experimental study was designed with a non-equivalent control group pre- and post-test design, and the study period was September to December 2013. Of the pneumoconiosis inpatient subjects, 39 were assigned to the experimental group and the 39 to the control group. Only the experimental group was subjected to a 6-min walking test three times a week for 10 weeks. Subjective dyspnea was measured based on anxiety about dyspnea during and after the exercise. FEV1% prediction and FEV1/FVC% were used to measure the pulmonary function. The arterial blood gas was measured based on the pH, PaO2, PaCO2, and activities of daily living. The data were analyzed through an χ(2) and t-test. The study results showed that the 6-min walking test reduced the anxiety about dyspnea of the pneumoconiosis patients during the exercise, moderated the dyspnea index after the performance of the activities, and improved the patients' ability to perform activities of daily living. Thus, walking exercise seems to be an effective nursing intervention to maintain the respiratory rehabilitation outcomes by minimizing the pneumoconiosis patients' burden.

500-m and 1000-m moderate walks equally assess cardiorespiratory fitness in male outpatients with cardiovascular diseases.

PubMed

Mazzoni, Gianni; Chiaranda, Giorgio; Myers, Jonathan; Sassone, Biagio; Pasanisi, Giovanni; Mandini, Simona; Volpato, Stefano; Conconi, Francesco; Grazzi, Giovanni

2017-09-29

The walking speed maintained during a moderate 1-km treadmill walk (1k-TWT) has been demonstrated to be a valid tool for estimating peak oxygen uptake (VO2peak), and to be inversely related to long-term survival and hospitalization in outpatients with cardiovascular disease (CVD). We aimed to examine whether 500-m and 1-k moderate treadmill-walking tests equally estimate VO2peak in male outpatients with CVD. 142 clinically stable male outpatients with CVD, aged 34-92 years, referred to an exercise-based secondary prevention program, performed a moderate and perceptually-regulated (11-13/20 on the Borg scale) 1k- TWT. Age, height, weight, time to walk 500-m and the entire 1000-m, and the corresponding heart rates were entered into validated equations to estimate VO2peak. VO2peak estimated from the 500-m test was not different from that estimated from the 1k test (25.2±5.1 vs 25.1±5.2 mL/kg/min). The correlation coefficient between the two was 0.98. The slope and the intercept of the relationship between the 500-m and 1k tests were not different from the line of identity. Bland-Altman analysis demonstrated that 96% of the data points were within two standard deviations (from -1.9 to 1.7 mL/kg/min). The 500-m treadmill-walking test is a reliable method for estimating VO2peak in stable male outpatients with CVD. A shorter version of the test, 500-m, provides similar information as that from the original 1k test, but is more time efficient. These findings have practical implications in the context of transitioning patients from clinically based and supervised programs to fitness facilities or self-guided exercise programs.

Longitudinal relationships among posturography and gait measures in multiple sclerosis.

PubMed

Fritz, Nora E; Newsome, Scott D; Eloyan, Ani; Marasigan, Rhul Evans R; Calabresi, Peter A; Zackowski, Kathleen M

2015-05-19

Gait and balance dysfunction frequently occurs early in the multiple sclerosis (MS) disease course. Hence, we sought to determine the longitudinal relationships among quantitative measures of gait and balance in individuals with MS. Fifty-seven ambulatory individuals with MS (28 relapsing-remitting, 29 progressive) were evaluated using posturography, quantitative sensorimotor and gait measures, and overall MS disability with the Expanded Disability Status Scale at each session. Our cohort's age was 45.8 ± 10.4 years (mean ± SD), follow-up time 32.8 ± 15.4 months, median Expanded Disability Status Scale score 3.5, and 56% were women. Poorer performance on balance measures was related to slower walking velocity. Two posturography measures, the anterior-posterior sway and sway during static eyes open, feet apart conditions, were significant contributors to walk velocity over time (approximate R(2) = 0.95), such that poorer performance on the posturography measures was related to slower walking velocity. Similarly, the anterior-posterior sway and sway during static eyes closed, feet together conditions were also significant contributors to the Timed 25-Foot Walk performance over time (approximate R(2) = 0.83). This longitudinal cohort study establishes a strong relationship between clinical gait measures and posturography. The data show that increases in static posturography and reductions in dynamic posturography are associated with a decline in walk velocity and Timed 25-Foot Walk performance over time. Furthermore, longitudinal balance measures predict future walking performance. Quantitative walking and balance measures are important additions to clinical testing to explore longitudinal change and understand fall risk in this progressive disease population. © 2015 American Academy of Neurology.

Action observation training of community ambulation for improving walking ability of patients with post-stroke hemiparesis: a randomized controlled pilot trial.

PubMed

Park, Hyun-Ju; Oh, Duck-Won; Choi, Jong-Duk; Kim, Jong-Man; Kim, Suhn-Yeop; Cha, Yong-Jun; Jeon, Su-Jin

2017-08-01

To investigate the effects of action observation training involving community-based ambulation for improving walking ability after stroke. Randomized, controlled pilot study. Inpatient rehabilitation hospital. A total of 25 inpatients with post-stroke hemiparesis were randomly assigned to either the experimental group ( n = 12) or control group ( n = 13). Subjects of the experimental group watched video clips demonstrating four-staged ambulation training with a more complex environment factor for 30 minutes, three times a week for four weeks. Meanwhile, subjects of the control group watched video clips, which showed different landscape pictures. Walking function was evaluated before and after the four-week intervention using a 10-m walk test, community walk test, activities-specific balance confidence scale, and spatiotemporal gait measures. Changes in the values for the 10-m walk test (0.17 ±0.19 m/s vs. 0.05 ±0.08 m/s), community walk test (-151.42 ±123.82 seconds vs. 67.08 ±176.77 seconds), and activities-specific balance confidence (6.25 ±5.61 scores vs. 0.72 ±2.24 scores) and the spatiotemporal parameters (i.e. stride length (19.00 ±11.34 cm vs. 3.16 ±11.20 cm), single support (5.87 ±5.13% vs. 0.25 ±5.95%), and velocity (15.66 ±12.34 cm/s vs. 2.96 ±10.54 cm/s)) indicated a significant improvement in the experimental group compared with the control group. In the experimental group, walking function and ambulation confidence was significantly different between the pre- and post-intervention, whereas the control group showed a significant difference only in the 10-m walk test. Action observation training of community ambulation may be favorably used for improving walking function of patients with post-stroke hemiparesis.

42 CFR 84.104 - Gas tightness test; minimum requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Section 84.104 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL... times respectively. Walks at 4.8 km. (3 miles) per hour 3 5 3 4 8 12 18 Sampling and readings 2 2 2 2 2 Walks at 4.8 km. (3 miles) per hour 3 5 8 12 18 Sampling and readings 2 2 2 2 2 Walks at 4.8 km. (3...

42 CFR 84.104 - Gas tightness test; minimum requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Section 84.104 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL... times respectively. Walks at 4.8 km. (3 miles) per hour 3 5 3 4 8 12 18 Sampling and readings 2 2 2 2 2 Walks at 4.8 km. (3 miles) per hour 3 5 8 12 18 Sampling and readings 2 2 2 2 2 Walks at 4.8 km. (3...

Increasing walking among older people: A test of behaviour change techniques using factorial randomised N-of-1 trials

PubMed Central

Nyman, Samuel R.; Goodwin, Kelly; Kwasnicka, Dominika; Callaway, Andrew

2016-01-01

Objective: Evaluations of techniques to promote physical activity usually adopt a randomised controlled trial (RCT). Such designs inform how a technique performs on average but cannot be used for treatment of individuals. Our objective was to conduct the first N-of-1 RCTs of behaviour change techniques with older people and test the effectiveness of the techniques for increasing walking within individuals. Design: Eight adults aged 60–87 were randomised to a 2 (goal-setting vs. active control) × 2 (self-monitoring vs. active control) factorial RCT over 62 days. The time series data were analysed for each single case using linear regressions. Main outcome measures: Walking was objectively measured using pedometers. Results: Compared to control days, goal-setting increased walking in 4 out of 8 individuals and self-monitoring increased walking in 7 out of 8 individuals. While the probability for self-monitoring to be effective in 7 out of 8 participants was beyond chance (p = .03), no intervention effect was significant for individual participants. Two participants had a significant but small linear decrease in walking over time. Conclusion: We demonstrate the utility of N-of-1 trials for advancing scientific enquiry of behaviour change and in practice for increasing older people’s physical activity. PMID:26387689

Longitudinal timed function tests in Duchenne muscular dystrophy: ImagingDMD cohort natural history.

PubMed

Arora, Harneet; Willcocks, Rebecca J; Lott, Donovan J; Harrington, Ann T; Senesac, Claudia R; Zilke, Kirsten L; Daniels, Michael J; Xu, Dandan; Tennekoon, Gihan I; Finanger, Erika L; Russman, Barry S; Finkel, Richard S; Triplett, William T; Byrne, Barry J; Walter, Glenn A; Sweeney, H Lee; Vandenborne, Krista

2018-05-09

Tests of ambulatory function are common clinical trial endpoints in Duchenne muscular dystrophy (DMD). The ImagingDMD study has generated a large data set using these tests, which can describe the contemporary natural history of DMD in 5-12.9 year olds. 92 corticosteroid treated boys with DMD and 45 controls participated in this longitudinal study. Subjects performed the 6 minute walk test (6MWT) and timed function tests (TFTs: 10m walk/run, 4 stairs, supine to stand). Boys with DMD had impaired functional performance even at 5-6.9 years. Boys older than 7 had significant declines in function over 1 year for 10m walk/run and 6MWT. 80% of subjects could perform all functional tests at 9 years old. TFTs appear to be slightly more responsive and predictive of disease progression than 6MWT in 7-12.9 year olds. This study provides insight into the contemporary natural history of key functional endpoints in DMD. This article is protected by copyright. All rights reserved. © 2018 Wiley Periodicals, Inc.

Relationship between physical activity, physical fitness and multiple metabolic risk in youths from Muzambinho's study.

PubMed

Barbosa, João Paulo Dos Anjos Souza; Basso, Luciano; Seabra, André; Prista, Antonio; Tani, Go; Maia, José António Ribeiro; Forjaz, Cláudia Lúcia De Moraes

2016-08-01

Negative associations between physical activity (PA), physical fitness and multiple metabolic risk factors (MMRF) in youths from populations with low PA are reported. The persistence of this association in moderately-to highly active populations is not, however, well established. The aim of the present study was to investigate this association in a Brazilian city with high frequency of active youths. We assessed 122 subjects (9.9 ± 1.3 years) from Muzambinho city. Body mass index, waist circumference, glycaemia, cholesterolaemia, systolic and diastolic blood pressures were measured. Maximal handgrip strength and one-mile walk/run test were used. Leisure time PA was assessed by interview. Poisson regression was used in the analysis. The model explained 11% of the total variance. Only relative muscular strength and one-mile walk/run were statistically significant (p < .05). Those who needed more time to cover the one-mile walk/run test had an increased in metabolic risk of 11%, and those with greater strength reduced the risk by about 82%. In conclusion, children and youths from an active population who need less time to cover the one-mile walk/run test or who had greater muscular strength showed a reduced metabolic risk. These results suggest that even in children and youths with high leisure time PA, a greater aerobic fitness and strength might help to further reduce their MMRF.

Oxygen uptake on-kinetics during six-minute walk test predicts short-term outcomes after off-pump coronary artery bypass surgery.

PubMed

Rocco, Isadora Salvador; Viceconte, Marcela; Pauletti, Hayanne Osiro; Matos-Garcia, Bruna Caroline; Marcondi, Natasha Oliveira; Bublitz, Caroline; Bolzan, Douglas William; Moreira, Rita Simone Lopes; Reis, Michel Silva; Hossne, Nelson Américo; Gomes, Walter José; Arena, Ross; Guizilini, Solange

2017-12-26

We aimed to investigate the ability of oxygen uptake kinetics to predict short-term outcomes after off-pump coronary artery bypass grafting. Fifty-two patients aged 60.9 ± 7.8 years waiting for off-pump coronary artery bypass surgery were evaluated. The 6-min walk test distance was performed pre-operatively, while simultaneously using a portable cardiopulmonary testing device. The transition of oxygen uptake kinetics from rest to exercise was recorded to calculate oxygen uptake kinetics fitting a monoexponential regression model. Oxygen uptake at steady state, constant time, and mean response time corrected by work rate were analysed. Short-term clinical outcomes were evaluated during the early post-operative of off-pump coronary artery bypass surgery. Multivariate analysis showed body mass index, surgery time, and mean response time corrected by work rate as independent predictors for short-term outcomes. The optimal mean response time corrected by work rate cut-off to estimate short-term clinical outcomes was 1.51 × 10 -3  min 2 /ml. Patients with slower mean response time corrected by work rate demonstrated higher rates of hypertension, diabetes, EuroSCOREII, left ventricular dysfunction, and impaired 6-min walk test parameters. The per cent-predicted distance threshold of 66% in the pre-operative was associated with delayed oxygen uptake kinetics. Pre-operative oxygen uptake kinetics during 6-min walk test predicts short-term clinical outcomes after off-pump coronary artery bypass surgery. From a clinically applicable perspective, a threshold of 66% of pre-operative predicted 6-min walk test distance indicated slower kinetics, which leads to longer intensive care unit and post-surgery hospital length of stay. Implications for rehabilitation Coronary artery bypass grafting is a treatment aimed to improve expectancy of life and prevent disability due to the disease progression; The use of pre-operative submaximal functional capacity test enabled the identification of patients with high risk of complications, where patients with delayed oxygen uptake kinetics exhibited worse short-term outcomes; Our findings suggest the importance of the rehabilitation in the pre-operative in order to "pre-habilitate" the patients to the surgical procedure; Faster oxygen uptake on-kinetics could be achieved by improving the oxidative capacity of muscles and cardiovascular conditioning through rehabilitation, adding better results following cardiac surgery.

Safety and Feasibility of the 6-Minute Walk Test in Patients with Acute Stroke.

PubMed

Kubo, Hiroki; Nozoe, Masafumi; Yamamoto, Miho; Kamo, Arisa; Noguchi, Madoka; Kanai, Masashi; Mase, Kyoshi; Shimada, Shinichi

2018-06-01

Our objective was to investigate the safety and feasibility of the 6-minute walk test in patients with acute stroke. Consecutive patients with acute stroke, admitted to the Itami Kosei Neurosurgical Hospital from September 2016 to April 2017 were enrolled. Walking capacity was assessed by a physical therapist using the 6-minute walk test in 94 patients with acute stroke within 14 days of hospital admission. The primary outcomes were safety (i.e., the prevalence of new adverse events during and after the test) and feasibility (i.e., test completion rate) of the 6-minute walk test. The 6-minute walk test was performed for a mean duration of 5.1 days (standard deviation, 2.6 days) after hospital admission. Seventy patients (74.5%) could walk without standby assistance or a walking aid, and 24 patients (25.5%) could walk without standby assistance but with a walking aid. The average distance walked by patients during the 6-minute walk test was 331 m (standard deviation, 107.2 m). Adverse events following the 6-minute walk test occurred in 6 patients (6.4%) and included stroke progression, stroke recurrence, seizures, and neurological deterioration. Heart rate increase (>120 beats/min) occurred in 3 patients (3.2%) during the test. Lastly, 6 patients (6.4%) were unable to complete the 6-minute walk test. Although performance in the 6-minute walk test was decreased in patients with acute stroke, the test itself appears to be safe and feasible in this patient population. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Treadmill sideways gait training with visual blocking for patients with brain lesions.

PubMed

Kim, Tea-Woo; Kim, Yong-Wook

2014-09-01

[Purpose] The aim of this study was to verify the effect of sideways treadmill training with and without visual blocking on the balance and gait function of patients with brain lesions. [Subjects] Twenty-four stroke and traumatic brain injury subjects participated in this study. They were divided into two groups: an experimental group (12 subjects) and a control group (12 subjects). [Methods] Each group executed a treadmill training session for 20 minutes, three times a week, for 6 weeks. The sideways gait training on the treadmill was performed with visual blocking by the experimental group and with normal vision by the control group. A Biodex Gait Trainer 2 was used to assess the gait function. It was used to measure walking speed, walking distance, step length, and stance time on each foot. The Five-Times-Sit-To-Stand test (FTSST) and Timed Up and Go test (TUG) were used as balance measures. [Results] The sideways gait training with visual blocking group showed significantly improved walking speed, walking distance, step length, and stance time on each foot after training; FTSST and TUG times also significantly improved after training in the experimental group. Compared to the control group, the experimental group showed significant increases in stance time on each foot. [Conclusion] Sideways gait training on a treadmill with visual blocking performed by patients with brain lesions significantly improved their balance and gait function.

The effect of impedance-controlled robotic gait training on walking ability and quality in individuals with chronic incomplete spinal cord injury: an explorative study.

PubMed

Fleerkotte, Bertine M; Koopman, Bram; Buurke, Jaap H; van Asseldonk, Edwin H F; van der Kooij, Herman; Rietman, Johan S

2014-03-04

There is increasing interest in the use of robotic gait-training devices in walking rehabilitation of incomplete spinal cord injured (iSCI) individuals. These devices provide promising opportunities to increase the intensity of training and reduce physical demands on therapists. Despite these potential benefits, robotic gait-training devices have not yet demonstrated clear advantages over conventional gait-training approaches, in terms of functional outcomes. This might be due to the reduced active participation and step-to-step variability in most robotic gait-training strategies, when compared to manually assisted therapy. Impedance-controlled devices can increase active participation and step-to-step variability. The aim of this study was to assess the effect of impedance-controlled robotic gait training on walking ability and quality in chronic iSCI individuals. A group of 10 individuals with chronic iSCI participated in an explorative clinical trial. Participants trained three times a week for eight weeks using an impedance-controlled robotic gait trainer (LOPES: LOwer extremity Powered ExoSkeleton). Primary outcomes were the 10-meter walking test (10 MWT), the Walking Index for Spinal Cord Injury (WISCI II), the six-meter walking test (6 MWT), the Timed Up and Go test (TUG) and the Lower Extremity Motor Scores (LEMS). Secondary outcomes were spatiotemporal and kinematics measures. All participants were tested before, during, and after training and at 8 weeks follow-up. Participants experienced significant improvements in walking speed (0.06 m/s, p = 0.008), distance (29 m, p = 0.005), TUG (3.4 s, p = 0.012), LEMS (3.4, p = 0.017) and WISCI after eight weeks of training with LOPES. At the eight-week follow-up, participants retained the improvements measured at the end of the training period. Significant improvements were also found in spatiotemporal measures and hip range of motion. Robotic gait training using an impedance-controlled robot is feasible in gait rehabilitation of chronic iSCI individuals. It leads to improvements in walking ability, muscle strength, and quality of walking. Improvements observed at the end of the training period persisted at the eight-week follow-up. Slower walkers benefit the most from the training protocol and achieve the greatest relative improvement in speed and walking distance.

The effect of impedance-controlled robotic gait training on walking ability and quality in individuals with chronic incomplete spinal cord injury: an explorative study

PubMed Central

2014-01-01

Background There is increasing interest in the use of robotic gait-training devices in walking rehabilitation of incomplete spinal cord injured (iSCI) individuals. These devices provide promising opportunities to increase the intensity of training and reduce physical demands on therapists. Despite these potential benefits, robotic gait-training devices have not yet demonstrated clear advantages over conventional gait-training approaches, in terms of functional outcomes. This might be due to the reduced active participation and step-to-step variability in most robotic gait-training strategies, when compared to manually assisted therapy. Impedance-controlled devices can increase active participation and step-to-step variability. The aim of this study was to assess the effect of impedance-controlled robotic gait training on walking ability and quality in chronic iSCI individuals. Methods A group of 10 individuals with chronic iSCI participated in an explorative clinical trial. Participants trained three times a week for eight weeks using an impedance-controlled robotic gait trainer (LOPES: LOwer extremity Powered ExoSkeleton). Primary outcomes were the 10-meter walking test (10MWT), the Walking Index for Spinal Cord Injury (WISCI II), the six-meter walking test (6MWT), the Timed Up and Go test (TUG) and the Lower Extremity Motor Scores (LEMS). Secondary outcomes were spatiotemporal and kinematics measures. All participants were tested before, during, and after training and at 8 weeks follow-up. Results Participants experienced significant improvements in walking speed (0.06 m/s, p = 0.008), distance (29 m, p = 0.005), TUG (3.4 s, p = 0.012), LEMS (3.4, p = 0.017) and WISCI after eight weeks of training with LOPES. At the eight-week follow-up, participants retained the improvements measured at the end of the training period. Significant improvements were also found in spatiotemporal measures and hip range of motion. Conclusion Robotic gait training using an impedance-controlled robot is feasible in gait rehabilitation of chronic iSCI individuals. It leads to improvements in walking ability, muscle strength, and quality of walking. Improvements observed at the end of the training period persisted at the eight-week follow-up. Slower walkers benefit the most from the training protocol and achieve the greatest relative improvement in speed and walking distance. PMID:24594284

The immediate and long-term effects of a walking-skill program compared to usual physiotherapy care in patients who have undergone total knee arthroplasty (TKA): a randomized controlled trial.

PubMed

Bruun-Olsen, Vigdis; Heiberg, Kristi Elisabeth; Wahl, Astrid Klopstad; Mengshoel, Anne Marit

2013-01-01

To examine the immediate and long-term effects of a walking-skill program compared with usual physiotherapy on physical function, pain and perceived self-efficacy in patients after total knee arthroplasty (TKA). A single blind randomized controlled trial design was applied. Fifty-seven patients with primary TKA, mean age of 69 years (SD ± 9), were randomly assigned to a walking-skill program emphasizing weight-bearing exercises or usual physiotherapy. Outcomes were assessed before the interventions started at 6 weeks postoperatively (T1), directly after the interventions at 12-14 weeks (T2) and 9 months after the interventions (T3). Walking was the primary outcome, assessed by the 6 min walk test (6MWT). The secondary outcomes were timed stair climbing, timed stands, Figure-of-eight test, Index of muscle function, active knee range of motion, Knee Injury and Osteoarthritis Outcome Score and self-efficacy score. From T1 to T2, a better 6MWT score was found in favor of the walking-skill program of 39 m (2-76), p = 0.04. The difference between the groups in 6MWT persisted at T3, 44 m (8-80), p = 0.02. No differences in other outcome measures were found. The walking-skill program had better effect on walking than usual physiotherapy. Weight bearing was tolerated. Implications for Rehabilitation Weight-bearing exercises are tolerated by the patients in the early stage after TKA. Physiotherapy that focuses on learning different ways of walking through practice may be a plausible way to train patients after TKA.

The Effect of Chinese Yuanji-Dance on Dynamic Balance and the Associated Attentional Demands in Elderly Adults

PubMed Central

Wu, Wen-Lan; Wei, Ta-Sen; Chen, Shen-Kai; Chang, Jyh-Jong; Guo, Lan-Yuen; Lin, Hwai-Ting

2010-01-01

Walking performance changes with age. This has implications for the problem of falls in older adults. The aim of this study was to investigate the effects of Yuanji-Dance practice on walking balance and the associated attention demand in healthy elderly. Fifteen community-dwelling elderly (comparison group, no regular exercise habit) and fifteen Yuanji- Dance elderly (exercise group, dancing experience: 5.40 ± 1.95 years), aged 60-70 years, were included in this study. The subjects in exercise group participated in a 90-minute Yuanji-Dance practice at least three times per week and the comparison group continued their normal daily physical activity. Walking balance measures (including walking velocity, step length, step width, and percentage of time spent in double limb support, COM velocity and COM-COP inclination angles) and attentional demand tests (button reaction time and accuracy) were conducted under different conditions. Our results showed that stride lengths, walking velocities, peak A/P velocities (AP V) of the COM, medial COM-COP inclination (M angle) angles, reaction time, and accuracy decrease significantly as the dual-task (walking plus hand button pressing tasks) applied for either the comparison or exercise groups. These results demonstrated that walking performance is attenuated in our elderly participants as the cognitive tasks applied. Analysis also identified a significantly faster RT for our exercise group both in standing and walking conditions. This may indicate that physical exercise (Yuanji-Dance) may have facilitating effects on general cognitive and perceptual- motor functions. This implies that Chinese Yuanji-Dance practice for elderly adults may improve their personal safety when walking especially under the condition of multiple task demand. Key points The purpose of this study was to investigate the training effects of a Chinese traditional exercise, Yuanji-Dance, on walking balance and the associated attention demand in the healthy elderly. Walking performance is attenuated in elderly participants as the cognitive tasks applied. A significantly faster reaction time for our exercise group both in standing and walking conditions. Yuanji-Dance exercise training can improve the information processing speed of elderly people and has no influence of the dynamic walking balance. PMID:24149395

Children's GPS-determined versus self-reported transport in leisure time and associations with parental perceptions of the neighborhood environment.

PubMed

Vanwolleghem, Griet; Schipperijn, Jasper; Gheysen, Freja; Cardon, Greet; De Bourdeaudhuij, Ilse; Van Dyck, Delfien

2016-05-05

This study aimed to examine both GPS-determined and self-reported walking, cycling and passive transport in leisure time during week- and weekend-days among 10 to 12-year old children. Comparisons between GPS-determined and self-reported transport in leisure time were investigated. Second, associations between parental perceptions of the neighborhood environment and GPS-determined walking, cycling and passive transport in leisure time were studied. Children (10 to 12-years old; n = 126) wore a GPS device and an accelerometer for 7 consecutive days to assess objectively measured transport in leisure time and filled out a diary to assess self-reported transport in leisure time. Parents completed a questionnaire to assess parental perceptions of the neighborhood environment. Pearson correlations and t-tests were used to test for concurrent validity and differences between GPS-determined and self-reported transport in leisure time. Generalized linear models were used to determine the associations between the parental perceptions of the neighborhood environment and GPS-determined transport in leisure time. Overall, children under-reported their walking and cycling in leisure time, compared to GPS-determined measures (all p values <0.001). However, children reported their passive transport in leisure time during weekend days quite accurate. GPS-determined measures revealed that children walked most during weekdays (M = 3.96 trips/day; 26.10 min/day) and used passive transport more frequently during weekend days (M = 2.12 trips/day; 31.39 min/day). Only a few parental perceived environmental attributes of the neighborhood (i.e. residential density, land use mix access, quality and availability of walking and cycling facilities, and aesthetics) were significantly associated with children's GPS-determined walking, cycling or passive transport in leisure time. To accurately assess children's active transport in leisure time, GPS measures are recommended over self-reports. More research using GPS with a focus on children's transport in leisure time and investigating the associations with parental perceptions of the neighborhood environment is needed to confirm the results of the present study.

First Steps into Language? Examining the Specific Longitudinal Relations between Walking, Exploration and Linguistic Skills

PubMed Central

Oudgenoeg-Paz, Ora; Volman, M(Chiel). J. M.; Leseman, Paul P. M.

2016-01-01

Recent empirical evidence demonstrates relationships between motor and language development that are partially mediated by exploration. This is in line with the embodied cognition approach to development that views language as grounded in real-life sensorimotor interactions with the environment. This view implies that the relations between motor and linguistic skills should be specific. Moreover, as motor development initially changes the possibilities children have to explore the environment, initial relations between motor and linguistic skills should become weaker over time. Empirical evidence pertaining to the duration and specificity of these relations is still lacking. The current study investigated longitudinal relations between attainment of walking and the development of several linguistic skills, and tested whether exploration through self-locomotion mediated these relations. Linguistic skills were measured at age 43 months, which is later than the age used in previous studies. Three hypotheses were tested: (1) the relations between walking and language found at younger ages will decrease over time (2) exploration through self-locomotion will remain an important predictor of spatial language (3) no relation will be found between walking, exploration and the use of grammatical and lexical categories and between exploration and general vocabulary. Thirty-one Dutch children took part in a longitudinal study. Parents reported about age of attainment of walking. Exploration through self-locomotion was measured using observations of play with a standard set of toys at age 20 months. Receptive vocabulary, spatial language and use of grammatical and lexical categories were measured at age 43 months using (standard) tests. Results reveal that age of walking does not directly predict spatial language at age 43 months. Exploration through self-locomotion does significantly and completely mediate the indirect effect of age of walking on spatial language. Moreover, neither age of walking nor exploration predict general vocabulary and the use of grammatical and lexical categories. Results support the idea that the initial relations between motor development and linguistic skills decrease over time and that these relations are specific and intrinsically dependent on the information children pick up through the execution of specific motor activities. PMID:27729885

First Steps into Language? Examining the Specific Longitudinal Relations between Walking, Exploration and Linguistic Skills.

PubMed

Oudgenoeg-Paz, Ora; Volman, M Chiel J M; Leseman, Paul P M

2016-01-01

Recent empirical evidence demonstrates relationships between motor and language development that are partially mediated by exploration. This is in line with the embodied cognition approach to development that views language as grounded in real-life sensorimotor interactions with the environment. This view implies that the relations between motor and linguistic skills should be specific. Moreover, as motor development initially changes the possibilities children have to explore the environment, initial relations between motor and linguistic skills should become weaker over time. Empirical evidence pertaining to the duration and specificity of these relations is still lacking. The current study investigated longitudinal relations between attainment of walking and the development of several linguistic skills, and tested whether exploration through self-locomotion mediated these relations. Linguistic skills were measured at age 43 months, which is later than the age used in previous studies. Three hypotheses were tested: (1) the relations between walking and language found at younger ages will decrease over time (2) exploration through self-locomotion will remain an important predictor of spatial language (3) no relation will be found between walking, exploration and the use of grammatical and lexical categories and between exploration and general vocabulary. Thirty-one Dutch children took part in a longitudinal study. Parents reported about age of attainment of walking. Exploration through self-locomotion was measured using observations of play with a standard set of toys at age 20 months. Receptive vocabulary, spatial language and use of grammatical and lexical categories were measured at age 43 months using (standard) tests. Results reveal that age of walking does not directly predict spatial language at age 43 months. Exploration through self-locomotion does significantly and completely mediate the indirect effect of age of walking on spatial language. Moreover, neither age of walking nor exploration predict general vocabulary and the use of grammatical and lexical categories. Results support the idea that the initial relations between motor development and linguistic skills decrease over time and that these relations are specific and intrinsically dependent on the information children pick up through the execution of specific motor activities.

Risk Factors for Falls in Older Adults With Mild Cognitive Impairment and Mild Alzheimer Disease.

PubMed

Ansai, Juliana Hotta; de Andrade, Larissa Pires; Masse, Fernando Arturo Arriagada; Gonçalves, Jessica; de Medeiros Takahashi, Anielle Cristhine; Vale, Francisco Assis Carvalho; Rebelatto, José Rubens

2017-03-03

Understanding fall risk factors in people with mild cognitive impairment (MCI) and Alzheimer disease (AD) can help to establish specific plans for prevention of falls. The purpose of this study was to identify fall risk factors in older adults with MCI and mild AD. A prospective study was conducted with community-dwelling older adults (40 MCI; 38 mild AD). The assessments consisted of sociodemographic and health variables, caloric expenditure, functional status, functional mobility (10-m walk test, dual-task test, and transition Timed Up and Go phases), cognitive domains, and depressive symptoms. Falls were recorded for 6 months by a falls calendar and monthly telephone calls. Falls were reported in 52.6% and 51.4% of people with MCI and mild AD, respectively. Among people with MCI, lower functional status, higher time spent on walk and dual task tests, and higher depressive symptom scores were associated with falls. Higher time spent on the dual-task test was independently associated with falls. Among people with mild AD, falls were associated with lower time spent on the walk test and turn-to-sit phase, and a higher visuospatial domain score. Lower time spent on the turn-to-sit phase was identified as an independent predictor of falls. Careful attention should be given to dual-task and turn-to-sit activities when detecting risk of falls among older people with MCI and mild AD.

A Simple Exoskeleton That Assists Plantarflexion Can Reduce the Metabolic Cost of Human Walking

PubMed Central

Malcolm, Philippe; Derave, Wim; Galle, Samuel; De Clercq, Dirk

2013-01-01

Background Even though walking can be sustained for great distances, considerable energy is required for plantarflexion around the instant of opposite leg heel contact. Different groups attempted to reduce metabolic cost with exoskeletons but none could achieve a reduction beyond the level of walking without exoskeleton, possibly because there is no consensus on the optimal actuation timing. The main research question of our study was whether it is possible to obtain a higher reduction in metabolic cost by tuning the actuation timing. Methodology/Principal Findings We measured metabolic cost by means of respiratory gas analysis. Test subjects walked with a simple pneumatic exoskeleton that assists plantarflexion with different actuation timings. We found that the exoskeleton can reduce metabolic cost by 0.18±0.06 W kg−1 or 6±2% (standard error of the mean) (p = 0.019) below the cost of walking without exoskeleton if actuation starts just before opposite leg heel contact. Conclusions/Significance The optimum timing that we found concurs with the prediction from a mathematical model of walking. While the present exoskeleton was not ambulant, measurements of joint kinetics reveal that the required power could be recycled from knee extension deceleration work that occurs naturally during walking. This demonstrates that it is theoretically possible to build future ambulant exoskeletons that reduce metabolic cost, without power supply restrictions. PMID:23418524

Is physiotherapy integrated virtual walking effective on pain, function, and kinesiophobia in patients with non-specific low-back pain? Randomised controlled trial.

PubMed

Yilmaz Yelvar, Gul Deniz; Çırak, Yasemin; Dalkılınç, Murat; Parlak Demir, Yasemin; Guner, Zeynep; Boydak, Ayşenur

2017-02-01

According to literature, virtual reality was found to reduce pain and kinesiophobia in patients with chronic pain. The purpose of the study was to investigate short-term effect of the virtual reality on pain, function, and kinesiophobia in patients with subacute and chronic non-specific low-back pain METHODS: This randomised controlled study in which 44 patients were randomly assigned to the traditional physiotherapy (control group, 22 subjects) or virtual walking integrated physiotherapy (experimental group, 22 subjects). Before and after treatment, Visual Analog Scale (VAS), TAMPA Kinesiophobia Scale (TKS), Oswestry Disability Index (ODI), Nottingham Health Profile (NHP), Timed-up and go Test (TUG), 6-Minute Walk Test (6MWT), and Single-Leg Balance Test were assessed. The interaction effect between group and time was assessed by using repeated-measures analysis of covariance. After treatment, both groups showed improvement in all parameters. However, VAS, TKS, TUG, and 6MWT scores showed significant differences in favor of the experimental group. Virtual walking integrated physiotherapy reduces pain and kinesiophobia, and improved function in patients with subacute and chronic non-specific low-back pain in short term.

Exercise in Patients on Dialysis: A Multicenter, Randomized Clinical Trial

PubMed Central

Manfredini, Fabio; Mallamaci, Francesca; D’Arrigo, Graziella; Baggetta, Rossella; Bolignano, Davide; Torino, Claudia; Lamberti, Nicola; Bertoli, Silvio; Ciurlino, Daniele; Rocca-Rey, Lisa; Barillà, Antonio; Battaglia, Yuri; Rapanà, Renato Mario; Zuccalà, Alessandro; Bonanno, Graziella; Fatuzzo, Pasquale; Rapisarda, Francesco; Rastelli, Stefania; Fabrizi, Fabrizio; Messa, Piergiorgio; De Paola, Luciano; Lombardi, Luigi; Cupisti, Adamasco; Fuiano, Giorgio; Lucisano, Gaetano; Summaria, Chiara; Felisatti, Michele; Pozzato, Enrico; Malagoni, Anna Maria; Castellino, Pietro; Aucella, Filippo; Abd ElHafeez, Samar; Provenzano, Pasquale Fabio; Tripepi, Giovanni; Catizone, Luigi

2017-01-01

Previous studies have suggested the benefits of physical exercise for patients on dialysis. We conducted the Exercise Introduction to Enhance Performance in Dialysis trial, a 6-month randomized, multicenter trial to test whether a simple, personalized walking exercise program at home, managed by dialysis staff, improves functional status in adult patients on dialysis. The main study outcomes included change in physical performance at 6 months, assessed by the 6-minute walking test and the five times sit-to-stand test, and in quality of life, assessed by the Kidney Disease Quality of Life Short Form (KDQOL-SF) questionnaire. We randomized 296 patients to normal physical activity (control; n=145) or walking exercise (n=151); 227 patients (exercise n=104; control n=123) repeated the 6-month evaluations. The distance covered during the 6-minute walking test improved in the exercise group (mean distance±SD: baseline, 328±96 m; 6 months, 367±113 m) but not in the control group (baseline, 321±107 m; 6 months, 324±116 m; P<0.001 between groups). Similarly, the five times sit-to-stand test time improved in the exercise group (mean time±SD: baseline, 20.5±6.0 seconds; 6 months, 18.2±5.7 seconds) but not in the control group (baseline, 20.9±5.8 seconds; 6 months, 20.2±6.4 seconds; P=0.001 between groups). The cognitive function score (P=0.04) and quality of social interaction score (P=0.01) in the kidney disease component of the KDQOL-SF improved significantly in the exercise arm compared with the control arm. Hence, a simple, personalized, home-based, low-intensity exercise program managed by dialysis staff may improve physical performance and quality of life in patients on dialysis. PMID:27909047

Interaction of obstructive sleep apnoea and cognitive impairment with slow gait speed in middle-aged and older adults.

PubMed

Lee, Sunghee; Shin, Chol

2017-07-01

to investigate whether slow gait speed is associated with cognitive impairment and further whether the association is modified by obstructive sleep apnoea (OSA). in total, 2,222 adults aged 49-80 years, free from dementia, stroke and head injury were asked to walk a 4-m course at fast and usual gait speeds. The time taken to walk was measured. All participants completed the Korean Mini-Mental State Examination, which was validated in the Korean language, to assess cognitive function. Additionally, the participants completed a polysomnography test to ascertain OSA (defined as an apnoea-hypopnoea index ≥15). Multivariable linear regression models were utilised to test the associations. time taken to walk 4 m showed significant inverse associations with cognitive scores (P value = 0.001 at fast gait speed and P = 0.002 at usual gait speed). Furthermore, a significant interaction according to OSA on the association between time to walk and cognitive impairment was found (P value for interaction = 0.003 at fast gait speed and P value for interaction = 0.007 at usual gait speed). we found that the inverse association between the time taken to walk 4 m and a cognitive score became significantly stronger, if an individual had OSA. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Effects of combined aerobic and resistance exercise on central arterial stiffness and gait velocity in patients with chronic poststroke hemiparesis.

PubMed

Lee, Yong Hee; Park, Soo Hyun; Yoon, Eun Sun; Lee, Chong-Do; Wee, Sang Ouk; Fernhall, Bo; Jae, Sae Young

2015-09-01

The effects of combined aerobic and resistance exercise training on central arterial stiffness and gait velocity in patients with chronic poststroke hemiparesis were investigated. Twenty-six patients with chronic poststroke hemiparesis were randomly assigned to either the combined aerobic and resistance exercise group (n = 14) or the control group (n = 12). The exercise intervention group received a combined aerobic and resistance exercise training (1 hr/day, three times/week for 16 wks), whereas the control group received usual care. Central arterial stiffness was determined by pulse wave velocity and augmentation index. Gait velocity was assessed using the 6-min walk test, 10-m walk test, and the Timed Up-and-Go test. Patients in the exercise intervention group had greater improvement of mean pulse wave velocity (P < 0.001), augmentation index (P = 0.048), and gait velocity (6-min walk test, P < 0.001; 10-m walk test, P < 0.001) than did patients in the control group. Patients in the exercise intervention group also had greater improvements in physical fitness component (grip strength, P < 0.001; muscular strength of upper and lower limbs, P < 0.027; flexibility, P < 0.001) when compared with control patients. The combined aerobic and resistance exercise program significantly reduced central arterial stiffness and increased gait velocity in patients with chronic poststroke hemiparesis.

Walking performance and muscle strength in the later stage poststroke: a nonlinear relationship.

PubMed

Carvalho, Cristiane; Sunnerhagen, Katharina S; Willén, Carin

2013-05-01

To evaluate the relation between muscle strength in the lower extremities and walking performance (speed and distance) in subjects in the later stage poststroke and to compare this with normative data. A cross-sectional observational study. University hospital department. Subjects poststroke (n=41; 31 men, 10 women) with a mean age of 59±5.8 years and a time from stroke onset of 52±36 months were evaluated. An urban sample (n=144) of 40- to 79-year-olds (69 men, 75 women) formed the healthy reference group. Not applicable. Muscle strength in the lower extremities was measured with an isokinetic dynamometer and combined into a strength index. Values for the 30-meter walk test for self-selected and maximum speed and the 6-minute walk test were measured. A nonlinear regression model was used. The average strength index was 730±309 in the subjects after stroke compared with 1112±362 in the healthy group. A nonlinear relation between walking performance and muscle strength was evident. The model explained 37% of the variance in self-selected speed in the stroke group and 20% in the healthy group, and 63% and 38%, respectively, in the maximum walking speed. For the 6-minute walk test, the model explained 44% of the variance in the stroke group. Subjects in the later stage poststroke were weaker than the healthy reference group, and their weakness was associated with walking performance. At the same strength index, subjects walked at lower speeds and shorter distances after stroke, indicating that there are multiple impairments that affect walking ability. Treatments focused on increasing muscle strength thus continue to hold promise. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Exercise in claudicants increase or decrease walking ability and the response relates to mitochondrial function.

PubMed

van Schaardenburgh, Michel; Wohlwend, Martin; Rognmo, Øivind; Mattsson, Erney J R

2017-06-07

Exercise of patients with intermittent claudication improves walking performance. Exercise does not usually increase blood flow, but seems to increase muscle mitochondrial enzyme activities. Although exercise is beneficial in most patients, it might be harmful in some. The mitochondrial response to exercise might therefore differ between patients. Our hypothesis was that changes in walking performance relate to changes in mitochondrial function after 8 weeks of exercise. At a subgroup level, negative responders decrease and positive responders increase mitochondrial capacity. Two types of exercise were studied, calf raising and walking (n = 28). We wanted to see whether there were negative and positive responders, independent of type of exercise. Measurements of walking performance, peripheral hemodynamics, mitochondrial respiration and content (citrate synthase activity) were obtained on each patient before and after the intervention period. Multiple linear regression was used to test whether changes in peak walking time relate to mitochondrial function. Subgroups of negative (n = 8) and positive responders (n = 8) were defined as those that either decreased or increased peak walking time following exercise. Paired t test and analysis of covariance was used to test changes within and between subgroups. Changes in peak walking time were related to changes in mitochondrial respiration supported by electron transferring flavoprotein (ETF + CI) P (p = 0.004), complex I (CI + ETF) P (p = 0.003), complex I + complex II (CI + CII + ETF) P (p = 0.037) and OXPHOS coupling efficiency (p = 0.046) in the whole group. Negative responders had more advanced peripheral arterial disease. Mitochondrial respiration supported by electron transferring flavoprotein (ETF + CI) P (p = 0.0013), complex I (CI + ETF) P (p = 0.0005), complex I + complex II (CI + CII + ETF) P (p = 0.011) and electron transfer system capacity (CI + CII + ETF) E (p = 0.021) and OXPHOS coupling efficiency decreased in negative responders (p = 0.0007) after exercise. Positive responders increased citrate synthase activity (p = 0.010). Changes in walking performance seem to relate to changes in mitochondrial function after exercise. Negative responders have more advanced peripheral arterial disease and decrease, while positive responders increase mitochondrial capacity. Trial registration ClinicalTrials.gov ID: NCT023110256.

The retest reliability of the six-minute walk test in patients referred to a cardiac rehabilitation programme.

PubMed

Hanson, Lisa C; McBurney, Helen; Taylor, Nicholas F

2012-03-01

The purpose of this paper was to determine if the Six-minute Walk Test (6MWT) was a reliable exercise test for patients referred to cardiac rehabilitation when up to three tests were performed and to determine if test scores differed according to between-test time interval. Thirty adults aged 63 ± 7.9 years referred to cardiac rehabilitation participated in a repeated measures reliability trial. Participants completed three 6MWTs within a one-week period. Participants were randomly allocated to one of three groups: on the first day, Group A completed three walks, Group B completed two walks and Group C completed one walk. Relative reliability was expressed in a ratio (ICC(2,1) ), and absolute reliability was expressed in metres (95% confidence intervals) for group and individuals. The 6MWT demonstrated a high level of relative reliability (intraclass correlation coefficients [ICC] = 0.94) across the three walks. There was no statistically significant difference between the test scores of the three groups. However, there was an increase in distance walked from the first to the second to the third 6MWT. Absolute reliability indicated that a change of at least 44 m would be required to be interpreted as true change in a group, and at least 95 m to be interpreted as true change in an individual with 95% confidence. Three 6MWTs completed in relatively short timeframes were not sufficient for reliable results as there was an increase in the distance walked, and relatively large increases in distances would be required to be interpreted as change. It did not make any difference whether the tests were all completed on one day or over one week. This study highlighted problems that may arise when relying on reliability coefficients alone to interpret reliability. These results suggest that the 6MWT may not have sufficient reliability to be a suitable test to evaluate exercise tolerance in patients referred to cardiac rehabilitation. Copyright © 2011 John Wiley & Sons, Ltd.

The Motor and the Brake of the Trailing Leg in Human Walking: Leg Force Control Through Ankle Modulation and Knee Covariance

PubMed Central

Toney, Megan E.; Chang, Young-Hui

2016-01-01

Human walking is a complex task, and we lack a complete understanding of how the neuromuscular system organizes its numerous muscles and joints to achieve consistent and efficient walking mechanics. Focused control of select influential task-level variables may simplify the higher-level control of steady state walking and reduce demand on the neuromuscular system. As trailing leg power generation and force application can affect the mechanical efficiency of step-to-step transitions, we investigated how joint torques are organized to control leg force and leg power during human walking. We tested whether timing of trailing leg force control corresponded with timing of peak leg power generation. We also applied a modified uncontrolled manifold analysis to test whether individual or coordinated joint torque strategies most contributed to leg force control. We found that leg force magnitude was adjusted from step-to-step to maintain consistent leg power generation. Leg force modulation was primarily determined by adjustments in the timing of peak ankle plantar-flexion torque, while knee torque was simultaneously covaried to dampen the effect of ankle torque on leg force. We propose a coordinated joint torque control strategy in which the trailing leg ankle acts as a motor to drive leg power production while trailing leg knee torque acts as a brake to refine leg power production. PMID:27334888

Interception of moving objects while walking in children with spastic hemiparetic cerebral palsy.

PubMed

Ricken, Annieck X C; Savelsbergh, G J P; Bennett, S J

2007-01-15

The purpose of the study was to examine the coordination of reaching and walking behaviour when children with Spastic Hemiparetic Cerebral Palsy (SHCP) intercept an approaching and hence externally-timed object. Using either the impaired or non-impaired arm, children intercepted a ball approaching from a fixed distance with one of three velocities. Each participant's initial starting position was scaled to their maximum walking velocity determined prior to testing; for the medium ball velocity, participants would arrive at the point of interception at the correct time if they walked with their maximum velocity. Children with SHCP adapted their reaching and walking behaviour to the different ball approach velocities. These adaptations were exhibited when using the impaired and non-impaired arm, and resulted in similar outcome performance irrespective of which arm was used. Still, children with SHCP found it necessary to increase trunk movement to compensate for the decreased elbow excursion and a decreased peak velocity of the impaired arm. Children with SHCP exhibited specific adaptations to their altered movement capabilities when performing a behaviourally-realistic task. The provision of an external timing constraint appeared to facilitate both reaching and walking movements and hence could represent a useful technique in rehabilitation.

Stock market context of the Lévy walks with varying velocity

NASA Astrophysics Data System (ADS)

Kutner, Ryszard

2002-11-01

We developed the most general Lévy walks with varying velocity, shorter called the Weierstrass walks (WW) model, by which one can describe both stationary and non-stationary stochastic time series. We considered a non-Brownian random walk where the walker moves, in general, with a velocity that assumes a different constant value between the successive turning points, i.e., the velocity is a piecewise constant function. This model is a kind of Lévy walks where we assume a hierarchical, self-similar in a stochastic sense, spatio-temporal representation of the main quantities such as waiting-time distribution and sojourn probability density (which are principal quantities in the continuous-time random walk formalism). The WW model makes possible to analyze both the structure of the Hurst exponent and the power-law behavior of kurtosis. This structure results from the hierarchical, spatio-temporal coupling between the walker displacement and the corresponding time of the walks. The analysis uses both the fractional diffusion and the super Burnett coefficients. We constructed the diffusion phase diagram which distinguishes regions occupied by classes of different universality. We study only such classes which are characteristic for stationary situations. We thus have a model ready for describing the data presented, e.g., in the form of moving averages; the operation is often used for stochastic time series, especially financial ones. The model was inspired by properties of financial time series and tested for empirical data extracted from the Warsaw stock exchange since it offers an opportunity to study in an unbiased way several features of stock exchange in its early stage.

Geriatric rehabilitation after hip fracture. Role of body-fixed sensor measurements of physical activity.

PubMed

Benzinger, P; Lindemann, U; Becker, C; Aminian, K; Jamour, M; Flick, S E

2014-04-01

The demand for geriatric rehabilitation will drastically increase over the next years. It will be increasingly important to demonstrate the efficacy and effectiveness of geriatric rehabilitation. One component is the use of objective and valid assessment procedures. These should be understandable to patients, relevant for goal attainment, and able to document change. A number of currently used physical capacity measures have floor effects. The use of body-fixed sensor technology for monitoring physical activity is a possible supplement for the assessment during geriatric rehabilitation to overcome floor effects and directly monitor improvement of mobility as a component of geriatric rehabilitation in many patients. The observational study with a pre-post design examined 65 consecutive geriatric hip fracture inpatients. Measurements were performed on admission and 2 weeks later. The capacity measures included gait speed, chair rise time, a balance test, 2-Minute-Walk test and the Timed-Up-and-Go test. Physical activity was measured over 9 h using body-fixed sensor technology and expressed as cumulated walking and walking plus standing (time on feet). Body-fixed sensors allowed direct measurement of physical activity in all patients available for testing. Cumulated walking and standing (time on feet) increased from a median 83.6 to 102.6 min. Cumulated walking increased from a median 7.0 to 16.3 min. The comparison with the physical capacity measures demonstrated a modest to fair correlation (rs = 0.455 and 0.653). This indicates that physical capacity measures are not the same construct as physical activity. Body-fixed sensor-based assessment of physical activity was feasible even in geriatric patients with severe mobility problems and decreased the number of patients with missing data both on admission and 2 weeks later. Body-fixed sensor data documented change in activity level.

The effect of rhythmic-cued motor imagery on walking, fatigue and quality of life in people with multiple sclerosis: A randomised controlled trial.

PubMed

Seebacher, Barbara; Kuisma, Raija; Glynn, Angela; Berger, Thomas

2017-02-01

Motor imagery and rhythmic auditory stimulation are physiotherapy strategies for walking rehabilitation. To investigate the effect of motor imagery combined with rhythmic cueing on walking, fatigue and quality of life (QoL) in people with multiple sclerosis (MS). Individuals with MS and Expanded Disability Status Scale scores of 1.5-4.5 were randomised into one of three groups: 17 minutes of motor imagery, six times per week, for 4 weeks, with music (A) or metronome cues (B), both with verbal cueing, and (C) controls. Primary outcomes were walking speed (Timed 25-Foot Walk) and distance (6-Minute Walk Test). Secondary outcomes were walking perception (Multiple Sclerosis Walking Scale-12), fatigue (Modified Fatigue Impact Scale) and QoL (Short Form-36 Health Survey, Multiple Sclerosis Impact Scale-29, Euroquol-5D-3L Questionnaire). Of the 112 participants randomised, 101 completed the study. Compared to controls, both interventions significantly improved walking speed, distance and perception. Significant improvements in cognitive but not psychosocial fatigue were seen in the intervention groups, and physical fatigue improved only in the music-based group. Both interventions improved QoL; however, music-cued motor imagery was superior at improving health-related QoL. Rhythmic-cued motor imagery improves walking, fatigue and QoL in people with MS, with music-cued motor imagery being more effective.

Modeling spatial segregation and travel cost influences on utilitarian walking: Towards policy intervention

PubMed Central

Yang, Yong; Auchincloss, Amy H.; Rodriguez, Daniel A.; Brown, Daniel G.; Riolo, Rick; Diez-Roux, Ana V.

2015-01-01

We develop an agent-based model of utilitarian walking and use the model to explore spatial and socioeconomic factors affecting adult utilitarian walking and how travel costs as well as various educational interventions aimed at changing attitudes can alter the prevalence of walking and income differentials in walking. The model is validated against US national data. We contrast realistic and extreme parameter values in our model and test effects of changing these parameters across various segregation and pricing scenarios while allowing for interactions between travel choice and place and for behavioral feedbacks. Results suggest that in addition to income differences in the perceived cost of time, the concentration of mixed land use (differential density of residences and businesses) are important determinants of income differences in walking (high income walk less), whereas safety from crime and income segregation on their own do not have large influences on income differences in walking. We also show the difficulty in altering walking behaviors for higher income groups who are insensitive to price and how adding to the cost of driving could increase the income differential in walking particularly in the context of segregation by income and land use. We show that strategies to decrease positive attitudes towards driving can interact synergistically with shifting cost structures to favor walking in increasing the percent of walking trips. Agent-based models, with their ability to capture dynamic processes and incorporate empirical data, are powerful tools to explore the influence on health behavior from multiple factors and test policy interventions. PMID:25733776

Within-day variability on short and long walking tests in persons with multiple sclerosis.

PubMed

Feys, Peter; Bibby, Bo; Romberg, Anders; Santoyo, Carme; Gebara, Benoit; de Noordhout, Benoit Maertens; Knuts, Kathy; Bethoux, Francois; Skjerbæk, Anders; Jensen, Ellen; Baert, Ilse; Vaney, Claude; de Groot, Vincent; Dalgas, Ulrik

2014-03-15

To compare within-day variability of short (10 m walking test at usual and fastest speed; 10MWT) and long (2 and 6-minute walking test; 2MWT/6MWT) tests in persons with multiple sclerosis. Observational study. MS rehabilitation and research centers in Europe and US within RIMS (European network for best practice and research in MS rehabilitation). Ambulatory persons with MS (Expanded Disability Status Scale 0-6.5). Subjects of different centers performed walking tests at 3 time points during a single day. 10MWT, 2MWT and 6MWT at fastest speed and 10MWT at usual speed. Ninety-five percent limits of agreement were computed using a random effects model with individual pwMS as random effect. Following this model, retest scores are with 95% certainty within these limits of baseline scores. In 102 subjects, within-day variability was constant in absolute units for the 10MWT, 2MWT and 6MWT at fastest speed (+/-0.26, 0.16 and 0.15m/s respectively, corresponding to +/-19.2m and +/-54 m for the 2MWT and 6MWT) independent on the severity of ambulatory dysfunction. This implies a greater relative variability with increasing disability level, often above 20% depending on the applied test. The relative within-day variability of the 10MWT at usual speed was +/-31% independent of ambulatory function. Absolute values of within-day variability on walking tests at fastest speed were independent of disability level and greater with short compared to long walking tests. Relative within-day variability remained overall constant when measured at usual speed. Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.

A comparison of the health benefits of reduced-exertion high-intensity interval training (REHIT) and moderate-intensity walking in type 2 diabetes patients.

PubMed

Ruffino, José S; Songsorn, Preeyaphorn; Haggett, Malindi; Edmonds, Daniel; Robinson, Anthony M; Thompson, Dylan; Vollaard, Niels B J

2017-02-01

Reduced-exertion high-intensity interval training (REHIT) is a genuinely time-efficient intervention that can improve aerobic capacity and insulin sensitivity in sedentary individuals. The present study compared the effects of REHIT and moderate-intensity walking on health markers in patients with type 2 diabetes (T2D) in a counter-balanced crossover study. Sixteen men with T2D (mean ± SD age: 55 ± 5 years, body mass index: 30.6 ± 2.8 kg·m -2 , maximal aerobic capacity: 27 ± 4 mL·kg -1 ·min -1 ) completed 8 weeks of REHIT (three 10-min low-intensity cycling sessions/week with two "all-out" 10-20-s sprints) and 8 weeks of moderate-intensity walking (five 30-min sessions/week at an intensity corresponding to 40%-55% of heart-rate reserve), with a 2-month wash-out period between interventions. Before and after each intervention, participants underwent an incremental fitness test, an oral glucose tolerance test (OGTT), a whole-body dual-energy X-ray absorptiometry scan, and continuous glucose monitoring. REHIT was associated with a significantly larger increase in maximal aerobic capacity compared with walking (7% vs. 1%; time × intervention interaction effect: p < 0.05). Both REHIT and walking decreased resting mean arterial pressure (-4%; main effect of time: p < 0.05) and plasma fructosamine (-5%; main effect of time: p < 0.05). Neither intervention significantly improved OGTT-derived measures of insulin sensitivity, glycaemic control measured using continuous glucose monitors, blood lipid profile, or body composition. We conclude that REHIT is superior to a 5-fold larger volume of moderate-intensity walking in improving aerobic fitness, but similar to walking REHIT is not an effective intervention for improving insulin sensitivity or glycaemic control in T2D patients in the short term.

An integrated gait rehabilitation training based on Functional Electrical Stimulation cycling and overground robotic exoskeleton in complete spinal cord injury patients: Preliminary results.

PubMed

Mazzoleni, S; Battini, E; Rustici, A; Stampacchia, G

2017-07-01

The aim of this study is to investigate the effects of an integrated gait rehabilitation training based on Functional Electrical Stimulation (FES)-cycling and overground robotic exoskeleton in a group of seven complete spinal cord injury patients on spasticity and patient-robot interaction. They underwent a robot-assisted rehabilitation training based on two phases: n=20 sessions of FES-cycling followed by n= 20 sessions of robot-assisted gait training based on an overground robotic exoskeleton. The following clinical outcome measures were used: Modified Ashworth Scale (MAS), Numerical Rating Scale (NRS) on spasticity, Penn Spasm Frequency Scale (PSFS), Spinal Cord Independence Measure Scale (SCIM), NRS on pain and International Spinal Cord Injury Pain Data Set (ISCI). Clinical outcome measures were assessed before (T0) after (T1) the FES-cycling training and after (T2) the powered overground gait training. The ability to walk when using exoskeleton was assessed by means of 10 Meter Walk Test (10MWT), 6 Minute Walk Test (6MWT), Timed Up and Go test (TUG), standing time, walking time and number of steps. Statistically significant changes were found on the MAS score, NRS-spasticity, 6MWT, TUG, standing time and number of steps. The preliminary results of this study show that an integrated gait rehabilitation training based on FES-cycling and overground robotic exoskeleton in complete SCI patients can provide a significant reduction of spasticity and improvements in terms of patient-robot interaction.

Effects of a short burst of gait training with body weight-supported treadmill training for a person with chronic stroke: a single-subject study.

PubMed

Combs, Stephanie A; Miller, Ellen Winchell

2011-04-01

The purpose of this study was to investigate the effects of a short-burst dose of intense gait training with body weight-supported treadmill training (BWSTT) on walking speed, endurance, and quality of life of a participant with chronic stroke. A single-subject experimental (A-B-A-A) design with immediate and 3-month retention phases was used. The participant was a 66-year-old woman, 1 year after left cerebrovascular accident. Repeated baseline walking performance was established during 2 weeks of testing using the comfortable 10-meter walk test (CWT) and the 6-minute walk test (6MWT). The Stroke Impact Scale (SIS) was measured one time during baseline. Baseline testing was followed by ten 30-minute sessions of BWSTT over a 2-week duration. Retention testing was conducted immediately and 3 months following the intervention. Statistically significant improvements from baseline with the CWT and the 6MWT were achieved and maintained by the participant across all subsequent measurement phases. Improvements considered to be clinically meaningful changes in the SIS domains of strength and mobility achieved immediately after the intervention were not maintained at 3-month retention testing. For the participant in this study, the short-burst dosage of BWSTT provided a feasible and effective means for improving goal-oriented functional walking ability.

Smartphone App-Based Assessment of Gait During Normal and Dual-Task Walking: Demonstration of Validity and Reliability.

PubMed

Manor, Brad; Yu, Wanting; Zhu, Hao; Harrison, Rachel; Lo, On-Yee; Lipsitz, Lewis; Travison, Thomas; Pascual-Leone, Alvaro; Zhou, Junhong

2018-01-30

Walking is a complex cognitive motor task that is commonly completed while performing another task such as talking or making decisions. Gait assessments performed under normal and "dual-task" walking conditions thus provide important insights into health. Such assessments, however, are limited primarily to laboratory-based settings. The objective of our study was to create and test a smartphone-based assessment of normal and dual-task walking for use in nonlaboratory settings. We created an iPhone app that used the phone's motion sensors to record movements during walking under normal conditions and while performing a serial-subtraction dual task, with the phone placed in the user's pants pocket. The app provided the user with multimedia instructions before and during the assessment. Acquired data were automatically uploaded to a cloud-based server for offline analyses. A total of 14 healthy adults completed 2 laboratory visits separated by 1 week. On each visit, they used the app to complete three 45-second trials each of normal and dual-task walking. Kinematic data were collected with the app and a gold-standard-instrumented GAITRite mat. Participants also used the app to complete normal and dual-task walking trials within their homes on 3 separate days. Within laboratory-based trials, GAITRite-derived heel strikes and toe-offs of the phone-side leg aligned with smartphone acceleration extrema, following filtering and rotation to the earth coordinate system. We derived stride times-a clinically meaningful metric of locomotor control-from GAITRite and app data, for all strides occurring over the GAITRite mat. We calculated stride times and the dual-task cost to the average stride time (ie, percentage change from normal to dual-task conditions) from both measurement devices. We calculated similar metrics from home-based app data. For these trials, periods of potential turning were identified via custom-developed algorithms and omitted from stride-time analyses. Across all detected strides in the laboratory, stride times derived from the app and GAITRite mat were highly correlated (P<.001, r 2 =.98). These correlations were independent of walking condition and pocket tightness. App- and GAITRite-derived stride-time dual-task costs were also highly correlated (P<.001, r 2 =.95). The error of app-derived stride times (mean 16.9, SD 9.0 ms) was unaffected by the magnitude of stride time, walking condition, or pocket tightness. For both normal and dual-task trials, average stride times derived from app walking trials demonstrated excellent test-retest reliability within and between both laboratory and home-based assessments (intraclass correlation coefficient range .82-.94). The iPhone app we created enabled valid and reliable assessment of stride timing-with the smartphone in the pocket-during both normal and dual-task walking and within both laboratory and nonlaboratory environments. Additional work is warranted to expand the functionality of this tool to older adults and other patient populations. ©Brad Manor, Wanting Yu, Hao Zhu, Rachel Harrison, On-Yee Lo, Lewis Lipsitz, Thomas Travison, Alvaro Pascual-Leone, Junhong Zhou. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 30.01.2018.

The relationship between ground reaction force in sit-to-stand movement and lower extremity function in community-dwelling Japanese older adults using long-term care insurance services

PubMed Central

Shen, Shaoshuai; Abe, Takumi; Tsuji, Taishi; Fujii, Keisuke; Ma, Jingyu; Okura, Tomohiro

2017-01-01

[Purpose] The purpose of this study was to investigate which of the four chair-rising methods has low-load and the highest success rate, and whether the GRF parameters in that method are useful for measuring lower extremity function among physically frail Japanese older adults. [Subjects and Methods] Fifty-two individuals participated in this study. The participants voluntarily attempted four types of Sit-to-stand test (one variation without and three variations with the use of their arms). The following parameters were measured: peak reaction force (F/w), two force development rate parameters (RFD1.25/w, RFD8.75/w) and two time-related parameters (T1, T2). Three additional commonly employed clinical tests (One-leg balance with eyes open, Timed up and go and 5-meter walk test) were also conducted. [Results] “Hands on a chair” chair-rising method produced the highest success rate among the four methods. All parameters were highly reliable between testing occasions. T2 showed strongly significant associations with Timed up and go and 5-meter walk test in males. RFD8.75/w showed significant associations with Timed up and go and 5-meter walk test in females. [Conclusion] Ground reaction force parameters in the Sit-to-stand test are a reliable and useful method for assessment of lower extremity function in physically frail Japanese older adults. PMID:28931988

Dynamometer-based measure of spasticity confirms limited association between plantarflexor spasticity and walking function in persons with multiple sclerosis

PubMed Central

Kremer, Theodore R.; Van Dillen, Linda R.; Wagner, Joanne M.

2017-01-01

The literature shows inconsistent evidence regarding the association between clinically assessed plantarflexor (PF) spasticity and walking function in ambulatory persons with multiple sclerosis (pwMS). The use of a dynamometer-based spasticity measure (DSM) may help to clarify this association. Our cohort included 42 pwMS (27 female, 15 male; age: 42.9 +/− 10.2 yr) with mild clinical disability (Expanded Disability Status Scale score: 3.6 +/− 1.6). PF spasticity was assessed using a clinical measure, the modified Ashworth Scale (MAS), and an instrumented measure, the DSM. Walking function was assessed by the timed 25-foot walk test (T25FWT), the 6-minute walk test (6MWT), and the 12-item Multiple Sclerosis Walking Scale (MSWS-12). Spearman rho correlations were used to evaluate relationships between spasticity measures, measures of walking speed and endurance, and self-perceived limitations in walking. The correlation was small between PF spasticity and the T25FWT (PF maximum [Max] MAS rho = 0.27, PF Max DSM rho = 0.26), the 6MWT (PF Max MAS rho = −0.20, PF Max DSM rho = −0.21), and the MSWS-12 (PF Max MAS rho = 0.11, PF Max DSM rho = 0.26). Our results are similar to reports in other neurologic clinical populations, wherein spasticity has a limited association with walking dysfunction. PMID:25356797

Analysis of static and dynamic balance in healthy elderly practitioners of Tai Chi Chuan versus ballroom dancing

PubMed Central

Rahal, Miguel Antônio; Alonso, Angélica Castilho; Andrusaitis, Felix Ricardo; Rodrigues, Thuam Silva; Speciali, Danielli Souza; Greve, Júlia Maria D′Andréa; Leme, Luiz Eugênio Garcez

2015-01-01

OBJECTIVE: To determine whether Tai Chi Chuan or ballroom dancing promotes better performance with respect to postural balance, gait, and postural transfer among elderly people. METHODS: We evaluated 76 elderly individuals who were divided into two groups: the Tai Chi Chuan Group and the Dance Group. The subjects were tested using the NeuroCom Balance Master® force platform system with the following protocols: static balance tests (the Modified Clinical Tests of Sensory Interaction on Balance and Unilateral Stance) and dynamic balance tests (the Walk Across Test and Sit-to-stand Transfer Test). RESULTS: In the Modified Clinical Test of Sensory Interaction on Balance, the Tai Chi Chuan Group presented a lower sway velocity on a firm surface with open and closed eyes, as well as on a foam surface with closed eyes. In the Modified Clinical Test of Sensory Interaction on Unilateral Stance, the Tai Chi Chuan Group presented a lower sway velocity with open eyes, whereas the Dance Group presented a lower sway velocity with closed eyes. In the Walk Across Test, the Tai Chi Chuan Group presented faster walking speeds than those of the Dance Group. In the Sit-to-stand Transfer Test, the Tai Chi Chuan Group presented shorter transfer times from the sitting to the standing position, with less sway in the final standing position. CONCLUSION: The elderly individuals who practiced Tai Chi Chuan had better bilateral balance with eyes open on both types of surfaces compared with the Dance Group. The Dance Group had better unilateral postural balance with eyes closed. The Tai Chi Chuan Group had faster walking speeds, shorter transfer times, and better postural balance in the final standing position during the Sit-to-stand Test. PMID:26017644

Analysis of static and dynamic balance in healthy elderly practitioners of Tai Chi Chuan versus ballroom dancing.

PubMed

Rahal, Miguel Antônio; Alonso, Angélica Castilho; Andrusaitis, Felix Ricardo; Rodrigues, Thuam Silva; Speciali, Danielli Souza; Greve, Júlia Maria D Andréa; Leme, Luiz Eugênio Garcez

2015-03-01

To determine whether Tai Chi Chuan or ballroom dancing promotes better performance with respect to postural balance, gait, and postural transfer among elderly people. We evaluated 76 elderly individuals who were divided into two groups: the Tai Chi Chuan Group and the Dance Group. The subjects were tested using the NeuroCom Balance Master¯ force platform system with the following protocols: static balance tests (the Modified Clinical Tests of Sensory Interaction on Balance and Unilateral Stance) and dynamic balance tests (the Walk Across Test and Sit-to-stand Transfer Test). In the Modified Clinical Test of Sensory Interaction on Balance, the Tai Chi Chuan Group presented a lower sway velocity on a firm surface with open and closed eyes, as well as on a foam surface with closed eyes. In the Modified Clinical Test of Sensory Interaction on Unilateral Stance, the Tai Chi Chuan Group presented a lower sway velocity with open eyes, whereas the Dance Group presented a lower sway velocity with closed eyes. In the Walk Across Test, the Tai Chi Chuan Group presented faster walking speeds than those of the Dance Group. In the Sit-to-stand Transfer Test, the Tai Chi Chuan Group presented shorter transfer times from the sitting to the standing position, with less sway in the final standing position. The elderly individuals who practiced Tai Chi Chuan had better bilateral balance with eyes open on both types of surfaces compared with the Dance Group. The Dance Group had better unilateral postural balance with eyes closed. The Tai Chi Chuan Group had faster walking speeds, shorter transfer times, and better postural balance in the final standing position during the Sit-to-stand Test.

Promoting Activity in Geriatric Rehabilitation: A Randomized Controlled Trial of Accelerometry.

PubMed

Peel, Nancye M; Paul, Sanjoy K; Cameron, Ian D; Crotty, Maria; Kurrle, Susan E; Gray, Leonard C

2016-01-01

Low activity levels in inpatient rehabilitation are associated with adverse outcomes. The study aimed to test whether activity levels can be increased by the provision of monitored activity data to patients and clinicians in the context of explicit goal setting. A randomized controlled trial in three sites in Australia included 255 inpatients aged 60 and older who had a rehabilitation goal to become ambulant. The primary outcome was patients' walking time measured by accelerometers during the rehabilitation admission. Walking times from accelerometry were made available daily to treating therapists and intervention participants to motivate patients to improve incidental activity levels and reach set goals. For the control group, 'usual care' was followed, including the setting of mobility goals; however, for this group, neither staff nor patients received data on walking times to aid the setting of daily walking time targets. The median daily walking time in the intervention group increased from 10.3 minutes at baseline to 32.1 minutes at day 28, compared with an increase from 9.5 to 26.5 minutes per day in the control group. Subjects in the intervention group had significantly higher non-therapy walking time by about 7 minutes [mean (95% CI): 24.6 (21.7, 27.4)] compared to those in the control group [mean(95% CI): 17.3 (14.4, 20.3)] (p = 0.001). Daily feedback to patients and therapists using an accelerometer increased walking times during rehabilitation admissions. The results of this study suggest objective monitoring of activity levels could provide clinicians with information on clinically important, mobility-related activities to assist goal setting. Australian New Zealand Clinical Trials Registry ACTRN12611000034932 http://www.ANZCTR.org.au/.

[Diagnosis of musculoskeletal ambulation disability symptom complex (MADS)].

PubMed

Ito, Hiromoto

2008-11-01

It was described to diagnosis of Musculoskeletal Ambulation Disability Symptom Complex (MADS). The definition of MADS is an person of advanced years with lower leveled balance and walking ability, high risk for fall, and who is keeping to the house. The diagnosis of MADS was decided to a history of 11 musculoskeletal disorders and evaluation of balanced and walking function. The determination method of time of one leg standing and 3 m timed timed up and go test were described.

Balance exercise program reduced falls in people with multiple sclerosis: a single-group, pretest-posttest trial.

PubMed

Nilsagård, Ylva Elisabet; von Koch, Lena Kristina; Nilsson, Malin; Forsberg, Anette Susanne

2014-12-01

To evaluate the effects of a balance exercise program on falls in people with mild to moderate multiple sclerosis (MS). Multicenter, single-blinded, single-group, pretest-posttest trial. Seven rehabilitation units within 5 county councils. Community-dwelling adults with MS (N=32) able to walk 100m but unable to maintain 30-second tandem stance with arms alongside the body. Seven weeks of twice-weekly, physiotherapist-led 60-minute sessions of group-based balance exercise targeting core stability, dual tasking, and sensory strategies (CoDuSe). Primary outcomes: number of prospectively reported falls and proportion of participants classified as fallers during 7 preintervention weeks, intervention period, and 7 postintervention weeks. Secondary outcomes: balance performance on the Berg Balance Scale, Four Square Step Test, sit-to-stand test, timed Up and Go test (alone and with cognitive component), and Functional Gait Assessment Scale; perceived limitations in walking on the 12-item MS Walking Scale; and balance confidence on the Activities-specific Balance Confidence Scale rated 7 weeks before intervention, directly after intervention, and 7 weeks later. Number of falls (166 to 43; P≤.001) and proportion of fallers (17/32 to 10/32; P≤.039) decreased significantly between the preintervention and postintervention periods. Balance performance improved significantly. No significant differences were detected for perceived limitations in walking, balance confidence, the timed Up and Go test, or sit-to-stand test. The CoDuSe program reduced falls and proportion of fallers and improved balance performance in people with mild to moderate MS but did not significantly alter perceived limitations in walking and balance confidence. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Does Nordic walking improves the postural control and gait parameters of women between the age 65 and 74: a randomized trial

PubMed Central

Kocur, Piotr; Wiernicka, Marzena; Wilski, Maciej; Kaminska, Ewa; Furmaniuk, Lech; Maslowska, Marta Flis; Lewandowski, Jacek

2015-01-01

[Purpose] To assess the effect of 12-weeks Nordic walking training on gait parameters and some elements of postural control. [Subjects and Methods] Sixty-seven women aged 65 to 74 years were enrolled in this study. The subjects were divided into a Nordic Walking group (12 weeks of Nordic walking training, 3 times a week for 75 minutes) and a control group. In both study groups, a set of functional tests were conducted at the beginning and at the end of the study: the Forward Reach Test (FRT) and the Upward Reach Test (URT) on a stabilometric platform, and the analysis of gait parameters on a treadmill. [Results] The NW group showed improvements in: the range of reach in the FRT test and the URT test in compared to the control group. The length of the gait cycle and gait cycle frequency also showed changes in the NW group compared to the control group. [Conclusion] A 12-week NW training program had a positive impact on selected gait parameters and may improve the postural control of women aged over 65 according to the results selected functional tests. PMID:26834341

Does Nordic walking improves the postural control and gait parameters of women between the age 65 and 74: a randomized trial.

PubMed

Kocur, Piotr; Wiernicka, Marzena; Wilski, Maciej; Kaminska, Ewa; Furmaniuk, Lech; Maslowska, Marta Flis; Lewandowski, Jacek

2015-12-01

[Purpose] To assess the effect of 12-weeks Nordic walking training on gait parameters and some elements of postural control. [Subjects and Methods] Sixty-seven women aged 65 to 74 years were enrolled in this study. The subjects were divided into a Nordic Walking group (12 weeks of Nordic walking training, 3 times a week for 75 minutes) and a control group. In both study groups, a set of functional tests were conducted at the beginning and at the end of the study: the Forward Reach Test (FRT) and the Upward Reach Test (URT) on a stabilometric platform, and the analysis of gait parameters on a treadmill. [Results] The NW group showed improvements in: the range of reach in the FRT test and the URT test in compared to the control group. The length of the gait cycle and gait cycle frequency also showed changes in the NW group compared to the control group. [Conclusion] A 12-week NW training program had a positive impact on selected gait parameters and may improve the postural control of women aged over 65 according to the results selected functional tests.

Measuring joint kinematics of treadmill walking and running: Comparison between an inertial sensor based system and a camera-based system.

PubMed

Nüesch, Corina; Roos, Elena; Pagenstert, Geert; Mündermann, Annegret

2017-05-24

Inertial sensor systems are becoming increasingly popular for gait analysis because their use is simple and time efficient. This study aimed to compare joint kinematics measured by the inertial sensor system RehaGait® with those of an optoelectronic system (Vicon®) for treadmill walking and running. Additionally, the test re-test repeatability of kinematic waveforms and discrete parameters for the RehaGait® was investigated. Twenty healthy runners participated in this study. Inertial sensors and reflective markers (PlugIn Gait) were attached according to respective guidelines. The two systems were started manually at the same time. Twenty consecutive strides for walking and running were recorded and each software calculated sagittal plane ankle, knee and hip kinematics. Measurements were repeated after 20min. Ensemble means were analyzed calculating coefficients of multiple correlation for waveforms and root mean square errors (RMSE) for waveforms and discrete parameters. After correcting the offset between waveforms, the two systems/models showed good agreement with coefficients of multiple correlation above 0.950 for walking and running. RMSE of the waveforms were below 5° for walking and below 8° for running. RMSE for ranges of motion were between 4° and 9° for walking and running. Repeatability analysis of waveforms showed very good to excellent coefficients of multiple correlation (>0.937) and RMSE of 3° for walking and 3-7° for running. These results indicate that in healthy subjects sagittal plane joint kinematics measured with the RehaGait® are comparable to those using a Vicon® system/model and that the measured kinematics have a good repeatability, especially for walking. Copyright © 2017 Elsevier Ltd. All rights reserved.

Using built environment characteristics to predict walking for exercise

PubMed Central

Lovasi, Gina S; Moudon, Anne V; Pearson, Amber L; Hurvitz, Philip M; Larson, Eric B; Siscovick, David S; Berke, Ethan M; Lumley, Thomas; Psaty, Bruce M

2008-01-01

Background Environments conducive to walking may help people avoid sedentary lifestyles and associated diseases. Recent studies developed walkability models combining several built environment characteristics to optimally predict walking. Developing and testing such models with the same data could lead to overestimating one's ability to predict walking in an independent sample of the population. More accurate estimates of model fit can be obtained by splitting a single study population into training and validation sets (holdout approach) or through developing and evaluating models in different populations. We used these two approaches to test whether built environment characteristics near the home predict walking for exercise. Study participants lived in western Washington State and were adult members of a health maintenance organization. The physical activity data used in this study were collected by telephone interview and were selected for their relevance to cardiovascular disease. In order to limit confounding by prior health conditions, the sample was restricted to participants in good self-reported health and without a documented history of cardiovascular disease. Results For 1,608 participants meeting the inclusion criteria, the mean age was 64 years, 90 percent were white, 37 percent had a college degree, and 62 percent of participants reported that they walked for exercise. Single built environment characteristics, such as residential density or connectivity, did not significantly predict walking for exercise. Regression models using multiple built environment characteristics to predict walking were not successful at predicting walking for exercise in an independent population sample. In the validation set, none of the logistic models had a C-statistic confidence interval excluding the null value of 0.5, and none of the linear models explained more than one percent of the variance in time spent walking for exercise. We did not detect significant differences in walking for exercise among census areas or postal codes, which were used as proxies for neighborhoods. Conclusion None of the built environment characteristics significantly predicted walking for exercise, nor did combinations of these characteristics predict walking for exercise when tested using a holdout approach. These results reflect a lack of neighborhood-level variation in walking for exercise for the population studied. PMID:18312660

Comparison of two 6-minute walk tests to assess walking capacity in polio survivors.

PubMed

Brehm, Merel-Anne; Verduijn, Suzan; Bon, Jurgen; Bredt, Nicoline; Nollet, Frans

2017-11-21

To compare walking dynamics and test-retest reliability for 2 frequently applied walk tests in polio survivors: the 6-minute walk test (6MWT) to walk as far as possible; and the 6-minute walking energy cost test (WECT) at comfortable speed. Observational study. Thirty-three polio survivors, able to walk ≥ 150 m. On the same day participants performed a 6MWT and a WECT, which were repeated 1-3 weeks later. For each test, distance walked, heart rate and reduction in speed were assessed. The mean distance walked and mean heart rate were significantly higher in the 6MWT (441 m (standard deviation) (SD 79.7); 118 bpm (SD 19.2)) compared with the WECT (366 m (SD 67.3); 103 bpm (SD 14.3)); p< 0.001. Furthermore, during the 6MWT, patients continuously slowed down (-6%), while during the WECT speed dropped only slightly during the first 2 min, by -1.8% in total. Test-retest reliability of both tests was excellent (intraclass correlation coefficient (ICC) ≥ 0.95; lower bound 95% confidence interval (95% CI) ≥ 0.87). The smallest detectable change for the walked distance was 42 m (9.7% change from the mean) and 50 m (13.7%) on the 6MWT and WECT, respectively. Both the 6MWT and the WECT are reliable to assess walking capacity in polio survivors, with slightly superior sensitivity to detect change for the 6MWT. Differences in walking dynamics confirm that the tests cannot be used interchangeably. The 6MWT is recommended for measuring maximal walking capacity and the WECT for measuring submaximal walking capacity.

Association between walking, dysphoric mood and anxiety in late pregnancy: A cross-sectional study.

PubMed

Petrovic, Danica; Perovic, Milan; Lazovic, Biljana; Pantic, Igor

2016-12-30

Relationship between physical activity and mental disorders in late pregnancy is unclear. In this work, we demonstrate that there is a significant association between the time spent on walking and symptoms of depression and anxiety in antenatal period. The cross-sectional study was done on a sample of 200 healthy women in 9th month of physiological pregnancy at Health center Kraljevo, Serbia during 2015. Each participant was given a questionnaire consisting of general questions regarding physical activity, pregnancy, and other parameters. Also, each participant completed a Beck depression inventory (BDI) and Zung anxiety scale (ZAS). There was a statistically significant negative correlation (p<0.05) between the BDI score and the daily time spent on walking. There was also a strong positive connection between the daily time spent on walking and level of anxiety (p<0.01). To our knowledge this is the first study to jointly test the relationship between scores of Beck depression inventory and Zung anxiety scale, and time spent on walking as physical activity in antenatal period. The results represent the basis for further research in the field of gynecological psychology, psychiatry and behavioral physiology. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Effect of bilateral lower limb strengthening exercise on balance and walking in hemiparetic patients after stroke: a randomized controlled trial.

PubMed

Jeon, Hye Joo; Hwang, Byong Yong

2018-02-01

[Purpose] To evaluate the effect of bilateral lower limb strengthening designed to improve balance and walking in stroke patients. [Subjects and Methods] Twenty hemiparetic stroke patients were divided into two groups: a unilateral therapy group (UTG) (n=10) and a bilateral therapy group (BTG) (n=10). The UTG completed strength training only in the paretic lower limb. The BTG completed strength training in the paretic and non-paretic lower limbs. Assessment tools included the functional reach test (FRT), the Berg balance scale (BBS), the timed up and go (TUG) test, and a 10-meter walk test (10MWT). [Results] In both groups, the lower limb strengthening exercise for balance and walking significantly improved the FRT, BBS, TUG, and 10MWT scores. Compared with UTG, the BTG attained significantly improved FRT and BBS scores. [Conclusion] Bilateral therapy using this lower limb strengthening exercise effectively promotes balance in hemiparetic stroke patients.

Effect of bilateral lower limb strengthening exercise on balance and walking in hemiparetic patients after stroke: a randomized controlled trial

PubMed Central

Jeon, Hye Joo; Hwang, Byong Yong

2018-01-01

[Purpose] To evaluate the effect of bilateral lower limb strengthening designed to improve balance and walking in stroke patients. [Subjects and Methods] Twenty hemiparetic stroke patients were divided into two groups: a unilateral therapy group (UTG) (n=10) and a bilateral therapy group (BTG) (n=10). The UTG completed strength training only in the paretic lower limb. The BTG completed strength training in the paretic and non-paretic lower limbs. Assessment tools included the functional reach test (FRT), the Berg balance scale (BBS), the timed up and go (TUG) test, and a 10-meter walk test (10MWT). [Results] In both groups, the lower limb strengthening exercise for balance and walking significantly improved the FRT, BBS, TUG, and 10MWT scores. Compared with UTG, the BTG attained significantly improved FRT and BBS scores. [Conclusion] Bilateral therapy using this lower limb strengthening exercise effectively promotes balance in hemiparetic stroke patients. PMID:29545693

Understanding the Physiological, Biomechanical, and Performance Effects of Body Armor Use

DTIC Science & Technology

2008-12-01

force plates were collected through a single data acquisition (DAQ) system and were time-synchronized. 2.1 Testing Equipment Figure 1. Examples of 3...For analysis purposes, it was scaled to the volunteer’s body mass (ml/kg/min). For walking trials, the force plate treadmill was set at a speed of...familiarized with walking and running on the force plate treadmill at these speeds. For familiarization, a volunteer first walked at 1.34 mls without any

Rollator use and functional outcome of geriatric rehabilitation.

PubMed

Vogt, Lutz; Lucki, Katrin; Bach, Matthias; Banzer, Winfried

2010-01-01

In a quasi-experimental pre- and postdesign, we examined the effect of rollator use on functional rehabilitation outcome in geriatric patients.From a sample of 458 geriatric inpatients, we matched 30 subjects who were not using assistive devices in their everyday lives but received a wheeled walker at the time of hospital admission (first-time user group) according to their admission scores on three motor performance tests (Timed Up-and-Go, Five-Times-Sit-to-Stand, and Performance-Oriented Mobility Assessment -Balance) with 30 patients who were actively using rollators as their primary walking aid for at least 3 months (long-term user group) and 30 control subjects without walking-aid assistance. Measurements were repeated after the inpatient rehabilitation regimen.The Kruskal-Wallis test did not reveal significant group differences in rehabilitation progress. Controls and device users, regardless of walking-aid experience, demonstrated nearly comparable mobility, strength, and balance improvements. More than half of each cohort (controls, n = 22; first-time, n = 17; long-term, n = 18) achieved functional gains in all three motor tests.The study showed that rollator assistance does not interfere with rehabilitation outcome and, to some extent, legitimates the prescription of assistive devices to improve confidence and restore or maintain motor ability at the highest possible level.

Effects of Single Bouts of Walking Exercise and Yoga on Acute Mood Symptoms in People with Multiple Sclerosis

PubMed Central

Ensari, Ipek; Sandroff, Brian M.

2016-01-01

Background: Little is known about the acute or immediate effects of walking exercise and yoga on mood in people with multiple sclerosis (MS). Such an examination is important for identifying an exercise modality for inclusion in exercise-training interventions that yields mood benefits in MS. We examined the effects of single bouts of treadmill walking and yoga compared with a quiet, seated-rest control condition on acute mood symptoms in MS. Methods: Twenty-four participants with MS completed 20 minutes of treadmill walking, yoga, or quiet rest in a randomized, counterbalanced order with 1 week between sessions. Participants completed the Profile of Mood States questionnaire before and immediately after each condition. Total mood disturbance (TMD) and the six subscales of the Profile of Mood States were analyzed using repeated-measures analysis of variance and paired-samples t tests. Results: There was a significant condition × time interaction on TMD scores (ηp2 = 0.13). Walking and yoga conditions yielded comparable reductions in TMD scores. There was a significant condition × time interaction on vigor (ηp2 = 0.23) whereby walking but not yoga yielded an improvement in vigor. There was a significant main effect of time on anger, confusion, depression, and tension (P < .05) but not on fatigue. Conclusions: Walking and yoga yielded similar improvements in overall acute mood symptoms, and walking improved feelings of vigor. These effects should be further investigated in long-term exercise-training studies. PMID:26917992

Validity of the Timed Up and Go Test as a Measure of Functional Mobility in Persons With Multiple Sclerosis.

PubMed

Sebastião, Emerson; Sandroff, Brian M; Learmonth, Yvonne C; Motl, Robert W

2016-07-01

To examine the validity of the timed Up and Go (TUG) test as a measure of functional mobility in persons with multiple sclerosis (MS) by using a comprehensive framework based on construct validity (ie, convergent and divergent validity). Cross-sectional study. Hospital setting. Community-residing persons with MS (N=47). Not applicable. Main outcome measures included the TUG test, timed 25-foot walk test, 6-minute walk test, Multiple Sclerosis Walking Scale-12, Late-Life Function and Disability Instrument, posturography evaluation, Activities-specific Balance Confidence scale, Symbol Digits Modalities Test, Expanded Disability Status Scale, and the number of steps taken per day. The TUG test was strongly associated with other valid outcome measures of ambulatory mobility (Spearman rank correlation, rs=.71-.90) and disability status (rs=.80), moderately to strongly associated with balance confidence (rs=.66), and weakly associated with postural control (ie, balance) (rs=.31). The TUG test was moderately associated with cognitive processing speed (rs=.59), but not associated with other nonambulatory measures (ie, Late-Life Function and Disability Instrument-upper extremity function). Our findings support the validity of the TUG test as a measure of functional mobility. This warrants its inclusion in patients' assessment alongside other valid measures of functional mobility in both clinical and research practice in persons with MS. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Association between stride time fractality and gait adaptability during unperturbed and asymmetric walking.

PubMed

Ducharme, Scott W; Liddy, Joshua J; Haddad, Jeffrey M; Busa, Michael A; Claxton, Laura J; van Emmerik, Richard E A

2018-04-01

Human locomotion is an inherently complex activity that requires the coordination and control of neurophysiological and biomechanical degrees of freedom across various spatiotemporal scales. Locomotor patterns must constantly be altered in the face of changing environmental or task demands, such as heterogeneous terrains or obstacles. Variability in stride times occurring at short time scales (e.g., 5-10 strides) is statistically correlated to larger fluctuations occurring over longer time scales (e.g., 50-100 strides). This relationship, known as fractal dynamics, is thought to represent the adaptive capacity of the locomotor system. However, this has not been tested empirically. Thus, the purpose of this study was to determine if stride time fractality during steady state walking associated with the ability of individuals to adapt their gait patterns when locomotor speed and symmetry are altered. Fifteen healthy adults walked on a split-belt treadmill at preferred speed, half of preferred speed, and with one leg at preferred speed and the other at half speed (2:1 ratio asymmetric walking). The asymmetric belt speed condition induced gait asymmetries that required adaptation of locomotor patterns. The slow speed manipulation was chosen in order to determine the impact of gait speed on stride time fractal dynamics. Detrended fluctuation analysis was used to quantify the correlation structure, i.e., fractality, of stride times. Cross-correlation analysis was used to measure the deviation from intended anti-phasing between legs as a measure of gait adaptation. Results revealed no association between unperturbed walking fractal dynamics and gait adaptability performance. However, there was a quadratic relationship between perturbed, asymmetric walking fractal dynamics and adaptive performance during split-belt walking, whereby individuals who exhibited fractal scaling exponents that deviated from 1/f performed the poorest. Compared to steady state preferred walking speed, fractal dynamics increased closer to 1/f when participants were exposed to asymmetric walking. These findings suggest there may not be a relationship between unperturbed preferred or slow speed walking fractal dynamics and gait adaptability. However, the emergent relationship between asymmetric walking fractal dynamics and limb phase adaptation may represent a functional reorganization of the locomotor system (i.e., improved interactivity between degrees of freedom within the system) to be better suited to attenuate externally generated perturbations at various spatiotemporal scales. Copyright © 2018 Elsevier B.V. All rights reserved.

HAL® exoskeleton training improves walking parameters and normalizes cortical excitability in primary somatosensory cortex in spinal cord injury patients.

PubMed

Sczesny-Kaiser, Matthias; Höffken, Oliver; Aach, Mirko; Cruciger, Oliver; Grasmücke, Dennis; Meindl, Renate; Schildhauer, Thomas A; Schwenkreis, Peter; Tegenthoff, Martin

2015-08-20

Reorganization in the sensorimotor cortex accompanied by increased excitability and enlarged body representations is a consequence of spinal cord injury (SCI). Robotic-assisted bodyweight supported treadmill training (BWSTT) was hypothesized to induce reorganization and improve walking function. To assess whether BWSTT with hybrid assistive limb® (HAL®) exoskeleton affects cortical excitability in the primary somatosensory cortex (S1) in SCI patients, as measured by paired-pulse somatosensory evoked potentials (ppSEP) stimulated above the level of injury. Eleven SCI patients took part in HAL® assisted BWSTT for 3 months. PpSEP were conducted before and after this training period, where the amplitude ratios (SEP amplitude following double pulses - SEP amplitude following single pulses) were assessed and compared to eleven healthy control subjects. To assess improvement in walking function, we used the 10-m walk test, timed-up-and-go test, the 6-min walk test, and the lower extremity motor score. PpSEPs were significantly increased in SCI patients as compared to controls at baseline. Following training, ppSEPs were increased from baseline and no longer significantly differed from controls. Walking parameters also showed significant improvements, yet there was no significant correlation between ppSEP measures and walking parameters. The findings suggest that robotic-assisted BWSTT with HAL® in SCI patients is capable of inducing cortical plasticity following highly repetitive, active locomotive use of paretic legs. While there was no significant correlation of excitability with walking parameters, brain areas other than S1 might reflect improvement of walking functions. EEG and neuroimaging studies may provide further information about supraspinal plastic processes and foci in SCI rehabilitation.

Assessing interactions among multiple physiological systems during walking outside a laboratory: An Android based gait monitor

PubMed Central

Sejdić, E.; Millecamps, A.; Teoli, J.; Rothfuss, M. A.; Franconi, N. G.; Perera, S.; Jones, A. K.; Brach, J. S.; Mickle, M. H.

2015-01-01

Gait function is traditionally assessed using well-lit, unobstructed walkways with minimal distractions. In patients with subclinical physiological abnormalities, these conditions may not provide enough stress on their ability to adapt to walking. The introduction of challenging walking conditions in gait can induce responses in physiological systems in addition to the locomotor system. There is a need for a device that is capable of monitoring multiple physiological systems in various walking conditions. To address this need, an Android-based gait-monitoring device was developed that enabled the recording of a patient's physiological systems during walking. The gait-monitoring device was tested during self-regulated overground walking sessions of fifteen healthy subjects that included 6 females and 9 males aged 18 to 35 years. The gait-monitoring device measures the patient's stride interval, acceleration, electrocardiogram, skin conductance and respiratory rate. The data is stored on an Android phone and is analyzed offline through the extraction of features in the time, frequency and time-frequency domains. The analysis of the data depicted multisystem physiological interactions during overground walking in healthy subjects. These interactions included locomotion-electrodermal, locomotion-respiratory and cardiolocomotion couplings. The current results depicting strong interactions between the locomotion system and the other considered systems (i.e., electrodermal, respiratory and cardivascular systems) warrant further investigation into multisystem interactions during walking, particularly in challenging walking conditions with older adults. PMID:26390946

Walking execution is not affected by divided attention in patients with multiple sclerosis with no disability, but there is a motor planning impairment.

PubMed

Nogueira, Leandro Alberto Calazans; Santos, Luciano Teixeira Dos; Sabino, Pollyane Galinari; Alvarenga, Regina Maria Papais; Thuler, Luiz Claudio Santos

2013-08-01

We analysed the cognitive influence on walking in multiple sclerosis (MS) patients, in the absence of clinical disability. A case-control study was conducted with 12 MS patients with no disability and 12 matched healthy controls. Subjects were referred for completion a timed walk test of 10 m and a 3D-kinematic analysis. Participants were instructed to walk at a comfortable speed in a dual-task (arithmetic task) condition, and motor planning was measured by mental chronometry. Scores of walking speed and cadence showed no statistically significant differences between the groups in the three conditions. The dual-task condition showed an increase in the double support duration in both groups. Motor imagery analysis showed statistically significant differences between real and imagined walking in patients. MS patients with no disability did not show any influence of divided attention on walking execution. However, motor planning was overestimated as compared with real walking.

Incidence of loss of ability to walk 400 meters in a functionally limited older population.

PubMed

Chang, Milan; Cohen-Mansfield, Jiska; Ferrucci, Luigi; Leveille, Suzanne; Volpato, Stefano; de Rekeneire, Nathalie; Guralnik, Jack M

2004-12-01

To assess the incidence of and factors related to nondisabled but functionally limited older adults aged 75 to 85 years losing the ability to walk 400 m. Observational study with average follow-up of 21 months. Community. At baseline, 101 persons with objective signs of functional limitations and intact cognitive function agreed to participate in the study. Of these, 81 were able to walk 400 m at baseline, and 62 participated in the follow-up examination. Mobility disability was defined as an inability to complete a 400-m walk test. At baseline, eligible participants (n=81) had the ability to walk 400 m, scored between 4 and 9 on the Short Physical Performance Battery (SPPB; range 0-12), and scored 18 or more on the Mini-Mental State Examination. Demographics, difficulty in daily activities, disease status, behavioral risk factors, and muscle strength were assessed at baseline and follow-up. Of 62 persons at follow-up, 21 (33.9%) developed incident mobility disability. The strongest predictors of loss of mobility were the time to complete the 400-m walk at baseline (odds ratio (OR)=1.6 per 1-minute difference, 95% confidence interval (CI)=1.04-2.45), and decline in SPPB score over the follow-up (OR=1.4 per 1-point difference, 95% CI=1.01-1.92). Older persons with functional limitations have a high rate of loss of ability to walk 400 m. The 400-m walk test is a highly relevant, discrete outcome that is an ideal target for testing preventive interventions in vulnerable older populations.

Functional Outcome of Neurologic-Controlled HAL-Exoskeletal Neurorehabilitation in Chronic Spinal Cord Injury: A Pilot With One Year Treatment and Variable Treatment Frequency.

PubMed

Jansen, Oliver; Schildhauer, Thomas A; Meindl, Renate C; Tegenthoff, Martin; Schwenkreis, Peter; Sczesny-Kaiser, Matthias; Grasmücke, Dennis; Fisahn, Christian; Aach, Mirko

2017-12-01

Longitudinal prospective study. Whether 1-year HAL-BWSTT of chronic spinal cord injured patients can improve independent ambulated mobility further as a function of training frequency, after an initial 3-month training period. Eight patients with chronic SCI were enrolled. They initially received full standard physical therapy and neurorehabilitation in the acute/subacute posttrauma phase. During this trial, all patients first underwent a daily (5 per week) HAL-BWSTT for 12 weeks. Subsequently, these patients performed a 40-week HAL-BWSTT with a training session frequency of either 1 or 3 to 5 sessions per week. The patients' functional status including HAL-associated treadmill-walking time, -distance, and -speed with additional analysis of gait pattern, and their independent (without wearing the robot suit) functional mobility improvements, were assessed using the 10-Meter-Walk Test (10MWT), Timed-Up-and-Go Test (TUG) and 6-Minute-Walk Test (6MinWT) on admission, at 6 weeks, 12 weeks, and 1 year after enrollment. The data were analyzed separately for the 2 training frequency subgroups after the initial 12-week training period, which was identical in both groups. During the 1-year follow-up, HAL-associated walking parameters and independent functional improvements were maintained in all the patients. This result held irrespective of the training frequency. Long-term 1-year maintenance of HAL-associated treadmill walking parameters and of improved independent walking abilities after initial 12 weeks of daily HAL-BWSTT is possible and depends mainly on the patients' ambulatory status accomplished after initial training period. Subsequent regular weekly training, but not higher frequency training, seems to be sufficient to preserve the improvements accomplished.

Functional Outcome of Neurologic-Controlled HAL-Exoskeletal Neurorehabilitation in Chronic Spinal Cord Injury: A Pilot With One Year Treatment and Variable Treatment Frequency

PubMed Central

Schildhauer, Thomas A.; Meindl, Renate C.; Tegenthoff, Martin; Schwenkreis, Peter; Sczesny-Kaiser, Matthias; Grasmücke, Dennis; Fisahn, Christian; Aach, Mirko

2017-01-01

Study Design: Longitudinal prospective study. Objectives: Whether 1-year HAL-BWSTT of chronic spinal cord injured patients can improve independent ambulated mobility further as a function of training frequency, after an initial 3-month training period. Methods: Eight patients with chronic SCI were enrolled. They initially received full standard physical therapy and neurorehabilitation in the acute/subacute posttrauma phase. During this trial, all patients first underwent a daily (5 per week) HAL-BWSTT for 12 weeks. Subsequently, these patients performed a 40-week HAL-BWSTT with a training session frequency of either 1 or 3 to 5 sessions per week. The patients’ functional status including HAL-associated treadmill-walking time, -distance, and -speed with additional analysis of gait pattern, and their independent (without wearing the robot suit) functional mobility improvements, were assessed using the 10-Meter-Walk Test (10MWT), Timed-Up-and-Go Test (TUG) and 6-Minute-Walk Test (6MinWT) on admission, at 6 weeks, 12 weeks, and 1 year after enrollment. The data were analyzed separately for the 2 training frequency subgroups after the initial 12-week training period, which was identical in both groups. Results: During the 1-year follow-up, HAL-associated walking parameters and independent functional improvements were maintained in all the patients. This result held irrespective of the training frequency. Conclusions: Long-term 1-year maintenance of HAL-associated treadmill walking parameters and of improved independent walking abilities after initial 12 weeks of daily HAL-BWSTT is possible and depends mainly on the patients’ ambulatory status accomplished after initial training period. Subsequent regular weekly training, but not higher frequency training, seems to be sufficient to preserve the improvements accomplished. PMID:29238636

Immediate Effects of Mental Singing While Walking on Gait Disturbance in Hemiplegic Stroke Patients: A Feasibility Study

PubMed Central

2018-01-01

Objective To investigate the immediate therapeutic effects of mental singing while walking intervention on gait disturbances in hemiplegic stroke patients. Methods Eligible, post-stroke, hemiplegic patients were prospectively enrolled in this study. The inclusion criteria were a diagnosis of hemiplegia due to stroke, and ability to walk more than 10 m with or without gait aids. Each patient underwent structured music therapy sessions comprising 7 consecutive tasks, and were trained to sing in their mind (mental singing) while walking. Before, and after training sessions, gait ability was assessed using the 10-Meter Walk Test (10MWT), the Timed Up and Go test (TUG), gait velocity, cadence and stride length. Results Twenty patients were enrolled in the interventions. Following the mental singing while walking intervention, significant improvement was observed in the 10MWT (13.16±7.61 to 12.27±7.58; p=0.002) and the TUG test (19.36±15.37 to 18.42±16.43; p=0.006). Significant improvement was also seen in gait cadence (90.36±29.11 to 95.36±30.2; p<0.001), stride length (90.99±33.4 to 98.17±35.33; p<0.001) and velocity (0.66±0.45 to 0.71±0.47; p<0.002). Conclusion These results indicate the possible effects of mental singing while walking on gait in patients diagnosed with hemiplegic stroke. PMID:29560318

Smartphone App–Based Assessment of Gait During Normal and Dual-Task Walking: Demonstration of Validity and Reliability

PubMed Central

Yu, Wanting; Zhu, Hao; Harrison, Rachel; Lo, On-Yee; Lipsitz, Lewis; Travison, Thomas; Pascual-Leone, Alvaro; Zhou, Junhong

2018-01-01

Background Walking is a complex cognitive motor task that is commonly completed while performing another task such as talking or making decisions. Gait assessments performed under normal and “dual-task” walking conditions thus provide important insights into health. Such assessments, however, are limited primarily to laboratory-based settings. Objective The objective of our study was to create and test a smartphone-based assessment of normal and dual-task walking for use in nonlaboratory settings. Methods We created an iPhone app that used the phone’s motion sensors to record movements during walking under normal conditions and while performing a serial-subtraction dual task, with the phone placed in the user’s pants pocket. The app provided the user with multimedia instructions before and during the assessment. Acquired data were automatically uploaded to a cloud-based server for offline analyses. A total of 14 healthy adults completed 2 laboratory visits separated by 1 week. On each visit, they used the app to complete three 45-second trials each of normal and dual-task walking. Kinematic data were collected with the app and a gold-standard–instrumented GAITRite mat. Participants also used the app to complete normal and dual-task walking trials within their homes on 3 separate days. Within laboratory-based trials, GAITRite-derived heel strikes and toe-offs of the phone-side leg aligned with smartphone acceleration extrema, following filtering and rotation to the earth coordinate system. We derived stride times—a clinically meaningful metric of locomotor control—from GAITRite and app data, for all strides occurring over the GAITRite mat. We calculated stride times and the dual-task cost to the average stride time (ie, percentage change from normal to dual-task conditions) from both measurement devices. We calculated similar metrics from home-based app data. For these trials, periods of potential turning were identified via custom-developed algorithms and omitted from stride-time analyses. Results Across all detected strides in the laboratory, stride times derived from the app and GAITRite mat were highly correlated (P<.001, r2=.98). These correlations were independent of walking condition and pocket tightness. App- and GAITRite-derived stride-time dual-task costs were also highly correlated (P<.001, r2=.95). The error of app-derived stride times (mean 16.9, SD 9.0 ms) was unaffected by the magnitude of stride time, walking condition, or pocket tightness. For both normal and dual-task trials, average stride times derived from app walking trials demonstrated excellent test-retest reliability within and between both laboratory and home-based assessments (intraclass correlation coefficient range .82-.94). Conclusions The iPhone app we created enabled valid and reliable assessment of stride timing—with the smartphone in the pocket—during both normal and dual-task walking and within both laboratory and nonlaboratory environments. Additional work is warranted to expand the functionality of this tool to older adults and other patient populations. PMID:29382625

Decreased Variability of the 6-Minute Walk Test by Heart Rate Correction in Patients with Neuromuscular Disease

PubMed Central

Prahm, Kira P.; Witting, Nanna; Vissing, John

2014-01-01

Objective The 6-minute walk test is widely used to assess functional status in neurological disorders. However, the test is subject to great inter-test variability due to fluctuating motivation, fatigue and learning effects. We investigated whether inter-test variability of the 6MWT can be reduced by heart rate correction. Methods Sixteen patients with neuromuscular diseases, including Facioscapulohumeral muscular dystrophy, Limb-girdle muscular dystrophy, Charcot-Marie-Tooths, Dystrophia Myotonica and Congenital Myopathy and 12 healthy subjects were studied. Patients were excluded if they had cardiac arrhythmias, if they received drug treatment for hypertension or any other medical conditions that could interfere with the interpretation of the heart rate and walking capability. All completed three 6-minute walk tests on three different test-days. Heart rate was measured continuously. Results Successive standard 6-minute walk tests showed considerable learning effects between Tests 1 and 2 (4.9%; P = 0.026), and Tests 2 and 3 (4.5%; P = 0.020) in patients. The same was seen in controls between Tests 1 and 2 (8.1%; P = 0.039)). Heart rate correction abolished this learning effect. Conclusion A modified 6-minute walk test, by correcting walking distance with average heart rate during walking, decreases the variability among repeated 6-minute walk tests, and should be considered as an alternative outcome measure to the standard 6-minute walk test in future clinical follow-up and treatment trials. PMID:25479403

[A new procedure for the estimation of physical fitness of patients during clinical rehabilitation using the 6-minutes walk test].

PubMed

Marek, W; Marek, E; Friz, Y; Vogel, P; Mückenhoff, K; Kotschy-Lang, N

2010-03-01

AIMS OF THE INVESTIGATION: The repetition of the 6-minutes walk test (6 MWT) in older patients is frequently performed in order to document the maximal walking distance, although it is not recommended in any guidelines on exercise tests and although there is common consent to save clinical resources in terms of time and staff. Therefore, we have examined whether and to what extent the repetition of the walk tests helps patients to get more familiar with this kind of exercise test. Thus the acquired physiological data should reliably describe the physical fitness of the patients at the beginning and at the end of their clinical rehabilitation. 35 patients performed their walk tests before and after 3 - 4 weeks of clinical rehabilitation. Each test has been repeated after one hour of recovery. The patients were instructed to walk during 6 minutes as fast as possible. They were equipped with a mobile pulse oximeter for recording oxygen saturation and heart rate. The distance, S, and the heart rate, fc, were measured. Measurements were performed every 30 seconds and recorded. The efficiency, E (E = S/6/fc), was calculated as the ratio of distance per minute and the mean heart rate during the test. In the first test the patients walked 416 +/- 63 m at a heart rate of 104.7 +/- 15.7 beats/min, in the first repeated test 454 +/- 71 m at a heart of 106.3 +/- 17.4 beats/min. In the second test, after clinical therapy, they walked 438 +/- 58 m at a heart rate of 106.3 +/- 17.4 beats/min, in the second repeated test 473 +/- 56 m at 108.6 +/- 13.2/min. The difference of the walking distances of the tests at the entrance were found to be 38.4 +/- 26.2 m (+ 9.3 +/- 6.2%), at the end of clinical rehabilitation 35 +/- 26 m (+ 8.4 +/- 6.4%). Both differences are found to be independent from the distance of the first test. They are not significantly different. The efficiency was not significantly different in the initial and final test (0.673 +/- 0.129 and 0.689 +/- 0.085 m/beat, respectively). The difference in efficiency, when repeating the tests at the beginning, was: 0.053 +/- 0.062 m/beat; at the end of the rehabilitation: 0.042 +/- 0.047 m/beat. They are found to be similar. The distances the patients walked in the repeated tests at the entrance and at the end of their clinical rehabilitation were, besides the calculated efficiency, E, significantly increased. However, the increases in distance and efficiency are identical on both occasions, therefore the repetition delivers no further information. The test should be performed without repetitions in clinical routine investigations. The patient's performance in the second walk test with an unchanged distance at a lower heart rate reveals an improved physical fitness. This is solely described by an increase of efficiency, E. Therefore the introduction of E is a suitable measure of the quantified effect of exercise training, even if the patient is not cooperative during the tests. E is proved to be a suitable estimation for the assessment of physical fitness as a benefit of clinical rehabilitation. Georg Thieme Verlag KG Stuttgart, New York.

Impact of a pilot walking school bus intervention on children's pedestrian safety behaviors: a pilot study

USDA-ARS?s Scientific Manuscript database

Walking school buses (WSB) increased children's physical activity, but impact on pedestrian safety behaviors (PSB) is unknown. We tested the feasibility of a protocol evaluating changes to PSB during a WSB program. Outcomes were school-level street crossing PSB prior to (Time 1) and during weeks 4–5...

76 FR 33631 - Energy Conservation Program: Test Procedures for Walk-In Coolers and Walk-In Freezers

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-09

... a multiplex condensing system. U-factor means the heat transmission in a unit time through a unit... 550 08 19 or http://www.cen.eu/ . (1) DIN EN 13164:2009-02, (``DIN EN 13164''), Thermal insulation... 13165''), Thermal insulation products for buildings--Factory made rigid polyurethane foam (PUR) products...

Anxiogenic effects of chronic exposure to nandrolone decanoate (ND) at supraphysiological dose in rats: a brief report.

PubMed

Rosic, Gvozden; Joksimovic, Jovana; Selakovic, Dragica; Milovanovic, Dragan; Jakovljevic, Vladimir

2014-01-01

Nandrolone decanoate (ND) is frequently used anabolic androgenic steroid (AAS) among the athletes. Despite the health risks, there is significant increase in prevalence of AAS abuse. The aim of this study was to investigate the effects of chronic exposure to ND at supraphysiological dose (to mimic the doses for human AAS abusers) on anxiety levels in adult rats. We performed several behavioral tests (open field test, elevated plus maze test, beam-walking test, evoked beam-walking test and tail suspension test) for estimation of anxiety in rats. Adult rats received 20 mg/kg intraperitoneal injection of ND weekly for four weeks. Behavioral test were performed on the seventh day after the last dose of ND. Anxiogenic-like pattern of behavior was clearly observed in several behavioral tests, such as open field test (decrease of total distance moved and cumulative duration of moving, decrease of an average velocity of the animals, decrease of frequency and total time in centre zone); elevated plus maze (decreased total time spent in open arms and the number of entries in open arms of the elevated plus maze); evoked beam-walking test (decreased time to cross the beam) and tail suspension test (increased latency to first immobility and decreased total duration of immobility). Results of this study show that four-week treatment with the supraphysiological dose of ND produced anxiogenic effects in sedentary male rats. Our results show that rats after chronic treatment with a supraphysiological dose of ND exhibited anxiety-like behavior.

Nordic walking versus walking without poles for rehabilitation with cardiovascular disease: Randomized controlled trial.

PubMed

Girold, Sébastien; Rousseau, Jérome; Le Gal, Magalie; Coudeyre, Emmanuel; Le Henaff, Jacqueline

2017-07-01

With Nordic walking, or walking with poles, one can travel a greater distance and at a higher rate than with walking without poles, but whether the activity is beneficial for patients with cardiovascular disease is unknown. This randomized controlled trial was undertaken to determine whether Nordic walking was more effective than walking without poles on walk distance to support rehabilitation training for patients with acute coronary syndrome (ACS) and peripheral arterial occlusive disease (PAOD). Patients were recruited in a private specialized rehabilitation centre for cardiovascular diseases. The entire protocol, including patient recruitment, took place over 2 months, from September to October 2013. We divided patients into 2 groups: Nordic Walking Group (NWG, n=21) and Walking Group without poles (WG, n=21). All patients followed the same program over 4 weeks, except for the walk performed with or without poles. The main outcome was walk distance on the 6-min walk test. Secondary outcomes were maximum heart rate during exercise and walk distance and power output on a treadmill stress test. We included 42 patients (35 men; mean age 57.2±11 years and BMI 26.5±4.5kg/m 2 ). At the end of the training period, both groups showed improved walk distance on the 6-min walk test and treatment stress test as well as power on the treadmill stress test (P<0.05). The NWG showed significantly greater walk distance than the WG (P<0.05). Both ACS and PAOD groups showed improvement, but improvement was significant for only PAOD patients. After a 4-week training period, Nordic walking training appeared more efficient than training without poles for increasing walk distance on the 6-min walk test for patients with ACS and PAOD. Copyright © 2017. Published by Elsevier Masson SAS.

Use of trunk stabilization and locomotor training in an adult with cerebellar ataxia: a single system design.

PubMed

Freund, Jane E; Stetts, Deborah M

2010-10-01

The purpose of this study is to describe the effects of trunk stabilization training and locomotor training (LT) using body-weight support on a treadmill (BWST) and overground walking on balance, gait, self-reported function, and trunk muscle performance in an adult with severe ataxia secondary to brain injury. There are no studies on the effectiveness of these combined interventions in persons with ataxia. The subject was a 23-year-old male who had a traumatic brain injury 13 months prior. An A-B-A withdrawal single-system design was used. Outcome measures were Berg Balance Test (BBT), timed unsupported stance, Functional Ambulation Category (FAC), 10-meter walk test (10-MWT), Outpatient Physical Therapy Improvement in Movement Assessment Log (OPTIMAL), transverse abdominis (TrA) thickness, and isometric trunk endurance tests. Performance on the BBT, timed unsupported stance, FAC, 10-MWT, and OPTIMAL each improved after 10 weeks of intervention. In additions, TrA symmetry at rest improved as did right side-bridge endurance time. LT, using BWST and overground walking, and trunk stabilization training may be effective in improving balance, gait, function, and trunk performance in individuals with severe ataxia. Further research with additional subjects is indicated.

An investigation of the validity of six measures of physical function in people awaiting joint replacement surgery of the hip or knee.

PubMed

Gill, Stephen D; de Morton, Natalie A; Mc Burney, Helen

2012-10-01

To assess and compare the validity of six physical function measures in people awaiting hip or knee joint replacement. Eighty-two people awaiting hip or knee replacement were assessed using six physical function measures including the WOMAC Function scale, SF-36 Physical Function scale, SF-36 Physical Component Summary scale, Patient Specific Functional Scale, 30-second chair stand test, and 50-foot timed walk. Validity was assessed using a head-to-head comparison design. Convergent validity was demonstrated with significant correlations between most measures (Spearman's rho 0.22 to 0.71). The Patient Specific Functional Scale had the lowest correlations with other measures of physical function. Discriminant validity was demonstrated with low correlations between mental health and physical function scores (Spearman's rho -0.12 to 0.33). Only the WOMAC Function scale, 30-second chair stand test, and 50-foot timed walk demonstrated known groups validity when scores for participants who walked with a gait aid were compared with those who did not. Standardized response means and Guyatt's responsiveness indexes indicated that the SF-36 was the least responsive measure. For those awaiting joint replacement surgery of the hip or knee, the current investigation found that the WOMAC Function scale, 30-second chair stand test, and 50-foot timed walk demonstrated the most evidence of validity. The Patient Specific Functional Scale might complement other measures by capturing a different aspect of physical function.

[Association between the canine monoamine oxidase B (MAOB) gene polymorphisms and behavior of puppies in open-field test].

PubMed

Li, Xiao-Hui; Xu, Han-Kun; Mao, Da-Gan; Ma, Da-Jun; Chen, Peng; Yang, Li-Guo

2006-11-01

Excitability, activity and exploration behavior of puppies in a novel open-field were tested in a total of 204 two-month-old German shepherd dog, labrador retriever or English springer spaniel puppies. The polymorphisms of monoamine oxidase B gene (MAOB) were detected by PCR-RFLP. Statistics analysis indicated that genotype and allele frequencies of the polymorphisms were significantly different among three breeds (P < 0.01). With GLM analysis of SAS software, association analysis was conducted between MAOB gene polymorphisms and locomotion and vocalization behavior parameters in the open-field test. The results showed that MAOB gene polymorphisms had a significant effect on walking time, squares crossed, lying time, the times of standing up against walls(P < 0.01 or P < 0.05) and were associated with the times of posture change (P=0.064). Walking time and squares crossed were higher in TT genotype puppies than those in TC and CC puppies (P < 0.05) and the times of posture change and standing up against walls were also higher than those in CC (P < 0.05). In addition, lying time in CC genotype puppies were higher than that in TT (P < 0.05). MAOB had a positive effect on walking time, lying time, squares crossed, the times of posture change, the times of standing up against walls in the three dog breeds that was highly statistically significant (P < 0.01 or P < 0.05). Our results imply that MAOB gene significantly affects the excitability, activity and exploration behavior of puppies in open-field test and TT genotype has favorable effects in these behavior traits.

Effects of a 6-Week Aquatic Treadmill Exercise Program on Cardiorespiratory Fitness and Walking Endurance in Subacute Stroke Patients: A PILOT TRIAL.

PubMed

Han, Eun Young; Im, Sang Hee

2017-03-15

To assess the feasibility and safety of a 6-week course of water walking performed using a motorized aquatic treadmill in individuals with subacute stroke for cardiorespiratory fitness, walking endurance, and activities of daily living. Twenty subacute stroke patents were randomly assigned to aquatic treadmill exercise (ATE) or land-based exercise (LBE). The ATE group (n = 10) performed water-based aerobic exercise on a motorized aquatic treadmill, and the LBE group (n = 10) performed land-based aerobic exercise on a cycle ergometer. Both groups performed aerobic exercise for 30 minutes, 5 times per week for 6 weeks. Primary outcome measures were 6-minute walk test for walking endurance and cardiopulmonary fitness parameters of a symptom-limited exercise tolerance test, and secondary measures were Korean version of the Modified Barthel Index (K-MBI) for activities of daily living. All variables were assessed at baseline and at the end of the intervention. The ATE group showed significant improvements in 6-minute walk test (P = .005), peak oxygen uptake (V·o2peak; P = .005), peak heart rate (P = .007), exercise tolerance test duration (P = .005), and K-MBI (P = .008). The LBE group showed a significant improvement only in K-MBI (P = .012). In addition, improvement in V·o2peak was greater in the ATE than in the LBE group. This preliminary study showed that a 6-week ATE program improved peak aerobic capacity and walking endurance in patients with subacute stroke. The improvement in V·o2peak after an ATE exercise program was greater than that observed after an LBE program. Therefore, ATE effectively improves cardiopulmonary fitness in patients with subacute stroke.

Automatic identification of inertial sensor placement on human body segments during walking

PubMed Central

2013-01-01

Background Current inertial motion capture systems are rarely used in biomedical applications. The attachment and connection of the sensors with cables is often a complex and time consuming task. Moreover, it is prone to errors, because each sensor has to be attached to a predefined body segment. By using wireless inertial sensors and automatic identification of their positions on the human body, the complexity of the set-up can be reduced and incorrect attachments are avoided. We present a novel method for the automatic identification of inertial sensors on human body segments during walking. This method allows the user to place (wireless) inertial sensors on arbitrary body segments. Next, the user walks for just a few seconds and the segment to which each sensor is attached is identified automatically. Methods Walking data was recorded from ten healthy subjects using an Xsens MVN Biomech system with full-body configuration (17 inertial sensors). Subjects were asked to walk for about 6 seconds at normal walking speed (about 5 km/h). After rotating the sensor data to a global coordinate frame with x-axis in walking direction, y-axis pointing left and z-axis vertical, RMS, mean, and correlation coefficient features were extracted from x-, y- and z-components and magnitudes of the accelerations, angular velocities and angular accelerations. As a classifier, a decision tree based on the C4.5 algorithm was developed using Weka (Waikato Environment for Knowledge Analysis). Results and conclusions After testing the algorithm with 10-fold cross-validation using 31 walking trials (involving 527 sensors), 514 sensors were correctly classified (97.5%). When a decision tree for a lower body plus trunk configuration (8 inertial sensors) was trained and tested using 10-fold cross-validation, 100% of the sensors were correctly identified. This decision tree was also tested on walking trials of 7 patients (17 walking trials) after anterior cruciate ligament reconstruction, which also resulted in 100% correct identification, thus illustrating the robustness of the method. PMID:23517757

Automatic identification of inertial sensor placement on human body segments during walking.

PubMed

Weenk, Dirk; van Beijnum, Bert-Jan F; Baten, Chris T M; Hermens, Hermie J; Veltink, Peter H

2013-03-21

Current inertial motion capture systems are rarely used in biomedical applications. The attachment and connection of the sensors with cables is often a complex and time consuming task. Moreover, it is prone to errors, because each sensor has to be attached to a predefined body segment. By using wireless inertial sensors and automatic identification of their positions on the human body, the complexity of the set-up can be reduced and incorrect attachments are avoided.We present a novel method for the automatic identification of inertial sensors on human body segments during walking. This method allows the user to place (wireless) inertial sensors on arbitrary body segments. Next, the user walks for just a few seconds and the segment to which each sensor is attached is identified automatically. Walking data was recorded from ten healthy subjects using an Xsens MVN Biomech system with full-body configuration (17 inertial sensors). Subjects were asked to walk for about 6 seconds at normal walking speed (about 5 km/h). After rotating the sensor data to a global coordinate frame with x-axis in walking direction, y-axis pointing left and z-axis vertical, RMS, mean, and correlation coefficient features were extracted from x-, y- and z-components and magnitudes of the accelerations, angular velocities and angular accelerations. As a classifier, a decision tree based on the C4.5 algorithm was developed using Weka (Waikato Environment for Knowledge Analysis). After testing the algorithm with 10-fold cross-validation using 31 walking trials (involving 527 sensors), 514 sensors were correctly classified (97.5%). When a decision tree for a lower body plus trunk configuration (8 inertial sensors) was trained and tested using 10-fold cross-validation, 100% of the sensors were correctly identified. This decision tree was also tested on walking trials of 7 patients (17 walking trials) after anterior cruciate ligament reconstruction, which also resulted in 100% correct identification, thus illustrating the robustness of the method.

Plantarflexor weakness negatively impacts walking in persons with multiple sclerosis more than plantarflexor spasticity

PubMed Central

Wagner, Joanne M.; Kremer, Theodore R.; Van Dillen, Linda R.; Naismith, Robert T.

2014-01-01

Objective To determine if plantarflexor (PF) spasticity or ankle strength best predicts variance in walking capacity or self-perceived limitations in walking in persons with multiple sclerosis (pwMS), and if pwMS with PF spasticity are weaker and have greater walking dysfunction than pwMS without PF spasticity. Design Cross-sectional study. Setting University research laboratory. Participants Forty-two pwMS (age: 42.9 ± 10.1 years; Expanded Disability Status Scale (EDSS): median = 3.0, range = 0–6) and 14 adults without disability (WD) (age: 41.9 ± 10.1 years). Intervention Not applicable. Main Outcome Measures PF spasticity and dorsiflexion (DF) and PF maximum voluntary isometric torque (MVIT) were assessed using the Modified Ashworth Scale (MAS) and a computerized dynamometer, respectively. The Timed 25-Foot Walk Test (T25FWT) was the primary outcome measure of walking capacity. Secondary measures included the Six Minute Walk Test (6MWT) and 12-item Multiple Sclerosis Walking Scale (MSWS-12). Results PF strength was the most consistent predictor of the variance in walking capacity (T25FWT: R2 change = 0.23 to 0.29, p ≤ 0.001; 6MWT: R2 change = 0.12 to 0.29, p ≤ 0.012), and self-perceived limitations of walking (MSWS-12: R2 change = 0.04 to 0.14, p < 0.18). There were no significant differences (p > 0.05) between the pwMS with PF spasticity and pwMS without PF spasticity for any of the outcome measures. Conclusions Our study suggests a unique contribution of PF weakness to walking dysfunction in pwMS, and highlights the importance of evaluating PF strength in this clinical population. PMID:24582617

Maximum walking speeds obtained using treadmill and overground robot system in persons with post-stroke hemiplegia

PubMed Central

2012-01-01

Background Previous studies demonstrated that stroke survivors have a limited capacity to increase their walking speeds beyond their self-selected maximum walking speed (SMWS). The purpose of this study was to determine the capacity of stroke survivors to reach faster speeds than their SMWS while walking on a treadmill belt or while being pushed by a robotic system (i.e. “push mode”). Methods Eighteen chronic stroke survivors with hemiplegia were involved in the study. We calculated their self-selected comfortable walking speed (SCWS) and SMWS overground using a 5-meter walk test (5-MWT). Then, they were exposed to walking at increased speeds, on a treadmill and while in “push mode” in an overground robotic device, the KineAssist, until they were tested at a speed that they could not sustain without losing balance. We recorded the time and number of steps during each trial and calculated gait speed, average cadence and average step length. Results Maximum walking speed in the “push mode” was 13% higher than the maximum walking speed on the treadmill and both were higher (“push mode”: 61%; treadmill: 40%) than the maximum walking speed overground. Subjects achieved these faster speeds by initially increasing both step length and cadence and, once individuals stopped increasing their step length, by only increasing cadence. Conclusions With post-stroke hemiplegia, individuals are able to walk at faster speeds than their SMWS overground, when provided with a safe environment that provides external forces that requires them to attempt dynamic stability maintenance at higher gait speeds. Therefore, this study suggests the possibility that, given the appropriate conditions, people post-stroke can be trained at higher speeds than previously attempted. PMID:23057500

Detecting Behavioral Deficits in Rats After Traumatic Brain Injury

PubMed Central

Parsley, Margaret A.; Guptarak, Jutatip; Spratt, Heidi; Sell, Stacy L.

2018-01-01

With the increasing incidence of traumatic brain injury (TBI) in both civilian and military populations, TBI is now considered a chronic disease; however, few studies have investigated the long-term effects of injury in rodent models of TBI. Shown here are behavioral measures that are well-established in TBI research for times early after injury, such as two weeks, until two months. Some of these methods have previously been used at later times after injury, up to one year, but by very few laboratories. The methods demonstrated here are a short neurological assessment to test reflexes, a Beam-Balance to test balance, a Beam-Walk to test balance and motor coordination, and a working memory version of the Morris water maze that can be sensitive to deficits in reference memory. Male rats were handled and pre-trained to neurological, balance, and motor coordination tests prior to receiving parasagittal fluid percussion injury (FPI) or sham injury. Rats can be tested on the short neurological assessment (neuroscore), the beam-balance, and the Beam-Walk multiple times, while testing on the water maze can only be done once. This difference is because rats can remember the task, thus confounding the results if repeated testing is attempted in the same animal. When testing from one to three days after injury, significant differences are detected in all three non-cognitive tasks. However, differences in the Beam-Walk task were not detectable at later time points (after 3 months). Deficits were detected at 3 months in the Beam-Balance and at 6 months in the neuroscore. Deficits in working memory were detected out to 12 months after injury, and a deficit in a reference memory first appeared at 12 months. Thus, standard behavioral tests can be useful measures of persistent behavioral deficits after FPI. PMID:29443022

Urban form relationships with walk trip frequency and distance among youth.

PubMed

Frank, Lawrence; Kerr, Jacqueline; Chapman, Jim; Sallis, James

2007-01-01

To assess the relationship among objectively measured urban form variables, age, and walking in youth. Cross-sectional analyses of travel diary data mapped against urban form characteristics within a 1-km buffer of participant's place of residence. Setting. Youth in the Atlanta, Georgia region with selection stratified by income, household size, and residential density. A total of 3161 5- to 20-year-olds who completed 2-day travel diaries. Diaries of those under 15 years were completed by a parent or legal guardian. Walking distances were calculated from a 2-day travel diary. Residential density, intersection density, land use mix, and commercial and recreation space were assessed within a 1-km network distance around residences. Analysis. Logistic regression analyses were performed for each urban form variable by age groups controlling for the demographic variables. All variables were then entered simultaneously into an analysis of the whole sample. All five urban form variables tested were related to walking. Recreation space was the only variables associated with walking across the four different age groups. All the urban form variables were related to walking in the 12 to 15 years age cohort. For this group, the odds of walking were 3. 7 times greater for those in highest- versus lowest-density tertile and 2.6 times greater for those with at least one commercial and 2.5 times greater for those with at least one recreational destination within 1 km from home. In the analysis of the full sample, number of cars, recreation space, and residential density were most strongly related to walking. Access to recreation or open space was the most important urban form variable related to walking for all age groups. Children aged 12 to 15 years old may be particularly influenced by urban form.

The relative temporal sequence of decline in mobility and cognition among initially unimpaired older adults: Results from the Baltimore Longitudinal Study of Aging.

PubMed

Tian, Qu; An, Yang; Resnick, Susan M; Studenski, Stephanie

2017-05-01

most older individuals who experience mobility decline, also show cognitive decline, but whether cognitive decline precedes or follows mobility limitation is not well understood. examine the temporal sequence of mobility and cognition among initially unimpaired older adults. mobility and cognition were assessed every 2 years for 6 years in 412 participants aged ≥60 with initially unimpaired cognition and gait speed. Using autoregressive models, accounting for the dependent variable from the prior assessment, baseline age, sex, body mass index and education, we examine the temporal sequence of change in mobility (6 m usual gait speed, 400 m fast walk time) and executive function (visuoperceptual speed: Digit Symbol Substitution Test (DSST); cognitive flexibility: Trail Making Test part B (TMT-B)) or memory (California Verbal Learning Test (CVLT) immediate, short-delay, long-delay). there was a bidirectional relationship over time between slower usual gait speed and both poorer DSST and TMT-B scores (Bonferroni-corrected P < 0.005). In contrast, slower 400 m fast walk time predicted subsequent poorer DSST, TMT-B, CVLT immediate recall and CVLT short-delay scores (P < 0.005), while these measures did not predict subsequent 400 m fast walk time (P > 0.005). among initially unimpaired older adults, the temporal relationship between usual gait speed and executive function is bidirectional, with each predicting change in the other, while poor fast walking performance predicts future executive function and memory changes but not vice versa. Challenging tasks like the 400 m walk appear superior to usual gait speed for predicting executive function and memory change in unimpaired older adults. Published by Oxford University Press on behalf of the British Geriatrics Society 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Combining Fast-Walking Training and a Step Activity Monitoring Program to Improve Daily Walking Activity After Stroke: A Preliminary Study.

PubMed

Danks, Kelly A; Pohlig, Ryan; Reisman, Darcy S

2016-09-01

To determine preliminary efficacy and to identify baseline characteristics predicting who would benefit most from fast walking training plus a step activity monitoring program (FAST+SAM) compared with fast walking training (FAST) alone in persons with chronic stroke. Randomized controlled trial with blinded assessors. Outpatient clinical research laboratory. Individuals (N=37) >6 months poststroke. Subjects were assigned to either FAST, which was walking training at their fastest possible speed on the treadmill (30min) and overground 3 times per week for 12 weeks, or FAST+SAM. The step activity monitoring program consisted of daily step monitoring with an activity monitor, goal setting, and identification of barriers to activity and strategies to overcome barriers. Daily step activity metrics (steps/day [SPD], time walking per day), walking speed, and 6-minute walk test (6MWT) distance. There was a significant effect of time for both groups, with all outcomes improving from pre- to posttraining (all P values <.05). The FAST+SAM was superior to FAST for 6MWT (P=.018), with a larger increase in the FAST+SAM group. The interventions had differential effectiveness based on baseline step activity. Sequential moderated regression models demonstrated that for subjects with baseline levels of step activity and 6MWT distances that were below the mean, the FAST+SAM intervention was more effective than FAST (1715±1584 vs 254±933 SPD; P<.05 for overall model and ΔR(2) for SPD and 6MWT). The addition of a step activity monitoring program to a fast walking training intervention may be most effective in persons with chronic stroke who have initial low levels of walking endurance and activity. Regardless of baseline performance, the FAST+SAM intervention was more effective for improving walking endurance. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Combining fast walking training and a step activity monitoring program to improve daily walking activity after stroke: a preliminary study

PubMed Central

Danks, Kelly A.; Pohlig, Ryan; Reisman, Darcy S.

2016-01-01

Objective To determine preliminary efficacy and to identify baseline characteristics predicting who would benefit most from fast walking training plus a step activity monitoring program (FAST+SAM) compared to fast walking training alone (FAST) in persons with chronic stroke. Design Randomized controlled trial with blinded assessors Setting Outpatient clinical research laboratory Participants 37 individuals greater than 6 months post-stroke. Interventions Subjects were assigned to either FAST which was walking training at their fastest possible speed on the treadmill (30 minutes) and over ground 3 times/week for 12 weeks or FAST plus a step activity monitoring program (FAST+SAM). The step activity monitoring program consisted of daily step monitoring with a StepWatch Activity monitor, goal setting, and identification of barriers to activity and strategies to overcome barriers. Main Outcome Measures Daily step activity metrics (steps/day, time walking/day), walking speed and six minute walk test distance (6MWT). Results There was a significant effect of time for both groups with all outcomes improving from pre to post-training, (all p<0.05). The FAST+SAM was superior to FAST for 6MWT (p=0.018), with a larger increase in the FAST+SAM group. The interventions had differential effectiveness based on baseline step activity. Sequential moderated regression models demonstrated that for subjects with baseline levels of step activity and 6MWT distances that were below the mean, the FAST+SAM intervention was more effective than FAST (1715±1584 vs. 254±933 steps/day, respectively; p<0.05 for overall model and ΔR2 for steps/day and 6MWT). Conclusions The addition of a step activity monitoring program to a fast walking training intervention may be most effective in persons with chronic stroke that have initial low levels of walking endurance and activity. Regardless of baseline performance, the FAST + SAM intervention was more effective for improving walking endurance. PMID:27240430

Women with fibromyalgia walk with an altered muscle synergy.

PubMed

Pierrynowski, Michael R; Tiidus, Peter M; Galea, Victoria

2005-11-01

Most individuals can use different movement and muscle recruitment patterns to perform a stated task but often only one pattern is selected which optimizes an unknown global objective given the individual's neuromusculoskeletal characteristics. Patients with fibromyalgia syndrome (FS), characterized by their chronic pain, reduced physical work capacity and muscular fatigue, could exhibit a different control signature compared to asymptomatic control volunteers (CV). To test this proposal, 22 women with FS, and 11 CV, were assessed in a gait analysis laboratory. Each subject walked repeatedly at self-selected slow, comfortable, and fast walking speeds. The gait analysis provided, for each walk, each subject's stride time, length, and velocity, and ground reaction force, and lower extremity joint kinematics, moments and powers. The data were then anthropometrically scaled and velocity normalized to reduce the influence of subject mass, leg length, and walking speed on the measured gait outcomes. Similarities and differences in the two groups' scaled and normalized gait patterns were then determined. Results show that FS and CV walk with externally similar stride lengths, times, and velocities, and joint angles and ground reaction forces but they use internally different muscle recruitment patterns. Specifically, FS preferentially power gait using their hip flexors instead of their ankle plantarflexors. Interestingly, CV use a similar muscle fatiguing recruitment pattern to walk fast which parallels the common complaint of fatigue reported by FS walking at comfortable speed.

Functional effects of treadmill-based gait training at faster speeds in stroke survivors: a prospective, single-group study.

PubMed

Mohammadi, Roghayeh; Ershad, Navid; Rezayinejad, Marziyeh; Fatemi, Elham; Phadke, Chetan P

2017-09-01

To examine the functional effects of walking retraining at faster than self-selected speed (SSS). Ten individuals with chronic stroke participated in a 4-week training over a treadmill at walking speeds 40% faster than SSS, three times per week, 30 min/session. Outcome measures assessed before, after, and 2 months after the end of intervention were the Timed Up and Go, the 6-Minute Walk, the 10-Meter Walk test, the Modified Ashworth Scale, SSS, and fastest comfortable speed. After 4 weeks of training, all outcome measures showed clinically meaningful and statistically significant improvements (P<0.05) that were maintained at 2 months after the end of the training. The results showed that a strategy of training at a speed 40% faster than SSS can improve functional activity in individuals with chronic stroke, with effects lasting up to 2 months after the intervention.

Walking stability and sensorimotor function in older people with diabetic peripheral neuropathy.

PubMed

Menz, Hylton B; Lord, Stephen R; St George, Rebecca; Fitzpatrick, Richard C

2004-02-01

To evaluate, in older people with diabetic peripheral neuropathy (DPN) and in age-matched controls, acceleration patterns of the head and pelvis when walking to determine the effect of lower-limb sensory loss on walking stability. Case-control study. Falls and balance laboratory in Australia. Thirty persons with diabetes mellitus (age range, 55-91 y) and 30 age-matched controls. Acceleration patterns of the head and pelvis were measured while participants walked on a level surface and an irregular walkway. Participants also underwent tests of vision, sensation, strength, reaction time, and balance. Temporospatial gait parameters and variables derived from acceleration signals. Participants with DPN had reduced walking speed, cadence, and step length, and less rhythmic acceleration patterns at the head and pelvis compared with controls. These differences were particularly evident when participants walked on the irregular surface. Participants with DPN also had impaired peripheral sensation, reaction time, and balance. Older people with DPN have an impaired ability to stabilize their body when walking on irregular surfaces, even if they adopt a more conservative gait pattern. These results provide further insights into the role of peripheral sensory input in the control of gait stability, and suggest possible mechanisms underlying the increased risk of falling in older people with diabetic neuropathy.

An evaluation of the impact of flooring types on exposures to fine and coarse particles within the residential micro-environment using CONTAM.

PubMed

Bramwell, Lisa; Qian, Jing; Howard-Reed, Cynthia; Mondal, Sumona; Ferro, Andrea R

2016-01-01

Typical resuspension activities within the home, such as walking, have been estimated to contribute up to 25% of personal exposures to PM10. Chamber studies have shown that for moderate walking intensities, flooring type can impact the rate at which particles are re-entrained into the air. For this study, the impact of residential flooring type on incremental average daily (24 h) time-averaged exposure was investigated. Distributions of incremental time-averaged daily exposures to fine and coarse PM while walking within the residential micro-environment were predicted using CONTAM, the multizone airflow and contaminant transport program of the National Institute of Standards and Technology. Knowledge of when and where a person was walking was determined by randomly selecting 490 daily diaries from the EPA's consolidated human activity database (CHAD). On the basis of the results of this study, residential flooring type can significantly impact incremental time-averaged daily exposures to coarse and fine particles (α=0.05, P<0.05, N=490, Kruskal-Wallis test) with high-density cut pile carpeting resulting in the highest exposures. From this study, resuspension from walking within the residential micro-environment contributed 6-72% of time-averaged daily exposures to PM10.

Exercise in Patients on Dialysis: A Multicenter, Randomized Clinical Trial.

PubMed

Manfredini, Fabio; Mallamaci, Francesca; D'Arrigo, Graziella; Baggetta, Rossella; Bolignano, Davide; Torino, Claudia; Lamberti, Nicola; Bertoli, Silvio; Ciurlino, Daniele; Rocca-Rey, Lisa; Barillà, Antonio; Battaglia, Yuri; Rapanà, Renato Mario; Zuccalà, Alessandro; Bonanno, Graziella; Fatuzzo, Pasquale; Rapisarda, Francesco; Rastelli, Stefania; Fabrizi, Fabrizio; Messa, Piergiorgio; De Paola, Luciano; Lombardi, Luigi; Cupisti, Adamasco; Fuiano, Giorgio; Lucisano, Gaetano; Summaria, Chiara; Felisatti, Michele; Pozzato, Enrico; Malagoni, Anna Maria; Castellino, Pietro; Aucella, Filippo; Abd ElHafeez, Samar; Provenzano, Pasquale Fabio; Tripepi, Giovanni; Catizone, Luigi; Zoccali, Carmine

2017-04-01

Previous studies have suggested the benefits of physical exercise for patients on dialysis. We conducted the Exercise Introduction to Enhance Performance in Dialysis trial, a 6-month randomized, multicenter trial to test whether a simple, personalized walking exercise program at home, managed by dialysis staff, improves functional status in adult patients on dialysis. The main study outcomes included change in physical performance at 6 months, assessed by the 6-minute walking test and the five times sit-to-stand test, and in quality of life, assessed by the Kidney Disease Quality of Life Short Form (KDQOL-SF) questionnaire. We randomized 296 patients to normal physical activity (control; n =145) or walking exercise ( n =151); 227 patients (exercise n =104; control n =123) repeated the 6-month evaluations. The distance covered during the 6-minute walking test improved in the exercise group (mean distance±SD: baseline, 328±96 m; 6 months, 367±113 m) but not in the control group (baseline, 321±107 m; 6 months, 324±116 m; P <0.001 between groups). Similarly, the five times sit-to-stand test time improved in the exercise group (mean time±SD: baseline, 20.5±6.0 seconds; 6 months, 18.2±5.7 seconds) but not in the control group (baseline, 20.9±5.8 seconds; 6 months, 20.2±6.4 seconds; P =0.001 between groups). The cognitive function score ( P =0.04) and quality of social interaction score ( P =0.01) in the kidney disease component of the KDQOL-SF improved significantly in the exercise arm compared with the control arm. Hence, a simple, personalized, home-based, low-intensity exercise program managed by dialysis staff may improve physical performance and quality of life in patients on dialysis. Copyright © 2017 by the American Society of Nephrology.

Rehabilitation that incorporates virtual reality is more effective than standard rehabilitation for improving walking speed, balance and mobility after stroke: a systematic review.

PubMed

Corbetta, Davide; Imeri, Federico; Gatti, Roberto

2015-07-01

In people after stroke, does virtual reality based rehabilitation (VRBR) improve walking speed, balance and mobility more than the same duration of standard rehabilitation? In people after stroke, does adding extra VRBR to standard rehabilitation improve the effects on gait, balance and mobility? Systematic review with meta-analysis of randomised trials. Adults with a clinical diagnosis of stroke. Eligible trials had to include one these comparisons: VRBR replacing some or all of standard rehabilitation or VRBR used as extra rehabilitation time added to a standard rehabilitation regimen. Walking speed, balance, mobility and adverse events. In total, 15 trials involving 341 participants were included. When VRBR replaced some or all of the standard rehabilitation, there were statistically significant benefits in walking speed (MD 0.15 m/s, 95% CI 0.10 to 0.19), balance (MD 2.1 points on the Berg Balance Scale, 95% CI 1.8 to 2.5) and mobility (MD 2.3 seconds on the Timed Up and Go test, 95% CI 1.2 to 3.4). When VRBR was added to standard rehabilitation, mobility showed a significant benefit (0.7 seconds on the Timed Up and Go test, 95% CI 0.4 to 1.1), but insufficient evidence was found to comment about walking speed (one trial) and balance (high heterogeneity). Substituting some or all of a standard rehabilitation regimen with VRBR elicits greater benefits in walking speed, balance and mobility in people with stroke. Although the benefits are small, the extra cost of applying virtual reality to standard rehabilitation is also small, especially when spread over many patients in a clinic. Adding extra VRBR time to standard rehabilitation also has some benefits; further research is needed to determine if these benefits are clinically worthwhile. Copyright © 2015 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

Effect of Australia's Walk to Work Day campaign on adults' active commuting and physical activity behavior.

PubMed

Merom, Dafna; Miller, Yvette; Lymer, Sharyn; Bauman, Adrian

2005-01-01

To determine whether Australia's Walk to Work Day media campaign resulted in behavioral change among targeted groups. Pre- and postcampaign telephone surveys of a cohort of adults aged 18 to 65 years (n = 1100, 55% response rate) were randomly sampled from Australian major metropolitan areas. Tests for dependent samples were applied (McNemar chi2 or paired t-test). Among participants who did not usually actively commute to work was a significant decrease in "car only" use and an increase in walking combined with public transport. Among those who were employed was a significant increase in total time walking (+ 16 min/wk; t [780] = 2.04, p < .05) and in other moderate physical activity (+120 min/wk; t [1087] = 4.76, p < .005), resulting in a significant decrease in the proportion who were "inactive" (chi2 (1) = 6.1, p <.05). Although nonexperimental, the Walk to Work Day initiative elicited shortterm changes in targeted behaviors among target groups. Reinforcement by integrating worksite health promotion strategies may be required for sustained effects.

Peripheral neuropathy, decreased muscle strength and obesity are strongly associated with walking in persons with type 2 diabetes without manifest mobility limitations.

PubMed

van Sloten, Thomas T; Savelberg, Hans H C M; Duimel-Peeters, Inge G P; Meijer, Kenneth; Henry, Ronald M A; Stehouwer, Coen D A; Schaper, Nicolaas C

2011-01-01

We evaluated the associations of diabetic complications and underlying pathology with daily walking activity in type 2 diabetic patients without manifest mobility limitations. 100 persons with type 2 diabetes (mean age 64.5 ± 9.4 years) were studied. Persons with manifest mobility limitations were excluded. Possible determinants measured: peripheral neuropathy, neuropathic pain, peripheral arterial disease, cardiovascular disease, decreased muscle strength (handgrip strength), BMI, depression, falls and fear of falling. Walking activity was measured during one week with a pedometer. Functional capacity was measured with the 6 min walk test, the timed "up and go" test and a stair climbing test. prevalence of neuropathy (40%) and obesity (53%) was high. Persons took a median of 6429 steps/day. In multivariate regression analysis, adjusted for age and sex, neuropathy was associated with a reduction of 1967 steps/day, decreased muscle strength with 1782 steps/day, and an increase in BMI of 1 kg/m(2) with a decrease of 210 steps/day (all p<0.05). Decreased muscle strength and BMI, but not neuropathy, were associated with outcome of functional capacity tests in multiple regression analysis. peripheral neuropathy, decreased muscle strength and obesity are strongly associated with walking in persons with type 2 diabetes without manifest mobility limitations. 2010 Elsevier Ireland Ltd. All rights reserved.

Walk well: a randomised controlled trial of a walking intervention for adults with intellectual disabilities: study protocol

PubMed Central

2013-01-01

Background Walking interventions have been shown to have a positive impact on physical activity (PA) levels, health and wellbeing for adult and older adult populations. There has been very little work carried out to explore the effectiveness of walking interventions for adults with intellectual disabilities. This paper will provide details of the Walk Well intervention, designed for adults with intellectual disabilities, and a randomised controlled trial (RCT) to test its effectiveness. Methods/design This study will adopt a RCT design, with participants allocated to the walking intervention group or a waiting list control group. The intervention consists of three PA consultations (baseline, six weeks and 12 weeks) and an individualised 12 week walking programme. A range of measures will be completed by participants at baseline, post intervention (three months from baseline) and at follow up (three months post intervention and six months from baseline). All outcome measures will be collected by a researcher who will be blinded to the study groups. The primary outcome will be steps walked per day, measured using accelerometers. Secondary outcome measures will include time spent in PA per day (across various intensity levels), time spent in sedentary behaviour per day, quality of life, self-efficacy and anthropometric measures to monitor weight change. Discussion Since there are currently no published RCTs of walking interventions for adults with intellectual disabilities, this RCT will examine if a walking intervention can successfully increase PA, health and wellbeing of adults with intellectual disabilities. Trial registration ISRCTN: ISRCTN50494254 PMID:23816316

Effects of Acupuncture on Gait of Patients with Multiple Sclerosis.

PubMed

Criado, Maria Begoña; Santos, Maria João; Machado, Jorge; Gonçalves, Arminda Manuela; Greten, Henry Johannes

2017-11-01

Multiple sclerosis is considered a complex and heterogeneous disease. Approximately 85% of patients with multiple sclerosis indicate impaired gait as one of the major limitations in their daily life. Acupuncture studies found a reduction of spasticity and improvement of fatigue and imbalance in patients with multiple sclerosis, but there is a lack of studies regarding gait. We designed a study of acupuncture treatment, according to the Heidelberg model of Traditional Chinese Medicine (TCM), to investigate if acupuncture can be a useful therapeutic strategy in patients with gait impairment in multiple sclerosis of relapsing-remitting type. The sample consisted of 20 individuals with diagnosis of multiple sclerosis of relapsing-remitting type. Gait impairment was evaluated by the 25-foot walk test. The results showed differences in time to walk 25 feet following true acupuncture. In contrast, there was no difference in time to walk 25 feet following sham acupuncture. When using true acupuncture, 95% of cases showed an improvement in 25-foot walk test, compared with 45% when sham acupuncture was done. Our study protocol provides evidence that acupuncture treatment can be an attractive option for patients with multiple sclerosis, with gait impairment.

Validity and reliability of the 6 minute walk in persons with fibromyalgia.

PubMed

King, S; Wessel, J; Bhambhani, Y; Maikala, R; Sholter, D; Maksymowych, W

1999-10-01

To assess the reliability and construct validity of the 6 minute walk (6MW) in persons with fibromyalgia (FM) and to determine an equation for predicting peak oxygen consumption (pVO2) from the distance covered in 6 minutes. Ninety-six women who met the American College of Rheumatology (ACR) criteria for FM were tested on the 6MW and the Fibromyalgia Impact Questionnaire (FIQ). A subset (n = 23) were tested on a separate day for pVO2 during a symptom-limited, incremental treadmill test. Twelve subjects repeated the 6MW five times over 10 days. Heart rate and rating of perceived exertion (RPE) were recorded for each walk. Intraclass correlations were used to determine the reliability of the 6MW. Validity was examined by correlating the 6MW with pVO2 and the FIQ. Body mass index (BMI) and 6MW were independent variables in a stepwise regression to predict pVO2. A significant increase in distance occurred from Walk 1 to Walk 2 (p = 0.000) with the distance maintained on the remaining walks (p = 0.148) The correlations of the 6MW with the FIQ and pVO2 were -0.325 and 0.657, respectively. The regression equation to predict pVO2 from 6MW distance and BMI was: pVO2 (ml/kg/min) = 21.48 + (-0.4316 x BMI) + [0.0304 x distance(m)] (R = 0.76, R2 = 0.66). When using the 6MW it is necessary to conduct a practice walk, with the second walk taken as the baseline measure. It was determined from the correlations that the 6MW cannot replace the FIQ as a measure of function. The 6MW may be used as an indicator of aerobic fitness, although obtaining VO2 by means of a graded exercise test is preferable.

Quantitative measures of walking and strength provide insight into brain corticospinal tract pathology in multiple sclerosis.

PubMed

Fritz, Nora E; Keller, Jennifer; Calabresi, Peter A; Zackowski, Kathleen M

2017-01-01

At least 85% of individuals with multiple sclerosis report walking dysfunction as their primary complaint. Walking and strength measures are common clinical measures to mark increasing disability or improvement with rehabilitation. Previous studies have shown an association between strength or walking ability and spinal cord MRI measures, and strength measures with brainstem corticospinal tract magnetization transfer ratio. However, the relationship between walking performance and brain corticospinal tract magnetization transfer imaging measures and the contribution of clinical measurements of walking and strength to the underlying integrity of the corticospinal tract has not been explored in multiple sclerosis. The objectives of this study were explore the relationship of quantitative measures of walking and strength to whole-brain corticospinal tract-specific MRI measures and to determine the contribution of quantitative measures of function in addition to basic clinical measures (age, gender, symptom duration and Expanded Disability Status Scale) to structural imaging measures of the corticospinal tract. We hypothesized that quantitative walking and strength measures would be related to brain corticospinal tract-specific measures, and would provide insight into the heterogeneity of brain pathology. Twenty-nine individuals with relapsing-remitting multiple sclerosis (mean(SD) age 48.7 (11.5) years; symptom duration 11.9(8.7); 17 females; median[range] Expanded Disability Status Scale 4.0 [1.0-6.5]) and 29 age and gender-matched healthy controls (age 50.8(11.6) years; 20 females) participated in clinical tests of strength and walking (Timed Up and Go, Timed 25 Foot Walk, Two Minute Walk Test ) as well as 3 T imaging including diffusion tensor imaging and magnetization transfer imaging. Individuals with multiple sclerosis were weaker (p = 0.0024) and walked slower (p = 0.0013) compared to controls. Quantitative measures of walking and strength were significantly related to corticospinal tract fractional anisotropy (r > 0.26; p < 0.04) and magnetization transfer ratio (r > 0.29; p < 0.03) measures. Although the Expanded Disability Status Scale was highly correlated with walking measures, it was not significantly related to either corticospinal tract fractional anisotropy or magnetization transfer ratio (p > 0.05). Walk velocity was a significant contributor to magnetization transfer ratio (p = 0.006) and fractional anisotropy (p = 0.011) in regression modeling that included both quantitative measures of function and basic clinical information. Quantitative measures of strength and walking are associated with brain corticospinal tract pathology. The addition of these quantitative measures to basic clinical information explains more of the variance in corticospinal tract fractional anisotropy and magnetization transfer ratio than the basic clinical information alone. Outcome measurement for multiple sclerosis clinical trials has been notoriously challenging; the use of quantitative measures of strength and walking along with tract-specific imaging methods may improve our ability to monitor disease change over time, with intervention, and provide needed guidelines for developing more effective targeted rehabilitation strategies.

Balance and postural skills in normal-weight and overweight prepubertal boys.

PubMed

Deforche, Benedicte I; Hills, Andrew P; Worringham, Charles J; Davies, Peter S W; Murphy, Alexia J; Bouckaert, Jacques J; De Bourdeaudhuij, Ilse M

2009-01-01

This study investigated differences in balance and postural skills in normal-weight versus overweight prepubertal boys. Fifty-seven 8-10-year-old boys were categorized overweight (N = 25) or normal-weight (N = 32) according to the International Obesity Task Force cut-off points for overweight in children. The Balance Master, a computerized pressure plate system, was used to objectively measure six balance skills: sit-to-stand, walk, step up/over, tandem walk (walking on a line), unilateral stance and limits of stability. In addition, three standardized field tests were employed: standing on one leg on a balance beam, walking heel-to-toe along the beam and the multiple sit-to-stand test. Overweight boys showed poorer performances on several items assessed on the Balance Master. Overweight boys had slower weight transfer (p < 0.05), lower rising index (p < 0.05) and greater sway velocity (p < 0.001) in the sit-to-stand test, greater step width while walking (p < 0.05) and lower speed when walking on a line (p < 0.01) compared with normal-weight counterparts. Performance on the step up/over test, the unilateral stance and the limits of stability were comparable between both groups. On the balance beam, overweight boys could not hold their balance on one leg as long (p < 0.001) and had fewer correct steps in the heel-to-toe test (p < 0.001) than normal-weight boys. Finally, overweight boys were slower in standing up and sitting down five times in the multiple sit-to-stand task (p < 0.01). This study demonstrates that when categorised by body mass index (BMI) level, overweight prepubertal boys displayed lower capacity on several static and dynamic balance and postural skills.

Effect of using a treadmill workstation on performance of simulated office work tasks.

PubMed

John, Dinesh; Bassett, David; Thompson, Dixie; Fairbrother, Jeffrey; Baldwin, Debora

2009-09-01

Although using a treadmill workstation may change the sedentary nature of desk jobs, it is unknown if walking while working affects performance on office-work related tasks. To assess differences between seated and walking conditions on motor skills and cognitive function tests. Eleven males (24.6 +/- 3.5 y) and 9 females (27.0 +/- 3.9 y) completed a test battery to assess selective attention and processing speed, typing speed, mouse clicking/drag-and-drop speed, and GRE math and reading comprehension. Testing was performed under seated and walking conditions on 2 separate days using a counterbalanced, within subjects design. Participants did not have an acclimation period before the walking condition. Paired t tests (P < .05) revealed that in the seated condition, completion times were shorter for mouse clicking (26.6 +/- 3.0 vs. 28.2 +/- 2.5s) and drag-and-drop (40.3 +/- 4.2 vs. 43.9 +/- 2.5s) tests, typing speed was greater (40.2 +/- 9.1 vs. 36.9 +/- 10.2 adjusted words x min(-1)), and math scores were better (71.4 +/- 15.2 vs. 64.3 +/- 13.4%). There were no significant differences between conditions in selective attention and processing speed or in reading comprehension. Compared with the seated condition, treadmill walking caused a 6% to 11% decrease in measures of fine motor skills and math problem solving, but did not affect selective attention and processing speed or reading comprehension.

Does Dog Walking Predict Physical Activity Participation: Results From a National Survey.

PubMed

Richards, Elizabeth A

2016-05-01

The purpose of this study is to: (1) identify characteristics associated with dog owners who walk their dog, (2) describe the frequency and duration of walking the dog, and (3) determine whether dog owners who walk their dog participate in more physical activity than dog owners who do not walk their dog and non-dog owners. A cross-sectional study design was used. The study setting was nationwide. Adults (n = 4010) participating in the 2005 ConsumerStyles mail-panel survey were the study subjects. Measures used were demographic, physical activity, dog ownership, and dog walking questions from the 2005 ConsumerStyles mail-panel survey. Chi-square tests and analyses of variance were conducted to examine participant characteristics associated with dog walking and to describe the frequency and duration of dog walking. Analysis of covariance was used to determine whether dog owners who walk their dog participate in more physical activity than dog owners who do not walk their dog and non-dog owners. Among dog owners, 42% reported some dog walking in a typical week. Dog owners walked their dog an average 4.3 ± 0.1 times and 128.8 ± 5.6 minutes per week. There were no significant differences in weekly minutes of moderate or vigorous physical activity across the dog-ownership and dog walking groups. Most dog owners did not walk their dog. Dog owners were not more active than non-dog owners, except when considering the activity obtained via dog walking. © The Author(s) 2016.

A Comparison of Tandem Walk Performance Between Bed Rest Subjects and Astronauts

NASA Technical Reports Server (NTRS)

Miller, Chris; Peters, Brian; Kofman, Igor; Philips, Tiffany; Batson, Crystal; Cerisano, Jody; Fisher, Elizabeth; Mulavara, Ajitkumar; Feiveson, Alan; Reschke, Millard;

Value of Impedance Cardiography during 6‐Minute Walk Test in Pulmonary Hypertension

PubMed Central

Alkukhun, Laith; Arelli, Vineesha; Ramos, José; Newman, Jennie; McCarthy, Kevin; Pichurko, Bohdan; Minai, Omar A.; Dweik, Raed A.

2013-01-01

Abstract Background Methods that predict prognosis and response to therapy in pulmonary hypertension (PH) are lacking. We tested whether the noninvasive estimation of hemodynamic parameters during 6‐minute walk test (6MWT) in PH patients provides information that can improve the value of the test. Methods We estimated hemodynamic parameters during the 6MWT using a portable, signal‐morphology‐based, impedance cardiograph (PhysioFlow Enduro) with real‐time wireless monitoring via a bluetooth USB adapter. Results We recruited 48 subjects in the study (30 with PH and 18 healthy controls). PH patients had significantly lower maximum stroke volume (SV) and CI and slower cardiac output (CO) acceleration and decelerations slopes during the test when compared with healthy controls. In PH patients, CI change was associated with total distance walked (R = 0.62; P < 0.001) and percentage of predicted (R = 0.4, P = 0.03), HR recovery at 1 minute (0.57, P < 0.001), 2 minutes (0.65, P < 0.001), and 3 minutes (0.66, P < 0.001). Interestingly, in PH patients CO change during the test was predominantly related to an increase in SV instead of HR. Conclusions Estimation of hemodynamic parameters such as cardiac index during 6‐minute walk test is feasible and may provide useful information in patients with PH. Clin Trans Sci 2013; Volume #: 1–7 PMID:24330692

Combined exercise is more effective than aerobic exercise in the improvement of fall risk factors: a randomized controlled trial in community-dwelling older men.

PubMed

Sousa, Nelson; Mendes, Romeu; Silva, André; Oliveira, José

2017-04-01

To compare the long-term effects of two community-based exercise programs on fall risk factors, such as balance, postural control, mobility and leg strength, in community-dwelling older men. Single-blinded randomized controlled trial, comparing three groups, with follow-ups at eight, 16, 24 and 32 weeks. Older men independent-living residing in Maia city, Portugal. A total of 66 older men (aged 69.0 ±4.9 years) were randomly assigned to an aerobic exercise group ( n = 22), a combined aerobic and resistance exercise group ( n = 22) or a control group ( n = 22). Both community-based exercise programs consisted of three sessions each week for 32 consecutive weeks and were planned for moderate-to-vigorous intensity. The control group had no exercise intervention. Main outcomes were measured by the Timed Up and Go Test, functional reach test, 30-second chair stand test and 6-minute walk test, on five different occasions. Repeated measures of analysis of covariance revealed significant main effects between time × group interaction in all outcomes over time (Timed Up and Go Test: p < 0.001; functional reach test: p = 0.002; 30-second chair stand: p = 0.001; 6-minute walk test: p < 0.001). Both exercise groups reported improvements; however, better performance was identified in the combined aerobic and resistance exercise group compared with the aerobic exercise group (-20.3% vs. -9.1% on the Timed Up and Go Test, +27.5% vs. +10.9% on the functional reach test, +20.8% vs. +7.3% on 30-second chair stand, +10.9% vs. +3.5% on 6-minute walk test). Adding resistance exercise to aerobic exercise improves factors associated with an increased risk of falls. However, both exercise regimes, combined or aerobic alone, are more effective than no exercise in the reduction of fall risk factors. ClinicalTrials.org #NCT01874132.

Evaluation of the Dogs, Physical Activity, and Walking (Dogs PAW) Intervention: A Randomized Controlled Trial.

PubMed

Richards, Elizabeth A; Ogata, Niwako; Cheng, Ching-Wei

2016-01-01

To facilitate physical activity (PA) adoption and maintenance, promotion of innovative population-level strategies that focus on incorporating moderate-intensity lifestyle PAs are needed. The purpose of this randomized controlled trial was to evaluate the Dogs, Physical Activity, and Walking intervention, a 3-month, social cognitive theory (SCT), e-mail-based PA intervention. In a longitudinal, repeated-measures design, 49 dog owners were randomly assigned to a control (n = 25) or intervention group (n = 24). The intervention group received e-mail messages (twice weekly for 4 weeks and weekly for 8 weeks) designed to influence SCT constructs of self-efficacy, self-regulation, outcome expectations and expectancies, and social support. At baseline and every 3 months through 1 year, participants completed self-reported questionnaires of individual, interpersonal, and PA variables. Linear mixed models were used to assess for significant differences in weekly minutes of dog walking and theoretical constructs between groups (intervention and control) across time. To test self-efficacy as a mediator of social support for dog walking, tests for mediation were conducted using the bootstrapping technique. With the exception of Month 9, participants in the intervention group accumulated significantly more weekly minutes of dog walking than the control group. On average, the intervention group accumulated 58.4 more minutes (SD = 18.1) of weekly dog walking than the control group (p < .05). Self-efficacy partially mediated the effect of social support variables on dog walking. Results indicate that a simple SCT-based e-mail intervention is effective in increasing and maintaining an increase in dog walking among dog owners at 12-month follow-up. In light of these findings, it may be advantageous to design dog walking interventions that focus on increasing self-efficacy for dog walking by fostering social support.

Heart Rate Response to a Timed Walk & Cardiovascular Outcomes in Older Adults: The Cardiovascular Health Study

PubMed Central

Girotra, Saket; Kitzman, Dalane W.; Kop, Willem J.; Stein, Phyllis K.; Gottdiener, John S.; Mukamal, Kenneth J.

2012-01-01

OBJECTIVES To determine the relationship between heart rate response during low-grade physical exertion (six-minute walk) with mortality and adverse cardiovascular outcomes in the elderly. METHODS Participants in the Cardiovascular Health Study, who completed a six-minute walk test, were included. We used delta heart rate (difference between post-walk heart rate and resting heart rate) as a measure of chronotropic response and examined its association with 1) all-cause mortality and 2) incident coronary heart disease (CHD) event, using multivariable Cox regression models. RESULTS We included 2224 participants (mean age 77±4 years; 60% women, 85% white). The average delta heart rate was 26 beats/min. Participants in the lowest tertile of delta heart rate (<20 beats/min) had higher risk-adjusted mortality (hazard ratio [HR] 1.18; 95% confidence interval [CI][1.00, 1.40]) and incident CHD (HR 1.37; 95% CI[1.05, 1.78]) compared to subjects in the highest tertile (≥30 beats/min), with a significant linear trend across tertiles (P for trend <0.05 for both outcomes). This relationship was not significant after adjustment for distance walked. CONCLUSION Impaired chronotropic response during six-minute walk test was associated with an increased risk of mortality and incident CHD among the elderly. This association was attenuated after adjusting for distance walked. PMID:22722364

A New Method of Random Environmental Walking for Assessing Behavioral Preferences for Different Lighting Applications

PubMed Central

Patching, Geoffrey R.; Rahm, Johan; Jansson, Märit; Johansson, Maria

2017-01-01

Accurate assessment of people’s preferences for different outdoor lighting applications is increasingly considered important in the development of new urban environments. Here a new method of random environmental walking is proposed to complement current methods of assessing urban lighting applications, such as self-report questionnaires. The procedure involves participants repeatedly walking between different lighting applications by random selection of a lighting application and preferred choice or by random selection of a lighting application alone. In this manner, participants are exposed to all lighting applications of interest more than once and participants’ preferences for the different lighting applications are reflected in the number of times they walk to each lighting application. On the basis of an initial simulation study, to explore the feasibility of this approach, a comprehensive field test was undertaken. The field test included random environmental walking and collection of participants’ subjective ratings of perceived pleasantness (PP), perceived quality, perceived strength, and perceived flicker of four lighting applications. The results indicate that random environmental walking can reveal participants’ preferences for different lighting applications that, in the present study, conformed to participants’ ratings of PP and perceived quality of the lighting applications. As a complement to subjectively stated environmental preferences, random environmental walking has the potential to expose behavioral preferences for different lighting applications. PMID:28337163

Restoration of gait for spinal cord injury patients using HAL with intention estimator for preferable swing speed.

PubMed

Tsukahara, Atsushi; Hasegawa, Yasuhisa; Eguchi, Kiyoshi; Sankai, Yoshiyuki

2015-03-01

This paper proposes a novel gait intention estimator for an exoskeleton-wearer who needs gait support owing to walking impairment. The gait intention estimator not only detects the intention related to the start of the swing leg based on the behavior of the center of ground reaction force (CoGRF), but also infers the swing speed depending on the walking velocity. The preliminary experiments categorized into two stages were performed on a mannequin equipped with the exoskeleton robot [Hybrid Assistive Limb: (HAL)] including the proposed estimator. The first experiment verified that the gait support system allowed the mannequin to walk properly and safely. In the second experiment, we confirmed the differences in gait characteristics attributed to the presence or absence of the proposed swing speed profile. As a feasibility study, we evaluated the walking capability of a severe spinal cord injury patient supported by the system during a 10-m walk test. The results showed that the system enabled the patient to accomplish a symmetrical walk from both spatial and temporal standpoints while adjusting the speed of the swing leg. Furthermore, the critical differences of gait between our system and a knee-ankle-foot orthosis were obtained from the CoGRF distribution and the walking time. Through the tests, we demonstrated the effectiveness and practical feasibility of the gait support algorithms.

The Reliability and Validity of Measures of Gait Variability in Community-Dwelling Older Adults

PubMed Central

Brach, Jennifer S.; Perera, Subashan; Studenski, Stephanie; Newman, Anne B.

2009-01-01

Objective To examine the test-retest reliability and concurrent validity of variability of gait characteristics. Design Cross-sectional study. Setting Research laboratory. Participants Older adults (N=558) from the Cardiovascular Health Study. Interventions Not applicable. Main Outcome Measures Gait characteristics were measured using a 4-m computerized walkway. SD determined from the steps recorded were used as the measures of variability. Intraclass correlation coefficients (ICC) were calculated to examine test-retest reliability of a 4-m walk and two 4-m walks. To establish concurrent validity, the measures of gait variability were compared across levels of health, functional status, and physical activity using independent t tests and analysis of variances. Results Gait variability measures from the two 4-m walks demonstrated greater test-retest reliability than those from the single 4-m walk (ICC=.22–.48 and ICC=.40–.63, respectively). Greater step length and stance time variability were associated with poorer health, functional status and physical activity (P<.05). Conclusions Gait variability calculated from a limited number of steps has fair to good test-retest reliability and concurrent validity. Reliability of gait variability calculated from a greater number of steps should be assessed to determine if the consistency can be improved. PMID:19061741

The association between the maximum step length test and the walking efficiency in children with cerebral palsy.

PubMed

Kimoto, Minoru; Okada, Kyoji; Sakamoto, Hitoshi; Kondou, Takanori

2017-05-01

[Purpose] To improve walking efficiency could be useful for reducing fatigue and extending possible period of walking in children with cerebral palsy (CP). For this purpose, current study compared conventional parameters of gross motor performance, step length, and cadence in the evaluation of walking efficiency in children with CP. [Subjects and Methods] Thirty-one children with CP (21 boys, 10 girls; mean age, 12.3 ± 2.7 years) participated. Parameters of gross motor performance, including the maximum step length (MSL), maximum side step length, step number, lateral step up number, and single leg standing time, were measured in both dominant and non-dominant sides. Spatio-temporal parameters of walking, including speed, step length, and cadence, were calculated. Total heart beat index (THBI), a parameter of walking efficiency, was also calculated from heartbeats and walking distance in 10 minutes of walking. To analyze the relationships between these parameters and the THBI, the coefficients of determination were calculated using stepwise analysis. [Results] The MSL of the dominant side best accounted for the THBI (R 2 =0.759). [Conclusion] The MSL of the dominant side was the best explanatory parameter for walking efficiency in children with CP.

Time-Motion Analysis of Four Automated Systems for the Detection of Chlamydia trachomatis and Neisseria gonorrhoeae by Nucleic Acid Amplification Testing.

PubMed

Williams, James A; Eddleman, Laura; Pantone, Amy; Martinez, Regina; Young, Stephen; Van Der Pol, Barbara

2014-08-01

Next-generation diagnostics for Chlamydia trachomatis and Neisseria gonorrhoeae are available on semi- or fully-automated platforms. These systems require less hands-on time than older platforms and are user friendly. Four automated systems, the ABBOTT m2000 system, Becton Dickinson Viper System with XTR Technology, Gen-Probe Tigris DTS system, and Roche cobas 4800 system, were evaluated for total run time, hands-on time, and walk-away time. All of the systems evaluated in this time-motion study were able to complete a diagnostic test run within an 8-h work shift, instrument setup and operation were straightforward and uncomplicated, and walk-away time ranged from approximately 90 to 270 min in a head-to-head comparison of each system. All of the automated systems provide technical staff with increased time to perform other tasks during the run, offer easy expansion of the diagnostic test menu, and have the ability to increase specimen throughput. © 2013 Society for Laboratory Automation and Screening.

Integrated DNA walking system to characterize a broad spectrum of GMOs in food/feed matrices.

PubMed

Fraiture, Marie-Alice; Herman, Philippe; Lefèvre, Loic; Taverniers, Isabel; De Loose, Marc; Deforce, Dieter; Roosens, Nancy H

2015-08-14

In order to provide a system fully integrated with qPCR screening, usually used in GMO routine analysis, as well as being able to detect, characterize and identify a broad spectrum of GMOs in food/feed matrices, two bidirectional DNA walking methods targeting p35S or tNOS, the most common transgenic elements found in GM crops, were developed. These newly developed DNA walking methods are completing the previously implemented DNA walking method targeting the t35S pCAMBIA element. Food/feed matrices containing transgenic crops (Bt rice or MON863 maize) were analysed using the integrated DNA walking system. First, the newly developed DNA walking methods, anchored on the sequences used for the p35S or tNOS qPCR screening, were tested on Bt rice that contains these two transgenic elements. Second, the methods were assessed on a maize sample containing a low amount of the GM MON863 event, representing a more complex matrix in terms of genome size and sensitivity. Finally, to illustrate its applicability in GMO routine analysis by enforcement laboratories, the entire workflow of the integrated strategy, including qPCR screening to detect the potential presence of GMOs and the subsequent DNA walking methods to characterize and identify the detected GMOs, was applied on a GeMMA Scheme Proficiency Test matrix. Via the characterization of the transgene flanking region between the transgenic cassette and the plant genome as well as of a part of the transgenic cassette, the presence of GMOs was properly confirmed or infirmed in all tested samples. Due to their simple procedure and their short time-frame to get results, the developed DNA walking methods proposed here can be easily implemented in GMO routine analysis by the enforcement laboratories. In providing crucial information about the transgene flanking regions and/or the transgenic cassettes, this DNA walking strategy is a key molecular tool to prove the presence of GMOs in any given food/feed matrix.

Comparing peak and submaximal cardiorespiratory responses during field walking tests with incremental cycle ergometry in COPD.

PubMed

Hill, Kylie; Dolmage, Thomas E; Woon, Lynda; Coutts, Debbie; Goldstein, Roger; Brooks, Dina

2012-02-01

Field and laboratory-based tests are used to measure exercise capacity in people with COPD. A comparison of the cardiorespiratory responses to field tests, referenced to a laboratory test, is needed to appreciate the relative physiological demands. We sought to compare peak and submaximal cardiorespiratory responses to the 6-min walk test, incremental shuttle walk test and endurance shuttle walk test with a ramp cycle ergometer test (CET) in patients with COPD. Twenty-four participants (FEV(1) 50 ± 14%; 66.5 ± 7.7 years; 15 men) completed four sessions, separated by ≥24 h. During an individual session, participants completed either two 6-min walk tests, incremental shuttle walk tests, endurance shuttle walk tests using standardized protocols, or a single CET, wearing a portable gas analysis unit (Cosmed K4b(2)) which included measures of heart rate and arterial oxygen saturation (SpO(2)). Between tests, no difference was observed in the peak rate of oxygen uptake (F(3,69) = 1.2; P = 0.31), end-test heart rate (F(2,50) = 0.6; P = 0.58) or tidal volume (F(3,69) = 1.5; P = 0.21). Compared with all walking tests, the CET elicited a higher peak rate of carbon dioxide output (1173 ± 350 mL/min; F(3,62) = 4.8; P = 0.006), minute ventilation (48 ± 17 L/min; F(3,69) = 10.2; P < 0.001) and a higher end-test SpO(2) (95 ± 4%; F(3,63) = 24.9; P < 0.001). In patients with moderate COPD, field walking tests elicited a similar peak rate of oxygen uptake and heart rate as a CET, demonstrating that both self- and externally paced walking tests progress to high intensities. © 2011 The Authors. Respirology © 2011 Asian Pacific Society of Respirology.

Walking speed and peak plantar pressure distribution during barefoot walking in persons with diabetes.

PubMed

Ko, Mansoo; Hughes, Lynne; Lewis, Harriet

2012-03-01

The impact of walking speed has not been evaluated as a feasible outcome measure associated with peak plantar pressure (PPP) distribution, which may result in tissue damage in persons with diabetic foot complications. The objective of this pilot study was to determine the walking speed and PPP distribution during barefoot walking in persons with diabetes.   Nine individuals with diabetes and nine age-gender matched individuals without diabetes participated in this study. Each individual was marked at 10 anatomical landmarks for vibration and tactile pressure sensation tests to determine the severity of sensory deficits on the plantar surface of the dominant limb foot. A steady state walking speed, PPP, the fore and rear foot (F/R) PPP ratio and gait variables were measured during barefoot walking.   Persons with diabetes had a significantly slower walking speed than the age-gender matched group resulting in a significant reduction of PPP at the F/R foot during barefoot walking (p < 0.05). There was no significant difference in F/R foot PPP ratio in the diabetic group compared with the age-gender matched group during barefoot walking (p > 0.05). There was a significant difference between the diabetic and non-diabetic groups for cadence, step time, toe out angle and the anterior-posterior excursion (APE) for centre of force (p < 0.05).   Walking speed may be a potential indicator for persons with diabetes to identify PPP distribution during barefoot walking in a diabetic foot. However, the diabetic group demonstrated a more cautious walking pattern than the age-gender matched group by decreasing cadence, step length and APE, and increasing step time and toe in/out angle. People with diabetes may reduce the risk of foot ulcerations as long as they are able to prevent severe foot deformities such as callus, hammer toe or charcot foot. Copyright © 2011 John Wiley & Sons, Ltd.

Anticipatory kinematics and muscle activity preceding transitions from level-ground walking to stair ascent and descent.

PubMed

Peng, Joshua; Fey, Nicholas P; Kuiken, Todd A; Hargrove, Levi J

2016-02-29

The majority of fall-related accidents are during stair ambulation-occurring commonly at the top and bottom stairs of each flight, locations in which individuals are transitioning to stairs. Little is known about how individuals adjust their biomechanics in anticipation of walking-stair transitions. We identified the anticipatory stride mechanics of nine able-bodied individuals as they approached transitions from level ground walking to stair ascent and descent. Unlike prior investigations of stair ambulation, we analyzed two consecutive "anticipation" strides preceding the transitions strides to stairs, and tested a comprehensive set of kinematic and electromyographic (EMG) data from both the leading and trailing legs. Subjects completed ten trials of baseline overground walking and ten trials of walking to stair ascent and descent. Deviations relative to baseline were assessed. Significant changes in mechanics and EMG occurred in the earliest anticipation strides analyzed for both ascent and descent transitions. For stair descent, these changes were consistent with observed reductions in walking speed, which occurred in all anticipation strides tested. For stair ascent, subjects maintained their speed until the swing phase of the latest anticipation stride, and changes were found that would normally be observed for decreasing speed. Given the timing and nature of the observed changes, this study has implications for enhancing intent recognition systems and evaluating fall-prone or disabled individuals, by testing their abilities to sense upcoming transitions and decelerate during locomotion. Copyright © 2016 Elsevier Ltd. All rights reserved.

Motor assessment in Parkinson`s disease.

PubMed

Opara, Józef; Małecki, Andrzej; Małecka, Elżbieta; Socha, Teresa

2017-09-21

Parkinson's disease (PD) is one of most disabling disorders of the central nervous system. The motor symptoms of Parkinson's disease: shaking, rigidity, slowness of movement, postural instability and difficulty with walking and gait, are difficult to measure. When disease symptoms become more pronounced, the patient experiences difficulties with hand function and walking, and is prone to falls. Baseline motor impairment and cognitive impairment are probable predictors of more rapid motor decline and disability. An additional difficulty is the variability of the symptoms caused by adverse effects of drugs, especially levodopa. Motor assessment of Parkinson`s Disease can be divided into clinimetrics, assessment of balance and posture, arm and hand function, and gait/walking. These are many clinimetric scales used in Parkinson`s Disease, the most popular being the Hoehn and Yahr stages of progression of the disease and Unified Parkinson's Disease Rating Scale. Balance and posture can be assessed by clinimetric scales like the Berg BS, Tinetti, Brunel BA, and Timed Up and Go Test, or measured by posturometric platforms. Among skill tests, the best known are: the Purdue Pegboard Test, Nine-Hole Peg Test, Jebsen and Taylor test, Pig- Tail Test, Frenchay Arm Test, Action Research Arm Test, Wolf FMT and Finger-Tapping Test. Among motricity scales, the most popular are: the Fugl-Meyer Motor Assessment Scale and Södring Motor Evaluation. Gait and walking can also be assessed quantitatively and qualitatively. Recently, the most popular is three-dimensional analysis of movement. This review article presents the current possibilities of motor assessment in Parkinson`s disease.

Two Independent Contributions to Step Variability during Over-Ground Human Walking

PubMed Central

Collins, Steven H.; Kuo, Arthur D.

2013-01-01

Human walking exhibits small variations in both step length and step width, some of which may be related to active balance control. Lateral balance is thought to require integrative sensorimotor control through adjustment of step width rather than length, contributing to greater variability in step width. Here we propose that step length variations are largely explained by the typical human preference for step length to increase with walking speed, which itself normally exhibits some slow and spontaneous fluctuation. In contrast, step width variations should have little relation to speed if they are produced more for lateral balance. As a test, we examined hundreds of overground walking steps by healthy young adults (N = 14, age < 40 yrs.). We found that slow fluctuations in self-selected walking speed (2.3% coefficient of variation) could explain most of the variance in step length (59%, P < 0.01). The residual variability not explained by speed was small (1.5% coefficient of variation), suggesting that step length is actually quite precise if not for the slow speed fluctuations. Step width varied over faster time scales and was independent of speed fluctuations, with variance 4.3 times greater than that for step length (P < 0.01) after accounting for the speed effect. That difference was further magnified by walking with eyes closed, which appears detrimental to control of lateral balance. Humans appear to modulate fore-aft foot placement in precise accordance with slow fluctuations in walking speed, whereas the variability of lateral foot placement appears more closely related to balance. Step variability is separable in both direction and time scale into balance- and speed-related components. The separation of factors not related to balance may reveal which aspects of walking are most critical for the nervous system to control. PMID:24015308

Test-Retest Reliability of the 10-Metre Fast Walk Test and 6-Minute Walk Test in Ambulatory School-Aged Children with Cerebral Palsy

ERIC Educational Resources Information Center

Thompson, Patricia; Beath, Tricia; Bell, Jacqueline; Jacobson, Gabrielle; Phair, Tegan; Salbach, Nancy M.; Wright, F. Virginia

2008-01-01

Short-term test-retest reliability of the 10-metre fast walk test (10mFWT) and 6-minute walk test (6MWT) was evaluated in 31 ambulatory children with cerebral palsy (CP), with subgroup analyses in Gross Motor Function Classification System (GMFCS) Levels I (n=9), II (n=8), and III (n=14). Sixteen females and 15 males participated, mean age 9 years…

Exploring cued and non-cued motor imagery interventions in people with multiple sclerosis: a randomised feasibility trial and reliability study.

PubMed

Seebacher, Barbara; Kuisma, Raija; Glynn, Angela; Berger, Thomas

2018-01-01

Motor imagery (MI) is increasingly used in neurorehabilitation to facilitate motor performance. Our previous study results demonstrated significantly improved walking after rhythmic-cued MI in people with multiple sclerosis (pwMS). The present feasibility study was aimed to obtain preliminary information of changes in walking, fatigue, quality of life (QoL) and MI ability following cued and non-cued MI in pwMS. The study further investigated the feasibility of a larger study and examined the reliability of a two-dimensional gait analysis system. At the MS-Clinic, Department of Neurology, Medical University of Innsbruck, Austria, 15 adult pwMS (1.5-4.5 on the Expanded Disability Status Scale, 13 females) were randomised to one of three groups: 24 sessions of 17 min of MI with music and verbal cueing (MVMI), with music alone (MMI), or non-cued (MI). Descriptive statistics were reported for all outcomes. Primary outcomes were walking speed (Timed 25-Foot Walk) and walking distance (6-Minute Walk Test). Secondary outcomes were recruitment rate, retention, adherence, acceptability, adverse events, MI ability (Kinaesthetic and Visual Imagery Questionnaire, Time-Dependent MI test), fatigue (Modified Fatigue Impact Scale) and QoL (Multiple Sclerosis Impact Scale-29). The reliability of a gait analysis system used to assess gait synchronisation with music beat was tested. Participants showed adequate MI abilities. Post-intervention, improvements in walking speed, walking distance, fatigue, QoL and MI ability were observed in all groups. Success of the feasibility criteria was demonstrated by recruitment and retention rates of 8.6% (95% confidence interval, CI 5.2, 13.8%) and 100% (95% CI 76.4, 100%), which exceeded the target rates of 5.7% and 80%. Additionally, the 83% (95% CI 0.42, 0.99) adherence rate surpassed the 67% target rate. Intra-rater reliability analysis of the gait measurement instruments demonstrated excellent Intra-Class Correlation coefficients for step length of 0.978 (95% CI 0.973, 0.982) and step time of 0.880 (95% CI 0.855, 0.902). Results from our study suggest that cued and non-cued MI are valuable interventions in pwMS who were able to imagine movements. A larger study appears feasible, however, substantial improvements to the methods are required such as stratified randomisation using a computer-generated sequence and blinding of the assessors. ISRCTN ISRCTN92351899. Registered 10 December 2015.

Development and psychometric testing of the Dogs and WalkinG Survey (DAWGS).

PubMed

Richards, Elizabeth A; McDonough, Meghan H; Edwards, Nancy E; Lyle, Roseann M; Troped, Philip J

2013-12-01

Dog owners represent 40% of the population, a promising audience to increase population levels of physical activity. The purpose of this study was to develop and test the psychometric properties of a new instrument to assess social-cognitive theory constructs related to dog walking. Dog owners (N = 431) completed the Dogs and WalkinG Survey (DAWGS). Survey items assessed dog-walking behaviors and self-efficacy, social support, outcome expectations, and outcome expectancies for dog walking. Test-retest reliability was assessed among 252 (58%) survey respondents who completed the survey twice. Factorial validity and factorial invariance by age and walking level were tested using confirmatory factor analysis. DAWGS items demonstrated moderate test-retest reliability (p = .39-.79; k = .41-.89). Acceptable model fit was found for all subscales. All subscales were invariant by age and walking level, except self-efficacy, which showed mixed evidence of invariance. The DAWGS is a psychometrically sound instrument for examining individual and interpersonal correlates of dog walking.

Daily intermittent hypoxia enhances walking after chronic spinal cord injury

PubMed Central

Hayes, Heather B.; Jayaraman, Arun; Herrmann, Megan; Mitchell, Gordon S.; Rymer, William Z.

2014-01-01

Objectives: To test the hypothesis that daily acute intermittent hypoxia (dAIH) and dAIH combined with overground walking improve walking speed and endurance in persons with chronic incomplete spinal cord injury (iSCI). Methods: Nineteen subjects completed the randomized, double-blind, placebo-controlled, crossover study. Participants received 15, 90-second hypoxic exposures (dAIH, fraction of inspired oxygen [Fio2] = 0.09) or daily normoxia (dSHAM, Fio2 = 0.21) at 60-second normoxic intervals on 5 consecutive days; dAIH was given alone or combined with 30 minutes of overground walking 1 hour later. Walking speed and endurance were quantified using 10-Meter and 6-Minute Walk Tests. The trial is registered at ClinicalTrials.gov (NCT01272349). Results: dAIH improved walking speed and endurance. Ten-Meter Walk time improved with dAIH vs dSHAM after 1 day (mean difference [MD] 3.8 seconds, 95% confidence interval [CI] 1.1–6.5 seconds, p = 0.006) and 2 weeks (MD 3.8 seconds, 95% CI 0.9–6.7 seconds, p = 0.010). Six-Minute Walk distance increased with combined dAIH + walking vs dSHAM + walking after 5 days (MD 94.4 m, 95% CI 17.5–171.3 m, p = 0.017) and 1-week follow-up (MD 97.0 m, 95% CI 20.1–173.9 m, p = 0.014). dAIH + walking increased walking distance more than dAIH after 1 day (MD 67.7 m, 95% CI 1.3–134.1 m, p = 0.046), 5 days (MD 107.0 m, 95% CI 40.6–173.4 m, p = 0.002), and 1-week follow-up (MD 136.0 m, 95% CI 65.3–206.6 m, p < 0.001). Conclusions: dAIH ± walking improved walking speed and distance in persons with chronic iSCI. The impact of dAIH is enhanced by combination with walking, demonstrating that combinatorial therapies may promote greater functional benefits in persons with iSCI. Classification of evidence: This study provides Class I evidence that transient hypoxia (through measured breathing treatments), along with overground walking training, improves walking speed and endurance after iSCI. PMID:24285617

Environmental perceptions and objective walking trail audits inform a community-based participatory research walking intervention

PubMed Central

2012-01-01

Background Given the documented physical activity disparities that exist among low-income minority communities and the increased focused on socio-ecological approaches to address physical inactivity, efforts aimed at understanding the built environment to support physical activity are needed. This community-based participatory research (CBPR) project investigates walking trails perceptions in a high minority southern community and objectively examines walking trails. The primary aim is to explore if perceived and objective audit variables predict meeting recommendations for walking and physical activity, MET/minutes/week of physical activity, and frequency of trail use. Methods A proportional sampling plan was used to survey community residents in this cross-sectional study. Previously validated instruments were pilot tested and appropriately adapted and included the short version of the validated International Physical Activity Questionnaire, trail use, and perceptions of walking trails. Walking trails were assessed using the valid and reliable Path Environmental Audit Tool which assesses four content areas including: design features, amenities, maintenance, and pedestrian safety from traffic. Analyses included Chi-square, one-way ANOVA's, multiple linear regression, and multiple logistic models. Results Numerous (n = 21) high quality walking trails were available. Across trails, there were very few indicators of incivilities and safety features rated relatively high. Among the 372 respondents, trail use significantly predicted meeting recommendations for walking and physical activity, and MET/minutes/week. While controlling for other variables, significant predictors of trail use included proximity to trails, as well as perceptions of walking trail safety, trail amenities, and neighborhood pedestrian safety. Furthermore, while controlling for education, gender, and income; for every one time per week increase in using walking trails, the odds for meeting walking recommendations increased 1.27 times, and the odds for meeting PA recommendation increased 3.54 times. Perceived and objective audit variables did not predict meeting physical activity recommendations. Conclusions To improve physical activity levels, intervention efforts are needed to maximize the use of existing trails, as well as improve residents' perceptions related to incivilities, safety, conditions of trail, and amenities of the walking trails. This study provides important insights for informing development of the CBPR walking intervention and informing local recreational and environmental policies in this southern community. PMID:22289653

Effects of Progressive Body Weight Support Treadmill Forward and Backward Walking Training on Stroke Patients' Affected Side Lower Extremity's Walking Ability.

PubMed

Kim, Kyunghoon; Lee, Sukmin; Lee, Kyoungbo

2014-12-01

[Purpose] The purpose of the present study was to examine the effects of progressive body weight supported treadmill forward and backward walking training (PBWSTFBWT), progressive body weight supported treadmill forward walking training (PBWSTFWT), progressive body weight supported treadmill backward walking training (PBWSTBWT), on stroke patients' affected side lower extremity's walking ability. [Subjects and Methods] A total of 36 chronic stroke patients were divided into three groups with 12 subjects in each group. Each of the groups performed one of the progressive body weight supported treadmill training methods for 30 minute, six times per week for three weeks, and then received general physical therapy without any other intervention until the follow-up tests. For the assessment of the affected side lower extremity's walking ability, step length of the affected side, stance phase of the affected side, swing phase of the affected side, single support of the affected side, and step time of the affected side were measured using optogait and the symmetry index. [Results] In the within group comparisons, all the three groups showed significant differences between before and after the intervention and in the comparison of the three groups, the PBWSTFBWT group showed more significant differences in all of the assessed items than the other two groups. [Conclusion] In the present study progressive body weight supported treadmill training was performed in an environment in which the subjects were actually walked, and PBWSTFBWT was more effective at efficiently training stroke patients' affected side lower extremity's walking ability.

Usefulness of a 50-meter round walking test for fall prediction in the elderly requiring long-term care

PubMed Central

Hachiya, Mizuki; Murata, Shin; Otao, Hiroshi; Ihara, Takehiko; Mizota, Katsuhiko; Asami, Toyoko

2015-01-01

[Purpose] This study aimed to verify the usefulness of a 50-m round walking test developed as an assessment method for walking ability in the elderly. [Subjects] The subjects were 166 elderly requiring long-term care individuals (mean age, 80.5 years). [Methods] In order to evaluate the factors that had affected falls in the subjects in the previous year, we performed the 50-m round walking test, functional reach test, one-leg standing test, and 5-m walking test and measured grip strength and quadriceps strength. [Results] The 50-m round walking test was selected as a variable indicating fall risk based on the results of multiple logistic regression analysis. The cutoff value of the 50-m round walking test for determining fall risk was 0.66 m/sec. The area under the receiver operating characteristic curve was 0.64. The sensitivity of the cutoff value was 65.7%, the specificity was 63.6%, the positive predictive value was 55.0%, the negative predictive value was 73.3%, and the accuracy was 64.5%. [Conclusion] These results suggest that the 50-m round walking test is a potentially useful parameter for the determination of fall risk in the elderly requiring long-term care. PMID:26834327

Usefulness of a 50-meter round walking test for fall prediction in the elderly requiring long-term care.

PubMed

Hachiya, Mizuki; Murata, Shin; Otao, Hiroshi; Ihara, Takehiko; Mizota, Katsuhiko; Asami, Toyoko

2015-12-01

[Purpose] This study aimed to verify the usefulness of a 50-m round walking test developed as an assessment method for walking ability in the elderly. [Subjects] The subjects were 166 elderly requiring long-term care individuals (mean age, 80.5 years). [Methods] In order to evaluate the factors that had affected falls in the subjects in the previous year, we performed the 50-m round walking test, functional reach test, one-leg standing test, and 5-m walking test and measured grip strength and quadriceps strength. [Results] The 50-m round walking test was selected as a variable indicating fall risk based on the results of multiple logistic regression analysis. The cutoff value of the 50-m round walking test for determining fall risk was 0.66 m/sec. The area under the receiver operating characteristic curve was 0.64. The sensitivity of the cutoff value was 65.7%, the specificity was 63.6%, the positive predictive value was 55.0%, the negative predictive value was 73.3%, and the accuracy was 64.5%. [Conclusion] These results suggest that the 50-m round walking test is a potentially useful parameter for the determination of fall risk in the elderly requiring long-term care.

Challenging Gait Conditions Predict 1-Year Decline in Gait Speed in Older Adults With Apparently Normal Gait

PubMed Central

Perera, Subashan; VanSwearingen, Jessie M.; Hile, Elizabeth S.; Wert, David M.; Studenski, Stephanie A.

2011-01-01

Background Mobility often is tested under a low challenge condition (ie, over a straight, uncluttered path), which often fails to identify early mobility difficulty. Tests of walking during challenging conditions may uncover mobility difficulty that is not identified with usual gait testing. Objective The purpose of this study was to determine whether gait during challenging conditions predicts decline in gait speed over 1 year in older people with apparently normal gait (ie, gait speed of ≥1.0 m/s). Design This was a prospective cohort study. Methods Seventy-one older adults (mean age=75.9 years) with a usual gait speed of ≥1.0 m/s participated. Gait was tested at baseline under 4 challenging conditions: (1) narrow walk (15 cm wide), (2) stepping over obstacles (15.24 cm [6 in] and 30.48 cm [12 in]), (3) simple walking while talking (WWT), and (4) complex WWT. Usual gait speed was recorded over a 4-m course at baseline and 1 year later. A 1-year change in gait speed was calculated, and participants were classified as declined (decreased ≥0.10 m/s, n=18), stable (changed <0.10 m/s, n=43), or improved (increased ≥0.10 m/s, n=10). Analysis of variance was used to compare challenging condition cost (usual − challenging condition gait speed difference) among the 3 groups. Results Participants who declined in the ensuing year had a greater narrow walk and obstacle walk cost than those who were stable or who improved in gait speed (narrow walk cost=0.43 versus 0.33 versus 0.22 m/s and obstacle walk cost=0.35 versus 0.26 versus 0.13 m/s). Simple and complex WWT cost did not differ among the groups. Limitations The participants who declined in gait speed over time walked the fastest, and those who improved walked the slowest at baseline; thus, the potential contribution of regression to the mean to the findings should not be overlooked. Conclusions In older adults with apparently normal gait, the assessment of gait during challenging conditions appears to uncover mobility difficulty that is not identified by usual gait testing. PMID:22003167

A walking prescription for statically-stable walkers based on walker/terrain interaction

NASA Technical Reports Server (NTRS)

Nagy, Peter V.; Whittaker, William L.; Desa, Subhas

1992-01-01

The walker/terrain interaction phenomena for the control of a statically stable walking machine are described. The algorithms, measures, and knowledge of walker/terrain interaction phenomena are then combined to form a prescription for how to walk on general terrain. This prescription consists of two parts: nominal control and reactive control. The function of nominal control is the evaluation and execution of planned motions, based on predicted foot force redistributions, to achieve reliable locomotion. The function of reactive control is the monitoring of walker/terrain interaction in real-time to detect anomalous conditions and then respond with the appropriate reflexive actions. Simulations and experiments have been used to test and verify various aspects of the walking prescription.

Reliability and Validity of Ten Consumer Activity Trackers Depend on Walking Speed.

PubMed

Fokkema, Tryntsje; Kooiman, Thea J M; Krijnen, Wim P; VAN DER Schans, Cees P; DE Groot, Martijn

2017-04-01

To examine the test-retest reliability and validity of ten activity trackers for step counting at three different walking speeds. Thirty-one healthy participants walked twice on a treadmill for 30 min while wearing 10 activity trackers (Polar Loop, Garmin Vivosmart, Fitbit Charge HR, Apple Watch Sport, Pebble Smartwatch, Samsung Gear S, Misfit Flash, Jawbone Up Move, Flyfit, and Moves). Participants walked three walking speeds for 10 min each; slow (3.2 km·h), average (4.8 km·h), and vigorous (6.4 km·h). To measure test-retest reliability, intraclass correlations (ICC) were determined between the first and second treadmill test. Validity was determined by comparing the trackers with the gold standard (hand counting), using mean differences, mean absolute percentage errors, and ICC. Statistical differences were calculated by paired-sample t tests, Wilcoxon signed-rank tests, and by constructing Bland-Altman plots. Test-retest reliability varied with ICC ranging from -0.02 to 0.97. Validity varied between trackers and different walking speeds with mean differences between the gold standard and activity trackers ranging from 0.0 to 26.4%. Most trackers showed relatively low ICC and broad limits of agreement of the Bland-Altman plots at the different speeds. For the slow walking speed, the Garmin Vivosmart and Fitbit Charge HR showed the most accurate results. The Garmin Vivosmart and Apple Watch Sport demonstrated the best accuracy at an average walking speed. For vigorous walking, the Apple Watch Sport, Pebble Smartwatch, and Samsung Gear S exhibited the most accurate results. Test-retest reliability and validity of activity trackers depends on walking speed. In general, consumer activity trackers perform better at an average and vigorous walking speed than at a slower walking speed.

The 1-mile walk test is a valid predictor of VO(2max) and is a reliable alternative fitness test to the 1.5-mile run in U.S. Air Force males.

PubMed

Weiglein, Laura; Herrick, Jeffery; Kirk, Stacie; Kirk, Erik P

2011-06-01

The purpose of this study was to assess the validity of the 1-mile walk (Rockport Walk Test) as a predictor of VO(2max) and determine whether the 1-mile walk is a reliable alternative to the 1.5-mile run in moderately fit to highly fit U.S. Air Force males. Twenty-four (33.0 +/- 1.5 years) males completed a maximal treadmill VO(2max) (50.3 +/- 1.4 mL/ kg/min), 1-mile walk, and 1.5-mile run. For the 1-mile walk, there were no significant differences between measured and predicted VO(2max) (p = 0.177, r = 0.817). There were no significant differences (p = 0.573) between points scored in the Air Force Fitness Test for the 1-mile walk and 1.5-mile run tests. In conclusion, the 1-mile walk test is a valid predictor of VO(2max) and can be used as an alternative fitness test to the 1.5-mile run in assessing cardiovascular fitness in Air Force males.

Associations between physical function, dual-task performance and cognition in patients with mild Alzheimer's disease.

PubMed

Sobol, Nanna Aue; Hoffmann, Kristine; Vogel, Asmus; Lolk, Annette; Gottrup, Hanne; Høgh, Peter; Hasselbalch, Steen G; Beyer, Nina

2016-11-01

Alzheimer's disease (AD) causes a gradual decline in cognition, limitations of dual-tasking and physical function leading to total dependence. Hence, information about the interaction between physical function, dual-task performance and cognition may lead to new treatment strategies with the purpose of preserving function and quality of life. The objective of this study was to investigate the associations between physical function, dual-task performance and cognition in community-dwelling patients with mild AD. Baseline results from 185 participants (50-90 years old) in the single blinded multicenter RCT 'ADEX' (Alzheimer's disease: the effect of physical exercise) were used. Assessments included tests of physical function: 400-m walk test, 10-m walk test, Timed Up and Go test and 30-s chair stand test; dual-task performance, i.e., 10-m walk while counting backwards from 50 or naming the months backwards; and cognition, i.e., Mini Mental State Examination, Symbol Digit Modalities Test, the Stroop Color and Word Test, and Lexical verbal fluency test. Results in the 30-s chair stand test correlated significantly with all tests of cognition (r = .208-.242) while the other physical function tests only randomly correlated with tests of cognition. Results in the dual-task counting backwards correlated significantly with results in all tests of cognition (r = .259-.388), which accounted for 7%-15% of the variation indicating that a faster time to complete dual-task performance was associated with better cognitive performance. The evidence of the associations between physical function, dual-task performance and cognition is important when creating new rehabilitation interventions to patients with mild AD.

Are the average gait speeds during the 10meter and 6minute walk tests redundant in Parkinson disease?

PubMed

Duncan, Ryan P; Combs-Miller, Stephanie A; McNeely, Marie E; Leddy, Abigail L; Cavanaugh, James T; Dibble, Leland E; Ellis, Terry D; Ford, Matthew P; Foreman, K Bo; Earhart, Gammon M

2017-02-01

We investigated the relationships between average gait speed collected with the 10Meter Walk Test (Comfortable and Fast) and 6Minute Walk Test (6MWT) in 346 people with Parkinson disease (PD) and how the relationships change with increasing disease severity. Pearson correlation and linear regression analyses determined relationships between 10Meter Walk Test and 6MWT gait speed values for the entire sample and for sub-samples stratified by Hoehn & Yahr (H&Y) stage I (n=53), II (n=141), III (n=135) and IV (n=17). We hypothesized that redundant tests would be highly and significantly correlated (i.e. r>0.70, p<0.05) and would have a linear regression model slope of 1 and intercept of 0. For the entire sample, 6MWT gait speed was significantly (p<0.001) related to the Comfortable 10 Meter Walk Test (r=0.75) and Fast 10Meter Walk Test (r=0.79) gait speed, with 56% and 62% of the variance in 6MWT gait speed explained, respectively. The regression model of 6MWT gait speed predicted by Comfortable 10 Meter Walk gait speed produced slope and intercept values near 1 and 0, respectively, especially for participants in H&Y stages II-IV. In contrast, slope and intercept values were further from 1 and 0, respectively, for the Fast 10Meter Walk Test. Comfortable 10 Meter Walk Test and 6MWT gait speeds appeared to be redundant in people with moderate to severe PD, suggesting the Comfortable 10 Meter Walk Test can be used to estimate 6MWT distance in this population. Copyright © 2016 Elsevier B.V. All rights reserved.

Are the Average Gait Speeds During the 10 Meter and 6 Minute Walk Tests Redundant in Parkinson Disease?

PubMed Central

Duncan, Ryan P.; Combs-Miller, Stephanie A.; McNeely, Marie E.; Leddy, Abigail L.; Cavanaugh, James T.; Dibble, Leland E.; Ellis, Terry D.; Ford, Matthew P.; Foreman, K. Bo; Earhart, Gammon M.

2016-01-01

We investigated the relationships between average gait speed collected with the 10 Meter Walk Test (Comfortable and Fast) and 6 Minute Walk Test (6MWT) in 346 people with Parkinson disease (PD) and how the relationships change with increasing disease severity. Pearson correlation and linear regression analyses determined relationships between 10 Meter Walk Test and 6MWT gait speed values for the entire sample and for sub-samples stratified by Hoehn & Yahr (H&Y) stage I (n=53), II (n=141), III (n=135) and IV (n=17). We hypothesized that redundant tests would be highly and significantly correlated (i.e. r > 0.70, p < 0.05) and would have a linear regression model slope of 1 and intercept of 0. For the entire sample, 6MWT gait speed was significantly (p<0.001) related to the Comfortable 10 Meter Walk Test (r=0.75) and Fast 10 Meter Walk Test (r=0.79) gait speed, with 56% and 62% of the variance in 6MWT gait speed explained, respectively. The regression model of 6MWT gait speed predicted by Comfortable 10 Meter Walk gait speed produced slope and intercept values near 1 and 0, respectively, especially for participants in H&Y stages II–IV. In contrast, slope and intercept values were further from 1 and 0, respectively, for the Fast 10 Meter Walk Test. Comfortable 10 Meter Walk Test and 6MWT gait speeds appeared to be redundant in people with moderate to severe PD, suggesting the Comfortable 10 Meter Walk Test can be used to estimate 6MWT distance in this population. PMID:27915221

The immediate intervention effects of robotic training in patients after anterior cruciate ligament reconstruction.

PubMed

Hu, Chunying; Huang, Qiuchen; Yu, Lili; Ye, Miao

2016-07-01

[Purpose] The purpose of this study was to examine the immediate effects of robot-assisted therapy on functional activity level after anterior cruciate ligament reconstruction. [Subjects and Methods] Participants included 10 patients (8 males and 2 females) following anterior cruciate ligament reconstruction. The subjects participated in robot-assisted therapy and treadmill exercise on different days. The Timed Up-and-Go test, Functional Reach Test, surface electromyography of the vastus lateralis and vastus medialis, and maximal extensor strength of isokinetic movement of the knee joint were evaluated in both groups before and after the experiment. [Results] The results for the Timed Up-and-Go Test and the 10-Meter Walk Test improved in the robot-assisted rehabilitation group. Surface electromyography of the vastus medialis muscle showed significant increases in maximum and average discharge after the intervention. [Conclusion] The results suggest that walking ability and muscle strength can be improved by robotic training.

Safe RESIDential Environments? A longitudinal analysis of the influence of crime-related safety on walking.

PubMed

Foster, Sarah; Hooper, Paula; Knuiman, Matthew; Christian, Hayley; Bull, Fiona; Giles-Corti, Billie

2016-02-16

Numerous cross-sectional studies have investigated the premise that the perception of crime will cause residents to constrain their walking; however the findings to date are inconclusive. In contrast, few longitudinal or prospective studies have examined the impact of crime-related safety on residents walking behaviours. This study used longitudinal data to test whether there is a causal relationship between crime-related safety and walking in the local neighbourhood. Participants in the RESIDential Environments Project (RESIDE) in Perth, Australia, completed a questionnaire before moving to their new neighbourhood (n = 1813) and again approximately one (n = 1467), three (n = 1230) and seven years (n = 531) after relocating. Self-report measures included neighbourhood perceptions (modified NEWS items) and walking inside the neighbourhood (min/week). Objective built environmental measures were generated for each participant's 1600 m neighbourhood at each time-point, and the count of crimes reported to police were generated at the suburb-level for the first three time-points only. The impact of crime-related safety on walking was examined in SAS using the Proc Mixed procedure (marginal repeated measures model with unrestricted variance pattern). Initial models controlled for demographics, time and self-selection, and subsequent models progressively adjusted for other built and social environment factors based on a social ecological model. For every increase of one level on a five-point Likert scale in perceived safety from crime, total walking within the local neighbourhood increased by 18.0 min/week (p = 0.000). This relationship attenuated to an increase of 10.5 min/week after accounting for other built and social environment factors, but remained significant (p = 0.008). Further analyses examined transport and recreational walking separately. In the fully adjusted models, each increase in safety from crime was associated with a 7.0 min/week increase in recreational walking (p = 0.009), however findings for transport walking were non-significant. All associations between suburb-level crime and walking were non-significant. This study provides longitudinal evidence of a potential causal relationship between residents' perceptions of safety from crime and recreational walking. Safety perceptions appeared to influence recreational walking, rather than transport-related walking. Given the popularity of recreational walking and the need to increase levels of physical activity, community social and physical environmental interventions that foster residents' feelings of safety are likely to increase recreational walking and produce public health gains.

Pilot evaluation of a walking school bus program in a low-income, urban community

PubMed Central

Mendoza, Jason A; Levinger, David D; Johnston, Brian D

2009-01-01

Background To evaluate the impact of a walking school bus (WSB) program on student transport in a low-income, urban neighborhood. Methods The design was a controlled, quasi-experimental trial with consecutive cross-sectional assessments. The setting was three urban, socioeconomically disadvantaged, public elementary schools (1 intervention vs. 2 controls) in Seattle, Washington, USA. Participants were ethnically diverse students in kindergarten-5th grade (aged 5–11 years). The intervention was a WSB program consisting of a part-time WSB coordinator and parent volunteers. Students' method of transportation to school was assessed by a classroom survey at baseline and one-year follow-up. The Pearson Chi-squared test compared students transported to school at the intervention versus control schools at each time point. Due to multiple testing, we calculated adjusted p-values using the Ryan-Holm stepdown Bonferroni procedure. McNemar's test was used to examine the change from baseline to 12-month follow-up for walking versus all other forms of school transport at the intervention or control schools. Results At baseline, the proportions of students (n = 653) walking to the intervention (20% +/- 2%) or control schools (15% +/- 2%) did not differ (p = 0.39). At 12-month follow up, higher proportions of students (n = 643, p = 0.001)) walked to the intervention (25% +/- 2%) versus the control schools (7% +/- 1%). No significant changes were noted in the proportion of students riding in a car or taking the school bus at baseline or 12-month follow up (all p > 0.05). Comparing baseline to 12-month follow up, the numbers of students who walked to the intervention school increased while the numbers of students who used the other forms of transport did not change (p < 0.0001). In contrast, the numbers of students who walked to the control schools decreased while the numbers of students who used the other forms of transport did not change (p < 0.0001). Conclusion A WSB program is a promising intervention among urban, low-income elementary school students that may promote favorable changes toward active transport to school. Trial Registration ClinicalTrials.gov NCT00402701 PMID:19413910

Is walking a random walk? Evidence for long-range correlations in stride interval of human gait

NASA Technical Reports Server (NTRS)

Hausdorff, Jeffrey M.; Peng, C.-K.; Ladin, Zvi; Wei, Jeanne Y.; Goldberger, Ary L.

1995-01-01

Complex fluctuation of unknown origin appear in the normal gait pattern. These fluctuations might be described as being (1) uncorrelated white noise, (2) short-range correlations, or (3) long-range correlations with power-law scaling. To test these possibilities, the stride interval of 10 healthy young men was measured as they walked for 9 min at their usual rate. From these time series we calculated scaling indexes by using a modified random walk analysis and power spectral analysis. Both indexes indicated the presence of long-range self-similar correlations extending over hundreds of steps; the stride interval at any time depended on the stride interval at remote previous times, and this dependence decayed in a scale-free (fractallike) power-law fashion. These scaling indexes were significantly different from those obtained after random shuffling of the original time series, indicating the importance of the sequential ordering of the stride interval. We demonstrate that conventional models of gait generation fail to reproduce the observed scaling behavior and introduce a new type of central pattern generator model that sucessfully accounts for the experimentally observed long-range correlations.

The effects of a walking/talking program on communication, ambulation, and functional status in residents with Alzheimer disease.

PubMed

Cott, Cheryl A; Dawson, Pamela; Sidani, Souraya; Wells, Donna

2002-01-01

The purpose of this study was to investigate the effects of a walking/talking program on residents' communication, ambulation, and level of function when there were two residents to one care provider (2:1). A randomized control trial design was used. Subjects were residents with Alzheimer disease in three geriatric long-term care facilities in Metropolitan Toronto. Residents who met the inclusion criteria were randomly assigned to one of three groups: walk-and-talk group (30 min, 5 times per week for 16 weeks, walking/talking in pairs), talk-only group (30 min, 5 times per week for 16 weeks, talk only in pairs), or no intervention. The outcome measures were the Functional Assessment of Communication Skills for Adults, the 2-min walk test, and London Psychogeriatric Rating Scale. Residents who received the walk-and-talk intervention did not demonstrate statistically significant differences in the outcome variables measured posttest when compared with residents who received the talk-only intervention or no intervention, even after controlling for individual differences. Variability in the outcomes measured posttest is explained by differences in the residents' level of cognitive impairment before the study rather than by study group membership. These findings are contradictory to those of previous studies.

Monitoring walking and cycling of middle-aged to older community dwellers using wireless wearable accelerometers.

PubMed

Zhang, Yuting; Beenakker, Karel G M; Butala, Pankil M; Lin, Cheng-Chieh; Little, Thomas D C; Maier, Andrea B; Stijntjes, Marjon; Vartanian, Richard; Wagenaar, Robert C

2012-01-01

Changes in gait parameters have been shown to be an important indicator of several age-related cognitive and physical declines of older adults. In this paper we propose a method to monitor and analyze walking and cycling activities based on a triaxial accelerometer worn on one ankle. We use an algorithm that can (1) distinguish between static and dynamic functional activities, (2) detect walking and cycling events, (3) identify gait parameters, including step frequency, number of steps, number of walking periods, and total walking duration per day, and (4) evaluate cycling parameters, including cycling frequency, number of cycling periods, and total cycling duration. Our algorithm is evaluated against the triaxial accelerometer data obtained from a group of 297 middle-aged to older adults wearing an activity monitor on the right ankle for approximately one week while performing unconstrained daily activities in the home and community setting. The correlation coefficients between each of detected gait and cycling parameters on two weekdays are all statistically significant, ranging from 0.668 to 0.873. These results demonstrate good test-retest reliability of our method in monitoring walking and cycling activities and analyzing gait and cycling parameters. This algorithm is efficient and causal in time and thus implementable for real-time monitoring and feedback.

Do walking strategies to increase physical activity reduce reported sitting in workplaces: a randomized control trial

PubMed Central

Gilson, Nicholas D; Puig-Ribera, Anna; McKenna, Jim; Brown, Wendy J; Burton, Nicola W; Cooke, Carlton B

2009-01-01

Background Interventions designed to increase workplace physical activity may not automatically reduce high volumes of sitting, a behaviour independently linked to chronic diseases such as obesity and type II diabetes. This study compared the impact two different walking strategies had on step counts and reported sitting times. Methods Participants were white-collar university employees (n = 179; age 41.3 ± 10.1 years; 141 women), who volunteered and undertook a standardised ten-week intervention at three sites. Pre-intervention step counts (Yamax SW-200) and self-reported sitting times were measured over five consecutive workdays. Using pre-intervention step counts, employees at each site were randomly allocated to a control group (n = 60; maintain normal behaviour), a route-based walking group (n = 60; at least 10 minutes sustained walking each workday) or an incidental walking group (n = 59; walking in workday tasks). Workday step counts and reported sitting times were re-assessed at the beginning, mid- and endpoint of intervention and group mean± SD steps/day and reported sitting times for pre-intervention and intervention measurement points compared using a mixed factorial ANOVA; paired sample-t-tests were used for follow-up, simple effect analyses. Results A significant interactive effect (F = 3.5; p < 0.003) was found between group and step counts. Daily steps for controls decreased over the intervention period (-391 steps/day) and increased for route (968 steps/day; t = 3.9, p < 0.000) and incidental (699 steps/day; t = 2.5, p < 0.014) groups. There were no significant changes for reported sitting times, but average values did decrease relative to the control (routes group = 7 minutes/day; incidental group = 15 minutes/day). Reductions were most evident for the incidental group in the first week of intervention, where reported sitting decreased by an average of 21 minutes/day (t = 1.9; p < 0.057). Conclusion Compared to controls, both route and incidental walking increased physical activity in white-collar employees. Our data suggests that workplace walking, particularly through incidental movement, also has the potential to decrease employee sitting times, but there is a need for on-going research using concurrent and objective measures of sitting, standing and walking. PMID:19619295

Relationship of Sit-to-Stand Lower-Body Power With Functional Fitness Measures Among Older Adults With and Without Sarcopenia.

PubMed

Glenn, Jordan M; Gray, Michelle; Binns, Ashley

When evaluating health in older adults, batteries of tests are typically utilized to assess functional fitness. Unfortunately, physician's visits are time-sensitive, and it may be important to develop faster methods to assess functional fitness that can be utilized in professional or clinical settings. Therefore, the purpose of this investigation was to examine the relationship of sit-to-stand (STS) power generated through the STS task with previously established measures of functional fitness, specifically strength, endurance, speed, agility, and flexibility in older adults with and without sarcopenia. This study consisted of 57 community-dwelling older adults (n = 16 males; n = 41 females). Functional fitness was assessed using the Short Physical Performance Battery (SPPB), Senior Fitness Test, handgrip, gait speed (habitual and maximal), balance, and STS power generated via the Tendo Weightlifting Analyzer. On the basis of data distribution, second-degree polynomial (quadratic) curvilinear models (lines of best fit) were applied for the relationships of 5-time STS time with average and peak power. Zero-order correlations were evaluated between STS power and all other functional fitness measures. Older adults with sarcopenia were also identified (n = 15), and relationships were reevaluated within this subset. STS power (average and peak) was significantly (P ≤ .01) correlated with physical performance measured via previously established assessments. For average power, this was observed during the senior fitness test (6-minute walk [r = 0.39], 8-ft up-and-go [r = -0.46], arm curl [r = 0.46], and chair stand [r = 0.55]), SPPB (5-time STS time [r = -0.63] and 8-ft walk [r = -0.32]), and other independent functional fitness measures (grip strength [r = 0.65] and maximal gait speed [r = -0.31]). Similar results were observed for peak power during the senior fitness test (6-minute walk [r = 0.39], 8-ft up-and-go [r = -0.46], arm curl [r = 0.45], chair stand [r = 0.52], and sit-and-reach [r = -0.27]), SPPB (5-time STS time [r = -0.60] and 8-ft walk [r = -0.33]), and other independent functional fitness measures (grip strength [r = 0.70] and maximal gait speed [r = -0.32]). Within the sarcopenic subset, for average and peak power, respectively, significant relationships were still retained for handgrip strength (r = 0.57 and r = 0.57), 6-minute walk (r = 0.55 and r = 0.61), chair stand (r = 0.76 and r = 0.81), and 5-time STS time (r = -0.76 and r = -0.80) tests. STS power generated via the STS task significantly relates to commonly administered functional fitness measures. These relationships also appear to exist when evaluating these relationships in older adults with sarcopenia. STS power may be utilized as an independent measure of functional fitness that is feasible to incorporate in clinical settings where time and space are often limiting factors.

ACTN3 genotype and physical function and frailty in an elderly Chinese population: the Rugao Longevity and Ageing Study.

PubMed

Ma, Teng; Lu, Deyi; Zhu, Yin-Sheng; Chu, Xue-Feng; Wang, Yong; Shi, Guo-Ping; Wang, Zheng-Dong; Yu, Li; Jiang, Xiao-Yan; Wang, Xiao-Feng

2018-05-01

To examine the associations of the actinin alpha 3 gene (ACTN3) R577X polymorphism with physical performance and frailty in an older Chinese population. Data from 1,463 individuals (57.8% female) aged 70-87 years from the Rugao Longevity and Ageing Study were used. The associations between R577X and timed 5-m walk, grip strength, timed Up and Go test, and frailty index (FI) based on deficits of 23 laboratory tests (FI-Lab) were examined. Analysis of variance and linear regression models were used to evaluate the genetic effects of ACTN3 R577X on physical performance and FI-Lab. The XX and RX genotypes of the ACTN3 R557X polymorphism accounted for 17.1 and 46.9%, respectively. Multivariate regression analysis revealed that in men aged 70-79 years, the ACTN3 577X allele was significantly associated with physical performance (5-m walk time, regression coefficient (β) = 0.258, P = 0.006; grip strength, β = -1.062, P = 0.012; Up and Go test time β = 0.368, P = 0.019). In women aged 70-79 years, a significant association between the ACTN3 577X allele and the FI-Lab score was observed, with a regression coefficient of β = 0.019 (P = 0.003). These findings suggest an age- and gender-specific X-additive model of R577X for 5-m walk time, grip strength, Up and Go Test time, and FI-Lab score. The ACTN3 577X allele is associated with an age- and sex-specific decrease in physical performance and an increase in frailty in an older population.

42 CFR Appendix - Tables to Subpart H of Part 84

Code of Federal Regulations, 2010 CFR

2010-10-01

... HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND... Sampling and readings 2 2 2 2 Perform 1 hour test 2, 3, or 4 times respectively. Walks at 4.8 km. (3 miles) per hour 3 5 3 4 8 12 18 Sampling and readings 2 2 2 2 2 Walks at 4.8 km. (3 miles) per hour 3 5 8 12...

Stroke-Related Changes in Neuromuscular Fatigue of the Hip Flexors and Functional Implications

PubMed Central

Hyngstrom, Allison S.; Onushko, Tanya; Heitz, Robert P.; Rutkowski, Anthony; Hunter, Sandra K.; Schmit, Brian D.

2014-01-01

Objective To compare stroke-related changes in hip-flexor neuromuscular fatigue of the paretic leg during a sustained, isometric sub-maximal contraction with the non-paretic leg and controls, and correlate fatigue with clinical measures of function. Design Hip torques were measured during a fatiguing hip-flexion contraction at 20% of the hip flexion maximal voluntary contraction (MVC) in the paretic and non-paretic legs of 13 people with chronic stroke and 10 age-matched controls. In addition, participants with stroke performed a fatiguing contraction of the paretic leg at the absolute torque equivalent to 20% MVC of the non-paretic leg and were tested for self-selected walking speed (Ten-Meter Walk Test) and balance (Berg). Results When matching the non-paretic target torque, the paretic hip flexors had a shorter time to task failure compared with the non-paretic leg and controls (p<0.05). Time to failure of the paretic leg was inversely correlated with the reduction of hip flexion MVC torque. Self-selected walking speed was correlated with declines in torque and steadiness. Berg-Balance scores were inversely correlated with the force fluctuation amplitude. Conclusions Fatigue and precision of contraction are correlated with walking function and balance post stroke. PMID:22157434

Effect of early and late rehabilitation onset in a chronic rat model of ischemic stroke- assessment of motor cortex signaling and gait functionality over time.

PubMed

Nielsen, Rasmus K; Samson, Katrine L; Simonsen, Daniel; Jensen, Winnie

2013-11-01

The aim of the present study was to investigate the effects of ischemic stroke and onset of subsequent rehabilitation of gait function in rats. Nine male Sprague-Dawley rats were instrumented with a 16-channel intracortical (IC) electrode array. An ischemic stroke was induced within the hindlimb area of the left motor cortex. The rehabilitation consisted of a repetitive training paradigm over 28 days, initiated on day one ("Early-onset", 5 rats) and on day seven, ("Late-onset", 4 rats). Data were obtained from IC microstimulation tests, treadmill walking tests, and beam walking tests. Results revealed an expansion of the hindlimb representation within the motor cortex area and an increased amount of cortical firing rate modulation for the "Early-onset" group but not for the "Late-onset" group. Kinematic data revealed a significant change for both intervention groups. However, this difference was larger for the "Early-onset" group. Results from the beam walking test showed functional performance deficits following stroke which returned to pre-stroke level after the rehabilitative training. The results from the present study indicate the existence of a critical time period following stroke where onset of rehabilitative training may be more effective and related to a higher degree of true recovery.

Changes in Function After a 6-Month Walking Intervention in Patients With Intermittent Claudication Who Are Obese or Nonobese.

PubMed

Addison, Odessa; Ryan, Alice S; Prior, Steven J; Katzel, Leslie I; Kundi, Rishi; Lal, Brajesh K; Gardner, Andrew W

Both obesity and peripheral artery disease (PAD) limit function and may work additively to reduce mobility. The purpose of this study was to compare the effects of a 6-month, center-based walking program on mobility function between adults who are weight-stable obese and nonobese with PAD. This is a secondary data analysis of 2 combined studies taken from previous work. Fifty-three adults with PAD and intermittent claudication participated in 6 months of treadmill training or standard of care. Patients were divided into 4 groups for analyses: exercise nonobese (Ex), exercise obese (ExO), standard-of-care nonobese (SC), and standard-of-care obese (SCO). Mobility was assessed by a standardized treadmill test to measure claudication onset time (COT) and peak walking time (PWT) as well as the distance walked during a 6-minute walk distance (6MWD) test. There was a significant (P < .001) interaction (intervention × obesity) effect on 6MWD, wherein both exercise groups improved (Ex = 7%, ExO = 16%; P < .02), the SC group did not change (0.9%; P > .05), and the SCO group tended to decline (-18%; P = .06). Both exercise intervention groups significantly improved COT (Ex = 92%, ExO = 102%; P < .01) and PWT (Ex = 54%, ExO = 103%; P < .001). There was no change (P > .05) in either standard-of-care group. Individuals who are obese and nonobese with PAD made similar improvements after a 6-month, center-based walking program. However, patients who are obese with PAD and do not exercise may be susceptible to greater declines in mobility. Exercise may be particularly important in patients who are obese with PAD to avoid declines in mobility.

Biomechanics of stair walking and jumping.

PubMed

Loy, D J; Voloshin, A S

1991-01-01

Physical activities such as stair walking and jumping result in increased dynamic loading on the human musculoskeletal system. Use of light weight, externally attached accelerometers allows for in-vivo monitoring of the shock waves invading the human musculoskeletal system during those activities. Shock waves were measured in four subjects performing stair walking up and down, jumping in place and jumping off a fixed elevation. The results obtained show that walking down a staircase induced shock waves with amplitude of 130% of that observed in walking up stairs and 250% of the shock waves experienced in level gait. The jumping test revealed levels of the shock waves nearly eight times higher than that in level walking. It was also shown that the shock waves invading the human musculoskeletal system may be generated not only by the heel strike, but also by the metatarsal strike. To moderate the risk of degenerative joint disorders four types of viscoelastic insoles were utilized to reduce the impact generated shock waves. The insoles investigated were able to reduce the amplitude of the shock wave by between 9% and 41% depending on the insole type and particular physical activity. The insoles were more effective in the reduction of the heel strike impacts than in the reduction of the metatarsal strike impacts. In all instances, the shock attenuation capacities of the insoles tested were greater in the jumping trials than in the stair walking studies. The insoles were ranked in three groups on the basis of their shock absorbing capacity.

Six-minute walk test in children and adolescents with cystic fibrosis.

PubMed

Cunha, Maristela Trevisan; Rozov, Tatiana; de Oliveira, Rosangela Caitano; Jardim, José R

2006-07-01

The 6-min walk test is a simple, rapid, and low-cost method that determines tolerance to exercise. We examined the reproducibility of the 6-min walk test in 16 children with cystic fibrosis (11 female, 5 male; age range, 11.0 +/- 1.9 years). We related the distance walked and the work performed (distance walked x body weight) with nutritional (body mass index and respiratory muscle strength) and clinical (degree of bronchial obstruction and Shwachman score) status. Patients were asked to walk as far as possible upon verbal command on two occasions. There was no statistical difference between distances walked (582.3 +/- 60 and 598.2 +/- 56.8 m, P = 0.31), heart rate, respiratory rate, pulse oxygen saturation, arterial blood pressure, dyspnea, and percentage of maximal heart rate for age in the two tests. Distance walked correlated (Pearson) with maximal expiratory pressure (98.6 +/- 28.1 cmH2O, r = 0.60, P < 0.01), maximal heart rate (157.9 +/- 10.1 bpm, r = 0.59, P < 0.02), Borg dyspnea scale (1.7 +/- 2.4, r = 0.55, P < 0.03), and double product (blood pressure x heart rate; r = 0.59, P < 0.02). The product of distance walked and body weight (work) correlated (Pearson) with height (r = 0.83, P = 0.000), maximal expiratory pressure (r = 0.64, P < 0.01), systolic blood pressure (r = 0.56, P < 0.02), and diastolic blood pressure (r = 0.55, P < 0.03). We conclude that the 6-min walk test is reproducible and easy to perform in children and adolescents with cystic fibrosis. The distance walked was related to the clinical variables studied. Work in the 6-min walk test may be an additional parameter in the determination of physical capacity.

Tribological measurements on a Charnley-type artificial hip joint

NASA Technical Reports Server (NTRS)

Jones, W. R., Jr.

1983-01-01

A total hip simulator was used to determine the friction and wear properties of Charnley-type (316L stainless steel balls and sterile ultrahigh molecular weight polyethylene cups) hip prostheses. Three different sets of specimens were tested to 395,000, 101,500 and 233,000 walking cycles, respectively. All tests were run unlubricated, at ambient conditions (22 to 26 C, 30 to 50 percent relative humidity), at 30 walking cycles per minute, under a dynamic load simulating walking. Polyethylene cup wear rates ranged from 1.4 to 39 ten billions cu m which corresponds to dimensional losses of 4.0 to 11 microns per year. Although these wear rates are lower than those obtained from other hip simulators and from in vivo X-ray measurements, they are comparable when taking run-in and plastic deformation into account. Maximum tangential friction forces ranged from 93 to 129 N under variable load (267 to 3090 N range) and from 93 to 143 N under a static load of 3090 N. A portion of one test 250,000 walking cycles) run under dry air ( 1 percent relative humidity) yielded a wear rate almost 6 times greater than that obtained under wet air ( 70 percent relative humidity) conditions.

[A new procedure for the estimation of physical fitness of patients during clinical rehabilitation using the 6-minute-walk-test].

PubMed

Marek, W; Marek, E; Vogel, P; Mückenhoff, K; Kotschy-Lang, N

2008-11-01

AIMS OF THE INVESTIGATION: The 6-minute-walk-test (6-MW) is an effective tool for measuring physical fitness in elderly patients. The increased walking distance is taken as a parameter for improved physical conditions. Frequently an unaltered walking distance is found after clinical treatment, but heart rate is significantly lower in the second challenge, indicating an improved physical fitness. This positive effect is not recognised when only the walking distance is analysed. An analysis of the 6-MW test was performed on 263 patients before and after 3 - 4 weeks clinical rehabilitation. In a control group of 26 patients 6-MW was repeated after recovery at the beginning and the end of the clinical treatment. Instrumented by a mobile pulse oximeter for recording oxygen saturation and heart rate, patients were instructed to walk as fast as they can do during 6 minutes. Measurements were performed every 30 seconds and printed out. Two new parameters, efficiency (E = S/f (C)), the ratio of distance and mean heart rate, and the theoretical increase in walking distance (S (z) = Delta f (C1)/Delta f (C2) x S (2) - S (1)) were introduced and tested. S (z) = theoretical increase in distance, Delta f (C1) = difference in heart rate at rest and mean heart rate at steady state during the first walk test with distance, S1. Delta f (C2), and S2 are measured during the second walk. Thus, the increase in distance is calculated under the assumption that the second walk test would have been performed by the patient with the same difference in heart rate that he/she achieved in the first walk. The patient groups walked 353 +/- 80 m at 106 +/- 14.3 beats/min in the 1st. 6-MW and 368 +/- 76.9 m at a heart rate of 105 +/- 14.0 beats/min in the final test. The increase of the walking distance was most significant in patients with shorter distances in the 1st 6-MW. A significant increase in the walking distance and in efficiency was found in patients with shorter walking distances or lower heart rates in the final test, using the numerical procedure described above. The patient's performance of the second walk test with an unchanged distance at a lower heart rate reveals an improved physical fitness. This is solely described by an increase by the parameter of efficiency, E. The calculation of the parameter, Sz, theoretical difference in walking distance (i. e., theoretical increase in almost all tests) provides a quantification of the effect of exercise training, even if the patient is not cooperative during the tests. Both parameters have proved to be suitable estimations for the assessment of physical fitness as a beneficial effect of clinical rehabilitation.

Short-distance walking speed tests in people with Parkinson disease: reliability, responsiveness, and validity.

PubMed

Combs, Stephanie A; Diehl, M Dyer; Filip, Jacqueline; Long, Erin

2014-02-01

The aims of this study were to determine test-retest reliability and responsiveness of short-distance walking speed tests for persons with Parkinson disease (PD). Discriminant and convergent validity of walking speed tests were also examined. Eighty-eight participants with PD (mean age, 66 years) with mild to moderate severity (stages 1-4 on the Hoehn and Yahr Scale) were tested on medications. Measures of activity included the comfortable and fast 10-m walk tests (CWT, FWT), 6-min walk test (6MWT), mini balance evaluations systems test (mini-BEST Test), fear of falling (FoF), and the Activity-Specific Balance Confidence Scale (ABC). The mobility subsection of the PD quality of life-39 (PDQ39-M) served as a participation-based measure. Test-retest reliability was high for both walking speed measures (CWT, ICC(2,1) = 0.98; FWT, ICC(2,1) = 0.99). Minimal detectable change (MDC(95)) for the CWT and FWT was 0.09 m/s and 0.13 m/s respectively. Participants at Hoehn & Yahr levels 3/4 demonstrated significantly slower walking speed with the CWT and FWT than participants at Hoehn & Yahr levels 1 and 2 (P < .01). The CWT and FWT were both significantly (P ≤ .002) correlated with all activity and participation-based measures. Short-distance walking speed tests are clinically useful measures for persons with PD. The CWT and FWT are highly reliable and responsive to change in persons with PD. Short distance walking speed can be used to discriminate differences in gait function between persons with mild and moderate PD severity. The CWT and FWT had moderate to strong associations with other activity and participation based measures demonstrating convergent validity. Copyright © 2013 Elsevier B.V. All rights reserved.

Effects of home-based locomotor treadmill training on gross motor function in young children with cerebral palsy: a quasi-randomized controlled trial.

PubMed

Mattern-Baxter, Katrin; McNeil, Stefani; Mansoor, Jim K

2013-11-01

To examine the effects of an intensive home-based program of treadmill training on motor skills related to walking in preambulatory children with cerebral palsy (CP). Quasi-randomized controlled trial. Homes of the participants. Children with CP (N=12) with Gross Motor Function Classification System levels I and II were assigned to the intervention group (n=6; mean age ± SD, 21.76±6.50mo) and control group (n=6; 21.25±6.07mo). All children were tested preintervention, postintervention, at a 1-month follow-up, and at a 4-month follow-up. All children received their weekly scheduled physical therapy sessions at their homes. In addition, children in the intervention group walked on a portable treadmill in their homes 6 times per week, twice daily for 10- to 20-minute sessions, for 6 weeks. The intervention was carried out by the children's parents with weekly supervision by a physical therapist. Gross Motor Function Measure-66 Dimensions D/E, Peabody Developmental Motor Scales-2 (PDMS-2), Pediatric Evaluation of Disability Inventory (PEDI), timed 10-m walk test (10MWT), and Functional Mobility Scale (FMS). The Friedman test and Mann-Whitney U test were conducted for within-group and between-group differences, respectively. There was a significant between-group treatment effect for the PDMS-2 at posttest (P=.01) and 1-month postintervention follow-up (P=.09), as well as for the PEDI at posttest (P=.01), the 1-month postintervention follow-up (P=.009), and the 4-month postintervention follow-up (P=.04). The FMS was significant at the posttest (P=.04). Home-based treadmill training accelerates the attainment of walking skills and decreases the amount of support used for walking in young children with CP. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

No relevant impact of ambient temperature on disability measurements in a large cohort of patients with multiple sclerosis.

PubMed

Stellmann, J-P; Young, K L; Vettorazzi, E; Pöttgen, J; Heesen, C

2017-06-01

Many patients with multiple sclerosis (MS) report a worsening of symptoms due to high ambient temperatures, but objective data about this association are rare and contradictory. The aim of this study was to investigate the influence of ambient temperature on standard clinical tests. We extracted the Symbol Digit Modality Test, Nine Hole Peg Test, Timed 25 Foot Walk (T25FW), Timed Tandem Walk, Expanded Disability Status Scale (EDSS) and quality-of-life items on cognition, fatigue and depression from our clinical database and matched them to historical temperatures. We used linear mixed-effect models to investigate the association between temperature and outcomes. A total of 1254 patients with MS (mean age, 42.7 years; 69.9% females; 52.1% relapsing-remitting MS, mean EDSS, 3.8) had 5751 assessments between 1996 and 2012. We observed a worsening in the T25FW with higher ambient temperatures in moderately disabled patients (EDSS ≥ 4) but not in less disabled patients. However, an increase of 10°C prolonged the T25FW by just 0.4 s. Other outcomes were not associated with ambient temperatures. Higher ambient temperature might compromise walking capabilities in patients with MS with a manifest walking impairment. However, effects are small and not detectable in mildly disabled patients. Hand function, cognition, mood and fatigue do not appear to be correlated with ambient temperature. © 2017 EAN.

Reproducibility of the Self-Controlled Six-Minute Walking Test in Heart Failure Patients

PubMed Central

Guimarães, Guilherme Veiga; Carvalho, Vitor Oliveira; Bocchi, Edimar Alcides

2008-01-01

INTRODUCTION The six-minute walk test (6WT) has been proposed to be a submaximal test, but could actually demand a high level of exercise intensity from the patient, expressed by a respiratory quotient >1.0, following the guideline recommendations. Standardizing the 6WT using the Borg scale was proposed to make sure that all patients undergo a submaximal walking test. PURPOSE To test the reproducibility of the six-minute treadmill cardiopulmonary walk test (6CWT) using the Borg scale and to make sure that all patients undergo a submaximal test. METHODS Twenty-three male heart failure patients (50±9 years) were included; these patients had both ischemic (5) and non-ischemic (18) heart failure with a left ventricle ejection fraction of 23±7%, were diagnosed as functional class NYHA II-III and were undergoing optimized drug therapy. Patients were guided to walk at a pace between “relatively easy and slightly tiring” (11 and 13 on Borg scale). The 6CWT using the Borg scale was performed two times on a treadmill with zero inclination and patient control of speed with an interval of 24 hours. During the sixth minute, we analyzed ventilation (VE, L/min), respiratory quotient, Oxygen consumption (VO2, ml/kg/min), VE/VCO2 slope, heart rate (HR, bpm), systolic blood pressure (SBP, mmHg), diastolic (DBP, mmHg) blood pressure and distance. RESULTS The intraclass correlation coefficients at the sixth minute were: HR (ri=0.96, p<0.0001), VE (ri=0.84, p<0.0001), SBP (ri=0.72, p=0.001), distance (ri=0.88, p<0.0001), VO2 (ri=0.92, p<0.0001), SlopeVE/VCO2 (ri=0.86, p<0.0001) and RQ<1 (ri=0.6, p=0.004). CONCLUSION Using the 6CWT with the Borg scale was reproducible, and it seems to be an appropriate method to evaluate the functional capacity of heart failure patients while making sure that they undergo a submaximal walking test. PMID:18438574

Reproducibility of the self-controlled six-minute walking test in heart failure patients.

PubMed

Guimarães, Guilherme Veiga; Carvalho, Vitor Oliveira; Bocchi, Edimar Alcides

2008-04-01

The six-minute walk test (6WT) has been proposed to be a submaximal test, but could actually demand a high level of exercise intensity from the patient, expressed by a respiratory quotient >1.0, following the guideline recommendations. Standardizing the 6WT using the Borg scale was proposed to make sure that all patients undergo a submaximal walking test. To test the reproducibility of the six-minute treadmill cardiopulmonary walk test (6CWT) using the Borg scale and to make sure that all patients undergo a submaximal test. Twenty-three male heart failure patients (50+/-9 years) were included; these patients had both ischemic (5) and non-ischemic (18) heart failure with a left ventricle ejection fraction of 23+/-7%, were diagnosed as functional class NYHA II-III and were undergoing optimized drug therapy. Patients were guided to walk at a pace between "relatively easy and slightly tiring" (11 and 13 on Borg scale). The 6CWT using the Borg scale was performed two times on a treadmill with zero inclination and patient control of speed with an interval of 24 hours. During the sixth minute, we analyzed ventilation (VE, L/min), respiratory quotient, Oxygen consumption (VO2, ml/kg/min), VE/VCO2 slope, heart rate (HR, bpm), systolic blood pressure (SBP, mmHg), diastolic (DBP, mmHg) blood pressure and distance. The intraclass correlation coefficients at the sixth minute were: HR (r i=0.96, p<0.0001), VE (r i=0.84, p<0.0001), SBP (r i=0.72, p=0.001), distance (r i=0.88, p<0.0001), VO2 (r i=0.92, p<0.0001), SlopeVE/VCO2 (r i=0.86, p<0.0001) and RQ<1 (r i=0.6, p=0.004). Using the 6CWT with the Borg scale was reproducible, and it seems to be an appropriate method to evaluate the functional capacity of heart failure patients while making sure that they undergo a submaximal walking test.

A task-oriented circuit training in multiple sclerosis: a feasibility study

PubMed Central

2014-01-01

Background The aim of this study was to evaluate the safety, feasibility and preliminary effects of a high-intensity rehabilitative task-oriented circuit training (TOCT) in a sample of multiple sclerosis (MS) subjects on walking competency, mobility, fatigue and health-related quality of life (HRQoL). Methods 24 MS subjects (EDSS 4.89 ± 0.54, 17 female and 7 male, 52.58 ± 11.21 years, MS duration 15.21 ± 8.68 years) have been enrolled and randomly assigned to 2 treatment groups: (i) experimental group received 10 TOCT sessions over 2 weeks (2 hours/each session) followed by a 3 months home exercise program, whereas control group did not receive any specific rehabilitation intervention. A feasibility patient-reported questionnaire was administered after TOCT. Functional outcome measures were: walking endurance (Six Minute Walk Test), gait speed (10 Meter Walk Test), mobility (Timed Up and Go test) and balance (Dynamic Gait Index). Furthermore, self-reported questionnaire of motor fatigue (Fatigue Severity Scale), walking ability (Multiple Sclerosis Walking Scale – 12) and health-related quality of life (Multiple Sclerosis Impact Scale – 29) were included. Subjects’ assessments were delivered at baseline (T0), after TOCT (T1) and 3 months of home-based exercise program (T2). Results After TOCT subjects reported a positive global rating on the received treatment. At 3 months, we found a 58.33% of adherence to the home-exercise program. After TOCT, walking ability and health-related quality of life were improved (p < 0.05) with minor retention after 3 months. The control group showed no significant changes in any variables. Conclusions This two weeks high-intensity task-oriented circuit class training followed by a three months home-based exercise program seems feasible and safe in MS people with moderate mobility impairments; moreover it might improve walking abilities. Trial registration NCT01464749 PMID:24906545

Urban form and psychosocial factors: do they interact for leisure-time walking?

PubMed

Beenackers, Mariëlle A; Kamphuis, Carlijn B M; Prins, Richard G; Mackenbach, Johan P; Burdorf, Alex; van Lenthe, Frank J

2014-02-01

This cross-sectional study uses an adaptation of a social-ecological model on the hierarchy of walking needs to explore direct associations and interactions of urban-form characteristics and individual psychosocial factors for leisure-time walking. Questionnaire data (n = 736) from adults (25-74 yr) and systematic field observations within 14 neighborhoods in Eindhoven (the Netherlands) were used. Multilevel logistic regression models were used to relate the urban-form characteristics (accessibility, safety, comfort, and pleasurability) and individual psychosocial factors (attitude, self-efficacy, social influence, and intention) to two definitions of leisure-time walking, that is, any leisure-time walking and sufficient leisure-time walking according to the Dutch physical activity norm and to explore their interactions. Leisure-time walking was associated with psychosocial factors but not with characteristics of the urban environment. For sufficient leisure-time walking, interactions between attitude and several urban-form characteristics were found, indicating that positive urban-form characteristics contributed toward leisure-time walking only in residents with a less positive attitude toward physical activity. In contrast, living in a neighborhood that was accessible for walking was stronger associated with leisure-time walking among residents who experienced a positive social influence to engage in physical activity compared with those who reported less social influence. This study showed some evidence for an interaction between the neighborhood environment and the individual psychosocial factors in explaining leisure-time walking. The specific mechanism of interaction may depend on the specific combination of psychosocial factor and environmental factor. The lack of association between urban form and leisure-time walking could be partly due to the little variation in urban-form characteristics between neighborhoods.

Reducing the metabolic cost of walking with an ankle exoskeleton: interaction between actuation timing and power.

PubMed

Galle, Samuel; Malcolm, Philippe; Collins, Steven Hartley; De Clercq, Dirk

2017-04-27

Powered ankle-foot exoskeletons can reduce the metabolic cost of human walking to below normal levels, but optimal assistance properties remain unclear. The purpose of this study was to test the effects of different assistance timing and power characteristics in an experiment with a tethered ankle-foot exoskeleton. Ten healthy female subjects walked on a treadmill with bilateral ankle-foot exoskeletons in 10 different assistance conditions. Artificial pneumatic muscles assisted plantarflexion during ankle push-off using one of four actuation onset timings (36, 42, 48 and 54% of the stride) and three power levels (average positive exoskeleton power over a stride, summed for both legs, of 0.2, 0.4 and 0.5 W∙kg -1 ). We compared metabolic rate, kinematics and electromyography (EMG) between conditions. Optimal assistance was achieved with an onset of 42% stride and average power of 0.4 W∙kg -1 , leading to 21% reduction in metabolic cost compared to walking with the exoskeleton deactivated and 12% reduction compared to normal walking without the exoskeleton. With suboptimal timing or power, the exoskeleton still reduced metabolic cost, but substantially less so. The relationship between timing, power and metabolic rate was well-characterized by a two-dimensional quadratic function. The assistive mechanisms leading to these improvements included reducing muscular activity in the ankle plantarflexors and assisting leg swing initiation. These results emphasize the importance of optimizing exoskeleton actuation properties when assisting or augmenting human locomotion. Our optimal assistance onset timing and average power levels could be used for other exoskeletons to improve assistance and resulting benefits.

[Assessing Motor-Cognition Interaction of Patients with Cognitive Disorders: Clinical Aspects].

PubMed

Schniepp, R; Wuehr, M; Schöberl, F; Zwergal, A

2016-08-01

Difficulties of walking and deficits of cognitive functions appear to be associated in the elderly. Thus, clinical assessment in geriatry and neurology should focus on: (1) diagnostic approaches covering both domains of everyday functioning; (2) therapeutic interventions that take into account possible interactions and synergies of both domains. In order to assess the capability for motor-cognitive interactions in the elderly it is recommended to investigate walking patterns during dual-tasks (e.g. walking and counting backwards, walking and naming words) and to examine clinical tests of everyday mobility tasks, such as the Timed-up-and-go-Test and spatial navigation tasks. Patients with cognitive disorders often perform inferior with a reduction of walking speed and an increase of stepping variability. Dual-task performance appears to be a reliable parameter for long-term observations of the course of the disease. Moreover, it might improve the quality of the gait examination during diagnostic or therapeutic interventions (e.g. the spinal tap test in patients with NPH). Several studies further highlight gait deficits during dual-task walking as a marker for the everyday functioning and the quality of life in elderly persons and patients with cognitive disorders.Therapeutic approaches in this context comprise complex motor-cognitive interventions, such as Thai Chi and Dalcroze rhythmic exercises. These interventions appear to act synergistically in motor and cognitive domains. First evidence for the efficacy for improving executive functions and reducing the fall risk of patients with cognitive impairments is given, thought randomized, controlled trials are rare. © Georg Thieme Verlag KG Stuttgart · New York.

Deviation between self-reported and measured occupational physical activity levels in office employees: effects of age and body composition.

PubMed

Wick, Katharina; Faude, Oliver; Schwager, Susanne; Zahner, Lukas; Donath, Lars

2016-05-01

Whether occupational physical activity (PA) will be assessed via questionnaires or accelerometry depends on available resources. Although self-reported data collection seems feasible and inexpensive, obtained information could be biased by demographic determinants. Thus, we aimed at comparing self-reported and objectively measured occupational sitting, standing, and walking times adjusted for socio-demographic variables. Thirty-eight office employees (eight males, 30 females, age 40.8 ± 11.4 years, BMI 23.9 ± 4.2 kg/m(2)) supplied with height-adjustable working desks were asked to report sitting, standing, and walking times using the Occupational Sitting and Physical Activity Questionnaire during one working week. The ActiGraph wGT3X-BT was used to objectively measure occupational PA during the same week. Subjectively and objectively measured data were compared computing the intra-class correlation coefficients, paired t tests and Bland-Altman plots. Furthermore, repeated-measurement ANOVAs for measurement (subjective vs. objective) and socio-demographic variables were calculated. Self-reported data yielded a significant underestimation of standing time (13.3 vs. 17.9%) and an overestimation of walking time (12.7 vs. 5.0%). Significant interaction effects of age and measurement of standing time (F = 6.0, p = .02, ηp(2) = .14) and BMI group and measurement of walking time were found (F = 3.7, p = .04, ηp(2) = .17). Older employees (>39 years) underestimated their standing time, while underweight workers (BMI < 20 kg/m(2)) overestimated their walking time. Self-reported PA data differ from objective data. Demographic variables (age, BMI) affect the amount of self-reported misjudging of PA. In order to improve the validity of self-reported data, a correction formula for the economic assessment of PA by subjective measures is needed, considering age and BMI.

Functional Mobility Performance and Balance Confidence in Older Adults after Sensorimotor Adaptation Training

NASA Technical Reports Server (NTRS)

Buccello-Stout, Regina R.; Cromwell, Ronita L.; Bloomberg, Jacob J.; Weaver, G. D.

2010-01-01

Research indicates a main contributor of injury in older adults is from falling. The decline in sensory systems limits information needed to successfully maneuver through the environment. The objective of this study was to determine if prolonged exposure to the realignment of perceptual-motor systems increases adaptability of balance, and if balance confidence improves after training. A total of 16 older adults between ages 65-85 were randomized to a control group (walking on a treadmill while viewing a static visual scene) and an experimental group (walking on a treadmill while viewing a rotating visual scene). Prior to visual exposure, participants completed six trials of walking through a soft foamed obstacle course. Participants came in twice a week for 4 weeks to complete training of walking on a treadmill and viewing the visual scene for 20 minutes each session. Participants completed the obstacle course after training and four weeks later. Average time, penalty, and Activity Balance Confidence Scale scores were computed for both groups across testing times. The older adults who trained, significantly improved their time through the obstacle course F (2, 28) = 9.41, p < 0.05, as well as reduced their penalty scores F (2, 28) = 21.03, p < 0.05, compared to those who did not train. There was no difference in balance confidence scores between groups across testing times F (2, 28) = 0.503, p > 0.05. Although the training group improved mobility through the obstacle course, there were no differences between the groups in balance confidence.

Is the 6-minute walk test a reliable substitute for peak oxygen uptake in patients with dilated cardiomyopathy?

PubMed

Zugck, C; Krüger, C; Dürr, S; Gerber, S H; Haunstetter, A; Hornig, K; Kübler, W; Haass, M

2000-04-01

The 6-min walk test may serve as a more simple clinical tool to assess functional capacity in congestive heart failure than determination of peak oxygen uptake by cardiopulmonary exercise testing. The purpose of the study was to prospectively examine whether the distance ambulated during a 6-min walk test (i) correlates with peak oxygen uptake, (ii) allows peak oxygen uptake to be predicted, and (iii) provides prognostic information similar to peak oxygen uptake in patients with dilated cardiomyopathy and left ventricular ejection fraction < or = 35%. In 113 patients (age: 54+/-12 years, NYHA: 2.2+/-0.8) with dilated cardiomyopathy (left ventricular ejection fraction 19+/-7%) a 6-min walk test and cardiopulmonary exercise testing were performed. The 6-min walk test and peak oxygen uptake were closely correlated at the initial visit (r=0.68, n=113), as well as after 263+/-114 (r=0.71, n=28) and 381+/-170 days (r=0.74, n=14). During serial exercise testing the 6-min walk test allowed peak oxygen uptake to be reliably predicted (r=0.76 between calculated and real peak oxygen uptake). After 528+/-234 days, 42 patients were hospitalized due to worsening heart failure and/or died from cardiovascular causes. Compared to clinically stable patients, these 42 patients walked a shorter distance (423+/-104 vs 501+/-95 m, P<0.001) and had a lower peak oxygen uptake (12.7+/-4.0 vs 17.4 + 5.6 ml x min(-1) x kg(-1), P<0.001). By univariate analysis the 6-min walk test outperformed other prognostic parameters such as left ventricular ejection fraction, cardiac index and plasma norepinephrine concentration and conferred a prognostic power similar to peak oxygen uptake. This predictive value could be further improved in a multivariate model, by combining the 6-min walk test with independent variables, such as left ventricular ejection fraction or cardiac index. The 6-min walk test correlated with peak oxygen uptake when tested serially over the course of the disease. Although both tests define two distinct domains of functional capacity, the 6-min walk test provides prognostic information very similar to peak oxygen uptake in congestive heart failure patients with dilated cardiomyopathy.

Walking Capacity Is Positively Related with Heart Rate Variability in Symptomatic Peripheral Artery Disease.

PubMed

Lima, A H R A; Soares, A H G; Cucato, G G; Leicht, A S; Franco, F G M; Wolosker, N; Ritti-Dias, R M

2016-07-01

The aim was to investigate the association between walking capacity and HRV in patients with symptomatic peripheral artery disease (PAD). This was a cross sectional study. Ninety-five patients were recruited. Patients undertook a supine position for 20 minutes, with the final 10 minutes used to examine for resting HRV. Time domain, frequency domain, and non-linear indices were evaluated. A maximal treadmill test (Gardner protocol) was performed to assess maximal walking distance (MWD) and claudication distance (CD) in groups of PAD patients based upon their walking abilities (low, moderate, high). Differences between PAD patient groups were examined using non-parametric analyses, and Spearman rank correlations identified the relationship between MWD and CD, and HRV parameters. Symptomatic PAD patients with high MWD exhibited significantly greater HRV than patients with low MWD. Furthermore, MWD was positively associated with time domain and non-linear indices of HRV (all p < .05). However, no statistically significant correlations were observed between CD and HRV parameters or between PAD groups. A greater walking capacity is associated with better HRV in symptomatic PAD patients. Copyright © 2016 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Whole Body Vibration Training Improves Walking Performance of Stroke Patients with Knee Hyperextension: A Randomized Controlled Pilot Study.

PubMed

Guo, Chuan; Mi, Xun; Liu, Shouguo; Yi, Wenchao; Gong, Chen; Zhu, Lan; Machado, Sergio; Yuan, Ti-Fei; Shan, Chunlei

2015-01-01

To investigate the effect of 8-week whole body vibration training on gait performance and lower extremity function in stroke patients with knee hyperextension. Total 30 subjects with stroke were randomized into the control group (n=15) or the intervention group (n=15). The patients of intervention group were treated with whole body vibration while the control group was treated with placebo. The walking function, lower limb function and knee hyperextension times were assessed in this study. Gait performances were evaluated by 10-meter walk test. The knee hyperextension times was visually observed and counted. The lower limb function was evaluated by Fugl-Meyer motor assessment. The times of the knee hyperextension of the intervention group was significantly decreased compared with control groups (P=0.000, d=1.749, 95%CI[2.915,7.285]). The walking function assessed by 10-meter test of intervention group was significantly improved compared with control group (P=0.001, d=1.345, 95%CI[1.896,6.704]). The performances of all the three tests were improved after training in both groups (P=0.000/P=0.000, d=1.500/d=1.952, 95%CI[3.309,9.891]/ 95%CI[5.549,12.45]; P=0.000/P=0.000, d=2.015/d=2.952, 95%CI[5.214,11.39]/95%CI[9.423, 15.98]; P=0.000/P=0.000, d=3.537/d=5.108, 95%CI[19.05,12.35]/95%CI[16.52,22.28]). The results suggest that 8 weeks whole body vibration training can reduce knee hyperextension and increase ambulatory speed in stroke patients.

[Posture and aging. Current fundamental studies and management concepts].

PubMed

Mourey, F; Camus, A; Pfitzenmeyer, P

2000-02-19

FUNDAMENTAL IMPORTANCE OF POSTURE: In the elderly subject, preservation of posture is fundamental to maintaining functional independence. In recent years, there has been much progress in our understanding of the mechanisms underlying strategies used to control equilibrium in the upright position. Physiological aging, associated with diverse disease states, dangerously alters the postural function, particularly anticipated adjustments which allow an adaptation of posture to movement. CLINICAL ASSESSMENT OF POSTURE: Several tests have been developed to assess posture in the elderly subject, particularly the time it takes to start walking. We selected certain tests which can be used in everyday practice to predict falls: the stance test, the improved Romberg test, the "timed get up and go test", measurement of walking cadence, assessment of balance reactions, sitting-standing and standing-sitting movements and capacity to get up off the floor. PATIENT CARE: Elderly patients with equilibrium disorders can benefit from specific personalized rehabilitation protocols. Different techniques have been developed for multiple afferential stimulation, reprogramming postural strategies, and correcting for deficient motor automatisms.

The influence of gait speed on the stability of walking among the elderly.

PubMed

Fan, Yifang; Li, Zhiyu; Han, Shuyan; Lv, Changsheng; Zhang, Bo

2016-06-01

Walking speed is a basic factor to consider when walking exercises are prescribed as part of a training programme. Although associations between walking speed, step length and falling risk have been identified, the relationship between spontaneous walking pattern and falling risk remains unclear. The present study, therefore, examined the stability of spontaneous walking at normal, fast and slow speed among elderly (67.5±3.23) and young (21.4±1.31) individuals. In all, 55 participants undertook a test that involved walking on a plantar pressure platform. Foot-ground contact data were used to calculate walking speed, step length, pressure impulse along the plantar-impulse principal axis and pressure record of time series along the plantar-impulse principal axis. A forward dynamics method was used to calculate acceleration, velocity and displacement of the centre of mass in the vertical direction. The results showed that when the elderly walked at different speeds, their average step length was smaller than that observed among the young (p=0.000), whereas their anterior/posterior variability and lateral variability had no significant difference. When walking was performed at normal or slow speed, no significant between-group difference in cadence was found. When walking at a fast speed, the elderly increased their stride length moderately and their cadence greatly (p=0.012). In summary, the present study found no correlation between fast walking speed and instability among the elderly, which indicates that healthy elderly individuals might safely perform fast-speed walking exercises. Copyright © 2016 Elsevier B.V. All rights reserved.

Improving Motor Control in Walking: A Randomized Clinical Trial in Older Adults with Subclinical Walking Difficulty

PubMed Central

Brach, Jennifer S.; Lowry, Kristin; Perera, Subashan; Hornyak, Victoria; Wert, David; Studenski, Stephanie A.; VanSwearingen, Jessie M.

2016-01-01

Objective The objective was to test the proposed mechanism of action of a task-specific motor learning intervention by examining its effect on measures of the motor control of gait. Design Single blinded randomized clinical trial. Setting University research laboratory. Participants Forty older adults 65 years of age and older, with gait speed >1.0 m/s and impaired motor skill (Figure of 8 walk time > 8 secs). Interventions The two interventions included a task-oriented motor learning and a standard exercise program. Both interventions lasted 12 weeks, with twice weekly one hour physical therapist supervised sessions. Main Outcome Measures Two measure of the motor control of gait, gait variability and smoothness of walking, were assessed pre and post intervention by assessors masked to treatment arm. Results Of 40 randomized subjects; 38 completed the trial (mean age 77.1±6.0 years). Motor control group improved more than standard group in double support time variability (0.13 vs. 0.05 m/s; adjusted difference, AD=0.006, p=0.03). Smoothness of walking in the anterior/posterior direction improved more in motor control than standard for all conditions (usual: AD=0.53, p=0.05; narrow: AD=0.56, p=0.01; dual task: AD=0.57, p=0.04). Conclusions Among older adults with subclinical walking difficulty, there is initial evidence that task-oriented motor learning exercise results in gains in the motor control of walking, while standard exercise does not. Task-oriented motor learning exercise is a promising intervention for improving timing and coordination deficits related to mobility difficulties in older adults, and needs to be evaluated in a definitive larger trial. PMID:25448244

The effect of spasticity, sense and walking aids in falls of people after chronic stroke.

PubMed

Soyuer, Ferhan; Oztürk, Ahmet

2007-05-15

To study the effects of spasticity, sensory impairment, and type of walking aid on falls in community dwellers with chronic stroke. Functional Independence Measure (FIM) Instrument, Joint Position Sense Evaluation (JPS), the Rivermead motor assessment scale (RMA), Ashworth Scale, Tinetti Assessment Tool were used to assess 100 cases. Fifty-three of the cases were grouped as nonfallers, 36 as one-time fallers and 11 as repeat fallers. These 3 groups were found to be different from each other in respect to FIM, Tinetti test and RMA (p < 0.001). In respect to knee JPS, nonfallers and one-time faller groups were found to be different from repeat fallers (p = 0.001). There is a difference among the groups in respect to Ashworth assessment (p < 0.001), use of walking aid (p = 0.01) and type of walking aid (p = 0.01). Some 43% of the cases use a walking aid (58.1% cane, 41.9% high cane). According to Ordinal logistic regression analysis, it was found that the possibility of fall increased (p < 0.01), as the value of spasticity increased while the possibility of the fall of the individuals with stroke decreased (p < 0.00 - 0.01) as Tinetti, RMA and FIM variables increased. In respect to falls, spasticity is also an indicator for chronic stroke patients, as is motor impairment, functional situation, impairment of balance and walking. Sensory impairment, using a walking aid and the type were found to be ineffective.

Walking Aids Moderate Exercise Effects on Gait Speed in People With Dementia: A Randomized Controlled Trial.

PubMed

Toots, Annika; Littbrand, Håkan; Holmberg, Henrik; Nordström, Peter; Lundin-Olsson, Lillemor; Gustafson, Yngve; Rosendahl, Erik

2017-03-01

To investigate the effects of exercise on gait speed, when tested using walking aids and without, and whether effects differed according to amount of support in the test. A cluster-randomized controlled trial. The Umeå Dementia and Exercise (UMDEX) study was set in 16 nursing homes in Umeå, Sweden. One hundred forty-one women and 45 men (mean age 85 years) with dementia, of whom 145 (78%) habitually used walking aids. Participants were randomized to the high-intensity functional exercise program or a seated attention control activity. Blinded assessors measured 4-m usual gait speed with walking aids if any gait speed (GS), and without walking aids and with minimum amount of support, at baseline, 4 months (on intervention completion), and 7 months. Linear mixed models showed no between-group effect in either gait speed test at 4 or 7 months. In interaction analyses exercise effects differed significantly between participants who walked unsupported compared with when walking aids or minimum support was used. Positive between-group exercise effects on gait speed (m/s) were found in subgroups that walked unsupported at 4 and 7 months (GS: 0.07, P = .009 and 0.13, P < .001; and GS test without walking aids: 0.05, P = .011 and 0.07, P = .029, respectively). In people with dementia living in nursing homes exercise had positive effects on gait when tested unsupported compared with when walking aids or minimum support was used. The study suggests that the use of walking aids in gait speed tests may conceal exercise effects. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Comparing Algorithms for Graph Isomorphism Using Discrete- and Continuous-Time Quantum Random Walks

DOE PAGES

Rudinger, Kenneth; Gamble, John King; Bach, Eric; ...

2013-07-01

Berry and Wang [Phys. Rev. A 83, 042317 (2011)] show numerically that a discrete-time quan- tum random walk of two noninteracting particles is able to distinguish some non-isomorphic strongly regular graphs from the same family. Here we analytically demonstrate how it is possible for these walks to distinguish such graphs, while continuous-time quantum walks of two noninteracting parti- cles cannot. We show analytically and numerically that even single-particle discrete-time quantum random walks can distinguish some strongly regular graphs, though not as many as two-particle noninteracting discrete-time walks. Additionally, we demonstrate how, given the same quantum random walk, subtle di erencesmore » in the graph certi cate construction algorithm can nontrivially im- pact the walk's distinguishing power. We also show that no continuous-time walk of a xed number of particles can distinguish all strongly regular graphs when used in conjunction with any of the graph certi cates we consider. We extend this constraint to discrete-time walks of xed numbers of noninteracting particles for one kind of graph certi cate; it remains an open question as to whether or not this constraint applies to the other graph certi cates we consider.« less

Effects of Nordic walking and walking on spatiotemporal gait parameters and ground reaction force.

PubMed

Park, Seung Kyu; Yang, Dae Jung; Kang, Yang Hun; Kim, Je Ho; Uhm, Yo Han; Lee, Yong Seon

2015-09-01

[Purpose] The purpose of this study was to investigate the effects of Nordic walking and walking on spatiotemporal gait parameters and ground reaction force. [Subjects] The subjects of this study were 30 young adult males, who were divided into a Nordic walking group of 15 subjects and a walking group of 15 subjects. [Methods] To analyze the spatiotemporal parameters and ground reaction force during walking in the two groups, the six-camera Vicon MX motion analysis system was used. The subjects were asked to walk 12 meters using the more comfortable walking method for them between Nordic walking and walking. After they walked 12 meters more than 10 times, their most natural walking patterns were chosen three times and analyzed. To determine the pole for Nordic walking, each subject's height was multiplied by 0.68. We then measured the spatiotemporal gait parameters and ground reaction force. [Results] Compared with the walking group, the Nordic walking group showed an increase in cadence, stride length, and step length, and a decrease in stride time, step time, and vertical ground reaction force. [Conclusion] The results of this study indicate that Nordic walking increases the stride and can be considered as helping patients with diseases affecting their gait. This demonstrates that Nordic walking is more effective in improving functional capabilities by promoting effective energy use and reducing the lower limb load, because the weight of the upper and lower limbs is dispersed during Nordic walking.

Preoperative prediction of inpatient recovery of function after total hip arthroplasty using performance-based tests: a prospective cohort study.

PubMed

Oosting, Ellen; Hoogeboom, Thomas J; Appelman-de Vries, Suzan A; Swets, Adam; Dronkers, Jaap J; van Meeteren, Nico L U

2016-01-01

The aim of this study was to evaluate the value of conventional factors, the Risk Assessment and Predictor Tool (RAPT) and performance-based functional tests as predictors of delayed recovery after total hip arthroplasty (THA). A prospective cohort study in a regional hospital in the Netherlands with 315 patients was attending for THA in 2012. The dependent variable recovery of function was assessed with the Modified Iowa Levels of Assistance scale. Delayed recovery was defined as taking more than 3 days to walk independently. Independent variables were age, sex, BMI, Charnley score, RAPT score and scores for four performance-based tests [2-minute walk test, timed up and go test (TUG), 10-meter walking test (10 mW) and hand grip strength]. Regression analysis with all variables identified older age (>70 years), Charnley score C, slow walking speed (10 mW >10.0 s) and poor functional mobility (TUG >10.5 s) as the best predictors of delayed recovery of function. This model (AUC 0.85, 95% CI 0.79-0.91) performed better than a model with conventional factors and RAPT scores, and significantly better (p = 0.04) than a model with only conventional factors (AUC 0.81, 95% CI 0.74-0.87). The combination of performance-based tests and conventional factors predicted inpatient functional recovery after THA. Two simple functional performance-based tests have a significant added value to a more conventional screening with age and comorbidities to predict recovery of functioning immediately after total hip surgery. Patients over 70 years old, with comorbidities, with a TUG score >10.5 s and a walking speed >1.0 m/s are at risk for delayed recovery of functioning. Those high risk patients need an accurate discharge plan and could benefit from targeted pre- and postoperative therapeutic exercise programs.

Towards a Passive Low-Cost In-Home Gait Assessment System for Older Adults

PubMed Central

Wang, Fang; Stone, Erik; Skubic, Marjorie; Keller, James M.; Abbott, Carmen; Rantz, Marilyn

2013-01-01

In this paper, we propose a webcam-based system for in-home gait assessment of older adults. A methodology has been developed to extract gait parameters including walking speed, step time and step length from a three-dimensional voxel reconstruction, which is built from two calibrated webcam views. The gait parameters are validated with a GAITRite mat and a Vicon motion capture system in the lab with 13 participants and 44 tests, and again with GAITRite for 8 older adults in senior housing. An excellent agreement with intra-class correlation coefficients of 0.99 and repeatability coefficients between 0.7% and 6.6% was found for walking speed, step time and step length given the limitation of frame rate and voxel resolution. The system was further tested with 10 seniors in a scripted scenario representing everyday activities in an unstructured environment. The system results demonstrate the capability of being used as a daily gait assessment tool for fall risk assessment and other medical applications. Furthermore, we found that residents displayed different gait patterns during their clinical GAITRite tests compared to the realistic scenario, namely a mean increase of 21% in walking speed, a mean decrease of 12% in step time, and a mean increase of 6% in step length. These findings provide support for continuous gait assessment in the home for capturing habitual gait. PMID:24235111

Continuous-time quantum walks on star graphs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Salimi, S.

2009-06-15

In this paper, we investigate continuous-time quantum walk on star graphs. It is shown that quantum central limit theorem for a continuous-time quantum walk on star graphs for N-fold star power graph, which are invariant under the quantum component of adjacency matrix, converges to continuous-time quantum walk on K{sub 2} graphs (complete graph with two vertices) and the probability of observing walk tends to the uniform distribution.

Discrepancy between functional exercise capacity and daily physical activity: a cross-sectional study in patients with mild to moderate COPD.

PubMed

Fastenau, Annemieke; van Schayck, Onno C P; Gosselink, Rik; Aretz, Karin C P M; Muris, Jean W M

2013-12-01

In patients with moderate to severe chronic obstructive pulmonary disease (COPD) the six-minute walk distance reflects the functional exercise level for daily physical activity. It is unknown if this also applies to patients with mild to moderate COPD in primary care. To assess the relationship between functional exercise capacity and physical activity in patients with mild to moderate COPD. A cross-sectional study was performed in 51 patients with mild to moderate COPD in primary care. Functional exercise capacity was assessed by the six-minute walk test and physical activity was measured with an accelerometer-based activity monitor. Functional exercise capacity was close to normal values. However, the daily physical activity of the patients could be classified as 'sedentary' and 'low active'. No significant correlations were observed between six-minute walk distance (% predicted) and any of the physical activity variables (steps per day, movement intensity during walking, total active time, total walking time, physical activity level, and time spent in moderate physical activity). A discrepancy was found between functional exercise capacity and daily physical activity in patients with mild to moderate COPD recruited and assessed in primary care. We conclude that these variables represent two different concepts. Our results reinforce the importance of measuring daily physical activity in order to fine-tune treatment (i.e. focusing on enhancement of exercise capacity or behavioural change, or both).

The relationship between walking, manual dexterity, cognition and activity/participation in persons with multiple sclerosis.

PubMed

Kierkegaard, Marie; Einarsson, Ulrika; Gottberg, Kristina; von Koch, Lena; Holmqvist, Lotta Widén

2012-05-01

Multiple sclerosis has a vast impact on health, but the relationship between walking, manual dexterity, cognition and activity/participation is unclear. The specific aims were to explore the discriminative ability of measures of walking, manual dexterity and cognition, and to identify cut-off values in these measures, for prediction of independence in personal and instrumental activities of daily living (ADL) and activity/participation in social and lifestyle activities. Data from 164 persons with multiple sclerosis were collected during home visits with the following measures: the 2 × 5 m walk test, the Nine-hole Peg Test, the Symbol Digit Modalities Test, the Katz Personal and Instrumental ADL Indexes, and the Frenchay Activities Index (measuring frequency in social and lifestyle activities). The 2 × 5 m walk test and the Nine-hole Peg Test had high and better discriminative and predictive ability than the Symbol Digit Modalities Test. Cut-off values were identified. The accuracy of predictions was increased above all by combining the 2 × 5 m walk test and the Nine-hole Peg Test. The proposed cut-off values in the 2 × 5 m walk test and the Nine-hole Peg Test may be used as indicators of functioning and to identify persons risking activity limitations and participation restrictions. However, further studies are needed to confirm the usefulness in clinical practice.

Changes in cardiopulmonary function in normal adults after the Rockport 1 mile walking test: a preliminary study.

PubMed

Kim, Kyoung; Lee, Hye-Young; Lee, Do-Youn; Nam, Chan-Woo

2015-08-01

[Purpose] The purpose of this study was to investigate the changes of cardiopulmonary function in normal adults after the Rockport 1 mile walking test. [Subjects and Methods] University students (13 males and 27 females) participated in this study. Before and after the Rockport 1 mile walking test, pulmonary function, respiratory pressure, and maximal oxygen uptake were measured. [Results] Significant improvements in forced vital capacity and maximal inspiratory pressure were observed after the Rockport 1 mile walking test in males, and significant improvements in forced vital capacity, forced expiratory volume at 1 s, maximal inspiratory pressure, and maximal expiratory pressure were observed after the Rockport 1 mile walking test in females. However, the maximal oxygen uptake was not significantly different. [Conclusion] Our findings indicate that the Rockport 1 mile walking test changes cardiopulmonary function in males and females, and that it may improve cardiopulmonary function in middle-aged and older adults and provide basic data on cardiopulmonary endurance.

Changes in cardiopulmonary function in normal adults after the Rockport 1 mile walking test: a preliminary study

PubMed Central

Kim, Kyoung; Lee, Hye-Young; Lee, Do-Youn; Nam, Chan-Woo

2015-01-01

[Purpose] The purpose of this study was to investigate the changes of cardiopulmonary function in normal adults after the Rockport 1 mile walking test. [Subjects and Methods] University students (13 males and 27 females) participated in this study. Before and after the Rockport 1 mile walking test, pulmonary function, respiratory pressure, and maximal oxygen uptake were measured. [Results] Significant improvements in forced vital capacity and maximal inspiratory pressure were observed after the Rockport 1 mile walking test in males, and significant improvements in forced vital capacity, forced expiratory volume at 1 s, maximal inspiratory pressure, and maximal expiratory pressure were observed after the Rockport 1 mile walking test in females. However, the maximal oxygen uptake was not significantly different. [Conclusion] Our findings indicate that the Rockport 1 mile walking test changes cardiopulmonary function in males and females, and that it may improve cardiopulmonary function in middle-aged and older adults and provide basic data on cardiopulmonary endurance. PMID:26356048

The Not-so-Random Drunkard's Walk

ERIC Educational Resources Information Center

Ehrhardt, George

2013-01-01

This dataset contains the results of a quasi-experiment, testing Karl Pearson's "drunkard's walk" analogy for an abstract random walk. Inspired by the alternate hypothesis that drunkards stumble to the side of their dominant hand, it includes data on intoxicated test subjects walking a 10' line. Variables include: the…

Validity of the occupational sitting and physical activity questionnaire.

PubMed

Chau, Josephine Y; Van Der Ploeg, Hidde P; Dunn, Scott; Kurko, John; Bauman, Adrian E

2012-01-01

Sitting at work is an emerging occupational health risk. Few instruments designed for use in population-based research measure occupational sitting and standing as distinct behaviors. This study aimed to develop and validate brief measure of occupational sitting and physical activity. A convenience sample (n = 99, 61% female) was recruited from two medium-sized workplaces and by word-of-mouth in Sydney, Australia. Participants completed the newly developed Occupational Sitting and Physical Activity Questionnaire (OSPAQ) and a modified version of the MONICA Optional Study on Physical Activity Questionnaire (modified MOSPA-Q) twice, 1 wk apart. Participants also wore an ActiGraph accelerometer for the 7 d in between the test and retest. Analyses determined test-retest reliability with intraclass correlation coefficients and assessed criterion validity against accelerometers using the Spearman ρ. The test-retest intraclass correlation coefficients for occupational sitting, standing, and walking for OSPAQ ranged from 0.73 to 0.90, while that for the modified MOSPA-Q ranged from 0.54 to 0.89. Comparison of sitting measures with accelerometers showed higher Spearman correlations for the OSPAQ (r = 0.65) than for the modified MOSPA-Q (r = 0.52). Criterion validity correlations for occupational standing and walking measures were comparable for both instruments with accelerometers (standing: r = 0.49; walking: r = 0.27-0.29). The OSPAQ has excellent test-retest reliability and moderate validity for estimating time spent sitting and standing at work and is comparable to existing occupational physical activity measures for assessing time spent walking at work. The OSPAQ brief instrument measures sitting and standing at work as distinct behaviors and would be especially suitable in national health surveys, prospective cohort studies, and other studies that are limited by space constraints for questionnaire items.

Randomized controlled trial of physical activity, cognition, and walking in multiple sclerosis.

PubMed

Sandroff, Brian M; Klaren, Rachel E; Pilutti, Lara A; Dlugonski, Deirdre; Benedict, Ralph H B; Motl, Robert W

2014-02-01

The present study adopted a randomized controlled trial design and examined the effect of a physical activity behavioral intervention on cognitive and walking performance among persons with MS who have mild or moderate disability status. A total of 82 MS patients were randomly allocated into intervention or wait-list control conditions. The intervention condition received a theory-based program for increasing physical activity behavior that was delivered via the Internet, and one-on-one video chat sessions with a behavior-change coach. Participants completed self-report measures of physical activity and disability status, and underwent the oral Symbol Digit Modalities Test (SDMT) and 6-minute walk (6MW) test before and after the 6-month period. Analysis using mixed-model ANOVA indicated a significant time × condition × disability group interaction on SDMT scores (p = 0.02, partial-η (2) = 0.08), such that persons with mild disability in the intervention condition demonstrated a clinically meaningful improvement in SDMT scores (~6 point change). There was a further significant time × condition interaction on 6MW distance (p = 0.02, partial-η (2) = 0.07), such that those in the intervention condition demonstrated an increase in 6MW distance relative to those in the control group. The current study supports physical activity as a promising tool for managing cognitive impairment and impaired walking performance in persons with MS, and suggests that physical activity might have specific effects on cognition and non-specific effects on walking performance in this population.

Comparison of Removable and Irremovable Walking Boot to Total Contact Casting in Offloading the Neuropathic Diabetic Foot Ulceration.

PubMed

Piaggesi, Alberto; Goretti, Chiara; Iacopi, Elisabetta; Clerici, Giacomo; Romagnoli, Fabio; Toscanella, Fabrizia; Vermigli, Cristiana

2016-08-01

Despite its efficacy in healing neuropathic diabetic foot ulcers (DFUs), total contact cast (TCC) is often underused because of technical limitations and poor patient acceptance. We compared TCC to irremovable and removable commercially available walking boots for DFU offloading. We prospectively studied 60 patients with DFUs, randomly assigned to 3 different offloading modalities: TCC (group A), walking boot rendered irremovable (i-RWD; group B), and removable walking boot (RWD; group C). Patients were followed up weekly for 90 days or up to complete re-epithelization; ulcer survival, healing time, and ulcer size reduction (USR) were considered for efficacy, whereas number of adverse events was considered for safety. Patients' acceptance and costs were also evaluated. Mean healing time in the 3 groups did not differ (P = .5579), and survival analysis showed no difference between the groups (logrank test P = .8270). USR from baseline to the end of follow-up was significant (P < .01) in all groups without differences between the groups. Seven patients in group A (35%), 2 in group B (10%), and 1 in group C (5%) (Fisher exact test P = .0436 group A vs group C) reported nonsevere adverse events. Patients' acceptance and costs were significantly better in group C (P < .05). Our results suggest that a walking boot was as effective and safe as TCC in offloading the neuropathic DFUs, irrespective of removability. The better acceptability and lesser costs of a removable device may actually extend the possibilities of providing adequate offloading. Level II, prospective comparative study. © The Author(s) 2016.

Walking ability and quality of life in subjects with transfemoral amputation: a comparison of osseointegration with socket prostheses.

PubMed

Van de Meent, Hendrik; Hopman, Maria T; Frölke, Jan Paul

2013-11-01

To investigate walking ability and quality of life of osseointegrated leg prostheses compared with socket prostheses. Prospective case-control study. University medical center. Subjects (N=22) with transfemoral amputation (1 bilateral) referred to our center because of socket-related skin and residual limb problems resulting in limited prosthesis use. Their mean age was 46.5 years (range, 23-67y) and mean time since amputation was 16.4 years (range, 2-45y). Causes of amputation were trauma (n=20) and tumor (n=2). Implantation of an osseointegration prosthesis (OIP). Global score of the Questionnaire for Persons With a Transfemoral Amputation (Q-TFA), prosthesis use, 6-minute walk test (6MWT), Timed Up & Go (TUG) test, and oxygen consumption during treadmill walking. With the socket prosthesis, the mean ± SD Q-TFA global score, prosthesis use, 6MWT, TUG, and oxygen consumption were 39±4.7 points, 56±7.9h/wk, 321±28m, 15.1±2.1 seconds, and 1330±310mL/min, respectively, and significantly improved with OIP to 63±5.3 points, 101±2.4h/wk, 423±21m, 8.1±0.7 seconds, and 1093±361mL/min, respectively. Osseointegration is a suitable intervention for persons whose prosthesis use is reduced because of socket-related problems. Subjects with OIP significantly increased their walking ability and prosthesis-related quality of life. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Risk of falls in older people during fast-walking--the TASCOG study.

PubMed

Callisaya, M L; Blizzard, L; McGinley, J L; Srikanth, V K

2012-07-01

To investigate the relationship between fast-walking and falls in older people. Individuals aged 60-86 years were randomly selected from the electoral roll (n=176). Gait speed, step length, cadence and a walk ratio were recorded during preferred- and fast-walking using an instrumented walkway. Falls were recorded prospectively over 12 months. Log multinomial regression was used to estimate the relative risk of single and multiple falls associated with gait variables during fast-walking and change between preferred- and fast-walking. Covariates included age, sex, mood, physical activity, sensorimotor and cognitive measures. The risk of multiple falls was increased for those with a smaller walk ratio (shorter steps, faster cadence) during fast-walking (RR 0.92, CI 0.87, 0.97) and greater reduction in the walk ratio (smaller increase in step length, larger increase in cadence) when changing to fast-walking (RR 0.73, CI 0.63, 0.85). These gait patterns were associated with poorer physiological and cognitive function (p<0.05). A higher risk of multiple falls was also seen for those in the fastest quarter of gait speed (p=0.01) at fast-walking. A trend for better reaction time, balance, memory and physical activity for higher categories of gait speed was stronger for fallers than non-fallers (p<0.05). Tests of fast-walking may be useful in identifying older individuals at risk of multiple falls. There may be two distinct groups at risk--the frail person with short shuffling steps, and the healthy person exposed to greater risk. Copyright © 2012 Elsevier B.V. All rights reserved.

Effect of a Combined Walking and Conversation Intervention on Functional Mobility of Nursing Home Residents With Alzheimer Disease

PubMed Central

Tappen, Ruth M.; Roach, Kathryn E.; Applegate, E. Brooks; Stowell, Paula

2007-01-01

Summary Assisted walking and walking combined with conversation were compared to a conversation-only intervention in nursing home residents with Alzheimer disease. Sixty-five subjects randomly assigned to treatment group were tested at baseline and end of treatment. Subjects mean Mini-Mental State Examination score was 10.83; mean age was 87. Treatment was given for 30 minutes three times a week for 16 weeks. Subjects in the assisted walking group declined 20.9% in functional mobility; the conversation group declined 18.8%. The combined walking and conversation treatment group declined only 2.5%. These differences in outcome were significant and appear to have been affected by differences in treatment fidelity. Subjects in the conversation treatment group completed 90% of intended treatment compared with 75% in the combined group and only 57% in the assisted walking group. Failure to treat was due to subject refusal and physical illness. The conversation component of the combined walking and conversation treatment intervention appears to have improved compliance with the intervention, thereby improving treatment outcome. Results indicate that assisted walking with conversation can contribute to maintenance of functional mobility in institutionalized populations with Alzheimer disease. Staff assigned to this task should be prepared to use effective communication strategies to gain acceptance of the intervention. PMID:11186596

Effect of course length and corridor width on the 2-minute walk test performance in geriatric patients.

PubMed

Lindemann, Ulrich; Beck, Luisa; Becker, Clemens

2017-02-01

To evaluate the effect of course length and corridor width on 2-minute walk test results in older adults. Cross-sectional and experimental study with different test conditions. Geriatric rehabilitation clinic. A total of 21 patients (median age 81 years). Patients walked two minutes on a 20 m and 40 m course with a 2 m or 1 m corridor width and on a continuous course without any turning in a corridor of 2 m width, five walks in total. The distance traveled within the 2 minutes was recorded. Compared with the 20 m course length, median walking distances measured by the 2-minute walk test in a walk way 2 m broad were better on the continuous corridor without any turn (136.9 m vs. 129.3 m, p = 0.002) and on the 40 m course (131.8 m vs. 129.3 m, p = 0.003). Walking distance on a 20 m course length was longer in a corridor of 2 m width compared with the 1 m corridor width (129.3 m vs. 119.2 m, p = 0.005). The walking distance was not affected by corridor width on the 40 m course length. Performance of elderly patients on the 2-minute walk test is influenced by the width of the corridor and the length of the course used.

A Biomechanical Investigation of Selected Lumbopelvic Hip Tests: Implications for the Examination of Walking.

PubMed

Bailey, Robert Walter; Richards, Jim; Selfe, James

2016-01-01

The purpose of this study was to compare lumbopelvic hip ranges of motion during the Trendelenburg, Single Leg Squat, and Corkscrew Tests to walking and to describe the 3-dimensional lumbopelvic hip motion during the tests. This may help clinicians to select appropriate tests when examining gait. An optoelectronic movement analysis tracking system was used to assess the lumbopelvic hip region of 14 healthy participants while performing Trendelenburg, Single Leg Squat, and Corkscrew Tests and walking. The lumbopelvic hip 3-dimensional ranges of movement for the clinical tests were compared with walking using a repeated-measures analysis of variance with pairwise comparisons. No significant differences were found between the pelvic obliquity during the Trendelenburg Test and walking (Trendelenburg Test: L, 11.3° ± 4.8°, R, 10.8° ± 5.0° vs walk: L, 8.3° ± 4.8°, R 8.3° ± 5.1°, L, P = .143, R, P = .068). Significant differences were found between the hip sagittal plane range of movement during the Single Leg Squat and walking (Single Leg Squat: L, 44.2° ±13.7°, R, 41.7° ±10.9° vs walk: 38.6° ±7.0°, R 37.8° ±5.1°, P < .05), the hip coronal plane range of movement (Single Leg Squat: L, 9.1° ±5.8°, R, 9.0° ± 4.6° vs walk: L, 9.4° ± 2.3°, R 9.5° ± 2.0°, P < .05), and the hip coronal plane range of movement during the Corkscrew Test and walking (Corkscrew: L, 5.7° ±3.3°, R, 5.7° ±3.2° vs walk: L, 9.4° ± 2.3°, R 9.5° ± 2.0°, P < .05). The results of the present study showed that, in young asymptomatic participants with no known lumbopelvic hip pathology, the pelvic obliquity during the Trendelenburg Test and walking is similar. During the Single Leg Squat, the hip moved more in the sagittal plane and less in the coronal plane when compared with walking. There was more movement in the hip transverse plane movement during the Corkscrew Test than during walking. These results suggest that for the Trendelenburg Test to be interpreted as normal, the pelvis should achieve at least 10° of pelvic obliquity; during the Single Leg Squat, the hip should move through 43° in the sagittal plane and under 10° in the coronal plane; and for the Corkscrew Test to be interpreted as normal, the hip should move through 6° of rotation and the trunk through 27° of rotation. Copyright © 2016. Published by Elsevier Inc.

Effects of 12-week brisk walking training on exercise blood pressure in elderly patients with essential hypertension: a pilot study.

PubMed

He, L I; Wei, Wang Ren; Can, Zhao

2018-01-24

Essential hypertension (EP) is characterized by blood pressure (BP) elevations, which often lead to target organ damage and cardiovascular illness. The following study investigates whether aerobic exercise programs with different intensities could reduce the magnitude of BP rise. Patients with essential hypertension were recruited from the Baoshan Community Health Service Center. A total of 46 patients were finally selected and randomly assigned into two groups: control group (CON) included patients who did not participate in exercise intervention training; treatment group (TRG) included patients who participated in 12-week brisk walking training (60-min of brisk walking, three times a week for a total of 12 weeks). 3-minute step tests of low and high intensity were conducted pre- and post-intervention. To compare the effects of exercise intervention, 23 subjects with normal blood pressure (NBP) who did not participate in 12-week brisk walking training, were recruited. After 12 weeks of brisk walking, SBP of TRG during resting, low and high-intensity exercise was significantly reduced by 8.3mmHg, 15.6mmHg, and 22.6mmHg, respectively; while HR of TRG's during resting, low and high intensity was significantly reduced by 3.6beats/minute, 8.7beats/minute and 11.3beats/minute, respectively. Meanwhile, after 12 weeks of brisk walking, TRG's steps per day, [Formula: see text]o 2max , moderate physical activity time and physical activity energy expenditure significantly increased by 6000 steps, 2.4 ml/kg/m, 40 minutes and 113 kcal, respectively. At the same time, TRG's body fat rate and sedentary time significantly reduced by 2% and 60 minutes per day. Brisk walking can reduce the magnitude of BP rise during exercise of different intensities and may be reduced the risk of acute cardiovascular incidents in elderly patients with essential hypertension. EP: Essential hypertension; BP: blood pressure; CON: control group; TRG: treatment group; NBP: normal blood pressure; PA: physical activity.

Evaluation of Cooper 12-minute walk/run test as a marker of cardiorespiratory fitness in young urban children with persistent asthma.

PubMed

Weisgerber, Michael; Danduran, Michael; Meurer, John; Hartmann, Kathryn; Berger, Stuart; Flores, Glenn

2009-07-01

To evaluate Cooper 12-minute run/walk test (CT12) as a one-time estimate of cardiorespiratory fitness and marker of fitness change compared with treadmill fitness testing in young children with persistent asthma. A cohort of urban children with asthma participated in the asthma and exercise program and a subset completed pre- and postintervention fitness testing. Treadmill fitness testing was conducted by an exercise physiologist in the fitness laboratory at an academic children's hospital. CT12 was conducted in a college recreation center gymnasium. Forty-five urban children with persistent asthma aged 7 to 14 years participated in exercise interventions. A subset of 19 children completed pre- and postintervention exercise testing. Participants completed a 9-week exercise program where they participated in either swimming or golf 3 days a week for 1 hour. A subset of participants completed fitness testing by 2 methods before and after program completion. CT12 results (meters), maximal oxygen consumption ((.)Vo2max) (mL x kg(-1) x min(-1)), and treadmill exercise time (minutes). CT12 and maximal oxygen consumption were moderately correlated (preintervention: 0.55, P = 0.003; postintervention: 0.48, P = 0.04) as one-time measures of fitness. Correlations of the tests as markers of change over time were poor and nonsignificant. In children with asthma, CT12 is a reasonable one-time estimate of fitness but a poor marker of fitness change over time.

Effects of a 6-month exercise program pilot study on walking economy, peak physiological characteristics, and walking performance in patients with peripheral arterial disease.

PubMed

Crowther, Robert G; Leicht, Anthony S; Spinks, Warwick L; Sangla, Kunwarjit; Quigley, Frank; Golledge, Jonathan

2012-01-01

The purpose of this study was to examine the effects of a 6-month exercise program on submaximal walking economy in individuals with peripheral arterial disease and intermittent claudication (PAD-IC). Participants (n = 16) were randomly allocated to either a control PAD-IC group (CPAD-IC, n = 6) which received standard medical therapy, or a treatment PAD-IC group (TPAD-IC; n = 10) which took part in a supervised exercise program. During a graded treadmill test, physiological responses, including oxygen consumption, were assessed to calculate walking economy during submaximal and maximal walking performance. Differences between groups at baseline and post-intervention were analyzed via Kruskal-Wallis tests. At baseline, CPAD-IC and TPAD-IC groups demonstrated similar walking performance and physiological responses. Postintervention, TPAD-IC patients demonstrated significantly lower oxygen consumption during the graded exercise test, and greater maximal walking performance compared to CPAD-IC. These preliminary results indicate that 6 months of regular exercise improves both submaximal walking economy and maximal walking performance, without significant changes in maximal walking economy. Enhanced walking economy may contribute to physiological efficiency, which in turn may improve walking performance as demonstrated by PAD-IC patients following regular exercise programs.

Effectiveness of a Navy remedial exercise intervention.

PubMed

Croteau, K A; Young, C J

2000-10-01

The purpose of this study was to evaluate the effectiveness of a Navy remedial exercise program (REP) in improving the physical fitness levels of its participants. Subjects were 27 Navy personnel assigned to a Northeast naval air station who had failed to pass either the body composition (circumference measures) or aerobic fitness (1.5-mile run/walk) portion of the semiannual physical readiness test. The REP consisted of three 1-hour supervised exercise sessions per week for 16 weeks, with primary emphasis on running and walking. Paired t tests revealed that the REP was effective in reducing body weight (-3.1%) and body fat (mean absolute loss of 2.7%) and in improving 1.5-mile run/walk time (-6.2%). No changes were seen in muscular endurance measures (2-minute push-ups, 2-minute curl-ups). Findings from this study indicate that improvements in PF can be attained through a 16-week Navy remedial exercise program.

Fixed-distance walk tests at comfortable and fast speed: Potential tools for the functional assessment of coronary patients?

PubMed

Morard, Marie-Doriane; Besson, Delphine; Laroche, Davy; Naaïm, Alexandre; Gremeaux, Vincent; Casillas, Jean-Marie

2017-01-01

There is ambiguity concerning the walk tests available for functional assessment of coronary patients, particularly for the walking speed. This study explores the psychometric properties of two walking tests, based on fixed-distance tests, at comfortable and fast velocity, in stabilized patients at the end of a cardiac rehabilitation program. At a three-day interval 58 coronary patients (mean age of 64.85±6.03 years, 50 men) performed three walk tests, the first two at a comfortable speed in a random order (6-minute walk test - 6MWT - and 400-metre comfortable walk test - 400mCWT) and the third at a brisk speed (200-metre fast walk test - 200mFWT). A modified Bruce treadmill test was associated at the end of the second phase. Monitored main parameters were: heart rate, walking velocity, VO 2 . Tolerance to the 3 tests was satisfactory. The reliability of the main parameters was good (intraclass correlation coefficient>0.8). The VO 2 concerning 6MWT and 400mCWT were not significantly different (P=0.33) and were lower to the first ventilatory threshold determined by the stress test (P<0.001): 16.2±3.0 vs. 16.5±2.6 vs. 20.7±5.1mL·min -1 ·kg -1 respectively. The VO 2 of the 200mFWT (20.2±3.7) was not different from the first ventilatory threshold. 400mCWT and 200mFWT are feasible, well-tolerated and reliable. They explore two levels of effort intensity (lower and not different to the first ventilatory threshold respectively). 400mCWT is a possible alternative to 6MWT. Associated with 200mFWT it should allow a better measurement of physical capacities and better customization of exercise training. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Determinants of distance walked during the six-minute walk test in patients undergoing cardiac surgery at hospital discharge

PubMed Central

2014-01-01

Introduction The aim of this study was to identify the determinants of distance walked in six-minute walk test (6MWD) in patients undergoing cardiac surgery at hospital discharge. Methods The assessment was performed preoperatively and at discharge. Data from patient records were collected and measurement of the Functional Independence Measure (FIM) and the Nottingham Health Profile (NHP) were performed. The six-minute walk test (6MWT) was performed at discharge. Patients undergoing elective cardiac surgery, coronary artery bypass grafting or valve replacement were eligible. Patients older than 75 years who presented arrhythmia during the protocol, with psychiatric disorders, muscular or neurological disorders were excluded from the study. Results Sixty patients (44.26% male, mean age 51.53 ± 13 years) were assessed. In multivariate analysis the following variables were selected: type of surgery (P = 0.001), duration of cardiopulmonary bypass (CPB) (P = 0.001), Functional Independence Measure - FIM (0.004) and body mass index - BMI (0.007) with r = 0.91 and r2 = 0.83 with P < 0.001. The equation derived from multivariate analysis: 6MWD = Surgery (89.42) + CPB (1.60) + MIF (2.79 ) - BMI (7.53) - 127.90. Conclusion In this study, the determinants of 6MWD in patients undergoing cardiac surgery were: the type of surgery, CPB time, functional capacity and body mass index. PMID:24885130

Reliability of heart rate measures during walking before and after running maximal efforts.

PubMed

Boullosa, D A; Barros, E S; del Rosso, S; Nakamura, F Y; Leicht, A S

2014-11-01

Previous studies on HR recovery (HRR) measures have utilized the supine and the seated postures. However, the most common recovery mode in sport and clinical settings after running exercise is active walking. The aim of the current study was to examine the reliability of HR measures during walking (4 km · h(-1)) before and following a maximal test. Twelve endurance athletes performed an incremental running test on 2 days separated by 48 h. Absolute (coefficient of variation, CV, %) and relative [Intraclass correlation coefficient, (ICC)] reliability of time domain and non-linear measures of HR variability (HRV) from 3 min recordings, and HRR parameters over 5 min were assessed. Moderate to very high reliability was identified for most HRV indices with short-term components of time domain and non-linear HRV measures demonstrating the greatest reliability before (CV: 12-22%; ICC: 0.73-0.92) and after exercise (CV: 14-32%; ICC: 0.78-0.91). Most HRR indices and parameters of HRR kinetics demonstrated high to very high reliability with HR values at a given point and the asymptotic value of HR being the most reliable (CV: 2.5-10.6%; ICC: 0.81-0.97). These findings demonstrate these measures as reliable tools for the assessment of autonomic control of HR during walking before and after maximal efforts. © Georg Thieme Verlag KG Stuttgart · New York.

Quantitative Gait Measurement With Pulse-Doppler Radar for Passive In-Home Gait Assessment

PubMed Central

Skubic, Marjorie; Rantz, Marilyn; Cuddihy, Paul E.

2014-01-01

In this paper, we propose a pulse-Doppler radar system for in-home gait assessment of older adults. A methodology has been developed to extract gait parameters including walking speed and step time using Doppler radar. The gait parameters have been validated with a Vicon motion capture system in the lab with 13 participants and 158 test runs. The study revealed that for an optimal step recognition and walking speed estimation, a dual radar set up with one radar placed at foot level and the other at torso level is necessary. An excellent absolute agreement with intraclass correlation coefficients of 0.97 was found for step time estimation with the foot level radar. For walking speed, although both radars show excellent consistency they all have a system offset compared to the ground truth due to walking direction with respect to the radar beam. The torso level radar has a better performance (9% offset on average) in the speed estimation compared to the foot level radar (13%–18% offset). Quantitative analysis has been performed to compute the angles causing the systematic error. These lab results demonstrate the capability of the system to be used as a daily gait assessment tool in home environments, useful for fall risk assessment and other health care applications. The system is currently being tested in an unstructured home environment. PMID:24771566

Quantitative gait measurement with pulse-Doppler radar for passive in-home gait assessment.

PubMed

Wang, Fang; Skubic, Marjorie; Rantz, Marilyn; Cuddihy, Paul E

2014-09-01

In this paper, we propose a pulse-Doppler radar system for in-home gait assessment of older adults. A methodology has been developed to extract gait parameters including walking speed and step time using Doppler radar. The gait parameters have been validated with a Vicon motion capture system in the lab with 13 participants and 158 test runs. The study revealed that for an optimal step recognition and walking speed estimation, a dual radar set up with one radar placed at foot level and the other at torso level is necessary. An excellent absolute agreement with intraclass correlation coefficients of 0.97 was found for step time estimation with the foot level radar. For walking speed, although both radars show excellent consistency they all have a system offset compared to the ground truth due to walking direction with respect to the radar beam. The torso level radar has a better performance (9% offset on average) in the speed estimation compared to the foot level radar (13%-18% offset). Quantitative analysis has been performed to compute the angles causing the systematic error. These lab results demonstrate the capability of the system to be used as a daily gait assessment tool in home environments, useful for fall risk assessment and other health care applications. The system is currently being tested in an unstructured home environment.

Gait speed is limited but improves over the course of acute care physical therapy.

PubMed

Braden, Heather J; Hilgenberg, Sean; Bohannon, Richard W; Ko, Man-Soo; Hasson, Scott

2012-01-01

Gait is a common focus of physical therapists' management of patients in acute care settings. Walking speed, the distance a patient covers per unit time, has been advocated as a "sixth vital sign." However, the feasibility of measuring walking speed and the degree to which walking speed is limited or improves over the course of therapy in the acute care setting are unclear. The purpose of this study of patients undergoing physical therapy during acute care hospitalization, therefore, was to determine whether walking speed can be measured in acute care and whether walking speed is limited and changes over the course of therapy. This was an observational cross-sectional study. Participants were 46 hospital inpatients, mean age 75.0 years (SD = 7.8), referred to physical therapy and able to walk at least 20 ft. Information regarding diagnosis, comorbidities, physical assistance, device use, body height, and weight was obtained. Speed was determined during initial and final physical therapy visits while patients walked at their self-selected speed over a marked course in a hospital corridor. Therapists reported that walking speed was clinically feasible, requiring inexpensive, available resources, 4 minutes' additional time, and simple calculations for documentation. Initial walking speed was a mean of 0.33 m/s (SD = 0.21; 95% confidence interval [CI]: 0.27-0.39), whereas final speed was 0.37 m/s (SD = 0.20; 95% CI: 0.31-0.43). The Wilcoxon test showed the increase in walking speed (0.04 m/s) to be significant (P = .005) over a mean therapy period of 2.0 days (SD = 1.4) and total hospitalization period of 5.5 days (SD = 3.6). The effect size and standardized response mean were 0.19 and 0.36, respectively. Minimal detectable change was 0.18 m/s. Walking speed is a feasible measure for patients admitted to an acute care hospital. It shows that patients walk slowly relative to community requirements but that their speed improves even over a short course of therapy.

A pilot clinical trial on a Variable Automated Speed and Sensing Treadmill (VASST) for hemiparetic gait rehabilitation in stroke patients.

PubMed

Chua, Karen S G; Chee, Johnny; Wong, Chin J; Lim, Pang H; Lim, Wei S; Hoo, Chuan M; Ong, Wai S; Shen, Mira L; Yu, Wei S

2015-01-01

Impairments in walking speed and capacity are common problems after stroke which may benefit from treadmill training. However, standard treadmills, are unable to adapt to the slower walking speeds of stroke survivors and are unable to automate training progression. This study tests a Variable Automated Speed and Sensing Treadmill (VASST) using a standard clinical protocol. VASST is a semi-automated treadmill with multiple sensors and micro controllers, including wireless control to reposition a fall-prevention harness, variable pre-programmed exercise parameters and laser beam foot sensors positioned on the belt to detect subject's foot positions. An open-label study with assessor blinding was conducted in 10 community-dwelling chronic hemiplegic patients who could ambulate at least 0.1 m/s. Interventions included physiotherapist-supervised training on VASST for 60 min three times per week for 4 weeks (total 12 h). Outcome measures of gait speed, quantity, balance, and adverse events were assessed at baseline, 2, 4, and 8 weeks. Ten subjects (8 males, mean age 55.5 years, 2.1 years post stroke) completed VASST training. Mean 10-m walk test speed was 0.69 m/s (SD = 0.29) and mean 6-min walk test distance was 178.3 m (84.0). After 4 weeks of training, 70% had significant positive gains in gait speed (0.06 m/s, SD = 0.08 m/s, P = 0.037); and 90% improved in walking distance. (54.3 m, SD = 30.9 m, P = 0.005). There were no adverse events. This preliminary study demonstrates the initial feasibility and short-term efficacy of VASST for walking speed and distance for people with chronic post-stroke hemiplegia.

Prosthetic ankle push-off work reduces metabolic rate but not collision work in non-amputee walking.

PubMed

Caputo, Joshua M; Collins, Steven H

2014-12-03

Individuals with unilateral below-knee amputation expend more energy than non-amputees during walking and exhibit reduced push-off work and increased hip work in the affected limb. Simple dynamic models of walking suggest a possible solution, predicting that increasing prosthetic ankle push-off should decrease leading limb collision, thereby reducing overall energy requirements. We conducted a rigorous experimental test of this idea wherein ankle-foot prosthesis push-off work was incrementally varied in isolation from one-half to two-times normal levels while subjects with simulated amputation walked on a treadmill at 1.25 m · s(-1). Increased prosthesis push-off significantly reduced metabolic energy expenditure, with a 14% reduction at maximum prosthesis work. In contrast to model predictions, however, collision losses were unchanged, while hip work during swing initiation was decreased. This suggests that powered ankle push-off reduces walking effort primarily through other mechanisms, such as assisting leg swing, which would be better understood using more complete neuromuscular models.

Prosthetic ankle push-off work reduces metabolic rate but not collision work in non-amputee walking

NASA Astrophysics Data System (ADS)

Caputo, Joshua M.; Collins, Steven H.

2014-12-01

Individuals with unilateral below-knee amputation expend more energy than non-amputees during walking and exhibit reduced push-off work and increased hip work in the affected limb. Simple dynamic models of walking suggest a possible solution, predicting that increasing prosthetic ankle push-off should decrease leading limb collision, thereby reducing overall energy requirements. We conducted a rigorous experimental test of this idea wherein ankle-foot prosthesis push-off work was incrementally varied in isolation from one-half to two-times normal levels while subjects with simulated amputation walked on a treadmill at 1.25 m.s-1. Increased prosthesis push-off significantly reduced metabolic energy expenditure, with a 14% reduction at maximum prosthesis work. In contrast to model predictions, however, collision losses were unchanged, while hip work during swing initiation was decreased. This suggests that powered ankle push-off reduces walking effort primarily through other mechanisms, such as assisting leg swing, which would be better understood using more complete neuromuscular models.

Prosthetic ankle push-off work reduces metabolic rate but not collision work in non-amputee walking

PubMed Central

Caputo, Joshua M.; Collins, Steven H.

2014-01-01

Individuals with unilateral below-knee amputation expend more energy than non-amputees during walking and exhibit reduced push-off work and increased hip work in the affected limb. Simple dynamic models of walking suggest a possible solution, predicting that increasing prosthetic ankle push-off should decrease leading limb collision, thereby reducing overall energy requirements. We conducted a rigorous experimental test of this idea wherein ankle-foot prosthesis push-off work was incrementally varied in isolation from one-half to two-times normal levels while subjects with simulated amputation walked on a treadmill at 1.25 m·s−1. Increased prosthesis push-off significantly reduced metabolic energy expenditure, with a 14% reduction at maximum prosthesis work. In contrast to model predictions, however, collision losses were unchanged, while hip work during swing initiation was decreased. This suggests that powered ankle push-off reduces walking effort primarily through other mechanisms, such as assisting leg swing, which would be better understood using more complete neuromuscular models. PMID:25467389

Self-reported walking ability predicts functional mobility performance in frail older adults.

PubMed

Alexander, N B; Guire, K E; Thelen, D G; Ashton-Miller, J A; Schultz, A B; Grunawalt, J C; Giordani, B

2000-11-01

To determine how self-reported physical function relates to performance in each of three mobility domains: walking, stance maintenance, and rising from chairs. Cross-sectional analysis of older adults. University-based laboratory and community-based congregate housing facilities. Two hundred twenty-one older adults (mean age, 79.9 years; range, 60-102 years) without clinical evidence of dementia (mean Folstein Mini-Mental State score, 28; range, 24-30). We compared the responses of these older adults on a questionnaire battery used by the Established Populations for the Epidemiologic Study of the Elderly (EPESE) project, to performance on mobility tasks of graded difficulty. Responses to the EPESE battery included: (1) whether assistance was required to perform seven Katz activities of daily living (ADL) items, specifically with walking and transferring; (2) three Rosow-Breslau items, including the ability to walk up stairs and walk a half mile; and (3) five Nagi items, including difficulty stooping, reaching, and lifting objects. The performance measures included the ability to perform, and time taken to perform, tasks in three summary score domains: (1) walking ("Walking," seven tasks, including walking with an assistive device, turning, stair climbing, tandem walking); (2) stance maintenance ("Stance," six tasks, including unipedal, bipedal, tandem, and maximum lean); and (3) chair rise ("Chair Rise," six tasks, including rising from a variety of seat heights with and without the use of hands for assistance). A total score combines scores in each Walking, Stance, and Chair Rise domain. We also analyzed how cognitive/ behavioral factors such as depression and self-efficacy related to the residuals from the self-report and performance-based ANOVA models. Rosow-Breslau items have the strongest relationship with the three performance domains, Walking, Stance, and Chair Rise (eta-squared ranging from 0.21 to 0.44). These three performance domains are as strongly related to one Katz ADL item, walking (eta-squared ranging from 0.15 to 0.33) as all of the Katz ADL items combined (eta-squared ranging from 0.21 to 0.35). Tests of problem solving and psychomotor speed, the Trails A and Trails B tests, are significantly correlated with the residuals from the self-report and performance-based ANOVA models. Compared with the rest of the EPESE self-report items, self-report items related to walking (such as Katz walking and Rosow-Breslau items) are better predictors of functional mobility performance on tasks involving walking, stance maintenance, and rising from chairs. Compared with other self-report items, self-reported walking ability may be the best predictor of overall functional mobility.

Improved Leg Tracking Considering Gait Phase and Spline-Based Interpolation during Turning Motion in Walk Tests.

PubMed

Yorozu, Ayanori; Moriguchi, Toshiki; Takahashi, Masaki

2015-09-04

Falling is a common problem in the growing elderly population, and fall-risk assessment systems are needed for community-based fall prevention programs. In particular, the timed up and go test (TUG) is the clinical test most often used to evaluate elderly individual ambulatory ability in many clinical institutions or local communities. This study presents an improved leg tracking method using a laser range sensor (LRS) for a gait measurement system to evaluate the motor function in walk tests, such as the TUG. The system tracks both legs and measures the trajectory of both legs. However, both legs might be close to each other, and one leg might be hidden from the sensor. This is especially the case during the turning motion in the TUG, where the time that a leg is hidden from the LRS is longer than that during straight walking and the moving direction rapidly changes. These situations are likely to lead to false tracking and deteriorate the measurement accuracy of the leg positions. To solve these problems, a novel data association considering gait phase and a Catmull-Rom spline-based interpolation during the occlusion are proposed. From the experimental results with young people, we confirm   that the proposed methods can reduce the chances of false tracking. In addition, we verify the measurement accuracy of the leg trajectory compared to a three-dimensional motion analysis system (VICON).

Intra-fraction motion of the prostate is a random walk

NASA Astrophysics Data System (ADS)

Ballhausen, H.; Li, M.; Hegemann, N.-S.; Ganswindt, U.; Belka, C.

2015-01-01

A random walk model for intra-fraction motion has been proposed, where at each step the prostate moves a small amount from its current position in a random direction. Online tracking data from perineal ultrasound is used to validate or reject this model against alternatives. Intra-fraction motion of a prostate was recorded by 4D ultrasound (Elekta Clarity system) during 84 fractions of external beam radiotherapy of six patients. In total, the center of the prostate was tracked for 8 h in intervals of 4 s. Maximum likelihood model parameters were fitted to the data. The null hypothesis of a random walk was tested with the Dickey-Fuller test. The null hypothesis of stationarity was tested by the Kwiatkowski-Phillips-Schmidt-Shin test. The increase of variance in prostate position over time and the variability in motility between fractions were analyzed. Intra-fraction motion of the prostate was best described as a stochastic process with an auto-correlation coefficient of ρ = 0.92  ±  0.13. The random walk hypothesis (ρ = 1) could not be rejected (p = 0.27). The static noise hypothesis (ρ = 0) was rejected (p < 0.001). The Dickey-Fuller test rejected the null hypothesis ρ = 1 in 25% to 32% of cases. On average, the Kwiatkowski-Phillips-Schmidt-Shin test rejected the null hypothesis ρ = 0 with a probability of 93% to 96%. The variance in prostate position increased linearly over time (r2 = 0.9  ±  0.1). Variance kept increasing and did not settle at a maximum as would be expected from a stationary process. There was substantial variability in motility between fractions and patients with maximum aberrations from isocenter ranging from 0.5 mm to over 10 mm in one patient alone. In conclusion, evidence strongly suggests that intra-fraction motion of the prostate is a random walk and neither static (like inter-fraction setup errors) nor stationary (like a cyclic motion such as breathing, for example). The prostate tends to drift away from the isocenter during a fraction, and this variance increases with time, such that shorter fractions are beneficial to the problem of intra-fraction motion. As a consequence, fixed safety margins (which would over-compensate at the beginning and under-compensate at the end of a fraction) cannot optimally account for intra-fraction motion. Instead, online tracking and position correction on-the-fly should be considered as the preferred approach to counter intra-fraction motion.

Dalfampridine Effects Beyond Walking Speed in Multiple Sclerosis

PubMed Central

Fjeldstad, Cecilie; Suárez, Gustavo; Klingler, Michael; Henney, Herbert R.; Rabinowicz, Adrian L.

2015-01-01

Background: Dalfampridine extended release (ER) improves walking in people with multiple sclerosis (MS), as demonstrated by walking speed improvement. This exploratory study evaluated treatment effects of dalfampridine-ER on gait, balance, and walking through treatment withdrawal and reinitiation. Methods: Dalfampridine-ER responders, based on Timed 25-Foot Walk (T25FW) assessment before study entry, were included in this open-label, three-period, single-center study. Period 1: on-drug evaluations performed at screening and 1 week after screening. Period 2: dalfampridine-ER withdrawal and off-drug evaluations (days 5 and 11). Period 3: dalfampridine-ER reinitiation/final on-drug evaluation (day 15). Primary outcome variables: NeuroCom composite scores for gait and balance; balance was evaluated if gait changes were significant. Secondary variables: individual NeuroCom scores, walking speed (T25FW) and distance (2-Minute Walk Test [2MWT]), and balance (Berg Balance Scale [BBS]). Results: All 20 patients completed the study: mean age, 53.1 years; mean MS duration, 11.3 years; mean time taking dalfampridine-ER, 315.3 days. NeuroCom gait composite scores worsened during period 2 relative to period 1 and improved during period 3; the mean ± SD difference in gait composite scores on drug was 4.03 ± 1.51 points (P = .015). Balance composite scores did not change significantly. Improvements were observed for off-drug versus on-drug for T25FW (0.36 ft/sec, P < .001), 2MWT (25.4 ft, P = .006), and BBS (1.7 points, P = .003). Safety profile was consistent with previous studies. Conclusions: Significant improvements in gait, walking speed, distance, and balance were demonstrated by dalfampridine-ER reinitiation after a 10-day withdrawal period. PMID:26664333

Impacts of small vestibular schwannoma on community ambulation, postural, and ocular control.

PubMed

Low Choy, Nancy L; Lucey, Mary-Therese M; Lewandowski, Susan L; Panizza, Benedict J

2017-05-01

To investigate balance, community mobility, gaze instability, and dizziness handicap and assess falls risk in people who are conservatively managed with small vestibular schwannoma (VS). Cross-sectional study with controls. The study involved 18 people (mean age 58.7 ± 12.2 years) diagnosed with VS (<12 mm) and 22 age-matched controls (mean age 56.9 ± 8.0 years). Measures included standing on firm and foam surfaces with feet apart, then together with eyes open and closed, Timed Up and Go (TUG) test and dual TUG test, Dynamic Gait Index, 6-Minute Walk Test, Halmagyi Impulse Test, Dynamic Visual Acuity Test, and the Dizziness Handicap Inventory. The clinical group failed more trials standing feet together on foam with eyes closed (P < .05); had inferior mobility and walked more slowly with divided attention (P < .05); had more difficulty walking with head movement, negotiating obstacles, and using stairs (P < .01); and walked shorter distances (P < .001) than controls. Reduced gaze stability (P < .01) and higher total (P = .007) and subcategory dizziness handicap scores (P < .05) were revealed compared to age-matched controls. Although outcomes for the clinical group are inferior to the control group across all measures and the dizziness impact is higher, the results fall in the low-risk category for falls. Preliminary data (level 4 evidence) support using a suite of clinical measures to monitor people with VS during conservative management. 4 Laryngoscope, 127:1147-1152, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Impact of a pilot walking school bus intervention on children's pedestrian safety behaviors: a pilot study.

PubMed

Mendoza, Jason A; Watson, Kathy; Chen, Tzu-An; Baranowski, Tom; Nicklas, Theresa A; Uscanga, Doris K; Hanfling, Marcus J

2012-01-01

Walking school buses (WSB) increased children's physical activity, but impact on pedestrian safety behaviors (PSB) is unknown. We tested the feasibility of a protocol evaluating changes to PSB during a WSB program. Outcomes were school-level street crossing PSB prior to (Time 1) and during weeks 4-5 (Time 2) of the WSB. The protocol collected 1252 observations at Time 1 and 2548 at Time 2. Mixed model analyses yielded: intervention schoolchildren had 5-fold higher odds (p<0.01) of crossing at the corner/crosswalk but 5-fold lower odds (p<0.01) of stopping at the curb. The protocol appears feasible for documenting changes to school-level PSB. Copyright © 2011 Elsevier Ltd. All rights reserved.

Cognitive Performance and Locomotor Adaptation in Persons With Anterior Cruciate Ligament Reconstruction.

PubMed

Stone, Amanda E; Roper, Jaimie A; Herman, Daniel C; Hass, Chris J

2018-05-01

Persons with anterior cruciate ligament reconstruction (ACLR) show deficits in gait and neuromuscular control following rehabilitation. This altered behavior extends to locomotor adaptation and learning, however the contributing factors to this observed behavior have yet to be investigated. The purpose of this study was to assess differences in locomotor adaptation and learning between ACLR and controls, and identify underlying contributors to motor adaptation in these individuals. Twenty ACLR individuals and 20 healthy controls (CON) agreed to participate in this study. Participants performed four cognitive and dexterity tasks (local version of Trail Making Test, reaction time test, electronic pursuit rotor test, and the Purdue pegboard). Three-dimensional kinematics were also collected while participants walked on a split-belt treadmill. ACLR individuals completed the local versions of Trails A and Trails B significantly faster than CON. During split-belt walking, ACLR individuals demonstrated smaller step length asymmetry during EARLY and LATE adaptation, smaller double support asymmetry during MID adaptation, and larger stance time asymmetry during DE-ADAPT compared with CON. ACLR individuals performed better during tasks that required visual attention and task switching and were less perturbed during split-belt walking compared to controls. Persons with ACLR may use different strategies than controls, cognitive or otherwise, to adapt locomotor patterns.

The Relationship of Walking Intensity to Total and Cause-Specific Mortality. Results from the National Walkers’ Health Study

PubMed Central

Williams, Paul T.; Thompson, Paul D.

2013-01-01

Purpose Test whether: 1) walking intensity predicts mortality when adjusted for walking energy expenditure, and 2) slow walking pace (≥24-minute mile) identifies subjects at substantially elevated risk for mortality. Methods Hazard ratios from Cox proportional survival analyses of all-cause and cause-specific mortality vs. usual walking pace (min/mile) in 7,374 male and 31,607 female recreational walkers. Survival times were left censored for age at entry into the study. Other causes of death were treated as a competing risk for the analyses of cause-specific mortality. All analyses were adjusted for sex, education, baseline smoking, prior heart attack, aspirin use, diet, BMI, and walking energy expenditure. Deaths within one year of baseline were excluded. Results The National Death Index identified 1968 deaths during the average 9.4-year mortality surveillance. Each additional minute per mile in walking pace was associated with an increased risk of mortality due to all causes (1.8% increase, P=10-5), cardiovascular diseases (2.4% increase, P=0.001, 637 deaths), ischemic heart disease (2.8% increase, P=0.003, 336 deaths), heart failure (6.5% increase, P=0.001, 36 deaths), hypertensive heart disease (6.2% increase, P=0.01, 31 deaths), diabetes (6.3% increase, P=0.004, 32 deaths), and dementia (6.6% increase, P=0.0004, 44 deaths). Those reporting a pace slower than a 24-minute mile were at increased risk for mortality due to all-causes (44.3% increased risk, P=0.0001), cardiovascular diseases (43.9% increased risk, P=0.03), and dementia (5.0-fold increased risk, P=0.0002) even though they satisfied the current exercise recommendations by walking ≥7.5 metabolic equivalent (MET)-hours per week. Conclusions The risk for mortality: 1) decreases in association with walking intensity, and 2) increases substantially in association for walking pace ≥24 minute mile (equivalent to <400m during a six-minute walk test) even among subjects who exercise regularly. PMID:24260542

Logical-rule models of classification response times: a synthesis of mental-architecture, random-walk, and decision-bound approaches.

PubMed

Fific, Mario; Little, Daniel R; Nosofsky, Robert M

2010-04-01

We formalize and provide tests of a set of logical-rule models for predicting perceptual classification response times (RTs) and choice probabilities. The models are developed by synthesizing mental-architecture, random-walk, and decision-bound approaches. According to the models, people make independent decisions about the locations of stimuli along a set of component dimensions. Those independent decisions are then combined via logical rules to determine the overall categorization response. The time course of the independent decisions is modeled via random-walk processes operating along individual dimensions. Alternative mental architectures are used as mechanisms for combining the independent decisions to implement the logical rules. We derive fundamental qualitative contrasts for distinguishing among the predictions of the rule models and major alternative models of classification RT. We also use the models to predict detailed RT-distribution data associated with individual stimuli in tasks of speeded perceptual classification. PsycINFO Database Record (c) 2010 APA, all rights reserved.

Physical activity and 5-year changes in physical performance tests and bone mineral density in postmenopausal women: the Yokogoshi Study.

PubMed

Kitamura, Kaori; Nakamura, Kazutoshi; Kobayashi, Ryosaku; Oshiki, Rieko; Saito, Toshiko; Oyama, Mari; Takahashi, Shunsuke; Nishiwaki, Tomoko; Iwasaki, Masanori; Yoshihara, Akihiro

2011-09-01

The effect of physical activity on musculoskeletal health in older adults is not completely understood. The aim of this study was to determine the relationship between physical activity and 5-year changes in physical performance tests and bone mineral density (BMD) in postmenopausal women. The design was a 5-year cohort study. Subjects were 507 women (55-74 years old) living in a rural community in Japan. Physical activity assessed included housework, farm work, and moderate leisure-time physical activity within the previous week. Measurements at baseline included handgrip strength, walking time (timed "Up & Go" test) and BMD of the femoral neck and vertebrae. Five-year changes in these measures (outcome variables) were compared among groups with different levels of physical activity by analysis of covariance. Women who did not do housework performed worse in changes in handgrip strength (difference=2.22 kg, P=0.0201) and worse in changes in the walking time (difference=0.54 s, P=0.0072) than those who did housework alone. Women who spent at least 9h per week (median=24) doing farm work performed better in changes in handgrip strength (difference=0.28 kg, P=0.0334), but worse in changes in the walking time (difference=0.66 s, P<0.0001) than those who did not do farm work. However, leisure-time activity was not associated with changes in any outcome variable, and none of the physical activities predicted BMD changes. Engaging in housework and farm work are determinants of physical function in postmenopausal women, which may help them maintain independence in daily living. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Investigating the role of backward walking therapy in alleviating plantar pressure of patients with diabetic peripheral neuropathy.

PubMed

Zhang, Xingguang; Zhang, Yanqi; Gao, Xiaoxiao; Wu, Jinxiao; Jiao, Xiumin; Zhao, Jing; Lv, Xiaofeng

2014-05-01

To investigate the effect of combination therapy of backward walking training and alpha-lipoic acid (ALA) treatment on the distribution of plantar pressure in patients with diabetic peripheral neuropathy (DPN). This study is a double-blinded, randomized controlled trial. The test group was treated with combination therapy of backward walking exercise and ALA (ALA for 2wk, backward walking exercise for 12wk), and the control group only received ALA treatment. Clinical and laboratory setting. Patients with DPN (N=60) were divided into the test group (n=30) or control group (n=30). Backward walking exercise with ALA treatment for the test group; lipoic acid treatment for the control group. Plantar pressure before and after treatment was tested and analyzed with the flatbed plantar pressure measurement system. After treatment, peak plantar pressure in the forefoot dropped for both the test and control groups; peak plantar pressure for the test group dropped significantly. Peak plantar pressure in the medial foot slightly increased for the test group, suggesting a more even distribution of plantar pressure in the test group after treatment. The combination therapy of ALA and backward walking proved to be more effective than ALA monotherapy. Backward walking also proved to have an ameliorating effect on balance ability and muscle strength of patients with DPN. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

A personalized, intense physical rehabilitation program improves walking in people with multiple sclerosis presenting with different levels of disability: a retrospective cohort.

PubMed

Kalron, Alon; Nitzani, Dalia; Magalashvili, David; Dolev, Mark; Menascu, Shay; Stern, Yael; Rosenblum, Uri; Pasitselsky, Diana; Frid, Lior; Zeilig, Gabi; Barmatz, Caroline; Givon, Uri; Achiron, Anat

2015-03-04

People with multiple sclerosis (PwMS) endure walking limitations. To address this restriction, various physical rehabilitation programs have been implemented with no consensus regarding their efficacy. Our objective was to report on the efficacy of an integrated tailored physical rehabilitation program on walking in people with multiple sclerosis categorized according to their level of neurological disability. Retrospective data were examined and analyzed. Specifically, data obtained from all patients who participated in the Multiple Sclerosis Center's 3 week rehabilitation program were extracted for in depth exploration. The personalized rehabilitation program included three major components modified according to the patient's specific impairments and functional needs: (a) goal directed physical therapy (b) moderately intense aerobic exercise training on a bicycle ergometer and (c) aquatic therapy chiefly oriented to body structures appropriate to movement. Gait outcome measurements included the 10 meter, 20 meter, Timed up and go and 2 minute walking tests measured pre and post the rehabilitation program. Three hundred and twelve people with relapsing-remitting multiple sclerosis were included in the final analysis. Patients were categorized into mild (n = 87), moderate (n = 104) and severely (n = 121) disabled groups. All clinical walking outcome measurements demonstrated statistically significant improvements, however, only an increase in the 2 minute walking test was above the minimal clinical difference value. The moderate and severe groups considerably improved compared to the mild gait disability group. Mean change scores (%) of the pre-post intervention period of the 2 minute walking test were 19.0 (S.E. = 3.4) in the moderate group, 16.2 (S.E. = 5.4) in the severe group and 10.9 (S.E. = 2.3) in the mild gait disability group. We presented comprehensive evidence verifying the effects of an intense goal-directed physical rehabilitation program on ambulation in people with multiple sclerosis presenting with different neurological impairment levels.

Joint proprioception, muscle strength, and functional ability in patients with osteoarthritis of the knee.

PubMed

van der Esch, M; Steultjens, M; Harlaar, J; Knol, D; Lems, W; Dekker, J

2007-06-15

To test the hypotheses that poor knee joint proprioception is related to limitations in functional ability, and poor proprioception aggravates the impact of muscle weakness on limitations in functional ability in osteoarthritis (OA) of the knee. Sixty-three patients with symptomatic OA of the knee were tested. Proprioceptive acuity was assessed by establishing the joint motion detection threshold (JMDT) in the anteroposterior direction. Muscle strength was measured using a computer-driven isokinetic dynamometer. Functional ability was assessed by the 100-meter walking test, the Get Up and Go (GUG) test, and the Western Ontario and McMaster Universities Osteoarthritis Index physical function (WOMAC-PF) questionnaire. Correlation analyses were performed to assess the relationship between proprioception, muscle strength, and functional ability. Regression analyses were performed to assess the impact of proprioception on the relationship between muscle strength and functional ability. Poor proprioception (high JMDT) was related to more limitation in functional ability (walking time r = 0.30, P < 0.05; GUG time r = 0.30, P < 0.05; WOMAC-PF r = 0.26, P <0.05). In regression analyses, the interaction between proprioception and muscle strength was significantly related to functional ability (walking time, P < 0.001 and GUG time, P < 0.001) but not to WOMAC-PF score (P = 0.625). In patients with poor proprioception, reduction of muscle strength was associated with more severe deterioration of functional ability than in patients with accurate proprioception. Patients with poor proprioception show more limitation in functional ability, but this relationship is rather weak. In patients with poor proprioception, muscle weakness has a stronger impact on limitations in functional ability than in patients with accurate proprioception.

Validation of an ambient measurement system (AMS) for walking speed.

PubMed

Varsanik, Jonathan S; Kimmel, Zebadiah M; de Moor, Carl; Gabel, Wendy; Phillips, Glenn A

2017-07-01

Walking speed is an important indicator of worsening in a variety of neurological and neuromuscular diseases, yet typically is measured only infrequently and in a clinical setting. Passive measurement of walking speed at home could provide valuable information to track the progression of many neuromuscular conditions. The purpose of this study was to validate the measurement of walking speed by a shelf-top ambient measurement system (AMS) that can be placed in a patient's home. Twenty-eight healthy adults (16 male, 12 female) were asked to walk three pre-defined routes two times each (total of 168 traversals). For each traversal, walking speed was measured simultaneously by five sources: two independent AMSs and three human timers with stopwatches. Measurements across the five sources were compared by generalised estimating equations (GEE). Correlation coefficients compared pairwise for walking speeds across the two AMSs, three human timers, and three routes all exceeded 0.86 (p < .0001), and for AMS-to-AMS exceeded 0.92 (p < .0001). Aggregated across all routes, there was no significant difference in measured walking speeds between the two AMSs (p = .596). There was a statistically significant difference between the AMSs and human timers of 8.5 cm/s (p < .0001), which is comparable to differences reported for other non-worn sensors. The tested AMS demonstrated the ability to automatically measure walking speeds comparable to manual observation and recording, which is the current standard for assessing walking speed in a clinical setting. The AMS may be used to detect changes in walking speed in community settings.

Walking for leisure among adults from three Brazilian cities and its association with perceived environment attributes and personal factors.

PubMed

Gomes, Grace A O; Reis, Rodrigo S; Parra, Diana C; Ribeiro, Isabela; Hino, Adriano A F; Hallal, Pedro C; Malta, Deborah C; Brownson, Ross C

2011-10-13

Walking is a popular form of physical activity and a convenient option to prevent chronic diseases. However, most of the evidence on this topic derives from high-income countries and little is known about walking patterns and its association with environmental features in low and middle income countries. To describe walking for leisure and to identify its association with perceived environment and personal factors among residents of three state capitals from different regions of Brazil Cross sectional phone surveys were conducted in Recife, Curitiba and Vitória (n = 6,166) in 2007, 2008 and 2009 respectively. Physical activity was measured using the leisure-time sections of the long version of the International Physical Activity Questionnaire (IPAQ). Perceived environment characteristics were assessed using a modified version of the Neighborhood Environment Walkability Scale (NEWS). Multivariable analysis tested the associations between walking for leisure and perceived environment characteristics across the cities using logistic regression. The proportions of respondents meeting physical activity recommendations through walking for leisure were 9.6%, 16.0% and 8.8% in Curitiba, Recife and Vitoria, respectively. Engaging in 150 min/wk or more of walking for leisure was significantly associated with younger age, higher education, better self-rated health and with lack of sidewalks on nearby streets. We did not find positive associations between walking for leisure and traffic conditions and safety related to cycling/walking during the day or night. Most environmental features were not associated with walking for leisure. Personal factors were stronger predictors of walking for leisure as compared with perceived environment factors.

Not Just "A Walking the Dog": Dog Walking and Pet Play and Their Association With Recommended Physical Activity Among Adolescents.

PubMed

Martin, Karen E; Wood, Lisa; Christian, Hayley; Trapp, Georgina S A

2015-01-01

To examine the role of pet play and dog walking in children's and adolescents' leisure time, and the relationship between these activities and physical activity. The study design was observational. The study setting was metropolitan Perth and nonmetropolitan regions in Western Australia. The study included 1097 primary school (mean age, 10.1 years; SD, 1.6 years) and 657 secondary school (mean age, 14.0 years; SD, 1.3 years) students. Validated measures of total physical activity, dog walking, and pet play activity (prevalence and time) were calculated. Generalized linear models tested for differences between proportions, while adjusting for socioeconomic status, age, and school-level clustering. Approximately one third of primary school and one quarter of secondary school students reported that they walked the dog at least once in the last week. Pet play was the most common play activity for primary and secondary school girls, and the second and third most popular play activity for secondary and primary school boys, respectively. Secondary school students who walked the dog or played with pets spent an average of 1 hour per week on each activity, and they were significantly more likely (p < .005) to meet national physical activity recommendations than secondary school students not reporting these activities. Given the significant proportion of young people who frequently engage in dog walking and pet play, and the high level of pet ownership in many Western countries, promotion of these activities to support young people's health is warranted.

Flexible Piezoelectric Sensor-Based Gait Recognition.

PubMed

Cha, Youngsu; Kim, Hojoon; Kim, Doik

2018-02-05

Most motion recognition research has required tight-fitting suits for precise sensing. However, tight-suit systems have difficulty adapting to real applications, because people normally wear loose clothes. In this paper, we propose a gait recognition system with flexible piezoelectric sensors in loose clothing. The gait recognition system does not directly sense lower-body angles. It does, however, detect the transition between standing and walking. Specifically, we use the signals from the flexible sensors attached to the knee and hip parts on loose pants. We detect the periodic motion component using the discrete time Fourier series from the signal during walking. We adapt the gait detection method to a real-time patient motion and posture monitoring system. In the monitoring system, the gait recognition operates well. Finally, we test the gait recognition system with 10 subjects, for which the proposed system successfully detects walking with a success rate over 93 %.

The effect of a pedometer-based community walking intervention "Walking for Wellbeing in the West" on physical activity levels and health outcomes: a 12-week randomized controlled trial.

PubMed

Baker, Graham; Gray, Stuart R; Wright, Annemarie; Fitzsimons, Claire; Nimmo, Myra; Lowry, Ruth; Mutrie, Nanette

2008-09-05

Recent systematic reviews have suggested that pedometers may be effective motivational tools to promote walking. However, studies tend to be of a relatively short duration, with small clinical based samples. Further research is required to demonstrate their effectiveness in adequately powered, community based studies. Using a randomized controlled trial design, this study assessed the impact of a 12-week graduated pedometer-based walking intervention on daily step-counts, self-reported physical activity and health outcomes in a Scottish community sample not meeting current physical activity recommendations. Sixty-three women and 16 men (49.2 years +/- 8.8) were randomly assigned to either an intervention (physical activity consultation and 12-week pedometer-based walking program) or control (no action) group. Measures for step-counts, 7-day physical activity recall, affect, quality of life (n = 79), body mass, BMI, % body fat, waist and hip circumference (n = 76), systolic/diastolic blood pressure, total cholesterol and HDL cholesterol (n = 66) were taken at baseline and week 12. Analyses were performed on an intention to treat basis using 2-way mixed factorial analyses of variance for parametric data and Mann Whitney and Wilcoxon tests for non-parametric data. Significant increases were found in the intervention group for step-counts (p < .001), time spent in leisure walking (p = .02) and positive affect (p = .027). Significant decreases were found in this group for time spent in weekday (p = .003), weekend (p = .001) and total sitting (p = .001) with no corresponding changes in the control group. No significant changes in any other health outcomes were found in either group. In comparison with the control group at week 12, the intervention group reported a significantly greater number of minutes spent in leisure time (p = .008), occupational (p = .045) and total walking (p = .03), and significantly fewer minutes in time spent in weekend (p = .003) and total sitting (p = .022). A pedometer-based walking program, incorporating a physical activity consultation, is effective in promoting walking and improving positive affect over 12 weeks in community based individuals. The discussion examines possible explanations for the lack of significant changes in health outcomes. Continued follow-up of this study will examine adherence to the intervention and possible resulting effects on health outcomes.

Balance and ankle muscle strength predict spatiotemporal gait parameters in individuals with diabetic peripheral neuropathy.

PubMed

Camargo, Marcela R; Barela, José A; Nozabieli, Andréa J L; Mantovani, Alessandra M; Martinelli, Alessandra R; Fregonesi, Cristina E P T

2015-01-01

The aims of this study were to evaluate aspects of balance, ankle muscle strength and spatiotemporal gait parameters in individuals with diabetic peripheral neuropathy (DPN) and verify whether deficits in spatiotemporal gait parameters were associated with ankle muscle strength and balance performance. Thirty individuals with DPN and 30 control individuals have participated. Spatiotemporal gait parameters were evaluated by measuring the time to walk a set distance during self-selected and maximal walking speeds. Functional mobility and balance performance were assessed using the Functional Reach and the Time Up and Go tests. Ankle isometric muscle strength was assessed with a handheld digital dynamometer. Analyses of variance were employed to verify possible differences between groups and conditions. Multiple linear regression analysis was employed to uncover possible predictors of gait deficits. Gait spatiotemporal, functional mobility, balance performance and ankle muscle strength were affected in individuals with DPN. The Time Up and Go test performance and ankle muscle isometric strength were associated to spatiotemporal gait changes, especially during maximal walking speed condition. Functional mobility and balance performance are damaged in DPN and balance performance and ankle muscle strength can be used to predict spatiotemporal gait parameters in individuals with DPN. Copyright © 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.

[Clinical application of the "Stop walking while talking test". Relationship with geriatric assessment parameters and other tests of balance and gait].

PubMed

González-Ávila, Bárbara; Roqueta, Cristina; Farriols, Cristina; Álvaro, Margarita; Roig, Alba; Cervera, Anton Maria; Miralles, Ramón

To assess the relationship between the Stop Walking While Talking (SWWT) test and some parameters of the geriatric assessment, as well as other tests of balance and gait. A prospective, observational and cross-sectional study conducted on 108 patients (62% women), with a mean age of 80.5±8.4 years. Twenty-three of them were living at home, 24 in a nursing home, and 61 in an intermediate care unit. A record was made of the Barthel index, Mini-Mental State Examination of Folstein (MMSE), comorbidity (Charlson index), the presence of previous falls, and fear of falling. Timed Up and Go (TUG), Tinetti test, and Stop Walking While Talking (SWWT) test, were performed on all the patients. Based on the results of the SWWT test patients were divided in two groups: "stoppers" and "non-stoppers". All patients were able to walk (with or without walking aids). The stoppers group of patients had a mean age 82.2±8.7; Barthel index 64.6±20.7; MMSE 21.6±5.1; Charlson index 1.8±1.7, and the non-stoppers 78.5±7.6 (P=.024), 86.0±18.1 (P<.001), 24.3±4.0 (P=.004), and 1.3±1.6 (P=.130), respectively. Of the 58 stoppers patients, 39 (67.2%) had a previous fall, and 19 (32.8%) had not (P=.002); 43 (74.1%) had fear of falling, and 15 (25.9%) had not (P<0.009). Of the 63 patients with TUG>20seconds, 52 (82.5%) were stoppers and 11 (17.5%) non-stoppers. Of the 31 with TUG between 10-20seconds, 5 (16.1%) were stoppers and 26 (83.9%) non-stoppers. Of the 14 with TUG<10 seconds, 1 (7.1%) were stoppers, and 13 (92.9%) non-stoppers (P<0.0001). The score of Tinetti test in the stoppers group was 15.4±5.2, and in non-stoppers 23.9±4.6 (P<0.001). Those in the stopper group were significantly older, were more dependent in activities of daily living, had greater cognitive impairment, more previous falls, had greater fear of falling, lower scores on the Tinetti test, and longer times in the TUG. Copyright © 2016 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

Effects of ballates, step aerobics, and walking on balance in women aged 50-75 years.

PubMed

Clary, Sarah; Barnes, Cathleen; Bemben, Debra; Knehans, Allen; Bemben, Michael

2006-01-01

This study examined the effectiveness of Ballates training (strengthening of the central core musculature by the inception of balance techniques) compared to more traditional exercise programs, such as step aerobics and walking, on balance in women aged 50- 75 years. Participants were randomly assigned to one of three supervised training groups (1 hour/day, 3 days/week, 13 weeks), Ballates (n = 12), step aerobics (n = 17), or walking (n =15). Balance was measured by four different methods (modified Clinical Test for the Sensory Interaction on Balance - mCTSIB; Unilateral Stance with Eyes Open - US-EO or Eyes Closed - US-EC; Tandem Walk - TW; Step Quick Turn - SQT) using the NeuroCom Balance Master. A 2-way (Group and Trial) repeated measures ANOVA and post-hoc Bonferroni Pair-wise Comparisons were used to evaluate changes in the dependent variables used to describe stability and balance (sway velocity, turn sway, speed, and turn time). Measures of static postural stability and dynamic balance were similar for the three groups prior to training. Following the different exercise interventions, sway velocity on firm and foam surfaces (mCTSIB) with eyes closed (p < 0.05) increased for the Ballates group while the other two exercise groups either maintained or decreased their sway velocity following the training, therefore suggesting that these two groups either maintained or improved their balance. There were significant improvements in speed during the TW test (p < 0.01), and turn time (p < 0.01) and sway (p < 0.05) during the SQT test for each of the three groups. In general, all three training programs improved dynamic balance, however, step aerobics and walking programs resulted in be better improvements in postural stability or static balance when compared to the Ballates program. Key PointsExercise training can improve balanceNeed to consider both static and dynamic aspects of balance individuallyImproved balance can reduce the risk of fall.

Hybrid FES-robot cooperative control of ambulatory gait rehabilitation exoskeleton.

PubMed

del-Ama, Antonio J; Gil-Agudo, Angel; Pons, José L; Moreno, Juan C

2014-03-04

Robotic and functional electrical stimulation (FES) approaches are used for rehabilitation of walking impairment of spinal cord injured individuals. Although devices are commercially available, there are still issues that remain to be solved. Control of hybrid exoskeletons aims at blending robotic exoskeletons and electrical stimulation to overcome the drawbacks of each approach while preserving their advantages. Hybrid actuation and control have a considerable potential for walking rehabilitation but there is a need of novel control strategies of hybrid systems that adequately manage the balance between FES and robotic controllers. Combination of FES and robotic control is a challenging issue, due to the non-linear behavior of muscle under stimulation and the lack of developments in the field of hybrid control. In this article, a cooperative control strategy of a hybrid exoskeleton is presented. This strategy is designed to overcome the main disadvantages of muscular stimulation: electromechanical delay and change in muscle performance over time, and to balance muscular and robotic actuation during walking.Experimental results in healthy subjects show the ability of the hybrid FES-robot cooperative control to balance power contribution between exoskeleton and muscle stimulation. The robotic exoskeleton decreases assistance while adequate knee kinematics are guaranteed. A new technique to monitor muscle performance is employed, which allows to estimate muscle fatigue and implement muscle fatigue management strategies. Kinesis is therefore the first ambulatory hybrid exoskeleton that can effectively balance robotic and FES actuation during walking. This represents a new opportunity to implement new rehabilitation interventions to induce locomotor activity in patients with paraplegia.Acronym list: 10 mWT: ten meters walking test; 6 MWT: six minutes walking test; FSM: finite-state machine; t-FSM: time-domain FSM; c-FSM: cycle-domain FSM; FES: functional electrical stimulation; HKAFO: hip-knee-ankle-foot orthosis; ILC: iterative error-based learning control; MFE: muscle fatigue estimator; NILC: Normalized stimulation output from ILC controller; PID: Proportional-Integral-derivative Control; PW: Stimulation pulse width; QUEST: Quebec User Evaluation of Satisfaction with assistive Technology; SCI: Spinal cord injury; TTI: torque-time integral; VAS: Visual Analog Scale.

Hybrid FES-robot cooperative control of ambulatory gait rehabilitation exoskeleton

PubMed Central

2014-01-01

Robotic and functional electrical stimulation (FES) approaches are used for rehabilitation of walking impairment of spinal cord injured individuals. Although devices are commercially available, there are still issues that remain to be solved. Control of hybrid exoskeletons aims at blending robotic exoskeletons and electrical stimulation to overcome the drawbacks of each approach while preserving their advantages. Hybrid actuation and control have a considerable potential for walking rehabilitation but there is a need of novel control strategies of hybrid systems that adequately manage the balance between FES and robotic controllers. Combination of FES and robotic control is a challenging issue, due to the non-linear behavior of muscle under stimulation and the lack of developments in the field of hybrid control. In this article, a cooperative control strategy of a hybrid exoskeleton is presented. This strategy is designed to overcome the main disadvantages of muscular stimulation: electromechanical delay and change in muscle performance over time, and to balance muscular and robotic actuation during walking. Experimental results in healthy subjects show the ability of the hybrid FES-robot cooperative control to balance power contribution between exoskeleton and muscle stimulation. The robotic exoskeleton decreases assistance while adequate knee kinematics are guaranteed. A new technique to monitor muscle performance is employed, which allows to estimate muscle fatigue and implement muscle fatigue management strategies. Kinesis is therefore the first ambulatory hybrid exoskeleton that can effectively balance robotic and FES actuation during walking. This represents a new opportunity to implement new rehabilitation interventions to induce locomotor activity in patients with paraplegia. Acronym list: 10mWT: ten meters walking test; 6MWT: six minutes walking test; FSM: finite-state machine; t-FSM: time-domain FSM; c-FSM: cycle-domain FSM; FES: functional electrical stimulation; HKAFO: hip-knee-ankle-foot orthosis; ILC: iterative error-based learning control; MFE: muscle fatigue estimator; NILC: Normalized stimulation output from ILC controller; PID: Proportional-Integral-derivative Control; PW: Stimulation pulse width; QUEST: Quebec User Evaluation of Satisfaction with assistive Technology; SCI: Spinal cord injury; TTI: torque-time integral; VAS: Visual Analog Scale. PMID:24594302

The impact of dog walking on leisure-time physical activity: results from a population-based survey of Michigan adults.

PubMed

Reeves, Mathew J; Rafferty, Ann P; Miller, Corinne E; Lyon-Callo, Sarah K

2011-03-01

The extent to which dog walking promotes leisure-time physical activity (LTPA) remains unresolved. We describe the characteristics of people who walk their dog, and assess the impact on LTPA. Information on dog ownership, dog walking patterns, total walking activity and LTPA were assessed in the 2005 Michigan Behavioral Risk Factor Survey. Multiple logistic regression was used to generate adjusted odds ratios (AOR) for the effect of dog walking on total walking and LTPA. Of 5902 respondents 41% owned a dog, and of these, 61% walked their dog for at least 10 minutes at a time. However, only 27% walked their dog at least 150 minutes per week. Dog walking was associated with a significant increase in walking activity and LTPA. Compared with non-dog owners, the odds of obtaining at least 150 minutes per week of total walking were 34% higher for dog walkers (AOR = 1.34, 95% CI = 1.13 to 1.59), and the odds of doing any LTPA were 69% higher (AOR = 1.69, 95% CI = 1.33 to 2.15). Dog walking was associated with more walking and LTPA, however a substantial proportion of dog owners do not walk their dog. The promotion of dog walking could help increase LTPA.

Walking for Transportation and Leisure Among U.S. Adults--National Health Interview Survey 2010.

PubMed

Paul, Prabasaj; Carlson, Susan A; Carroll, Dianna D; Berrigan, David; Fulton, Janet E

2015-06-16

Walking, the most commonly reported physical activity among U.S. adults, is undertaken in various domains, including transportation and leisure. This study examined prevalence, bout length, and mean amount of walking in the last week for transportation and leisure, by selected characteristics. Self-reported data from the 2010 National Health Interview Survey (N = 24,017) were analyzed. Prevalence of transportation walking was 29.4% (95% CI: 28.6%-30.3%) and of leisure walking was 50.0% (95% CI: 49.1%-51.0%). Prevalence of transportation walking was higher among men; prevalence of leisure walking was higher among women. Most (52.4%) transportation walking bouts were 10 to 15 minutes; leisure walking bouts were distributed more evenly (28.0%, 10-15 minutes; 17.1%, 41-60 minutes). Mean time spent in transportation walking was higher among men, decreased with increasing BMI, and varied by race/ethnicity and region of residence. Mean time spent leisure walking increased with increasing age and with decreasing BMI. Demographic correlates and patterns of walking differ by domain. Interventions focusing on either leisure or transportation walking should consider correlates for the specific walking domain. Assessing prevalence, bout length, and mean time of walking for transportation and leisure separately allows for more comprehensive surveillance of walking.

Screening for physical inactivity among adults: the value of distance walked in the six-minute walk test. A cross-sectional diagnostic study.

PubMed

Sperandio, Evandro Fornias; Arantes, Rodolfo Leite; da Silva, Rodrigo Pereira; Matheus, Agatha Caveda; Lauria, Vinícius Tonon; Bianchim, Mayara Silveira; Romiti, Marcello; Gagliardi, Antônio Ricardo de Toledo; Dourado, Victor Zuniga

2016-01-01

Accelerometry provides objective measurement of physical activity levels, but is unfeasible in clinical practice. Thus, we aimed to identify physical fitness tests capable of predicting physical inactivity among adults. Diagnostic test study developed at a university laboratory and a diagnostic clinic. 188 asymptomatic subjects underwent assessment of physical activity levels through accelerometry, ergospirometry on treadmill, body composition from bioelectrical impedance, isokinetic muscle function, postural balance on a force platform and six-minute walk test. We conducted descriptive analysis and multiple logistic regression including age, sex, oxygen uptake, body fat, center of pressure, quadriceps peak torque, distance covered in six-minute walk test and steps/day in the model, as predictors of physical inactivity. We also determined sensitivity (S), specificity (Sp) and area under the curve of the main predictors by means of receiver operating characteristic curves. The prevalence of physical inactivity was 14%. The mean number of steps/day (≤ 5357) was the best predictor of physical inactivity (S = 99%; Sp = 82%). The best physical fitness test was a distance in the six-minute walk test and ≤ 96% of predicted values (S = 70%; Sp = 80%). Body fat > 25% was also significant (S = 83%; Sp = 51%). After logistic regression, steps/day and distance in the six-minute walk test remained predictors of physical inactivity. The six-minute walk test should be included in epidemiological studies as a simple and cheap tool for screening for physical inactivity.

A comparison of different balance tests in the prediction of falls in older women with vertebral fractures: a cohort study.

PubMed

Morris, Rob; Harwood, Rowan H; Baker, Ros; Sahota, Opinder; Armstrong, Sarah; Masud, Tahir

2007-01-01

people with vertebral fractures are at high risk of developing hip fractures. Falls risk is important in the pathogenesis of hip fractures. to investigate if balance tests, in conjunction with a falls history, can predict falls in older women with vertebral fractures. a cohort study of community-dwelling women aged over 60 years, with vertebral fractures. Balance tests investigated were: 5 m-timed-up-and-go-test (5 m-TUG), timed 10 m walk, TURN180 test (number of steps to turn 180 degrees ), tandem walk, ability to stand from chair with arms folded. Leg extensor power was also measured. fallers (at least one fall in a 12 month follow-up period) versus non-fallers. one hundred and four women aged 63-91 years [mean=78 +/- 7], were recruited. Eighty-six (83%) completed the study. Four variables were significantly associated with fallers: previous recurrent faller (2+ falls) [OR=6.52; 95% CI=1.69-25.22], 5 m-TUG test [OR=1.03; 1.00-1.06], timed 10 m walk [OR=1.07; 1.01-1.13] and the TURN180 test [OR=1.22; 1.00-1.49] [P <0.05]. Multi-variable analysis showed that only two variables, previous recurrent faller [OR=5.60; 1.40-22.45] and the 5 m-TUG test [OR=1.04; 1.00-1.08], were independently significantly associated with fallers. The optimal cut-off time for performing the 5 m-TUG test in predicting fallers was 30 s (area under ROC=60%). Combining previous recurrent faller with the 5 m-TUG improved prediction of fallers [OR=16.79, specificity=100%, sensitivity=13%]. a previous history of recurrent falls and the inability to perform the 5 m-TUG test within 30 s predicted falls in older women with vertebral fractures. Combining these two measures can predict fallers with a high degree of specificity (although a low sensitivity), allowing the identification of a group of patients suitable for fall and fracture prevention measures.

Effects of jumping skill training on walking balance for children with mental retardation and Down's syndrome.

PubMed

Wang, W Y; Chang, J J

1997-08-01

In the present study, we hypothesized that the enhancements obtained from the practice of jumping activity could be transferred to improve the walking balance in children with mental retardation (MR) and Down's syndrome (DS). Fourteen children with the diagnosis of MR or DS, aged 3 to 6 years, were recruited from a day care institution. They were ambulant but without jumping ability. Sixty-one non-handicapped children was used to serve as a normative comparison group. Before the training program, the performances of walking balance, jump skills and jumping distances were assessed individually by one physical therapist. The balance sub-test in the Bruininks Oseretsky Test of Motor Proficiency (BOTMP) was administered to assess the walking balance. Motor Skill Inventory (MSI) was used to assess the qualitative levels of jumping skills. A jumping skill training lesson that included horizontal jumps and vertical jumps was designed and integrated into the educational program. The recruited children received 3 sessions of training per-week for 6 weeks. A post-training test and a follow-up test were administered to the handicapped children. In BOTMP scores, statistical differences exited between the pre-training and post-training tests in the tested items of floor walk and beam walk. However, no significant difference was found in the items of floor stand, beam stand and floor heel-toe walk. MSI scales revealed there were significant differences between pre-training and post-training tests. There was no significant difference between the scores of post-training test and the follow-up test. The results implicated that the jumping activity might effectively evoke the automatic and dynamic postural control. Moreover, the significant improvements of the floor walk and beam walk performances might be due to the transferred effects via the practice of dynamic jumping activity. Furthermore, implications and suggestions are discussed.

A method for automated control of belt velocity changes with an instrumented treadmill.

PubMed

Hinkel-Lipsker, Jacob W; Hahn, Michael E

2016-01-04

Increased practice difficulty during asymmetrical split-belt treadmill rehabilitation has been shown to improve gait outcomes during retention and transfer tests. However, research in this area has been limited by manual treadmill operation. In the case of variable practice, which requires stride-by-stride changes to treadmill belt velocities, the treadmill control must be automated. This paper presents a method for automation of asymmetrical split-belt treadmill walking, and evaluates how well this method performs with regards to timing of gait events. One participant walked asymmetrically for 100 strides, where the non-dominant limb was driven at their self-selected walking speed, while the other limb was driven randomly on a stride-by-stride basis. In the control loop, the key factors to insure that the treadmill belt had accelerated to its new velocity safely during the swing phase were the sampling rate of the A/D converter, processing time within the controller software, and acceleration of the treadmill belt. The combination of these three factors resulted in a total control loop time during each swing phase that satisfied these requirements with a factor of safety that was greater than 4. Further, a polynomial fit indicated that belt acceleration was the largest contributor to changes in this total time. This approach appears to be safe and reliable for stride-by-stride adjustment of treadmill belt speed, making it suitable for future asymmetrical split-belt walking studies. Further, it can be incorporated into virtual reality rehabilitation paradigms that utilize split-belt treadmill walking. Copyright © 2015 Elsevier Ltd. All rights reserved.

Development and Validation of a New Method to Measure Walking Speed in Free-Living Environments Using the Actibelt® Platform

PubMed Central

Schimpl, Michaela; Lederer, Christian; Daumer, Martin

2011-01-01

Walking speed is a fundamental indicator for human well-being. In a clinical setting, walking speed is typically measured by means of walking tests using different protocols. However, walking speed obtained in this way is unlikely to be representative of the conditions in a free-living environment. Recently, mobile accelerometry has opened up the possibility to extract walking speed from long-time observations in free-living individuals, but the validity of these measurements needs to be determined. In this investigation, we have developed algorithms for walking speed prediction based on 3D accelerometry data (actibelt®) and created a framework using a standardized data set with gold standard annotations to facilitate the validation and comparison of these algorithms. For this purpose 17 healthy subjects operated a newly developed mobile gold standard while walking/running on an indoor track. Subsequently, the validity of 12 candidate algorithms for walking speed prediction ranging from well-known simple approaches like combining step length with frequency to more sophisticated algorithms such as linear and non-linear models was assessed using statistical measures. As a result, a novel algorithm employing support vector regression was found to perform best with a concordance correlation coefficient of 0.93 (95%CI 0.92–0.94) and a coverage probability CP1 of 0.46 (95%CI 0.12–0.70) for a deviation of 0.1 m/s (CP2 0.78, CP3 0.94) when compared to the mobile gold standard while walking indoors. A smaller outdoor experiment confirmed those results with even better coverage probability. We conclude that walking speed thus obtained has the potential to help establish walking speed in free-living environments as a patient-oriented outcome measure. PMID:21850254

Changes in the Built Environment and Changes in the Amount of Walking Over Time: Longitudinal Results From the Multi-Ethnic Study of Atherosclerosis

PubMed Central

Hirsch, Jana A.; Moore, Kari A.; Clarke, Philippa J.; Rodriguez, Daniel A.; Evenson, Kelly R.; Brines, Shannon J.; Zagorski, Melissa A.; Diez Roux, Ana V.

2014-01-01

Lack of longitudinal research hinders causal inference on the association between the built environment and walking. In the present study, we used data from 6,027 adults in the Multi-Ethnic Study of Atherosclerosis who were 45–84 years of age at baseline to investigate the association of neighborhood built environment with trends in the amount of walking between 2000 and 2012. Walking for transportation and walking for leisure were assessed at baseline and at 3 follow-up visits (median follow-up = 9.15 years). Time-varying built environment measures (measures of population density, land use, number of destinations, bus access, and street connectivity) were created using geographic information systems. We used linear mixed models to estimate the associations between baseline levels of and a change in each built environment feature and a change in the frequency of walking. After adjustment for potential confounders, we found that higher baseline levels of population density, area zoned for retail, social destinations, walking destinations, and street connectivity were associated with greater increases in walking for transportation over time. Higher baseline levels of land zoned for residential use and distance to buses were associated with less pronounced increases (or decreases) in walking for transportation over time. Increases in the number of social destinations, the number of walking destinations, and street connectivity over time were associated with greater increases in walking for transportation. Higher baseline levels of both land zoned for retail and walking destinations were associated with greater increases in leisure walking, but no changes in built environment features were associated with leisure walking. The creation of mixed-use, dense developments may encourage adults to incorporate walking for transportation into their everyday lives. PMID:25234431

Prospective analysis of time out-of-home and objectively measured walking duration during a week in a large cohort of older adults.

PubMed

Rapp, Kilian; Mikolaizak, Stefanie; Rothenbacher, Dietrich; Denkinger, Michael D; Klenk, Jochen

2018-01-01

Physical activity is considered an effective measure to promote health in older people. There is evidence that the number of outdoor trips increases physical activity by increasing walking duration. The objective of this study was to analyse the relationship between daily time out-of-home and walking duration. Furthermore, predictors for walking duration and time out-of-home were evaluated. Walking duration was measured prospectively over a 1 week period by a body-fixed sensor and the time out-of-home was assessed by a questionnaire at the same days. Seven thousand, two hundred and forty-three days from 1289 older people (mean age 75.4 years) with both sensor-based measures and completed questionnaires were included in the analyses. To account for several observation days per participant multilevel regression analyses were applied. Analyses were stratified according to the time out-of-home (more or less than 100 min/day). In the group with less than 100 min out-of-home, each additional minute out-of-home added 20 s to overall walking duration. If the time exceeded 100 min the additional increase of walking duration was only moderate or weak. Leaving the home once added 40 min of walking, the following trips 15 to 20 min. Increasing age, lower gait speed, comorbidities, low temperature, rain and specific week days (Sunday) decreased both the time out-of-home and walking duration. Other variables like gender (female), isolation or living with a spouse reduced the time out-of-home without affecting walking duration. Being out-of-home increases daily walking duration. The association is strongest if the time out-of-home is 100 min or less.

Association between neighborhood walkability and GPS-measured walking, bicycling and vehicle time in adolescents.

PubMed

Carlson, Jordan A; Saelens, Brian E; Kerr, Jacqueline; Schipperijn, Jasper; Conway, Terry L; Frank, Lawrence D; Chapman, Jim E; Glanz, Karen; Cain, Kelli L; Sallis, James F

2015-03-01

To investigate relations of walking, bicycling and vehicle time to neighborhood walkability and total physical activity in youth. Participants (N=690) were from 380 census block groups of high/low walkability and income in two US regions. Home neighborhood residential density, intersection density, retail density, entertainment density and walkability were derived using GIS. Minutes/day of walking, bicycling and vehicle time were derived from processing algorithms applied to GPS. Accelerometers estimated total daily moderate-to-vigorous physical activity (MVPA). Models were adjusted for nesting of days (N=2987) within participants within block groups. Walking occurred on 33%, active travel on 43%, and vehicle time on 91% of the days observed. Intersection density and neighborhood walkability were positively related to walking and bicycling and negatively related to vehicle time. Residential density was positively related to walking. Increasing walking in youth could be effective in increasing total physical activity. Built environment findings suggest potential for increasing walking in youth through improving neighborhood walkability. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Influence of Audio-Visual Cueing (Traffic Light) on Dual Task Walking in Healthy Older Adults and Older Adults with Balance Impairments.

PubMed

Kaewkaen, Kitchana; Wongsamud, Phongphat; Ngaothanyaphat, Jiratchaya; Supawarapong, Papawarin; Uthama, Suraphong; Ruengsirarak, Worasak; Chanabun, Suthin; Kaewkaen, Pratchaya

2018-02-01

The walking gait of older adults with balance impairment is affected by dual tasking. Several studies have shown that external cues can stimulate improvement in older adults' performance. There is, however, no current evidence to support the usefulness of external cues, such as audio-visual cueing, in dual task walking in older adults. Thus, the aim of this study was to investigate the influence of an audio-visual cue (simulated traffic light) on dual task walking in healthy older adults and in older adults with balance impairments. A two-way repeated measures study was conducted on 14 healthy older adults and 14 older adults with balance impairment, who were recruited from the community in Chiang Rai, Thailand. Their walking performance was assessed using a four-metre walking test at their preferred gait speed and while walking under two further gait conditions, in randomised order: dual task walking and dual task walking with a simulated traffic light. Each participant was tested individually, with the testing taking between 15 and 20 minutes to perform, including two-minute rest periods between walking conditions. Two Kinect cameras recorded the spatio-temporal parameters using MFU gait analysis software. Each participant was tested for each condition twice. The mean parameters for each condition were analysed using a two-way repeated measures analysis of variance (ANOVA) with participant group and gait condition as factors. There was no significant between-group effect for walking speed, stride length and cadence. There were also no significant effects between gait condition and stride length or cadence. However, the effect between gait condition and walking speed was found to be significant [F(1.557, 40.485) = 4.568, P = 0.024, [Formula: see text

Impact of physical exercise on reaction time in patients with Parkinson's disease-data from the Berlin BIG Study.

PubMed

Ebersbach, Georg; Ebersbach, Almut; Gandor, Florin; Wegner, Brigitte; Wissel, Jörg; Kupsch, Andreas

2014-05-01

To determine whether physical activity may affect cognitive performance in patients with Parkinson's disease by measuring reaction times in patients participating in the Berlin BIG study. Randomized controlled trial, rater-blinded. Ambulatory care. Patients with mild to moderate Parkinson's disease (N=60) were randomly allocated to 3 treatment arms. Outcome was measured at the termination of training and at follow-up 16 weeks after baseline in 58 patients (completers). Patients received 16 hours of individual Lee Silverman Voice Treatment-BIG training (BIG; duration of treatment, 4wk), 16 hours of group training with Nordic Walking (WALK; duration of treatment, 8wk), or nonsupervised domestic exercise (HOME; duration of instruction, 1hr). Cued reaction time (cRT) and noncued reaction time (nRT). Differences between treatment groups in improvement in reaction times from baseline to intermediate and baseline to follow-up assessments were observed for cRT but not for nRT. Pairwise t test comparisons revealed differences in change in cRT at both measurements between BIG and HOME groups (intermediate: -52ms; 95% confidence interval [CI], -84/-20; P=.002; follow-up: 55ms; CI, -105/-6; P=.030) and between WALK and HOME groups (intermediate: -61ms; CI, -120/-2; P=.042; follow-up: -78ms; CI, -136/-20; P=.010). There was no difference between BIG and WALK groups (intermediate: 9ms; CI, -49/67; P=.742; follow-up: 23ms; CI, -27/72; P=.361). Supervised physical exercise with Lee Silverman Voice Treatment-BIG or Nordic Walking is associated with improvement in cognitive aspects of movement preparation. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Influence of foot pain on walking ability of diabetic patients.

PubMed

Novak, Primoz; Burger, Helena; Marincek, Crt; Meh, Duska

2004-11-01

To assess foot pain and its correlation with walking ability in diabetic patients. Two groups of type 2 diabetic patients (30 with symptomatic neuropathy and 30 without symptomatic neuropathy) and 30 healthy volunteers were studied. Pain was assessed by the pain sub-scale of the Foot Function Index. Internal consistency for the pain sub-scale was tested. Walking ability was assessed by the 6-minute walking test. The pain was worse in diabetic patients, the pain sub-scale scores differed between the groups (p < 0.05). High internal consistency was found for the pain sub-scale of the Foot Function Index. Results of the 6-minute walking test differed among the 3 groups: healthy volunteers performed best, and diabetic patients with symptomatic neuropathy worst (p < 0.001). Foot pain correlated moderately with the result of walking test (r = -0.449, p < 0.001). The pain sub-scale of the Foot Function Index is suitable for the assessment of pain in diabetic patients. Patients with severe foot pain have more difficulties when walking long distances than patients with less severe or without any pain.

Walking efficiency before and after total hip replacement.

PubMed

Brown, M; Hislop, H J; Waters, R L; Porell, D

1980-10-01

The energy cost of walking and gait characteristics of patients with hip disease were studied to determine changes in walking efficiency following total hip replacement. Twenty-nine patients, 24 with unilateral hip disease and 5 with bilateral hip disease, were tested preoperatively and at various times postoperatively. Oxygen uptake was measured by a modified Douglas bag procedure. The temporal and distance characteristics of gait were measured with contact closing heel switches. Results showed postoperative increases in velocity, cadence, and stride length in patients with unilateral disease and with bilateral disease with bilateral replacement. After surgery, energy cost tended toward more normal levels, but the subjects were not within normal limits for oxygen uptake per minute, oxygen uptake per distance walked, or percent of predicted maximum aerobic capacity. Comparison of energy expenditure data with temporal and distance factors of gait indicated that all subjects became more physiologically efficient after hip replacement.

Hemorrhagic versus ischemic stroke: Who can best benefit from blended conventional physiotherapy with robotic-assisted gait therapy?

PubMed

Dierick, Frédéric; Dehas, Mélanie; Isambert, Jean-Luc; Injeyan, Soizic; Bouché, Anne-France; Bleyenheuft, Yannick; Portnoy, Sigal

2017-01-01

Contrary to common belief of clinicians that hemorrhagic stroke survivors have better functional prognoses than ischemic, recent studies show that ischemic survivors could experience similar or even better functional improvements. However, the influence of stroke subtype on gait and posture outcomes following an intervention blending conventional physiotherapy with robotic-assisted gait therapy is missing. This study compared gait and posture outcome measures between ambulatory hemorrhagic patients and ischemic patients, who received a similar 4 weeks' intervention blending a conventional bottom-up physiotherapy approach and an exoskeleton top-down robotic-assisted gait training (RAGT) approach with Lokomat. Forty adult hemiparetic stroke inpatient subjects were recruited: 20 hemorrhagic and 20 ischemic, matched by age, gender, side of hemisphere lesion, stroke severity, and locomotor impairments. Functional Ambulation Category, Postural Assessment Scale for Stroke, Tinetti Performance Oriented Mobility Assessment, 6 Minutes Walk Test, Timed Up and Go and 10-Meter Walk Test were performed before and after a 4-week long intervention. Functional gains were calculated for all tests. Hemorrhagic and ischemic subjects showed significant improvements in Functional Ambulation Category (P<0.001 and P = 0.008, respectively), Postural Assessment Scale for Stroke (P<0.001 and P = 0.003), 6 Minutes Walk Test (P = 0.003 and P = 0.015) and 10-Meter Walk Test (P = 0.001 and P = 0.024). Ischemic patients also showed significant improvements in Timed Up and Go. Significantly greater mean Functional Ambulation Category and Tinetti Performance Oriented Mobility Assessment gains were observed for hemorrhagic compared to ischemic, with large (dz = 0.81) and medium (dz = 0.66) effect sizes, respectively. Overall, both groups exhibited quasi similar functional improvements and benefits from the same type, length and frequency of blended conventional physiotherapy and RAGT protocol. The use of intensive treatment plans blending top-down physiotherapy and bottom-up robotic approaches is promising for post-stroke rehabilitation.

Hemorrhagic versus ischemic stroke: Who can best benefit from blended conventional physiotherapy with robotic-assisted gait therapy?

PubMed Central

Dehas, Mélanie; Isambert, Jean-Luc; Injeyan, Soizic; Bouché, Anne-France; Bleyenheuft, Yannick; Portnoy, Sigal

2017-01-01

Background Contrary to common belief of clinicians that hemorrhagic stroke survivors have better functional prognoses than ischemic, recent studies show that ischemic survivors could experience similar or even better functional improvements. However, the influence of stroke subtype on gait and posture outcomes following an intervention blending conventional physiotherapy with robotic-assisted gait therapy is missing. Objective This study compared gait and posture outcome measures between ambulatory hemorrhagic patients and ischemic patients, who received a similar 4 weeks’ intervention blending a conventional bottom-up physiotherapy approach and an exoskeleton top-down robotic-assisted gait training (RAGT) approach with Lokomat. Methods Forty adult hemiparetic stroke inpatient subjects were recruited: 20 hemorrhagic and 20 ischemic, matched by age, gender, side of hemisphere lesion, stroke severity, and locomotor impairments. Functional Ambulation Category, Postural Assessment Scale for Stroke, Tinetti Performance Oriented Mobility Assessment, 6 Minutes Walk Test, Timed Up and Go and 10-Meter Walk Test were performed before and after a 4-week long intervention. Functional gains were calculated for all tests. Results Hemorrhagic and ischemic subjects showed significant improvements in Functional Ambulation Category (P<0.001 and P = 0.008, respectively), Postural Assessment Scale for Stroke (P<0.001 and P = 0.003), 6 Minutes Walk Test (P = 0.003 and P = 0.015) and 10-Meter Walk Test (P = 0.001 and P = 0.024). Ischemic patients also showed significant improvements in Timed Up and Go. Significantly greater mean Functional Ambulation Category and Tinetti Performance Oriented Mobility Assessment gains were observed for hemorrhagic compared to ischemic, with large (dz = 0.81) and medium (dz = 0.66) effect sizes, respectively. Conclusion Overall, both groups exhibited quasi similar functional improvements and benefits from the same type, length and frequency of blended conventional physiotherapy and RAGT protocol. The use of intensive treatment plans blending top-down physiotherapy and bottom-up robotic approaches is promising for post-stroke rehabilitation. PMID:28575054

Effects of yoga on functional capacity and well being.

PubMed

Akhtar, Pooja; Yardi, Sujata; Akhtar, Murtaza

2013-01-01

Yoga has proven beneficial effects on various health domains including musculoskeletal conditions, cardiopulmonary conditions through the practice of asana and pranayamas as well as on mental health, as it is known to enhance the body-and mind coordination. There is paucity of data on the effect of yoga on functional capacity in literature using 6 min walk test. The present study aims to look at the effect of yoga on 6-min walked distance, rating of perceived exertion (RPE), recovery time following the walk and state of well being. This is a hospital-based longitudinal study where 30 physiotherapy students of the age group 18 - 22 years of either sex were enrolled. Subjects having musculoskeletal problems, cardio respiratory disease and those who were not willing to volunteer were excluded They received Yoga intervention in form of Yogic practices which included a combination of asanas, pranayamas and omkar chanting for 1 h for 30 sessions. A baseline 6-min walk test was conducted on subjects and the 6-min walked distance, rating of perceived exertion (RPE) on modified Borg's scale were recorded. The baseline state of well-being was noted using the Warwick- Edinburgh mental well-being scale and similar recording was done post intervention after 30 sessions. Of the 30 subjects, there were no drop outs as these were committed college students. Of them, 24 were females and 6 were males with a mean age of 21.5 years SD 2.38. Statistically significant improvements were observed in 6-min walk distance (P value = 0.000), RPE (P value < 0.000), recovery time (P value < 0.000) and sense of well being score (P value < 0.000). Yoga practices are beneficial in improving the functional capacity in young healthy adults. Yoga can very well be incorporated in medical practice for increasing the patient's functional capacity, for those who have limitations in performing aerobic training due to various health reasons. The improved state of well being motivates the patients to adhere to yogic practices.

Walking for Transportation: What do U.S. Adults Think is a Reasonable Distance and Time?

PubMed Central

Watson, Kathleen B; Carlson, Susan A; Humbert-Rico, Tiffany; Carroll, Dianna D.; Fulton, Janet E

2015-01-01

Background Less than one-third of U.S. adults walk for transportation. Public health strategies to increase transportation walking would benefit from knowing what adults think is a reasonable distance to walk. Our purpose was to determine (1) what adults think is a reasonable distance and amount of time to walk and (2) whether there were differences in minutes spent transportation walking by what adults think is reasonable. Methods Analyses used a cross-sectional nationwide adult sample (n=3,653) participating in the 2010 Summer ConsumerStyles mail survey. Results Most adults (>90%) think transportation walking is reasonable. However, less than half (43%) think walking a mile or more or for 20 minutes or more is reasonable. What adults think is reasonable is similar across most demographic subgroups, except for older adults (≥ 65 years) who think shorter distances and times are reasonable. Trend analysis that adjust for demographic characteristics indicates adults who think longer distances and times are reasonable walk more. Conclusions Walking for short distances is acceptable to most U.S. adults. Public health programs designed to encourage longer distance trips may wish to improve supports for transportation walking to make walking longer distances seem easier and more acceptable to most U.S. adults. PMID:25158016

Walking for Transportation: What do U.S. Adults Think is a Reasonable Distance and Time?

PubMed

Watson, Kathleen B; Carlson, Susan A; Humbert-Rico, Tiffany; Carroll, Dianna D; Fulton, Janet E

2015-06-16

Less than one-third of U.S. adults walk for transportation. Public health strategies to increase transportation walking would benefit from knowing what adults think is a reasonable distance to walk. Our purpose was to determine 1) what adults think is a reasonable distance and amount of time to walk and 2) whether there were differences in minutes spent transportation walking by what adults think is reasonable. Analyses used a cross-sectional nationwide adult sample (n = 3653) participating in the 2010 Summer ConsumerStyles mail survey. Most adults (> 90%) think transportation walking is reasonable. However, less than half (43%) think walking a mile or more or for 20 minutes or more is reasonable. What adults think is reasonable is similar across most demographic subgroups, except for older adults (≥ 65 years) who think shorter distances and times are reasonable. Trend analysis that adjust for demographic characteristics indicates adults who think longer distances and times are reasonable walk more. Walking for short distances is acceptable to most U.S. adults. Public health programs designed to encourage longer distance trips may wish to improve supports for transportation walking to make walking longer distances seem easier and more acceptable to most U.S. adults.

A population-based randomized controlled trial of the effect of combining a pedometer with an intervention toolkit on physical activity among individuals with low levels of physical activity or fitness.

PubMed

Petersen, Christina Bjørk; Severin, Maria; Hansen, Andreas Wolff; Curtis, Tine; Grønbæk, Morten; Tolstrup, Janne Schurmann

2012-02-01

To examine if receiving a pedometer along with an intervention toolkit is associated with increased physical activity, aerobic fitness and better self-rated health among individuals with low levels of physical activity or fitness. The intervention was nested in the Danish Health Examination Survey (DANHES) and carried out in 2008. Participants were randomly assigned to either a pedometer group (n=326) or a control group (n=329). Physical activity, aerobic fitness, and self-rated health were measured at baseline and at 3-month follow-up, and differences were tested by Wilcoxons signed rank tests and Chi-squared tests. At follow-up, no significant differences in physical activity, aerobic fitness and self-rated health were found between the groups. However, the oldest participants in the pedometer group reported significantly more walking time compared to the controls (controls=368 min/week, pedometer group=680 min/week, P=0.05). Among participants who completed the intervention, a significant effect on total walking time was observed (median difference=225 min/week, P=0.04). The results suggest that receiving a pedometer and along with an intervention toolkit can increase walking time in older individuals, but not in younger individuals. Thus, this type of intervention offers great potential for promoting physical activity in older individuals. NCT01071811. Copyright © 2011 Elsevier Inc. All rights reserved.

Association between the gait pattern characteristics of older people and their two-step test scores.

PubMed

Kobayashi, Yoshiyuki; Ogata, Toru

2018-04-27

The Two-Step test is one of three official tests authorized by the Japanese Orthopedic Association to evaluate the risk of locomotive syndrome (a condition of reduced mobility caused by an impairment of the locomotive organs). It has been reported that the Two-Step test score has a good correlation with one's walking ability; however, its association with the gait pattern of older people during normal walking is still unknown. Therefore, this study aims to clarify the associations between the gait patterns of older people observed during normal walking and their Two-Step test scores. We analyzed the whole waveforms obtained from the lower-extremity joint angles and joint moments of 26 older people in various stages of locomotive syndrome using principal component analysis (PCA). The PCA was conducted using a 260 × 2424 input matrix constructed from the participants' time-normalized pelvic and right-lower-limb-joint angles along three axes (ten trials of 26 participants, 101 time points, 4 angles, 3 axes, and 2 variable types per trial). The Pearson product-moment correlation coefficient between the scores of the principal component vectors (PCVs) and the scores of the Two-Step test revealed that only one PCV (PCV 2) among the 61 obtained relevant PCVs is significantly related to the score of the Two-Step test. We therefore concluded that the joint angles and joint moments related to PCV 2-ankle plantar-flexion, ankle plantar-flexor moments during the late stance phase, ranges of motion and moments on the hip, knee, and ankle joints in the sagittal plane during the entire stance phase-are the motions associated with the Two-Step test.

Relative and absolute reliability of the clinical version of the Narrow Path Walking Test (NPWT) under single and dual task conditions.

PubMed

Gimmon, Yoav; Jacob, Grinshpon; Lenoble-Hoskovec, Constanze; Büla, Christophe; Melzer, Itshak

2013-01-01

Decline in gait stability has been associated with increased fall risk in older adults. Reliable and clinically feasible methods of gait instability assessment are needed. This study evaluated the relative and absolute reliability and concurrent validity of the testing procedure of the clinical version of the Narrow Path Walking Test (NPWT) under single task (ST) and dual task (DT) conditions. Thirty independent community-dwelling older adults (65-87 years) were tested twice. Participants were instructed to walk within the 6-m narrow path without stepping out. Trial time, number of steps, trial velocity, number of step errors, and number of cognitive task errors were determined. Intraclass correlation coefficients (ICCs) were calculated as indices of agreement, and a graphic approach called "mountain plot" was applied to help interpret the direction and magnitude of disagreements between testing procedures. Smallest detectable change and smallest real difference (SRD) were computed to determine clinically relevant improvement at group and individual levels, respectively. Concurrent validity was assessed using Performance Oriented Mobility Assessment Tool (POMA) and the Short Physical Performance Battery (SPPB). Test-retest agreement (ICC1,2) varied from 0.77 to 0.92 in ST and from 0.78 to 0.92 in DT conditions, with no apparent systematic differences between testing procedures demonstrated by the mountain plot graphs. Smallest detectable change and smallest real change were small for motor task performance and larger for cognitive errors. Significant correlations were observed for trial velocity and trial time with POMA and SPPB. The present results indicate that the NPWT testing procedure is highly reliable and reproducible. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Peripheral Neuropathy, Sensory Processing, and Balance in Survivors of Acute Lymphoblastic Leukemia.

PubMed

Varedi, Mitra; Lu, Lu; Howell, Carrie R; Partin, Robyn E; Hudson, Melissa M; Pui, Ching-Hon; Krull, Kevin R; Robison, Leslie L; Ness, Kirsten K; McKenna, Raymond F

2018-05-29

Purpose To compare peripheral nervous system function and balance between adult survivors of childhood acute lymphoblastic leukemia (ALL) and matched controls and to determine associations between peripheral neuropathy (PN) and limitations in static balance, mobility, walking endurance, and quality of life (QoL) among survivors. Patients and Methods Three hundred sixty-five adult survivors of childhood ALL and 365 controls with no cancer history completed assessments of PN (modified Total Neuropathy Score [mTNS]), static balance (Sensory Organization Test [SOT]), mobility (Timed Up and Go), walking endurance (6-minute walk test), QoL (Medical Outcomes Study 36-Item Short Form Survey), and visual-motor processing speed (Wechsler Adult Intelligence Scale). Results PN, but not impairments, in performance on SOT was more common in survivors than controls (41.4% v 9.5%, respectively; P < .001). In multivariable models, higher mTNS scores were associated with longer time to complete the Timed Up and Go (β = 0.15; 95% CI, 0.06 to 0.23; P < .001), shorter distance walked in 6 minutes (β = -4.39; 95% CI, -8.63 to -0.14; P = .04), and reduced QoL (β = -1.33; 95% CI, -1.79 to -0.87; P < .001 for physical functioning; β = -1.16; 95% CI, -1.64 to -0.67; P < .001 for role physical; and β = -0.88; 95% CI, -1.34 to -0.42; P < .001 for general health). Processing speed (β = 1.69; 95% CI, 0.98 to 2.40; P < .001), but not mTNS score, was associated with anterior-posterior sway on the SOT. Conclusion PN in long-term ALL survivors is associated with movement, including mobility and walking endurance, but not with static standing balance. The association between processing speed and sway suggests that static balance impairment in ALL survivors may be influenced by problems with CNS function, including the processing of sensory information.

Effects of Nordic walking training on exercise capacity and fitness in men participating in early, short-term inpatient cardiac rehabilitation after an acute coronary syndrome--a controlled trial.

PubMed

Kocur, Piotr; Deskur-Smielecka, Ewa; Wilk, Malgorzata; Dylewicz, Piotr

2009-11-01

To investigate the effects of Nordic Walking training supplemental to a standard, early rehabilitation programme on exercise capacity and physical fitness in men after an acute coronary syndrome. A controlled trial. Cardiac rehabilitation service of a provincial hospital. Eighty men 2-3 weeks after an acute coronary syndrome, with good exercise tolerance. Three-week, inpatient cardiac rehabilitation programme (control group) supplemented with Nordic Walking (Nordic Walking group), or with traditional walking training (walking training group). Exercise capacity was assessed as peak energy cost (in metabolic equivalents) in symptom-limited treadmill exercise test, and physical fitness with the Fullerton Functional Fitness Test. Exercise capacity after the rehabilitation programme was higher in the Nordic Walking group than in the control group (10.8 +/- 1.8 versus 9.2 +/- 2.2 metabolic equivalents, P =0.025). The improvement in exercise capacity in the Nordic Walking group was higher than in the control group (1.8 +/- 1.5 versus 0.7 +/- 1.4 metabolic equivalents, P =0.002). In contrast to the control group, the results of all components of the Fullerton test improved in the Nordic Walking and walking training groups. After the programme, lower body endurance, and dynamic balance were significantly better in the Nordic Walking group in comparison with the walking training and control groups, and upper body endurance was significantly better in the Nordic Walking and walking training groups than in the control group. Nordic Walking may improve exercise capacity, lower body endurance and coordination of movements in patients with good exercise tolerance participating in early, short-term rehabilitation after an acute coronary syndrome.

Effect of body-weight suspension training versus treadmill training on gross motor abilities of children with spastic diplegic cerebral palsy.

PubMed

Emara, Hatem A; El-Gohary, Tarek M; Al-Johany, Ahmed A

2016-06-01

Suspension training and treadmill training are commonly used for promoting functional gross motor skills in children with cerebral palsy. The aim of this study was to compare the effect of body-weight suspension training versus treadmill training on gross motor functional skills. Assessor-blinded, randomized, controlled intervention study. Outpatient rehabilitation facility. Twenty children with spastic diplegia (7 boys and 13 girls) in the age ranged from 6 to 8 years old were randomly allocated into two equal groups. All children were assessed at baseline, after 18-session and after 36-session. During the twelve-week outpatient rehabilitation program, both groups received traditional therapeutic exercises. Additionally, one group received locomotor training using the treadmill while the other group received locomotor training using body-weight suspension through the dynamic spider cage. Assessment included dimensions "D" standing and "E" walking of the gross motor function measure, in addition to the 10-m Walking Test and the five times sit to stand test. Training was applied three times per week for twelve consecutive weeks. No significant difference was found in standing or walking ability for measurements taken at baseline or after 18-session of therapy. Measurements taken at 36-session showed that suspension training achieved significantly (P<0.05) higher average score than treadmill training for dimension D as well as for dimension E. No significant difference was found between suspension training and treadmill training regarding walking speed or sit to stand transitional skills. Body-weight suspension training is effective in improving walking and locomotor capabilities in children with spastic diplegia. After three month suspension training was superior to treadmill training. Body-weight suspension training promotes adequate postural stability, good balance control, and less exertion which facilitates efficient and safe gait.

Changes in balance, functional performance and fall risk following whole body vibration training and vitamin D supplementation in institutionalized elderly women. A 6 month randomized controlled trial.

PubMed

Bogaerts, An; Delecluse, Christophe; Boonen, Steven; Claessens, Albrecht L; Milisen, Koen; Verschueren, Sabine M P

2011-03-01

Falls in the elderly constitute a growing public health problem. This randomized controlled trial investigated the potential benefit of 6 months of whole body vibration (WBV) training and/or vitamin D supplementation on balance, functionality and estimated fall risk in institutionalized elderly women. A total of 113 women (mean age: 79.6) were randomly assigned to either a WBV or a no-training group, receiving either a conventional dose (880 IU/d) or a high dose (1600 IU/d) of vitamin D3. The WBV group performed exercises on a vibration platform 3×/week. Balance was evaluated by computerized posturography. Functionality was assessed by 10 m walk test, Timed up and Go (TUG) performance and endurance capacity (Shuttle Walk). Fall risk was determined with the Physiological Profile Assessment. Performance on the 10 m walk test and on TUG improved over time in all groups. For none of the parameters, high-dose vitamin D resulted in a better performance than conventional dosing. The improvements in the WBV group in endurance capacity, walking at preferred speed, and TUG were significantly larger than the changes with supplementation alone. No additional benefit of WBV training could be detected on fall risk and postural control, although sway velocity and maximal isometric knee extension strength improved only in the WBV group. This trial showed that a high-dose vitamin D supplementation is not more efficient than conventional dosing in improving functionality in institutionalized elderly. WBV training on top of vitamin D supplementation provided an added benefit with regard to walking, TUG performance, and endurance capacity. Copyright © 2010 Elsevier B.V. All rights reserved.

Correlations between gait speed, 6-minute walk distance, physical activity, and self-efficacy in patients with severe chronic lung disease.

PubMed

DePew, Zachary S; Karpman, Craig; Novotny, Paul J; Benzo, Roberto P

2013-12-01

Four-meter gait speed (4MGS) has been associated with functional capacity and overall mortality in elderly patients, and may easily be translated to daily practice. We evaluated the association of 4MGS with meaningful outcomes. In 70 subjects we conducted the 4MGS, 6-min walk test (6MWT), objectively measured physical activity, and assessed dyspnea, quality of life, and self-efficacy for walking and routine physical activity. 4MGS was measured in 3 separate time epochs during the 6MWT, to explore 4MGS variability. Diagnoses included COPD (51.4%), interstitial lung disease (38.6%), and other pulmonary conditions (10%). The mean ± SD values were: 4MGS 0.85 ± 0.21 m/s, 6-min walk distance (6MWD) 305 ± 115 m, and physical activity level 1.28 ± 0.17, which is consistent with severe physical inactivity. The gait speeds within the time epochs 1-2, 3-4, and 5-6 min during the 6MWT were not significantly different: 1.01 ± 0.29 m/s, 0.98 ± 0.31 m/s, and 1.00 ± 0.31 m/s, respectively. 4MGS had a significant correlation with 6MWD (r = 0.70, P < .001). 6MWD was the dominant variable for predicting 4MGS. Other significant predictors of 4MGS included dyspnea, self-efficacy, quality of life, and objectively measured physical activity. 4MGS is significantly and independently associated with 6MWD, and may serve as a reasonable simple surrogate for 6MWD in subjects with chronic lung disease. Gait speed was remarkably stable throughout the 6MWT, which supports the validity of an abbreviated walk test such as 4MGS.

Effects of Twice-Weekly Intense Aerobic Exercise in Early Subacute Stroke: A Randomized Controlled Trial.

PubMed

Sandberg, Klas; Kleist, Marie; Falk, Lars; Enthoven, Paul

2016-08-01

To examine the effects of 12 weeks of twice-weekly intensive aerobic exercise on physical function and quality of life after subacute stroke. Randomized controlled trial. Ambulatory care. Patients (N=56; 28 women) aged ≥50 years who had a mild stroke (98% ischemic) and were discharged to independent living and enrolled 20 days (median) after stroke onset. Sixty minutes of group aerobic exercise, including 2 sets of 8 minutes of exercise with intensity up to exertion level 14 or 15 of 20 on the Borg rating of perceived exertion scale, twice weekly for 12 weeks (n=29). The nonintervention group (n=27) received no organized rehabilitation or scheduled physical exercise. Primary outcome measures included aerobic capacity on the standard ergometer exercise stress test (peak work rate) and walking distance on the 6-minute walk test (6MWT). Secondary outcome measures included maximum walking speed for 10m, balance on the timed Up and Go (TUG) test and single leg stance (SLS), health-related quality of life on the European Quality of Life Scale (EQ-5D), and participation and recovery after stroke on the Stroke Impact Scale (SIS) version 2.0 domains 8 and 9. Participants were evaluated pre- and postintervention. Patient-reported measures were also evaluated at 6-month follow-up. The following improved significantly more in the intervention group (pre- to postintervention): peak work rate (group × time interaction, P=.006), 6MWT (P=.011), maximum walking speed for 10m (P<.001), TUG test (P<.001), SLS right and left (eyes open) (P<.001 and P=.022, respectively), and SLS right (eyes closed) (P=.019). Aerobic exercise was associated with improved EQ-5D scores (visual analog scale, P=.008) and perceived recovery (SIS domain 9, P=.002). These patient-reported improvements persisted at 6-month follow-up. Intensive aerobic exercise twice weekly early in subacute mild stroke improved aerobic capacity, walking, balance, health-related quality of life, and patient-reported recovery. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Physical activity patterns in morbidly obese and normal-weight women.

PubMed

Kwon, Soyang; Mohammad, Jamal; Samuel, Isaac

2011-01-01

To compare physical activity patterns between morbidly obese and normal-weight women. Daily physical activity of 18 morbidly obese and 7 normal-weight women aged 30-58 years was measured for 2 days using the Intelligent Device for Energy Expenditure and Activity (IDEEA) device. The obese group spent about 2 hr/day less standing and 30 min/day less walking than did the normal-weight group. Time spent standing (standing time) was positively associated with time spent walking (walking time). Age- and walking time-adjusted standing time did not differ according to weight status. Promoting standing may be a strategy to increase walking.

A comparison of walk-in counselling and the wait list model for delivering counselling services.

PubMed

Stalker, Carol A; Riemer, Manuel; Cait, Cheryl-Anne; Horton, Susan; Booton, Jocelyn; Josling, Leslie; Bedggood, Joanna; Zaczek, Margaret

2016-10-01

Walk-in counselling has been used to reduce wait times but there are few controlled studies to compare outcomes between walk-in and the traditional model of service delivery. To compare change in psychological distress by clients receiving services from two models of service delivery, a walk-in counselling model and a traditional counselling model involving a wait list. Mixed-methods sequential explanatory design including quantitative comparison of groups with one pre-test and two follow-ups, and qualitative analysis of interviews with a sub-sample. Five-hundred and twenty-four participants ≥16 years were recruited from two Family Counselling Agencies; the General Health Questionnaire-12 assessed change in psychological distress. Hierarchical linear modelling revealed clients of the walk-in model improved faster and were less distressed at the four-week follow-up compared to the traditional service delivery model. Ten weeks later, both groups had improved and were similar. Participants receiving instrumental services prior to baseline improved more slowly. The qualitative data confirmed participants highly valued the accessibility of the walk-in model, and were frustrated by the lengthy waits associated with the traditional model. This study improves methodologically on previous studies of walk-in counselling, an approach to service delivery not conducive to randomized controlled trials.

Effects of physical guidance on short-term learning of walking on a narrow beam.

PubMed

Domingo, Antoinette; Ferris, Daniel P

2009-11-01

Physical guidance is often used in rehabilitation when teaching patients to re-learn movements. However, the effects of guidance on motor learning of complex skills, such as walking balance, are not clear. We tested four groups of healthy subjects that practiced walking on a narrow (1.27 cm) or wide (2.5 cm) treadmill-mounted balance beam, with or without physical guidance. Assistance was given by springs attached to a hip belt that applied restoring forces towards beam center. Subjects were evaluated while walking unassisted before and after training by calculating the number of times subjects stepped off of the beam per minute of successful walking on the beam (Failures per Minute). Subjects in Unassisted groups had greater performance improvements in walking balance from pre to post compared to subjects in Assisted groups. During training, Unassisted groups had more Failures per Minute than Assisted groups. Performance improvements were smaller in Narrow Beam groups than in Wide Beam groups. The Unassisted-Wide and Assisted-Narrow groups had similar Failures per Minute during training, but the Unassisted-Wide group had much greater performance gains after training. These results suggest that physical assistance can hinder motor learning of walking balance, assistance appears less detrimental for more difficult tasks, and task-specific dynamics are important to learning independent of error experience.

The Development and Preliminary Test of a Powered Alternately Walking Exoskeleton With the Wheeled Foot for Paraplegic Patients.

PubMed

Ma, Qingchuan; Ji, Linhong; Wang, Rencheng

2018-02-01

Upright walking has both physical and social meanings for paraplegic patients. The main purpose of this paper is to reduce the automatic functioning of the powered exoskeleton and enable the user to fully control the walking procedure in real-time, aiming to further improve the engagement of the patient during rehabilitation training. For this prototype, a custom-made hub motor was placed at the bottom of the exoskeleton's foot, and a pair of crutches with the embedded wireless controller were utilized as the auxiliary device. The user could alternatively press the button of the crutch to control the movement of the leg and by repeating this procedure, the user could complete a continuous walking motion. For safety, an automatic brake and mechanical limitation for maximum step length were implemented. A gait analysis was performed to evaluate the exoskeleton's motion capability and corresponding response of user's major muscles. The kinematic results of this paper showed that this exoskeleton could assist the user to walk in a motion trend close to the normally walk, especially for ankle joint. The electromyography results indicated that this exoskeleton could decrease the loading burden of the user's lower limb while requiring more involvements of upper-limb muscles to maintain balance while walking.

Use of Accelerometer-Based Feedback of Walking Activity for Appraising Progress With Walking-Related Goals in Inpatient Stroke Rehabilitation: A Randomized Controlled Trial.

PubMed

Mansfield, Avril; Wong, Jennifer S; Bryce, Jessica; Brunton, Karen; Inness, Elizabeth L; Knorr, Svetlana; Jones, Simon; Taati, Babak; McIlroy, William E

2015-10-01

Regaining independent ambulation is important to those with stroke. Increased walking practice during "down time" in rehabilitation could improve walking function for individuals with stroke. To determine the effect of providing physiotherapists with accelerometer-based feedback on patient activity and walking-related goals during inpatient stroke rehabilitation. Participants with stroke wore accelerometers around both ankles every weekday during inpatient rehabilitation. Participants were randomly assigned to receive daily feedback about walking activity via their physiotherapists (n = 29) or to receive no feedback (n = 28). Changes in measures of daily walking (walking time, number of steps, average cadence, longest bout duration, and number of "long" walking bouts) and changes in gait control and function assessed in-laboratory were compared between groups. There was no significant increase in walking time, number of steps, longest bout duration, or number of long walking bouts for the feedback group compared with the control group (P values > .20). However, individuals who received feedback significantly increased cadence of daily walking more than the control group (P = .013). From the in-laboratory gait assessment, individuals who received feedback had a greater increase in walking speed and decrease in step time variability than the control group (P values < .030). Feedback did not increase the amount of walking completed by individuals with stroke. However, there was a significant increase in cadence, indicating that intensity of daily walking was greater for those who received feedback than the control group. Additionally, more intense daily walking activity appeared to translate to greater improvements in walking speed. © The Author(s) 2015.

Effects of different frequencies of rhythmic auditory cueing on the stride length, cadence, and gait speed in healthy young females.

PubMed

Yu, Lili; Zhang, Qi; Hu, Chunying; Huang, Qiuchen; Ye, Miao; Li, Desheng

2015-02-01

[Purpose] The aim of this study was to explore the effects of different frequencies of rhythmic auditory cueing (RAC) on stride length, cadence, and gait speed in healthy young females. The findings of this study might be used as clinical guidance of physical therapy for choosing the suitable frequency of RAC. [Subjects] Thirteen healthy young females were recruited in this study. [Methods] Ten meters walking tests were measured in all subjects under 4 conditions with each repeated 3 times and a 3-min seated rest period between repetitions. Subjects first walked as usual and then were asked to listen carefully to the rhythm of a metronome and walk with 3 kinds of RAC (90%, 100%, and 110% of the mean cadence). The three frequencies (90%, 100%, and 110%) of RAC were randomly assigned. Gait speed, stride length, and cadence were calculated, and a statistical analysis was performed using the SPSS (version 17.0) computer package. [Results] The gait speed and cadence of 90% RAC walking showed significant decreases compared with normal walking and 100% and 110% RAC walking. The stride length, cadence, and gait speed of 110% RAC walking showed significant increases compared with normal walking and 90% and 100% RAC walking. [Conclusion] Our results showed that 110% RAC was the best of the 3 cueing frequencies for improvement of stride length, cadence, and gait speed in healthy young females.

Reliability and validity of the 6-min walk test in adults and seniors with intellectual disabilities.

PubMed

Guerra-Balic, Myriam; Oviedo, Guillermo R; Javierre, Casimiro; Fortuño, Jesús; Barnet-López, Silvia; Niño, Oscar; Alamo, Juan; Fernhall, Bo

2015-12-01

Adults with intellectual disabilities (ID) have significantly lower rates of physical activity and fitness than adults without ID. The 6-min walk test (6 MWT) is an inexpensive and simple way to test mobility and submaximal work capacity. To evaluate the test-retest reliability and validity of the 6 MWT in adults and seniors with ID and explore factors contributing to the 6 MWT distance (6 MWD). 46 participants with mild, moderate and severe ID levels (age=41 ± 11 years) performed the 6 MWT three times (T1; T2; T3) to determine test-retest reliability. To test validity, peak oxygen uptake (VO2 peak) was measured using a treadmill protocol. To analyze factors contributing to the 6 MWD, sex, height, fat mass % and fat free mass %, ID level, isometric leg strength and relative VO2 peak were also measured. The walking distances for T1, T2 and T3 were 460.3 ± 76.9; 489.4 ± 81.2 and 491.4 ± 77.9 m, respectively. The 6 MWDs between T1-T2 and T1-T3 were significantly different (p<0.001), but T2 and T3 were not different. The intraclass correlation coefficient between T2 and T3 was 0.96 indicating high reliability. Relative VO2 peak and isometric leg strength significantly contributed to the 6 MWD (R(2)=0.55). The 6 MWT is an easy, inexpensive, reliable and valid test in adults and seniors with ID. Familiarization is necessary to obtain reliable values. Relative VO2 peak and leg strength have significant impact on the distance walked. Copyright © 2015 Elsevier Ltd. All rights reserved.

How do changes to the built environment influence walking behaviors? a longitudinal study within a university campus in Hong Kong

PubMed Central

2014-01-01

Background Previous studies testing the association between the built environment and walking behavior have been largely cross-sectional and have yielded mixed results. This study reports on a natural experiment in which changes to the built environment were implemented at a university campus in Hong Kong. Longitudinal data on walking behaviors were collected using surveys, one before and one after changes to the built environment, to test the influence of changes to the built environment on walking behavior. Methods Built environment data are from a university campus in Hong Kong, and include land use, campus bus services, pedestrian network, and population density data collected from campus maps, the university developmental office, and field surveys. Walking behavior data were collected at baseline in March 2012 (n = 198) and after changes to the built environment from the same cohort of subjects in December 2012 (n = 169) using a walking diary. Geographic information systems (GIS) was used to map walking routes and built environment variables, and compare each subject’s walking behaviors and built environment exposure before and after the changes to the built environment. Walking behavior outcomes were changes in: i) walking distance, ii) destination-oriented walking, and iii) walked altitude range. Multivariable linear regression models were used to test for associations between changes to the built environment and changes in walking behaviors. Results Greater pedestrian network connectivity predicted longer walking distances and an increased likelihood of walking as a means of transportation. The increased use of recreational (vs. work) buildings, largely located at mid-range altitudes, as well as increased population density predicted greater walking distances.Having more bus services and a greater population density encouraged people to increase their walked altitude range. Conclusions In this longitudinal study, changes to the built environment were associated with changes in walking behaviors. Use of GIS combined with walking diaries presents a practical method for mapping and measuring changes in the built environment and walking behaviors, respectively. Additional longitudinal studies can help clarify the relationships between the built environment and walking behaviors identified in this natural experiment. PMID:25069949

Association Between Physical Activity Intensity and Physical Capacity Among Individuals Awaiting Bariatric Surgery.

PubMed

Rioux, Brittany V; Sénéchal, Martin; Kwok, Karen; Fox, Jill; Gamey, Dean; Bharti, Neha; Vergis, Ashley; Hardy, Krista; Bouchard, Danielle R

2017-05-01

Physical activity is a routine component of the lifestyle modification program implemented prior to bariatric surgery, and one of the goals is to improve patients' physical capacity. However, the physical activity intensity recommended to meet that goal is unknown. This study aimed to assess the association between time spent at different physical activity intensities and physical capacity in patients awaiting bariatric surgery. A total of 39 women and 13 men were recruited. The primary outcome was physical capacity measured using six objective tests: 6-min walk, chair stand, sit and reach, unipodal balance (eyes open and eyes closed), and hand grip strength tests. The primary exposure variable was physical activity intensity (i.e., sedentary, light, moderate, and vigorous) measured by accelerometers. The average body mass index was 46.3 ± 5.4 kg/m 2 . Only 6% of total time was spent at moderate to vigorous intensity, while 71% of the time was spent sedentary. When adjusted for body mass index, age, and sex, four of the six physical capacity tests were significantly associated with moderate intensity physical activity β(SE): 6-min walk 9.7 (2.7), chair stand 0.3 (0.1), balance (eyes open) 1.8 (0.7), and hand grip strength 1.2 (0.4), and only the 6-min walk was associated with sedentary activity 1.7 (0.7). These results suggest that physical capacity is associated with time spent at moderate intensity in individuals awaiting bariatric surgery. The next step is to study if an increase in time spent at moderate intensity will translate to improvements in physical capacity.

THE 6-MINUTE WALK TEST AND OTHER CLINICAL ENDPOINTS IN DUCHENNE MUSCULAR DYSTROPHY: RELIABILITY, CONCURRENT VALIDITY, AND MINIMAL CLINICALLY IMPORTANT DIFFERENCES FROM A MULTICENTER STUDY

PubMed Central

McDonald, Craig M; Henricson, Erik K; Abresch, R Ted; Florence, Julaine; Eagle, Michelle; Gappmaier, Eduard; Glanzman, Allan M; Spiegel, Robert; Barth, Jay; Elfring, Gary; Reha, Allen; Peltz, Stuart W

2013-01-01

Introduction: An international clinical trial enrolled 174 ambulatory males ≥5 years old with nonsense mutation Duchenne muscular dystrophy (nmDMD). Pretreatment data provide insight into reliability, concurrent validity, and minimal clinically important differences (MCIDs) of the 6-minute walk test (6MWT) and other endpoints. Methods: Screening and baseline evaluations included the 6-minute walk distance (6MWD), timed function tests (TFTs), quantitative strength by myometry, the PedsQL, heart rate–determined energy expenditure index, and other exploratory endpoints. Results: The 6MWT proved feasible and reliable in a multicenter context. Concurrent validity with other endpoints was excellent. The MCID for 6MWD was 28.5 and 31.7 meters based on 2 statistical distribution methods. Conclusions: The ratio of MCID to baseline mean is lower for 6MWD than for other endpoints. The 6MWD is an optimal primary endpoint for Duchenne muscular dystrophy (DMD) clinical trials that are focused therapeutically on preservation of ambulation and slowing of disease progression. Muscle Nerve 48: 357–368, 2013 PMID:23674289

Effects of daily activity recorded by pedometer on peak oxygen consumption (VO2peak), ventilatory threshold and leg extension power in 30- to 69-year-old Japanese without exercise habit.

PubMed

Zhang, Jian-Guo; Ohta, Toshiki; Ishikawa-Takata, Kazuko; Tabata, Izumi; Miyashita, Mitsumasa

2003-09-01

The relationships among walk steps, exercise habits and peak oxygen consumption (VO2peak), ventilatory threshold (VT) and leg extension power (LEP) were examined in 709 apparently healthy Japanese subjects (male 372, female 337) aged 30-69 years. Walk steps were evaluated using a pedometer. VO2peak and VT were assessed by a cycle ergometer test, while LEP was measured with an isokinetic leg extension system (Combi, Anaero Press 3500, Japan). Subjects who participated in exercise three times or more a week demonstrated significantly greater VO2peak and VT when compared with subjects without exercise habits. When a separate analysis was conducted on subjects who exercised fewer than three times per week, we found that the subgroup with the highest number of walk steps showed significantly greater VT in all male subjects and female subjects aged 30-49 years, but a significantly greater VO2peak only in females aged 30-49 years, when compared to the subgroup with the fewest walk steps. These results suggest that although some people exercise less than three times a week, if they are quite active in daily life, such activities might also confer benefits upon their fitness.

Reference Values for the Six-Minute Walk Test in Healthy Children and Adolescents: a Systematic Review.

PubMed

Cacau, Lucas de Assis Pereira; de Santana-Filho, Valter Joviniano; Maynard, Luana G; Gomes, Mansueto; Fernandes, Marcelo; Carvalho, Vitor Oliveira

2016-01-01

The aim of the study is to compare the available reference values and the six-minute walk test equations in healthy children/adolescents. Our systematic review was planned and performed in accordance with the PRISMA guidelines. We included all studies that established reference values for the six-minute walk test in healthy children/adolescents. To perform this review, a research was performed in PubMed, EMBASE (via SCOPUS) and Cochrane (LILACS), Bibliographic Index Spanish in Health Sciences, Organization Collection Pan-American Health Organization, Publications of the World Health Organization and Scientific Electronic Library Online (SciELO) via Virtual Health Library until June 2015 without language restriction. The initial research identified 276 abstracts. Twelve studies met the inclusion criteria and were fully reviewed and approved by both reviewers. None of the selected studies presented sample size calculation. Most of the studies recruited children and adolescents from school. Six studies reported the use of random samples. Most studies used a corridor of 30 meters. All studies followed the American Thoracic Society guidelines to perform the six-minute walk test. The walked distance ranged 159 meters among the studies. Of the 12 included studies, 7 (58%) reported descriptive data and 6 (50%) established reference equation for the walked distance in the six-minute walk test. The reference value for the six-minute walk test in children and adolescents ranged substantially from studies in different countries. A reference equation was not provided in all studies, but the ones available took into account well established variables in the context of exercise performance, such as height, heart rate, age and weight. Countries that did not established reference values for the six-minute walk test should be encouraged to do because it would help their clinicians and researchers have a more precise interpretation of the test.

Reference Values for the Six-Minute Walk Test in Healthy Children and Adolescents: a Systematic Review

PubMed Central

Cacau, Lucas de Assis Pereira; de Santana-Filho, Valter Joviniano; Maynard, Luana G.; Gomes Neto, Mansueto; Fernandes, Marcelo; Carvalho, Vitor Oliveira

2016-01-01

Objective The aim of the study is to compare the available reference values and the six-minute walk test equations in healthy children/adolescents. Our systematic review was planned and performed in accordance with the PRISMA guidelines. We included all studies that established reference values for the six-minute walk test in healthy children/adolescents. Methods To perform this review, a research was performed in PubMed, EMBASE (via SCOPUS) and Cochrane (LILACS), Bibliographic Index Spanish in Health Sciences, Organization Collection Pan-American Health Organization, Publications of the World Health Organization and Scientific Electronic Library Online (SciELO) via Virtual Health Library until June 2015 without language restriction. Results The initial research identified 276 abstracts. Twelve studies met the inclusion criteria and were fully reviewed and approved by both reviewers. None of the selected studies presented sample size calculation. Most of the studies recruited children and adolescents from school. Six studies reported the use of random samples. Most studies used a corridor of 30 meters. All studies followed the American Thoracic Society guidelines to perform the six-minute walk test. The walked distance ranged 159 meters among the studies. Of the 12 included studies, 7 (58%) reported descriptive data and 6 (50%) established reference equation for the walked distance in the six-minute walk test. Conclusion The reference value for the six-minute walk test in children and adolescents ranged substantially from studies in different countries. A reference equation was not provided in all studies, but the ones available took into account well established variables in the context of exercise performance, such as height, heart rate, age and weight. Countries that did not established reference values for the six-minute walk test should be encouraged to do because it would help their clinicians and researchers have a more precise interpretation of the test. PMID:27982347

Factors Contributing to Single- and Dual-Task Timed "Up & Go" Test Performance in Middle-Aged and Older Adults Who Are Active and Dwell in the Community.

PubMed

Chen, Hui-Ya; Tang, Pei-Fang

2016-03-01

Dual-task Timed "Up & Go" (TUG) tests are likely to have applications different from those of a single-task TUG test and may have different contributing factors. The purpose of this study was to compare factors contributing to performance on single- and dual-task TUG tests. This investigation was a cross-sectional study. Sixty-four adults who were more than 50 years of age and dwelled in the community were recruited. Interviews and physical examinations were performed to identify potential contributors to TUG test performance. The time to complete the single-task TUG test (TUGsingle) or the dual-task TUG test, which consisted of completing the TUG test while performing a serial subtraction task (TUGcognitive) or while carrying water (TUGmanual), was measured. Age, hip extensor strength, walking speed, general mental function, and Stroop scores for word and color were significantly associated with performance on all TUG tests. Hierarchical multiple regression models, without the input of walking speed, revealed different independent factors contributing to TUGsingle performance (Mini-Mental Status Examination score, β=-0.32), TUGmanual performance (age, β=0.35), and TUGcognitive performance (Stroop word score, β=-0.40; Mini-Mental Status Examination score, β=-0.31). At least 40% of the variance in the performance on the 3 TUG tests was not explained by common clinical measures, even when the factor of walking speed was considered. However, this study successfully identified some important factors contributing to performance on different TUG tests, and other studies have reported similar findings for single-task TUG test and dual-task gait performance. Although the TUGsingle and the TUGcognitive shared general mental function as a common factor, the TUGmanual was uniquely influenced by age and the TUGcognitive was uniquely influenced by focused attention. These results suggest that both common and unique factors contribute to performance on single- and dual-task TUG tests and suggest important applications of the combined use of the 3 TUG tests. © 2016 American Physical Therapy Association.

Dog ownership, dog walking, and leisure-time walking among Taiwanese metropolitan and nonmetropolitan older adults.

PubMed

Liao, Yung; Huang, Pin-Hsuan; Chen, Yi-Ling; Hsueh, Ming-Chun; Chang, Shao-Hsi

2018-04-04

This study examined the prevalence of dog ownership and dog walking and its association with leisure-time walking among metropolitan and nonmetropolitan older adults. A telephone-based cross-sectional survey targeting Taiwanese older adults was conducted in November 2016. Data related to dog ownership, time spent dog walking (categorized as non-dog owner, non-dog walkers, and dog walkers), and sociodemographic variables were obtained from 1074 older adults. Adjusted binary logistic regression was then performed. In this sample, 12% of Taiwanese older adults owned a dog and 31% of them walked their dogs for an average of 232.13 min over 5.9 days/week (standard deviation = 2.03). Older adults living in nonmetropolitan areas were more likely to own a dog (14.7% vs. 9.1%) but less likely to walk their dog (25.9% vs. 39.6%) than were those living in metropolitan areas. Compared with non-dog owners, only older adults living in nonmetropolitan areas who were dog walkers achieved 150 min of leisure-time walking (odds ratio: 3.03, 95% confidence interval: 1.05-8.77), after adjustment for potential confounders. Older Taiwanese adults living in nonmetropolitan areas who owned and walked their dogs were more likely to achieve health-enhancing levels of leisure-time walking. Tailored physical activity interventions for promoting dog walking should be developed for older adults who are dog owners living in nonmetropolitan areas and who do not engage in dog walking.

Social inequality in walking speed in early old age in the Whitehall II study.

PubMed

Brunner, Eric; Shipley, Martin; Spencer, Victoria; Kivimaki, Mika; Chandola, Tarani; Gimeno, David; Singh-Manoux, Archana; Guralnik, Jack; Marmot, Michael

2009-10-01

We investigated social inequalities in walking speed in early old age. Walking speed was measured by timed 8-ft (2.44 m) test in 6,345 individuals, with mean age of 61.1 (SD 6.0) years. Current or last known civil service employment grade defined socioeconomic position. Mean walking speed was 1.36 (SD 0.29) m/s in men and 1.21 (SD 0.30) in women. Average age- and ethnicity-adjusted walking speed was approximately 13% higher in the highest employment grade compared with the lowest. Based on the relative index of inequality (RII), the difference in walking speed across the social hierarchy was 0.15 m/s (95% confidence interval [CI] 0.12-0.18) in men and 0.17 m/s (0.12-0.22) in women, corresponding to an age-related difference of 18.7 (13.6-23.8) years in men and 14.9 (9.9-19.9) years in women. The RII for slow walking speed (logistic model for lowest sex-specific quartile vs others) adjusted for age, sex, and ethnicity was 3.40 (2.64-4.36). Explanatory factors for the social gradient in walking speed included Short-Form 36 physical functioning, labor market status, financial insecurity, height, and body mass index. Demographic, psychosocial, behavioral, biologic, and health factors in combination accounted for 40% of social inequality in walking speed. Social inequality in walking speed is substantial in early old age and reflects many factors beyond the direct effects of physical health.

Reliability and validity of bilateral ankle accelerometer algorithms for activity recognition and walking speed after stroke.

PubMed

Dobkin, Bruce H; Xu, Xiaoyu; Batalin, Maxim; Thomas, Seth; Kaiser, William

2011-08-01

Outcome measures of mobility for large stroke trials are limited to timed walks for short distances in a laboratory, step counters and ordinal scales of disability and quality of life. Continuous monitoring and outcome measurements of the type and quantity of activity in the community would provide direct data about daily performance, including compliance with exercise and skills practice during routine care and clinical trials. Twelve adults with impaired ambulation from hemiparetic stroke and 6 healthy controls wore triaxial accelerometers on their ankles. Walking speed for repeated outdoor walks was determined by machine-learning algorithms and compared to a stopwatch calculation of speed for distances not known to the algorithm. The reliability of recognizing walking, exercise, and cycling by the algorithms was compared to activity logs. A high correlation was found between stopwatch-measured outdoor walking speed and algorithm-calculated speed (Pearson coefficient, 0.98; P=0.001) and for repeated measures of algorithm-derived walking speed (P=0.01). Bouts of walking >5 steps, variations in walking speed, cycling, stair climbing, and leg exercises were correctly identified during a day in the community. Compared to healthy subjects, those with stroke were, as expected, more sedentary and slower, and their gait revealed high paretic-to-unaffected leg swing ratios. Test-retest reliability and concurrent and construct validity are high for activity pattern-recognition Bayesian algorithms developed from inertial sensors. This ratio scale data can provide real-world monitoring and outcome measurements of lower extremity activities and walking speed for stroke and rehabilitation studies.

Continuous-time quantum random walks require discrete space

NASA Astrophysics Data System (ADS)

Manouchehri, K.; Wang, J. B.

2007-11-01

Quantum random walks are shown to have non-intuitive dynamics which makes them an attractive area of study for devising quantum algorithms for long-standing open problems as well as those arising in the field of quantum computing. In the case of continuous-time quantum random walks, such peculiar dynamics can arise from simple evolution operators closely resembling the quantum free-wave propagator. We investigate the divergence of quantum walk dynamics from the free-wave evolution and show that, in order for continuous-time quantum walks to display their characteristic propagation, the state space must be discrete. This behavior rules out many continuous quantum systems as possible candidates for implementing continuous-time quantum random walks.

Comparison between treadmill training with rhythmic auditory stimulation and ground walking with rhythmic auditory stimulation on gait ability in chronic stroke patients: A pilot study.

PubMed

Park, Jin; Park, So-yeon; Kim, Yong-wook; Woo, Youngkeun

2015-01-01

Generally, treadmill training is very effective intervention, and rhythmic auditory stimulation is designed to feedback during gait training in stroke patients. The purpose of this study was to compare the gait abilities in chronic stroke patients following either treadmill walking training with rhythmic auditory stimulation (TRAS) or over ground walking training with rhythmic auditory stimulation (ORAS). Nineteen subjects were divided into two groups: a TRAS group (9 subjects) and an ORAS group (10 subjects). Temporal and spatial gait parameters and motor recovery ability were measured before and after the training period. Gait ability was measured by the Biodex Gait trainer treadmill system, Timed up and go test (TUG), 6 meter walking distance (6MWD) and Functional gait assessment (FGA). After the training periods, the TRAS group showed a significant improvement in walking speed, step cycle, step length of the unaffected limb, coefficient of variation, 6MWD, and, FGA when compared to the ORAS group (p <  0.05). Treadmill walking training during the rhythmic auditory stimulation may be useful for rehabilitation of patients with chronic stroke.

Investigating the correlation between paediatric stride interval persistence and gross energy expenditure.

PubMed

Fairley, Jillian A; Sejdić, Ervin; Chau, Tom

2010-02-26

Stride interval persistence, a term used to describe the correlation structure of stride interval time series, is thought to provide insight into neuromotor control, though its exact clinical meaning has not yet been realized. Since human locomotion is shaped by energy efficient movements, it has been hypothesized that stride interval dynamics and energy expenditure may be inherently tied, both having demonstrated similar sensitivities to age, disease, and pace-constrained walking. This study tested for correlations between stride interval persistence and measures of energy expenditure including mass-specific gross oxygen consumption per minute (VO₂), mass-specific gross oxygen cost per meter (VO₂) and heart rate (HR). Metabolic and stride interval data were collected from 30 asymptomatic children who completed one 10-minute walking trial under each of the following conditions: (i) overground walking, (ii) hands-free treadmill walking, and (iii) handrail-supported treadmill walking. Stride interval persistence was not significantly correlated with (p > 0.32), VO₂ (p > 0.18) or HR (p > 0.56). No simple linear dependence exists between stride interval persistence and measures of gross energy expenditure in asymptomatic children when walking overground and on a treadmill.

Walking for Transportation and Leisure Among U.S. Adults—National Health Interview Survey 2010

PubMed Central

Paul, Prabasaj; Carlson, Susan A.; Carroll, Dianna D.; Berrigan, David; Fulton, Janet E.

2015-01-01

Background Walking, the most commonly reported physical activity among U.S. adults, is undertaken in various domains, including transportation and leisure. Methods This study examined prevalence, bout length, and mean amount of walking in the last week for transportation and leisure, by selected characteristics. Self-reported data from the 2010 National Health Interview Survey (N = 24,017) were analyzed. Results Prevalence of transportation walking was 29.4% (95% CI: 28.6%–30.3%) and of leisure walking was 50.0% (95% CI: 49.1%–51.0%). Prevalence of transportation walking was higher among men; prevalence of leisure walking was higher among women. Most (52.4%) transportation walking bouts were 10 to 15 minutes; leisure walking bouts were distributed more evenly (28.0%, 10–15 minutes; 17.1%, 41–60 minutes). Mean time spent in transportation walking was higher among men, decreased with increasing BMI, and varied by race/ethnicity and region of residence. Mean time spent leisure walking increased with increasing age and with decreasing BMI. Conclusion Demographic correlates and patterns of walking differ by domain. Interventions focusing on either leisure or transportation walking should consider correlates for the specific walking domain. Assessing prevalence, bout length, and mean time of walking for transportation and leisure separately allows for more comprehensive surveillance of walking. PMID:25133651

Recovery of dynamic balance after general anesthesia with sevoflurane in short-duration oral surgery.

PubMed

Fujisawa, Toshiaki; Miyamoto, Eriko; Takuma, Shigeru; Shibuya, Makiko; Kurozumi, Akihiro; Kimura, Yukifumi; Kamekura, Nobuhito; Fukushima, Kazuaki

2009-01-01

Recovery of dynamic balance, involving adjustment of the center of gravity, is essential for safe discharge on foot after ambulatory anesthesia. The purpose of this study was to assess the recovery of dynamic balance after general anesthesia with sevoflurane, using two computerized dynamic posturographies. Nine hospitalized patients undergoing oral surgery of less than 2 h duration under general anesthesia (air-oxygensevoflurane) were studied. A dynamic balance test, assessing the ability of postural control against unpredictable perturbation stimuli (Stability System; Biodex Medical), a walking analysis test using sheets with foot pressure sensors (Walk Way-MG1000; Anima), and two simple psychomotor function tests were performed before anesthesia (baseline), and 150 and 210 min after the emergence from anesthesia. Only the double-stance phase in the walking analysis test showed a significant difference between baseline and results at 150 min. None of the other variables showed any differences among results at baseline and at 150 and 210 min. The recovery times for dynamic balance and psychomotor function seem to be within 150 min after emergence from general anesthesia with sevoflurane in patients undergoing oral surgery of less than 2-h duration.

Influence of restricted vision and knee joint range of motion on gait properties during level walking and stair ascent and descent.

PubMed

Demura, Tomohiro; Demura, Shin-ich

2011-01-01

Because elderly individuals experience marked declines in various physical functions (e.g., vision, joint function) simultaneously, it is difficult to clarify the individual effects of these functional declines on walking. However, by imposing vision and joint function restrictions on young men, the effects of these functional declines on walking can be clarified. The authors aimed to determine the effect of restricted vision and range of motion (ROM) of the knee joint on gait properties while walking and ascending or descending stairs. Fifteen healthy young adults performed level walking and stair ascent and descent during control, vision restriction, and knee joint ROM restriction conditions. During level walking, walking speed and step width decreased, and double support time increased significantly with vision and knee joint ROM restrictions. Stance time, step width, and walking angle increased only with knee joint ROM restriction. Stance time, swing time, and double support time were significantly longer in level walking, stair descent, and stair ascent, in that order. The effects of vision and knee joint ROM restrictions were significantly larger than the control conditions. In conclusion, vision and knee joint ROM restrictions affect gait during level walking and stair ascent and descent. This effect is marked in stair ascent with knee joint ROM restriction.

Musical motor feedback (MMF) in walking hemiparetic stroke patients: randomized trials of gait improvement.

PubMed

Schauer, Michael; Mauritz, Karl-Heinz

2003-11-01

To demonstrate the effect of rhythmical auditory stimulation in a musical context for gait therapy in hemiparetic stroke patients, when the stimulation is played back measure by measure initiated by the patient's heel-strikes (musical motor feedback). Does this type of musical feedback improve walking more than a less specific gait therapy? The randomized controlled trial considered 23 registered stroke patients. Two groups were created by randomization: the control group received 15 sessions of conventional gait therapy and the test group received 15 therapy sessions with musical motor feedback. Inpatient rehabilitation hospital. Median post-stroke interval was 44 days and the patients were able to walk without technical aids with a speed of approximately 0.71 m/s. Gait velocity, step duration, gait symmetry, stride length and foot rollover path length (heel-on-toe-off distance). The test group showed more mean improvement than the control group: stride length increased by 18% versus 0%, symmetry deviation decreased by 58% versus 20%, walking speed increased by 27% versus 4% and rollover path length increased by 28% versus 11%. Musical motor feedback improves the stroke patient's walk in selected parameters more than conventional gait therapy. A fixed memory in the patient's mind about the song and its timing may stimulate the improvement of gait even without the presence of an external pacemaker.

The environmental correlates of overall and neighborhood based recreational walking (a cross-sectional analysis of the RECORD Study).

PubMed

Chaix, Basile; Simon, Chantal; Charreire, Hélène; Thomas, Frédérique; Kestens, Yan; Karusisi, Noëlla; Vallée, Julie; Oppert, Jean-Michel; Weber, Christiane; Pannier, Bruno

2014-02-21

Preliminary evidence suggests that recreational walking has different environmental determinants than utilitarian walking. However, previous studies are limited in their assessment of environmental exposures and recreational walking and in the applied modeling strategies. Accounting for individual sociodemographic profiles and weather over the walking assessment period, the study examined whether numerous street network-based neighborhood characteristics related to the sociodemographic, physical, service, social-interactional, and symbolic environments were associated with overall recreational walking and recreational walking in one's residential neighborhood and could explain their spatial distribution. Based on the RECORD Cohort Study (Paris region, France, n=7105, 2007-2008 data), multilevel-spatial regression analyses were conducted to investigate environmental factors associated with recreational walking (evaluated by questionnaire at baseline). A risk score approach was applied to quantify the overall disparities in recreational walking that were predicted by the environmental determinants. Sixty-nine percent of the participants reported recreational walking over the past 7 days. Their mean reported recreational walking time was 3h 31mn. After individual-level adjustment, a higher neighborhood education, a higher density of destinations, green and open spaces of quality, and the absence of exposure to air traffic were associated with higher odds of recreational walking and/or a higher recreational walking time in one's residential neighborhood. As the overall disparities that were predicted by these environmental factors, the odds of reporting recreational walking and the odds of a higher recreational walking time in one's neighborhood were, respectively, 1.59 [95% confidence interval (CI): 1.56, 1.62] times and 1.81 (95% CI: 1.73, 1.87) times higher in the most vs. the least supportive environments (based on the quartiles). Providing green/open spaces of quality, building communities with services accessible from the residence, and addressing environmental nuisances such as those related to air traffic may foster recreational walking in one's environment.

The environmental correlates of overall and neighborhood based recreational walking (a cross-sectional analysis of the RECORD Study)

PubMed Central

2014-01-01

Background Preliminary evidence suggests that recreational walking has different environmental determinants than utilitarian walking. However, previous studies are limited in their assessment of environmental exposures and recreational walking and in the applied modeling strategies. Accounting for individual sociodemographic profiles and weather over the walking assessment period, the study examined whether numerous street network-based neighborhood characteristics related to the sociodemographic, physical, service, social-interactional, and symbolic environments were associated with overall recreational walking and recreational walking in one’s residential neighborhood and could explain their spatial distribution. Methods Based on the RECORD Cohort Study (Paris region, France, n = 7105, 2007–2008 data), multilevel-spatial regression analyses were conducted to investigate environmental factors associated with recreational walking (evaluated by questionnaire at baseline). A risk score approach was applied to quantify the overall disparities in recreational walking that were predicted by the environmental determinants. Results Sixty-nine percent of the participants reported recreational walking over the past 7 days. Their mean reported recreational walking time was 3h31mn. After individual-level adjustment, a higher neighborhood education, a higher density of destinations, green and open spaces of quality, and the absence of exposure to air traffic were associated with higher odds of recreational walking and/or a higher recreational walking time in one’s residential neighborhood. As the overall disparities that were predicted by these environmental factors, the odds of reporting recreational walking and the odds of a higher recreational walking time in one’s neighborhood were, respectively, 1.59 [95% confidence interval (CI): 1.56, 1.62] times and 1.81 (95% CI: 1.73, 1.87) times higher in the most vs. the least supportive environments (based on the quartiles). Conclusions Providing green/open spaces of quality, building communities with services accessible from the residence, and addressing environmental nuisances such as those related to air traffic may foster recreational walking in one’s environment. PMID:24555820

Walk Test Used to Monitor the Performance in the Health-Directed Nordic Walking

ERIC Educational Resources Information Center

Kamien, Dorota

2008-01-01

Study aim: To assess the performance of subjects engaged in health-directed Nordic Walking training (with poles) and subjected to 2-km walk test (no poles). Material and methods: A total of 72 subjects, including 8 men and 32 women aged 23-73 years and 32 female students aged 19-25 years participated in the study. They were subjected twice to 2-km…

Physiological response to the 6-minute walk test in chronic heart failure patients versus healthy control subjects.

PubMed

Deboeck, Gaël; Van Muylem, Alain; Vachiéry, Jean Luc; Naeije, Robert

2014-08-01

The distance walked in 6 minutes (6MWD) has been reported to be linearly related to peak oxygen uptake (VO2) in cardiac diseases and in lung diseases. In these patients, the VO2 during a 6-min walk test (walkVO2) has been found to be nearly equivalent to peakVO2, but with a lower respiratory exchange ratio (RER). Whether these observations translate to the less functionally impaired patients or healthy control subjects is not exactly known. Thirty-two healthy control subjects and 15 chronic heart failure (CHF) patients performed a 6-min walk test and a maximal cardiopulmonary exercise test (CPET) both with measurements of gas exchange. The 6MWD and peakVO2 were linearly correlated, but with an increased slope appearing above 532 m. In CHF patients, walkVO2 was similar to peakVO2, but with lower heart rate and ventilation than measured at peak exercise. In healthy control subjects, VO2, ventilation and heart rate were lower during the 6-min walk than at maximal exercise but higher than at the anaerobic threshold. The RER during the 6-min walk remained <1 in both groups. Above 500 m, 6MWD becomes less sensitive to any increase in peakVO2. Furthermore, CHF patients and healthy control subjects exercise respectively at maximal and high VO2, but below the anaerobic threshold (as assessed by a CPET) during the 6-min walk test. © The European Society of Cardiology 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Ultrafast Single-Shot Optical Oscilloscope based on Time-to-Space Conversion due to Temporal and Spatial Walk-Off Effects in Nonlinear Mixing Crystal

NASA Astrophysics Data System (ADS)

Takagi, Yoshihiro; Yamada, Yoshifumi; Ishikawa, Kiyoshi; Shimizu, Seiji; Sakabe, Shuji

2005-09-01

A simple method for single-shot sub-picosecond optical pulse diagnostics has been demonstrated by imaging the time evolution of the optical mixing onto the beam cross section of the sum-frequency wave when the interrogating pulse passes over the tested pulse in the mixing crystal as a result of the combined effect of group-velocity difference and walk-off beam propagation. A high linearity of the time-to-space projection is deduced from the process solely dependent upon the spatial uniformity of the refractive indices. A snap profile of the accidental coincidence between asynchronous pulses from separate mode-locked lasers has been detected, which demonstrates the single-shot ability.

Separate physical tests of lower extremities and postural control are associated with cognitive impairment. Results from the general population study Good Aging in Skåne (GÅS-SNAC)

PubMed Central

Bramell-Risberg, Eva; Jarnlo, Gun-Britt; Elmståhl, Sölve

2012-01-01

Purpose To investigate whether separate physical tests of the lower extremities, that assess movement speed and postural control, were associated with cognitive impairment in older community-dwelling subjects. Subjects and methods In this population-based, cross-sectional, cohort study, the following items were assessed: walking speed, walking 2 × 15 m, Timed Up and Go (TUG) at self-selected and fast speeds, one-leg standing, and performance in step- and five chair-stand tests. The study comprised 2115 subjects, aged 60–93 years, with values adjusted for demographics, health-related factors, and comorbidity. Global cognitive function was assessed using the Mini-Mental State Examination (MMSE), and cognitive impairment was defined by the three-word delayed recall task of the MMSE. Subjects who scored 0/3 on the three-word delayed recall task were defined as cases (n = 328), those who scored 1/3 were defined as intermediates (n = 457), and the others as controls (n = 1330). Results Physical tests performed rapidly were significantly associated with cognitive impairment; this was the case in increased time of five chair stands (P = 0.009, odds ratio [OR] = 1.03), TUG (P < 0.001, OR = 1.11) and walking 2 × 15 m (P < 0.001, OR = 1.05). Inability to stand on one leg for 10 seconds was associated with increased risk of being a case (P < 0.001, OR = 1.78), compared to those able to stand for 30 seconds or longer. More steps during the step test (P < 0.001, OR = 0.95) and higher fast walking speed (P < 0.001, OR = 0.51) were associated with lower risk of being a case. Conclusion Slower movements and reduced postural control were related to an increased risk of being cognitively impaired. All tests that were performed rapidly were able to separate cases from controls. These findings suggest that physical tests that are related to lower extremity and postural control, emphasizing velocity, might be useful in investigating relationships between physical and cognitive function; furthermore, they can be used to complement cognitive impairment diagnoses. PMID:22807629

78 FR 12827 - Petition for Waiver of Compliance

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-25

... that the conductor does not have adequate time to remain at the rear of the train to perform the brake test while the engineer changes operating position and then walk forward to the conductor's operating...

[Sub-maximal aerobic capacity and quality of life of patients with rheumatoid arthritis].

PubMed

Lataoui, S; Belghali, S; Zeglaoui, H; Bouajina, E; Ben Saad, H

2017-01-01

Studies about sub-maximal aerobic capacity of patients with rheumatoid arthritis are scarce. To assess the sub-maximal aerobic capacity of these patients through the 6-min walk test, estimated age of the "muscular and cardiorespiratory" chain. Thirty-seven consecutive patients (aged 20 to 60 years) with newly diagnosed rheumatoid arthritis will be included. Non-inclusion criteria will be: use of drugs (e.g.; methotrexate, beta-blockers), orthopaedic or rheumatologic conditions (other than rheumatoid arthritis) that may alter walking ability and recent infections. Exclusion criteria will be: 6-min walking test contra-indications and imperfect performance of the required lung function and walking maneuvers. Signs of walking intolerance will be: test interruption, distance ≤lower limit of normal, dyspnea score ≥5/10 (visual analogue scale) at the end of the test, haemoglobin oxygen saturation (SpO 2 ) drop ≥5%, cardiac frequency at the end of the test ≤60% of maximum predicted. An estimated "muscular and cardiorespiratory chain" age higher than the chronological one will be considered as a sign of accelerated ageing. A high percentage of patients suffering from rheumatoid arthritis would show evidences of walking limitation and accelerated "muscular and cardiorespiratory chain" ageing. There would be a significant correlation between the walking test and clinical, biological, radiological and pulmonary function data and the patients' quality-of-life status. Copyright © 2016 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Training to Facilitate Adaptation to Novel Sensory Environments

NASA Technical Reports Server (NTRS)

Bloomberg, J. J.; Peters, B. T.; Mulavara, A. P.; Brady, R. A.; Batson, C. D.; Ploutz-Snyder, R. J.; Cohen, H. S.

2010-01-01

After spaceflight, the process of readapting to Earth s gravity causes locomotor dysfunction. We are developing a gait training countermeasure to facilitate adaptive responses in locomotor function. Our training system is comprised of a treadmill placed on a motion-base facing a virtual visual scene that provides an unstable walking surface combined with incongruent visual flow designed to train subjects to rapidly adapt their gait patterns to changes in the sensory environment. The goal of our present study was to determine if training improved both the locomotor and dual-tasking ability responses to a novel sensory environment and to quantify the retention of training. Subjects completed three, 30-minute training sessions during which they walked on the treadmill while receiving discordant support surface and visual input. Control subjects walked on the treadmill without any support surface or visual alterations. To determine the efficacy of training, all subjects were then tested using a novel visual flow and support surface movement not previously experienced during training. This test was performed 20 minutes, 1 week, and 1, 3, and 6 months after the final training session. Stride frequency and auditory reaction time were collected as measures of postural stability and cognitive effort, respectively. Subjects who received training showed less alteration in stride frequency and auditory reaction time compared to controls. Trained subjects maintained their level of performance over 6 months. We conclude that, with training, individuals became more proficient at walking in novel discordant sensorimotor conditions and were able to devote more attention to competing tasks.

Random walks and diffusion on networks

NASA Astrophysics Data System (ADS)

Masuda, Naoki; Porter, Mason A.; Lambiotte, Renaud

2017-11-01

Random walks are ubiquitous in the sciences, and they are interesting from both theoretical and practical perspectives. They are one of the most fundamental types of stochastic processes; can be used to model numerous phenomena, including diffusion, interactions, and opinions among humans and animals; and can be used to extract information about important entities or dense groups of entities in a network. Random walks have been studied for many decades on both regular lattices and (especially in the last couple of decades) on networks with a variety of structures. In the present article, we survey the theory and applications of random walks on networks, restricting ourselves to simple cases of single and non-adaptive random walkers. We distinguish three main types of random walks: discrete-time random walks, node-centric continuous-time random walks, and edge-centric continuous-time random walks. We first briefly survey random walks on a line, and then we consider random walks on various types of networks. We extensively discuss applications of random walks, including ranking of nodes (e.g., PageRank), community detection, respondent-driven sampling, and opinion models such as voter models.

Validity and Responsiveness of the Two-Minute Walk Test for Measuring Functional Recovery After Total Knee Arthroplasty.

PubMed

Unnanuntana, Aasis; Ruangsomboon, Pakpoom; Keesukpunt, Worawut

2018-06-01

The 2-minute walk test (2mwt) is a performance-based test that evaluates functional recovery after total knee arthroplasty (TKA). This study evaluated its validity compared with the modified Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oxford Knee Score (OKS), modified Knee Score, Numerical Pain Rating Scale, and Timed Up and Go test, and its responsiveness in assessing functional recovery in TKA patients. This prospective cohort study included 162 patients undergoing primary TKA between 2013 and 2015. We used patient-reported outcome measures (modified WOMAC, OKS, modified Knee Score, Numerical Pain Rating Scale) and performance-based tests (2mwt and Timed Up and Go test) at baseline and 3, 6, and 12 months postoperatively. The construct validity of 2mwt was determined between the 2mwt distances walked and other outcome measurements. To assess responsiveness, effect size and standardized response mean were analyzed. Minimal clinically important difference of 2mwt at 12 months after TKA was also calculated. All outcome measurements improved significantly from baseline to 3, 6, and 12 months postoperatively. Bivariate analysis revealed mild to moderate associations between the 2mwt and modified WOMAC function subscales, and moderate to strong associations with OKS. Mild to moderate correlations were found for pain and stiffness between 2mwt and other outcome measurements. The effect size and standardized response mean at 12 months were large, with a minimal clinically important difference of 12.7 m. 2mwt is a validated performance-based test with responsiveness properties. Being simple and easy to perform, it can be used routinely in clinical practice to evaluate functional recovery after TKA. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Alternatives to the Six-Minute Walk Test in Pulmonary Arterial Hypertension

PubMed Central

Mainguy, Vincent; Malenfant, Simon; Neyron, Anne-Sophie; Saey, Didier; Maltais, François; Bonnet, Sébastien; Provencher, Steeve

2014-01-01

Introduction The physiological response during the endurance shuttle walk test (ESWT), the cycle endurance test (CET) and the incremental shuttle walk test (ISWT) remains unknown in PAH. We tested the hypothesis that endurance tests induce a near-maximal physiological demand comparable to incremental tests. We also hypothesized that differences in respiratory response during exercise would be related to the characteristics of the exercise tests. Methods Within two weeks, twenty-one PAH patients (mean age: 54(15) years; mean pulmonary arterial pressure: 42(12) mmHg) completed two cycling exercise tests (incremental cardiopulmonary cycling exercise test (CPET) and CET) and three field tests (ISWT, ESWT and six-minute walk test (6MWT)). Physiological parameters were continuously monitored using the same portable telemetric device. Results Peak oxygen consumption (VO2peak) was similar amongst the five exercise tests (p = 0.90 by ANOVA). Walking distance correlated markedly with the VO2peak reached during field tests, especially when weight was taken into account. At 100% exercise, most physiological parameters were similar between incremental and endurance tests. However, the trends overtime differed. In the incremental tests, slopes for these parameters rose steadily over the entire duration of the tests, whereas in the endurance tests, slopes rose sharply from baseline to 25% of maximum exercise at which point they appeared far less steep until test end. Moreover, cycling exercise tests induced higher respiratory exchange ratio, ventilatory demand and enhanced leg fatigue measured subjectively and objectively. Conclusion Endurance tests induce a maximal physiological demand in PAH. Differences in peak respiratory response during exercise are related to the modality (cycling vs. walking) rather than the progression (endurance vs. incremental) of the exercise tests. PMID:25111294

Alternatives to the six-minute walk test in pulmonary arterial hypertension.

PubMed

Mainguy, Vincent; Malenfant, Simon; Neyron, Anne-Sophie; Saey, Didier; Maltais, François; Bonnet, Sébastien; Provencher, Steeve

2014-01-01

The physiological response during the endurance shuttle walk test (ESWT), the cycle endurance test (CET) and the incremental shuttle walk test (ISWT) remains unknown in PAH. We tested the hypothesis that endurance tests induce a near-maximal physiological demand comparable to incremental tests. We also hypothesized that differences in respiratory response during exercise would be related to the characteristics of the exercise tests. Within two weeks, twenty-one PAH patients (mean age: 54(15) years; mean pulmonary arterial pressure: 42(12) mmHg) completed two cycling exercise tests (incremental cardiopulmonary cycling exercise test (CPET) and CET) and three field tests (ISWT, ESWT and six-minute walk test (6MWT)). Physiological parameters were continuously monitored using the same portable telemetric device. Peak oxygen consumption (VO(2peak)) was similar amongst the five exercise tests (p = 0.90 by ANOVA). Walking distance correlated markedly with the VO(2peak) reached during field tests, especially when weight was taken into account. At 100% exercise, most physiological parameters were similar between incremental and endurance tests. However, the trends overtime differed. In the incremental tests, slopes for these parameters rose steadily over the entire duration of the tests, whereas in the endurance tests, slopes rose sharply from baseline to 25% of maximum exercise at which point they appeared far less steep until test end. Moreover, cycling exercise tests induced higher respiratory exchange ratio, ventilatory demand and enhanced leg fatigue measured subjectively and objectively. Endurance tests induce a maximal physiological demand in PAH. Differences in peak respiratory response during exercise are related to the modality (cycling vs. walking) rather than the progression (endurance vs. incremental) of the exercise tests.

Reducing robotic guidance during robot-assisted gait training improves gait function: a case report on a stroke survivor.

PubMed

Krishnan, Chandramouli; Kotsapouikis, Despina; Dhaher, Yasin Y; Rymer, William Z

2013-06-01

To test the feasibility of patient-cooperative robotic gait training for improving locomotor function of a chronic stroke survivor with severe lower-extremity motor impairments. Single-subject crossover design. Performed in a controlled laboratory setting. A 62-year-old man with right temporal lobe ischemic stroke was recruited for this study. The baseline lower-extremity Fugl-Meyer score of the subject was 10 on a scale of 34, which represented severe impairment in the paretic leg. However, the subject had a good ambulation level (community walker with the aid of a stick cane and ankle-foot orthosis) and showed no signs of sensory or cognitive impairments. The subject underwent 12 sessions (3 times per week for 4wk) of conventional robotic training with the Lokomat, where the robot provided full assistance to leg movements while walking, followed by 12 sessions (3 times per week for 4wk) of patient-cooperative robotic control training, where the robot provided minimal guidance to leg movements during walking. Clinical outcomes were evaluated before the start of the intervention, immediately after 4 weeks of conventional robotic training, and immediately after 4 weeks of cooperative control robotic training. These included: (1) self-selected and fast walking speed, (2) 6-minute walk test, (3) Timed Up & Go test, and (4) lower-extremity Fugl-Meyer score. Results showed that clinical outcomes changed minimally after full guidance robotic training, but improved considerably after 4 weeks of reduced guidance robotic training. The findings from this case study suggest that cooperative control robotic training is superior to conventional robotic training and is a feasible option to restoring locomotor function in ambulatory stroke survivors with severe motor impairments. A larger trial is needed to verify the efficacy of this advanced robotic control strategy in facilitating gait recovery after stroke. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Balance in Astronauts Performing Jumps, Walking and Quiet Stance Following Spaceflight

NASA Technical Reports Server (NTRS)

Reschke, Millard F.; Bloomberg, J. J.; Wood, S. J.; Harm, D. L.

2011-01-01

Introduction: Both balance and locomotor ataxia is severe in astronauts returning from spaceflight with serious implications for unassisted landings. As a part of an ongoing effort to demonstrate the functional significance of the postflight ataxia problem our laboratory has evaluated jumping, walking heel-to-toe and quite stance balance immediately following spaceflight. Methods: Six astronauts from 12-16 day flights and three from 6-month flights were asked to perform three self-initiated two-footed jumps from a 30-cm-high platform, walking for 10 steps (three trials) placing the feet heel to toe in tandem, arms folded across the chest and the eyes closed, and lastly, recover from a simulated fall by standing from a prone position on the floor and with eyes open maintain a quiet stance for 3 min with arms relaxed along the side of the body and feet comfortably positioned on a force plate. Crewmembers were tested twice before flight, on landing day (short-duration), and days 1, 6, and 30 following all flight durations. Results/Conclusions: Many of astronauts tested fell on their first postflight jump but recovered by the third jump showing a rapid learning progression. Changes in take-off strategy were clearly evident in duration of time in the air between the platform and the ground (significant reduction in time to land), and also in increased asymmetry in foot latencies on take-off postflight. During the tandem heel-to-toe walking task there was a significant decrease in percentage of correct steps on landing day (short-duration crew) and on first day following landing (long-duration) with only partial recovery the following day. Astronauts for both short and long duration flight times appeared to be unaware of foot position relative to their bodies or the floor. During quite stance most of crewmembers tested exhibited increased stochastic activity (larger short-term COP diffusion coefficients postflight in all planes and increases in mean sway speed).

Response-Time Tests of Logical-Rule Models of Categorization

ERIC Educational Resources Information Center

Little, Daniel R.; Nosofsky, Robert M.; Denton, Stephen E.

2011-01-01

A recent resurgence in logical-rule theories of categorization has motivated the development of a class of models that predict not only choice probabilities but also categorization response times (RTs; Fific, Little, & Nosofsky, 2010). The new models combine mental-architecture and random-walk approaches within an integrated framework and…

Six-minute walking test done in a hallway or on a treadmill: how close do the two methods agree?

PubMed

Lenssen, Antoine F; Wijnen, Lambert C A M; Vankan, Dion G; Van Eck, Bart H; Berghmans, Danielle P; Roox, George M

2010-12-01

The 6-min walking test (6-MWT) is probably the most widely used test to measure the functional capacity in cardiac rehabilitation. Although the American Thoracic Society recommends testing on a flat surface, treadmills are also used for testing. Therefore, we want to investigate the interchangeability of results of treadmill and hallway 6-MWT in a population of patients participating in a cardiac rehabilitation programme. Preexperimental design. University hospital Department of Cardiology and Physiotherapy. Patients entering the cardiac rehabilitation programme of the Maastricht University Cardiology Department. Agreement in 6-min walking distance between the hallway and treadmill test results were calculated by taking the mean difference between the two methods and the 95% confidence interval of the difference and plotting this against the average of the two test results. A Bland and Altman plot was constructed, showing the mean difference and the 95% limits of agreement between the two methods. Sixty-nine patients participated in this study. Mean difference between walking on a treadmill and walking in a hallway was 9 m in favour of the hallway test. The 95% limits of agreement were±118 m. Results of the 6-MWT conducted in a hallway or on a treadmill are not interchangeable, because of large between-test variations in the distances walked by individual participants.

Does walking strategy in older people change as a function of walking distance?

PubMed

Najafi, Bijan; Helbostad, Jorunn L; Moe-Nilssen, Rolf; Zijlstra, Wiebren; Aminian, Kamiar

2009-02-01

This study investigates whether the spatio-temporal parameters of gait in the elderly vary as a function of walking distance. The gait pattern of older subjects (n=27) over both short (SWD<10 m) and long (LWD>20 m) walking was evaluated using an ambulatory device consisting of body-worn sensors (Physilog). The stride velocity (SV), gait cycle time (GCT), and inter-cycle variability of each parameter (CV) were evaluated for each subject. Analysis was undertaken after evaluating the errors and the test-retest reliability of the Physilog device compared with an electronic walkway system (GaitRite) over the SWD with different walking speeds. While both systems were highly reliable with respect to the SV and GCT parameters (ICC>0.82), agreement for the gait variability was poor. Interestingly, our data revealed that the measured gait parameters over SWD and LWD were significantly different. LWD trials had a mean increase of 5.2% (p<0.05) in SV, and a mean decrease of 3.7% (p<0.05) in GCT compared with SWD trials. Although variability in both the SV and GCT measured during LWD trials decreased by an average of 1% relative to the SWD case, the drop was not significant. Moreover, reliability for gait variability measures was poor, irrespective of the instrument and despite a moderate improvement for LWD trials. Taken together, our findings indicate that for valid and reliable comparisons, test and retest should be performed under identical distance conditions. Furthermore, our findings suggest that the older subjects may choose different walking strategies for SWD and LWD conditions.

Pain and functional capacity in female fibromyalgia patients.

PubMed

Carbonell-Baeza, Ana; Aparicio, Virginia A; Sjöström, Michael; Ruiz, Jonatan R; Delgado-Fernández, Manuel

2011-11-01

To examine the association between pain and functional capacity levels. [corrected] Cross-sectional study. University of Granada. One hundred twenty-three women with fibromyalgia (51.7 ± 7.2 years). We measured weight and height, and body mass index (BMI) was calculated. We assessed tender points by pressure pain and functional capacity by means of the 30-second chair stand, handgrip strength, chair sit and reach, back scratch, blind flamingo, 8-ft up and go and 6-minute walk tests. We observed an association of tender points count with the chair stand and 6-minute walk tests (r = -0.273, P = 0.004 and r = -0.183, P = 0.046, respectively). These associations became nonsignificant once the analyses were adjusted by weight or BMI. We observed an association of algometer score with the back scratch, chair stand, and 6-minute walk tests (r = 0.238, P = 0.009; r = 0.363, P < 0.001; and r = 0.186, P = 0.043, respectively), which remained after adjusting for weight or BMI, except the association between algometer score and the 6-minute walk test that became nonsignificant once the analyses were adjusted by weight. Prevalence of overweight and obesity was 39.2 and 33.3%, respectively. There is an inverse association of tender points count with the chair stand and distance walked in the 6-minute walk tests, and a positive association of algometer score with the chair stand, distance walked in the 6-minute walk and back scratch tests, yet, weight status seems to play a role in these associations. Wiley Periodicals, Inc.

The impact of carrying supplemental oxygen on exercise capacity and dyspnea in patients with interstitial lung disease.

PubMed

Ramadurai, Deepa; Riordan, Maeveen; Graney, Bridget; Churney, Tara; Olson, Amy L; Swigris, Jeffrey J

2018-05-01

May patients with interstitial lung disease (ILD) require supplementary oxygen (O 2 ) therapy to maintain normoxia. However, ambulatory O 2 delivery devices are constraining and cumbersome. The physiologic and symptomatic impact of these devices on ILD patients is unknown. We conducted a prospective study of 30 clinically stable ILD patients (with varying disease severity), half of whom used O 2 at baseline. Each subject completed two six-minute walk tests (6MWTs); for O 2 users, one walk was completed while wearing a backpack (weight 7.2 pounds) containing a tank with compressed O 2 , and for non-users, one walk was completed with a similarly-weighted backpack. For each subject, during the second walk, no backpack was worn; for the second walk, O 2 users received oxygen via a stationary delivery system. For both walks, O 2 non-users wore a portable metabolic system, which measured variables related to respiratory physiology and gas exchange. Borg dyspnea and exertion ratings were recorded after each walk. Wearing the O 2 -containing backpack resulted in decreased distance covered during the 6MWT, and increased dyspnea and perceived exertion among O 2 users. While wearing the weighted backpack, O 2 non-users had a significantly lower peripheral O 2 saturation and distance-saturation product. Compared with carrying O 2 in the backpack, receiving O 2 via the stationary concentrator resulted in the largest improvement in walk distance for the three subjects with greatest impairment at baseline (6MWT ≤ 300 m). Among ILD patients, carrying portable O 2 versus receiving O 2 via a stationary concentrator results in significantly greater dyspnea and shorter distances covered in timed testing. Patients with the greatest impairment may be affected most. When prescribing O 2 , practitioners should alert patients to this effect and help patients decide on the best O 2 delivery mode to meet their needs. Copyright © 2018 Elsevier Ltd. All rights reserved.

Spatio-temporal gait disorder and gait fatigue index in a six-minute walk test in women with fibromyalgia.

PubMed

Heredia-Jimenez, Jose; Latorre-Roman, Pedro; Santos-Campos, Maria; Orantes-Gonzalez, Eva; Soto-Hermoso, Victor M

2016-03-01

Gait disorders in fibromyalgia patients affect several gait parameters and different muscle recruitment patterns. The aim of this study was to assess the gait differences observed during a six-minute walk test between fibromyalgia patients and healthy controls. Forty-eight women with fibromyalgia and 15 healthy women were evaluated. Fibromyalgia patients met the American College of Rheumatology criteria for fibromyalgia selected of an ambulatory care. Both patients and controls had a negative history of musculoskeletal disease, neurological disorders, and gait abnormalities. The 15 controls were healthy women matched to the patients in age, height and body weight. Spatio-temporal gait variables and the rate of perceived exertion during the six-minute walk test (all subjects) and Fibromyalgia Impact Questionnaire (fibromyalgia subjects) were evaluated. All walking sets on the GaitRITE were collected and the gait variables were selected at three stages during the six-minute walk test: two sets at the beginning, two sets at 3 min and two sets at the end of the test. In addition, the Fibromyalgia Impact Questionnaire was used for the fibromyalgia patients. Fibromyalgia patients showed a significant decrease in all spatio-temporal gait variables at each of the three stages and had a lower walk distance covered in the six-minute walk test and higher rate of perceived exertion. No correlations were found between the Fibromyalgia Impact Questionnaire and gait variables. The fibromyalgia and control subjects showed lower gait fatigue indices between the middle and last stages. Gait analysis during a six-minute walk test is a good tool to assess the fatigue and physical symptoms of patients with fibromyalgia. Copyright © 2016 Elsevier Ltd. All rights reserved.

Whole-Body Vibration Intensities in Chronic Stroke: A Randomized Controlled Trial.

PubMed

Liao, Lin-Rong; Ng, Gabriel Y F; Jones, Alice Y M; Huang, Mei-Zhen; Pang, Marco Y C

2016-07-01

A single-blinded randomized controlled study was conducted to investigate the effects of different whole-body vibration (WBV) intensities on body functions/structures, activity, and participation in individuals with stroke. Eighty-four individuals with chronic stroke (mean age = 61.2 yr, SD = 9.2) with mild to moderate motor impairment (Chedoke-McMaster Stroke Assessment lower limb motor score: median = 9 out of 14, interquartile range = 7-11.8) were randomly assigned to a low-intensity WBV, high-intensity WBV, or control group. The former two groups performed various leg exercises while receiving low-intensity and high-intensity WBV, respectively. Controls performed the same exercises without WBV. All individuals received 30 training sessions over an average period of 75.5 d (SD = 5.2). Outcome measurements included knee muscle strength (isokinetic dynamometry), knee and ankle joint spasticity (Modified Ashworth Scale), balance (Mini Balance Evaluation Systems Test), mobility (Timed-Up-and-Go test), walking endurance (6-Minute Walk Test), balance self-efficacy (Activities-specific Balance Confidence scale), participation in daily activities (Frenchay Activity Index), perceived environmental barriers to societal participation (Craig Hospital Inventory of Environmental Factors), and quality of life (Short-Form 12 Health Survey). Assessments were performed at baseline and postintervention. Intention-to-treat analysis revealed a significant time effect for muscle strength, Timed-Up-and-Go distance, and oxygen consumption rate achieved during the 6-Minute Walk Test, the Mini Balance Evaluation Systems Test, the Activities-specific Balance Confidence scale, and the Short-Form 12 Health Survey physical composite score domain (P < 0.05). However, the time-group interaction was not significant for any of the outcome measures (P > 0.05). The addition of the 30-session WBV paradigm to the leg exercise protocol was no more effective in enhancing body functions/structures, activity, and participation than leg exercises alone in chronic stroke patients with mild to moderate motor impairments.

Balance and gait performance after maximal and submaximal endurance exercise in seniors: is there a higher fall-risk?

PubMed

Donath, Lars; Zahner, Lukas; Roth, Ralf; Fricker, Livia; Cordes, Mareike; Hanssen, Henner; Schmidt-Trucksäss, Arno; Faude, Oliver

2013-03-01

Impaired balance and gait performance increase fall-risk in seniors. Acute effects of different exercise bouts on gait and balance were not yet addressed. Therefore, 19 healthy seniors (10 women, 9 men, age: 64.6 ± 3.2 years) were examined on 3 days. After exhaustive treadmill testing, participants randomly completed a 2-km treadmill walking test (76 ± 8 % VO(2max)) and a resting control condition. Standing balance performance (SBALP) was assessed by single limb-eyes opened (SLEO) and double limb-eyes closed (DLEC) stance. Gait parameters were collected at comfortable walking velocity. A condition × time interaction of center of pressure path length (COP(path)) was observed for both balance tasks (p < 0.001). Small (Cohen's d = 0.42, p = 0.05) and large (d = 1.04, p < 0.001) COP(path) increases were found after 2-km and maximal exercise during DLEC. Regarding SLEO, slightly increased COP(path) occurred after 2-km walking (d = 0.29, p = 0.65) and large increases after exhaustive exercise (d = 1.24, p < 0.001). No significant differences were found for gait parameters. Alterations of SBALP after exhaustive exercise might lead to higher fall-risk in seniors. Balance changes upon 2-km testing might be of minor relevance. Gait is not affected during single task walking at given velocities.

Effects of a new walking and cycling route on leisure-time physical activity of Brazilian adults: A longitudinal quasi-experiment.

PubMed

Pazin, Joris; Garcia, Leandro Martin Totaro; Florindo, Alex Antonio; Peres, Marco Aurélio; Guimarães, Adriana Coutinho de Azevedo; Borgatto, Adriano Ferreti; Duarte, Maria de Fátima da Silva

2016-05-01

The primary aim of this study was to evaluate the effects of a new walking and cycling route on leisure-time physical activity (PA) (walking and moderate-to-vigorous PA) of adults. Furthermore, we also investigated the use, intention to use and barriers to use the new route for leisure-time PA. A longitudinal quasi-experiment was carried out. Three exposure groups were defined, based on the distance from home to the new route: 0-500m, 501-1000m and 1001-1500m. Telephone-based interviews were carried out in 2009 and 2012. Those living around the new walking and cycling route increased their leisure-time walking by 15min/week on average. Those residing up to 500m from the route increased leisure-time walking by 30min/week and walking plus moderate-to-vigorous PA by 50min/week. The proportion of people who started walking or practicing moderate-to-vigorous PA during leisure time and who reported intention to use the new route was higher among those living closer to it. Perceived distance was the most prevalent barrier to use the new route. Copyright © 2016 Elsevier Ltd. All rights reserved.

Comparison of walking performance over the first 2 minutes and the full 6 minutes of the Six-Minute Walk Test

PubMed Central

2014-01-01

Background Although the Six-Minute Walk Test (6MWT), as recommended by the American Thoracic Society, is widely used as a measure of functional endurance, it may not be applicable in some settings and populations. We sought to examine, therefore, performance over the first 2 minutes and the full 6 minutes of the 6MWT. Specifically, we investigated completion rates, distances walked, test-retest reliability, and the relationship between distances walked over the first 2 and the full 6 minutes of the 6MWT. Methods Community-dwelling children and adults age 3–85 years (n = 337) were asked to walk back and forth on a 15.24 meter (50 ft) course as far as possible without running over a 6 minute period. Test completion and the distance covered by the participants at 2 and 6 minutes were documented. The reliability of distances covered at 2 and 6 minutes was determined by retesting a subsample of 54 participants 6 to 10 days later. The relationship between distances covered at 2 and 6 minutes was determined for the 330 participants completing the 6MWT. Results All 337 participants completed at least 2 minutes of walking, but 7 children less than 5 years of age ceased walking before 6 minutes had elapsed. For the remaining 330 participants the mean distance walked was 186 meters at 2 minutes and 543 meters at 6 minutes. The distances covered at 2 and 6 minutes were reliable between sessions (intraclass correlation coefficients = 0.888 and 0.917, respectively). The distances covered over 2 and 6 minutes were highly correlated (r = 0.968). Conclusions The completion rate, values obtained, test-retest reliability, and relationship of the distances walked in 2 and 6 minutes support documentation of 2 minute distance during the 6MWT. The findings also provide support for use of a Two-Minute Walk Test as the endurance component in the Motor Battery of the NIH Toolbox. PMID:24767634

Measuring Steady-State Oxygen Uptake during the 6-Min Walk Test in Adults with Cerebral Palsy: Feasibility and Construct Validity

ERIC Educational Resources Information Center

Maltais, Desiree B.; Robitaille, Nancy-Michelle; Dumas, Francine; Boucher, Normand; Richards, Carol L.

2012-01-01

This study evaluated the feasibility of measuring steady-state oxygen uptake (V[Combining Dot Above]O[subscript 2]) during the 6-min walk test (6MWT) in adults with cerebral palsy (CP) who walk without support and whether there is construct validity for net 6MWT V[Combining Dot Above]O[subscript 2] as a measure of their walking ability.…

Changes in the built environment and changes in the amount of walking over time: longitudinal results from the multi-ethnic study of atherosclerosis.

PubMed

Hirsch, Jana A; Moore, Kari A; Clarke, Philippa J; Rodriguez, Daniel A; Evenson, Kelly R; Brines, Shannon J; Zagorski, Melissa A; Diez Roux, Ana V

2014-10-15

Lack of longitudinal research hinders causal inference on the association between the built environment and walking. In the present study, we used data from 6,027 adults in the Multi-Ethnic Study of Atherosclerosis who were 45-84 years of age at baseline to investigate the association of neighborhood built environment with trends in the amount of walking between 2000 and 2012. Walking for transportation and walking for leisure were assessed at baseline and at 3 follow-up visits (median follow-up = 9.15 years). Time-varying built environment measures (measures of population density, land use, number of destinations, bus access, and street connectivity) were created using geographic information systems. We used linear mixed models to estimate the associations between baseline levels of and a change in each built environment feature and a change in the frequency of walking. After adjustment for potential confounders, we found that higher baseline levels of population density, area zoned for retail, social destinations, walking destinations, and street connectivity were associated with greater increases in walking for transportation over time. Higher baseline levels of land zoned for residential use and distance to buses were associated with less pronounced increases (or decreases) in walking for transportation over time. Increases in the number of social destinations, the number of walking destinations, and street connectivity over time were associated with greater increases in walking for transportation. Higher baseline levels of both land zoned for retail and walking destinations were associated with greater increases in leisure walking, but no changes in built environment features were associated with leisure walking. The creation of mixed-use, dense developments may encourage adults to incorporate walking for transportation into their everyday lives. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Reliability and intensity of the six-minute walk test in healthy elderly subjects.

PubMed

Kervio, Gaelle; Carre, Francois; Ville, Nathalie S

2003-01-01

The 6-min walk test (6-MWT) is an easy and validated field test, generally used in patients to assess their physical capacity. We think that the 6-MWT could also be conducted in the same perspective in healthy subjects, aged 60-70 yr. However, little is known about the effect of the familiarization on the 6-MWT performance and the relative intensity of this test. The aims of this study were therefore to bring precision to the 6-MWT reliability and intensity in this population. METHODS; Over 3 d, 12 subjects performed two maximal exercise tests on treadmill and five 6-MWT (two in the morning and three in the afternoon) with a portable metabolic measurement system (Cosmed K4, Rome, Italy). The distance, walking speed, oxygen uptake (VO2 (max)), and heart rate (HR) values were measured during the 6-MWT. Distance, walking speed, and VO2(max) were only lower during the first two 6-MWT (respectively, P< 0.001, P< 0.001, and P< 0.05). HR was reliable from the first 6-MWT and was higher during the tests performed in the afternoon (P< 0.001). The intensity of the 6-MWT corresponded to 79.6 +/- 4.5% of the VO2(max), 85.8 +/- 2.5% of the HR (max), and 78.0 +/- 6.3% of the HR (reserve). Moreover, it was higher than the ventilatory threshold in each subject (P< 0.01). In healthy elderly subjects, the 6-MWT represents a submaximal exercise, but at almost 80% of the VO2(max). To be exploitable, two familiarization attempts are required to limit the learning effect. Finally, the 6-MWT time of day must be taken into account when assessing HR.

Aircast walking boot and below-knee walking cast for avulsion fractures of the base of the fifth metatarsal: a comparative cohort study.

PubMed

Shahid, Mohammad Kamran; Punwar, Shahid; Boulind, Caroline; Bannister, Gordon

2013-01-01

Acute avulsion fractures of the base of the fifth metatarsal are common and are treated in a variety of ways. The aims of this study were to compare pain, functional outcome, and time taken off work after treatment with a walking boot or a short-leg cast. Of 39 patients with acute avulsion fractures of the base of the fifth metatarsal, 23 were treated with a short-leg cast and 16 with a walking boot, according to the preference of the consultant present at outpatient clinic. Functional outcome was assessed by the Visual Analogue Scale Foot and Ankle Questionnaire (VAS FA), pain, and other complaints on presentation and at 3, 6, 9, and 12 weeks after injury. The VAS FA scores were compared between the 2 groups by a paired Student t test. The mean time to return to the level of pain and function before injury was approximately 9 weeks after treatment in the walking boot group and 12 weeks with a short-leg cast. Patients with walking boots reported less pain between 3 and 12 weeks than did those with short-leg casts after 6 (P = .06), 9 (P = .020), and 12 weeks (P = .33). Function was significantly better with Aircast walking boots after 3 (P = .006), 6 (P = .002), and 9 weeks (P = .002) but not after 12 weeks (P = .09). Patients returned to their preinjury level of driving after 6 weeks with walking boots and 12 weeks with short-leg casts (P = .006). Employed patients took a mean of 35.8 days off work (range, 28-42 days), fewer with boots (31.5 days) than with short-leg casts (39.2 days). The walking boot was better treatment than a short-leg cast for avulsion fractures of the base of the fifth metatarsal. Patients had an improved combined level of pain and function 3 weeks earlier, at 9 weeks post injury, when managed in a walking boot. Level II, prospective comparative series.

Artificial gait in complete spinal cord injured subjects: how to assess clinical performance.

PubMed

Pithon, Karla Rocha; Abreu, Daniela Cristina Carvalho de; Vasconcelos-Neto, Renata; Martins, Luiz Eduardo Barreto; Cliquet, Alberto

2015-02-01

Adapt the 6 minutes walking test (6MWT) to artificial gait in complete spinal cord injured (SCI) patients aided by neuromuscular electrical stimulation. Nine male individuals with paraplegia (AIS A) participated in this study. Lesion levels varied between T4 and T12 and time post injured from 4 to 13 years. Patients performed 6MWT 1 and 6MWT 2. They used neuromuscular electrical stimulation, and were aided by a walker. The differences between two 6MWT were assessed by using a paired t test. Multiple r-squared was also calculated. The 6MWT 1 and 6MWT 2 were not statistically different for heart rate, distance, mean speed and blood pressure. Multiple r-squared (r2 = 0.96) explained 96% of the variation in the distance walked. The use of 6MWT in artificial gait towards assessing exercise walking capacity is reproducible and easy to apply. It can be used to assess SCI artificial gait clinical performance.

Quantifying prosthetic gait deviation using simple outcome measures

PubMed Central

Kark, Lauren; Odell, Ross; McIntosh, Andrew S; Simmons, Anne

2016-01-01

AIM: To develop a subset of simple outcome measures to quantify prosthetic gait deviation without needing three-dimensional gait analysis (3DGA). METHODS: Eight unilateral, transfemoral amputees and 12 unilateral, transtibial amputees were recruited. Twenty-eight able-bodied controls were recruited. All participants underwent 3DGA, the timed-up-and-go test and the six-minute walk test (6MWT). The lower-limb amputees also completed the Prosthesis Evaluation Questionnaire. Results from 3DGA were summarised using the gait deviation index (GDI), which was subsequently regressed, using stepwise regression, against the other measures. RESULTS: Step-length (SL), self-selected walking speed (SSWS) and the distance walked during the 6MWT (6MWD) were significantly correlated with GDI. The 6MWD was the strongest, single predictor of the GDI, followed by SL and SSWS. The predictive ability of the regression equations were improved following inclusion of self-report data related to mobility and prosthetic utility. CONCLUSION: This study offers a practicable alternative to quantifying kinematic deviation without the need to conduct complete 3DGA. PMID:27335814

Non-invasive assessment of respiratory muscle function and its relationship to exercise tolerance in patients with chronic obstructive pulmonary disease.

PubMed

Chlumský, J; Filipova, P; Terl, M

2006-01-01

Most patients with chronic obstructive pulmonary disease (COPD) have impaired respiratory muscle function. Maximal oesophageal pressure correlates closely with exercise tolerance and seems to predict the distance walked during the 6-min walk test. This study assessed the non-invasive parameters of respiratory muscle function in 41 patients with COPD to investigate their relationship to pulmonary function tests and exercise tolerance. The COPD patients, who demonstrated the full range of airway obstruction severity, had a mean forced expiratory volume in 1 s of 42.5% predicted (range, 20 - 79% predicted). Both the maximal inspiratory muscle strength and non-invasive tension-time index were significantly correlated with the degree of lung hyperinflation, as expressed by the ratio of residual volume to total lung capacity, and the distance walked in 6 min. We conclude that respiratory muscle function was influenced mainly by lung hyperinflation and that it had an important effect on exercise tolerance in COPD patients.

The interplays among technology and content, immersant and VE

NASA Astrophysics Data System (ADS)

Song, Meehae; Gromala, Diane; Shaw, Chris; Barnes, Steven J.

2010-01-01

The research program aims to explore and examine the fine balance necessary for maintaining the interplays between technology and the immersant, including identifying qualities that contribute to creating and maintaining a sense of "presence" and "immersion" in an immersive virtual reality (IVR) experience. Building upon and extending previous work, we compare sitting meditation with walking meditation in a virtual environment (VE). The Virtual Meditative Walk, a new work-in-progress, integrates VR and biofeedback technologies with a self-directed, uni-directional treadmill. As immersants learn how to meditate while walking, robust, real-time biofeedback technology continuously measures breathing, skin conductance and heart rate. The physiological states of the immersant will in turn affect the audio and stereoscopic visual media through shutter glasses. We plan to test the potential benefits and limitations of this physically active form of meditation with data from a sitting form of meditation. A mixed-methods approach to testing user outcomes parallels the knowledge bases of the collaborative team: a physician, computer scientists and artists.

The association between sleep duration and physical performance in Chinese community-dwelling elderly.

PubMed

Fu, Liyuan; Jia, Liye; Zhang, Wen; Han, Peipei; Kang, Li; Ma, Yixuan; Yu, Hairui; Zhai, Tianqi; Chen, Xiaoyu; Guo, Qi

2017-01-01

Physical performance is an important healthy factor in elder people. Good living habits, which include sleep, can maintain physical strength and physical performance. The aim of the present study was to conduct a cross-sectional study to determine the association between total sleep duration and physical performance. Our study population comprised residents of the township central hospital in the suburban of Tianjin, China. We measured muscle strength, walk speed and balance function by grip, 4-m walk test and timed up and go test (TUGT). We divided sleep duration into four groups <7h, 7-8h, >8-9h, >9h. A total 898 participants had completed data (392 men and 506 women, mean age 67.71 years). In man, adjusted sleep duration was associated with lower grip in > 9 h group, the mean value (95% CI) was 0.429 (0.409, 0.448), and longer TUGT time was also associated with long sleep duration, 10.46s (9.97 s, 10.95 s). In women, adjusted slower 4-m walk speed present an inverse U-shaped relation with sleep duration, by 0.93 m/s (0.86 m/s, 0.98 m/s), 0.97 m/s (0.96 m/s, 1.00 m/s), 0.97 m/s (0.95 m/s, 0.99 m/s) and 0.92 m/s (0.89 m/s, 0.96 m/s); longer TUGT time were associated with long sleep duration (> 9 h), by 11.23 s (10.70 s, 11.77 s). In Chinese community-dwelling elderly, lower muscle strength and lower balance function were associated with long sleep duration in men. Slower walk speed and lower balance function were associated with long sleep duration in women.

Effect of prophylactic non-invasive mechanical ventilation on functional capacity after heart valve replacement: a clinical trial

PubMed Central

de Araújo-Filho, Amaro Afrânio; de Cerqueira-Neto, Manoel Luiz; de Assis Pereira Cacau, Lucas; Oliveira, Géssica Uruga; Cerqueira, Telma Cristina Fontes; de Santana-Filho, Valter Joviniano

2017-01-01

OBJECTIVE: During cardiac surgery, several factors contribute to the development of postoperative pulmonary complications. Non-invasive ventilation is a promising therapeutic tool for improving the functionality of this type of patient. The aim of this study is to evaluate the functional capacity and length of stay of patients in a nosocomial intensive care unit who underwent prophylactic non-invasive ventilation after heart valve replacement. METHOD: The study was a controlled clinical trial, comprising 50 individuals of both sexes who were allocated by randomization into two groups with 25 patients in each group: the control group and experimental group. After surgery, the patients were transferred to the intensive care unit and then participated in standard physical therapy, which was provided to the experimental group after 3 applications of non-invasive ventilation within the first 26 hours after extubation. For non-invasive ventilation, the positive pressure was 10 cm H2O, with a duration of 1 hour. The evaluation was performed on the 7th postoperative day/discharge and included a 6-minute walk test. The intensive care unit and hospitalization times were monitored in both groups. Brazilian Registry of Clinical Trials (REBeC): RBR number 8bxdd3. RESULTS: Analysis of the 6-minute walk test showed that the control group walked an average distance of 264.34±76 meters and the experimental group walked an average distance of 334.07±71 meters (p=0.002). The intensive care unit and hospitalization times did not differ between the groups. CONCLUSION: Non-invasive ventilation as a therapeutic resource was effective toward improving functionality; however, non-invasive ventilation did not influence the intensive care unit or hospitalization times of the studied cardiac patients. PMID:29160424

The Six-Minute Walk Test for Adults with Intellectual Disability: A Study of Validity and Reliability

ERIC Educational Resources Information Center

Nasuti, Gabriella; Stuart-Hill, Lynneth; Temple, Viviene A.

2013-01-01

Background: The Six-Minute Walk Test (6MWT) has been used with clinical and healthy populations to assess functional capacity and cardiovascular fitness. The aim of this study was to determine the test-retest reliability of a modified-6MWT as well as concurrent validity of walk distance with peak oxygen uptake (VO[subscript 2] peak). Method:…

Blood lactate thresholds and walking/running economy are determinants of backpack-running performance in trained soldiers.

PubMed

Simpson, Richard J; Graham, Scott M; Connaboy, Christopher; Clement, Richard; Pollonini, Luca; Florida-James, Geraint D

2017-01-01

We developed a standardized laboratory treadmill protocol for assessing physiological responses to a simulated backpack load-carriage task in trained soldiers, and assessed the efficacy of blood lactate thresholds (LTs) and economy in predicting future backpack running success over an 8-mile course in field conditions. LTs and corresponding physiological responses were determined in 17 elite British soldiers who completed an incremental treadmill walk/run protocol to exhaustion carrying 20 kg backpack load. Treadmill velocity at the breakpoint (r = -0.85) and Δ 1 mmol l(-1) (r = -0.80) LTs, and relative V˙O2 at 4 mmol l(-1) (r = 0.76) and treadmill walk/run velocities of 6.4 (r = 0.76), 7.4 (r = 0.80), 11.4 (r = 0.66) and 12.4 (r = 0.65) km h(-1) were significantly associated with field test completion time. We report for the first time that LTs and backpack walk/run economy are major determinants of backpack load-carriage performance in trained soldiers. Copyright © 2016 Elsevier Ltd. All rights reserved.

Analysis of Individual Social-ecological Mediators and Moderators and Their Ability to Explain Effect of a Randomized Neighborhood Walking Intervention.

PubMed

Michael, Yvonne L; Carlson, Nichole E

2009-07-30

Using data from the SHAPE trial, a randomized 6-month neighborhood-based intervention designed to increase walking activity among older adults, this study identified and analyzed social-ecological factors mediating and moderating changes in walking activity. Three potential mediators (social cohesion, walking efficacy, and perception of neighborhood problems) and minutes of brisk walking were assessed at baseline, 3-months, and 6-months. One moderator, neighborhood walkability, was assessed using an administrative GIS database. The mediating effect of change in process variables on change in brisk walking was tested using a product-of-coefficients test, and we evaluated the moderating effect of neighborhood walkability on change in brisk walking by testing the significance of the interaction between walkability and intervention status. Only one of the hypothesized mediators, walking efficacy, explained the intervention effect (product of the coefficients (95% CI) = 8.72 (2.53, 15.56). Contrary to hypotheses, perceived neighborhood problems appeared to suppress the intervention effects (product of the coefficients (95% CI = -2.48, -5.6, -0.22). Neighborhood walkability did not moderate the intervention effect. Walking efficacy may be an important mediator of lay-lead walking interventions for sedentary older adults. Social-ecologic theory-based analyses can support clinical interventions to elucidate the mediators and moderators responsible for producing intervention effects.

Validity of the microsoft kinect system in assessment of compensatory stepping behavior during standing and treadmill walking.

PubMed

Shani, Guy; Shapiro, Amir; Oded, Goldstein; Dima, Kagan; Melzer, Itshak

2017-01-01

Rapid compensatory stepping plays an important role in preventing falls when balance is lost; however, these responses cannot be accurately quantified in the clinic. The Microsoft Kinect™ system provides real-time anatomical landmark position data in three dimensions (3D), which may bridge this gap. Compensatory stepping reactions were evoked in 8 young adults by a sudden platform horizontal motion on which the subject stood or walked on a treadmill. The movements were recorded with both a 3D-APAS motion capture and Microsoft Kinect™ systems. The outcome measures consisted of compensatory step times (milliseconds) and length (centimeters). The average values of two standing and walking trials for Microsoft Kinect™ and the 3D-APAS systems were compared using t -test, Pearson's correlation, Altman-bland plots, and the average difference of root mean square error (RMSE) of joint position. The Microsoft Kinect™ had high correlations for the compensatory step times ( r  = 0.75-0.78, p  = 0.04) during standing and moderate correlations for walking ( r  = 0.53-0.63, p  = 0.05). The step length, however had a very high correlations for both standing and walking ( r  > 0.97, p  = 0.01). The RMSE showed acceptable differences during the perturbation trials with smallest relative error in anterior-posterior direction (2-3%) and the highest in the vertical direction (11-13%). No systematic bias were evident in the Bland and Altman graphs. The Microsoft Kinect™ system provides comparable data to a video-based 3D motion analysis system when assessing step length and less accurate but still clinically acceptable for step times during balance recovery when balance is lost and fall is initiated.

Physical Function, Hyperuricemia, and Gout in Older Adults.

PubMed

Burke, Bridget Teevan; Köttgen, Anna; Law, Andrew; Windham, Beverly Gwen; Segev, Dorry; Baer, Alan N; Coresh, Josef; McAdams-DeMarco, Mara A

2015-12-01

Gout prevalence is high in older adults and those affected are at risk of physical disability, yet it is unclear whether they have worse physical function. We studied gout, hyperuricemia, and physical function in 5,819 older adults (age ≥65 years) attending the 2011-2013 Atherosclerosis Risk in Communities Study visit, a prospective US population-based cohort. Differences in lower extremity function (Short Physical Performance Battery [SPPB] and 4-meter walking speed) and upper extremity function (grip strength) by gout status and by hyperuricemia prevalence were estimated in adjusted ordinal logistic regression (SPPB) and linear regression (walking speed and grip strength) models. Lower scores or times signify worse function. The prevalence of poor physical performance (first quartile) by gout and hyperuricemia was estimated using adjusted modified Poisson regression. Ten percent of participants reported a history of gout and 21% had hyperuricemia. There was no difference in grip strength by history of gout (P = 0.77). Participants with gout performed worse on the SPPB test; they had 0.77 times (95% confidence interval [95% CI] 0.65, 0.90, P = 0.001) the prevalence odds of a 1-unit increase in SPPB score and were 1.18 times (95% CI 1.07, 1.32, P = 0.002) more likely to have poor SPPB performance. Participants with a history of gout had slower walking speed (mean difference -0.03; 95% CI -0.05, -0.01, P < 0.001) and were 1.19 times (95% CI 1.06, 1.34, P = 0.003) more likely to have poor walking speed. Similarly, SPPB score and walking speed, but not grip strength, were worse in participants with hyperuricemia. Older adults with gout and hyperuricemia are more likely to have worse lower extremity, but not upper extremity, function. © 2015, American College of Rheumatology.

Brisk walking can promote functional recovery in chronic stroke patients.

PubMed

Batcho, Charles Sèbiyo; Stoquart, Gaëtan; Thonnard, Jean-Louis

2013-09-01

To determine whether regular brisk walking can promote functional recovery in community-dwelling stroke patients. A total of 44 chronic stroke patients, recruited in Belgium and Benin, respectively European high-income and African low-income countries. This longitudinal, single-cohort, observational study with 1 intervention period and 4 time-points of assessments (2 baseline, 1 post-intervention and 1 follow-up) was structured in 3 periods: pre-intervention period (1 month), intervention period (3 months) and follow-up period (3 month). Intervention consisted of a 3 times/week group-based brisk walking programme. Primary outcome measures were ACTIVLIM-Stroke questionnaire and the 6-minute walk test (6MWT). Secondary outcome measures were the Stroke Impairment Assessment Set (SIAS), the Hospital Anxiety and Depression Scale (HADS), and the Berg Balance Scale (BBS). All outcome measures were stable during the pre-intervention period (p ≥ 0.16). They all improved significantly after intervention (p ≤ 0.01), except the HADS (p = 0.058). However, during the follow-up period, SIAS (p = 0.002) and BBS (p = 0.001) decreased, while ACTIVLIM-Stroke, 6MWT and HADS showed no significant change (p ≥ 0.13). This study suggests regular brisk walking as an effective approach to promote functional recovery in chronic stroke survivors. However, further studies are required before generalizing these results to the whole stroke population.

Repeat six-minute walk tests in patients with chronic heart failure: are they clinically necessary?

PubMed

Adsett, Julie; Mullins, Robert; Hwang, Rita; Hogden, Amy; Gibson, Ellen; Houlihan, Kylie; Tuppin, Michael; Korczyk, Dariusz; Mallitt, Kylie-Ann; Mudge, Alison

2011-08-01

Owing to a reported learning effect in patients with chronic cardiopulmonary disease, performance of at least two six-minute walk tests (6MWT) are recommended as standard practice. Patients with chronic heart failure (CHF) are typically elderly and frail and it is unknown whether current guidelines are practical in a clinical setting. The aim of this study was to determine whether repeat performance of 6MWTs in patients with CHF is related to between-test interval or baseline performance. This was a multisite observational study enrolling participants entering into heart failure rehabilitation programmes. Participants performed two 6MWTs with randomly allocated inter-test intervals between 15 and 90 minutes. Distance walked in the second test was compared with the first test using a paired t test. Eighty-eight participants (45 females, age 65 ± 14 years) with stable CHF were enrolled. Mean distance walked increased from 301 metres in test 1 to 313 metres in test 2 (p < 0.001). No significant change was recorded between test 1 and test 2 for those whose baseline distance was <300 metres. The interval between tests had no significant effect on the distance walked. The change in 6MWT distance was significantly associated with better baseline performance but not with the interval between tests.

[Six-minute walk test in children with neuromuscular disease.

PubMed

Cruz-Anleu, Israel Didier; Baños-Mejía, Benjamín Omar; Galicia-Amor, Susana

2013-01-01

Background: neuromuscular diseases affect the motor unit. When they evolve, respiratory complications are common; the six-minute walk test plays an important role in the assessment of functional capacity. Methods: prospective, transversal, descriptive and observational study. We studied seven children with a variety of neuromuscular diseases and spontaneous ambulation. We tested their lung function, and administered a six-minute walk test and a test of respiratory muscle strength to these children. Results: the age was 9.8 ± 2.4 years. All patients were males. Forced vital capacity decreased in three patients (42.8 %), forced expiratory volume during the first second (2.04 ± 1.4 L) and peak expiratory flow (4.33 ± 3.3 L/s) were normal. The maximum strength of respiratory muscles was less than 60 % of predicted values. The distance covered in the six-minute walk test was lower when compared with healthy controls (29.9 %). Conclusions: the six-minute walk test can be a useful tool in early stages of this disease, since it is easy to perform and well tolerated by the patients.

Time Spent Walking and Risk of Diabetes in Japanese Adults: The Japan Public Health Center-Based Prospective Diabetes Study.

PubMed

Kabeya, Yusuke; Goto, Atsushi; Kato, Masayuki; Matsushita, Yumi; Takahashi, Yoshihiko; Isogawa, Akihiro; Inoue, Manami; Mizoue, Tetsuya; Tsugane, Shoichiro; Kadowaki, Takashi; Noda, Mitsuhiko

2016-01-01

The association between time spent walking and risk of diabetes was investigated in a Japanese population-based cohort. Data from the Japan Public Health Center-based Prospective Diabetes cohort were analyzed. The surveys of diabetes were performed at baseline and at the 5-year follow-up. Time spent walking per day was assessed using a self-reported questionnaire (<30 minutes, 30 minutes to <1 hour, 1 to <2 hours, or ≥2 hours). A cross-sectional analysis was performed among 26 488 adults in the baseline survey. Logistic regression was used to examine the association between time spent walking and the presence of unrecognized diabetes. We then performed a longitudinal analysis that was restricted to 11 101 non-diabetic adults who participated in both the baseline and 5-year surveys. The association between time spent walking and the incidence of diabetes during the 5 years was examined. In the cross-sectional analysis, 1058 participants had unrecognized diabetes. Those with time spent walking of <30 minutes per day had increased odds of having diabetes in relation to those with time spent walking of ≥2 hours (adjusted odds ratio [OR] 1.23; 95% CI, 1.02-1.48). In the longitudinal analysis, 612 participants developed diabetes during the 5 years of follow-up. However, a significant association between time spent walking and the incidence of diabetes was not observed. Increased risk of diabetes was implied in those with time spent walking of <30 minutes per day, although the longitudinal analysis failed to show a significant result.

[Association between walking time and perception of built environment among urban adults in Hangzhou].

PubMed

Liu, Qingmin; Ren, Yanjun; Cao, Chengjian; Su, Meng; Lyu, Jun; Li, Liming

2015-10-01

To explore the association between walking time and the perception of built environment among local adults in Hangzhou. Through multistage stratified random sampling, a total of 1 440 urban residents aged 25-59 years were surveyed in Hangzhou by face-to face interview in 2012. The international physical activity questionnaire-long version (IPAQ-L) was used to assess the physical activity levels, including walking time in the past week. Neighborhood Environment Walkability Scale-Abbreviated (NEWS-A) was used to obtain information about their perception of built environment. Multiple logistic regression was applied to estimate the relationship between waking and the perception of built environment. Among the local adults in Hangzhou, the median of total physical activity was 2 766 met·min⁻¹·week⁻¹, the average walking time per week was 90 min for leisure and 100 min for transportation respectively. After controlling the age, marital status, BMI, educational level, employment, community type and the total PA scores, the leisure-time walking was negatively related to the accessibility to stores, facilities and other things for both man (OR=0.764, 95% CI: 0.588-0.992) and woman (OR=0.633, 95% CI: 0.481-0.833). In sex specific analysis, the leisure-time walking was negatively related with the residential density (OR=0.997, 95% CI: 0.996-0.999) while transportation related walking was positively related with walking/cycling way scores (OR=1.537, 95% CI: 1.138-2.075) in females. In contrast, there were no significant associations between perception of built environment and transportation related walking in males. Improving the built environment, such as the walking/cycling way, might be useful to increase the transportation related walking time for adults. The sex specific differences need to be considered in the environment intervention for walking promotion.

Evaluation of the implementation of a whole-workplace walking programme using the RE-AIM framework.

PubMed

Adams, Emma J; Chalkley, Anna E; Esliger, Dale W; Sherar, Lauren B

2017-05-18

Promoting walking for the journey to/from work and during the working day is one potential approach to increase physical activity in adults. Walking Works was a practice-led, whole-workplace walking programme delivered by employees (walking champions). This study aimed to evaluate the implementation of Walking Works using the RE-AIM framework and provide recommendations for future delivery of whole-workplace walking programmes. Two cross sectional surveys were conducted; 1544 (28%) employees completed the baseline survey and 918 employees (21%) completed the follow-up survey. Effectiveness was assessed using baseline and follow-up data; reach, implementation and maintenance were assessed using follow-up data only. For categorical data, Chi square tests were conducted to assess differences between surveys or groups. Continuous data were analysed to test for significant differences using a Mann-Whitney U test. Telephone interviews were conducted with the lead organisation co-ordinator, eight walking champions and three business representatives at follow-up. Interviews were transcribed verbatim and analysed to identify key themes related to adoption, implementation and maintenance. Adoption: Five workplaces participated in Walking Works. Reach: 480 (52.3%) employees were aware of activities and 221 (24.1%) participated. A variety of walking activities were delivered. Some programme components were not delivered as planned which was partly due to barriers in using walking champions to deliver activities. These included the walking champions' capacity, skills, support needs, ability to engage senior management, and the number and type of activities they could deliver. Other barriers included lack of management support, difficulties communicating information about activities and challenges embedding the programme into normal business activities. Effectiveness: No significant changes in walking to/from work or walking during the working day were observed. Maintenance: Plans to continue activities were mainly dependent on identifying continued funding. RE-AIM provided a useful framework for evaluating Walking Works. No changes in walking behaviour were observed. This may have been due to barriers in using walking champions to deliver activities, programme components not being delivered as intended, the types of activities delivered, or lack of awareness and participation by employees. Recommendations are provided for researchers and practitioners implementing future whole-workplace walking programmes.

Sarcopenia in Peripheral Arterial Disease: Prevalence and Effect on Functional Status.

PubMed

Addison, Odessa; Prior, Steven J; Kundi, Rishi; Serra, Monica C; Katzel, Leslie I; Gardner, Andrew W; Ryan, Alice S

2018-04-01

(1) To determine the prevalence of sarcopenia in older men with peripheral arterial disease (PAD); (2) to compare a subgroup of the group with age-, race-, sex-, and body mass index (BMI)-matched non-PAD control counterparts, and (3) to compare the functional status of those with PAD with and without sarcopenia. Cohort study. Medical center. Sedentary community-dwelling men (N=108; age, >50y) with a confirmed diagnosis of PAD (44% blacks; BMI, 27.8±0.4kg/m 2 ; ankle-brachial index, .62±.01). Not applicable. Dual-energy x-ray absorptiometry scans were used to assess appendicular lean mass and determine the prevalence of sarcopenia by/height 2 . Treadmill tests were used to determine claudication onset time, peak walking time, and claudication recovery time. 6-Minute walk distance was also measured. Sarcopenia prevalence in our PAD cohort was 25%. The PAD subgroup (n=42) matched with control counterparts in terms of race, sex, age, and BMI had higher prevalence rates than did their non-PAD counterparts (23.8% vs 2.4%; P<.05). Individuals with sarcopenia (n=28) had a shorter 6-minute walk distance (326±18.8m vs 380±9.7m; P<.05) and higher claudication recovery time (592±98s vs 395±29s; P<.05) than did individuals with PAD but without sarcopenia (n=80). There was no difference in claudication onset time or peak walking time between the PAD groups. Men with PAD demonstrate a high prevalence of sarcopenia. Those with sarcopenia and PAD demonstrate decreased mobility function. Published by Elsevier Inc.

Factors Influencing the Efficacy of Aerobic Exercise for Improving Fitness and Walking Capacity After Stroke: A Meta-Analysis With Meta-Regression.

PubMed

Boyne, Pierce; Welge, Jeffrey; Kissela, Brett; Dunning, Kari

2017-03-01

To assess the influence of dosing parameters and patient characteristics on the efficacy of aerobic exercise (AEX) poststroke. A systematic review was conducted using PubMed, MEDLINE, Cumulative Index of Nursing and Allied Health Literature, Physiotherapy Evidence Database, and Academic Search Complete. Studies were selected that compared an AEX group with a nonaerobic control group among ambulatory persons with stroke. Extracted outcome data included peak oxygen consumption (V˙o 2 peak) during exercise testing, walking speed, and walking endurance (6-min walk test). Independent variables of interest were AEX mode (seated or walking), AEX intensity (moderate or vigorous), AEX volume (total hours), stroke chronicity, and baseline outcome scores. Significant between-study heterogeneity was confirmed for all outcomes. Pooled AEX effect size estimates (AEX group change minus control group change) from random effects models were V˙o 2 peak, 2.2mL⋅kg -1 ⋅min -1 (95% confidence interval [CI], 1.3-3.1mL⋅kg -1 ⋅min -1 ); walking speed, .06m/s (95% CI, .01-.11m/s); and 6-minute walk test distance, 29m (95% CI, 15-42m). In meta-regression, larger V˙o 2 peak effect sizes were significantly associated with higher AEX intensity and higher baseline V˙o 2 peak. Larger effect sizes for walking speed and the 6-minute walk test were significantly associated with a walking AEX mode. In contrast, seated AEX did not have a significant effect on walking outcomes. AEX significantly improves aerobic capacity poststroke, but may need to be task specific to affect walking speed and endurance. Higher AEX intensity is associated with better outcomes. Future randomized studies are needed to confirm these results. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Mixing times in quantum walks on two-dimensional grids

DOE Office of Scientific and Technical Information (OSTI.GOV)

Marquezino, F. L.; Portugal, R.; Abal, G.

2010-10-15

Mixing properties of discrete-time quantum walks on two-dimensional grids with toruslike boundary conditions are analyzed, focusing on their connection to the complexity of the corresponding abstract search algorithm. In particular, an exact expression for the stationary distribution of the coherent walk over odd-sided lattices is obtained after solving the eigenproblem for the evolution operator for this particular graph. The limiting distribution and mixing time of a quantum walk with a coin operator modified as in the abstract search algorithm are obtained numerically. On the basis of these results, the relation between the mixing time of the modified walk and themore » running time of the corresponding abstract search algorithm is discussed.« less

Mixing times in quantum walks on two-dimensional grids

NASA Astrophysics Data System (ADS)

Marquezino, F. L.; Portugal, R.; Abal, G.

2010-10-01

Mixing properties of discrete-time quantum walks on two-dimensional grids with toruslike boundary conditions are analyzed, focusing on their connection to the complexity of the corresponding abstract search algorithm. In particular, an exact expression for the stationary distribution of the coherent walk over odd-sided lattices is obtained after solving the eigenproblem for the evolution operator for this particular graph. The limiting distribution and mixing time of a quantum walk with a coin operator modified as in the abstract search algorithm are obtained numerically. On the basis of these results, the relation between the mixing time of the modified walk and the running time of the corresponding abstract search algorithm is discussed.

Wii-Fit for Improving Gait and Balance in an Assisted Living Facility: A Pilot Study

PubMed Central

Padala, Kalpana P.; Padala, Prasad R.; Malloy, Timothy R.; Geske, Jenenne A.; Dubbert, Patricia M.; Dennis, Richard A.; Garner, Kimberly K.; Bopp, Melinda M.; Burke, William J.; Sullivan, Dennis H.

2012-01-01

Objectives. To determine the effects on balance and gait of a Wii-Fit program compared to a walking program in subjects with mild Alzheimer's dementia (AD). Methods. A prospective randomized (1 : 1) pilot study with two intervention arms was conducted in an assisted living facility with twenty-two mild AD subjects. In both groups the intervention occurred under supervision for 30 minutes daily, five times a week for eight weeks. Repeated measures ANOVA and paired t-tests were used to analyze changes. Results. Both groups showed improvement in Berg Balance Scale (BBS), Tinetti Test (TT) and Timed Up and Go (TUG) over 8 weeks. However, there was no statistically significant difference between the groups over time. Intragroup analysis in the Wii-Fit group showed significant improvement on BBS (P = 0.003), and TT (P = 0.013). The walking group showed a trend towards improvement on BBS (P = 0.06) and TUG (P = 0.07) and significant improvement in TT (P = 0.06). Conclusion. This pilot study demonstrates the safety and efficacy of Wii-Fit in an assisted living facility in subjects with mild AD. Use of Wii-Fit resulted in significant improvements in balance and gait comparable to those in the robust monitored walking program. These results need to be confirmed in a larger, methodologically sound study. PMID:22745909

Effects of eccentric-focused and conventional resistance training on strength and functional capacity of older adults.

PubMed

Dias, Caroline Pieta; Toscan, Rafael; de Camargo, Mainara; Pereira, Evelyn Possobom; Griebler, Nathália; Baroni, Bruno Manfredini; Tiggemann, Carlos Leandro

2015-10-01

The aim of the study was to assess the effect of eccentric training using a constant load with longer exposure time at the eccentric phase on knee extensor muscle strength and functional capacity of elderly subjects in comparison with a conventional resistance training program. Twenty-six healthy elderly women (age = 67 ± 6 years) were randomly assigned to an eccentric-focused training group (ETG; n = 13) or a conventional training group (CTG; n = 13). Subjects underwent 12 weeks of resistance training twice a week. For the ETG, concentric and eccentric phases were performed using 1.5 and 4.5 s, respectively, while for CTG, each phase lasted 1.5 s. Maximum dynamic strength was assessed by the one-repetition maximum (1RM) test in the leg press and knee extension exercises, and for functional capacity, subjects performed specific tests (6-m walk test, timed up-and-go test, stair-climbing test, and chair-rising test). Both groups improved knee extension 1RM (24-26 %; p = 0.021), timed up-and-go test (11-16 %; p < 0.001), 6-m walk test (9-12 %; p = 0.004), stair-climbing test (8-13 %; p = 0.007), and chair-rising test (15-16 %; p < 0.001), but there was no significant difference between groups. In conclusion, the strategy of increasing the exposure time at the eccentric phase of movement using the same training volume and intensity does not promote different adaptations in strength or functional capacity compared to conventional resistance training in elderly woman.

Balance ability and cognitive impairment influence sustained walking in an assisted living facility.

PubMed

Bowen, Mary Elizabeth; Crenshaw, Jeremy; Stanhope, Steven J

The purpose of this study was to determine the influence of cognitive impairment (CI), 1 gait quality, and balance ability on walking distance and speed in an assisted living facility. This was a longitudinal cohort study of institutionalized older adults (N = 26; 555 observations) followed for up to 8 months. Hierarchical linear modeling statistical techniques were used to examine the effects of gait quality and balance ability (using the Tinetti Gait and Balance Test) and cognitive status (using the Montreal Cognitive Assessment) on walking activity (distance, sustained distance, sustained speed). The latter were measured objectively and continuously by a real-time locating system (RTLS). A one-point increase in balance ability was associated with an 8% increase in sustained walking distance (p = 0.03) and a 4% increase in sustained gait speed (p = 0.00). Gait quality was associated with decreased sustained gait speed (p = 0.03). Residents with moderate (ERR = 2.34;p = 0.01) or severe CI (trend with an ERR = 1.62; p = 0.06) had longer sustained walking distances at slower speeds when compared to residents with no CI. After accounting for cognitive status, it was balance ability, not gait quality, that was a determinant of sustained walking distances and speeds. Therefore, balance interventions for older adults in assisted living may enable sustained walking activity. Given that CI was associated with more sustained walking, limiting sustained walking in the form of wandering behavior, especially for those with balance impairments, may prevent adverse events, including fall-related injury. Published by Elsevier B.V.

Zero velocity interval detection based on a continuous hidden Markov model in micro inertial pedestrian navigation

NASA Astrophysics Data System (ADS)

Sun, Wei; Ding, Wei; Yan, Huifang; Duan, Shunli

2018-06-01

Shoe-mounted pedestrian navigation systems based on micro inertial sensors rely on zero velocity updates to correct their positioning errors in time, which effectively makes determining the zero velocity interval play a key role during normal walking. However, as walking gaits are complicated, and vary from person to person, it is difficult to detect walking gaits with a fixed threshold method. This paper proposes a pedestrian gait classification method based on a hidden Markov model. Pedestrian gait data are collected with a micro inertial measurement unit installed at the instep. On the basis of analyzing the characteristics of the pedestrian walk, a single direction angular rate gyro output is used to classify gait features. The angular rate data are modeled into a univariate Gaussian mixture model with three components, and a four-state left–right continuous hidden Markov model (CHMM) is designed to classify the normal walking gait. The model parameters are trained and optimized using the Baum–Welch algorithm and then the sliding window Viterbi algorithm is used to decode the gait. Walking data are collected through eight subjects walking along the same route at three different speeds; the leave-one-subject-out cross validation method is conducted to test the model. Experimental results show that the proposed algorithm can accurately detect different walking gaits of zero velocity interval. The location experiment shows that the precision of CHMM-based pedestrian navigation improved by 40% when compared to the angular rate threshold method.

Reliability and validity of an audio signal modified shuttle walk test.

PubMed

Singla, Rupak; Rai, Richa; Faye, Abhishek Anil; Jain, Anil Kumar; Chowdhury, Ranadip; Bandyopadhyay, Debdutta

2017-01-01

The audio signal in the conventionally accepted protocol of shuttle walk test (SWT) is not well-understood by the patients and modification of the audio signal may improve the performance of the test. The aim of this study is to study the validity and reliability of an audio signal modified SWT, called the Singla-Richa modified SWT (SWTSR), in healthy normal adults. In SWTSR, the audio signal was modified with the addition of reverse counting to it. A total of 54 healthy normal adults underwent conventional SWT (CSWT) at one instance and two times SWTSRon the same day. The validity was assessed by comparing outcomes of the SWTSRto outcomes of CSWT using the Pearson correlation coefficient and Bland-Altman plot. Test-retest reliability of SWTSRwas assessed using the intraclass correlation coefficient (ICC). The acceptability of the modified test in comparison to the conventional test was assessed using Likert scale. The distance walked (mean ± standard deviation) in the CSWT and SWTSRtest was 853.33 ± 217.33 m and 857.22 ± 219.56 m, respectively (Pearson correlation coefficient - 0.98; P < 0.001) indicating SWTSRto be a valid test. The SWTSRwas found to be a reliable test with ICC of 0.98 (95% confidence interval: 0.97-0.99). The acceptability of SWTSRwas significantly higher than CSWT. The SWTSRwith modified audio signal with reverse counting is a reliable as well as a valid test when compared with CSWT in healthy normal adults. It better understood by subjects compared to CSWT.

Neuromechanical adaptations during a robotic powered exoskeleton assisted walking session.

PubMed

Ramanujam, Arvind; Cirnigliaro, Christopher M; Garbarini, Erica; Asselin, Pierre; Pilkar, Rakesh; Forrest, Gail F

2017-04-20

To evaluate gait parameters and neuromuscular profiles of exoskeleton-assisted walking under Max Assist condition during a single-session for; (i) able bodied (AB) individuals walking assisted with (EXO) and without (non-EXO) a powered exoskeleton, (ii) non-ambulatory SCI individuals walking assisted with a powered exoskeleton. Single-session. Motion analysis laboratory. Four AB individuals and four individuals with SCI. Powered lower extremity exoskeleton. Temporal-spatial parameters, kinematics, walking velocity and electromyography data. AB individuals in exoskeleton showed greater stance time and a significant reduction in walking velocity (P < 0.05) compared to non-EXO walking. Interestingly, when the AB individuals voluntarily assisted the exoskeleton movements, they walked with an increased velocity and lowered stance time to resemble that of slow walking. For SCI individuals, mean percent stance time was higher and walking velocity was lower compared to all AB walking conditions (P < 0.05). There was muscle activation in several lower limb muscles for SCI group. For AB individuals, there were similarities among EXO and non-EXO walking conditions however there were differences in several lower limb EMGs for phasing of muscle activation. The data suggests that our AB individuals experienced reduction in walking velocity and muscle activation amplitudes while walking in the exoskeleton and moreover with voluntary control there is a greater temporal-spatial response of the lower limbs. Also, there are neuromuscular phasic adaptions for both AB and SCI groups while walking in the exoskeleton that are inconsistent to non-EXO gait muscle activation.

A Lunchtime Walk in Nature Enhances Restoration of Autonomic Control during Night-Time Sleep: Results from a Preliminary Study.

PubMed

Gladwell, Valerie F; Kuoppa, Pekka; Tarvainen, Mika P; Rogerson, Mike

2016-03-03

Walking within nature (Green Exercise) has been shown to immediately enhance mental well-being but less is known about the impact on physiology and longer lasting effects. Heart rate variability (HRV) gives an indication of autonomic control of the heart, in particular vagal activity, with reduced HRV identified as a risk factor for cardiovascular disease. Night-time HRV allows vagal activity to be assessed whilst minimizing confounding influences of physical and mental activity. The aim of this study was to investigate whether a lunchtime walk in nature increases night-time HRV. Participants (n = 13) attended on two occasions to walk a 1.8 km route through a built or a natural environment. Pace was similar between the two walks. HRV was measured during sleep using a RR interval sensor (eMotion sensor) and was assessed at 1-2 h after participants noted that they had fallen asleep. Markers for vagal activity were significantly greater after the walk in nature compared to the built walk. Lunchtime walks in nature-based environments may provide a greater restorative effect as shown by vagal activity than equivalent built walks. Nature walks may improve essential recovery during night-time sleep, potentially enhancing physiological health.

Physiological responses and energy cost of walking on the Gait Trainer with and without body weight support in subacute stroke patients

PubMed Central

2014-01-01

Background Robotic-assisted walking after stroke provides intensive task-oriented training. But, despite the growing diffusion of robotic devices little information is available about cardiorespiratory and metabolic responses during electromechanically-assisted repetitive walking exercise. Aim of the study was to determine whether use of an end-effector gait training (GT) machine with body weight support (BWS) would affect physiological responses and energy cost of walking (ECW) in subacute post-stroke hemiplegic patients. Methods Participants: six patients (patient group: PG) with hemiplegia due to stroke (age: 66 ± 15y; time since stroke: 8 ± 3 weeks; four men) and 6 healthy subjects as control group (CG: age, 76 ± 7y; six men). Interventions: overground walking test (OWT) and GT-assisted walking with 0%, 30% and 50% BWS (GT-BWS0%, 30% and 50%). Main Outcome Measures: heart rate (HR), pulmonary ventilation, oxygen consumption, respiratory exchange ratio (RER) and ECW. Results Intervention conditions significantly affected parameter values in steady state (HR: p = 0.005, V’E: p = 0.001, V'O2: p < 0.001) and the interaction condition per group affected ECW (p = 0.002). For PG, the most energy (V’O2 and ECW) demanding conditions were OWT and GT-BWS0%. On the contrary, for CG the least demanding condition was OWT. On the GT, increasing BWS produced a decrease in energy and cardiac demand in both groups. Conclusions In PG, GT-BWS walking resulted in less cardiometabolic demand than overground walking. This suggests that GT-BWS walking training might be safer than overground walking training in subacute stroke patients. PMID:24720844

Physiological responses and energy cost of walking on the Gait Trainer with and without body weight support in subacute stroke patients.

PubMed

Delussu, Anna Sofia; Morone, Giovanni; Iosa, Marco; Bragoni, Maura; Traballesi, Marco; Paolucci, Stefano

2014-04-10

Robotic-assisted walking after stroke provides intensive task-oriented training. But, despite the growing diffusion of robotic devices little information is available about cardiorespiratory and metabolic responses during electromechanically-assisted repetitive walking exercise. Aim of the study was to determine whether use of an end-effector gait training (GT) machine with body weight support (BWS) would affect physiological responses and energy cost of walking (ECW) in subacute post-stroke hemiplegic patients. six patients (patient group: PG) with hemiplegia due to stroke (age: 66 ± 15y; time since stroke: 8 ± 3 weeks; four men) and 6 healthy subjects as control group (CG: age, 76 ± 7y; six men). overground walking test (OWT) and GT-assisted walking with 0%, 30% and 50% BWS (GT-BWS0%, 30% and 50%). heart rate (HR), pulmonary ventilation, oxygen consumption, respiratory exchange ratio (RER) and ECW. Intervention conditions significantly affected parameter values in steady state (HR: p = 0.005, V'E: p = 0.001, V'O2: p < 0.001) and the interaction condition per group affected ECW (p = 0.002). For PG, the most energy (V'O2 and ECW) demanding conditions were OWT and GT-BWS0%. On the contrary, for CG the least demanding condition was OWT. On the GT, increasing BWS produced a decrease in energy and cardiac demand in both groups. In PG, GT-BWS walking resulted in less cardiometabolic demand than overground walking. This suggests that GT-BWS walking training might be safer than overground walking training in subacute stroke patients.

Effects of curved-walking training on curved-walking performance and freezing of gait in individuals with Parkinson's disease: A randomized controlled trial.

PubMed

Cheng, Fang-Yu; Yang, Yea-Ru; Wu, Yih-Ru; Cheng, Shih-Jung; Wang, Ray-Yau

2017-10-01

The purpose of this study was to investigate the effects of curved-walking training (CWT) on curved-walking performance and freezing of gait (FOG) in people with Parkinson's disease (PD). Twenty-four PD subjects were recruited and randomly assigned to the CWT group or control exercise (CE) group and received 12 sessions of either CWT with a turning-based treadmill or general exercise training for 30 min followed by 10 min of over-ground walking in each session for 4-6 weeks. The primary outcomes included curved-walking performance and FOG. All measurements were assessed at baseline, after training, and at 1-month follow-up. Our results showed significant improvements in curved-walking performance (speed, p = 0.007; cadence, p = 0.003; step length, p < 0.001) and FOG, measured by a FOG questionnaire (p = 0.004). The secondary outcomes including straight-walking performance (speed, cadence and step length, p < 0.001), timed up and go test (p = 0.014), functional gait assessment (p < 0.001), Unified Parkinson's disease Rating Scale III (p = 0.001), and quality of life (p < 0.001) were also improved in the experimental group. We further noted that the improvements were maintained for at least one month after training (p < 0.05). A 12-session CWT program can improve curved-walking ability, FOG, and other measures of functional walking performance in individuals with PD. Most of the improvements were sustained for at least one month after training. Copyright © 2017 Elsevier Ltd. All rights reserved.

Barriers associated with reduced physical activity in COPD patients.

PubMed

Amorim, Priscila Batista; Stelmach, Rafael; Carvalho, Celso Ricardo Fernandes; Fernandes, Frederico Leon Arrabal; Carvalho-Pinto, Regina Maria; Cukier, Alberto

2014-10-01

To evaluate the ability of COPD patients to perform activities of daily living (ADL); to identify barriers that prevent these individuals from performing ADL; and to correlate those barriers with dyspnea severity, six-minute walk test (6MWT), and an ADL limitation score. In COPD patients and healthy, age-matched controls, the number of steps, the distance walked, and walking time were recorded with a triaxial accelerometer, for seven consecutive days. A questionnaire regarding perceived barriers and the London Chest Activity of Daily Living (LCADL) scale were used in order to identify the factors that prevent the performance of ADL. The severity of dyspnea was assessed with two scales, whereas submaximal exercise capacity was determined on the basis of the 6MWT. We evaluated 40 COPD patients and 40 controls. In comparison with the control values, the mean walk time was significantly shorter for COPD patients (68.5 ± 25.8 min/day vs. 105.2 ± 49.4 min/day; p < 0.001), as was the distance walked (3.9 ± 1.9 km/day vs. 6.4 ± 3.2 km/day; p < 0.001). The COPD patients also walked fewer steps/day. The most common self-reported barriers to performing ADL were lack of infrastructure, social influences, and lack of willpower. The 6MWT distance correlated with the results obtained with the accelerometer but not with the LCADL scale results. Patients with COPD are less active than are healthy adults of a comparable age. Physical inactivity and the barriers to performing ADL have immediate implications for clinical practice, calling for early intervention measures.

Overground walking training with the i-Walker, a robotic servo-assistive device, enhances balance in patients with subacute stroke: a randomized controlled trial.

PubMed

Morone, Giovanni; Annicchiarico, Roberta; Iosa, Marco; Federici, Alessia; Paolucci, Stefano; Cortés, Ulises; Caltagirone, Carlo

2016-05-26

Patients affected by mild stroke benefit more from physiological overground walking training than walking-like training performed in place using specific devices. The aim of the study was to evaluate the effects of overground robotic walking training performed with the servo-assistive robotic rollator (i-Walker) on walking, balance, gait stability and falls in a community setting in patients with mild subacute stroke. Forty-four patients were randomly assigned to two different groups that received the same therapy in two daily 40-min sessions 5 days a week for 4 weeks. Twenty sessions of standard therapy were performed by both groups. In the other 20 sessions the subjects enrolled in the i-Walker-Group (iWG) performed with the i-Walker and the Control-Group patients (CG) performed the same amount of conventional walking oriented therapy. Clinical and instrumented gait assessments were made pre- and post-treatment. The follow-up observation consisted of recording the number of fallers in the community setting after 6 months. Treatment effectiveness was higher in the iWG group in terms of balance improvement (Tinetti: 68.4 ± 27.6 % vs. 48.1 ± 33.9 %, p = 0.033) and 10-m and 6-min timed walking tests (significant interaction between group and time: F(1,40) = 14.252, p = 0.001; and F(1,40) = 7.883, p = 0.008, respectively). When measured, latero-lateral upper body accelerations were reduced in iWG (F = 4.727, p = 0.036), suggesting increased gait stability, which was supported by a reduced number of falls at home. A robotic servo-assisted i-Walker improved walking performance and balance in patients affected by mild/moderate stroke, leading to increased gait stability and reduced falls in the community. This study was registered on anzctr.org.au (July 1, 2015; ACTRN12615000681550 ).

Effects of physical guidance on short-term learning of walking on a narrow beam

PubMed Central

Domingo, Antoinette; Ferris, Daniel P.

2009-01-01

Physical guidance is often used in rehabilitation when teaching patients to re-learn movements. However, the effects of guidance on motor learning of complex skills, such as walking balance, are not clear. We tested four groups of healthy subjects that practiced walking on a narrow (1.27 cm) or wide (2.5 cm) treadmill-mounted balance beam, with or without physical guidance. Assistance was given by springs attached to a hip belt that applied restoring forces towards beam center. Subjects were evaluated while walking unassisted before and after training by calculating the number of times subjects stepped off of the beam per minute of successful walking on the beam (Failures per Minute). Subjects in Unassisted groups had greater performance improvements in walking balance from pre to post compared to subjects in Assisted groups. During training, Unassisted groups had more Failures per Minute than Assisted groups. Performance improvements were smaller in Narrow Beam groups than in Wide Beam groups. The Unassisted-Wide and Assisted-Narrow groups had similar Failures per Minute during training, but the Unassisted-Wide group had much greater performance gains after training. These results suggest that physical assistance can hinder motor learning of walking balance, assistance appears less detrimental for more difficult tasks, and task-specific dynamics are important to learning independent of error experience. PMID:19674900

Measures of static postural control moderate the association of strength and power with functional dynamic balance.

PubMed

Forte, Roberta; Boreham, Colin A G; De Vito, Giuseppe; Ditroilo, Massimiliano; Pesce, Caterina

2014-12-01

Age-related reductions in strength and power are considered to negatively impact balance control, but the existence of a direct association is still an issue of debate. This is possibly due to the fact that balance assessment is complex, reflects different underlying physiologic mechanisms and involves quantitative measurements of postural sway or timing of performance during balance tasks. The present study evaluated the moderator effect of static postural control on the association of power and strength with dynamic balance tasks. Fifty-seven healthy 65-75 year old individuals performed tests of dynamic functional balance (walking speed under different conditions) and of strength, power and static postural control. Dynamic balance performance (walking speed) was associated with lower limb strength and power, as well as postural control under conditions requiring postural adjustments (narrow surface walking r(2) = 0.31, p < 0.001). An interaction effect between strength and static postural control was found with narrow surface walking and talking while walking (change of β 0.980, p < 0.001 in strength for 1 SD improvements in static postural control for narrow walking, and [Formula: see text] -0.730, p < 0.01 in talking while walking). These results indicate that good static postural control facilitates the utilisation of lower limb strength to better perform complex, dynamic functional balance tasks. Practical implications for assessment and training are discussed.

Assessment of motor balance and coordination in mice using the balance beam.

PubMed

Luong, Tinh N; Carlisle, Holly J; Southwell, Amber; Patterson, Paul H

2011-03-10

Brain injury, genetic manipulations, and pharmacological treatments can result in alterations of motor skills in mice. Fine motor coordination and balance can be assessed by the beam walking assay. The goal of this test is for the mouse to stay upright and walk across an elevated narrow beam to a safe platform. This test takes place over 3 consecutive days: 2 days of training and 1 day of testing. Performance on the beam is quantified by measuring the time it takes for the mouse to traverse the beam and the number of paw slips that occur in the process. Here we report the protocol used in our laboratory, and representative results from a cohort of C57BL/6 mice. This task is particularly useful for detecting subtle deficits in motor skills and balance that may not be detected by other motor tests, such as the Rotarod.

Assessment of Motor Balance and Coordination in Mice using the Balance Beam

PubMed Central

Southwell, Amber; Patterson, Paul H.

2011-01-01

Brain injury, genetic manipulations, and pharmacological treatments can result in alterations of motor skills in mice. Fine motor coordination and balance can be assessed by the beam walking assay. The goal of this test is for the mouse to stay upright and walk across an elevated narrow beam to a safe platform. This test takes place over 3 consecutive days: 2 days of training and 1 day of testing. Performance on the beam is quantified by measuring the time it takes for the mouse to traverse the beam and the number of paw slips that occur in the process. Here we report the protocol used in our laboratory, and representative results from a cohort of C57BL/6 mice. This task is particularly useful for detecting subtle deficits in motor skills and balance that may not be detected by other motor tests, such as the Rotarod. PMID:21445033

Metabolic Rate and Perceived Exertion of Walking in Older Adults With Idiopathic Chronic Fatigue

PubMed Central

Corbett, Duane B.; Knaggs, Jeffrey D.; Manini, Todd M.

2016-01-01

Abstract Background: Fatigue is a common complaint in older adults, often not associated with underlying medical conditions. The purpose of this study was to investigate metabolic rate (MR) of walking, walking performance, and perception-based exertion during walking in older adults with and without idiopathic chronic fatigue (ICF). Methods: 20 older adults (aged 70.8±4.9 years), reporting 2 SD above normative values of the Functional Assessment of Chronic Illness Therapy-Fatigue scale and without overt health conditions that explained their symptoms, were compared with 25 age-matched older adults (73.2±5.1 years) without fatigue symptoms. Participants walked 400 m at a rapid pace on a 20-m course. On a separate visit, oxygen consumption was measured during treadmill test at standard (40.2 m/min), preferred paces (40–83 m/min) and peak capacity. Ratings of perceived exertion (RPE) were measured at each treadmill stage and after each lap of the 400-m walk test. Results: During the 400-m walk test, individuals with ICF showed lower overall walking speed and reported a steady increase in RPE with no change observed in non-fatigued group (1.63±1.72 vs 0.27±0.68, p < .01). Similar findings on RPE were noted on treadmill test. Gross MR, mass-specific MR, mass-specific net MR, and MR as a percent of peak oxygen consumption of walking were similar between groups during standard, preferred paces and peak capacity on treadmill. Conclusions: This study suggests that ICF in older adults is not related to elevated metabolic cost of walking. Higher RPE without concomitant decreases in performance indicate a potential disconnect between metabolic output and sensations during movement. PMID:27271253

Thoracopelvic assisted movement training to improve gait and balance in elderly at risk of falling: a case series

PubMed Central

Springer, Shmuel; Friedman, Itamar; Ohry, Avi

2018-01-01

Background Age-related changes in coordinated movement pattern of the thorax and pelvis may be one of the factors contributing to fall risk. This report describes the feasibility of using a new thoracopelvic assisted movement device to improve gait and balance in an elderly population with increased risk for falls. Methods In this case series, 19 older adults were recruited from an assisted living facility. All had gait difficulties (gait speed <1.0 m/s) and history of falls. Participants received 12 training sessions with the thoracopelvic assisted movement device. Functional performance was measured before, during (after 6 sessions), and after the 12 sessions. Outcomes measures were Timed Up and Go, Functional Reach Test, and the 10-meter Walk Test. Changes in outcomes were calculated for each participant in the context of minimal detectable change (MDC) values. Results More than 25% of participants showed changes >MDC in their clinical measures after 6 treatment sessions, and more than half improved >MDC after 12 sessions. Six subjects (32%) improved their Timed Up and Go time by >4 seconds after 6 sessions, and 10 (53%) after 12 sessions. After the intervention, 4 subjects (21%) improved their 10-meter Walk Test velocity from limited community ambulation (0.4–0.8 m/s) to functional community ambulation (>0.8 m/s). Conclusion Thoracopelvic assisted movement training that mimics normal walking pattern may have clinical implications, by improving skills that enhance balance and gait function. Additional randomized, controlled studies are required to examine the effects of this intervention on larger cohorts with a variety of subjects.

Development of VariLeg, an exoskeleton with variable stiffness actuation: first results and user evaluation from the CYBATHLON 2016.

PubMed

Schrade, Stefan O; Dätwyler, Katrin; Stücheli, Marius; Studer, Kathrin; Türk, Daniel-Alexander; Meboldt, Mirko; Gassert, Roger; Lambercy, Olivier

2018-03-13

Powered exoskeletons are a promising approach to restore the ability to walk after spinal cord injury (SCI). However, current exoskeletons remain limited in their walking speed and ability to support tasks of daily living, such as stair climbing or overcoming ramps. Moreover, training progress for such advanced mobility tasks is rarely reported in literature. The work presented here aims to demonstrate the basic functionality of the VariLeg exoskeleton and its ability to enable people with motor complete SCI to perform mobility tasks of daily life. VariLeg is a novel powered lower limb exoskeleton that enables adjustments to the compliance in the leg, with the objective of improving the robustness of walking on uneven terrain. This is achieved by an actuation system with variable mechanical stiffness in the knee joint, which was validated through test bench experiments. The feasibility and usability of the exoskeleton was tested with two paraplegic users with motor complete thoracic lesions at Th4 and Th12. The users trained three times a week, in 60 min sessions over four months with the aim of participating in the CYBATHLON 2016 competition, which served as a field test for the usability of the exoskeleton. The progress on basic walking skills and on advanced mobility tasks such as incline walking and stair climbing is reported. Within this first study, the exoskeleton was used with a constant knee stiffness. Test bench evaluation of the variable stiffness actuation system demonstrate that the stiffness could be rendered with an error lower than 30 Nm/rad. During training with the exoskeleton, both users acquired proficient skills in basic balancing, walking and slalom walking. In advanced mobility tasks, such as climbing ramps and stairs, only basic (needing support) to intermediate (able to perform task independently in 25% of the attempts) skill levels were achieved. After 4 months of training, one user competed at the CYBATHLON 2016 and was able to perform 3 (stand-sit-stand, slalom and tilted path) out of 6 obstacles of the track. No adverse events occurred during the training or the competition. Demonstration of the applicability to restore ambulation for people with motor complete SCI was achieved. The CYBATHLON highlighted the importance of training and gaining experience in piloting an exoskeleton, which were just as important as the technical realization of the robot.

Safety and efficacy of at-home robotic locomotion therapy in individuals with chronic incomplete spinal cord injury: a prospective, pre-post intervention, proof-of-concept study.

PubMed

Rupp, Rüdiger; Schließmann, Daniel; Plewa, Harry; Schuld, Christian; Gerner, Hans Jürgen; Weidner, Norbert; Hofer, Eberhard P; Knestel, Markus

2015-01-01

The compact Motorized orthosis for home rehabilitation of Gait (MoreGait) was developed for continuation of locomotion training at home. MoreGait generates afferent stimuli of walking with the user in a semi-supine position and provides feedback about deviations from the reference walking pattern. Prospective, pre-post intervention, proof-of-concept study to test the feasibility of an unsupervised home-based application of five MoreGait prototypes in subjects with incomplete spinal cord injury (iSCI). Twenty-five (5 tetraplegia, 20 paraplegia) participants with chronic (mean time since injury: 5.8 ± 5.4 (standard deviation, SD) years) sensorimotor iSCI (7 ASIA Impairment Scale (AIS) C, 18 AIS D; Walking Index for Spinal Cord Injury (WISCI II): Interquartile range 9 to 16) completed the training (45 minutes / day, at least 4 days / week, 8 weeks). Baseline status was documented 4 and 2 weeks before and at training onset. Training effects were assessed after 4 and 8 weeks of therapy. After therapy, 9 of 25 study participants improved with respect to the dependency on walking aids assessed by the WISCI II. For all individuals, the short-distance walking velocity measured by the 10-Meter Walk Test showed significant improvements compared to baseline (100%) for both self-selected (Mean 139.4% ± 35.5% (SD)) and maximum (Mean 143.1% ± 40.6% (SD)) speed conditions as well as the endurance estimated with the six-minute walk test (Mean 166.6% ± 72.1% (SD)). One device-related adverse event (pressure sore on the big toe) occurred in over 800 training sessions. Home-based robotic locomotion training with MoreGait is feasible and safe. The magnitude of functional improvements achieved by MoreGait in individuals with iSCI is well within the range of complex locomotion robots used in hospitals. Thus, unsupervised MoreGait training potentially represents an option to prolong effective training aiming at recovery of locomotor function beyond in-patient rehabilitation. German Clinical Trials Register (DKRS) DRKS00005587.

Shuttle walking test and 6-minute walking test induce a similar cardiorespiratory performance in patients recovering from an acute exacerbation of chronic obstructive pulmonary disease.

PubMed

Vagaggini, B; Taccola, M; Severino, S; Marcello, M; Antonelli, S; Brogi, S; De Simone, C; Giardina, A; Paggiaro, P L

2003-01-01

The incremental shuttle walking test (SWT) has recently been proposed as a more valid and reproducible alternative to the conventional 6-min walking test (6MWT) in the evaluation of exercise tolerance in patients with chronic obstructive pulmonary disease (COPD). To compare the cardiorespiratory performance obtained during two sessions of SWT with that obtained during two sessions of 6MWT. We examined 18 patients (forced expiratory volume in 1 s: 48 +/- 14%) recovering from an acute exacerbation of COPD that had required hospitalization. In the same afternoon, each patient performed two SWT and two 6MWT, with an interval of at least 30 min between each test; the sequence of the tests was randomized. Mean walking distance was greater in the second SWT test than in the first SWT. The changes from baseline in systolic blood pressure, heart rate, respiratory rate, oxygen saturation and dyspnea Borg index at the end of the test were similar between the two 6MWT and the two SWT. There was a highly significant correlation between walking distances measured during SWT and during 6MWT (rho: 0.85, p < 0.0005). Neither SWT nor 6MWT correlated with functional data of COPD. SWT, though being considered to be closer to a submaximal exercise test than 6MWT, does not induce a greater cardiorespiratory performance than 6MWT in patients recovering from acute exacerbation of COPD. Copyright 2003 S. Karger AG, Basel

Minimum toe clearance events in divided attention treadmill walking in older and young adults: a cross-sectional study.

PubMed

Santhiranayagam, Braveena K; Lai, Daniel T H; Sparrow, W A; Begg, Rezaul K

2015-07-12

Falls in older adults during walking frequently occur while performing a concurrent task; that is, dividing attention to respond to other demands in the environment. A particularly hazardous fall-related event is tripping due to toe-ground contact during the swing phase of the gait cycle. The aim of this experiment was to determine the effects of divided attention on tripping risk by investigating the gait cycle event Minimum Toe Clearance (MTC). Fifteen older adults (mean 73.1 years) and 15 young controls (mean 26.1 years) performed three walking tasks on motorized treadmill: (i) at preferred walking speed (preferred walking), (ii) while carrying a glass of water at a comfortable walking speed (dual task walking), and (iii) speed-matched control walking without the glass of water (control walking). Position-time coordinates of the toe were acquired using a 3 dimensional motion capture system (Optotrak NDI, Canada). When MTC was present, toe height at MTC (MTC_Height) and MTC timing (MTC_Time) were calculated. The proportion of non-MTC gait cycles was computed and for non-MTC gait cycles, toe-height was extracted at the mean MTC_Time. Both groups maintained mean MTC_Height across all three conditions. Despite greater MTC_Height SD in preferred gait, the older group reduced their variability to match the young group in dual task walking. Compared to preferred speed walking, both groups attained MTC earlier in dual task and control conditions. The older group's MTC_Time SD was greater across all conditions; in dual task walking, however, they approximated the young group's SD. Non-MTC gait cycles were more frequent in the older group across walking conditions (for example, in preferred walking: young - 2.9 %; older - 18.7 %). In response to increased attention demands older adults preserve MTC_Height but exercise greater control of the critical MTC event by reducing variability in both MTC_Height and MTC_Time. A further adaptive locomotor control strategy to reduce the likelihood of toe-ground contacts is to attain higher mid-swing clearance by eliminating the MTC event, i.e. demonstrating non-MTC gaits cycles.

Effects of intervention using a community-based walking program for prevention of mental decline: a randomized controlled trial.

PubMed

Maki, Yohko; Ura, Chiaki; Yamaguchi, Tomoharu; Murai, Tatsuhiko; Isahai, Mikie; Kaiho, Ayumi; Yamagami, Tetsuya; Tanaka, Satoshi; Miyamae, Fumiko; Sugiyama, Mika; Awata, Shuichi; Takahashi, Ryutaro; Yamaguchi, Haruyasu

2012-03-01

To evaluate the efficacy of a municipality-led walking program under the Japanese public Long-Term Care Insurance Act to prevent mental decline. Randomized controlled trial. The city of Takasaki. One hundred fifty community members aged 72.0 ± 4.0 were randomly divided into intervention (n = 75) and control (n = 75) groups. A walking program was conducted once a week for 90 minutes for 3 months. The program encouraged participants to walk on a regular basis and to increase their steps per day gradually. The intervention was conducted in small groups of approximately six, so combined benefits of exercise and social interaction were expected. Cognitive function was evaluated focusing on nine tests in five domains: memory, executive function, word fluency, visuospatial abilities, and sustained attention. Quality of life (QOL), depressive state, functional capacity, range of activities, and social network were assessed using questionnaires, and motor function was evaluated. Significant differences between the intervention and control groups were shown in word fluency related to frontal lobe function (F(1, 128) = 6.833, P = .01), QOL (F(1,128) = 9.751, P = .002), functional capacity including social interaction (F(1,128) = 13.055, P < .001), and motor function (Timed Up and Go Test: F(1,127) = 10.117, P = .002). No significant differences were observed in other cognitive tests. Walking programs may provide benefits in some aspects of cognition, QOL, and functional capacity including social interaction in elderly community members. This study could serve as the basis for implementation of a community-based intervention to prevent mental decline. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

Poorer clock draw test scores are associated with greater functional impairment in peripheral artery disease: the Walking and Leg Circulation Study II.

PubMed

Zimmermann, Laura J; Ferrucci, Luigi; Kiang Liu; Lu Tian; Guralnik, Jack M; Criqui, Michael H; Yihua Liao; McDermott, Mary M

2011-06-01

We hypothesized that, in the absence of clinically recognized dementia, cognitive dysfunction measured by the clock draw test (CDT) is associated with greater functional impairment in men and women with peripheral artery disease (PAD). Participants were men and women aged 60 years and older with Mini-Mental Status Examination scores ≥ 24 with PAD (n = 335) and without PAD (n = 234). We evaluated the 6-minute walk test, 4-meter walking velocity at usual and fastest pace, the Short Physical Performance Battery (SPPB), and accelerometer-measured physical activity. CDTs were scored using the Shulman system as follows: Category 1 (worst): CDT score 0-2; Category 2: CDT score 3; Category 3 (best): CDT score 4-5. Results were adjusted for age, sex, race, education, ankle-brachial index (ABI), and comorbidities. In individuals with PAD, lower CDT scores were associated with slower 4-meter usual-paced walking velocity (Category 1: 0.78 meters/second; Category 2: 0.83 meters/second; Category 3: 0.86 meters/second; p-trend = 0.025) and lower physical activity (Category 1: 420 activity units; Category 2: 677 activity units; Category 3: 701 activity units; p-trend = 0.045). Poorer CDT scores were also associated with worse functional performance in individuals without PAD (usual and fast-paced walking velocity and SPPB, p-trend = 0.022, 0.043, and 0.031, respectively). In conclusion, cognitive impairment identified with CDT is independently associated with greater functional impairment in older, dementia-free individuals with and without PAD. Longitudinal studies are necessary to explore whether baseline CDT scores and changes in CDT scores over time can predict long-term decline in functional performance in individuals with and without PAD.

A 3-Month Aerobic Training Program Improves Brain Energy Metabolism in Mild Alzheimer's Disease: Preliminary Results from a Neuroimaging Study.

PubMed

Castellano, Christian-Alexandre; Paquet, Nancy; Dionne, Isabelle J; Imbeault, Hélène; Langlois, Francis; Croteau, Etienne; Tremblay, Sébastien; Fortier, Mélanie; Matte, J Jacques; Lacombe, Guy; Fülöp, Tamás; Bocti, Christian; Cunnane, Stephen C

2017-01-01

Aerobic training has some benefits for delaying the onset or progression of Alzheimer's disease (AD). Little is known about the implication of the brain's two main fuels, glucose and ketones (acetoacetate), associated with thesebenefits. To determine whether aerobic exercise training modifies brain energy metabolism in mild AD. In this uncontrolled study, ten patients with mild AD participated in a 3-month, individualized, moderate-intensity aerobic training on a treadmill (Walking). Quantitative measurement of brain uptake of glucose (CMRglu) and acetoacetate (CMRacac) using neuroimaging and cognitive testing were done before and after the Walking program. Four men and six women with an average global cognitive score (MMSE) of 26/30 and an average age of 73 y completed the Walking program. Average total distance and treadmill speed were 8 km/week and 4 km/h, respectively. Compared to the Baseline, after Walking, CMRacac was three-fold higher (0.6±0.4 versus 0.2±0.1 μmol/100 g/min; p = 0.01). Plasma acetoacetate concentration and the blood-to-brain acetoacetate influx rate constant were also increased by 2-3-fold (all p≤0.03). CMRglu was unchanged after Walking (28.0±0.1 μmol/100 g/min; p = 0.96). There was a tendency toward improvement in the Stroop-color naming test (-10% completion time, p = 0.06). Performance on the Trail Making A&B tests was also directly related to plasma acetoacetate and CMRacac (all p≤0.01). In mild AD, aerobic training improved brain energy metabolism by increasing ketone uptake and utilization while maintaining brain glucose uptake, and could potentially be associated with some cognitive improvement.

Coupled continuous time-random walks in quenched random environment

NASA Astrophysics Data System (ADS)

Magdziarz, M.; Szczotka, W.

2018-02-01

We introduce a coupled continuous-time random walk with coupling which is characteristic for Lévy walks. Additionally we assume that the walker moves in a quenched random environment, i.e. the site disorder at each lattice point is fixed in time. We analyze the scaling limit of such a random walk. We show that for large times the behaviour of the analyzed process is exactly the same as in the case of uncoupled quenched trap model for Lévy flights.

Urban versus suburban perceptions of the neighborhood food environment as correlates of adolescent food purchasing

PubMed Central

Hearst, Mary O.; Pasch, Keryn E.; Laska, Melissa N.

2012-01-01

Objective To assess the relationship between adolescent perception of time to walk to neighborhood food retail outlets and purchasing of sugar sweetened beverages (SSB), fast and convenience food items and test for differences by urban versus suburban environment. Design Cross-sectional observational study. Setting Twin Cities Metropolitan Area, Minnesota. Subjects Adolescents from two studies completed survey-based measures on perceptions of time to walk to food retail outlets from home, purchasing patterns of SSB and fast and convenience store items, perceptions of personal safety and pedestrian infrastructure and demographic characteristics. Descriptive analysis, Spearman correlations and multivariate linear regression, accounting for clustering, were conducted using SAS. Results There were 634 adolescents, approximately half male, predominately white, with a middle-class background. Greater perceived time to food outlets were associated with less frequent purchasing of SSB, convenience store foods and fast food items. Multivariate models showed that a perceived shorter walking time (i.e. 1–5 versus 31+ minutes) was significantly associated with more SSB purchasing. SSB purchases were also significantly associated with the number of food outlets within a 10–minute walk (B=0.05, p=0.02). Conclusions A reduction in consumption of SSB and other energy dense snacks is an important obesity prevention approach. An approach offering alternatives or reducing exposure in addition to education to alter purchasing habits may contribute to improving dietary habits and reducing the obesity epidemic. PMID:21859510

To walk or to fly? How birds choose among foraging modes

PubMed Central

Bautista, Luis M.; Tinbergen, Joost; Kacelnik, Alejandro

2001-01-01

We test the predictive value of the main energetic currencies used in foraging theory using starlings that choose between two foraging modes (walking versus flying). Walking is low-cost, low-yield, whereas flying is the opposite. We fixed experimentally, at 11 different values, the amount of flight required to get one food reward, and for each flight cost value, we titrated the amount of walking until the birds showed indifference between foraging modes. We then compared the indifference points to those predicted by gross rate of gain over time, net rate of gain over time, and the ratio of gain to expenditure (efficiency). The results for the choice between modes show strong qualitative and quantitative support for net rate of gain over time over the alternatives. However, the birds foraged for only a fraction of the available time, indicating that the choice between foraging and resting could not be explained by any of these currencies. We suggest that this discrepancy could be accounted for functionally because nonenergetic factors such as predation risk may differ between resting and foraging in any mode but may not differ much between foraging modes, hence releasing the choice between foraging modes from the influence of such factors. Alternatively, the discrepancy may be attributable to the use of predictable (rather than stochastic) ratios of effort per prey in our experiment, and it may thus be better understood with mechanistic rather than functional arguments. PMID:11158599

To walk or to fly? How birds choose among foraging modes.

PubMed

Bautista, L M; Tinbergen, J; Kacelnik, A

2001-01-30

We test the predictive value of the main energetic currencies used in foraging theory using starlings that choose between two foraging modes (walking versus flying). Walking is low-cost, low-yield, whereas flying is the opposite. We fixed experimentally, at 11 different values, the amount of flight required to get one food reward, and for each flight cost value, we titrated the amount of walking until the birds showed indifference between foraging modes. We then compared the indifference points to those predicted by gross rate of gain over time, net rate of gain over time, and the ratio of gain to expenditure (efficiency). The results for the choice between modes show strong qualitative and quantitative support for net rate of gain over time over the alternatives. However, the birds foraged for only a fraction of the available time, indicating that the choice between foraging and resting could not be explained by any of these currencies. We suggest that this discrepancy could be accounted for functionally because nonenergetic factors such as predation risk may differ between resting and foraging in any mode but may not differ much between foraging modes, hence releasing the choice between foraging modes from the influence of such factors. Alternatively, the discrepancy may be attributable to the use of predictable (rather than stochastic) ratios of effort per prey in our experiment, and it may thus be better understood with mechanistic rather than functional arguments.

Inpatient rehabilitation improves functional capacity, peripheral muscle strength and quality of life in patients with community-acquired pneumonia: a randomised trial.

PubMed

José, Anderson; Dal Corso, Simone

2016-04-01

Among people who are hospitalised for community-acquired pneumonia, does an inpatient exercise-based rehabilitation program improve functional outcomes, symptoms, quality of life and length of hospital stay more than a respiratory physiotherapy regimen? Randomised trial with concealed allocation, intention-to-treat analysis and blinding of some outcomes. Forty-nine adults hospitalised for community-acquired pneumonia. The experimental group (n=32) underwent a physical training program that included warm-up, stretching, peripheral muscle strength training and walking at a controlled speed for 15 minutes. The control group (n=17) underwent a respiratory physiotherapy regimen that included percussion, vibrocompression, respiratory exercises and free walking. The intervention regimens lasted 8 days. The primary outcome was the Glittre Activities of Daily Living test, which assesses the time taken to complete a series of functional tasks (eg, rising from a chair, walking, stairs, lifting and bending). Secondary outcomes were distance walked in the incremental shuttle walk test, peripheral muscle strength, quality of life, dyspnoea, lung function, C-reactive protein and length of hospital stay. Measures were taken 1 day before and 1 day after the intervention period. There was greater improvement in the experimental group than in the control group on the Glittre Activities of Daily Living test (mean between-group difference 39 seconds, 95% CI 20 to 59) and the incremental shuttle walk test (mean between-group difference 130 m, 95% CI 77 to 182). There were also significantly greater improvements in quality of life, dyspnoea and peripheral muscle strength in the experimental group than in the control group. There were no between-group differences in lung function, C-reactive protein or length of hospital stay. The improvement in functional outcomes after an inpatient rehabilitation program was greater than the improvement after standard respiratory physiotherapy. The exercise training program led to greater benefits in functional capacity, peripheral muscle strength, dyspnoea and quality of life. ClinicalTrials.gov, NCT02103400. Copyright © 2016 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

Recognition using gait.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Koch, Mark William

2007-09-01

Gait or an individual's manner of walking, is one approach for recognizing people at a distance. Studies in psychophysics and medicine indicate that humans can recognize people by their gait and have found twenty-four different components to gait that taken together make it a unique signature. Besides not requiring close sensor contact, gait also does not necessarily require a cooperative subject. Using video data of people walking in different scenarios and environmental conditions we develop and test an algorithm that uses shape and motion to identify people from their gait. The algorithm uses dynamic time warping to match stored templatesmore » against an unknown sequence of silhouettes extracted from a person walking. While results under similar constraints and conditions are very good, the algorithm quickly degrades with varying conditions such as surface and clothing.« less

Time Spent Walking and Risk of Diabetes in Japanese Adults: The Japan Public Health Center-Based Prospective Diabetes Study

PubMed Central

Kabeya, Yusuke; Goto, Atsushi; Kato, Masayuki; Matsushita, Yumi; Takahashi, Yoshihiko; Isogawa, Akihiro; Inoue, Manami; Mizoue, Tetsuya; Tsugane, Shoichiro; Kadowaki, Takashi; Noda, Mitsuhiko

2016-01-01

Background The association between time spent walking and risk of diabetes was investigated in a Japanese population-based cohort. Methods Data from the Japan Public Health Center-based Prospective Diabetes cohort were analyzed. The surveys of diabetes were performed at baseline and at the 5-year follow-up. Time spent walking per day was assessed using a self-reported questionnaire (<30 minutes, 30 minutes to <1 hour, 1 to <2 hours, or ≥2 hours). A cross-sectional analysis was performed among 26 488 adults in the baseline survey. Logistic regression was used to examine the association between time spent walking and the presence of unrecognized diabetes. We then performed a longitudinal analysis that was restricted to 11 101 non-diabetic adults who participated in both the baseline and 5-year surveys. The association between time spent walking and the incidence of diabetes during the 5 years was examined. Results In the cross-sectional analysis, 1058 participants had unrecognized diabetes. Those with time spent walking of <30 minutes per day had increased odds of having diabetes in relation to those with time spent walking of ≥2 hours (adjusted odds ratio [OR] 1.23; 95% CI, 1.02–1.48). In the longitudinal analysis, 612 participants developed diabetes during the 5 years of follow-up. However, a significant association between time spent walking and the incidence of diabetes was not observed. Conclusions Increased risk of diabetes was implied in those with time spent walking of <30 minutes per day, although the longitudinal analysis failed to show a significant result. PMID:26725285

[Application of the 6-Minute Walking Test and Shuttle Walking Test in the Exercise Tests of Patients With COPD].

PubMed

Ho, Chiung-Fang; Maa, Suh-Hwa

2016-08-01

Exercise training improves the management of stable chronic obstructive pulmonary disease (COPD). COPD patients benefit from exercise training programs in terms of improved VO2 peak values and decreased dyspnea, fatigue, hospital admissions, and rates of mortality, increasing exercise capacity and health-related quality of life (HRQOL). COPD is often associated with impairment in exercise tolerance. About 51% of patients have a limited capacity for normal activity, which often further degrades exercise capacity, creating a vicious circle. Exercise testing is highly recommended to assess a patient's individualized functions and limitations in order to determine the optimal level of training intensity prior to initiating an exercise-training regimen. The outcomes of exercise testing provide a powerful indicator of prognosis in COPD patients. The six-minute walking test (6MWT) and the incremental shuttle-walking test (ISWT) are widely used in exercise testing to measure a patient's exercise ability by walking distances. While nursing-related articles published in Taiwan frequently cite and use the 6MWT to assess exercise capacity in COPD patients, the ISWT is rarely used. This paper introduces the testing method, strengths and weaknesses, and application of the two tests in order to provide clinical guidelines for assessing the current exercise capacity of COPD patients.

Influence of heat and vibration on the movement of the northern fowl mite (Acari: Macronyssidae).

PubMed

Owen, Jeb P; Mullens, Bradley A

2004-09-01

Heat and vibration are common host-generated cues that ectoparasites use to orient to hosts. Three experiments evaluated effects of heat and vibration on the movement of northern fowl mite, Ornithonyssus sylviarum (Canestrini & Fanzago). Individual arrested mites in an isolation chamber always initiated movement (walking) after substrate vibration (7.8-min walking duration), but only initiated movement 50% of the time (2.8-min walking duration) upon exposure to a 3 degrees C heat fluctuation. Heat fluctuation in combination with vibration extended the period of activity by approximately 50% (11.6-min walking duration) compared with activity initiated by vibration alone. Mites with longer time off-host moved for shorter durations. In a choice test, individual mites consistently moved closer to a 35 degrees C heat source 1 or 6 mm away, but not to a heat source 11 mm away. In a circular arena, mites were able to orient accurately to a 35 degrees C heat source and reached the arena edge almost 4 times faster (11.2 s) than mites without a heat source (41.2 s). These results suggest that northern fowl mite is capable of directed thermo-orientation, as well as modulation of activity depending on the type of sensory information perceived. The adaptive significance of this orientation for a "permanent" ectoparasite is discussed.

Applicability of a new robotic walking aid in a patient with cerebral palsy. Case report.

PubMed

Smania, N; Gandolfi, M; Marconi, V; Calanca, A; Geroin, C; Piazza, S; Bonetti, P; Fiorini, P; Cosentino, A; Capelli, C; Conte, D; Bendinelli, M; Munari, D; Ianes, P; Fiaschi, A; Picelli, A

2012-03-01

Gait training with the help of assistive technological devices is an innovative field of research in neurological rehabilitation. Most of the available gait training devices do not allow free movement in the environment, which would be the most suitable natural and motivating condition for training children with neurological gait impairment. To evaluate the potential applicability of a new robotic walking aid as a tool for gait training in non-ambulatory children with Cerebral Palsy. Single case study Outpatient regimen A 11-years-old child unable to stand and walk independently as a result of spastic tetraplegic cerebral palsy (CP). The experimental device was a newly actuated version of a dynamic combined walking and standing aid (NF-Walker®) available in the market which was modified by means of two pneumatic artificial muscles driven by a foot-switch inserted in the shoes. The child was tested at baseline (while maintaining the standing position aided by the non-actuated NF-Walker®) and in the experimental condition (while using the actuated robotic aid). The outcome measures were: 2-minute walking test, 10-metre walking test, respiratory and heart parameters, energy cost of locomotion. At baseline, the child was unable to perform any autonomous form of locomotion. When assisted by the actuated aid (i.e. during the experimental condition), the child was successful in moving around in his environment. His performance was 19.63 m in the 2-minute walking test and 64 s in the 10-metre walking test. Respiratory and heart parameters were higher than healthy age-matched children both at baseline and in the experimental condition. The energy cost of gait, which was not valuable in the baseline condition, was significantly higher than normality during the experimental condition. The new robotic walking aid may help children suffering from CP with severe impairment of gait to move around in their environment. This new robotic walking device may have a potential impact in stimulating the development and in training of gait in children with neurological gait impairment. Future studies are warranted in order to test this hypothesis.

The reliability and preliminary validity of game-based fall risk assessment in community-dwelling older adults.

PubMed

Yamada, Minoru; Aoyama, Tomoki; Nakamura, Masatoshi; Tanaka, Buichi; Nagai, Koutatsu; Tatematsu, Noriatsu; Uemura, Kazuki; Nakamura, Takashi; Tsuboyama, Tadao; Ichihashi, Noriaki

2011-01-01

The purpose of this study was to examine whether the Nintendo Wii Fit program could be used for fall risk assessment in healthy, community-dwelling older adults. Forty-five community-dwelling older women participated in this study. The "Basic Step" and "Ski Slalom" modules were selected from the Wii Fit game program. The following 5 physical performance tests were performed: the 10-m walk test under single- and dual-task conditions, the Timed Up and Go test under single- and dual-task conditions, and the Functional Reach test. Compared with the faller group, the nonfaller group showed a significant difference in the Basic Step (P < .001) and a nonsignificant difference in the Ski Slalom (P = .453). The discriminating criterion between the 2 groups was a score of 111 points on the Basic Step (P < .001). The Basic Step showed statistically significant, moderate correlations between the dual-task lag of walking (r = -.547) and the dual-task lag of the Timed Up and Go test (r = -.688). These results suggest that game-based fall risk assessment using the Basic Step has a high generality and is useful in community-dwelling older adults. Copyright © 2011 Mosby, Inc. All rights reserved.

Regular dog-walking improves physical capacity in elderly patients after myocardial infarction.

PubMed

Ruzić, Alen; Miletić, Bojan; Ruzić, Tatjana; Persić, Viktor; Laskarin, Gordana

2011-09-01

Various positive effects of pet ownership on cardiovascular health are well known. The aim of this prospective and controlled longitudinal study was to determine the effects of everyday dog-walking on physical capacity in elderly patients during the first year after myocardial infarction. Regularly dog-walking for at least 15 minutes three times a day is related to significantly higher work load on the bicycle exercise test (72.5 +/- 10.75 versus 67.6 +/- 11.6 W p < 0.05) in the "dog-walking" group (N = 29, mean age 72.5 years) at 12 months compared to the control group (N = 30, mean age 71.7 years). Our results suggest that dogs may help to maintain continuous physical activity in elderly cardiovascular patients promoting their physical capacity. Further researches are needed to confirm this association as well to identify other possible influences of dog ownership on the cardiovascular health and on the outcome in patients after myocardial infarction.

Development of a Wearable Assist Robot for Walk Rehabilitation After Knee Arthroplasty Surgery

NASA Astrophysics Data System (ADS)

Terada, H.; Zhu, Y.; Horiguchi, K.; Nakamura, M.; Takahashi, R.

In Japan, it is popular that the disease knee joints will be replaced to artificial joints by surgery. And we have to assist so many patients for walk rehabilitation. So, the wearable assist robot has been developed. This robot includes the knee motion assist mechanism and the hip joint support mechanism. Especially, the knee motion assist mechanism consists of a non-circular gear and grooved cams. This mechanism rotates and slides simultaneously, which has two degree-of-freedom. Also, the hip joint support mechanism consists of a hip brace and a ball-joint. This mechanism can avoid motion constraints which are the internal or external rotation and the adduction or abduction. Then, the control algorithm, which considers an assisting timing for the walk rehabilitation, has been proposed. A sensing system of a walk state for this control system uses a heel contacts sensor and knee and hip joint rotation angle sensors. Also, the prototype robot has been tested. And it is confirmed that the assisting system is useful.

Random walk of passive tracers among randomly moving obstacles.

PubMed

Gori, Matteo; Donato, Irene; Floriani, Elena; Nardecchia, Ilaria; Pettini, Marco

2016-04-14

This study is mainly motivated by the need of understanding how the diffusion behavior of a biomolecule (or even of a larger object) is affected by other moving macromolecules, organelles, and so on, inside a living cell, whence the possibility of understanding whether or not a randomly walking biomolecule is also subject to a long-range force field driving it to its target. By means of the Continuous Time Random Walk (CTRW) technique the topic of random walk in random environment is here considered in the case of a passively diffusing particle among randomly moving and interacting obstacles. The relevant physical quantity which is worked out is the diffusion coefficient of the passive tracer which is computed as a function of the average inter-obstacles distance. The results reported here suggest that if a biomolecule, let us call it a test molecule, moves towards its target in the presence of other independently interacting molecules, its motion can be considerably slowed down.

A study of the 200-metre fast walk test as a possible new assessment tool to predict maximal heart rate and define target heart rate for exercise training of coronary heart disease patients.

PubMed

Casillas, Jean-Marie; Joussain, Charles; Gremeaux, Vincent; Hannequin, Armelle; Rapin, Amandine; Laurent, Yves; Benaïm, Charles

2015-02-01

To develop a new predictive model of maximal heart rate based on two walking tests at different speeds (comfortable and brisk walking) as an alternative to a cardiopulmonary exercise test during cardiac rehabilitation. Evaluation of a clinical assessment tool. A Cardiac Rehabilitation Department in France. A total of 148 patients (133 men), mean age of 59 ±9 years, at the end of an outpatient cardiac rehabilitation programme. Patients successively performed a 6-minute walk test, a 200 m fast-walk test (200mFWT), and a cardiopulmonary exercise test, with measure of heart rate at the end of each test. An all-possible regression procedure was used to determine the best predictive regression models of maximal heart rate. The best model was compared with the Fox equation in term of predictive error of maximal heart rate using the paired t-test. Results of the two walking tests correlated significantly with maximal heart rate determined during the cardiopulmonary exercise test, whereas anthropometric parameters and resting heart rate did not. The simplified predictive model with the most acceptable mean error was: maximal heart rate = 130 - 0.6 × age + 0.3 × HR200mFWT (R(2) = 0.24). This model was superior to the Fox formula (R(2) = 0.138). The relationship between training target heart rate calculated from measured reserve heart rate and that established using this predictive model was statistically significant (r = 0.528, p < 10(-6)). A formula combining heart rate measured during a safe simple fast walk test and age is more efficient than an equation only including age to predict maximal heart rate and training target heart rate. © The Author(s) 2014.

Standing beat-to-beat blood pressure variability is reduced among fallers in the Malaysian Elders Longitudinal Study.

PubMed

Goh, Choon-Hian; Ng, Siew-Cheok; Kamaruzzaman, Shahrul Bahyah; Chin, Ai-Vyrn; Tan, Maw Pin

2017-10-01

The aim of this study was to determine the relationship between falls and beat-to-beat blood pressure (BP) variability.Continuous noninvasive BP measurement is as accurate as invasive techniques. We evaluated beat-to-beat supine and standing BP variability (BPV) using time and frequency domain analysis from noninvasive continuous BP recordings.A total of 1218 older adults were selected. Continuous BP recordings obtained were analyzed to determine standard deviation (SD) and root mean square of real variability (RMSRV) for time domain BPV and fast-Fourier transform low frequency (LF), high frequency (HF), total power spectral density (PSD), and LF:HF ratio for frequency domain BPV.Comparisons were performed between 256 (21%) individuals with at least 1 fall in the past 12 months and nonfallers. Fallers were significantly older (P = .007), more likely to be female (P = .006), and required a longer time to complete the Timed-Up and Go test (TUG) and frailty walk test (P ≤ .001). Standing systolic BPV (SBPV) was significantly lower in fallers compared to nonfallers (SBPV-SD, P = .016; SBPV-RMSRV, P = .033; SBPV-LF, P = .003; SBPV-total PSD, P = .012). Nonfallers had significantly higher supine to standing ratio (SSR) for SBPV-SD, SBPV-RMSRV, and SBPV-total PSD (P = .017, P = .013, and P = .009). In multivariate analyses, standing BPV remained significantly lower in fallers compared to nonfallers after adjustment for age, sex, diabetes, frailty walk, and supine systolic BP. The reduction in frequency-domain SSR among fallers was attenuated by supine systolic BP, TUG, and frailty walk.In conclusion, reduced beat-to-beat BPV while standing is independently associated with increased risk of falls. Changes between supine and standing BPV are confounded by supine BP and walking speed.

Artifact Noise Removal Techniques on Seismocardiogram Using Two Tri-Axial Accelerometers

PubMed Central

Luu, Loc; Dinh, Anh

2018-01-01

The aim of this study is on the investigation of motion noise removal techniques using two-accelerometer sensor system and various placements of the sensors on gentle movement and walking of the patients. A Wi-Fi based data acquisition system and a framework on Matlab are developed to collect and process data while the subjects are in motion. The tests include eight volunteers who have no record of heart disease. The walking and running data on the subjects are analyzed to find the minimal-noise bandwidth of the SCG signal. This bandwidth is used to design filters in the motion noise removal techniques and peak signal detection. There are two main techniques of combining signals from the two sensors to mitigate the motion artifact: analog processing and digital processing. The analog processing comprises analog circuits performing adding or subtracting functions and bandpass filter to remove artifact noises before entering the data acquisition system. The digital processing processes all the data using combinations of total acceleration and z-axis only acceleration. The two techniques are tested on three placements of accelerometer sensors including horizontal, vertical, and diagonal on gentle motion and walking. In general, the total acceleration and z-axis acceleration are the best techniques to deal with gentle motion on all sensor placements which improve average systolic signal-noise-ratio (SNR) around 2 times and average diastolic SNR around 3 times comparing to traditional methods using only one accelerometer. With walking motion, ADDER and z-axis acceleration are the best techniques on all placements of the sensors on the body which enhance about 7 times of average systolic SNR and about 11 times of average diastolic SNR comparing to only one accelerometer method. Among the sensor placements, the performance of horizontal placement of the sensors is outstanding comparing with other positions on all motions. PMID:29614821

Effects of Muscle Strength and Balance Control on Sit-to-Walk and Turn Durations in the Timed Up and Go Test.

PubMed

Chen, Tzurei; Chou, Li-Shan

2017-12-01

To examine the association of muscle strength and balance control with the amount of time taken to perform sit-to-walk (STW) or turning components of the Timed Up and Go (TUG) test in older adults. Correlations; multiple regression models. General community. Older adults (N=60) age >70 years recruited from the community. Not applicable. Muscle strength, balance control, and TUG test performance time. Muscle strength was quantified by peak joint moments during the isometric maximal voluntary contraction test for bilateral hip abductors, knee extensors, and ankle plantar flexors. Balance control was assessed with the Berg Balance Scale, Fullerton Advanced Balance Scale, and center of mass and ankle inclination angle derived during the TUG test performance. We found that balance control measures were significantly associated with both STW and turning durations even after controlling for muscle strength and other confounders (STW duration: P<.001, turning duration: P=.001). Adding strength to the regression model was found to significantly improve its prediction of STW duration (F change =5.945, P=.018), but not turning duration (F change =1.03, P=.14). Our findings suggest that poor balance control is an important factor that contributes to longer STW and turning durations on the TUG test. Furthermore, strength has a higher association with STW than turning duration. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Walking, running, and resting under time, distance, and average speed constraints: optimality of walk-run-rest mixtures.

PubMed

Long, Leroy L; Srinivasan, Manoj

2013-04-06

On a treadmill, humans switch from walking to running beyond a characteristic transition speed. Here, we study human choice between walking and running in a more ecological (non-treadmill) setting. We asked subjects to travel a given distance overground in a given allowed time duration. During this task, the subjects carried, and could look at, a stopwatch that counted down to zero. As expected, if the total time available were large, humans walk the whole distance. If the time available were small, humans mostly run. For an intermediate total time, humans often use a mixture of walking at a slow speed and running at a higher speed. With analytical and computational optimization, we show that using a walk-run mixture at intermediate speeds and a walk-rest mixture at the lowest average speeds is predicted by metabolic energy minimization, even with costs for transients-a consequence of non-convex energy curves. Thus, sometimes, steady locomotion may not be energy optimal, and not preferred, even in the absence of fatigue. Assuming similar non-convex energy curves, we conjecture that similar walk-run mixtures may be energetically beneficial to children following a parent and animals on long leashes. Humans and other animals might also benefit energetically from alternating between moving forward and standing still on a slow and sufficiently long treadmill.

Exoskeleton Training May Improve Level of Physical Activity After Spinal Cord Injury: A Case Series.

PubMed

Gorgey, Ashraf S; Wade, Rodney; Sumrell, Ryan; Villadelgado, Lynette; Khalil, Refka E; Lavis, Timothy

2017-01-01

Objectives: To determine whether the use of a powered exoskeleton can improve parameters of physical activity as determined by walking time, stand up time, and number of steps in persons with spinal cord injury (SCI). Methods: Three men with complete (1 C5 AIS A and 2 T4 AIS A) and one man with incomplete (C5 AIS D) SCI participated in a clinical rehabilitation program. In the training program, the participants walked once weekly using a powered exoskeleton (Ekso) for approximately 1 hour over the course of 10 to 15 weeks. Walking time, stand up time, ratio of walking to stand up time, and number of steps were determined. Oxygen uptake (L/min), energy expenditure, and body composition were measured in one participant after training. Results: Over the course of 10 to 15 weeks, the maximum walking time increased from 12 to 57 minutes and the number of steps increased from 59 to 2,284 steps. At the end of the training, the 4 participants were able to exercise for 26 to 59 minutes. For one participant, oxygen uptake increased from 0.27 L/min during rest to 0.55 L/min during walking. Maximum walking speed was 0.24 m/s, and delta energy expenditure increased by 1.4 kcal/min during walking. Body composition showed a modest decrease in absolute fat mass in one participant. Conclusion: Exoskeleton training may improve parameters of physical activity after SCI by increasing the number of steps and walking time. Other benefits may include increasing energy expenditure and improving the profile of body composition.

Effects of the progressive walking-to-running technique on gait kinematics, ultrasound imaging, and motor function in spastic diplegic cerebral palsy - an experimenter-blind case study.

PubMed

Lee, Nam Gi; Jeong, Su Ji; You, Joshua Sung Hyun; Cho, Kang Hee; Lee, Tae Heon

2013-01-01

The purpose of this study was to investigate the effects of the progressive walking-to-running technique (PWRT) in a child with spastic diplegic cerebral palsy (CP). A single case study with pre-/post-test. An 11-year-old male, diagnosed with spastic diplegic CP. The PWRT was provided for 60 minutes a day, 2 times a week for 12 weeks. Gross motor function tests, ultrasound imaging, hand-held dynamometer, and the Vicon motion capture system were used to determine motor function, muscle size and strength, and gait kinematics. Gross motor function was improved after the intervention. The size of right and left rectus femoris and tibialis anterior muscles in their contracted states were enhanced by 1.36, 5.09, 83.74, and 54.37%, respectively. Associated muscle strength was also increased by 58.8, 30.8, 28.0, and 118.2% in both rectus femoris and tibialis anterior muscles. Left stride length, walking speed, maximal flexion-extension angular excursion of the hip joint were enhanced by 95.7, 87.8, and 100.4% after PWRT, respectively. Our novel walking-running training paradigm was effective for restoring gait and running ability in a child with spastic diplegic CP.

Accelerometer-based step initiation control for gait-assist neuroprostheses.

PubMed

Foglyano, Kevin M; Schnellenberger, John R; Kobetic, Rudi; Lombardo, Lisa; Pinault, Gilles; Selkirk, Stephen; Makowski, Nathaniel S; Triolo, Ronald J

2016-01-01

Electrical activation of paralyzed musculature can generate or augment joint movements required for walking after central nervous system trauma. Proper timing of stimulation relative to residual volitional control is critical to usefully affecting ambulation. This study evaluates three-dimensional accelerometers and customized algorithms to detect the intent to step from voluntary movements to trigger stimulation during walking in individuals with significantly different etiologies, mobility limitations, manual dexterities, and walking aids. Three individuals with poststroke hemiplegia or partial spinal cord injury exhibiting varying gait deficits were implanted with multichannel pulse generators to provide joint motions at the hip, knee, and ankle. An accelerometer integrated into the external control unit was used to detect heel strike or walker movement, and wireless accelerometers were used to detect crutch strike. Algorithms were developed for each sensor location to detect intent to step to progress through individualized stimulation patterns. Testing these algorithms produced detection accuracies of at least 90% on both level ground and uneven terrain. All participants use their accelerometer-triggered implanted gait systems in the community; the validation/system testing was completed in the hospital. The results demonstrated that safe, reliable, and convenient accelerometer-based step initiation can be achieved regardless of specific gait deficits, manual dexterities, and walking aids.

Horse-like walking, trotting, and galloping derived from kinematic Motion Primitives (kMPs) and their application to walk/trot transitions in a compliant quadruped robot.

PubMed

Moro, Federico L; Spröwitz, Alexander; Tuleu, Alexandre; Vespignani, Massimo; Tsagarakis, Nikos G; Ijspeert, Auke J; Caldwell, Darwin G

2013-06-01

This manuscript proposes a method to directly transfer the features of horse walking, trotting, and galloping to a quadruped robot, with the aim of creating a much more natural (horse-like) locomotion profile. A principal component analysis on horse joint trajectories shows that walk, trot, and gallop can be described by a set of four kinematic Motion Primitives (kMPs). These kMPs are used to generate valid, stable gaits that are tested on a compliant quadruped robot. Tests on the effects of gait frequency scaling as follows: results indicate a speed optimal walking frequency around 3.4 Hz, and an optimal trotting frequency around 4 Hz. Following, a criterion to synthesize gait transitions is proposed, and the walk/trot transitions are successfully tested on the robot. The performance of the robot when the transitions are scaled in frequency is evaluated by means of roll and pitch angle phase plots.

Reliability and feasibility of the six minute walk test in subjects with myotonic dystrophy.

PubMed

Kierkegaard, Marie; Tollbäck, Anna

2007-12-01

The objective was to describe test-retest reliability and feasibility of the six minute walk test in adult subjects with myotonic dystrophy type 1. Twelve subjects (28-68 years, mean 44) performed three six minute walk tests on two occasions, one week apart. Relative reliability was high (ICC(2.1)=0.99) and absolute reliability values were low (standard error of measurement 12 m, repeatability 33 m). Feasibility was investigated in a sample of 64 subjects (19-70 years, mean 43). Fifty-two subjects were able to perform two tests on the same day. Subjects with severe proximal weakness had difficulties performing repeated tests. A practice trial followed by a second test on the same day can be recommended for most subjects, and the best test should be used for evaluations. In conclusion, even though the study sample was small, the present study indicates that the six minute walk test is reliable and feasible in subjects with myotonic dystrophy type 1.

A Spectral Analysis of Discrete-Time Quantum Walks Related to the Birth and Death Chains

NASA Astrophysics Data System (ADS)

Ho, Choon-Lin; Ide, Yusuke; Konno, Norio; Segawa, Etsuo; Takumi, Kentaro

2018-04-01

In this paper, we consider a spectral analysis of discrete time quantum walks on the path. For isospectral coin cases, we show that the time averaged distribution and stationary distributions of the quantum walks are described by the pair of eigenvalues of the coins as well as the eigenvalues and eigenvectors of the corresponding random walks which are usually referred as the birth and death chains. As an example of the results, we derive the time averaged distribution of so-called Szegedy's walk which is related to the Ehrenfest model. It is represented by Krawtchouk polynomials which is the eigenvectors of the model and includes the arcsine law.

Comparative biomechanical analysis of current microprocessor-controlled prosthetic knee joints.

PubMed

Bellmann, Malte; Schmalz, Thomas; Blumentritt, Siegmar

2010-04-01

To investigate and identify functional differences of 4 microprocessor-controlled prosthetic knee joints (C-Leg, Hybrid Knee [also called Energy Knee], Rheo Knee, Adaptive 2). Tested situations were walking on level ground, on stairs and ramps; additionally, the fall prevention potentials for each design were examined. The measuring technology used included an optoelectronic camera system combined with 2 forceplates as well as a mobile spiroergometric system. The study was conducted in a gait laboratory. Subjects with unilateral transfemoral amputations (N=9; mobility grade, 3-4; age, 22-49y) were tested. Participants were fitted and tested with 4 different microprocessor-controlled knee joints. Static prosthetic alignment, time distance parameters, kinematic and kinetic data and metabolic energy consumption. Compared with the Hybrid Knee and the Adaptive 2, the C-Leg offers clear advantages in the provision of adequate swing phase flexion resistances and terminal extension damping during level walking at various speeds, especially at higher walking speeds. The Rheo Knee provides sufficient terminal extension; however, swing phase flexion resistances seem to be too low. The values for metabolic energy consumption show only slight differences during level walking. The joint resistances generated for descending stairs and ramps relieve the contralateral side to varying degrees. When walking on stairs, safety-relevant technical differences between the investigated joint types can be observed. Designs with adequate internal resistances offer stability advantages when the foot is positioned on the step. Stumble recovery tests reveal that the different knee joint designs vary in their effectiveness in preventing the patient from falling. The patient benefits provided by the investigated electronic prosthetic knee joints differ considerably. The C-Leg appears to offer the amputee greater functional and safety-related advantages than the other tested knee joints. Reduced loading of the contralateral side has been demonstrated during ramp and stair descent. Metabolic energy consumption does not vary significantly between the tested knees. Hence, this parameter seems not to be a suitable criterion for assessing microprocessor-controlled knee components. Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Utility of a patient-reported outcome in measuring functional impairment during autologous stem cell transplant in patients with multiple myeloma.

PubMed

Shah, Nina; Shi, Qiuling; Giralt, Sergio; Williams, Loretta; Bashir, Qaiser; Qazilbash, Muzaffar; Champlin, Richard E; Cleeland, Charles S; Wang, Xin Shelley

2018-04-01

We aimed to determine the utility of a patient-reported outcome (PRO) as it relates to patient performed testing (PPT) for measuring functional status in multiple myeloma patients after autologous hematopoietic stem cell transplantation (auto-HCT). Symptom interference on walking (a PRO) was measured by the MD Anderson Symptom Inventory (MDASI). PPT was assessed via 6-min walk test (6MWT). Mixed effects modeling was used to examine (1) the longitudinal relationship between the MDASI score and 6MWT distance and (2) the MDASI scores between patients who did or did not complete the 6WMT. Receiver operating characteristic (ROC) curve analysis was performed to quantify the construct validity of the PRO by differentiating performance status. Seventy-nine patients were included. Mean 6MWT distance significantly correlated with MDASI-walking interference score (PRO) over the first month of auto-HCT (est = 6.09, p = 0.006). There was a significantly higher completion rate for MDASI versus 6MWT at each time point (p < 0.01). Patients who completed the 6MWT reported less interference on walking during the study period (est = 1.61, p < 0.0001). Finally, the PRO demonstrated significant construct validity for measuring functioning status with MDASI-walking against ECOG-PS as the anchor (AUC = 0.77, 95% CI 0.60-0.94, p = 0.003). The PRO of MDASI-walking interference is a valid physical functioning measure, correlating with an objective functional measure (6MWT) in MM patients undergoing auto-HCT. As patients with poorer functional status during therapy are less likely to complete PPT, this PRO may offer a more practical quantitative measure of functioning in patients.

Functional roles of the calf and vastus muscles in locomotion.

PubMed

Brandell, B R

1977-04-01

Simultaneous and synchronized electromyography and cinematography were used to record the co-ordination of calf and vastus muscle activity with the angular motions of the segments and joints of the lower limb in two female and three male subjects, while each performed one complete series of tests in which they walked at 2.5, 3.2 and 4.2 mph on a treadmill, which was level, or held at upward tilts of 5 and 10 degrees. The raw EMG recordings were also integrated into uniform pulses, which were electronically counted in 5 second time blocks for each of the walking conditions tested. The objectives of this study were to: 1) quantitatively measure the relative increases of EMG activity in thses two groups of muscles under the various degrees of stress, which resulted from walking at increased speeds and degrees of upward tilt, and 2) correlate these gross quantitative relationships of activity with the patterns of co-ordination found between these two groups of muscles under the corresponding stressed conditions of walking. The results of this study indicate that although with increases of speed and upward tilt the absolute values of integrated EMG increased more for the calf than for the vastus muscles, the relative increases of EMG were consistently greater for the vasti, which reached their peak intensity of activity at moments during the walking stride, when their knee extending action stretched the gastrocnemius heads across the back of the knee joint, and thereby assisted the calf muscles lift the heel, and plantar flex the ankle joint--the most essential actions for producing the push-off and thrust in the normal walking stride.

Effects of aquatic exercise training using water-resistance equipment in elderly.

PubMed

Katsura, Yoshihiro; Yoshikawa, Takahiro; Ueda, Shin-Ya; Usui, Tatsuya; Sotobayashi, Daisuke; Nakao, Hayato; Sakamoto, Hiroshi; Okumoto, Tamiko; Fujimoto, Shigeo

2010-03-01

To prevent falls in Japan, both gait and resistance training of the lower extremities are recommended. However, resistance training for the elderly induces muscle damage. Recently, aquatic exercise using water buoyancy and resistance have commonly been performed by the elderly. We have now produced new water-resistance equipment. The purpose of the present study was to evaluate the efficacy of aquatic exercise training using the new equipment for the elderly. Subjects were divided into two groups: a resistance group of 12 subjects (using water-resistance equipment) and a non-resistance group of eight subjects (without the equipment). The aquatic exercise training was 90 min, three times per week for 8 weeks, and mostly consisted of walking. All subjects underwent anthropometric measurements, physical performance testing, and profile of mood states (POMS). Significant improvements were observed in muscle strength in plantar flexion, and the timed up and go test (TUG) in both groups. Additionally, 10-m obstacle walking and 5-m maximum walking speed and length with eye-open were significantly improved in the resistance group. Also, a low negative correlation was found between the degree of change in TUG and POMS (tension and anxiety) scores in the resistance group. As it became easier to maintain posture, stand, and move, tension and anxiety in everyday life were alleviated with improvement of strength of the lower extremities and balance function. The present aquatic exercise training using water-resistance equipment may be used by the elderly to improve balance and walking ability, which are associated with the prevention of falls.

[Benefits of using rapid HIV testing at the PMU-FLON walk-in clinic in Lausanne].

PubMed

Gilgien, W; Aubert, J; Bischoff, T; Herzig, L; Perdrix, J

2012-05-16

Lab tests are frequently used in primary care to guide patient care. This is particularly the case when a severe disorder, or one that will affect patients' initial care, needs to be excluded rapidly. At the PMU-FLON walk-in clinic the use of HIV testing as recommended by the Swiss Office of Public Health was hampered by the delay in obtaining test results. This led us to introduce rapid HIV testing which provides results within 30 minutes. Following the first 250 tests the authors discuss the results as well as the benefits of rapid HIV testing in an urban walk-in clinic.

78 FR 6273 - Public Use Limit on Commercial Dog Walking; Revised Disposal Conditions

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-30

... THE PRESIDIO TRUST 36 CFR Part 1002 Public Use Limit on Commercial Dog Walking; Revised Disposal... walking four or more dogs at one time in Area B of the Presidio of San Francisco for consideration (Commercial Dog Walkers). The limit will require any person walking four or more dogs at one time for...

Unertan syndrome: a case series demonstrating human devolution.

PubMed

Tan, Uner; Karaca, Sibel; Tan, Meliha; Yilmaz, Bekir; Bagci, Namik Kemal; Ozkur, Ayhan; Pence, Sadrettin

2008-01-01

A large family with six individuals exhibiting the Unertan syndrome (UTS) was identified residing in southern Turkey. All of the individuals had mental impairments and walked on all four extremities. The practice of intra-familial marriages suggested that the UTS may be an autosomal recessive disorder, similar to previously described cases. The inferior portions of the cerebellum and vermis were absent as evidenced by MRI and CT scans. The height and head circumference of those affected were within normal ranges. Barany's test suggested normal vestibular system function. The subjects could not name objects or their close relatives. The males (n = 4) could understand simple questions and commands, but answered questions with only one or two sounds. The females (n = 2) were superior to the males with respect to language skills and walking, suggesting an association between walking and speaking abilities. One male exhibited three walking patterns at the same time: quadripedal, tiptoe, and scissor walking. Another male used two walking styles: quadripedal and toe-walking. It is emphasized that there are important differences between the UTS and the disequilibrium syndrome. It is suggested that the inability to walk upright in those affected with the UTS may be best explained by a disturbance in lateral-balance mechanisms, without being related to the cerebello-vestibular system. An interruption of locomotor development during the transition from quadripedality to bipedality may result in habitual walking on all four extremities and is normal in some children. Because quadripedal gait is an ancestral trait, individuals with the UTS, exhibiting a manifestation of reverse evolution in humans, may be considered an experiment of nature, useful in understanding the mechanisms underlying the transition from quadripedality to bipedality during human evolution. The proposed mutant gene or gene pool playing a role in human quadrupedality may also be responsible for human bipedality at the same time. Herein there is no intent to insult or injure; rather, this report is an endeavor to better understand human beings. Supplementary materials are available for this article. Go to the publisher's online edition of International Journal of Neuroscience for the following free supplemental resource(s): video clips.

Evaluation of Five Tests for Sensitivity to Functional Deficits following Cervical or Thoracic Dorsal Column Transection in the Rat

PubMed Central

Eggers, Ruben; Tuinenbreijer, Lizz; Kouwenhoven, Dorette; Verhaagen, Joost; Mason, Matthew R. J.

2016-01-01

The dorsal column lesion model of spinal cord injury targets sensory fibres which originate from the dorsal root ganglia and ascend in the dorsal funiculus. It has the advantages that fibres can be specifically traced from the sciatic nerve, verifiably complete lesions can be performed of the labelled fibres, and it can be used to study sprouting in the central nervous system from the conditioning lesion effect. However, functional deficits from this type of lesion are mild, making assessment of experimental treatment-induced functional recovery difficult. Here, five functional tests were compared for their sensitivity to functional deficits, and hence their suitability to reliably measure recovery of function after dorsal column injury. We assessed the tape removal test, the rope crossing test, CatWalk gait analysis, and the horizontal ladder, and introduce a new test, the inclined rolling ladder. Animals with dorsal column injuries at C4 or T7 level were compared to sham-operated animals for a duration of eight weeks. As well as comparing groups at individual timepoints we also compared the longitudinal data over the whole time course with linear mixed models (LMMs), and for tests where steps are scored as success/error, using generalized LMMs for binomial data. Although, generally, function recovered to sham levels within 2–6 weeks, in most tests we were able to detect significant deficits with whole time-course comparisons. On the horizontal ladder deficits were detected until 5–6 weeks. With the new inclined rolling ladder functional deficits were somewhat more consistent over the testing period and appeared to last for 6–7 weeks. Of the CatWalk parameters base of support was sensitive to cervical and thoracic lesions while hind-paw print-width was affected by cervical lesion only. The inclined rolling ladder test in combination with the horizontal ladder and the CatWalk may prove useful to monitor functional recovery after experimental treatment in this lesion model. PMID:26934672